The Covid-19 induced flurry of changes are hopefully abating, as life slowly eases back to some semblance of normality (albeit with added precautions) since March this year. Nevertheless, many of us are still grappling with the short term and long term effects of Covid-19. The pandemic has left many parents also wondering about the impact the many lockdowns may have had on the health of their children. Has their immunity been compromised? Are they more susceptible to infections after the pandemic?
To help, Dr Lim Yin Sear and Dr Mahfuzah Mohamed, who are senior and guest lecturers respectively at Taylor’s University School of Medicine, lend their perspectives and expert advice as they unpackage this important topic.
Has there been an increase in infections, post-pandemic?
As a result of being stuck in the house, young kids have been less exposed to common bacteria and viruses, which ultimately causes their immune system to develop poorly. Generally, children have 8 to 10 respiratory tract infections per year, especially during early childhood and when they first start attending nursery or kindergarten (although it might feel like they’re always snotty and sick!).
As our children start to attend school, enrichment classes, and sports activities again, many young children have been falling ill with diseases such as influenza, hand-foot-and-mouth disease, and lung infections, leading to an elevated frequency of visits to the doctor. Currently though, there is no scientific data to show that children are more prone to infections after the pandemic.
What can cause a higher risk of infections?
Research has shown that unhealthy habits and other issues have unfortunately arisen due to the pandemic- resulting in known causes of vulnerabilities in children. Some of these issues include:
1. Children’s diet
A briefing by UNICEF on the impact of Covid-19 on children has shown that the prevalence of unhealthy diets, such as snacking, has increased. This may be due to a lack of easy access to fresh food and financial constraints, possibly leading to childhood obesity and malnourishment. A sedentary lifestyle and the lack of exercise could contribute to childhood obesity, escalating vulnerability to infections.
2. Immunisation disruption
Immunisations are of utmost importance for preventing certain infectious diseases. Another major issue that arose during the MCO period was the disruption of essential health services, including childhood immunisations. In a recent WHO pulse survey, 90% of countries reported disruptions to routine immunisations. Some children may also have been infected with Covid-19, despite getting immunised and are currently experiencing the ‘long COVID’ syndrome.
3. Mental health
Another important issue that needs to be taken seriously is the mental health of children and their caretakers. It has been observed that adults are more prone to infection when stressed. The Adverse Childhood experience (ACE) study showed that adverse childhood experiences in categories of abuse, household challenges and neglect are not only associated with worse mental health outcomes, but also with chronic health conditions such as diabetes, heart disease, chronic obstructive pulmonary disease, liver disease, and cancer.
Is your child immunocompromised?
If you suspect that your child is immunocompromised, it is advisable to seek professional advice. Here are some tell-tale signs of an immunocompromised child:
- Frequent and recurrent pneumonia, bronchitis, sinus infections, ear infections, meningitis, or skin infections
- Inflammation and infection of internal organs
- Blood disorders, such as low platelet count or anaemia
- Digestive problems, such as cramping, loss of appetite, nausea, and diarrhoea
- Delayed growth and development
- Autoimmune disorders, such as lupus, rheumatoid arthritis, or Type 1 diabetes
Should you give your child vitamin supplements?
Vitamin supplements have been gaining more attention, especially during the pandemic. In general though, children with a balanced diet and enough outdoor activities would be able to attain their daily requirement of nutrients. Vitamin D supplementation is only recommended for those who are unable to obtain an adequate amount of vitamin D from their diet, or have an inadequate exposure to sunlight. If your child (adolescents included) is not routinely exposed to sunlight, a minimum of 400 IU (10 µg/day) is recommended- especially among exclusively breastfed infants.
Do be conscious of the potentiality of Vitamin D toxicity if you are supplementing- with a daily Vitamin D intake of 2000IU or more predisposing individuals to Vitamin D toxicity.
Signs and symptoms of Vitamin D toxicity include:
- A metallic taste in one’s mouth
What can you do to reduce visits to the paediatrician?
Looking for practical ways you can help to safeguard your child’s health? Here are some tips that might help:
1) Act as a role model and take on a healthier lifestyle, such as having a three-meal-a-day diet.
3) Encourage your child to engage in at least 60 minutes of physical activity everyday.
4) Encourage routine sleeping habits.
5) Manage screen time (The American Academy of Paediatrics recommends no more than two hours of screen time for children and teenagers, and no screen time for children under the age of two).
6) Reschedule any missed health visits.
7) Do not buy over-the-counter antibiotics.
8) Do not reuse leftover medicine.
9) Seek opinions from your family physician or paediatrician, if your child is unwell
How can you create a clean (but not sterile) environment?
With an increased focus (and fear) of germs and viruses, some parents may be going to the extreme in creating a “super clean” environment, by forbidding their children to play or touch anything/anyone that has not been sanitised. Should this be the way going forward?
In the early years, our immune system was a blank canvas, and although infectious diseases were a legitimate cause for concern, our children need to develop an immunity to common pathogens. Overprotecting children from germs will be detrimental to their development- it’s all about the art of balancing between a clean environment, rather than a sterile environment!
And when you do need to need clean little hands, remember: studies have shown that soap and water is always a more effective option, compared to sanitisers. Sanitisers are recommended when washing with soap is not an option (we know how getting young toddlers to the toilet for a hand wash can be a bit of a drag!)
Here’s to us creating a cleaner, healthier and more positive environment for our children in this new normal, #makchicmumsquad.
Text by Taylor’s University School of Medicine senior lecturer of paediatrics, Dr Lim Yin Sear, and guest lecturer of paediatrics, Dr Mahfuzah Mohamed. The contents of the original article have been edited for brevity and clarity.