• Subtle signs of stress in kids includes disruptions in sleeping patterns, headaches, or changes in personality.
  • It's really important now more than ever for parents to check in with their kids, ask about their concerns, and encourage them to stay connected to their social networks.
  • Dealing with a once-every 100-years pandemic means it's ok to give ourselves a break when it comes to screen time.
  • Stressbuster tips for kids from the U.S. Surgeon General's playbook include getting daily exercise, sticking to a regular bedtime, and cooking fun and nutritious meals together.

Video Transcript

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JOHN WHYTE: You're watching Coronavirus in Context. I'm Dr. John Whyte, Chief Medical Officer at WebMD. Today we're going to talk about the impact of COVID-19 on kids. And my guest is Dr. Burke Harris. She's a pediatrician and surgeon general of the state of California. Dr. Burke Harris, thanks for joining me.

NADINE BURKE HARRIS: Hi. It's good to join you. Thank you.

JOHN WHYTE: Now all of our schedules have been thrown off. But for children, it's particularly concerning when they don't have schedules, especially for young children. Talk to us about how stressful this time can be for children and what parents might need to look out for.

NADINE BURKE HARRIS: That's right. So, you know, kids are seeing disruption in their regular routines. Uh, of course, you know, not being in school, uh, not having the same, uh, kind of usual school, after school activities. And things that, uh, you know, all of these changes can be really stressful for kids.

And so some of the ways that, um, kids can manifest stress, um, are really, you know, changes in their sleeping patterns. For little kids, changes in their toileting habits. So, you know, a kid who's been potty trained, they can have a little bit of that regression and, uh, you know, go back to wetting or something along those lines.

And then as kids get older, we see, you know, some kids have, uh, they don't necessarily say that, oh, you know, I'm feeling stressed. They may have tummy aches. They may have headaches. And for older kids like teenagers, we-- they may be more irritable or they could even be more withdrawn.

JOHN WHYTE: But perhaps it's that change in personality, maybe even subtle, or-- or change in some behaviors. Is that what parents should look for?

NADINE BURKE HARRIS: Yeah. I mean, I think one of the things that we're seeing, uh, right now and that we're really recognizing is that it's really important for parents to check in and see how their kids are doing, if their-- if their kids are more irritable or-- if they're more withdrawn. You know, any of the above. It's really important just to-- to touch base, see how they're doing, and just touch base more frequently.

JOHN WHYTE: And let's be real practical about that. How do we do that? Because to say to some kids, how are you doing, you know, we don't always get a response in kids. Do you have some tips and pointers that-- that parents can use to kind of broach that conversation, to really kind of figure out how their kids are managing, you know, this stress?

NADINE BURKE HARRIS: Well, some of the things I do with my own kids, and my husband and I have four boys, so I get lots of practice on this, is, um, you know, s-- some of the things that we do when we have dinner together as a family each night with our regular, you know, meal times is checking in on, you know, what are some of the most frustrating things about the pandemic or what are the things that are driving you the most crazy.

I think for, uh, some kids, asking how are they keeping in touch with their friends, how is so-and-so doing, that is, um, particularly for teenagers who stay in touch with their friends either via social media or through, um, you know, or through text or other technology.

Asking some of these rand-- you know, roundabout questions can help us understand, uh, whether or not our-- our kids are staying connected to their social networks. I think for littler kids, it's-- you can just, you know, really straightforwardly ask if they have any concerns.

Ask-- you know, what have they heard about the coronavirus and if they have any worries. And give them an opportunity to share, in their own language, what they've heard, you know, what they're nervous or scared about, and then correct any misperceptions that may be going on.

JOHN WHYTE: How do you feel about screen times as a pediatrician and a parent? Were you more lenient with that right now? You know, parents are trying to juggle a lot of different things. Doing those Zoom calls while their kids are in another room. What's your advice for screen times?

NADINE BURKE HARRIS: So, you know, screen time is something that folks have asked me about quite a bit. And, uh, you know, the thing that I say for-- for everyone right now is, now's the time for us to give ourselves a little bit more of a break. I think it's OK to be a little bit more lenient than we might typically be because we are in a once every 100 years pandemic.

So-- so I think that, uh, you know, although of course we want to put limits on kids' screen time. We, at the same time, have to recognize that, you know, it's OK for-- for us to give ourselves a break and give our kids a little bit of a break as well. JOHN WHYTE: So what are some stress busters that you use in your family?

NADINE BURKE HARRIS: So we actually use some of the-- the really evidence-based, uh, recommendations that we've included in the surgeon general's playbook for stress relief during COVID-19 that we've made available on our-- our website here in California, but is available to anyone, which is covid19.ca.gov.

Getting out and doing some exercise every day, really important. We make sure that the kids get on their bikes and, you know, go around the-- go around the park and have an opportunity to get some of that energy out. Um, also, even though kids are not going to school every day, I think keeping those regular routines is really important. So going to bed at the same time each night, waking up at the same time each morning, and having some regular routines. Having the kids have an opportunity to-- to share in setting those routines I think is really important. Um, and we have a lot of fun with, you know, nutrition. There's a lot more cooking that goes on during the pandemic time, uh, which is a lot of fun.

But we make sure that the kids are getting healthy meals, because it's very easy for all of us to be, you know, craving some of those high sugar, high fat foods. And that's not just because, you know, we're at home. It's because when we feel stressed, stress hormones like cortisol actually cause our bodies to crave high sugar, high fat foods. And so having good nutrition is actually really important to helping to regulate the stress response.

JOHN WHYTE: You've talked about buffers to allow kids time to process what's going on. What are examples of some of those buffers?

NADINE BURKE HARRIS: Well, one of the most important buffers is just, um, safe, stable, and nurturing relationships. In our house, there are a lot of snuggles that go on. So, you know, hugs, snuggles, giving, uh, kids an opportunity to-- to honestly share whatever is going on with them and, uh, talk about their feelings, whether they're good, bad, whatever. And having that safe place. I think that's really important.

But the other thing that's also really important that we often forget as parents and caregivers is that one of the most important things for children's well-being is our own well-being, right? In scary situations, what kids do is they instinctively look at their parents and caregivers.

And if we're freaking out, that gives them the signal that they-- that they should be freaking out. And so our ability to put our own oxygen mask on and do that self care so that we can be well regulated actually helps our kids be able to regulate themselves.

JOHN WHYTE: What are you optimistic about? There's a lot of stress. There's a lot of doom and gloom at times. Tell us what you're optimistic about.

NADINE BURKE HARRIS: Well, you know, what the research shows us is that, you know, the-- the way that our bodies respond to stress, it's actually three different, uh, biological responses our bodies can have. We can have, you know, the toxic stress response where the stress is harmful and leads to long term health problems.

The tolerable stress response where the body is affected by it, but through the buffering effect of caring relationships, the body returns to that natural biological balance. And there's something that's even called a positive stress responses, which is, you know, a little bit of stress that's self-limited can actually lead to further growth and development.

And so the thing that I'm really optimistic about is that with that safe and nurturing relationships and with that buffering care, I think that there's an opportunity to keep the stress into that positive or tolerable range and out of the toxic range.

And I think there's a lot of, um, growth and connection, a deepening of a sense of empathy, and a-- a level of development that can happen right now that, uh, I think ultimately has an-- an opportunity to be a time of growth.

JOHN WHYTE: Thank you for joining us today.

NADINE BURKE HARRIS: Oh, it's absolutely my pleasure. Thank you.

JOHN WHYTE: And I want to thank our viewers for watching Coronavirus in Context.