Parenting in a Pandemic: Tips From a Pediatrician

Kelly Fradin’10 is a pediatrician and mother of two from New York City. Her career has focused on children with chronic medical conditions and school health. She wrote the book titled “Parenting in a Pandemic: How to Help Your Family Through COVID-19” to provide calm, realistic, and evidence-based advice to families during this stressful time. 

Q: When you were 3, you were diagnosed with bilateral Wilms Tumor, a rare kidney cancer. You write how your health problems were in some ways harder on your mother than on yourself. How has that experience informed your perspective on parenting during COVID-19?

A: Having been on the patient side of receiving care certainly has made me a better doctor. When a child’s health and well-being are in jeopardy, parents experience a unique level of stress and fear. Personally, I have seen how worried my parents are about me even now as a healthy adult. Understanding this perspective has enriched my ability to be a pediatrician as parents do feel more fear even with “minor” common medical issues like asthma.

Now during the pandemic, addressing parents’ knee-jerk worry about their kids has been an important focus. Many parents have agonized over the social, developmental, and immunologic implications of the pandemic, and addressing those concerns helps parents worry less. Luckily the data on children, while still limited regarding long-term consequences, is reassuring. Once we put parents’ minds at ease, we can change the conversation from making decisions reactively based on panic to proactively based on our commitment to our broader community’s well-being.

 

Q: Parents want to know if it is safe or wise to send their students back to school. What do you recommend?

A: I have been a vocal advocate for schools reopening with precautions and staying open. The preliminary evidence shows they haven’t contributed to community spread as indoor dining and bars have. That said, when parents are faced with the decisions for their family, there is an entirely different calculus. Before making the decision, I encourage parents to take a true inventory of their family. Remote schooling children while working full time remotely is not sustainable for many parents. The reality is that many children require substantial support and can’t simply be plugged in. If you want your children to have some social contact, the structured environment of school with precautions in place may be safer for your family rather than putting together playdates or using sports teams where precautions may not be as thoughtful. Lastly, I would say that if you’ve decided to keep your children remote, many children have thrived during schooling at home. Though I advocate for in-person schooling to be prioritized, I don’t mean to imply that a child can’t have a positive experience learning at home. Frequently parents minimize the rich social and emotional development that family dinners and board games at home can provide.

 

Q: You write that prioritizing parental self-care is the most essential advice you can give. What do you tell parents who say their top priority is not themselves but their children?

Parents set the tone for their children. Most parents are overstretched with increased commitments to oversee remote schooling or handle more coronavirus induced crises at work at a time when parents have fewer resources for physical and emotional support. When this was billed as two weeks to flatten the curve, you can do anything for two weeks. But as the length of the pandemic wears on us, we can’t pretend the stress doesn’t have an impact.

Parental martyrdom has consequences. One of the most obvious is exposure to coronavirus. A 40-year-old parent is at approximately 100x higher risk than a 4-year-old from a complication due to coronavirus. I’ve seen many parents sitting on the sidelines watching children play sports during the pandemic or seen parents choose to avoid school and accept a pod of children and caregivers entering their home.

Regarding mental health, anxiety is contagious. The children I have seen struggling most with coronavirus are the ones whose parents are also unsettled. Anxious or depressed parents will have more trouble coping and making the many decisions we’re all facing during this time. The truth is, it’s because you want the best for your children that keeping yourself well-cared-for is so essential. In the long run, one of a parent’s most important responsibilities is to be a role model. Your children will learn how to set boundaries and how to care for themselves from you. So, what do you want them to do when they are parents?

 

Q: Have any of your parenting recommendations or concerns changed as the COVID-19 pandemic has evolved?

I wrote the whole book in July, and my biggest worry was that we would have earth-shattering findings come out subsequently to make the book’s recommendations incorrect or misleading. But thankfully that hasn’t been the case. What I understood about coronavirus early on has continued to be more or less correct. For example, last summer I estimated that fewer than 3/10,000 children with coronavirus would develop MIS-C, the late-immune reaction to COVID-19 that lands children in the ICU. Last month, a paper formally estimated 1.1/10,000. Obviously, my number was off, but close enough to help families with their approach to quantifying risk.

Many parents have felt overwhelmed at times because the media narrative emphasizes the unknowns and highlights changes. But in terms of information that drives your day-to-day decisions, we know what we need to know about coronavirus: masking, distancing, and spending time in well-ventilated environments are the keys to preventing infections.

A big portion of my book is spent on the mental health fallout from the pandemic. The data that has come out since the book validates my concern. The isolation and stress has caused a second pandemic of mental health concerns. Depression, anxiety, suicidality, substance abuse, and domestic violence are all surging. So soldiering on through the coming months of pandemic life before vaccines begin to save the day, I’d encourage every parent to ask for help from their community and check in with loved ones to help us make it through.

 

Q: Do you have any grandparenting advice for those who cannot see their grandchildren in person as they once did?

A: I would ask the grandparents to hang in there and line up for the vaccines as soon as they are available. The silver lining is that technology has provided us with some resources to stay connected though we’re apart. I would encourage grandparents to learn or obtain help to learn how to best utilize these resources. I would encourage setting up weekly dates to share a meal with your family; it may be messy, loud, or chaotic, but the routine and predictability of it can be comforting to everyone. More than FaceTime, you can read books, play Scrabble or chess with your grandchildren, and sometimes having an activity can keep children more functionally engaged.

 

Q: Is there anything else you would like to share with fellow alumni?

A: Transitioning from academics to public health and now from medicine to writing and public speaking work has reminded me of the fun of new challenges. I would encourage all alumni to follow their interests and passions; when you find a project you’re passionate about it doesn’t feel quite so much like work. Developing new skills mid-career can be engaging and fun. Additionally, when considering opportunities like this, don’t forget about the power of your alumni network. Some of the most helpful connections promoting my book and supporting my work have come from my undergraduate and medical school colleagues.

 

Visit Dr. Fradin’s website, Advice I Give My Friendsand join her more than 24,000 followers on Instagram