Sibling Rivalry versus Sibling Bullying

Its normal for siblings to fight. They bicker over everything from what to watch on television to who gets to sit in the front seat of the car. But when sibling disagreements become abusive, that’s no longer normal behavior, it’s sibling bullying.

What is it bullying versus typical sibling rivalry?

Here are some ways to identify sibling bullying:

  • If the incidents happen on a regular basis
  • If the bullying/teasing is meant to hurt
  • If it makes you as a parent uncomfortable or concerned, it is likely even worse for the target child
  • If the parent notices any negative impact on the child (e.g., changes in mood or behavior, anger/aggression, isolation, decline in grades)

Why should I be concerned? Isn’t this just part of childhood?

It is the rule, rather than the exception, that kids tease their siblings and there is bound to be some conflict. However, regular bullying or teasing, by siblings or by peers, can be associated with serious emotional and mental health difficulties:

  • Home should be a safe space where kids feel free to be themselves and to make mistakes. If they feel like they aren’t safe physically or emotionally, they are likely to experience a high level of stress which can cause a multitude of poor physical and emotional problems.
  • Siblings know each other’s weaknesses. Therefore, they can cause a lot of hurt by picking on their siblings where they are most vulnerable.
  • When kids are picked on in school, parents often step in, even if it is just to remind their child, “that’s not true – you are smart/beautiful, etc.” However, when this is coming from a sibling, parents are less likely to step in. Therefore, a child may think, “if the people who are supposed to love me most believe this, it must be true.” This can be very damaging to self-esteem.

What should parents do?

The good news is, when a child is being bullied at school, parents have no control over the bully. At home, parents have much more control. Here are some ways to help stop bullying at home:

  • Have a rule in the house that does not allow teasing/bullying. Make this applicable for all family members and have established consequences that follow the behavior.
  • Stop the behavior whenever you see it. Don’t let it slide.
  • Check in with school counselors/teachers to make sure your child isn’t bullying others at school as well.
  • If it reaches a point where you feel you cannot help the situation, consider talking to a professional.

Is Your Child Drinking Too Much Milk?

While it is true that milk can be a great part of a healthy diet for children, too much milk can lead to health problems such as iron deficiency anemia and protein loss from the gut.

What is iron deficiency anemia?

Iron is an important mineral we get from our diet that our bodies use to make hemoglobin, a protein in red blood cells that helps deliver oxygen to different tissues in our bodies. Iron deficiency anemia occurs when you have low levels of hemoglobin in your body due to not enough iron.

While breast milk or formula is a good source of iron for babies up until six months of age, after six months, milk alone does not provide enough iron, which is why solid foods should be introduced to children.

Common symptoms of iron deficiency anemia include pale skin, lack of energy and shortness of breath after activity.

What is protein loss from the gut?

Protein loss from the gut, or protein losing enteropathy, occurs when a child drinks too much milk, causing low levels of protein in the blood. This can cause blood vessels to leak fluid into the tissue which leads to swelling of the legs, back and face. It can also put you at risk for infections.

Protein loss and swelling can be caused by other disorders so your pediatrician will ask questions about your child’s overall health and symptoms to determine the cause.

Symptoms of protein losing enteropathy include:

  • swelling of the feet, legs and face
  • muscle cramps or weakness
  • extra fluid around the lungs
  • swelling of the abdomen

How can I prevent my child from getting iron deficiency anemia or protein losing enteropathy?

To prevent your child from getting iron deficiency anemia or protein losing enteropathy, make sure they are drinking no more than the recommended daily amount of cow’s milk. For toddlers, the recommended amount is about 250-500 mL, or 1-2 cups per day. Exceeding this amount can lead to problems.

How are iron deficiency anemia and protein losing enteropathy treated?

Iron deficiency and protein loss from the gut due to excess milk intake are treated by reducing the amount of milk a child drinks and increasing the amount iron rich foods in their diet. Often, iron supplements are also recommended.


Your child wakes up with a fever and stuffy nose. Is it the flu? Is it COVID-19? Or is it something else, like Respiratory Syncytial Virus (RSV)? Unfortunately, right now, all three are possibilities. So how can you figure out what’s causing your child’s illness, and more importantly, what should you do about it?

The short answer is that the cause of your child’s infection might not always be clear. COVID-19, the flu and respiratory viruses such as RSV have similar symptoms. But there are a few differences that can help you determine why your child is sick.

What is the biggest difference between COVID-19, RSV and the flu?

COVID-19 has many similarities to the flu and RSV because they are all contagious respiratory viruses that spread from person to person by droplets traveling through the air. But there are key differences as well:

  • Children with COVID-19 may not have symptoms at all, or may have a gradual onset of fever, congestion, cough and loss of taste and smell that last anywhere between seven to 28 days. Neither RSV nor the flu typically cause a loss of taste or smell, so if your child has these symptoms there’s a good chance they have COVID-19.
  • Older children with RSV usually have minor symptoms similar to a cold. Younger kids and babies with RSV tend to have a slow onset of cold-like symptoms and then a sudden escalation. Symptoms last three to seven days.
  • Most children who have the flu will experience a rapid onset of symptoms such as fever, cough and runny nose, and these symptoms will last from five to seven days.

COVID-19 symptoms

People with COVID-19 have reported a range of symptoms, and not everyone infected with the virus will have the same symptoms. Symptoms tend to appear from two to 14 days after exposure to the virus and include:

  • Fever/chills
  • Body aches
  • Loss of taste and/or smell
  • Cough
  • Shortness of breath
  • Headache
  • Tiredness/fatigue
  • Sore throat
  • Congestion
  • Diarrhea
  • Nausea or vomiting
  • Abdominal pain

Loss of taste or smell is unique to COVID-19 — it isn’t seen in any of the other illnesses — but it’s also important to know that may kids with COVID-19 never experience loss of taste or smell, so just because your child doesn’t have this symptom doesn’t mean they don’t have COVID-19.

Respiratory syncytial virus (RSV) symptoms

Infection with RSV is common among young children and usually begins as a mild cold, but can cause severe breathing problems in premature babies, as well as infants and toddlers under the age of two who have chronic lung disease and chronic heart disease. Symptoms of RSV include:

  • Coughing
  • Sneezing
  • Fever
  • Runny nose
  • Decrease in appetite
  • Trouble breathing
  • Unusual behavior such as excessive tiredness or irritability

Flu symptoms

The seasonal flu (influenza) can cause mild to severe illness. The flu usually comes on very suddenly. Your child may feel perfectly fine one day and be very sick the next. Common symptoms of the flu include:

  • Fever/chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Fatigue (tiredness)
  • Nausea
  • Loss of appetite

The good news is that flu shots can protect your child from having severe infections, or from even getting infected altogether. And since many symptoms of the flu are shared with COVID-19, it is more important than ever to get a flu shot this year.

Can kids get infected with multiple viruses at the same time?

Unfortunately, the answer to this question is yes. It’s not uncommon for kids to contract multiple respiratory viruses at once. Younger kids — toddlers and infants — who have multiple viral infections at the same time may have more severe illness than if they had only contracted one virus.

How can I protect my family from the flu, COVID-19 and RSV?

Fortunately, there are safe and effective vaccines for both the flu and COVID-19. Children ages 12 and older can get the COVID vacinne and children ages six months and older can get a flu shot.

There is a vaccine for RSV, but it is only for babies and children that have compromised immune systems. Since the RSV virus travels and lives on surfaces, washing your hands often and keeping infants away from children and adults who are exhibiting common cold symptoms can be extremely helpful. Breastfeeding and avoiding second-hand smoke also show natural benefits to possibly preventing RSV.

What should I do if my child has symptoms that could be COVID-19, the flu or RSV?

If your child develops symptoms, we first want to encourage you to offer them supportive care: allowing them adequate time to rest, keeping them well hydrated, and giving age-appropriate over the counter medicines if needed for comfort.

While symptoms are present, we recommend keeping your child at home and physically separate from those who do not have symptoms. This is particularly important for children who go to daycare, school or are exposed to individuals who are not vaccinated against COVID-19 as quarantining will help stop the spread of COVID-19 in our community.

Testing your child for COVID-19 is the fastest way to avoid strict quarantining, as recommendations still encourage quarantining for anyone with symptoms for at least if 10 days if they do not have a negative COVID-19 test.

Flu Vaccine

Getting a flu shot might not be at the top of your mind these days, but with the ongoing coronavirus (COVID-19) pandemic, flu shots are more important than ever. To help you better understand why, we answer some of your questions about the flu, the shot and the relationship between flu and COVID-19.

Why should I get a flu shot this year?

While it has always been important for everyone ages 6 months and up to get the flu shot, it is arguably even more important this year given the ongoing COVID-19 pandemic. Flu and COVID-19 cause similar symptoms and if your child is unlucky enough to catch both at the same time, they could have a worse course of illness as their body tries to fight both. Besides both viruses causing lung issues and breathing problems, in rare cases, both the flu and COVID viruses can cause life-threating, sudden heart attacks.

Another reason for your child to get the flu shot is to help them avoid trips to the doctor’s office. While doctor’s offices are cleaning more and using masks and gloves to keep you and your family safe, it may give you peace of mind to have fewer reasons to make a visit.

Lastly, by having large numbers of people protected against flu from having had the shot, there will be fewer cases of flu in the community. This means there will be fewer demands on the healthcare system which will allow doctors and hospitals to focus their scarce resources on people who are very sick with COVID-19.

Will getting the flu vaccine put my child at greater risk for contracting COVID-19?

No. The flu vaccine will not put your child at greater risk for getting COVID-19, but it also won’t prevent them from getting COVID-19.

Can my child get COVID-19 from the flu vaccine?

No. Your child will not get COVID-19 from the flu vaccine. The flu vaccine does not contain coronavirus. It contains inactive influenza virus or proteins from an influenza virus, which means getting a flu vaccine will not cause you or your child to get the flu or test positive for COVID-19 or any coronavirus.

Is it safe for my child to get the flu shot and the COVID-19 vaccine at the same time?

Yes, as long as your child is eligible to get the flu shot and the COVID-19 vaccine, then it is safe to administer them together.

Is the flu shot better than the flu mist?

No. Both versions of the flu vaccine are equally effective at protecting against the influenza virus. However, parents should talk to their pediatrician about which flu vaccine is recommended for their child. Children need to be at least 2 years old to receive the nasal spray vaccine. The flu nasal spray is not recommended for anyone with chronic lung problems like asthma or for anyone with a compromised immune system.

Can my child get the flu from the flu vaccine?

No, a flu vaccine cannot cause the flu. Flu shots are currently made with either flu vaccine viruses that have been killed (inactivated) and are therefore not infectious, or with proteins from a flu vaccine virus. The nasal spray is made with attenuated (weakened) flu viruses and cannot cause the flu. These weakened viruses are cold-adapted, which means they are designed to only cause infection at the cooler temperatures found within the nose. The viruses cannot infect the lungs or other warm areas.

Reports of illness after flu vaccine are typically due to side effects from the vaccine, or from unrelated viral illnesses that also tend to circulate during the time of year that flu shots are administered. Typical side effects from the flu vaccine include soreness (if given the flu shot), congestion (if given the nasal spray), cough, fever, body aches, headache and fatigue. Serious side effects are rare and less common than the severe complications that occur from the flu itself.

I got the flu vaccine and still got the flu!  Why?

Scientists make predictions about what flu strains will circulate the following year when they prepare the flu vaccine. In most years, these predictions result in a flu vaccine that provides significant protection, but there is still a chance you or your child may contract a strain that is not included in the vaccine.

Back To School Anxiety In Kids

Children have been staying home for a while now due to the coronavirus (COVID-19) pandemic. With schools finally opening up, parents likely have concerns about how their child might handle back-to-school anxiety and homesickness. Below we present some strategies for parents to reduce anxiety and homesickness and help ease the transition from being at home to being back in the classroom.

Strategies for parents to help reduce back-to-school anxiety and homesickness

  1. Practice coming up with a list of things your child would like to share with their teacher and classmates (e.g., unique interests or talents, fun things they did this summer).
    • For kids who feel shyer and more anxious, parents can practice these brief “sharing statements” so their child feels more comfortable talking.
    • Help your child with keeping their sharing time short (since the teachers may need to cut them off if it’s too long), speaking up so others can hear and making eye contact.
  2. If you know any of your child’s classmates, reach out to their parents and schedule a playdate. Getting time with friends or peers before school can ease some worries, help your child practice their rusty social skills and help all the kids feel more excited about return to school.
  3. Consider taking a tour of the school (especially if it is a new school) before the school year begins, if possible. Even driving around the school or taking a short walk or a picnic in school grounds may help kids re-familiarize with the school environment or feel comfortable with their new environment. Some schools may have a virtual tour, videos or pictures on their websites that could be helpful if going to the school physically is not possible.
  4. Tell your kids it’s normal to feel nervous or sad.
    • Ask your kids how they are feeling about return to school (open-ended questions are best, or prompt by saying “sometimes kids feel excited or nervous or happy or worried…sometimes they feel multiple things at the same time”)
    • Let them know it’s normal to feel nervous about going back to school and about doing any new things.
      • Talk about things that have helped them feel braver in the past when they started something new.
    • Children may be worried about getting sick when they go to school as they have been hearing a lot about germs and hygiene.
      • Discuss use of masks, hand hygiene and physical distancing rules and what they can do to keep themselves safe.
      • Practice wearing mask, washing hands (at least 20 seconds, making a “white glove” with the bubbles), and not touching eyes, mouth, etc.
    • Create a “Bravery Chart” in which they can earn stickers or points for managing their anxieties in a healthy way.
  5. Increase excitement about return to school.
    • Talk often about the exciting things to look forward to, like getting to meet kind teachers, finding out who will be in their class and the fun things they will get to learn.
      • Ask your child what things they are looking forward to with return to school.
    • Back-to-school shopping: new school supplies often help kids feel more excited, even though they are nervous about return to school. Get some new school supplies (new pencils, markers and a new pencil kit) to help your child feel excited about starting a new year.
  6. Help your children anticipate the change that comes with going to school. Before school starts, talk to them about the changes that are coming with the return to school. Be sure to discuss routines — schoolwork, learning, recess, lunch, etc. Focus on the positives and fun!
  1. Reassure your child that you are interested in their welfare and know that they might feel homesick. Let your child know that you will check in with them at the end of each day, and that they can share anything with you!
  2. Help your kids get used to being away from home.
    • Practice spending time away from your kids at home. Working/playing in different rooms, having structured small amounts of time on their own, and doing tasks by themselves may help them feel confident about not needing to be always with parents.
    • Spend more time outside the house with the kids – running errands, going on outing, etc. to help them feel comfortable with being away from home.
    • Remind children of the times prior to the pandemic when they were in school without parents and how they handled being scared or missing parents.
    • Talk to teachers about creating a plan for your child to feel comfortable at school if they have separation anxiety – planned video or phone calls to a parent, writing notes or letters to parents or having a special toy they can use for comfort.

Respiratory Syncytial Virus (RSV)

Respiratory syncytial virus, or RSV, is a common virus that usually spikes in cases during the winter months. Unfortunately, this summer it’s unexpectedly spreading, especially in the Southern United States. The outbreak has been so concerning that the Centers for Disease Control and Prevention (CDC) recently issued a health advisory about the spread of RSV in the country.

What is respiratory syncytial virus?

Respiratory syncytial virus, or RSV, is a common respiratory virus that usually causes mild, cold-like symptoms. Infection with RSV is common among young children and usually begins as a mild cold, but can cause severe breathing problems in premature babies, as well as infants and toddlers under the age of two who have chronic lung disease and chronic heart disease.

RSV is the most common cause of bronchiolitis (inflammation of the small airways in the lung) and pneumonia (infection of the lungs) in children younger than 1 year of age in the United States.

What are the symptoms of respiratory syncytial virus?

Early symptoms of RSV include:

  • Coughing
  • Sneezing
  • Fever
  • Runny nose
  • Decrease in appetite

Because it’s often difficult to distinguish RSV from a common cold, here are some signs to look out for if you suspect your child’s cold may be more serious:

  1. Difficulty breathing: After one or two days, the virus can travel to the lungs, affecting the small airways (called bronchioles) that allow your child to breathe easily. Once the airways are affected you may notice faster breathing, flaring of the nostrils, sinking of the neck and sucking in of the ribs while breathing. These are indicators that your child is having difficulties moving air into and out of the lungs and needs to be seen by a doctor.
  2. Unusual behavior: RSV may cause your child to be more irritable, sleepy or uncomfortable than normal. Another cause for concern may be if your baby is not feeding well.

How is respiratory syncytial virus treated?

Most RSV infections go away on their own in one or two weeks. While there is no specific treatment for RSV, some things you can do to relieve symptoms are:

  1. Manage fever and pain with over the counter fever reducers and pain relievers such as acetaminophen or ibuprofen.
  2. Keep your child hydrated.Make sure your child drinks a lot of fluids to prevent dehydration.

How do I prevent my child from catching respiratory syncytial virus?

Preventing RSV can be very difficult, especially because it is spread in droplets of fluid from sneezing, coughing or laughing. Since the virus travels and lives on surfaces, washing your hands often and keeping infants away from children and adults who are exhibiting common cold symptoms can be extremely helpful. Breastfeeding and avoiding second-hand smoke also show natural benefits to possibly preventing RSV.

Summertime Travel With The Kids

With all the hardships and emotional stress we’ve faced throughout the past year and a half since the outbreak of COVID-19, a relaxing family getaway might be more than needed. Though the threat of COVID-19 is decreasing with millions getting vaccinated, it’s still not quite safe to return to the pre-pandemic type of travel, especially with regulations in place that continue to restrict smaller children from receiving the vaccine. How can you be sure your family stays healthy and safe while traveling this summer, and what steps can be taken to further ensure everyone’s health and safety while doing so?

What should I think about while planning our trip?

Traveling with young kids can be hard enough on its own but traveling with younger passengers during a pandemic poses even more questions and risks for parents to think about. It’s important to do some pre-planning before booking any trip to make sure your getaway is as enjoyable as possible.

“Every decision we make about our kids is always risk-benefit. We always have to look at the best way to mitigate the risks and increase the benefit,” says Children’s National Hospital clinical pediatrician Dr. Boogaard. “At the beginning of the pandemic, we had this false-safety mindset regarding children and COVID-19. There are still consequences with COVID-19, and children can definitely still get it.”

As we continue to learn more about COVID-19 heading into the summer, Dr. Boogaard says, “When you think about traveling with young kids, the first thing that I would really encourage is that anyone allowed to get the vaccine should get it. The vaccine is very effective and safe and decreases the risk of hospitalization and death.”

However, this may not be possible for everyone in the family just yet, as clinical trials for the COVID-19 vaccine are still ongoing for children under 12.

“For unvaccinated kids there are a few rules you should follow: do not travel if you’re sick, if you have symptoms, if you’ve been recently exposed to COVID-19 or to someone with symptoms or if you’ve tested positive recently and thus have COVID-19,” Dr. Boogaard notes. (For further help making decisions about traveling with people who are unvaccinated, check out the CDC wbsite.)

Dr. Boogaard explains that, “If you’re unvaccinated the CDC recommends wearing a mask (if over the age of 2), avoiding large crowds and seeing people outside your household, and washing your hands for at least 20 seconds routinely.” Preventative actions such as these are one of the best ways to protect your family both before, during and after any travel.

What should I do before we leave?

There are direct actions that can be taken before departing for your vacation to further ensure everyone’s health and safety, as well as important questions to ask yourself and your family before you book your flights.

“There are things to consider before traveling: could you quarantine before seeing someone who is at a higher risk? Could you get them or yourself tested?” Dr. Boogaard explains.

Keeping questions like these in mind while planning your travel will offer a deeper sense of security for all traveling with you. Furthermore, Dr. Boogaard highlights the importance of preparing contingency plans before you leave to help you feel more confident and prepared before arriving.

“Be prepared when you go for the situations that might arise, for example if someone gets symptoms. This person should quarantine whether they are vaccinated or not until it can be confirmed that it is not COVID-19.”

Dr. Boogaard further notes that it may be helpful to research COVID-19 testing locations near the area you’re staying and put them somewhere accessible prior to departing so you already know where to go if something like this were to happen in an area that you and your family are not familiar with. Researching your destination’s specific COVID-19 policies and/or COVID-19 nearby health centers is a beneficial step to take before deciding to hop on a plane!

My family wants to get together, but we all have differing opinions regarding the safety of COVID-19. What should I do?

“What’s human nature is when you put a big group of people together, they all have their different anxieties around this, and you want to make sure everyone’s comfortable. So, just practicing that flexibility and resilience that we’ve practiced all year are good things to continue going forward,” Dr. Boogaard explains. “Just to be transparent about your own concerns, and your own risk-assessments, and be aware someone might have a different risk-assessment and comfort level, and plan on how to work through that.”

Communication regarding comfortability levels and everyone’s varying health concerns, before seeing them, is the key for all reunions this summer.

Can my unvaccinated kids see their vaccinated grandparents?

Although it has been important to quarantine and try to limit contact with others throughout this pandemic, Dr. Boogaard also emphasizes that, “There has been a lot of trauma associated with COVID-19 over the last year, a lot of loneliness, self-isolation and other mental challenges.” When thinking about traveling to see family during this time, important factors such as those are just as vital to consider when weighing them against the potential physical health risks that may be present. “If this is a grandparent you and your children are not able to see often and you get a chance to visit them this summer, you have to make that decision for your family because it’s different with every situation.”

Just as the pandemic has affected every single family differently, learning how to reincorporate things like travel and family gatherings will look different for every family as well. Ultimately, planning, communicating and cooperating with your own family and your individual family circumstances are some of the most important things to do to ensure you and your family’s getaway is as safe and enjoyable as possible.

Keeping Your Kids Hydrated This Summer

You’ve probably heard the phrase “hydration is key,” more than once. It often pertains to your exercise regimen, digestion benefits and, in general, your overall health. But what does hydration look like for young children?

Now is a good time to find out with summer coming and kids will be frequently spending time at playgrounds and in backyards.

What are some basic things people should know about young children in summer heat?
The key thing for the summer is really knowing all of the dangers that children can be exposed to. Avoid heat exhaustion (which can be caused by, or lead to, dehydration), administering sun protection (sunscreen, loose-fitting clothing and getting shade) and practicing water safety are really the three big issues to know about. Drwoning is the number one cause of death in children 1 to 4, so it’s essential for parents, guardians and caregivers to be aware of each of these risks individually, but also how they can all relate on a hot summer day.

How long should children be outside in the summer heat?
There’s no one single rule, but the middle of the day tends to be the hottest, so earlier in the day or in the evening can be better for getting outside time. It also depends on how extreme the physical activity is. They can be outside playing as long as they’re drinking enough water. It’s good to get outside and have some fun, and to get some exercise, but even before kids recognize thirst, they should be drinking enough fluids throughout the day.

How should children be getting their fluids?
Infants need to drink their breast milk or formula in order to stay hydrated. All of the water they need is in those two options, and that’s through about 6 months of age. Once they begin having solid foods or other foods beyond formula, that’s when they really begin drinking water. One rule of thumb for toddlers (and older) is 8 ounces of water for every year of age per day, until you get to the age of 8. For example, if a child is 3 years old, they should be drinking at least 24 ounces of water per day. And we’re all losing a typical amount of fluids through breathing and urinating, but then when we sweat, that’s our mechanism to stay cool, so that’s when we’re losing additional fluids.

How common is dehydration in young children?
It’s fairly common, but a careful and vigilant caregiver should be reminding children to drink, to take a rest, to have a break from the heat with some air conditioning and to just find some shade. Luckily for infants, they are not going to get dehydrated from the typical running around like toddlers could, since they’re not exercising in the same ways. They are much more likely to get dehydrated from illness that causes more output (stool and vomiting). But once a toddler is running around and exercising, that’s when they are getting more at risk for dehydration from the heat itself.

What are the dehydration symptoms caregivers should look out for?
In terms of symptoms, take notice if they’re not acting like themselves. When you know your child loves to play but then they start to be a little more sluggish, you might want to check in. They might have some cramps in their legs, and then when you see them sweating a lot, it’s a good sign to get them inside and to have more fluids. It’s really how they’re acting more than anything, although you might see dry mouth or lethargy. They just won’t be as interested in playing as they typically are because they’re starting to get exhausted from the heat and lack of fluids.

What To Say To Children When They Are The Only Family Members Without A COVID Vaccine

We are feeling so grateful and fortunate that vaccines are now offered to all individuals ages 16 and older. There is a collective sigh of relief that the end of this pandemic is in sight. However, it’s important to note that not all individuals have access to COVID-19 vaccines yet…the majority of our pediatric population at Children’s National (children ages 0-15) continues to wait for vaccines. So what should you say to a child who is the only unvaccinated person in the house and may be worried?

Validate that it’s hard to be patient

  • We know that it is hard to wait. This pandemic has changed our lives for more than a year and it is normal to be hopeful for a vaccine that helps us feel confident that we can remain safe and get back to our regular activities.
  • Parents can express that the COVID vaccines have yet to be tested/approved for kids through research studies; most studies have been focused on adults and older teens. The good news is that the research is underway – so kids can be hopeful that vaccines will be accessible to them soon!
  • Ending on a positive note when explaining things to kids helps to reduce anxiety/worry and set expectations for hopefulness.

“Why do I have to wait so long?”

  • Provide kids with education about how some individuals are more vulnerable than others, especially older individuals or healthcare providers, which is why they are being vaccinated before kids.
  • Remind them that kids have to wait their turn but might get the vaccine last because it is unusual for kids to get very sick even if they do get COVID:
    • Children infrequently get the severe symptoms that are more common in adults.
    • Scientists and doctors are focusing on getting vaccines to those who need it most first…but vaccines for kids are coming!
  • Continue to validate disappointments.
  • Kids may be missing exciting milestones with friends, achievements (sports championships, competitions, recitals), birthday celebrations – try to find ways to get as close to these experiences as possible while balancing safety.

Validate child worries about their own safety (because they haven’t gotten the vaccine)

  • Create open communication. Families should discuss any changes they are making to their family precaution plan now that most of the (more vulnerable) family members are vaccinated:
    • Be sure to review with the unvaccinated child your family’s continued precautions to keep them safe.
    • Also remind children that the members of your family that were most at risk of getting very sick are now protected, and that adults being vaccinated also means that kids will not spread COVID to their parents or vice-versa.
    • Reassure children that you are not forgetting about them and that your family is considering risks to that child (including risk of COVID and also psycho-social risks associated with prolonged isolation) as you make your plans.
    • Discuss any changes that you/vaccinated adults and that children will make and discuss how/why you believe this plan will keep everyone safe. For example, parents may choose to go to visit another vaccinated friend. Discuss how coming home to their child after this visit is still safe – vaccines help to reduce spread of the virus.
  • Give children a voice. Each family member, including children, needs to be given a voice to share and discuss their concerns, desires and goals with the family precaution plan.
    • Parents should ultimately make the choice about the family precaution plan, using CDC recommendationsand family physicians as needed (if there is a family member with underlying health conditions).
    • Every family member, including the youngest children, needs to be included in the discussions about any changes and reassured that each family member’s concerns and health are being considered.
    • Knowing the plan in advance helps children feel more safe and secure. Changes to precautions that we’ve told kids for a year are “keeping us safe” can make kids feel very anxious. Be sure to explain that it will take time to re-teach our brains what “being safe” means now (and at each change we make related to this virus).
  • Help provide children with language to express their concerns about other family member’s actions given that kids can’t be vaccinated yet.
    • For example: It makes me feel _____ when you _____. Please ____.
    • Role play using this language.

Deciding on a new “Safety Plan”

Vaccinated parents with one or more unvaccinated children may struggle deciding which precautions to keep and which to change. Can some things return to normal?

  • Parents should remember that there is no risk-free option. The extreme COVID precautions come with social isolation that impacts overall physical and mental health.
  • Each family will need to make their own educated choices…and there is more than one reasonable approach:
    • Some families may continue to be more cautious due to unknowns related to the novel coronavirus (particularly long-term effects) or due to concerns for a young child with underlying health conditions.
    • Other families may choose to increase their family’s activities, but using a thoughtful and educated process. Remember to reference the latest CDC Guideline frequently as recommendations change frequently, particularly with new variants emerging.
  • Families should consider their unvaccinated children when making decisions in their family’s best interests.

Validate when kids express they want things to go back to normal

  • Validate frustration if children are upset to learn that they will not immediately go back to their normal routine.
  • Continue to find ways to increase routine and structure for children.
  • Seek fun, new activities that change up the routine and fit within your family’s safety guidelines.

Allergies or COVID?

As we enter another pandemic spring, pollen counts are on the rise and the coronavirus continues to circulate in our communities. There is some overlap between seasonal allergy symptoms and COVID-19, so sometimes it can be hard to tell the difference! Here is a quick review of allergy symptoms versus COVID-19 symptoms.

Overlapping symptoms of allergies and COVID-19

The most common overlapping (meaning these can happen with allergies or COVID-19) symptoms of allergies and COVID-19 are:

  • Cough
  • Shortness of breath
  • Headache
  • Tiredness/fatigue
  • Sore throat
  • Runny or stuffy nose (this is less common in COVID-19)

Cough and shortness of breath happen less often with allergies unless the person has a history of asthma which can be triggered by pollen.

Allergy symptoms

Individuals with seasonal allergies frequently experience the following symptoms:

  • Sneezing
  • Itchy nose
  • Itchy and/or watery eyes

These symptoms are NOT associated with COVID-19, and generally get better with over-the-counter allergy medications (antihistamines) such as Zyrtec, Claritin or Allegra. Nasal corticosteroid sprays, such as Flonase, Nasonex or Nasacort are also often helpful for seasonal allergy symptoms.

COVID-19 symptoms

COVID-19 infection most often involves the following symptoms:

  • Fever/chills
  • Body aches
  • Loss of taste and/or smell

If any of these symptoms are present, your child should be kept home in quarantine as a precaution until a COVID can be arranged.