Mood-Boosting Tips for Families During the COVID-19 Pandemic

Feeling connected to the people and world around us is a key part of good mental health. After months of social distancing for COVID-19, families are still spending less time with others as the pandemic continues. If cancelled summer plans like festivals, family reunions, and other gatherings have made it challenging to keep your family’s spirits up, you’re not alone. Here are some simple ways to help boost everyone’s mood during the pandemic:

Lighten up

Sunshine can help brighten mood. Try to spend 30 to 60 minutes outdoors daily with your children and other members of your family, whenever possible. Bright lights, especially in the early morning, can also help.

Get plenty of sleep

Try to help your children stick to bedtime routines so they get enough sleep each night. Some ways to help promote relaxation and a good night’s sleep:

  • A shower or bath before bed
  • A story, song, or relaxing music
  • A back, hand, or foot rub
  • A cool, dark room
  • Using the bed just for sleep (not using your phone, watching TV or doing work or homework)

Talk it out

Talk with your children and teens ​regularly and be a good listener. Parents can also benefit from finding a friend or family member to discuss worries and disappointments. If conversation cannot be in person because of social distancing, then connect by phone, video calls, or other virtual connection.

Help your Family Eat Wisely

  • Include protein-rich foods for breakfast and lunch. Protein helps keep your blood sugar stable and gives your brain the fuel it needs. Also, if possible:
  • Eat foods rich in omega-3 fatty acids. Sources include fish (salmon, sardines, mackerel, herring); plants (flaxseeds, chia seeds, dark leafy vegetables, kidney beans, pinto beans, soybeans, walnuts, tofu); and certain oils (canola, soybean, walnut). Research suggests a diet rich in omega-3 fatty acids may help support mood.
  • Choose plenty of vegetables, fruits, and whole grains. They contain vitamins, fiber, and minerals your brain needs.
  • Limit junk food and fast food. They’re often full of fat, cholesterol, salt, and added sugars, which can cause spikes and slumps in energy that may leave us feeling irritable.

Go for gratitude

Focus on the positive. For what do you feel gratitude or appreciation? Research shows that regularly expressing gratitude helps boost overall happiness, leading to lower rates of stress and depression. Help your child write down at least three people, places, events, or things each day that make them feel thankful. Keep your own gratitude journal, too!

Step it up

Help your children to exercise or play so hard they break a sweat every day. When we exercise, our bodies release chemicals that can help boost mood. Remember to choose activities that help them stay at least 6 feet away from people outside your household. Also, try to avoid anything that involves sharing equipment such as balls, bats, and playground equipment.

Lend a hand

Helping other people makes us feel better about ourselves. It can be as simple as calling a neighbor or family member who is home alone or putting up a sign thanking people who deliver the mail. Help your children come up with at least one kind act each day. Keep a journal of all the things you and your family do for others—even the little things.

Manage screen time

Make a family media plan and limit your family’s exposure to TV and internet ads suggesting that buying things can make people happy. This will help limit messages about happiness that are false or unrealistic. It will also help you manage your family’s exposure to upsetting news. Consider instead: reading, playing cards or board games with family members, working a puzzle as a family, playing music or singing together, making a video to share, cooking together, or taking a family walk or bike ride.

Keep in mind: our electronic devices can also be used to create and maintain healthy social connections during the pandemic. You and your children may consider participating in online educational programs, virtual visits with grandparents and loved ones at higher risk from COVID-19, and participating in virtual online community events. It’s also good to become familiar with telehealth options offered by your doctor and your child’s pediatrician in case health questions arise.

Address stress

Try meditating as a family or other relaxation techniques such as yoga to help everyone decrease stress and improve mood. There are helpful mobile apps that that offer reminders take deep breaths and other tips to relax. Time in nature may help too.

What if your child’s mood doesn’t improve?

Sometimes, steps like these aren’t enough to improve your child’s mood or reduce their anxiety. Be sure to contact your pediatrician if you are concerned that your child is struggling with stress or anxiety or if you are worried they might hurt themselves or someone else. Your pediatrician can also help determine if underlying health conditions or medications may be causing mood problems. They can also connect you with other health professionals such as a psychologist, psychiatrist, or social worker.


By Kathi Kemper, MD, MPH, FAAP, a professor of Pediatrics at the Ohio State University College of Medicine. She is member of the AAP Section on Section on Integrative Medicine and is the author of Mental Health, Naturally: The Family Guide to Holistic Care for a Healthy Mind and Body published by the AAP. Last Updated: 6/24/2020. Source: American Academy of Pediatrics Section on Integrative Medicine and Mental Health Leadership Workgroup (Copyright © 2020). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


Stay Safe this 4th of July

On any other day of the year, would you hand your child matches or a flaming candle to play with? Probably, a hard no. You work so hard all year long to keep your child safe. Don’t let the 4th of July mess with your common sense.

With many 4th of July fireworks shows cancelled because of COVID-19 this year, there’s been a big jump in consumer fireworks sold. Lighting fireworks in the backyard or nearby field might seem like a festive and fun way to entertain the kids. However, thousands of people, most often children and teens, are injured each year while using fireworks.

Most of these injuries happen in the month around the 4th of July. In fact, an average of 180 people go to the emergency room with fireworks-related injuries every day during this time!

The AAP is part of the Alliance to Stop Consumer Fireworks, a group of health and safety organizations that urges the public to avoid the use of consumer fireworks and to only enjoy displays of fireworks conducted by trained professionals.

Fireworks were involved at least 12 deaths and more than 10,000 injuries treated in U.S. hospital emergency departments in 2019, according to the Consumer Product Safety Commission (CPSC).

Children under 15 accounted for more than a third of the injuries, which included burns and wounds to the hands, fingers and arms, the head and face, and eyes. Some of the most severe and fatal injuries happened when lit fireworks seemed not to work correctly and were being held by the victim when they exploded.

SAFER WAYS TO CELEBRATE

View from a distance.
While there are fewer community firework displays this year, some are going forward with firm social distancing rules in place. Some communities will be launching the fireworks higher so they can be seen from farther distances. Others are being held in parking lots so families can stay in their cars to view them. In addition, some displays will be televised for home viewing.

Wave a flag instead of a sparkler. Sparklers may seem relatively harmless, as fireworks go. But according to the CPSC, nearly half of fireworks injuries to children under age 5 are related to sparklers. Surprising? Consider this:

  • Sparklers burn at an extremely high heat: 1,200 degrees Fahrenheit—hot enough to melt some metals.
  • Sparks can ignite clothing on fire and cause eye injuries.
  • Touching a lit sparkler to skin can result in third degree burns.

There were about 900 emergency department-treated injuries associated with sparklers in 2019. Roughly 800 more injuries were related to firecrackers, and 400 more to bottle rockets.

Even if fireworks are legal to purchase and use in your community, they are not safe around children.

Keep the 4th of July fun, and leave the fireworks to the professionals.


Source: American Academy of Pediatrics (Copyright © 2020). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Recommended Reading: Books to Build Character & Teach Your Child Important Values

​In today’s world, children and teens are bombarded with conflicting, ever-shifting standards of ethics and morality. At the same time, you are trying to teach and instill good values at home. Fortunately, a really great book has the power to counterbalance these outside influences and teach children important lessons as they grow.

It might be a book on kindness after your child experienced or witnessed cruelty. It might be a book on expressing emotions after your child s​aw or heard scary news coverage, or maybe a book on understanding differences after your child saw someone who looked differently than they do.

The American Academy of Pediatrics (AAP) and Reach Out and Read have compiled the following list of books—organized by age and topic—to help you raise children who are aware of the world around them, curious, brave, kind, and thoughtful. Parents and caregivers are encouraged to review these titles in advance of sharing them with their children.

Then read together! Books are great conversation starters that can give you an opportunity to talk to your children about these issues and help them learn and understand your family’s values.

Books to Teach Kindness

Teaching kindness to children is an important skill to build and reinforce at all ages. Young children can learn how small acts of kindness help and please others, but teens can learn broader, larger concepts grounded in morals and ethics.

Preschoolers & Early Grades

  • Stand​ in My Shoes: Kids Learning About Empathy, by Bob Sornson; illustrated by Shelley Johannes
  • Those Shoes, by Maribeth Boelts, illustrated by Noah Z. Jones
  • Kindness is Cooler, Mrs Ruler, by Margery Cuyler, illustrated by Sachiko Yoshikawa
  • What Does It Mean To Be Kind?, by Rana DiOrio, illustrated by Stéphane Jorisch
  • Ordinary Mary’s Extraordinary Deed, by Emily Pearson, illustrated by Fumi Kosaka
  • Each Kindness, by Jacqueline Woodson, illustrated by E.B. Lewis
  • The Invisible Boy, by Trudy Ludwig, illustrated by Patrice Barton
  • Heartprints, by P.K. Hallinan

Middle Grades

  • Charlotte’s Web, by E.B. White, illustrated by Garth Williams
  • Wonder, by RJ Palacio
  • Kindness: A Treasury of Buddhist Wisdom for Children and Parents, by Sarah Conover and Valerie Wahl

Teens

  • Freak the Mighty by Rodman Philbrick
  • Rules, by Cynthia Lord

Books About Expressing Emotions

Children may see anger, sadness, and loss in parents and other adults in their lives and be uncertain how to respond. Younger children may have difficulty naming their emotions, but find it easier to identify with a character in a book. Older children may have difficulty sorting through complex feelings and worry about burdening adults who are struggling themselves. Books can help children process, clarify, and put a name to their feelings.

Preschoolers & Early Grades

  • Moody Cow Meditates, by Kerry Lee MacLean
  • That’s How I Feel (Asi Me Siento), by Rourke Publishing
  • Have you Filled a Bucket Today?, by Carol McCloud, illustrated by David Messing
  • What if Everybody Did That?, by Ellen Javernick, illustrated by Colleen M. Madden
  • I Was So Mad, by Mercer Mayer
  • Do Unto Otters: A Book About Manners, by Laurie Keller
  • My Many Colored Days, by Dr Seuss

Middle Grades

  • Michael Rosen’s Sad Book, by Michael Rosen, illustrated by Quentin Blake
  • Queenie Peavy, by Robert Burch

Teens

  • Don’t Let Your Emotions Run Your Life for Teens, by Sheri Van Dijk
  • A Still Quiet Place: A Mindfulness Program for Teaching Children and Adolescents to Ease
  • Stress and Difficult Emotions, by Amy Saltzman MD
  • Learning to Breathe: A Mindfulness Curriculum for Adolescents to Cultivate Emotion
  • Regulation, Attention, and Performance, by Patricia Broderick PhD

Books About Bullying & Harassment

Bullying and harassment are difficult topics for everyone, and they are an increasing issue in schools across the country. It’s common for younger children to repeat language they’ve heard without understanding the implications of what they’re saying. Those who are harassed (or are worried about being harassed) may have strong fear and anxiety. Children who are bystanders may not know how to respond, particularly if they fear being bullied themselves.

Preschoolers & Early Grades

  • Chrysanthemum, by Kevin Henkes
  • The Hundred Dresses, by Eleanor Estes, Illustrated by Louis Slobodkin
  • Edwardo: the Horriblest Boy in the Whole Wide World, by John Burningham
  • Say Something, by Peggy Moss, Illustrated by Lea Lyon
  • Babymouse: Queen of the World, by Jennifer Holm and Matthew Holm
  • Bully B.E.A.N.S., by Julia Cook, Illustrated by Anita DuFalla
  • Confessions of a Former Bully, by Trudy Ludwig, Illustrated by Beth Adam

Middle Grades

  • Stitches, by Glen Huser
  • To This Day: For the Bullied and the Beautiful, by Shane Koyczan
  • Understanding Buddy, by Marc Kornblatt
  • Loser, by Jerry Spinelli
  • Veronica Ganz, by Marilyn Sachs
  • Blubber, by Judy Blume

Teens

  • Dear Bully: Seventy Authors Tell Their Stories, by Megan Kelley Hall and Carrie Jones
  • Speak, by Laurie Halse Anderson
  • Freak Show, by James St James
  • Stargirl, by Jerry Spinelli
  • 7 Days at the Hot Corner, by Terry Trueman

Books on Listening to Others’ Views

Learning how to listen well and respect different views are important life skills. While younger children find it difficult to take the perspective of others, they gain that ability over time. Older children may become great debaters—especially with their parents. Books can offer models for engaging with others who have different views in a respectful and productive manner.

Preschoolers/Early Grades

  • When Sophie’s Feelings Are Really, Really Hurt, by Molly Bang
  • I’m the Best, by Lucy Cousins
  • Chocolate Milk, Por Favor, by Maria Dismondy, illustrated by Donna Farrell
  • The Sandwich Swap, by Queen Rania of Jordan & Kelly DiPucchio, illustrated by Tricia Tusa
  • Junkyard Wonders, by Patricia Polacco
  • The Conquerers, by David McKee

Middle Grades

  • Zero Tolerance, by Claudia Mills
  • The Cat at the Wall, by Deborah Ellis
  • The Three Questions, by Jon Muth

Adolescents

  • This Side of Home, by Renee Watson

Books About Respecting Differences

Children are naturally curious about others (particularly other children) who fall into groups other than their own. Think of your child’s curiosity as an opportunity to teach him or her about respecting these differences. Remember, in order to raise kids to embrace diversity, you’ll need to give them access to a variety of different cultures and traditions—books are a great way to do that!

Preschoolers & Early Grades

  • I Like Myself!, by Karen Beaumont, Illustrated by David Catrow
  • Red: A Crayon’s Story, by Michael Hall
  • Giraffes Can’t Dance, by Giles Andreae, Illustrated by Guy Parker-Rees
  • Strictly No Elephants, by Lisa Mantchev, Illustrated by Taeeun Yoo
  • Two Speckled Eggs, by Jennifer K. Mann
  • Willow, by Denise Brennan-Nelson and Rosemarie Brennan, Illustrated by Cyd Moore

Middle Grades

  • Out of My Mind, by Sharon M. Draper
  • Inside Out and Back Again, by Thanhha Lai
  • The Ordinary Princess, by M. M. Kaye

Books on Social Change & Civic Engagement

Many children are drawn to helping others—even at young ages. Maybe it is raising money for a cause or having a passion for issue impacting their community. Books can help them understand the broader concepts of social justice and civic engagement. Younger children tend to thinking of things as “good vs. bad,” but as they get older they develop very sophisticated and nuanced moral reasoning.

Preschoolers & Early Grades

  • Grace for President, by Kelly DiPucchio, Illustrated by LeUyen Pham
  • A Chair for My Mother, by Vera B. Williams
  • Mama’s Nightingale: A Story of Immigration and Separation, by Edwidge Danticat, Illustrated by Leslie Staub
  • House Mouse, Senate Mouse, by Peter W. Barnes and Cheryl Shaw Barnes
  • Being Me, by Rosemary McCarney, Illustrated by Yvonne Cathcart

Middle Grades

  • Zero Tolerance, by Claudia Mills
  • Paper Things, by Jennifer Richard Jacobson
  • The Kid’s Guide to Social Action, by Barbara A. Lewis
  • Hoot, by Carl Hiaasen
  • The Chocolate War, by Robert Cormier

Teens

  • The Great Greene Heist, by Varian Johnson
  • The Grapes of Wrath, by John Steinbeck
  • The Plain Janes, by Cecil Castellucci and Jim Rugg
  • Samir and Yonatan, by Daniella Carmi
  • The Lions of Little Rock, by Kristin Levine
  • March: Book One, by John Lewis and Andrew Aydin

By Dipesh Navsaria, MPH, MSLIS, MD, FAAP. Source: American Academy of Pediatrics (Copyright © 2016). Editor’s Note: Our collective thanks to the following colleagues who also helped compose this list: Amy Shriver, MD, FAAP, Jenny Radesky, MD, FAAP, Perri Klass, MD, FAAP, Dina Joy Lieser, MD, FAAP, and the librarians at the Cooperative Children’s Book Center, School of Education, University of Wisconsin–Madison.

Talking to Children about Racial Bias

By Ashaunta Anderson, MD, MPH, MSHS, FAAP & Jacqueline Dougé, MD, MPH, FAAP

Given the tragic and racially-charged current events, many parents are wrestling with their own feelings, the hopes they have for their children, and the difficulty of helping those children thrive in a world full of racial bias.

Parents may better face today’s challenges with an understanding of how racial bias works in children, as well as strategies to help them deal with and react to racial differences.

How Do Children Learn Racial Bias?

Children learn about racial differences and racial bias from an early age and learn from their first teachers — their parents — how to deal with and react to these differences.

The process of learning racial bias is a lot like learning a new language (e.g., a child raised bilingual vs. a child who starts learning Spanish in junior high). Biology determines a critical early learning period as well as a later window where learning is much harder.

  • As early as 6 months, a baby’s brain can notice race-based differences.
  • By ages 2 to 4, children can internalize racial bias.
  • By age 12, many children become set in their beliefs—giving parents a decade to mold the learning process, so that it decreases racial bias and improves cultural understanding.

But like language immersion, children exposed to society will gain fluency in racial bias even if their parents do nothing.

Strategies to Help Children Deal with Racial Bias

There are three strategies that parents can use to help their children deal with racial bias:

  • Talk to your children and acknowledge that racial differences and bias exist.
  • Confront your own bias and model how you want your children to respond to others who may be different than them.
  • Encourage your children to challenge racial stereotypes and racial bias by being kind and compassionate when interacting with people of all racial, ethnic, and cultural groups.

How Parents Can Confront Their Own Racial Bias

Parents must first confront their own biases, so that their example is consistent with messages of racial and ethnic tolerance.

  • Be a role model. Identify and correct your own racially biased thoughts, feelings, and actions. If you want your children to believe what you preach, you have to exhibit those behaviors as well. Your everyday comments and actions will say more than anything else.
  • Have a wide, culturally diverse social network. Encourage your children to have diverse circles of friends, as well. This lends itself to engagement in multicultural activities and experiences.
  • Travel and expose your children to other communities. This can help them understand that there is diversity in the world that might not be represented in the community that you live in.
  • Do not reverse stereotype police officers and other groups or talk about law enforcement in a negative way.
  • Get involved in your child’s school, your place of worship, and politics. Parents who are involved in this way are better able to advocate for fair treatment of racially marginalized groups and raise awareness of race issues in other groups.

Tips for Talking About Racial Differences & Racism

Talking about race is not racist. It’s OK—and important. From a young age, children may have questions about racial differences and parents must be prepared to answer them. But, it’s important to keep your child’s developmental readiness in mind.

  • For preschoolers: At this age, your child may begin to notice and point out differences in the people around you (i.e., at the grocery store, at the park, etc.). If your child asks about someone’s skin tone, you might say, “Isn’t it wonderful that we are all so different!” You can even hold your arm against theirs to show the differences in skin tones in your family.
  • For gradeschoolers: This is the age that is important to have open talks with your child about race, diversity, and racism. Discussing these topics will help your child see you as a trusted source of information on the topic, and he or she can come to you with any questions. Point out stereotypes and racial bias in media and books such as villains or “bad guys” in movies.
  • If your child makes comments or asks you questions about race based on school incidents or something they read or watched: Further the discussion with questions such as, “How do you feel about that?” and “Why do you think that?” This is also helpful if your child heard something insensitive or if your child experienced racial bias themselves. Before responding to his or her statement or question, figure out where it came from and what it means from his or her perspective.

These conversations begin to lay the groundwork for your child to accept and respect everyone’s differences and similarities. As children mature, the answers to questions will become more complex. These are moments to learn what your child understands or is struggling to understand about racial bias.

Remember:

To create a culture of inclusiveness, we all must look at and acknowledge our biases, so we can do something about the ones that are unfair or cause harm to others—like racial bias. Understanding the way people feel about and behave toward those outside their own group can help communities heal after a tragedy, as well as prevent future ones.


Author: Ashaunta Anderson, MD, MPH, MSHS, FAAP & Jacqueline Dougé, MD, MPH, FAAP. Source: American Academy of Pediatrics (Copyright © 2016). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


Talking to Children about Racism: The Time is Now

Horrific events like the killing of George Floyd and the protests and civil unrest that followed graphically illustrate how racism and discrimination harms everyone in our communities.

The American Academy of Pediatrics condemns racism in all forms. And pediatricians are deeply concerned about the effects of racism on children. Even vicarious racism – secondhand racism witnessed through social media, conversations with friends or family, or media images – harms children’s health. ​

Children are listening

As a parent, you must assume children of almost any age are hearing about what is happening in our nation today. They may overhear adult conversations, see a video on YouTube, or watch news coverage of violent protests. They may feel afraid for their own safety or their family’s safety. They might have questions about what the protests mean, why people have been killed by police, and if they are safe. ​
How to help your children understand

Ideally you can talk with them first, in ways they can understand, before they hear about it from other sources. When talking to your children, keep the following tips in mind:

  • Check in with your child. Ask what they know, what they’ve seen, and how they are feeling. Tell them you understand their feelings and reassure them it’s normal to feel these emotions. You know your child best and what information they can handle. For younger children, tell them what you are doing to keep your family safe. For pre-teens and older children, ask if they’ve ever experienced mistreatment or racism, or seen it happening to others.
  • Watch for changes in your child’s behavior. Some children may become more aggressive, while others will become withdrawn or scared. If you are concerned that your child may be struggling with anxiety, fear or distress, call your pediatrician or mental health provider for additional support.
  • Limit what your child sees in the media. Do not leave the TV on in the background. With older children and teens, watch with them and talk together about what you’re seeing. Listen to their observations and share your own. Use commercial breaks, or pause the video, to have brief discussions. With younger children, limit TV, smartphone, or tablet use, especially when the news is on. Make sure the media they do see occurs in a common area where you can check in.
  • Be aware of your own emotions. As an adult, tune into how you are feeling and check that you are ok. If you are not, ask for help to deal with the trauma and emotional impact of these events and images. Make a list of your own coping strategies, and when you need to use them, tap into that list.
  • Use this teachable moment. For all families, this is an opportunity to discuss the history of racism and discrimination in the US and help your children discover ways to make change. ​
  • Resources can help. If you struggle to find the “right” words, try using books or other resources to share with your child. The tips in this article can also help. Remind your children that no one is perfect, talk about what you are doing to be anti-racist, what you have learned, and how you as a family can step up.

Talk and act

It’s OK to acknowledge that people are treated differently based on the color of their skin and where they live and share examples of this happening. But this is also an opportunity to show your children how to make a positive difference. For example, perhaps your family can call your city council person or superintendent to advocate for issues faced by communities of color. Think about how you might confront your own biases and show how you want your children to respond to others who may be different than them.​

Remember

These are conversations that many Black American families have had for years. But if this is not something your family has discussed yet, what is happening right now is a teachable moment. If we are to progress in this country, it’s going to be because we help our children, adolescents and young adults learn not just that racism exists, but that it is something all of us can work together to dismantle. ​


By Nia Heard-Garris MD, MSc, FAAP & Jacqueline Dougé, MD, MPH, FAAP​. Source: American Academy of Pediatrics (Copyright © 2020).

Breastfeeding During the COVID-19 Pandemic

The outbreak of COVID-19 is a stressful time for everyone. This may be especially true for mothers who are breastfeeding and concerned about their baby’s health. However, new moms can successfully start and maintain breastfeeding during the pandemic​, with some recommended precautions.

Benefits of breastfeed​ing d​uring a pandemic

  • Breastfeeding is good for babies. It protects them from many infections. While it is still not clear if this is true for the COVID-19 virus, breastfed infants are generally less likely to have severe respiratory symptoms when they get sick.
  • Breastfeeding i​s good for moms. Hormones released in the mother’s body during breastfeeding promote wellness and can relieve stress and anxiety.
  • Breast milk is readily available. No purchase necessary!

Is breastfeeding and exp​ressed breast milk feeding safe during the COVID-19 pandemic?

COVID-19 spreads between people who are in close contact, mainly through respiratory droplets when an infected person coughs, sneezes, or talks. To date, there is no evidence that COVID-19 is passed from mother to baby in breastmilk. Breastfeeding has been shown to be safe when a mom has other illnesses like the flu.

Can my baby continue breas​tfeeding or drinking expressed breast milk if I test positive for COVID-19 or if I am a person under investigation?

Yes, babies can still receive breast milk even if you test positive for COVID-19. It is recommended that you pump or express your breast milk after carefully cleaning your breasts and hands and have a healthy caregiver feed your baby the expressed breast milk.

It’s also very important to clean your breast pump after each use. Follow CDC guidelines for proper cleaning and disinfecting recommendations.

Remind all caregivers to wash hands thoroughly before touching bottles, or feeding or caring for your baby. If you decide to breastfeed directly, take all the recommended steps to prevent the potential spread of the virus, including using a mask and following careful breast and hand hygiene.

If I have COVID-19, can​ I stay in the same room with my infant?

If you have COVID-19 or are suspected of having COVID-19, staying in a different room from your baby is the safest way to keep your newborn healthy. A healthy caregiver should take care of the baby and can feed expressed breast milk.

If you and your family decide to keep your baby in the same room as you, keep a distance of at least 6 feet from your baby. When closer than 6 feet, wear a mask and make sure your hands are clean.

If you have COVID-19, you can stop isolating yourself from your baby once you are fever-free without use of fever medicines (acetaminophen or ibuprofen) for at least 72 hours; when your other symptoms of COVID-19 are improving; and when at least 10 days have passed since your symptoms started.

​Tip: Ask your pediatrician​ for help with getting your baby to latch on again once you can restart breastfeeding.​

How can I maintai​n my milk supply if I am sick with COVID-19?

Hand pumping and hand expressing breast milk is especially helpful in the first few days after your baby is born to get the milk supply going. Frequent pumping (or breastfeeding if you have chosen to directly breastfeed and are following the strict precautions noted above) should line up with your infant’s feeding demands, about 8-10 times in a 24-hour period.

Most medications are safe to take while breastfeeding, but always check with your doctor.

​While this may be a stressful time, try to stay optimistic and practice healthy habits to reduce stress as much as possible. This includes getting enough sleep, eating​​ plenty of healthy foods, and getting regular exercise.​

Do not hesitate to ask for help if you have trouble with feeding, nipple pain, low milk supply, or with any other concerns.

How can I protect my infant from​ COVID-19 infection?

Wash your hands often with soap and water for at least 20 seconds. If soap and water are not available, use hand sanitizer. Look for one that is 60% or higher alcohol-based. Avoid touching your face, eyes, nose, or mouth with unwashed hands. Also, be sure to clean visibly dirty or possibly contaminated surfaces your infant may touch.

If you feel sick, be extra careful to cough or sneeze into your sleeve or a tissue. Throw away used tissues immediately and wash your hands.

Practice physical distancing by avoiding public spaces and stay 6 feet away from others whenever possible. And be sure that everyone in your home avoids close contact with anyone with respiratory symptoms such as coughing or individuals with probable COVID-19.

Your pediatrician is here to ​help

After leaving the hospital, it is important that your baby’s first follow-up visit happen in person so your baby can be measured and weighed accurately. Many doctors are scheduling newborn visits during specific times (such as first thing in the morning) to limit exposure to sick patients. While some doctors are also doing more work via phone and video, this is not the best option for newborns.

Rem​ember

Breastfeeding is a key preventive health step for baby and mother, even during the pandemic. Talk with your pediatrician about how to keep your baby healthy and what resources might be available in your community to help you.


By Temitope Awelewa, MBCHB, MPH, FAAP, IBCLC, is a board-certified general pediatrician, a physician informatics officer and a clinical assistant professor of pediatrics at the University of Iowa. Within the American Academy of Pediatrics, she is a member of the Section on Breastfeeding and the Chapter Breastfeeding Coordinator for the Iowa Chapter of the American Academy of Pediatrics. Source: American Academy of Pediatrics (Copyright © 2020). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Mental Health During COVID-19: Signs Your Teen May Need More Support

​​The stress, fear and uncertainty created by the COVID-19 pandemic can wear anyone down, but teens may have an especially tough time coping emotionally. Feeling depressed, hopeless, anxious, or angry during the COVID-19 pandemic may be signs they need more support during this difficult time.

How your​​ pediatrician can help

Staying in touch​ with your pediatrician is more important than ever during this pandemic. But it might not mean you need to go into the office for your teen to be seen. If you’re concerned, ask your pediatrician’s office about checking in on your teen’s social and emotional health through a telehealth visit.

Pediatricians can screen for depression and ask about other concerns like anxiety or trouble coping with stress. The doctor may also ask about these symptoms in other family members, as this can impact your teen’s health, and whether they know anyone who has become sick with COVID-19. It’s important to offer your teen some privacy to talk with the pediatrician during the visit to ensure they have the chance to speak as openly as possible.
​​​
How is your teen copin​g during COVID-19?

Check in with your teen often to discuss how they’re feeling and managing, and watch for signs of mental health struggles. Keep in mind that these signs are not the same for everyone; different people show different signs when trying to deal with mental health challenges.​

It’s normal for teens to feel sad during this time, crying sometimes because they miss their friends or because sports and musical productions were cancelled. However, your teen likely could benefit from extra support if they have:

  • changes in mood that are not usual for your child, such as ongoing irritability, feelings of hopelessness or rage, and frequent conflicts with friends and family.
  • changes in behavior, such as stepping back from personal relationships. If your ordinarily outgoing teen shows little interest in texting or video chatting with their friends while stuck at home, for example, this might be cause for concern.
  • a lack of interest in activities previously enjoyed. Did your music-loving child suddenly stop wanting to practice guitar, for example? Did your aspiring chef lose all interest in cooking and baking?
  • a hard time falling or staying asleep, or starting to sleep all the time.
  • changes in weight or eating patterns, such as never being hungry or eating all the time.
  • problems with memory, thinking, or concentration.
  • changes in appearance, such as lack of basic personal hygiene (within reason, since many are doing slightly less grooming during this time at home.)
  • an increase in risky or reckless behaviors, such as using drugs or alcohol.
    ​thoughts about death or suicide, or talking about it (see “A word about suicide risk in teens,” above).

Remem​ber

Parents set the tone in the household. Expressing extreme doom or fear can affect teens. Try to stay positive and relay consistent messages that a brighter future lies ahead. Keep lines of communication open between you and your teen, and don’t hesitate to talk with your pediatrician about ways to help maintain your family’s mental health during this difficult time.


Source: American Academy of Pediatrics (Copyright © 2020). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

​A Word about Bedtimes​

Children often have more trouble with bedtime during any stressful period. Try to keep normal nighttime routines for younger children. Put a family picture by their bed for “ex​​tra love” until morning. Bedtimes can shift some for older children and teens, but it is a good idea to keep it in a reasonable range so the sleep-wake cycle isn’t thrown off. Too little sleep makes it more challenging to learn and to deal with emotions. Remember to turn off cell phones and other mobile devices an hour before bedtime.​

For more information, read: “Brush, Book, Bed: How to Structure Your Child’s Nighttime Routine”

Feeling Overwhelmed with Parenting Demands?

Feeling Overwhelmed with Parenting Demands? If you’d like to take a step back ― if you are feeling maxed out ― but don’t know what to do, read on.

Here are some strategies to help you build resilience. (And no, they don’t involve spending lots of money). These opportunities focus on what you can do right now at home. Right now, in your neighborhood. Give yourself permission to reduce your stress and be happy―in whatever ways work best for you.

Change your perspective.
People sometimes experience anxiety after letting their worries take over. Are you releasing your tensions in unhealthy ways?

  • Break down big problems into smaller parts. This means tackling challenges head on yet doing so one at a time. This is often called compartmentalizing. Imagine putting each cause of stress inside separate plastic containers. Now visualize closing the lids. Segmenting challenges decreases stress because it spurs the realization problems can be dealt with individually, while the rest can be “stored” for another time.
  • Know how much power you give to each stressor in your life. Sometimes stress comes from real danger, but in most cases, the amount of stress we feel has more to do with how we think about the obstacles in our way. Take an accounting of how much influence you are giving to each challenge you are facing.

Reach out to others for help.

This is not a sign of weakness―in fact it is the opposite. Licensed and certified psychologists, social workers, and other mental health professionals can offer support and suggestions for big and small setbacks. A trusted pastor, rabbi, imam or other religious figure can help you with some faith-based strategies, as well.

If you are looking for help for yourself or someone else, you may be tempted to call someone who advertises in a local publication or who comes up from a search of the Internet. While you may, or may not, find a competent therapist in this manner, it is wise to check on credentials. Competent therapists hold advanced academic degrees and are trained in techniques for treating anger management. They should always be licensed to practice in your state.

Look for therapists affiliated with local universities or mental health facilities. You can also check membership listings on the websites of professional organizations, such as the Association for Behavioral and Cognitive Therapies or the American Psychological Association.

Ask yourself these key questions whenever a challenge pops up:

  1. Is this a real tiger or paper tiger? (Yes, a tiger!) Remember, humans are built to successfully flee ferocious carnivores. Our internal stress response launches us into survival mode―a period during which it’s nearly impossible to think clearly. You’ll solve problems more effectively if you are able to recognize most problems don’t represent immediate danger. Once you recognize that, you’ll be able to more effectively calm your thinking and determine what you need to do next.
  2. How will I feel about this problem tomorrow? Next week? Next year? Do you know the musical, Annie, and its famous song, “Tomorrow?” This show-stopping tune reminds us that our struggles nearly always ease with the passage of time. “The sun will come up tomorrow;” a good reminder when trying to keep things in perspective.
  3. Is this “good” situation permanent? OK, maybe this is a bit glass half empty. But sometimes―without meaning to think self-defeating thoughts —we do. We get nervous we’re unworthy of success. In the worse cases, we might even sabotage our good fortune. Don’t do this to yourself! Come to appreciate all the wonderful events in your life. You’ve earned it.

Give yourself a safe space to express feelings.
Writing―in any form―is a powerful way to lower stress and develop a more resilient mindset.

  1. Writing allows you to let go of controlling emotions. Once they’re on the page, our thoughts and feelings are no longer at the forefront of our minds. We’re able to worry less by writing more.
  2. Writing alters memories of stressful events. Research shows writing about stressful experiences, for example, has improved the health of many different people. Putting pen to paper has been proven to not only decrease stressful memories but improve how people cope with them. This is why reviewing your old writing, for example, can be a great way to reflect on the lessons you’ve learned along the way.

Remember: You don’t need to write every day. Writing can simply be a tool whenever you need to release tension or make sense of an emotion. Writing―in any form―shouldn’t add stress to your life! Write for yourself, not for others.

Give back. It feels good to give.

The ultimate act of resilience―to make yourself feel stronger―is to reach out to other people when they need support. (Read that line again—it can be lifesaving!) When we give, we learn it feels good to help. We’re then more likely to accept support when we need it.
Helping others also helps us in these essential ways:

  1. It boosts our well-being. It’s been studied! When we volunteer, we put aside our troubles and gain perspective. Perhaps, we determine our difficulties aren’t so bad after all. Giving back also comes with a welcome reminder: You matter, and you are valued.
  2. It gives more opportunities for family time or solo time. Volunteer solo or with your family. From local food pantries, to religious institutions, to your son or daughter’s school, the opportunities to volunteer are everywhere. Some people even manage to turn the act of volunteering into a family vacation.

Practice what you preach.

Think about working on some challenging homework with your kids. How often do you hear them say, “I can’t?” As parents, we can correct this self-defeating language with “You can. Let’s work on it.”

  • Add in “yet” to the end of your own self-defeating thoughts. When so many of our own thoughts begin with words like “I never” or “I can’t,” we close the door for progress. We undermine hope. Just like you do for your kids, work to add the transformative word “yet” to the end of your thoughts. “I can’t solve this problem” becomes “I can’t solve this problem YET.” Hope and possibility are are then restored with one simple word.

Yet, another upside to taking care of yourself.

Taking advantage of these techniques has a wonderful, unexpected upside: by controlling how you handle stress, you model how best to manage challenges for your children. And that will no doubt help them build a more resilient mindset, too.


Source: American Academy of Pediatrics and Children’s Hospital of Philadelphia (Copyright © 2019). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Simple Ways to Entertain & Boost Your Baby’s Development at Home

During social distancing to slow the spread of COVID-19, you may be looking for new ways to entertain and play with your young child. Thankfully, all you need is loving attention and some basic household items.

Try these time-tested activities, suggested by age, and let the fun happen!

Newborn to 3 Months

Puppet Play. Make a hand puppet using a sock. Move it up and down and back and forth where your baby can see it, doing a silly dance and singing silly songs. You can even have the puppet give her kisses!

Footloose. Gently dance with your baby positioned over your shoulder. She will enjoy the movement and at the same time will learn to tolerate the slight pressure against her tummy.

Pat-a-Cake. Hold your baby’s hands and gently clap them together to play a game of pat-a-cake:

Pat-a-cake, pat-a-cake, baker’s man (Take baby’s hands through the motions)
Bake me a cake as fast as you can
Roll it (Roll her hands around each other) and pat it (Clap)
and mark it with a B (Guide her finger to write a B in the air)
And put it in the oven for baby and me (Kiss your baby!)

​Can’t Smile Without You. Lie down on the floor,tummy down facing your baby. Try to get her to smile by sticking out your tongue, smiling at her, and making other funny faces. You may even hear your infant’s first giggle!

4 to 6 months

Little Piggy Game. Hold your baby’s foot up and wiggle each toe while teaching the classic “This Little Piggy” poem in an animated, singsong way. Don’t forget to give your infant a tickle at the end!

This little piggy went to market (big toe)
This little piggy stayed home (second toe)
This little piggy had roast beef (third toe)
This little piggy had none (fourth toe)
And this little piggy went wee wee wee all the way home (little toe)

Mustang Sally. Sit on the floor with your baby sitting on your raised knees. While holding on to her, slowly move your legs side to side and sing “Ride a Little Horsey.” When you say, “don’t fall down,” slide your feet forward!

Ride a little horsey
Down to town
Oops, little horsey
Don’t fall down!

Crocodile Rock. Hold your baby securely, tummy down on your chest. Rock your body from side to side and sing a song like “Row, Row, Row Your Boat.”

Homemade Toy: Stacking Baby B​locks
Collect different-sized clean milk cartons, small boxes and toilet paper rolls. Stuff each with newspaper or tissue paper. Fold the ends down to create blocks ​​and cylinders, then close them with masking or duct tape. Use a variety of fun colors of contact paper or duct tape to cover each block.​

Free Fallin’. Stack up some blocks and encourage your baby to bat at and reach for them. Most infants absolutely love to see and hear the blocks tumble to the ground!

7 to 9 mon​ths

Fly Me to the Moon. Carefully lift your baby up over your head and back down while playing or singing a song like, “Fly me to the moon!” If your child seems fearful, move more slowly and talk in a calm, soothing voice.

See You Later, Alligator. With your baby seated in front of you, hide a rattle under a blanket or behind your back. Shake the rattle while hiding it and see what happens. If your baby loses interest once it’s hidden, reveal part of the rattle and ask, “Where’s the toy?”

If the Hat Fits. Sit just in front of baby, place a colorful hat on your head and say, “Look! The hat is on my head.” Then remove it and say, “Now the hat is off.” Next, put the hat on and off your infant’s head! Encourage your baby to reach for the hat for more play.

The Humpty Dance. Sit your infant on your lap, either sitting up or tummy down, and gently bounce your legs up and down. For more fun, do this while using a rocking chair!

10 to 12 mo​nths

Be-Bop Baby. Seat your baby upright on the floor, legs separated just enough to place a medium-sized ball between them. Show your baby how to roll the ball in your direction, then roll the ball back. Continue taking turns.

Marching On. While seated, stand your baby on your thighs. Hold your baby’s hips and slowly make stepping motions by moving your legs up and down, one side at a time. Sing your favorite song.

You Light Up My Life. Shine a flashlight on the wall. Once your baby sees the light, move it slowly from one side of the room to the other and up and down to encourage visual tracking.

Homemade Toy: ​​​Baby Dr​ums​
Cover an oatmeal box or coffee can with colorful contact paper and use plastic baby spoons as drumsticks. (Or, sim​ply give your child a saucepan and a short wooden spoon.) ​

Beat It. Show your baby different ways to tap a drum using the palms of your hands, your fingertips, or a baby spoon. See if your baby can imitate you.
12-24 mon​ths

The Big Squeeze. Take colorful kitchen sponges and cut them into fun sizes and shapes to fit into your child’s hand at bath time. Show your little one how to sink a sponge underwater, watch it fill up, then hold it up and squeeze the water out.

​Homemade Toy: Toddler Tambou​​ri​ne
Tape two sturdy paper plates securely together halfway around using colorful duct tape. Fill the tambourine half-full of dry cereal, tape the paper plates together the rest of the way, and shake!​

Mr. Tambourine Man. Show your little one how to shake and tap a tambourine to make noise. Add more ways, like tapping it against your hip, over your head, and in various directions.

Poking Fun. Show your baby how to press numbers on an old phone or peck on an old keyboard. Glue different textures of fabric at the bottom of each section of an egg carton or old ice tray. Let your baby feel the various textures.
Remem​ber

You have the knowledge and tools to make play a fun and stimulating part of your baby’s daily routine. Keep it simple, be flexible, and do what works for you and your child.


By ​​​Anne H. Zachry, PhD, OTR/L​​. Source: Adapted from Retro Baby (Copyright © 2013 American Academy of Pediatrics): The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.