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This is just a quick entry about wearing masks. A lot of children have difficulty wearing them, though usually it is not due to a medical condition. Wearing a mask is uncomfortable and something we are not used to. For a lot of kids it is anxiety-provoking. But public schools will be opening for in-person instruction at some point this fall and some private schools are already open, so it's important for kids to learn to wear them.
For help teaching your kids to wear masks, click the link for a handout from the Children's Hospital of the King's Children in Norfolk, VA that gives advice on how to get children to wear them.
We hope this information is helpful. Always remember, the doctors and staff at Mesquite Pediatrics are here to help. If you have questions about this, or anythign else regariding your child, we are just a phone call away.
Jeff Couchman, MD
Many studies have shown masks to be effective in preventing the spread of COVID-19, but the type of mask you wear does matter. A study by Duke University released the first week of August, 2020, studied different types of masks and their effectiveness in stopping the spread of respiratory droplets of COVID-19. The study showed that most cloth masks are pretty effective and near the effectiveness of surgical masks. However, there are a few options out there that should be avoided. The first is any mask with an exhalation valve. These valves were designed to protect the user from harmful outside debris, such as dust or pollution. Unfortunately, these valves allow the user’s respiratory particles to escape and therefore do not protect others, which is the most important effect of masks on COVID-19. Therefore, these are not recommended. The second is a simple bandana. The bandana (depending on construction) may actually break up larger droplets into smaller ones that can remain in the air for longer. They may look cool, but they do not effectively protect others from you. The last mask that is not recommended is a fleece neck gaiter. In the study, this was listed worse than not wearing any mask. Again, this is because the material allows larger respiratory droplets to be converted into smaller droplets that remain in the air for longer and can potentially more easily infect others. As we continue to learn more about this virus and how it spreads, these mask recommendations may still evolve. Below are links to the actual study and some summary articles on the topic.
There has been a lot of research over the last several years on the phenomenon called Adverse Childhood Experiences (ACEs). According to the CDC: “Adverse childhood experiences (ACEs) are potentially traumatic events that occur in childhood. ACEs can include violence, abuse, and growing up in a family with mental health or substance abuse problems.” In addition, homelessness, community violence, death of a loved one, or deportation are ACEs, and today the list includes isolation due to the pandemic. ACEs shape a child's development and can have dramatic effects on health and welfare for the rest of the child's life. For some children, positive experiences and relationships can be an antidote for ACEs, helping build resilience that enables them to overcome or avoid the consequences of ACEs.
Simply put, having strong, nurturing, positive relationships and experiences with adults can help a child grow up to be a healthy, happy adult. Sounds pretty basic, but sometimes parenting can be complicated and turns into just managing life's complexities and frustrations rather than finding ways to make life fun and rewarding. But finding ways to have positive experiences, even things that may seem minor at the time, can have a big impact on both the joy of parenting and on the development and health of the child. The American Academy of Pediatrics' website for parents, healthychildren.org, has a new series of articles on how to create such positive experiences for different age groups. Check out the links below for more information. And while you're there, browse around and see what other great information is available on the site.
It's time for some non-COVID information. In general, fruit is thought of as healhy to eat and that you basically can't really eat too much of it. But it turns out that's not entirely true. Some fruits have high sugar (fructose) content without the benefits of high fiber. The importance of the fiber is that it is good for the health of the intestinal tract, fills you up without adding calories, and helps maintain a more steady blood sugar, which controls hunger and decreases overall calorc intake. The problem with fructose is that it raises blood sugar and also raises cholesterol and triglycerides. The article linked below has more information and a chart that can be helpful. People who are trying to lose weight or who have borderline or high cholesterol or triglycerides might want to limit their intake of foods in the blue area of the chart and increase their intake of those in the green area.
We get a lot of questions of what parents can do to protect their children from COVID-19. We continue to recommend physical distancing, masks, and hand washing as the most effective means of preventing infection. However, there has been some recent literature coming out about a possible connection between low Vitamin D levels and severe COVID-19 disease, including the rare severe disease in children called MIS-C.
We have reviewed the literature and feel this is a low risk and inexpensive recommendation that may have the potential to limit the severity of COVID-19. The dosing recommendation below is higher than standard dosing but well below toxic levels, even for those without vitamin D deficiency. Please note that Vitamin D will NOT necessarily prevent infection or the risk of hospitalization.
Vitamin D does have known health benefits, including improved bone health and prevention of heart disease; also vitamin D deficiency has been linked to some cancers. There have been numerous studies showing vitamin D to protect from some pediatric infections (especially respiratory infections) and to improve immune function.
If your child has an underlying medical condition in which they have high levels of calcium, then please do speak with your pediatrician first before considering supplementing Vitamin D.
Daily Vitamin D3 supplementation recommendations:
0 – 12 months: 800 IU (20 mcg) daily (2 drops of D-Drops or 2 ml of D-vi-sol = 800 International Units)
1 yr to 12 yr : 2,000 IU (50 mcg) daily
12y+ and Adults: 4,000 IU (100 mcg) daily