COVID-19: What Parents Need to Know

Q&A with Anita Juvvadi, MD, Stanford Children’s Health pediatrician with Juvvadi Pediatrics
Q&A with Anita Juvvadi, MD, Stanford Children’s Health pediatrician with Juvvadi Pediatrics

Original article updated on March 24, 2020 to accurately represent the evolving situation.

Ongoing news about the current outbreak of novel coronavirus (COVID-19), has parents wondering what they should do to keep their families protected. We sat down with Stanford Children’s Health pediatrician Anita Juvvadi, MD, with Juvvadi Pediatrics, to address the most common questions she is receiving from patients and their families.

Q: As a pediatrician, what are some of the most common questions you are hearing from patients and their families right now?

Dr. Juvvadi: The most common thing we are continuing to hear from parents is that their child has a fever and a cough, and they are wondering how worried they should be. Others are asking about exposure, concerned about one parent leaving the house to go to the grocery store and whether this could put the rest of the family at risk. The CDC is reporting that symptoms of COVID-19 are generally presenting as mild in children, but parents are asking if they would get a more severe version if they contracted it.

As the status of COVID-19 continues to evolve and we are hearing of more positive cases in the community, I am reminding families of the importance of staying at home according to the recommendations of their counties.

Q: In general, how susceptible are children to COVID-19?

Dr. Juvvadi: I want to reassure all families with young children that of the data from hundreds of thousands of cases, the pediatric age group is the least affected. So there is a very good chance that your child will not be severely affected even if exposed.

That said, with the general exposure to COVID-19 through mucus membranes, any human being could be susceptible to the disease. Because we know that the virus seems to cause a pneumonia, for children with severe asthma or a congenital heart problem, we are recommending parents take extra precautions right now.

Q: If a child exhibits flu-like symptoms, how do parents know whether the child has COVID-19 versus flu or a seasonal cold?

Dr. Juvvadi: If your child has a fever, cough, congestion, goopy eyes, stomach pain, nausea and vomiting, please contact your pediatrician for further evaluation. These visits can be conducted over the phone, or in some cases, virtually, using telehealth. If your doctor feels that the symptoms may be indicative of COVID-19, they can help arrange for your child to be tested at a designated facility. In accordance with recommendations from the CDC, before heading to urgent care or the ER directly, speak with your pediatrician to discuss if testing is warranted and find out if there is a local facility that does drive through testing.

Q: Should I cancel my child’s upcoming well-child visit if he or she is otherwise healthy?

Dr. Juvvadi: If your child is due for a vaccination, it is a good idea to keep your appointment, especially if he or she is under the age of two. The last thing we want to see right now is an outbreak of another disease, and we highly recommend that children get the required immunizations to protect their immune systems from other serious illnesses.

However, you should check with your pediatrician to determine whether they have adjusted schedules or designated times for well-child exams. In my office, I am conducting only well-child exams in the morning hours, and reserving the remainder of the day for sick visits. In addition, we are postponing all older children’s well exams that do not include vaccines that are due urgently.

At this time, we are recommending that patient families explore telehealth options for doctor visits whenever possible.

Q: What should parents be doing at home to protect against the virus?

Dr. Juvvadi: In general, practice good handwashing techniques, cover your cough within your elbow, and only wear a mask if you have a flu virus or a runny nose. It is not an exaggeration that most viruses are avoidable with good handwashing. How do you think doctors and nurses stay healthy?!

While there is no need to stock up on everything, if you have young children at home, it is a good idea to have at least two weeks’ worth of infant formula, diapers, wipes, and baby food if your baby is eating solids.

Follow the standard handwashing protocols, and during flu season we always want to remind kids to avoid touching their nose, eyes, and mouth.

Q: What medicines should I have on hand to be prepared in case my child contracts COVID-19?

Dr. Juvvadi: We are hearing that acetaminophen may be better than ibuprofen for the treatment of most coronaviruses, so make sure you have that at home in a preparation that your child likes. I also recommend keeping over-the-counter cough and cold medications, lozenges and herbal tea handy. Most importantly, if your child has asthma, make sure you have enough refills on the medications that they need.

Q: If I have a new baby at home, are there extra precautions we should be taking right now?

Dr. Juvvadi: If you have a newborn, continue to follow your usual hand hygiene practices, breastfeed your baby if possible, and make sure baby gets plenty of sunlight and fresh air. It is a good idea to use antibacterial wipes to wipe down countertops and diaper-changing stations once a day.

Q: If a woman who is pregnant or breastfeeding becomes sick, should she be concerned that her baby could contract COVID-19?

Dr. Juvvadi: According to the CDC, “in limited case series reported to date, no evidence of virus has been found in the breast milk of women with COVID-19. No information is available on the transmission of the virus that causes COVID-19 through breast milk (i.e., whether infectious virus is present in the breast milk of an infected woman).”

In most cases where mom is exposed to a virus or has any symptoms, we recommend that the best thing she can do is continue to breastfeed baby if possible, because through breastmilk, the baby receives the antibodies that mom’s body is producing. Historically, we have seen that with cases of influenza and other viruses, a baby who is breastfed tends to have the mildest version of the illness among anyone else in the family.

We don’t have enough information right now about adverse pregnancy outcomes in pregnant women with COVID-19. If you are pregnant, you should practice the usual preventive actions to avoid infection, like frequent handwashing, and avoid spending time with people who are sick.

Q: Do you have suggestions for activities that can keep kids busy at home during school closures and activity cancellations?

Dr. Juvvadi: Please continue to spend time outdoors, as long as you are able to maintain appropriate social distancing. The fresh air is good for kids, and for you as parents. Letting kids be active is the best thing we can do for them right now. Finger painting and sidewalk chalk are always fun—you can never have enough hopscotch! Now is also a great time to plant vegetables and herbs in the backyard that can be enjoyed this summer.

Indoors, this is a time to get creative!

  • Kids of all ages can help with cooking. Little ones can mix salads, find green vegetables in the fridge, help mix batter for baking or load the dishwasher. Older kids can research ingredients shown to boost immunity or help prevent respiratory infections (turmeric, garlic, ginger and vitamin C rich fruits and vegetables are good examples)
  • Use leftover Halloween face paint to draw a T-zone on kids’ faces and see how long they last without touching the paint; the one that holds out the longest wins
  • Set up competitions between family members to do squats one day, pushups and jump rope another
  • Establish a family book club
  • Challenge each other to invent a new card game
  • This is a great time for kids (and adults!) to clean out their closets of clothes, toys and books that they no longer need and make bags that can be donated after the shelter-in-place period ends

Information for patients with complex care needs

At Stanford Children’s Health, a significant number of our patients have complex medical conditions. At this time, we are not yet sure if specific underlying medical conditions are associated with worsened disease in children. In older adults, certain preexisting health problems are associated with more severe cases of COVID-19. Currently, Stanford Children’s Health care teams are advising pediatric patients with existing medical conditions to follow the same guidelines that are in place for all children, including social distancing and thorough handwashing. Parents should contact their pediatrician if their child shows signs of COVID-19, and follow their doctor’s directions on obtaining testing if appropriate. Parents of patients with subspecialty needs should call their subspecialty providers if their child is diagnosed with or being tested for COVID-19, so that their care team can advise them in real time.

For the latest information about COVID-19, please visit: http://coronavirus.stanfordchildrens.org

Authors

10 Responses to “COVID-19: What Parents Need to Know”

  1. Elewelt

    1.Do not participate in various public activities.
    2.Wear a Disposable Corona virus Medical face mask and wash your hands.
    3.Actively detect your physical condition.
    4.Keep your home environment clean

    Reply
  2. Medha Goli

    Thanks for sharing this! Very helpful!

    Are there any more detailed guidelines for kids with heart and lung conditions and which specific conditions pose the most risk?

    Reply
    • Julienne Jenkins

      Thank you for your question. At this time, we recommend that you contact your child’s provider for specific questions related to COVID-19.

      Reply
  3. Stephanie Mottard

    Thank you for this information. I am a Licensed Family Child Care Provider and will be forwarding this information to my families.

    Reply
  4. Susan Tuohy

    My grandson attends pre-school in San Francisco. I am “elderly” (72) and healthy, with no underlying conditions. My daughter thinks it may be risky for my health to babysit him, due to Covid 19. Is that correct?
    It would be fantastic if you & UCSF could host a Q & A page.

    Reply
    • Julienne Jenkins

      Thank you for your question. We are unable to provide medical guidance on this platform, and recommend that you contact your health care provider for specific questions related to COVID-19.

      Reply
  5. Suzanne Vincent MD

    Thanks for your input. I am a practicing pediatrician and am glad to have slant on things from another part of the country. You views and thoughts are exactly what I have been telling my patients

    Reply
  6. Stephanie L Ruckel

    I am currently 34 weeks pregnant (a health, normal pregnancy). My family has no other risk factors. Should I pull my 3 year old out of daycare? I’ll be working from home with my 5 year old whose school was cancelled. I’m concerned about him bringing home germs.

    Reply
    • Julienne Jenkins

      Thank you for your question. At this time, we recommend that you contact your child’s provider for specific questions related to COVID-19.

      Reply

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