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NPN and Dr. Dave Drelicharz recorded a 30-minute Zoom discussion on delivery protocol, pediatric visits and telemedicine practice during the pandemic. Dr. Dave also fielded questions from the audience, specific to COVID-19, school and children as well as a bit on the current climate with the pending vaccination rollout. Please note the video starts 2 minutes into the segment as there was a glitch in recording in the beginning.

We sure know how to bundle up in the Midwest. We don’t let winter stop us from living life and enjoying the parks, zoos and fun outdoor activities. But it’s a lot of work to get all that winter gear on, and then there's that “no coats in car seats” rule. Madness! As a child passenger safety instructor at Lurie Children's Hospital (and a mom), I have some practical tips on how you can buckle in your kids safely and quickly during our never-ending winters. Why can’t my kid wear a coat in their car seat? Let’s start out with a refresher of how to buckle up safely. Kids should always be buckled into their car seat snugly. To check this, use the pinch test—once your child is buckled up, try to pinch some harness webbing between your finger and thumb near your child’s shoulder. If you can pinch some slack, the harness needs to be tightened until your fingers slide right off and you can’t pinch any extra webbing. Once kids are snug enough, pull the chest clip up to armpit level. Kids need to be snug because the harness will stretch during a crash. This stretching keeps our bodies from stopping too quickly. When a child wears anything bulky in the car, it creates too much space between their body and the car seat harness. If a crash happens, a child who is wearing a coat or snowsuit isn’t buckled in snugly enough to begin with, so when the harness stretches, that child can pop out of the car seat harness. Even if they don’t come out completely, their little body is subjected to too much movement and they are more likely to have head contact with the interior of the car or with another passenger. Sometimes parents try to solve this coat problem by pulling the car seat harness even tighter and squishing the coat material down. This doesn’t totally compress all the bulk though, and it can create a few other problems, too. We don’t want to overheat our babies and increase their risk of SIDS. Pulling the harness tighter when a child has a coat can also squish the coat material closer to their face, creating a suffocation risk for babies and young kids. Then how can I keep my kids from freezing during a polar vortex? There are lots of ways to keep kids warm in the car, but only one way to keep them safe in the car. And kids don’t freeze to death in the short time it takes to get out to the car, buckle up and start driving. The warm air will be blowing through those vents in a matter of minutes. Here’s what my family does on those bone-chilling days: Start the car to warm it up, but not in a garage (carbon monoxide!) Actually, I’m lying. I’m always running late, so I don’t have time to warm the car up. I totally skip this step. Put on coats and hats, then run out to the car. Get in and start the car. Yank those coats off and get buckled up. Now here’s the best part—you can put those coats back on! Toddlers and older kids can put their coats on backward, over the car seat harness or seat belt.* The hood will end up on the front of their body when you do this. Now the bulky material isn’t between your child’s body and their harness or seat belt. If they start to overheat, it’s easier to remove. But this isn’t safe for babies, because the coat and hood could create a suffocation hazard. So… Dress baby in thin layers. Once baby is buckled in, tuck a blanket around baby’s torso and under their arms so they can’t accidentally flip it up on their face and create a suffocation risk. Thin layers and blankets are okay for big kids, too. If you have an infant seat, bring the seat in overnight so it’s not cold when you go out to the car. Once you switch to a convertible seat, it isn’t practical to bring it inside, obviously. * This is advice for toddlers and big kids who have good head and neck control and who don’t have any special needs that could compromise their airway safety. Always listen to your pediatrician about your child’s individual needs and safety.

Every patient encounter I have these days ends with the question, “So, doc, what should I do about my child going to daycare or school?” The question is general, and yet very personal. Each family has to weigh the risks and benefits, the costs both financial and emotional, and the balance of work and child safety that affect them. While this is an individual decision, each family is part of a community; at this time, more than ever, each family has to share in the communal responsibility to keep all of our children safe. Social distancing, wearing a mask, hand washing — you’ve heard these measures multiple times. But what else can you do? Be mindful of the following suggestions to keep your family and others healthy. [Related: What to expect when you're expecting during Covid] Sniffles Certainly, not every sniffle in your child is going to be due to coronavirus, but you have to act as if it could be. This means keeping your child home from daycare or school if they have the sniffles to see what else, if anything, develops over the next few days. If nothing else develops, you will need to have a discussion with your pediatrician about when it is safe to resume normal activity. Fevers Fevers have always been a reason to stay home and take good care of yourself. Not every fever is due to coronavirus, but you have to consider that it could be. This means potentially seeking care from your pediatrician earlier than you might have before. We will be there to evaluate and treat for all of the other causes of fever, cough and pain, too. Please: No treating your child with Tylenol or Motrin to “cover the fever” just to send them to school that day. Flu vaccine Pediatricians have long recommended yearly flu vaccines to help protect your child and your whole family from getting influenza. This year, more than ever, getting the flu shot could help decrease the potential for two similar illnesses (i.e., influenza and coronavirus) to be circulating at the same time. The flu shot is safe, and while it isn’t always a perfect match, it gives you more fighting power against the flu than not getting the shot. [Related: Supporting your gifted child during Covid] Emotional health Know that you aren’t alone. Children of all ages show different signs of stress — stuttering, poor sleep, poor appetite, tummy aches, acid reflux, recurrent bedwetting, poor grades, experimenting with drugs or alcohol, etc. You may feel more alone this year without your network of class parents or friends to discuss your child’s behavior. Your pediatrician is there to help and should be your resource to discuss your concerns. This year may pose many challenges, but we all have the same goal: a healthy educational environment for your child.

Presenters Pamela Epley, PhD, and Jena Valdez, MS, Adjunct Professor, both of the Erikson Institute, offer practical guidance and strategies you can use to support social interactions, learning and development for young children with developmental differences during Covid-19. They will also cover the roles and responsibilities of the U.S. Office of Special Education Programs in supporting students with IEPs during remote and hybrid learning.

As the new school year approaches amid the Covid pandemic, we all find ourselves approaching it with a heightened sense of apprehension with a new normal of social interaction. The previous school year concluded with distance learning and parents temporarily thrust into educator roles and many are anxiously wondering what will happen this fall. It’s impossible to know what the future holds, and with no clear roadmap, parents who have been managing anxiety are now struggling. The coronavirus has caused significant disruptions to everyone’s daily life, and children are particularly feeling all of these changes as the new “normal” continues to shift. These changes come with a mix of new emotions as the new school year quickly approaches. Some may be hopeful with the excitement of in-person while others may be fearful of returning to the social stressors. Regardless, it is our job as caregivers to support our children in exploring their many feelings while providing a sense of calm to ease anxiety. But how can we do that in a time like this? [Related: 4 tips for managing your kids' coronavirus anxiety] We often try to soothe our children’s anxieties by having “all” the answers, and you may feel exhausted by trying to force things to be certain. In this situation, it is important to let go of control as nobody is sure of what the future of school looks like. Become a safe space for your child by bringing awareness to the uncomfortable feeling of uncertainty that we are all experiencing. This will be tough but worth it, as figuring out how to manage anxiety and tolerate the uneasy feeling are essential skills for everyone these days. Here are some tips on how to navigate conversations about the upcoming school year with your child. Empathize and validate. Encourage your child to express any fear or anxiety while letting them know that what they are feeling is normal. Use curiosity. Children may have fears revolving around bullying, e-learning, conflicts with friends, or being separated from you. Ask open questions and actively listen while talking through strategies to help your child improve problem-solving skills and feel empowered. Emphasize what is predictable. With the uncertainties of the method of schooling these days, focus on what a child can expect—learning new things, interacting with a teacher, etc. Continue practicing. Have the family wear a face mask at home in a variety of situations. This can be playing a board game, coloring, or watching a family movie. Doing this will help with not only the potential to return to classrooms but going to places like the grocery store. Shift back into a routine. Routines promote feelings of safety and can give a child a sense of control. Create an expected school routine by following bedtimes, getting ready in the morning, etc. [Related: Will my relationship survive this virus?] Provide reassurance. Revisit the safety measures in place to help keep children and teachers safe. This can ease anxiety about their safety in public spaces. Be honest. It’s okay not to have all the answers! We cannot solve all of our children’s problems, but sometimes they don’t need solutions—just to feel understood and supported. Admit that you wish you knew what the future of school looked like, but the reality is that you don’t. You are unable to make all the decisions now, but you will when you have the information you need. With honesty, you are sure not to make promises you can’t keep. Acknowledge the uneasiness. It is difficult to sit in the uncomfortable feeling of anxiety as we tend to avoid or resist it. Begin to notice and gently observe what is happening in your body to increase your ability to handle it. By doing this with your children, it will model that it is okay to feel this way—even grownups do! Focus on what you can control. It’s easy to get caught up in the unknown and “what ifs?” Notice when this is happening and gently shift to focusing on what is within your control to stay in the present moment. Be kind to yourself. Being a parent in the best of times is already the hardest job in the world. It is impossible to avoid anxiety right now but doing the best you can is all you can do!.

Looking back at the first phase of the COVID-19 pandemic, as much as I was telling myself that everything was OK, I was dealing with my own internal panic: I can’t go to Trader Joe’s anymore because they don’t do Instacart. Eek. I am going to have to live with Instacart never getting my grocery order right. Eek! I am not going to get any work done because I will have to share my workday schedule’s blocks of free time to homeschool. Eek. My kids won’t have their normal Saturday activities and are going to become brain-dead from too much screen time and no social interaction. Eek. I will never have any space or time for ME. EEK! I am going to have to spend Mother’s Day with my family and not at the spa. Eek, eek, eek! I am not going to be able to hang out with my girlfriends because we really should be just hanging out outside (this was early in March/April). Eek. I like to work out online, and if I don’t work out I am not going to fit into my summer clothes. Eek, eek, eek. Summer camp is canceled and I still have to work full-time so they are probably going to have one of the worst summers ever (major mommy guilt). EEK. I internalized my personal freak-out as to not add to the anxiety my friends were already experiencing (but definitely let my husband hear it a couple of times). In the absence of a full-on panic attack, these were the thoughts going through my head the first 45-60 days. There was no silver lining—just me holding on as tight as I could to “normal,” all while trying to help keep my family safe and healthy. [Related: Help your kids capture memories of this strange year] After a while, I unintentionally fell into a new groove—and one not marked by rushing home from school pick-up to do dinner and homework; one free from spending Saturdays running ragged trying to fit in grocery store shopping between kid activities. (Because yes, I am the mom who tries to fit in too much in an unreasonably small amount of time.) I slowly started to experience what I am calling my “pandemic slowdown”: Sleep: I was not waking up for 5am workouts after too little sleep, and I was allowing myself to wind down and actually get in the bed at a decent hour. Cleanliness: Something about a house out of sorts increases my stress level, so I became more consistent at doing a little every day to keep the house clean and neat, versus saving it all for Sunday afternoons and burning myself out. Not only did it bring my stress level down, but it actually allowed me to enjoy my home. Hobbies: Typically, I used vacations as an excuse to dive into books. But with nowhere to go, I fell back in love with reading light, fun fiction. I also discovered adult coloring books (great for mindless relaxing!). Exercise: Live Zoom classes are not that bad; they give me a sense of normalcy and something to look forward to in the absence of not yet being ready to go to the gym. I have actually grown to enjoy this new normal. While I have never been a fan of working from home, I appreciate the absence of fussing with the kids to wake up and get dressed, and then rushing home from work and doing homework and cooking. I choose not to think about the brain cells that my children are annihilating every day with the exorbitant amount of screen time they are getting because, at the end of the day, they are not going to die from it. I have physically felt myself slowing down. And although my 7- and 9-year-old can’t articulate it, I know that they have felt the slowdown, too (in the absence of Mommy and Daddy fussing at them to move faster and hurry up). [Related: A pediatrician's guide to keeping your kids—and your community—safe from flu and Covid] Now, don’t get me wrong. While the slowdown has been awesome for my physical and mental health, I still grapple with my fair share of mommy guilt. My kids are literally screen zombies for a ridiculous amount of time each day. I still give my husband the occasional side-eye when I feel like he is not doing his fair share. Homeschooling while working is still like oil and water. But at the end of the day, I feel blessed because when we do get back to normal (whatever that new normal will be), I know I am going to PAUSE and make sure that I am not just throwing my family back into the crazy tempo we once had. If there are any blessings from this pandemic, it will be me and my family slowing down and focusing a little bit more on what matters most. I hope that you are encouraged to do the same.