FAQs: Pediatrics and COVID-19 for parents

Updated as of January 2021

Parenting is hard enough without a pandemic. At Maven, we are here for you to provide support and compassionate, on-demand care through our virtual clinic as you navigate this challenging time for you and your family. We’re committed to keeping you updated with all of the latest fact-based information as we have it, with our series of FAQs and Ask Maven Anything Q&As with Maven providers, including weekly Instagram Lives @mavenclinic.

We’ve partnered with economist and bestselling author Emily Oster on our COVID-19 Child Care Decision Tool, a free, evidence-based tool for parents to assess the risks, benefits, and their unique circumstances to make the best schooling and child care decisions for their family. Check it out, and we hope you find it helpful!

To share the latest clinical guidance for parents and answer common questions we’re hearing most from parents about keeping their newborns, infants, or school-aged children healthy during COVID-19, we spoke with Dr. Jamie Hutton, a board-certified Pediatrician and fellow of the American Academy of Pediatrics. A mother of three, Dr. Hutton has been practicing pediatrics for over a decade in a private practice, and is a trusted partner to many parents in Maven’s community through our virtual clinic.

What are your top three tips for parents right now?

1. Stay home as much as possible, and practice social distancing. These social distancing orders are serious and they’re to protect you and your kids and others that you love.
2. Stay calm. Try not to get too anxious because your anxiety will only make things worse. Try to limit news sources at home particularly around children because they will absorb graphic images and the anxiety and negativity from news programs, especially on TV.
3. Get outdoors and have fun with your kids! This is the type of quality time that some parents—if under better circumstances—would love to have with their children. So try to enjoy what you can.

What do parents need to know about the Multisystem Inflammatory Syndrome in Children (MIS-C) associated with COVID-19?

Multisystem Inflammatory Syndrome in Children (MIS-C) is a condition where different body parts can become inflamed. While we do not yet know much about MIS-C or what causes it, the children who have presented with this condition have tested positive for the virus that causes COVID-19 or were exposed to someone infected. It is important to know that while there have been deaths associated with MIS-C, and it must be taken seriously, most children who have been diagnosed with this condition have gotten better with medical care. The CDC is keeping all parents informed here on the latest information, findings, and guidance.

The CDC recommends that you seek emergency care right away if your child is showing any of these emergency warning signs of MIS-C or other concerning signs:

• Trouble breathing
• Pain or pressure in the chest that does not go away
• New confusion
• Inability to wake or stay awake
• Bluish lips or face
• Severe abdominal pain

What do we know so far about infants and COVID-19?  

The infant deaths that have occurred shouldn’t alarm parents. What we do know is that most kids with COVID-19 are either asymptomatic or have very mild symptoms, which was affirmed in a study published in late April in the journal Pediatrics. Infants—under age 1—are, however, more likely to be hospitalized or have more complications.

We are still learning. While COVID-19 is hitting kids harder than we had initially expected, they do still seem to be faring well.

What symptoms should parents be looking for in children for COVID-19?

• 20% of healthy children will be asymptomatic, so they will not have any symptoms whatsoever but they are good carriers, according to a recent study in Pediatrics
• The majority of children will show mild to moderate symptoms:
• mild symptoms are runny nose or a cough
• moderate symptoms are fever, runny nose, cough, and maybe diarrhea

This means that COVID-19 is going to look like a common cold to parents in children unless they have underlying conditions or lung issues.

What should parents be looking for in newborns? Can parents allow grandparents or other family to visit with and help take care of newborns?

For newborns, a fever is a big sign to keep an eye on. With the few infants who have gotten COVID-19 from contact or mothers who were sick, many of them did have a fever and/or had pneumonia symptoms such as cough, shortness of breath, poor feeding, and being really tired or lethargic.

I know people are starting to travel more and visit newborns, but I would definitely be cautious. Any newborn that gets a fever will be admitted to the hospital, and that can be very traumatic for a parent and for the newborn because often it includes blood and urine work, and sometimes even a spinal tap. I would definitely be cautious. If any potential visitors have had any contacts with those infected, known exposure, or have shown any symptoms whatsoever, then you should absolutely keep them away from the newborn.

If it's close family like grandparents or your siblings, if they haven't had any contact, they know they haven't had any exposure, and they haven't had any symptoms, I recommend talking through with the parents to determine what their preferences are and set expectations before visits. It’s ultimately their decision. It may be appropriate to allow family members to visit, wear a mask, and wash hands often.

What guidance can you share for parents of children with asthma or other lung conditions?

In kids with asthma, shortness of breath is common. Often kids won’t say “I can’t breathe” unless they’re old enough to vocalize that. You’ll see that they’re coughing so much that they can’t eat or they can’t finish a sentence. If you notice they’re coughing a lot more than usual, you should call your doctor.

If a child is currently on asthma medications or breathing treatments, you want to keep those going as usual. If there are any signs that things are worsening for your child in terms of their ability to breathe, you should call your pediatrician immediately. We do know that people with lung conditions are more susceptible for worse symptoms caused by COVID-19.

Through a telehealth visit, your doctor will assess risk with you and can guide you to in-person care if needed as we’ll want to manage any symptoms carefully and make sure you and your child get the help you need.

What is the latest guidance for wellness checkups and vaccinations?

Recently the American Academy of Pediatrics and the American Medical Association released a statement encouraging parents to continue to keep those well visits, particularly for vaccinations. With the pandemic we have seen pediatric well checks and vaccination rates drastically decreased, which is very concerning because when we all get back together with daycare and school, there could be other outbreaks of diseases such as measles that are preventable by vaccines if many parents and children are not staying on schedule with those.

It's also important for kids to keep their well checks if there's any underlying medical conditions, such as asthma, or if there are any growing problems or inflammatory diseases that need to be monitored closely. It's usually best for the pediatrician to see them in-person for a hands-on visit, but you can reach out for a telehealth conversation first to ask for their guidance and so that you know what to expect before going into the office. Keeping those well checks are recommended.

For older kids that don’t need vaccines, these well visits and checkups are great to do and just as effective through telehealth with your regular pediatrician or on Maven. Through video appointments, we can talk about developmental questions, nutrition, how to introduce different foods, and other concerns or questions.

What is top of mind for the parents that you’re speaking with?

Parents are concerned about how they can protect their children and their family. Our patients are asking about best practices for preventing the virus from getting into their house. Some best practices are to practice social distancing, wear a face mask when you leave your house, and continue to wash your hands and your childrens’ frequently.

Parents are also worried about how to talk to their kids about this. This is a huge event that will be remembered for decades and so having the children remember it in an appropriate way is a big concern, and not letting them get too bogged down by it.

How should parents talk to their children about COVID-19?

You definitely want to discuss it age-appropriately. Infants and toddlers go with the flow but they will play off of your emotions—so trying to stay calm and not anxious all the time is important.

School-age children and teenagers understand and absorb a lot, and they will play off your emotions also. Most of them are out of school now, so that’s a huge change in their daily lives and they likely have a lot of questions about it. They’re likely asking why they can’t see their friends, and how much longer this will be going on for as it now impacts their summer plans and activities as well.

Talking to your children about what is going on in a manner that doesn’t scare them too much but helps them understand the importance of the situation is best. For specific tips, the podcast ‘The Daily’ posted a great episode about talking to your kids about coronavirus that provides perfect guidance for parents.

What resources do you recommend for parents right now?

• The American Academy of Pediatrics has a great website for parents called healthychildren.org. They cover everything from how to talk about your kids about coronavirus, what to look for in your kids, or even questions like ongoing care without regular checkups. They have a Facebook page where they post almost daily updates and resources that are easy to understand and can be really helpful for parents.
• The CDC, of course, will give you straightforward answers and the latest facts.  
• I rely heavily on journals including Pediatrics or JAMA (the Journal of the American Medical Association). As care providers, we have to keep paying attention to those, as almost every week we’re getting a report of something new. For parents, a lot of reliable media outlets will have headlines about these studies and provide reports that share findings in a clear way from these medical journals.

Is there any treatment for children, or a vaccine?

There’s not a vaccine yet, but they’re working on it. In terms of treatments specifically for children, they haven’t tested the drugs in children that are now FDA-approved for adults and with those, we’re not entirely sure of the true benefits.

In terms of how to treat your child if they’re showing symptoms, it’s mostly symptomatically. You should, of course, call your doctor. It is okay to use ibuprofen for a fever, like you typically might, but be cautious not to overuse it with children. There had been a question of whether ibuprofen made COVID-19 worse which worried many parents, but the World Health Organization (WHO) and American Academy of Pediatrics said that, based on the information that we have, it does not worsen conditions and is safe to use ibuprofen for treating children.

How much has your practice and pediatrics changed over these recent months?

I’m a mom to three kids in addition to being a doctor, so this has definitely been a weird time across both sectors of work and home life. My practice has significantly changed. Usually this is a fairly busy time of the year for pediatrics with ongoing sick visits and checkups starting, but these have decreased drastically.

What precautions are pediatric doctors’ offices taking to keep children healthy while treating those who are sick?

We’ve restructured things in my clinic and many clinics to try to keep patients away from one another as much as possible:

• We’re seeing healthy children in the morning when the office has just been cleaned the night prior, and then seeing sick kids in the afternoon.
• If a practice has more than one office, they’re seeing well patients at one location and sick patients at the other location.
• We’ve made appointments longer so that there is only one family in the office at a time.
• We have a newborn room where only newborns go in, and we’re also using a separate entrance for newborns and their parents so they don’t use the same door or go through the waiting room.
• We have a room for only well patients, and we save one room for fevers so only kids with fevers go in that room.

For the staff, we look different than we usually do. We’re usually wearing normal clothes or maybe something friendly looking for the kids. But a lot of us now have gloves, masks, gowns, and other protective equipment on, so that looks scary for kids but it’s of course to keep us and them protected and healthy.

What’s working with your own family and kids to keep them occupied, engaged,  and active?

Mine are school-age so it’s difficult. But, of course, toddlers and infants are hard too because they are non-stop. For me, I am really trying to enjoy the time together. Typically I have three kids that are going in three different directions and we’re never home at the same time; we’re never eating dinner together. It’s fun to watch movies together, eat dinner together, go out and ride scooters together.

As a doctor and a mom, how are you managing your own self-care?

It’s important to eat healthy, get rest, sleep, and watch if you’re showing any signs of illness in yourself. It can be wearing to handle the stress from work, home, life, wearing multiple hats—so finding something that you enjoy is key. I love to read, so I’m making time to sit down and read.

Any final tips or resources?

Maven is a great resource. I want parents and families to know that we are here literally 24/7 if something is bothering you or you have googled too much and are feeling anxious or have concerns. Please reach out to us. We’d love to help.

Maven is here for you

Maven is a virtual clinic for women and families. If you have a specific question, or cannot get through to your doctor, you can schedule a virtual appointment to speak with Dr. Hutton or another Maven provider. There are more than 20 types of care providers available on Maven, including pediatricians, OB-GYNs, nurse practitioners, mental health specialists, doulas, and more.

To get started: Join Maven today. Download the Maven Clinic app (search for “Maven Clinic” in the iTunes or Google Play app store).

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Disclaimer: The information provided here is for educational purposes only. This information is not intended as legal advice or medical advice, and is provided on an “as is” and “as available” basis without any warranties of any kind. Moreover, due to rapidly changing developments, we make no warranty or guarantee concerning the accuracy or reliability of the content on this page. For the latest information regarding COVID-19, we refer you to the Centers for Disease Control and Prevention website (www.cdc.gov).