3 October 2020
ST. LOUIS (KMOV.com) — The year 2020 has been a difficult and confusing time for many families.
That includes parents with newborns who are trying to weigh the risks of letting loved ones meet their new baby, versus keeping them protected from COVID-19.
Neonatologist and Interim Chief Medical Officer at SSM Health Cardinal Glennon Dr. Marya Strand is offering some context and perspective for parents struggling with the anxiety of keeping their children under the age of one healthy and safe.
“Typically, we think of little babies being at higher risk of complications with flu or RSV or other seasonal illnesses, but it seems COVID has spared that smallest age group,” said Strand.
Statistics from the CDC supports that.
As of Sept. 25, 20 children under the age of one died and tested positive for COVID-19 in the United States. Compare that to the most at-risk group – those over the age of 85 – where more than 59,000 have died and tested positive. In the middle of the age range, there are more than 10,000 deaths for 45-54-year-olds.
With the mortality rate being relatively low for children under the age of one who contract coronavirus, some are wondering if they are doing more harm than good in keeping their child isolated in the bubble of immediate family only.
“There are two parts to that question in my mind to that question,” said Strand. “One is the immunological question of ‘Is he out sitting in the grass and playing in dirt and exposing himself to all of these antigens in nature that will help his immune system develop? Is he getting his vaccines from his pediatrician to protect him from those illnesses that we know are highly transmissible and highly dangerous to kids?’ He can augment his immunologic self in ways other than being exposed to the common cold.”
Strand adds, “to me, the second part of that question that we didn’t really vocalize is developmentally. ‘How do these kids do when they have been staying in their small bubble?'”
“I think we as parents and care providers and as a community need to be mindful about the importance of socialization for these infants and toddlers, making sure they understand people are safe, even if they are wearing masks, making sure they understand community is important, even if we are keeping to ourselves in our house most of the time these days.”
The influenza vaccine, commonly called the flu shot, is not recommended for children younger than six months. Strand says the same will likely be true for a COVID-19 vaccine.
“I do not anticipate infants will be eligible for the COVID vaccine for a multitude of reasons. One being, they are not being tested. They are not in the phase three trials at this point that I’m aware of and number two, they’re not the high-risk groups,” she said. “The production of vaccine is expensive and you want to get it to the right people who are at the highest risk and that’s not infants.”
By now, people have heard conflicting reports about the transmission of COVID-19 in young people, especially infants. Some suggest children do not breathe powerfully enough to spread the respiratory virus while another showed children who tested positive for COVID-19 have a higher concentration in their nose.
Strand said both can be true.
“I have big lungs and strong diaphragm, so I get flow that moves very quickly in and out of my raspatory track. Infants just don’t have that same rigidity of the chest wall. It just isn’t quite the same. So do they have a mucosal load of the virus that just hangs out there? And so it just doesn’t get transmitted out of the body or out of the lower respiratory tract? I don’t think again we have great knowledge about the transmission. But I don’t think saying they have an increased viral load and that they don’t transmit are necessarily opposites or impossible to coexist,” said Strand.
As we approach cold and flu season and as some children enter the teething phase of infancy, it can be difficult for parents to know whether their baby is showing symptoms of a common bug or COVID-19, and especially when to take their child to get the uncomfortable COVID test.
“You have to think, ‘What will the results do for us?’ If you have an infant who has a fever and may a little cough, how are you going to treat them differently if they have a teething fever, if they have influenza, or if they have COVID? I really encourage people to go to their pediatrician and not say, ‘I need a COVID test,’ but to call their pediatrician and say ‘This is what I’m seeing, how do we as a team of care providers think about what the best next step is for this child?’ If it’s mild symptoms, not causing significant discomfort, just a little fussy, maybe they don’t need to be tested for anything at all. Sometimes we have to live with the ambiguity of ‘Well they have something, we don’t know what it is.'”
However, Strand stresses that if your child has a consistent fever, is having trouble breathing, or is showing other concerning symptoms, do not hesitate to take them to the emergency room because of COVID.
“Hospitals are very safe right now. Everyone entering through those doors is being screened,” said Dr. Strand.
In the end, Dr. Strand says parents should remain vigilant about hand hygiene, mask-wearing, and minimizing exposure.
However, she said parents of children without underlying conditions should not let fear interfere with fulfilling their family needs, like going to the store to buy milk or bread.
“I think that we have every indication that the vast majority of those kids are going to do well through this pandemic,” said Strand.
Source: kmov.com