Tracy Evans-Gilbert | Keeping children healthy during COVID-19 pandemic

The direct effect of COVID-19 on children appears less severe when compared with adults. A small per cent may have severe presentations, especially those with underlying health conditions. Rarely, healthy children with COVID-19 develop inflammation throughout the body, leading to organ damage if left untreated. This condition is called “multisystem inflammatory syndrome in children”(MIS-C), and according to the World Health Organization, affects children up to age 19 years. Adhering to hand hygiene, social distancing, and the wearing of masks are among measures to keep children safe.

There are some indirect health risks to children and adolescents while they stay at home that can have adverse outcomes on their health. Here are some other ways to keep our children safe and healthy during the pandemic.

NUTRITION

Children are at risk of being undernourished. A UNICEF study during the pandemic among 500 Jamaican households with children revealed that about 80 per cent had a reduction in income more so in the lower socio-economic bracket. School closures reduced access to school-feeding programmes, and 45 per cent of households surveyed experienced food shortages, especially in female-headed households and households with two or more children.

The following are some suggestions to avert undernutrition:

• In the Caribbean, the multimix principle is about choosing foods from different groups and putting them together to make nutritious meals. Using what is available locally, families can combine food groups to make one-pot meals, enriched porridges, stews, and soups. Four foundation groups are legumes and nuts, food from animals, vegetables, and staples. When combined, they provide the highest nutritional content. A triple-mix meal would be rice and peas and vegetables, and a double-mix meal would be mackerel and green bananas.

• Families are encouraged to use limited resources to shop wisely in the market, purchasing more affordable produce; sharing seasonal foods, which they may have in excess; or starting a backyard garden.

• Use networks to reach out to churches, other family members, or social-support services.

• Ensure that your child has regular checkups at the clinic to monitor his or her growth.

Another form of poor nutrition is the risk of becoming overweight. The UNICEF study also highlighted that among the 500 households surveyed, 40 per cent of children were not getting any exercise and had twice as much screen time. Virtual learning has little or no physical education scheduled and reduces the activities for getting to and from school or physical activity during break time. Less exercise and a change of routine can also affect sleep patterns, affecting a child’s metabolism.

To reduce the risk of obesity:

• Avoid unhealthy sugary, salty, or processed snacks like chips, cookies, and sugary beverages.

• Encourage children to drink water with and between meals to aid digestion and maintain hydration.

• Provide balanced meals, ensuring complementary foods from each food group, and encourage routine mealtimes.

• Have healthy snack options such as fruit instead of cookies.

• Schedule at least 60 minutes daily of outdoor activity in a safe space.

• Reduce inactivity. Children should take time to stretch, stand, or walk around when seated for a prolonged period.

SCREEN TIME

Virtual learning mandates the need for productive screen time. Children may be using devices outside of class activities. In the UNICEF study in Jamaican children, 12 per cent of parents never/seldom monitored their children’s screen time, making them vulnerable to inappropriate content. Too much screen time can cause eye strain, eye fatigue, and dry, irritated eyes. Research shows that the blue light alters the brain’s sleep rhythms when used close to bedtime. The brain thinks the screen light is daylight and affects having a good night’s sleep. In young children, screen time above two hours can cause behavioural problems and affect their ability to focus.

To protect your children:

• Adjust room lighting or screen lighting, and increase the contrast on the screen to reduce eye strain.

• Keep the computer screen about an arm’s length, or 25 inches, away from the eyes as the eyes work harder when the screen is close to the face.

• Adjust the monitor height so that the top of the screen is at or slightly below eye level. The angle of the screen should have your child looking slightly downward.

• The American Ophthalmological Society recommends using the 20-20-20 rule to reduce eye strain. Take a break every 20 minutes by looking at an object 20 feet away for 20 seconds. This gives their eyes a break and allows them to refocus.

• For a good night’s rest, turn off devices at least an hour before bedtime and charge the phone/device outside of the room.

• Set limits for screen time outside of class activities and for small children.

• Supervise screen time. Monitor what your child sees and hears.

EMOTIONAL HEALTH

The UNICEF study highlighted that during the pandemic, children experienced emotional issues such as anxiety, sadness, and fear. They said that they missed being with friends at school.

Here are some suggestions:

• Maintain a routine. Helping children wake up, go to sleep, and eat meals regularly provides them with a sense of stability. Encourage them to do outdoor activities or play a musical instrument

• Encourage them to stay connected with their friends.

• Create opportunities for your children to talk, but do not force them.

• Listen to your child’s thoughts and feelings and share some of yours.

• It is essential for children to feel that they can share their feelings and understand their fears and worries.

• Be alert for any behaviour change.

• Are children sleeping more or less? Are they withdrawing from friends or family?

• Any changes in behaviour may be signs that your child is having trouble and may need support.

CHILD ABUSE

Being at home increases vulnerability to abuse. Being away from school reduces the opportunity to report abuse to a guidance counsellor or friend. Parents need to ensure that their children are safe at home. Listen to their concerns and observe any behaviour change.

Children and teens should be aware of opportunities to reach out to a trusted adult or organisation such as the Child Protection and Family Service Agency (CPFSA). Contact CPFSA at 1888PROTECT Twitter, Instagram, and Facebook @cpfsajm. Parents can also utilise parish support helplines established by the National Parenting Support Commission (NPSC). For more information contact the NPSC at 876-967-7977.

Pay attention to these health and safety tips and optimise the well-being of our children and adolescents during COVID-19 pandemic.

- Dr Tracy Evans-Gilbert is a senior associate lecturer at The University of the West Indies and a consultant in paediatrics, tropical medicine and public health at the Cornwall Regional Hospital. Send feedback to tracybabydoc@gmail.com.