Tips for Taking Care of Infants, Toddlers and Preschoolers During COVID-19

Many adults think that young children, especially infants and toddlers, don't really notice or understand what is going on around them. Sometimes adults might think, "They will never remember this, so it doesn't really matter to them."

However, even infants notice what is happening around them and can be affected by stress, especially the stress of their parents and caregivers.

Young children don't have the ability to understand the world like older children or adults do. So changes in routines and in people around them can easily make young children worried or anxious, even though they often cannot explain or tell us about their worries.

What young children need the most is a sense of safety and security from parents, which they feel when caregivers hold them, reassure them, stay calm with them and listen to them.

Common Reactions to Stress in Young Children

It's important for adults to remember that young children don't have the language or skills to talk about what is upsetting them.

But young children do show us when they are stressed, worried or upset. It's important for adults and caregivers to pay attention to young children's behaviors and think about how these behaviors might be showing us how children are feeling inside. Common reactions to stress in young children include:

• Increased crying
• Trouble being soothed or comforted
• Sleep problems
• Toileting problems
• Increased worries such as when separated from parents or at nighttime
• Bad dreams
• Temper tantrums
• Clingy or needy behaviors

What Caregivers Can Do

Young children need their parents to comfort them and to keep them feeling safe and secure; they are too young to do this for themselves. It is hard to comfort children when caregivers or parents are stressed themselves, so do the best you can. Some effective ways of helping young children when they are upset or worried or stressed include:

• Reassuring them that you will keep them safe through verbal reassurance (for children who understand language) and/or through physical closeness and comforting movements such as rocking or swaying while holding.
• Keeping the home quieter, like turning the TV volume down, playing soothing music, dimming lights, etc.
• having patience even when there is an increase in problematic behavior, keeping in mind that problem behaviors in young children are a sign of stress and not from being a "bad" kid.
• Encouraging expression of feelings through play and books and stories.
• Maintaining regular routines.
• Keeping good eating and sleep habits, but being aware that short-term changes in sleep arrangements may be necessary, such as if a small child is very anxious at night or when separated They may need some extra time being physically close with a caregiver.
• Getting fresh air and physical movement/exercise.
• Limiting children's exposure to TV and media about COVID-19, limiting exposure to adult discussions about COVID-19 and related stresses, such as loss of a job.
• For children who ask questions about the current outbreak, providing simple and brief information that is age-appropriate, followed up with reassurance that you and lots of helpers, such as doctors and teaches, love them and will take care of them.
• Keeping yourself calm; children take their cues from their caregivers about how they should feel and act. You are your child's most important role model.

Stress Management for You and Your Young Children

Parenting is hard, even in the best of times. It can be even harder when parents or caregivers are stressed themselves about what is happening around them. Be kind and gentle to yourself. A few important things to keep in mind to take good care of yourself during this time:

• Know that the current COVID-19 outbreak is causing an increase in anxiety for many people and may even trigger memories from stressful past events. If this is happening to you, you are not alone.
• Shift your expectations and priorities to focus more on what gives you a sense of calm, peace, purpose and fulfillment.
• Reach out and stay connected to people you trust through video chats or phone calls or other safe ways of communicating.
• Reach out for professional help if needed. Call your healthcare provider or your child's healthcare provider -- they can help connect you with needed resources. Or consider calling a national helpline, such as the National Parent Helpline, 1-855-427-2736 (Monday through Friday 7 a.m. to 4 p.m. EST).

Ideas for Activities to Promote Positive Interactions

• Face-to-face positive games such as peek-a-boo, patty cake.
• Quiet time reading books, looking at pictures or playing with toys.
• Playing with chalk or taking a walk or playing with bubbles outside when the weather permits these activities -- even very young children may enjoy a walk outside in the rain with raincoats or umbrellas.
• Singing or dancing and listening to music.
• Snuggling together while watching educational shows or videos such as those on PBSKids.

Compiled by the pediatric experts in UH Rainbow Babies & Children’s Division of Developmental/Behavioral Pediatrics & Psychology.

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