By Deirdre Imus, 10-1-2020
This is the third blog in my series on the psychological and social impact of the pandemic on children’s health. The first introduced the topic, and the second looked at some risks and lessons families of children with special needs might have for the rest of us. This edition delves into the impact on our youngest.
As I write this, there is still a lot we don’t understand about COVID-19: While healthy young children are far less likely to become seriously ill (1), those with mild to moderate symptoms tend to have a higher viral load than older children and adults with similar symptoms. (2) Also not yet well understood is why a small percentage of kids, including those with mild or no symptoms later develop MIS-C (multisystem inflammatory syndrome in children) which can seriously affect major organs, skin and eyes. (3)
We do know that protecting infants and young children during the pandemic includes protecting mothers, both physically and emotionally. Even before a baby is born, pregnant mothers should keep in contact with their obstetricians for proper pre-natal care and maintain a healthy diet and exercise. That is the baseline for staying positive, which can also bolster the immune system.
The “blues” are a real risk, especially if you or someone in your family is out of work or becomes sick. Even after a mother weathers the cycles of hormones during pregnancy, post-partum depression can take a mom by surprise. And no one can prepare first-time parents for the malaise caused by a lack of sleep. (And it is not easier the second time.)
The best advice for new families during this crisis is to know you are in it together. Reevaluate chores and shore up resources like “friends and family” (and frozen meals). If you still feel you are sinking, avoid taking it out on others. Find a way to build more rest and exercise into your schedule. However, if dark feelings persist, do not keep them bottled up, and don’t wait too long. Talk to your spouse, your friends, your doctor. There is a time for anti-depressants, but they are not right for everyone and may take time to work. Vitamin D, St. John’s Wort and other natural remedies may also help, though do consult with your physician as they may interfere with other medications.
Here are some COVID-19 resources if you are pregnant, breastfeeding or caring for young children. U.S. Centers for Disease Control & Prevention.
Infants and Toddlers
For healthy development, toddlers need to feel safe and secure. They need the touch of those who care for them, and they need to play.
With COVID-19, touch and play can be problematic in a pre-school environment. Infants and toddlers naturally explore by putting toys and other things in their mouths. They may suck a pacifier or thumb, and hug and kiss teachers and friends.
According to the U.S. Centers for Disease Control & Prevention (CDC), masks are not recommended for children under 2 or anyone who has trouble breathing or is unconscious, incapacitated or otherwise unable to remove the covering without assistance. Wearing masks may be difficult for people with sensory, cognitive, or behavioral issues. (4) Of course, masks are tough to keep on any energetic child -- and what healthy child isn’t full of energy? Click here for CDC Guidance for Direct Service Providers, Caregivers, Parents, and People with Developmental and Behavioral Disorders.
Keeping hands and surfaces clean is a constant battle that can also pose hazards from hand sanitizers and antimicrobial soaps to heavy cleaning chemicals. (See our tips for keeping schools clean during a pandemic.) For this reason, it is even more important for parents of young children to be aware of safe cleaning practices, whether their child is at home, in daycare or a nursery school.
While some school systems offer pre-school programs, some parents may opt-out because of these concerns and the potential of bringing the “19 Bug” home. Many young parents already keep toddlers home until kindergarten. Others including many single mothers may not have the option due to work and financial responsibilities. (More on this in my next blog.)
Every parent wants the best for their child. What happens during early childhood can impact their chances for success in school and life. Language is the building block of learning. Toddlers from any culture can easily acquire one or more languages as their brains are developing. This natural learning is fed by regular stimulation – talking, singing, and playing.
The best gift a child can receive in life may well be a conversational mother. A mother or another primary caregiver connects the child to their five senses and orients them to their surroundings. Other family members, teachers and other children build on this, expanding the child’s social environment. Children learn caring, sharing, empathy, emotional control and love by interacting with others – and the world desperately needs more of those things.
Yes, children are resilient. Supportive environments, rich with a variety of activities and involving other children learning language and social skills as they play, create peak learning opportunities. Parents must navigate the right path for their child and their family during this difficult time. Therefore, stay healthy, be strong, be courageous and aim high for your child. A new generation is at stake, and it is an awesome responsibility.

(Coronavirus in Kids and Babies, WebMD)
Footnotes
(1) “Children and COVID-19: State-Level Data Report,” American Academy of Pediatrics, August 27, 2020, Link: https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/children-and-covid-19-state-level-data-report/
(2) Taylor Heald-Sargent, MD, PhD, et. al. “Age-Related Differences in Nasopharyngeal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Levels in Patients with Mild to Moderate Coronavirus Disease 2019 (COVID-19),” Published online: July 30, 2020. doi:10.1001/jamapediatrics.2020.3651
(3) Mubbahseer Ahmed, et. al, “Multisystem inflammatory syndrome in children: A systematic review,” EClinical Medicine, The Lancet, September 4, 2020. doi: https://doi.org/10.1016/j.eclinm.2020.100527
(4) “Considerations for Wearing Masks,” U.S. Centers for Disease Control and Prevention, Updated August 6, 2020. https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover-guidance.html#feasibility-adaptations
Resources
If You Are Pregnant, Breastfeeding, or Caring for Young Children
(U.S. Centers for Disease Control & Prevention)
COVID-19 (coronavirus) in babies and children (Mayo Clinic)
The Power of Play: A Pediatric Role in Enhancing Development in Young Children
(Pediatrics)