How Does COVID-19 Affect Children?

The coronavirus pandemic has taken a toll on entire communities, from the youngest to the oldest. The infection affects each individual differently. Children are especially vulnerable because they do not fully understand all of the changes that are taking place around them.

Children, however resilient, will require education and encouragement to try to begin the process of understanding the adjustments needed to face this new normal. People are truly living in unprecedented times and things are changing daily.

Symptoms of COVID-19 in Children

A recent study published in the Morbidity and Mortality Weekly Report (MMWR, April 2020) showed that among pediatric patients younger than 18 years of age in the United States, 73% had at least one of the following symptoms: cough, fever, or shortness of breath.

These data were compared to those of 93% of adults aged 18–64. In the pediatric patients, fever was present in 58%, cough in 54%, and shortness of breath in 13%. In the study, headaches and muscle aches were more common than shortness of breath in both adults and children. (1)

Since symptoms vary, it is so important to contact your physician if you are sick and follow the guidelines set by the CDC regarding social distancing, wearing masks and proper hand hygiene, and staying home when sick. (2)

How Does the Novel Coronavirus Affect Children Differently Than Adults?

• The physical and mental effects of the coronavirus are varied as it relates to children and adults. So far, the majority of the reported cases of pediatric patients with COVID-19 have had less severe illness.
• There have, however, been reported pediatric deaths that have occurred. Older adults and adults with preexisting medical conditions, such as diabetes, heart, lung, and/or autoimmune disease, are the most vulnerable population. These individuals are most likely to suffer respiratory failure and have to be placed on a ventilator to help them breathe.
• Mentally, children and adults may both experience stress, worry, and anxiety. These responses look different in children and adults.
• Children may experience regression, acting out, nightmares, fear of going out of the home, and fear they, their parents, or loved one will die. This is why access to mental health professionals is so vital during this emotionally challenging time for both adults and children.
• Adults, especially those with a previous history of mental health disease, may go back into a depressive state, may isolate themselves, and may use drugs and/or alcohol as a way to cope with the stress. These behaviors will clearly affect the way they parent, interact socially, and function on their jobs.

Being aware of how the body responds to stress and having the right tools to cope will help both children and adults deal more effectively with these effects and other life changes during the coronavirus pandemic.

Importance of Sleep in Building Your Child’s Immunity

Sleep plays a critical role in how the immune system responds to illness.

The body repairs itself when you are asleep through a number of mechanisms, one of which is the release of infection-fighting proteins, which declines if you do not get enough sleep.

According to the National Sleep Foundation, (3) the amount of sleep needed varies by age:

Negative Effects of Stress and Anxiety on Your Child’s Immune System

The body reacts to stress by producing a hormone called cortisol, which hampers the body’s ability to effectively fight infections, while simultaneously decreasing the number of white blood cells, which are the foot soldiers of the immune system.

This pandemic can be quite harrowing for children, especially for those struggling with preexisting anxiety problems.

Since kids do not have well-developed coping skills or access to resources and therapists, it is the job of parents and caretakers to teach them about positively channeling their emotions to avoid stress. There are several apps for guided meditation that can help with the same.

Can a Child Contract COVID-19 Through Breastfeeding?

Breast milk provides antibodies to newborns who have zero immunity of their own and thus help them fight infection. Many mothers, however, may be concerned about the safety of breastfeeding if they test positive for COVID-19.

According to the American Academy of Pediatrics Committee on Fetus and Newborn, Section on Neonatal, Perinatal Medicine, and Committee on Infectious Diseases, no study has demonstrated the presence of SARS-CoV-2 in breast milk until now, but temporary separation of mother and newborn is recommended to minimize the risk of postnatal infant infection from maternal respiratory secretions. (4)

Mothers with suspected or a positive test for COVID-19 can express breast milk and have a designated caregiver feed the infant. It is also important to properly sterilize the breast pump with disinfectant wipes and wash the pump attachments with hot soapy water.

For moms who choose to directly breastfeed their infant, they should wear a mask and practice meticulous breast and hand hygiene while doing so.

Exercise for Better Immunity

Resigning yourself to a sedentary lifestyle during this lockdown can harm your mental and physical health. So, I advise my patients to maintain a daily routine and stay active inside the house. You should do the same for your children as well.

Encourage them to take up new hobbies and even participate with them when you can. Playing indoor sports and games can also keep your child active, which is major plus for his/her immunity and overall health. Moreover, these activities help keep the child engaged and entertained in these stressful and uncertain times.

Here are some ways to do keep yourself and your child active during lockdown:

• Find ways to fit exercise into your day.
• Go for a morning and/or afternoon walk.
• Dancing is also a very fun and effective way to exercise.
• The CDC’s commendation for children for daily exercise is 60 minutes of moderate to vigorous exercise.

Your immune system responds to exercise by increasing immune-fighting cells in the body and aiding your overall health in the following ways:

• Lowering blood pressure
• Weight loss and management
• Reducing the risk of heart disease
• Elevating your mood (5)
• Improving your sleep, which in turn helps boost your immune system (6)

Immunity-Boosting Foods for Children to Protect Them From COVID-19

You can eat your way to better health by adding immunity-boosting foods to your regular diet, which not only help ward off illnesses but also promote faster recovery in case you do fall ill. 

Citrus fruits, such as oranges, are touted for their rich vitamin C content, but you can derive almost the same amount of this prized antioxidant from red bell peppers. (7)

Other foods that can improve your body’s ability to fight infections such as COVID-19 include:

• Broccoli has vitamins A, C, and E. (8) You can eat it raw, dipped into dressing, included in salads, sautéed, or included in a casserole.
• Ginger helps to decrease inflammation and fight infection. It can be added to a variety of meals such as stir-fries and marinades. (9)
• Almonds contain vitamins E and C and help fight infection. They also contain healthy fats. (10) Add them to salads or make your own trail mix with dried fruits such as cranberries and blueberries.
• Papaya and pomegranate are packed with vitamin C and also help in the digestive process. (11)
• Green tea is full of antioxidants that help fight infection. (12)

Get creative in adding these foods to your family’s diet. Include your child in meal prepping and cooking to make healthy eating more enjoyable for them and increase the chances they will consume these beneficial foods.

Final Word

The impact of COVID-19 on children is difficult to fully determine at this time. How children respond to the changes depends on several factors. One is how parents cope and deal with the changes. As parents, you want to model behaviors that will enable your children to successfully navigate this new normal.

Be aware of your conversations and monitor your child’s exposure to social media. It is important to talk openly and honestly with your children about what is going on and to provide a safe place for them to share their feelings and ask questions.

It is important that the responses be simple and age appropriate for them to fully understand. It is important to pay close attention to their verbal and nonverbal cues. The consistency and assurance that you provide your children will be much more difficult to give but are greatly needed.