Keeping children safe in the COVID-19 pandemic

Living in a global health pandemic, many parents are understandably seeking ways to protect their children from the virus. Even as the world battles COVID-19 by ramping up the roll-out of vaccines, children remain one of the most vulnerable populations. None of the vaccines have been tested in children ≤ 12 years old thus far, which precludes their use in them. Here are 7 suggestions to keep our children as safe as possible in the COVID-19 pandemic.

1. Ensure Proper Personal Hygiene

To minimise the spread of germs, consider the following measures: 

• Wash hands thoroughly for at least 20 seconds with soap and water, especially before eating, after using the bathroom, after touching common surfaces like lift buttons/toys, after wiping nose/coughing/sneezing.
• Carry disposable antibacterial wipes or an alcohol-based hand sanitizer (at least 60% alcohol) for on-the-go cleanups, especially where access to soap and water for hand washing may not be immediately available. Teach young children to cover all surfaces of their hands with sanitiser and rub until they feel dry.
• Disinfect high-touch or shared surfaces e.g. door knobs; table tops and high chairs when dining out; toys after playdates with other children. 
• Avoid sharing personal items e.g. dining utensils/drinking ware, bring your own wherever possible.
• Shower immediately upon returning home after having spent considerable time out, at school/at the playground etc.
• Cover mouth and nose with a tissue when coughing or sneezing, throw used tissue away and wash hands immediately after.
• Children 2 years and older should wear a proper fitting mask when in public.

2. Encourage Regular Exercise

Studies have shown that regular exercise may support immune system function, by boosting circulation of disease-fighting white blood cells throughout the body. Engage in activity outdoors as indoor spaces may not be as well-ventilated, predisposing to higher risk of airborne transmission of virus. Furthermore, through exposure to sunlight outdoors, the body produces Vitamin D which is vital not only for bone and teeth health, but has been suggested to bolster immunity.

Exercise can also boost the brain’s production of feel-good neurotransmitters called endorphins, relieving stress, improving sleep, overall well-being and health.

When exercising in public however, avoid large crowds and maintain at least 1m apart. 

3. Ensure Adequate Hydration

The human body is composed of an average of 60% water. Water is vital for supporting good health in many ways: 

• Enables body to produce lymph which carries white blood cells and other immune system cells
• Supports a functioning digestive system which improves nutrient uptake 
• Aids the cardiovascular system in delivering nutrients and oxygen to cells all over body
• Removes wastes and toxins too, e.g. as part of urine produced by kidneys

It is thus important to ensure your child stays well-hydrated. Children between 3-6 years old are recommended to drink 3-5 glasses of water daily, and those between 7-12 are recommended to drink 6-8 glasses a day (one glass is ~250ml). Do note that besides age, fluid requirements may vary depending on activity level and the weather. Besides drinking water, other sources children can obtain fluids from include soups, fruits with high water content e.g. melons, barley water, store-bought, unsweetened fruit juices or milk fortified with vitamin D.

One useful tip to monitor healthy water intake is the colour of urine. Encourage your child to drink more fluids if urine is dark-coloured or concentrated.

Proper hydration is essential for all organ systems in the body, including the immune system!

4. Ensure Adequate Sleep

Children require sufficient good-quality sleep to recover from physical and mental stress. Sleep deprivation dampens the body’s production of protective proteins called cytokines, which weakens the immune system. Having ample sleep means at least 10 hours a day if they are 3-5 years old, and at least 9 hours a day if they are 6-13 years old.

To ensure restful sleep, they should wind down at night. A consistent bedtime ritual can help ease children into the land of nod. Make it relaxing and calm – such as reading a story or having a warm glass of milk. Avoid screen time before sleep as it may arouse them. Intense, close-up light exposure in the evening will delay sleep by not allowing the body to produce melatonin/sleep hormones.

5. Eat a Healthy, Balanced Diet

To keep their immune systems primed and ready to fight, children should eat a healthy well-balanced diet comprising 

•  Fruits and vegetables e.g. berries and dark leafy greens like kale/spinach provide antioxidants to protect cells from damage and disease. 
• Omega-3 rich fatty fish e.g. salmon have anti-inflammatory properties and research suggests a role in activation of immune cells
• Meat – proteins are a good source of energy and zinc contained in meats support white blood cell activity
• Whole grains/high-fibre oats (prebiotics) promote growth of good gut bacteria

Opt for healthy snacks e.g. nuts, cheese, yoghurt. In fact, live yoghurts are a source of probiotics for good gut health, which has also been linked to immunity, since 70% of the body’s immune system resides in the gut.

Cook your meals at home using fresh produce to improve the quality of your family’s diet. Avoid processed foods like frozen pizza, sausages or minimise eating food outside which are usually high in salt/sugar, trans fats, calorie-laden yet not nutrition-dense.

Moreover, with dining out or eating take-outs, there is always that risk of increased chance of exposure to virus from human traffic and we cannot ascertain that hygiene standards for food preparation process are being upheld.

For infants, breast is best. Breast milk contains all essential vitamins, minerals and nutrients for baby’s development for the first 4-6 months, providing antibodies that can build a robust immune system and good gut health.  The American Academy of Pediatrics recommends that moms exclusively breastfeed for first 6 months, but formula milk is an alternative where breastfeeding is insufficient or not possible.

6. Ensure Our Children Receive All Other Recommended Vaccines

The National Childhood Immunisation Schedule (NCIS) comprises childhood vaccinations recommended as the standard of care for protection against 14 vaccine-preventable diseases – tuberculosis, hepatitis B, diphtheria, tetanus, pertussis, Haemophilus influenzae type b, measles, mumps, rubella, pneumococcal diseases, human papillomavirus, varicella and influenza. By ensuring your child receives these vaccines, they will not fall prey to these serious diseases which is paramount for their immune system to be able to fend off other viruses like COVID-19.

7. Giving Vitamins and Supplements

In recent years, some of the more popular supplements touted to turbocharge immunity in children include Elderberry and Echinacea. However, there are no rigorous studies to date which can provide conclusive evidence of their antiviral effects or impact on duration/severity of colds. Besides these cold remedies, there are many vitamins and supplements available today, which claim to promote good health. 

It it worth noting that unlike drugs/medicines, supplements are not evaluated by regulatory bodies for their importation, manufacture and sales. There may be inconsistencies in product formulation; quality and efficacy cannot be ascertained without formal regulation. 

As such, it is still best to obtain vitamins and nutrients from dietary sources. However, if you are faced with a picky eater or your child has allergies or health conditions which render his nutritional intake from food insufficient, you may consider supplements. Buy only well-established brands from reputable sources, follow dose and storage recommendations. If in doubt, it is best to consult a pediatrician for advice.

Prevention is Better Than Cure 

Even with the steady pipeline of vaccines, mutant strains are emerging; the spread has slowed but it seems that the virus is here to stay for the long haul. Healthy habits like practicing proper hygiene, eating well, staying active and resting well are good protective measures for our children and our best bet in these uncertain times.