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We Know Kids

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Covid-19 Exposure Guidance

I was notified that my child was exposed to COVID, what should we do?

Boy looking up and washing his hands during Covid-19

As rates of COVID-19 increase in our area, more and more families are facing this situation. Parents may be notified through school, extracurriculars, or social contacts that they or their children have been exposed to COVID-19.

Families have been asking Willows Pediatrics what to do when they find out they have been exposed to someone who has a confirmed COVID-19 infection. This post will try to give you some guidance. We understand this can be scary and we are happy to talk you through the specifics of your situation, just give us a call at (203) 319-3939.

What counts as a COVID exposure?

According to the CDC, exposure to COVID-19 is defined as having close, prolonged contact, being within 6 feet for greater than 15 minutes, with a person who tested positive either while that person was symptomatic or in the 48 hours prior to that person becoming symptomatic.

If the person who tested positive was never symptomatic then consider any contact with that person within a few days of their test to be a possible exposure.

One of the members of my household was exposed to COVID. What should we do?

If a member of your household was exposed to COVID-19 then that person should quarantine for 14 days from their last contact with the positive person. Try to limit the spread of COVID in your household by having the exposed person self-isolate in one area of the house, wear a mask when in common spaces, and have their own bathroom, if possible. Of course, self-isolation is not an option for a young child so the parent should wear a mask around the child.

If the exposed person is asymptomatic, we recommend they get a PCR test 5-7 days from their exposure. Rapid tests have a high false negative rate in asymptomatic people and are not approved for this use. If the exposed person develops symptoms, then a rapid test is appropriate.

We were exposed but tested negative. Do we still have to quarantine?

It is very important to know, a negative test after an exposure does NOT exclude COVID-19 and you must continue to quarantine for 14 days from your last exposure.

Like other viruses, COVID-19 stays in your body and replicates over several days (for up to 14 days). Unfortunately, even a COVID-19 PCR test may not detect an early infection.

For example, if you were exposed on Monday, you could test negative on Thursday, but still be contagious or symptomatic by Saturday.  So, even if you test negative, you should still continue to quarantine after an exposure.

Family First: Developing And Encouraging Healthy Eating Habits During The Pandemic

As we head into the fall season, many parents are asking what they can do to keep their children as healthy as possible. With families needing to adjust work and school schedules, many familiar routines have changed, including meal time. Healthy nutrition has always been vital to the well being of children and adolescents, and even more so as families are spending more time at home, often in front of screens, and for many, managing a reduction in activities outside the home.

Abby Greenspun, RD, our nutritionist, was recently interviewed by Fox61 and offered her suggestions on how to encourage healthy eating habits during this time.

Some of the tips Abby offers include:

Brightly colored foods are often more appealing – “eating the rainbow” in particular bright colored fruits and vegetables. These foods are rich in minerals, vitamins, and fiber.

Fresh foods are preferred over processed, packaged foods.

Whole wheat pasta has all three layers of the wheat kernel: the bran, the germ, and the endosperm, which gives it an edge over white pasta when it comes to fiber and micronutrients.

Overall, Abby recommends keeping your family food options simple, colorful, and fresh. To hear Abby’s interview, please click here.

Sleep: Getting Back On Track For School

As we head into the school year, especially during this uncertain time, we thought it was a good time to talk about sleep.

Sleep is critical for many reasons. We are sure you have heard how important it is for growth and development and for encoding new memories. We also know not getting enough sleep can contribute to inattention, trouble focusing, and mood changes.

Right now, kids and adults are dealing with a lot of uncertainty. It can be extremely helpful for children and teens to have a consistent routine.

How much sleep do children need?

Of course, every child is different! But here are some general guidelines from the American Academy of Pediatrics.

Recommended sleep chart - Willows Pediatrics

Bedtime at our house has moved later and later, how do we move it back?

It is common for bedtimes to shift over the summer when it is lighter later and we don’t have to get up early for school. This is especially true this year since summer was preceded by several months of remote school. We recommend gradually shifting your child’s sleep schedule earlier.

Here are some strategies:

  • Starting a few weeks before school, wake your child up a little earlier each morning (try 15 minutes) and get ready for bed a little earlier each night
  • Get morning sunlight, this helps reset our biological clock
  • Try to get some active time each day
  • Put away screens 1 hour before bedtime
  • Limit snacks and sweets a few hours before bedtime
  • Establish a consistent routine that you can repeat each night so your child knows what to expect
  • Have a family discussion about the sleep plan so that your child will understand the new routine.

Why are screens bad for sleep?

Electronic devices such as tablets and phones emit an artificial blue light, which tricks the body into thinking it is daytime. Blue light suppresses your body’s natural release of melatonin. Melatonin induces sleep as part of your circadian rhythm, your body’s internal clock. Using screens later at night disrupts your body’s natural sleep drive.

We encourage parents to establish a bedtime routine that does not include screens. Instead encourage other quiet activities such as reading a print book or journaling.

Do you have any specific advice for teens?

Sleep is especially important but also difficult for teens. The biological clock in teenagers is shifted later, meaning they often have trouble initiating sleep as early as would like.  Here are some tips especially for them:

  • Have a conversation with your teen about sleep and getting back on track for school. Try to get their buy in, help them understand why you are doing this.
  • Lots of teens are sleeping in late this summer; start getting them up earlier to help them adjust to an earlier bedtime.

Advice for teens (continued)

  • Set an electronics curfew and store phones outside of the bedroom overnight. This is a great habit for teens to establish. We are all addicted to our phones but we want to protect our teens from this as much as possible.
  • Use an alarm clock that is not their phone! A traditional alarm clock is a worthwhile investment. They even make mobile ones, for hard to wake teens (check out Clocky).
  • Make your teen’s bed only for sleep. The brain will associate the bed with being awake if your teen spends the day lounging or doing remote school there. If possible, try to have your teen do their schoolwork in a different location.

What if I have other questions or these tips are not working?

We are here to help! These tips are just a starting point. We are happy to discuss your individual child and family. Please give your physician or PA a call!

COVID 19 Testing: Antibody and Viral tests

There are two kinds of tests for COVID-19: a viral test and an antibody test.

  • A viral test (nasal or oral swab) tells you if you have a current infection
  • An antibody test (blood test) tells you if had a previous infection

Viral Tests: Testing for current infection

To learn if you have a current infection, viral tests are used. A viral test is collected by a nasal or oral swab at a testing center in our area.

Who should be tested?

  • The decision to get tested depends on several different factors including how sick the patient is, what medical problems the patient has and who resides in the patient’s household (e.g. an immunosuppressed family member, a parent who is a health care worker)
  • At this time, we still encourage testing only if you have symptoms suggesting a COVID-19 infection.
  • If you have symptoms suggesting COVID-19 and want to get tested, please call our office.
  • If you have gotten tested and are awaiting the results, please isolate/quarantine to avoid possibly spreading the infection to others.

Interpreting the results

  • If you test NEGATIVE for COVID-19 by a viral test while you have symptoms, then you likely do NOT have COVID-19. Though we know that there are some false negatives, meaning people who actually DO have COVID but get a negative test result, a false negative result is unlikely.
  • If you test POSITIVE for COVID-19 by a viral test then you have an active infection. Please quarantine in your home and isolate as much as possible from others in your home. If you test positive, we can discuss with you how to minimize spread within your home and when you can safely leave isolation.

Antibody Tests: Testing for past infection

Antibody tests are blood tests that check if your body has antibodies from a previous infection with the virus. Antibodies are proteins our immune system makes when we are exposed to a virus and continue to circulate in our blood after we have recovered from the infection. COVID-19 antibody tests cannot be used to see if you have a current infection, as sometimes the antibodies cannot be detected for weeks after the initial infection.

We use antibody testing for many other diseases to tell us if a patient has had an infection or has immunity to a disease. For diseases that have been studied over time we know what level of antibody is effective and we know whether that antibody can give you temporary or permanent immunity. However, since COVID-19 is a new disease we don’t have all the facts yet.

Cautions regarding antibody tests:

  • We do not know at this time if antibodies provide immunity against getting re-infected
  • We do not know how specific the antibody tests are for detecting antibodies to SARS-CoV-2 versus closely related coronaviruses such as the common cold.
  • There are many tests available right now but few of them have been FDA approved, meaning we do not know how accurate these tests are. In other words, if the test says you have antibodies, or don’t have antibodies, how likely is that to be true?

Given all of these cautions, we are not currently recommending antibody testing for most people. The only scenario in which we DO recommend testing is if you have had a positive COVID-19 viral test and are interested in plasma donation.

Why we don’t think you should get an antibody test now:

  • We are concerned that you may get a “positive” result when you don’t actually have antibodies to COVID. This could happen because these tests are still very new, they were released to the market before the FDA validated them and you may have very similar antibodies from a very similar virus you’ve had in the past. If you got a positive result you may interpret that to mean you are immune, when in fact you are not. This could be dangerous as you may not be as rigorous about wearing a mask or social distancing and accidentally expose yourself or others.
  • We don’t know yet what having antibodies to COVID-19 means. We don’t know if those antibodies confer immunity and, if so, how long that immunity lasts.
  • Antibody tests are usually expensive. Since many of the tests on the market are not FDA approved they may not be covered by insurance.
  • Antibody tests require a blood draw in a doctor’s office or hospital. We usually do everything we can to minimize blood draws in kids to avoid discomfort.

Looking forward:

The scientific community is working furiously to learn more about COVID-19 each and every day. We are hopeful that soon we will know more about COVID-19 antibodies and immunity. We are also hopeful that the FDA will review the tests on the market and guide us to which tests are the most accurate. We will continue to follow this issue closely to give you the best guidance and we will update you when our recommendations change.

For now, please continue to social distance, stay home if you or anyone you’ve been in contact with is sick, and wear a mask when social distancing is not possible.

Sources and Suggested Reading

https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/testing.html

https://www.scientificamerican.com/article/what-covid-19-antibody-tests-can-and-cannot-tell-us/

https://www.idsociety.org/news–publications-new/articles/2020/emphasizing-need-for-more-information-idsa-releases-antibody-testing-primer2/

Baby Group Now On Zoom!

Due to Covid-19 precautions, we have replaced our in-office baby group with a virtual baby group meeting though Zoom. Our baby group is still led by our awesome lactation consultant Heather. The spirit of the group is as strong and vibrant as ever. Our virtual baby group is a great way to connect with lots of new moms, especially during this challenging time. The group meets Tuesdays at 11 am. If you have a baby 0-3 months, please call our office to learn how to join. We look forward to meeting soon!

Willows Pediatrics Baby Group on Zoom!

Save the Children: Story Time

Save with Stories - HashtagWe know that families are enduring unprecedented times.  With families spending more time self-isolating at home, we wanted to share with you a wonderful opportunity to bring story telling into your home.  Save the Children in Fairfield is on the front lines of helping millions of kids during these times of social distancing.  That’s why Save the Children and No Kid Hungry have partnered to offer stories on Instagram and Facebook to provide fun and education to kids and parents stuck at home during the coronavirus outbreak.

The #SavewithStories campaign was started by Jennifer Garner and Amy Adams.  They currently have over 100 celebrities reading some of their favorite children’s books.  Kids love listening to them!  No donation is required.  It’s a great way to keep your kids entertained, or listen to their favorite stories together.

See Dr. Allison read “The Hungry Caterpillar” on the Save with Stories Instagram account.
Join us, along with @savethechildren and @nokidhungry, to #SAVEWITHSTORIES.

Dr. Allison - Willows Pediatrics, Save With Stories

To access more information about Save with Stories, please click the link below. Save the Children also is providing tools and tips you can trust for parents, caregivers, teachers and all those who care about children in crisis. The Save the Children Coronavirus Resource Center offers parents tips on how to talk to their kids about Coronavirus, activities and how to cope with extended school closures.

Save the Children and No Kid Hungry Logo

Links:
Save With Stories
Coronavirus Resource Center

 

Virtual Visits: Willows Without Walls

Willows Pediatrics giving a virtual office visit via computer Willows Pediatrics giving a virtual office visit during COVID19

Due to the ongoing concerns with COVID 19 infection, we are offering virtual visits to all of our patients. When you call in with any health concerns, you will be directed to speak to one of our PAs or nurses.  Based on your child’s symptoms, we may recommend a virtual visit. A virtual visit is an audio and visual connection with your doctor or PA using your phone, iPad, or computer with a webcam. You will be a assigned an appointment time and directed to a website where you and your child will meet with your doctor or PA virtually. During this visit we can assess your child and make recommendations, or prescribe as necessary.

Just like an in-office visit, these virtual visits will be billed to your insurance company. As always, we cannot guarantee coverage. Please call us if you have any questions, we are here to help!

Connect To Your Virtual Visit

Please click on the links below to connect with Doxy.me.

MDs

Dr. Allison: Doxy.me/drallisonwillows
Dr. Marks: Doxy.me/drmarkswillows
Dr. Owens: Doxy.me/drowenswillows
Dr. Sheiman: Doxy.me/drsheimanwillows
Dr. Sollinger: Doxy.me/drsollingerwillows
Dr. Woodward: Doxy.me/drwoodwardwillows

PAs

Susan Amster PA-C: Doxy.me/pasusanwillows

Specialists

Susie Basler – Social Worker: Doxy.me/susiebwillows
Abby Greenspun – Nutritionist: Doxy.me/abbygnutrition

Coronavirus: News and resources for families

We understand that families are concerned about coronavirus (COVID-19). All of us at Willows Pediatrics are carefully monitoring the situation on a daily basis. We are here to answer your questions, and let you know how we can help you and your family stay safe at the same time we address the more routine questions and concerns about your child’s health. The CDC website is a reliable source of information for news and updates on COVID-19: cdc.gov/coronavirus. Below are steps you can take to protect yourself, your family, and our community. While most families are already aware of them, they are still key:  Read More

Lactation Support News

Heather Buccigross - Lactation Support at Willows PediatricsWe are pleased to announce that Physician Assistant Heather Buccigross is joining Cathy Peters to provide lactation consultations in our office. In addition to working closely with Cathy over the past several months, Heather has recently completed a lactation consultant training program consisting of 90 hours of course work. Most recently, Heather has successfully passed her International Lactation Consultant exam, certifying her to work with moms and newborns for all of their breast feeding needs.

Heather is thrilled to add lactation consultant to her set of skills, and is available by appointment and/or phone call most days. Please don’t hesitate to ask your doctor, PA, or nurse if you have any questions.

 

 

Dr. Allison Speaks About School Start Time

Pushing back school start times has been a topic of discussion at both the national level and local level. Nationally, the American Academy of Pediatrics and the American Academy of Sleep Medicine have recommended that middle and high schools delay the start of class to align school schedules to the biological sleep rhythms of adolescents. At the local level, a number of school systems in Fairfield County have either implemented, or are considering implementing delayed school start times. 

Speaking at a Westport Board of Education meeting on January 13th, Dr. Allison shared her support for pushing back the school start time in Westport, stating, In summary, many pediatric governing bodies have recommended this and found that it’s better for overall health in many areas,” she said, noting it was “really hard” to overcome a teenager’s biological drive to stay up at least until 11 p.m. and sleep in later.”

As Westport and other towns continue to discuss the implications of delayed start times, the physicians and PA’s at Willows Pediatrics will continue to advocate for the health of our families and patients. 

More Information On School Start Time And Sleep

Sleep For Success of Westport

WestportNow: Strong Opinions On Later School Start Times