My youngest son's birthday falls about a week before the start of school, allowing his annual well-child appointment to double as a routine back-to-school checkup. At the end of each visit, I schedule next year's appointment, place it in the calendar on my phone and forget about it until the pediatrician's office sends me a reminder almost 365 days later.
When I got a call in early August about this year's appointment, I started to wonder if I should reschedule since Kyle won't be starting school in person due to COVID-19. The vaccinations and other exams recommended to start the school year didn't seem as urgent with Kyle going to school virtually.
Dr. Erik Shessler, a pediatrician at Children’s Hospital at Dartmouth-Hitchcock in New Hampshire, set me straight. Shessler said it’s imperative that we maintain those annual visits to the pediatrician even if our children are learning remotely.
“When schools are in session, pediatricians and families get the chance to work with school nurses and others involved in school health,” Shessler said. “With children learning virtually, we lose those connections. It's even more important now for parents to make sure that they’re keeping up with their well-child care immunizations because we don’t want to trade one pandemic for another.”
Shessler offers these tips for parents to ensure their children have a healthy school experience this year, no matter their mode of learning.
“Our health system is going to be taxed by COVID, and every year in the fall-winter timeframe, our health system is taxed by cases of flu,” Shessler said. “Since we don't currently have a vaccine for COVID, it’s that much more important to do all we can to prevent the flu.”
With schools being extra vigilant to prevent the spread of COVID-19, any cold symptoms that might have been dismissed in the past could be flagged as possible COVID-19 symptoms, and children will be sent home for the health and safety of others. “The more illnesses we can prevent, the less confusion we'll have as we go back into the school setting,” Shessler said.
Praising younger children for wearing masks can encourage them to keep their masks on during the day. Shessler said he likes to tell his younger patients that they’re acting like superheroes when they’re wearing their masks because they’re protecting others from germs. For older children, Shessler suggests appealing to their sense of altruism by noting how mask wearing can protect their friends and teachers.
Protect your mental health: All families have a unique set of circumstances that will influence their decision about how their child will learn this year, including health issues within the family and the family’s experience with remote learning last year. Those choices, no matter what they might be, could create stress for children, and parents should address any fears children might have about returning to school or staying at home longer than expected.
“It's okay to talk about what makes us stressed and anxious and be able to show how we handle the stressful situations,” Shessler said.
He recommends incorporating stress reduction exercises and open conversations into a family’s routine, along with disconnecting from excessive media consumption that could create additional stress.
Sleep: Remote learning eliminated the daily beginning- and end-of-school schedule that helped regulate our brains and bodies, and that lack of routine disrupted many children’s sleep schedules. With school back in session, parents should create a consistent sleep schedule for their children with a regular wake time and bedtime to help their kids get adequate sleep.
“I recommend shutting off everything electronic at least a half-hour to an hour before going to bed,” Shessler said. “It's hard to ask a brain that's constantly being stimulated to immediately fall asleep right afterwards.”
For those who struggle to fall asleep, downtime routines that help calm the body — including reading books, taking a bath and drinking a hot liquid — can be instituted to help promote good sleep.
A COVID-19-era well check
Shessler said having a trusted pediatrician to consult about general health issues and concerns, especially during this pandemic, can help put families at ease. It’s another good reason not to put off a well-child checkup.
With that advice in mind, I decided to keep Kyle’s late August appointment. When we arrived, I was pleased to see how the practice had instituted multiple physical distancing practices, including requiring masks and creating separate entrances for sick-child and well-child visits. We also had to check in while waiting in the car, and a nurse called me to tell us she was ready — only then could we enter the building.
“Hey buddy, I love your mask,” the nurse told Kyle. I could see through his eyes that he was smiling.
We went to the exam room, and after checking Kyle’s vitals, she closed the door and told us the doctor would be in shortly. Kyle stared at the closed door and pointed to a poster.
“Look, a superhero!”
There was an illustration of a child dressed in a cape and wearing a mask covering her nose and mouth. “My mask protects you, and your mask protects me,” the caption read.
Kyle got the message, and I couldn’t have planned it any better.