Supporting Your Kids And Their Immune Systems As They Go Back Into the World

Gabriella Safdieh, MS, MD
Medically Reviewed
August 26, 2020

Note: At this time, Parsley can only accept members who are 18 and older, regardless of parental or guardian consent.

This year, your child’s return to school, whether remotely, in-person, or a mix of both undoubtedly looks and feels different than ever before. As a parent myself, I know all too well that our goal is to always ensure we’re setting our children up for a successful year ahead. However, with so many different dynamics at play this year in light of COVID-19, exactly how to set your child up for both success in learning and success in staying safe is a whole new way to think about the back-to-school transition.

While there’s no foolproof way to prevent coronavirus from affecting your child or family, there are key ways to support protecting both the physical and emotional health of your child as they re-enter the world. In this article, I’ll review my top tips as Parsley’s resident pediatrician for preparing your family and child for the safest possible 2020-2021 school year.

Understanding your child’s coronavirus risk

Understanding your individual child’s coronavirus risk is the first step in making decisions around best protecting their health as school, sports, or other activities re-open. To best analyze your child’s coronavirus risk it’s important to consider the following factors:

  • Your geography: Unfortunately, in many parts of the United States, there is currently uncontrolled spread of COVID-19 so staying up to date on infection rates in your state and local area are essential to understanding your family’s current risk. The AAP has published a report that provides the infection rate per state, with certain states such as Nevada and Arizona having higher infection rates. Also, airborne viruses, such as SARS-CoV-2, have great mobility and sufficiently long-surviving time for dispersion and residents situated in densely populated environments are highly vulnerable.
  • Your child’s age: Children under the age of 10 are less susceptible to COVID-19 infection, according to an article released ahead of peer review and publication by scientists at the Harvard T.H. Chan School of Public Health in Boston and the University of St Andrews in Scotland.
  • Your child’s co-existing medical conditions: Certain medical conditions such as cancer, chronic kidney disease, COPD (chronic obstructive pulmonary disease), obesity (body mass index [BMI] of 30 or higher), serious heart conditions, sickle cell disease, type 2 diabetes mellitus can put a child or person of any age at an increased risk of severe illness from COVID-19.
  • Whether your child is immunocompromised: Certain medical conditions may cause a child to become immunocompromised. These can include conditions such as primary immunodeficiency disorders such as chronic granulomatous disease (CGD) or severe combined immunodeficiency (SCID). Underlying diseases in children such as cancer or certain autoimmune conditions may require them to take medications that suppress their immune systems and make them more susceptible to infections. Children that have received organ or bone marrow transplantation likely also are on medications that decrease the efficacy of the immune system , making them immunocompromised.

If your child falls into any of the above categories, they have an increased risk of developing a severe case of COVID-19 and further precautions around their health, both in school and in any public setting, should be taken into account.

Preventive measures to help your child stay safe

Some of the most valuable preventive measures for limiting the spread of coronavirus are things our children have likely become very familiar with in recent months. When going back to school or other group activities, it’s important to continue emphasizing how the following measures can help in keeping your child and their friends and family safe and healthy:

Physical distancing: The simple act of keeping people separated with the goal of limiting the spread of disease has become a way of life in the wake of COVID-19—and that will remain true even as kids return to school. In classrooms, this means ensuring your child’s school is adhering to the CDC’s recommendations to space seating and desks at least 6 feet apart when feasible. If your child is attending in-person activities after school, talk with program directors around guidelines being implemented to keep kids safely distanced or outdoors whenever possible.

Mask wearing: Getting children comfortable with wearing a mask will be essential in the return to in-person activities. Investing in a mask that fits well and that they look forward to wearing is key. To help, consider buying a face covering with their favorite cartoon character, superhero, or sports team on it—or anything that would make your child actually want to wear it. The reality is that masks offer some of the best protection for our children because they reduce the risk of viral transmission, found a meta-analysis of 172 studies published in The Lancet . They can also lead to milder or asymptomatic infections by blocking some of the virus-carrying droplets you may inhale, research shows , so getting them on board with sporting a face covering will be key in helping protect them in any public environment.

Hand washing: Talk to your child about washing their hands whenever they get to school, transition between classrooms or activities, before eating, and as soon as they arrive home. As a goal, have them aim for washing their hands for 20 seconds—or two rounds of the “happy birthday” song—with warm soapy water or using hand sanitizer when washing isn’t an option. Research shows children are more likely than adults to touch their eyes, nose, and mouth and by making sure they’re regularly keeping their hands clean, they reduce their risk of unintentionally infecting themselves.

Checking temperatures: While your child’s school may already be taking students’ temperatures at the door, getting a thermometer and setting a routine of daily temperature checks can be an added layer of protection to adopt at home too. According to research from the University of Southern California, it appears that COVID-19 symptoms often start in a certain order with the first symptom of COVID-19 typically being a fever. With an easy way to keep an eye on this symptom, adding daily temperature checks as a part of your before school checklist is a no brainer.

Maintaining structure: Regardless of if your child is opting into an in-person, online, pod learning, or traditional homeschooling program this year, ensuring they have an established daily structure can be one of the most important things you can do to keep them safe emotionally. Most mental health experts agree that providing consistency in a child’s daily routine can help to reduce their stress and keep them feeling a sense of security, even in the midst of a crisis. Seemingly small rituals of lunchtime at the same hour each day, even if staying at home this year, can go a long way in providing comfort, ease, and familiarity to your child’s school day.

Supporting your child’s immune system

Outside of these measures, one of the best ways to lower your child’s risk of developing a severe case of coronavirus is to actively support their immune system. This is a big focus of my work with my pediatric and adult members at Parsley Health.

Our immune system is what protects us and enables us to effectively fight off illness from everything from the common cold or stomach bug to the flu and coronavirus. By supporting your child with a healthful diet, ample fluids, supportive supplements , proper sleep patterns, and regular movement, you enable their immune system to be better equipped to ward off foreign threats whenever they may pop up.

Nutrition: While kids can be picky eaters, it is extremely important to focus on whole foods as much as possible in your child’s diet—especially this school year. A dietary intake inclusive of a variety of vegetables, fruits, whole grains, nuts, seeds, and well-sourced protein choices allows for a child to consume a full spectrum of essential nutrients, vitamins, and minerals that keep the immune system operating efficiently. Specifically, anti-inflammatory fats from omega-3 rich foods like salmon, walnuts, chia, and flax seeds in addition to vitamin C, vitamin E, and zinc-rich foods such as citrus fruits, dark leafy greens, bell peppers, sunflower seeds, chickpeas, and almonds can help strengthen our immune defenses . Conversely, highly processed foods and added refined sugars, including candy, juice, and packaged snack foods, serve to weaken the immune response and should be limited as much as possible.

Hydration: In addition to nutrition, hydration is a key element to maintaining a healthy immune system. Pack your child with a filled water bottle or two to consume throughout the school day, aiming to have them drink at least two liters of filtered water everyday. Our immune system is highly dependent on the nutrients in our blood stream, and adequate hydration allows for mobilization of these nutrients throughout the body that help to keep our kids healthy.

Supplements: Even if your child has never taken a vitamin before, now might be a good time to consider adding in a few extra dietary supplements to support their immune system. Children can particularly benefit from high-quality supplementation as their diets often have nutritional gaps that may be causing deficiencies that affect their immune function. At Parsley Health, we commonly recommend vitamin C, vitamin D3/K2, a probiotic, an omega-3 EPA/DHA, and elderberry as foundational child-friendly immune-supportive supplements to consider adding into their daily regimen. It’s important to talk to your child’s pediatrician about appropriate doses and brands for their particular age group.

Sleep: Without sufficient sleep, the body makes fewer immune cells —creating a shortage of essential proteins needed to target infection and inflammation . A general guide for sufficient sleep for kids is aiming for around 12 hours of sleep per night for toddlers, 10-12 hours per night for children three to six, 10-11 hours for 7-12 year olds, and 8-9 hours for teens. For children, it’s also important to focus on establishing a bedtime routine which allows for a similar ritual each night such as brushing teeth, reading a book, and going to bed at around the same time. Evidence shows that establishing a regimented sleep-wake cycle can enhance the body’s production of immune-boosting cells and improve sleep quality.

Physical activity: A variety of different kinds of exercise including running, biking, dancing, and yoga have all been shown to improve immune function in children in some way. So regardless of their preference, keeping your child moving directly supports their health. A good goal I recommend parents’ to strive for is encouraging their kids to engage in at least 20-60 minutes of intentional activity each day. It helps to give kids a variety of options to choose from, model exercise for them, and provide the time and space in their schedule to prioritize this daily commitment to movement. For some families (including my own), I’ve found that the use of at-home and online fitness video streaming services can make exercise fun and exciting for kids. Some favorites at my house include Go Noodle and Cosmic Kids.

Final thoughts

For more about COVID-19 in kids see our previous post:

Gabriella Safdieh, MS, MD

Dr. Gabriella Safdieh is a certified Functional Medicine Physician who specializes in pediatrics and rheumatology. She trained at University of Pennsylvania School of Medicine, New York University School of Medicine, the Hospital for Special Surgery, and the Institute for Functional Medicine.

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