I worry about newborns with untreated hip dysplasia, jaundice or eye issues usually spotted during well baby visits. I lose sleep over toddlers with missed anemia, lead exposure or speech delays. I dread hearing that school-age kids have unacknowledged anxiety, stress and sleep problems. I fear missed growth concerns, elevated blood pressure, high cholesterol and diabetes. While waiting for a vaccine to prevent covid-19, we can’t place kids at risk for other preventable infectious diseases when safe and effective immunizations are available.
I hear parents’ concerns every day, and I hope to answer your questions while reassuring and encouraging you to see your pediatrician for important preventive health-care appointments.
Is it safe to bring my newborn baby to the pediatrician’s office?
Pediatricians are taking extra precautions to keep their office safe and clean for newborns and parents. Some have designated newborn exam rooms, and some see only babies in the morning or at home. It’s critical that newborns are examined head to toe, weighed, evaluated for jaundice and helped with feeding, and that parents get answers to all their questions.
Should I bring my school-age child to the pediatrician for their scheduled well-child visit, do a telehealth visit or wait until after the pandemic?
Although discussions on nutrition, sleep, school and mental health can be done virtually via telehealth, depending on your child’s age, we do need to examine their skin, listen to their heart, check vision, feel their abdomen, look at their spine, check balance, gait and more. With school starting in a few months (fingers crossed), many students need sports physicals and vaccines to prevent outbreaks of pertussis, measles and meningitis this fall. The CDC is already warning that the United States could begin seeing outbreaks of vaccine-preventable diseases, based on a study that found vaccinations and vaccine orders dropped precipitously in late March.
How are you ensuring your office is safe from covid-19 and other illnesses?
With kids home from school, we are seeing fewer illnesses in the office. In fact, pediatricians are seeing 30 percent of their normal patient volume right now, according to anecdotal reports from the American Academy of Pediatrics, making it an ideal time for an appointment. When kids are sick, some pediatricians are opting for car visits, home visits and video visits to avoid bringing sick kids to the office unless absolutely needed. Many offices are seeing well visits in the morning and sick visits at the end of the day while thoroughly disinfecting every room and tool between patients and again every night.
What should parents do if their child is sick, injured or is having a hard time emotionally?
Call your pediatrician; that is what we are here for. We can often help over the phone, such as discussing a tummy ache, or have a virtual visit to discuss headaches, or have you email a photo of a rash. If we really need to see you in person, we will do it safely. We care about your child. We aren’t too busy. Don’t wait if your child needs help, as some injuries and illnesses can get worse if not diagnosed and treated quickly.
What about this Kawasaki-like disease everyone is talking about? Should parents be worried?
Typical and atypical Kawasaki disease cases have been reported in the United States and abroad potentially linked to covid-19. Kawasaki is a rare disease, where blood vessels become inflamed. Symptoms are fever for more than five days, red eyes, rash, enlarged lymph nodes, dry cracked lips, redness and swelling of palms and soles, and if not treated, it can lead to heart problems. Additional symptoms can include abdominal pain, diarrhea, low blood pressure and even shock. If diagnosed early, most kids can be treated in the hospital. Although this is very rare, parents should call their pediatrician if a child has a fever for more than a few days, isn’t drinking fluids, has trouble breathing, is in constant pain or looks sick.
How can parents handle the stress of being home 24/7 with kids, while working, not working and navigating online school?
This is a real concern. Parents and caregivers are under tremendous stress right now, both emotional and financial. Although it’s not always easy, it’s important for parents and caregivers to take care of themselves — get enough sleep, eat healthy, exercise — and reach out to support networks for help, including your pediatrician. With a phone call or video visit, your pediatrician can help you with strategies to manage your children’s behavior, cope with a crying baby, handle other parenting challenges and direct you to other specialists if needed.
Any advice for children missing out on social interactions while being isolated at home right now?
Social distancing can be especially hard for kids and teens, who miss their friends and feel let down as important events such as birthday parties and graduations are canceled. As a parent, try your best to create a healthy daily routine, including online learning, exercise, sleep, family meals and downtime. Spend time talking with your child or teen every day and take an interest in something they enjoy. Encourage your children to connect with friends online or by phone — plan a surprise Zoom or drive-by party. If your child or teen is having symptoms of sadness, anxiety or sleep issues interfering with school or activities, contact your pediatrician or a mental health provider.
Pediatricians are not only available for colds and coughs. We also play a vital role in your child’s mental health, physical health, school success and life. Although covid-19 is clearly putting our country on hold, we can’t put our children’s health on pause as well.
Tanya Altmann is a pediatrician, founder of Calabasas Pediatrics Wellness Center, spokesperson for the American Academy of Pediatrics, author and mom of three boys.