There have been so many disappointments for children over the last few months – canceled birthday parties, events and activities. As the state gradually reopens, many parents are looking for opportunities to resume some activities and reconnect with friends and family.
Dr. Walter Rosenfeld, the chair of pediatrics at Goryeb Children’s Hospital and the medical director of Children’s Health for Atlantic Health System, answered questions from parents about how to keep kids healthy and safe this summer during a live Community Conversation on Facebook, held on June 2.
One of the few positive things during this pandemic is that the rates of infection and serious illness in children have been relatively low. However, the impacts of delayed medical care, anxiety and other mental health concerns could be significant.
Dr. Rosenfeld stressed the importance of seeking guidance from a doctor if your child exhibits signs of anxiety or depression, needs care for a chronic condition, is due for a wellness visit, or has symptoms you’re concerned about.
If you’re afraid to seek emergency care, at least call your doctor for guidance, he said. Dr. Rosenfeld has seen delays complicate treatment for conditions like acute appendicitis. A message about safe emergency care for kids >
What’s the first course of action for someone who has delayed wellness care?
“First of all, I don’t think people should be panicked that they’ve delayed these things, you can catch up,” Dr. Rosenfeld said.
Many serious illnesses are preventable through immunizations, such as measles, meningitis and even types of cancer. Wellness visits are also an opportunity to educate parents and track development in young children. Developmental disorders, or learning, hearing or visual problems are often discovered in a pediatrician’s office. In older children, doctors can help identify depression, anxiety, substance use, vaping use, or other health issues.
Ask your doctors how they’re keeping their offices safe for patients and staff. “We have our doctors’ offices set up to be safe,” Dr. Rosenfield assured viewers, citing measures like separate sick and well care areas, sanitizing procedures and use of facemasks. Learn more about our enhanced safety measures >
What about care for children with chronic conditions?
Care for children with chronic illnesses, conditions like inflammatory bowel disease, Crohn’s disease, ulcerative colitis, kidney or heart disease, high blood pressure and eating disorders, should continue, Dr. Rosenfeld emphasized. He urged parents of those children to stay in touch with their child’s specialists and primary care doctors. “Get back in touch with them, ask them questions,” he said.
What advice do you have regarding camp and other summer activities?
The outdoors is one of the safest places to be as long as social distancing measures are followed and masks are worn for closer contact. When visiting a pool, for example, the risk is probably not the water at all, it’s forgetting and getting too close, Dr. Rosenfeld said.
If you’re considering sending your child to camp, ask the camp about its plans for safety – how the staff will protect your child and what actions will be taken if a child at camp gets sick.
“If you’re getting vague answers and they don’t know, I would be really hesitant to send my child to any camp in that circumstance,” he said. However, the camp may have a good plan that you feel is reasonable.
Hand washing, and the use of hand sanitizers are going to be very important as the state reopens and contact increases. “If you’re playing catch, you’re going to have contact and should wash your hands,” he said.
As far as other activities go, Dr. Rosenfeld advised going online to look for creative things to do with your child.
One of the silver linings of this terrible epidemic is that many families have had more time together. That can be a good thing, he said, but “we also need to get out because you need a break. You need to mix it up a little bit.” Outdoor activities can include hiking or simply taking a walk together while social distancing. He said he wouldn’t underestimate how much younger children are able to socially distance.
A person who is sick should also still be isolated, Dr. Rosenfeld said. The individual may have a regular cold with a coinfection of COVID-19 and will be much more contagious while coughing and sneezing. “This is not the time to tough it out and go to work or be with other people when you’re sick.”
Should very young children wear a mask?
Children younger than two should be socially distanced, rather than wearing a mask, Dr. Rosenfeld said. The mask itself could be dangerous to them.
Even something as simple as speaking volume can impact transmission risk. Loud talking or yelling while playing a game, for example, produces more aerosolized material, Dr. Rosenfeld explained. Talking softly minimizes that.
How should parents address the emotional toll of the pandemic?
Like adults, children have been profoundly affected by COVID-19 and the social distancing measures of the last several months. The specific impact will depend on the child’s age, level of maturity and individual pre-COVID life. Some children were already experiencing depression or anxiety. For them, the impacts of this situation can be devastating, Dr. Rosenfeld said.
Dr. Rosenfeld’s advice for parents of very young children is to be a good observer. Talk to your child about what’s going on and their fears. Be aware that a young child may pick up on conversations, body language or tone of voice.
Parents of older children can have a more open discussion about how the child is feeling, Dr. Rosenfield said, and provide answers to their questions as honestly as possible. Answer what’s really being asked without going further with too much information, Rosenfield said.
What warning signs should parents watch out for?
- Signs of withdrawal: A child or an adolescent who was playing, interacting and verbal but is now much quieter.
- Hyperactivity: This can be a sign of anxiety or depression.
- Sadness or depression: Some children may talk about feeling sad or depressed.
- Talk of self-harm: If a child of any age says they’re thinking of harming themselves, take that seriously and get help.
What should parents know about multi-system inflammatory syndrome in kids?
Out of two million children in New Jersey, about 35 patients in the state have been reported to have this illness. “It is rare but, of course, if you’re a parent, you’re going to be concerned. Pediatricians are concerned if your child has it,” Dr. Rosenfeld said.
Parents should look for a persistent fever of more than 100.4°F that lasts more than a day, usually accompanied by one or several other symptoms, such as difficulty breathing, abdominal pains, stomach ache, a rash, lethargy, tiredness or irritability. If parents see even two of those symptoms, Dr. Rosenfeld recommends parents “call their pediatrician and say, ‘This is what I’m seeing. What do you think?’”
Get the right advice from your doctor, he said. If you can’t get in touch or there’s some other problem, call or go to your emergency room and get the right care there. “Our doctors are prepared to treat it.”
What are your thoughts about next steps and the fall?
Camps are a great outlet for many children, but they’re elective, Dr. Rosenfeld said. “Learning is not elective. That is such an important part of childhood.” The school systems are working to figure out how they can best educate children and keep them safe.
“I sometimes hear people saying, ‘We don’t know, we don’t know anything.’ That is not true,” he said. There are many unanswered questions and the situation is evolving, but we know a lot. Organizations like the Centers for Disease Control and Prevention, New Jersey Department of Health and Atlantic Health System help get a lot of good information out there.
“Stay in touch, talk with your pediatrician, go to these reliable websites,” he advised, and avoid websites that are not trusted resources.