Emily Oster

7 min Read Emily Oster

Emily Oster

Pediatric COVID

Guest Opinion Post: Stop Scaring Parents — How to consider the long-term issues facing children

Emily Oster

7 min Read

Through the COVID-19 fog, I’ve gotten to know Dr Kelly Fradin, who’s a pediatrician and mom in NYC. I’ve found her a helpful voice of sanity in parenting and pediatric advice (she’s on Instagram at @adviceigivemyfriends). She wrote a book (seriously, DURING THE PANDEMIC SHE WROTE A WHOLE BOOK) for parents which I highly recommend, and not only because it references my newsletter. You can find it here: Parenting in a Pandemic: How to help your family through COVID-19 or in audiobook here.

She sent me the opinion post below, on how to think through some of the scary headlines around long term impacts of COVID on kids. I found it helpful in my own thinking and thought many of you might, also. These are hard issues to think and talk about, and we really do not have any answers. But perspective is important, and I value hers. So here you go!

Recently we’ve seen increases in documented cases of coronavirus in children. This surge represents both increased testing of children and increased cases of coronavirus nationally. We’re focused as a nation on the safety of our children and rightly so. Parents are really scared and confused. I hear from my friends, “I was planning to send my kids back to school and then I heard there may be a risk of long-term neurologic problems.” Articles suggesting many children will have chronic problems with their physical health secondary to the direct effects of COVID-19 border on fear-mongering.

As a pediatrician, I am not worried about the direct long-term effects of coronavirus for children. Before diving into why, I want to state my goal in reassuring you is not to diminish the true urgency of containing coronavirus. Nearly 170,000 people have died of coronavirus in the United States. While most of these are adults, 105 children have died. Masking, social distancing, and taking precautions to limit the spread of coronavirus are essential to protect our families and our larger community.

But it pains me to hear already over-stretched and over-stressed parents panicked about something that I do not consider a real threat. So I want to discuss long-term problems following coronavirus.

Several studies have been cited incorrectly to support these concerns. The Morbidity and Mortality Weekly report from the CDC published the results of a telephone survey that showed 20% of young adults experienced fatigue, cough, congestion and other symptoms 2-3 weeks after testing positive for coronavirus. What’s not emphasized is the likelihood that some of the individuals feeling better may have not elected to complete the survey so individuals with longer courses of symptoms may have been oversampled. Also, this finding is in the range of what we see following many other respiratory infections where symptoms like cough and fatigue can persist in 11-25% of adults for 3-8 weeks.

Similarly a study in Italy found that 87% of adults had persistent COVID-19 symptoms two weeks following discharge from the hospital. Another study highlighted that 55% of adults hospitalized for more than two weeks for coronavirus experienced neurologic problems even 3 months after infection. These articles highlight real and significant concerns for adults, particularly those unlucky enough to have severe coronavirus requiring hospitalization. A two week hospitalization for any reason reflects a truly major medical illness and will require substantial recovery. We track hospitalizations because they are undesirable outcomes and this further describes what we already know.

We shouldn’t discount individual experiences. The research and discussions of long-term problems following coronavirus are important because doctors have to meet the needs of these people as they recover. But these studies don’t change the fact that most children who catch coronavirus are asymptomatic and do quite well.

COVID-19 is new. We do not have long term follow up data to guide us, but we do have some clues. The CovKids Project estimates that 2.6 million children have already had coronavirus in the US alone. Internationally it’s another order of magnitude. Enough children have had COVID-19 for long enough that we have been able to identify the multi-system inflammatory syndrome (MIS-C) which is estimated to affect as many as 3 out of 10,000 children after infection.

So certainly we have not detected every possible issue, and we’ll have to continue studying children who present with unexpected issues such as those described by CNN. But it’s unlikely that we haven’t noticed a common problem. Most viral complications begin soon after infection so we would have detected surges in most complications by now. We know that almost all viruses have rare complications, every year people suffer from Guillain Barré Syndrome, Kawasaki Disease, transverse myelitis, myalgic encephalitis / chronic fatigue syndrome and other illnesses. Most parents haven’t heard of these terrible complications for a reason – they are extraordinarily rare.

Coronavirus has shown a propensity to cause vascular inflammation and heart damage in adults with severe infection requiring hospitalization, but we haven’t seen this in other groups and it seems unlikely that mild cases of coronavirus have any long-term heart issues. The heart damage induced by MIS-C has so far appeared to respond well to treatment.

Early in the pandemic, physicians in China used CT scans of the lungs to make a diagnosis of coronavirus. These showed some children with mild disease had changes in the lungs. CT scan is very sensitive to detect lung problems, frequently a child who has abdominal CT has unrelated issues noted in the bottom of the lungs. We haven’t yet heard whether these changes persist, but respiratory syncytial virus (RSV), a common respiratory infection in children, is known to cause damage to the lungs when children have it at a young age. Having RSV before age 2 can increase the risk of reactive airways or asthma that requires treatment. However we do see that as children’s lungs continue to grow until age 8, this damage is almost always outgrown. Could coronavirus cause something similar? Yes, but we have no reason to think that it would be more serious.

So what do I worry about with our children and coronavirus – mental health. Loneliness, screens, and disruption of our lives can all increase the risk of significant anxiety and depression. Parents who are stressed in every way may not have the bandwidth to take on the role of child therapist in addition to their other responsibilities.

I worry about our children’s general well-being. Kids are less active than normal due to restricted sports and decreased commutes to school. Physical activity is an important component of overall health and known to improve mental health, sleep and learning. I worry that kids will snack a lot at home and gain weight, as it’s been shown that most kids become overweight or obese during school vacations. If kids aren’t vaccinated, attending regular checkups or dental cleanings, they may suffer other preventable complications.

We must keep studying and learning, but as a parent and a pediatrician, I think we should put risks in perspective. If 1/10,000 children experience a rare long-term complication, it matters. It’s one child in a medium-sized town and doctors need a plan to optimize their care. But if 8% of children already have significant anxiety or depression before the pandemic and it increases 50% during the pandemic, it’s 1 extra child out of an average class. This change will affect a generation of children on a different scale.

The other reason to focus on these more statistically likely complications is that we can mitigate these risks. We can organize our schedules to prioritize sleep and exercise to promote mental health. We can check in with our children and ask for help early if we think their mental health is struggling. We can prioritize preventive healthcare.

Let’s do our best to follow facts, not fear.

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SLEEP DATA 💤 PART 2: Let’s talk about naps. Comment “Link” for an article on what we learned about daytime sleep!

The first three months of life are a chaotic combination of irregular napping, many naps, and a few brave or lucky souls who appear to have already arrived at a two-to-three nap schedule. Over the next few months, the naps consolidate to three and then to two. By the 10-to-12-month period, a very large share of kids are napping a consistent two naps per day. Over the period between 12 and 18 months, this shifts toward one nap. And then sometime in the range of 3 to 5 years, naps are dropped. What I think is perhaps most useful about this graph is it gives a lot of color to the average napping ages that we often hear. 

Note: Survey data came from the ParentData audience and users of the Nanit sleep monitor system. Both audiences skew higher-education and higher-income than the average, and mostly have younger children. The final sample is 14,919 children. For more insights on our respondents, read the full article.

SLEEP DATA 💤 PART 2: Let’s talk about naps. Comment “Link” for an article on what we learned about daytime sleep!

The first three months of life are a chaotic combination of irregular napping, many naps, and a few brave or lucky souls who appear to have already arrived at a two-to-three nap schedule. Over the next few months, the naps consolidate to three and then to two. By the 10-to-12-month period, a very large share of kids are napping a consistent two naps per day. Over the period between 12 and 18 months, this shifts toward one nap. And then sometime in the range of 3 to 5 years, naps are dropped. What I think is perhaps most useful about this graph is it gives a lot of color to the average napping ages that we often hear.

Note: Survey data came from the ParentData audience and users of the Nanit sleep monitor system. Both audiences skew higher-education and higher-income than the average, and mostly have younger children. The final sample is 14,919 children. For more insights on our respondents, read the full article.
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Happy Father’s Day to the Fathers and Father figures in our ParentData community! 

Tag a Dad who this holiday may be tricky for. We’re sending you love. 💛

Happy Father’s Day to the Fathers and Father figures in our ParentData community!

Tag a Dad who this holiday may be tricky for. We’re sending you love. 💛
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#parentdata #postpartum #postpartumdepression #paternalmentalhealth #newparents #emilyoster

“Whilst googling things like ‘new dad sad’ and ‘why am I crying new dad,’ I came across an article written by a doctor who had trouble connecting with his second child. I read the symptoms and felt an odd sense of relief.” Today we’re bringing back an essay by Kevin Maguire of @newfatherhood about his experience with paternal postpartum depression. We need to demystify these issues in order to change things for the better. Comment “Link” for a DM to read his full essay.

#parentdata #postpartum #postpartumdepression #paternalmentalhealth #newparents #emilyoster
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#emilyoster #parentdata #parentingcommunity #lookslikedaddy #lookslikemommy

What does the data say about children who look more like one parent? Do they also inherit more character traits and mannerisms from that parent? Let’s talk about it 🔎

#emilyoster #parentdata #parentingcommunity #lookslikedaddy #lookslikemommy
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SLEEP DATA 💤 We asked you all about your kids’ sleep—and got nearly 15,000 survey responses to better understand kids’ sleep patterns. Comment “Link” for an article that breaks down our findings!

This graph shows sleeping location by age. You’ll notice that for the first three months, most kids are in their own sleeping location in a parent’s room. Then, over the first year, this switches toward their own room. As kids age, sharing a room with a sibling becomes more common. 

Head to the newsletter for more and stay tuned for part two next week on naps! 🌙

#parentdata #emilyoster #childsleep #babysleep #parentingcommunity

SLEEP DATA 💤 We asked you all about your kids’ sleep—and got nearly 15,000 survey responses to better understand kids’ sleep patterns. Comment “Link” for an article that breaks down our findings!

This graph shows sleeping location by age. You’ll notice that for the first three months, most kids are in their own sleeping location in a parent’s room. Then, over the first year, this switches toward their own room. As kids age, sharing a room with a sibling becomes more common.

Head to the newsletter for more and stay tuned for part two next week on naps! 🌙

#parentdata #emilyoster #childsleep #babysleep #parentingcommunity
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Weekends are good for extra cups of ☕️ and listening to podcasts. I asked our team how they pod—most people said on walks or during chores. What about you?

Comment “Link” to subscribe to ParentData with Emily Oster, joined by some excellent guests.

#parentdata #parentdatapodcast #parentingpodcast #parentingtips #emilyoster

Weekends are good for extra cups of ☕️ and listening to podcasts. I asked our team how they pod—most people said on walks or during chores. What about you?

Comment “Link” to subscribe to ParentData with Emily Oster, joined by some excellent guests.

#parentdata #parentdatapodcast #parentingpodcast #parentingtips #emilyoster
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Humility. That’s why. That’s the whole reason.

#emilyoster #secondbaby #parentingjokes #parentinghumor

Humility. That’s why. That’s the whole reason.

#emilyoster #secondbaby #parentingjokes #parentinghumor
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Bug season is upon us. Besides annoyance, this can bring up safety concerns, particularly with ticks. They are carriers of diseases, most notably Lyme disease. So what’s the best course of action?

Prevention is key! I suggest:
⭐ Regular tick checks
⭐ Using bug sprays with DEET 
⭐ Wearing long sleeves and pants in the woods

Some parents worry about DEET, but repellants with up to 30% DEET are recommended by both the CDC and AAP. The data says you’re in the clear, so go for it. Enjoy your summer!

#parentdata #emilyoster #tickseason #bugbites #bugspray

Bug season is upon us. Besides annoyance, this can bring up safety concerns, particularly with ticks. They are carriers of diseases, most notably Lyme disease. So what’s the best course of action?

Prevention is key! I suggest:
⭐ Regular tick checks
⭐ Using bug sprays with DEET
⭐ Wearing long sleeves and pants in the woods

Some parents worry about DEET, but repellants with up to 30% DEET are recommended by both the CDC and AAP. The data says you’re in the clear, so go for it. Enjoy your summer!

#parentdata #emilyoster #tickseason #bugbites #bugspray
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The list of what not to do while pregnant feels longer than a CVS receipt. At ParentData, we want to empower you to make the right decisions for you. 

What an amazing group of women, and an honor to speak at the #MomsFirstSummit debunking parenting myths. 

What are some pregnancy rules you chose to bend after being empowered by data?

#emilyoster #parentdata #pregnancyproblems #pregnancymyths

The list of what not to do while pregnant feels longer than a CVS receipt. At ParentData, we want to empower you to make the right decisions for you.

What an amazing group of women, and an honor to speak at the #MomsFirstSummit debunking parenting myths.

What are some pregnancy rules you chose to bend after being empowered by data?

#emilyoster #parentdata #pregnancyproblems #pregnancymyths
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Looking for Memorial Day Weekend plans? Might be the perfect time to give potty training a shot. Potty training is notoriously difficult, and we unfortunately don’t have a lot of evidence-based guidance on what works best. So I asked the ParentData community to fill out a survey and share their knowledge — about 6,000 people responded.

👉Comment “Link” for a DM to an article that summarizes all of the best potty training advice we collected. 

Remember, you are not alone in the potty training struggle! It can be incredibly challenging, so please give yourself some grace.

#emilyoster #parentdata #pottytraining #pottytrainingtips #toddlertips

Looking for Memorial Day Weekend plans? Might be the perfect time to give potty training a shot. Potty training is notoriously difficult, and we unfortunately don’t have a lot of evidence-based guidance on what works best. So I asked the ParentData community to fill out a survey and share their knowledge — about 6,000 people responded.

👉Comment “Link” for a DM to an article that summarizes all of the best potty training advice we collected.

Remember, you are not alone in the potty training struggle! It can be incredibly challenging, so please give yourself some grace.

#emilyoster #parentdata #pottytraining #pottytrainingtips #toddlertips
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We’re hiring an Associate Editor at ParentData! More details at my link in bio. Please share with the great writers and data-loving people in your network. 📊💻

We’re hiring an Associate Editor at ParentData! More details at my link in bio. Please share with the great writers and data-loving people in your network. 📊💻 ...

Do you brand things a certain way to get your kid to accept it? Like calling carrots “rabbit popsicles”? Or telling them to put on their “super speed socks” in the morning? Share your rebrands in the comments below! You never know who you might be helping out 👇

#emilyoster #funnytweets #relatabletweets #parentingjokes #kidssaythedarndestthings

Do you brand things a certain way to get your kid to accept it? Like calling carrots “rabbit popsicles”? Or telling them to put on their “super speed socks” in the morning? Share your rebrands in the comments below! You never know who you might be helping out 👇

#emilyoster #funnytweets #relatabletweets #parentingjokes #kidssaythedarndestthings
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Have you ever panic-googled a parenting question when everyone else is asleep? If so, you’re not alone. 

Today is the first episode of a new biweekly series on my podcast: Late-Night Panic Google. On these mini-episodes, you’ll hear from some familiar names about the questions keeping them up at night, and how data can help. First up: @claireholt!

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#parentdata #emilyoster #claireholt #parentingstruggles #parentingtips #latenightpanicgoogle

Have you ever panic-googled a parenting question when everyone else is asleep? If so, you’re not alone.

Today is the first episode of a new biweekly series on my podcast: Late-Night Panic Google. On these mini-episodes, you’ll hear from some familiar names about the questions keeping them up at night, and how data can help. First up: @claireholt!

Listen and subscribe to ParentData with Emily Oster in your favorite podcast app 🎧

#parentdata #emilyoster #claireholt #parentingstruggles #parentingtips #latenightpanicgoogle
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Sun safety is a must for all ages, especially babies! Here are my tips for keeping your littlest ones protected in the sunshine:
☀️ Most importantly, limit their time out in hot weather. (They get hotter than you do!)
☀️ Keep them in the shade as much as possible when you’re out.
☀️ Long-sleeve but lightweight clothing is your friend, especially on the beach, where even in the shade you can get sunlight reflecting off different surfaces.
☀️ If you want to add a little sunscreen on their hands and feet? Go for it! But be mindful as baby skin tends to more prone to irritation.

Comment “Link” for a DM to an article on the data around sun and heat exposure for babies.

#sunsafety #babysunscreen #babyhealth #parentdata #emilyoster

Sun safety is a must for all ages, especially babies! Here are my tips for keeping your littlest ones protected in the sunshine:
☀️ Most importantly, limit their time out in hot weather. (They get hotter than you do!)
☀️ Keep them in the shade as much as possible when you’re out.
☀️ Long-sleeve but lightweight clothing is your friend, especially on the beach, where even in the shade you can get sunlight reflecting off different surfaces.
☀️ If you want to add a little sunscreen on their hands and feet? Go for it! But be mindful as baby skin tends to more prone to irritation.

Comment “Link” for a DM to an article on the data around sun and heat exposure for babies.

#sunsafety #babysunscreen #babyhealth #parentdata #emilyoster
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