7 ways to help kids cope with Coronavirus (COVID-19) anxiety

If the ongoing spread of Coronavirus (COVID-19) is causing anxiety, stress and uncertainty for grownups, consider how troubling it may be for children.

Depending on their age and media exposure, children may know more about the virus than grownups think. And even if unaware, children still might sense tension and anxiety from adults around them.

Here, CHOC Children’s pediatric psychologist Dr. Sabrina Stutz offers seven things parents can do to help reduce their children’s anxiety about COVID-19.

Meet children’s concerns with validation, compassion

  • Listen carefully to their concerns and learn where they heard their information. Validate their fears by saying something like, “It can be frightening when a new illness comes around that we don’t know everything about.”
  • Gently correct any misconceptions they may have heard and encourage them to continue to ask questions.
  • Maintaining a routine can provide children a sense of security. Keeping a usual schedule – including school, activities and chores – will protect mental and physical health.

Stick to developmentally appropriate facts

  • ​Avoid having adult-level conversations about COVID-19 around children. Similarly, carefully monitor children’s exposure to media reports about the virus.
  • Answer questions with brief, developmentally appropriate explanations. For example, you might tell a young child, “Coronavirus is a new type of cold/flu, and so it is important for us to wash our hands more and sneeze in our elbows to keep healthy.”
  • Remind children that doctors and other experts around the world are working hard to stop the virus. This can help kids understand that smart, capable people are taking action.

Reassure kids by empowering them

  • Telling kids how they can help provides a sense of agency and can turn anxiety into an actionable goal.
  • Reassure children that they can protect themselves and others by practicing proper hand-washing and cough etiquette and taking other healthy steps.
  • Kids can also be included in other family-wide preparations. For example, if you were preparing for the possibility of being home for a while, ask the child what they might want to snack on or what activities they might enjoy during that time.

Look for kid-friendly methods

  • Make learning about hand-washing and other preventative measures fun. Help kids learn about germs by giving them some lotion and then sprinkling glitter on their hands. Tel them the glitter is like germs, and then ask the child to try to wipe it off with a paper towel or just water. They won’t get far! Then you can explain how soap and warm water removes the glitter – and germs – best.
  • Teach kids how long to wash hands for by singing a 20- to 30-second song together. “Happy Birthday” or the “ABCs” are classics. You can also be creative and estimate 20-to-30 seconds of any song the child likes.

Emphasize kindness

  • As always, it is helpful to teach kids to continue to be kind to all people, regardless of their country of origin or their appearance. Kindness is always possible – even when they feel afraid.
  • To help children more realistically assess risk, educate children that most people who visit the doctor or wear a mask probably don’t have the virus.
  • It is important to remind children that we are all trying our best to stay healthy and it’s not anyone’s fault if they do get sick.

Remember to model positive behavior

  • Parents who show good coping skills can help reassure kids that they are safe. After all, kids learn from their parents how to react in new situations.
  • Remember that kids make mistakes. If your child accidentally does not wash their hands or doesn’t sneeze into their elbow, gently remind them. Scaring children with the potential consequences of their mistakes is not helpful.
  • Adults should model self-care behaviors: Maintain activities and sleep schedules. Eat healthfully and practice hand hygiene and cough etiquette.
  • It’s also helpful for grownups to limit their own media consumption around Coronavirus (COVID-19) and stick to a few trusted resources such as the Centers for Disease Control to prevent information overload and anxiety.

Watch for behavior changes

  • Changes in a child’s sleep, appetite, interest in being with friends or leaving the house, or levels of reassurance seeking, as well as excessive hand-washing can be signs that more help is needed.
  • If basic stress reduction techniques like deep breathing, distraction or guided imagery don’t help, reach out to your primary care provider for additional support.
Learn more about mental health services at CHOC

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Hand-washing 101

When kids and adults alike come into contact with germs, they can become infected just by touching their eyes, nose or mouth. Proper hand-washing is the best way to stop germs from spreading.

Don’t underestimate the power of hand-washing, says Dr. Reshmi Basu, a CHOC Children’s pediatrician.

pediatrician
Dr. Reshmi Basu, a CHOC Children’s pediatrician

“Besides getting an influenza vaccine, washing your hands is the single best way to protect yourself against illness, including the seasonal flu,” said Dr. Basu. “Hand-washing is much more effective in preventing the spread of infection than wearing a mask.”

In general, wearing masks in public does not prevent people from getting sick, according to the Journal of the American Medical Association. Masks may only be useful if you live with someone who is infected, and the mask use is started immediately after the person has become infected.

Improper hand-washing can also lead to food contamination and foodborne illnesses. But when, how long, and with what should we wash our hands? Dr. Basu offers tips for parents:

Hand wash rules

  • Use warm water and soap for best hand hygiene
  • Scrub vigorously, and remember the backs of hands, between the fingers, under the nails and the wrists.
  • Wash your hands for at least 20 seconds — or the time it takes to sing “Happy birthday” twice
  • Rinse and dry with a clean towel

When to wash your hands

It’s important to wash your hands frequently throughout the day. However, a few times it’s especially needed:

  • Before and after cooking or eating
  • After using the restroom
  • After cleaning around the house
  • After touching animals, including family pets
  • Before and after visiting or caring for sick friends or relatives
  • After blowing your nose, coughing or sneezing
  • After changing a diaper
  • After being outside — playing, gardening, walking the dog, etc.

What kind of hand soap is best?

Using a moisturizing hand soap is best during winter months, when more frequent hand-washing is necessary, Dr. Basu says. To avoid further drying out the skin, choose a soap labeled “moisturizing” or “conditioning,” she adds.

Are hand sanitizers OK?

The Centers for Disease Control recommends washing hands with soap and whatever whenever possible because hand-washing reduces the amounts of all types of germs and chemicals on hands.

But if you’re on the go, and soap and water aren’t available, use a hand sanitizer with at least 60% alcohol that will kill at least 99% of germs.

Learn more about CHOC’s Primary Care Network

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One family, two NICU stays

Each year, one in 10 babies in the U.S. are born prematurely. For the Cushing family, that statistic is two in two. Eleanor and Spencer’s eldest son, James, was born at just 24 weeks gestation. Their newest addition, Walter, was born at 31 weeks.

Today, both boys are doing well, thanks to respective stays in the CHOC Children’s small baby unit (SBU), a special unit within the neonatal intensive care unit (NICU) that focuses on caring for the unique needs of the smallest and sickest babies.

Big brother James

James Theodore was born at a local hospital weighing just 1 pound 6 ounces. He was transferred to CHOC when he was 1 day old and spent four and a half months in CHOC’s SBU.

james-birth-small-baby-unit
James, shortly after his birth.

James’ SBU stay – July to November – was filled with myriad health challenges, in addition to his goals of gaining weight and learning to breathe on his own. During his hospitalization, James fought off a bloodstream infection, was intubated multiple times to help him breathe, underwent a minor cardiac procedure and eye surgery, and worked through feeding challenges. By the time he graduated from the SBU, his weight was up to 6 pounds. He was discharged with supplemental oxygen and a pulse oximeter to monitor the oxygen levels in his blood and had multiple follow-up appointments to track his progress.

Throughout a lengthy hospitalization, CHOC staff made sure the Cushings still had the opportunity to celebrate traditional milestones with their new baby – including his first Halloween. He was dressed up as Winnie the Pooh – in a Build-A-Bear costume, since typical Halloween costumes were still too big for him. His parents and nurses donned coordinating outfits to round out the Hundred Acre Wood characters.

James is now 3 years old. He’s smaller than other kids his age and has a slight speech delay, along with a new prescription for glasses. But despite his early start in life, James is doing well.

Each year on James’ birthday, the Cushings return to CHOC’s SBU to visit the doctors and nurses who cared for him during his early days.

James visit_Dr. Bhakta
Each year on his birthday, James visits the CHOC staff who cared for him as an infant. He’s pictured here with his dad Spencer (left) and Dr. Kushal Bhakta, medical director of CHOC’s SBU.

“Despite James’ life-threatening obstacles, the SBU team was able to care for our son and save his life,” Eleanor says.

Little brother Walter

Due to her existing medical issues, Eleanor knew she would likely deliver early with any additional pregnancies. When she and Spencer were ready to add another child to their family, they switched medical plans so that she could eventually deliver at St. Joseph Hospital in Orange, right next door to CHOC’s expert neonatologists and other pediatric specialists.

Walter Rudolph was born at 31 weeks gestation and admitted to CHOC’s SBU, just like his older brother. At birth, he weighed just 3 pounds, 7 ounces. Walter’s goals in the SBU focused on growing and gaining weight. Six weeks after birth – and two weeks before his original due date – he was discharged from the hospital. In that time, he had grown to 5 pounds, 11 ounces.

walter_small baby unit
Eleanor holds her newborn son Walter, alongside smiling big brother James.

During Walter’s SBU stay, he was cared for by many of the same doctors, nurses, and developmental and respiratory therapists who cared for his older brother.

“When James was born, it was so nice to see so many familiar faces from our first SBU stay,” Eleanor says.

These familiar faces included Dr. Kushal Bhakta, medical director of CHOC’s SBU, and Dr. Michel Mikhael, a CHOC neonatologist.

“Our medical team was not only super smart, but they were also warm and compassionate,” Eleanor says. “There was always a theme with staff; they were always asking, ‘Do you have any questions? Can I get you anything?’”

Eleanor and Spencer are both nurses by trade, but at CHOC they got to focus on just being parents.

“Because of our medical backgrounds, we knew what the machines and monitors were doing, but we didn’t have to worry about any of that. We got to focus on just being parents,” Eleanor says.

walter-nicu-graduation
Walter, on his graduation day from CHOC’s NICU. His graduation cap was knit by CHOC volunteers, and his graduation certificate showcases his impressive growth in the NICU.

With two NICU stays behind her family, Eleanor’s message to CHOC staff is a simple one.

“Thank you to everyone who walked us through this journey,” she says. “We are a stronger family because of it.”

Learn more about CHOC's small baby unit

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