Dr. Fradin’s Advice as a Pediatrician and a Mom: How to Navigate the Reopening with Kids

You wrote a book during a pandemic. How did that come about? 

I was working for New York City Department of Health doing school health, prior to the pandemic. When everything shut down in March 2020, I was really panicked about what was happening to families in my area and where they were they getting their information, especially when everything was changing so quickly. I started sharing what I was reading and hearing from the scientific medical community on my Instagram page. A lot of people were really desperate for guidance and information. 

In July, I went to send out my first newsletter and I realized I had written 70 pages about parenting in a pandemic and I decided to turn it into a book. I had taken a leave of absence from my job because I didn’t have any childcare like many people, so I decided to write it. I wrote it in a month after my kids were asleep, early in the morning, and during the rare movie. I just got it out there because I wanted to do something and try to be helpful during such a chaotic time.

What were some of the points that you share with parents about coping during this time?

 I think it’s important that parents embrace some of the strategies that we try to encourage our children to develop- such as a growth mindset. For example, every decision we make doesn’t always have to be perfect. As parents we can just be doing our best and accept that we’re still growing and changing. And I think that is helpful for us in having peace of mind as we go through parenting, especially when resources are constrained like they are during the pandemic. Sometimes, your best is just good enough. 

Another thing I really emphasize in the book is mental health. I was so concerned that all the isolation, change, fear, and uncertainty has created a perfect storm for heightening our anxieties, causing anxiety in children, and even variants of post-traumatic stress or OCD. I include how to prevent that, identify that, and sort of parent through that in the book. 

What advice do you have for families now that adults are vaccinated and kids are unvaccinated? 

I find that it’s a very disorienting time for most parents because the guidance from the CDC seems to have just left out young children. And then you see people in the medical community saying masks are no longer necessary and you see some people saying masks are more important for children than ever. It’s really confusing for parents. 

With that said, things are definitely improving. The rates of covid are the lowest they’ve been since the pandemic started. Vaccination rates are up and it’s very possible that in many of our communities where vaccines have been so accepted that we won’t see other surges of COVID, unless new variants spread. We’ll have small numbers of cases continuing to crop up because we didn’t eradicate it. However, when we have 70 percent of adults being vaccinated, that’s really going to limit the spread.  The complication that makes this even more confusing is that it’s not a nationally solved problem. If I’m talking to you in Boston, the advice might be really different than the advice I would give a parent in Mississippi where only 37 percent of adults have chosen to be vaccinated. 

I think that it’s very important that people be aware of their local communities and what’s happening there, as they think about advice because that’s what’s going to impact your family directly. 

We like to think that we control so much about our lives but in reality the community rates of COVID will determine your risk of exposure more than your behaviors.  I do think it’s safe for unvaccinated children to be unmasked outdoors unless they’re in a very crowded scenario- especially with the heat. When it comes to indoor exposures, I’m more selective about my family. I try to limit indoor activities, but I think you have to think about the risks and the benefits and decide what is best for your family. When it comes to cousins and family who they haven’t seen much in the last two years, I will accept some risk of exposure to allow them to play indoors because I think it’s worth it. So as parents we have to kind of make these decisions as best we can with the evidence and information we have access to.

Do you have any updates on vaccines for kids?

The last I heard Pfizer had decided that for kids aged 2-11, that they’ll be going for the FDA emergency use authorization in September. We have every reason to think that the vaccine is very safe and effective. It would provide confidence for a lot of parents who may be nervous about returning to in-person school to have the ability to get their child vaccinated beforehand. I’m really hoping that that will come through. I definitely will get it for my own kids, once once it’s available. 

I don’t think that vaccines under 2 will be available before the spring of 2022. I know we want it as soon as possible, but when community rates are low and going down, I feel confident that those youngest kids will be okay while waiting for the vaccine to be fully tested.

Now that there have been so many kids who are returning to in-person school or childcare settings, what are other factors that families should be considering about the transition period? 

I think one thing that’s important to be cognizant of is the child’s energy load. Being in in-person, full day education settings can be really draining for young children. It requires a lot of self-control and discipline and it’s very stimulating compared to the home environment. If your kids have been home for a lot of the pandemic and are transitioning back to a full person full-day environment, just be cognizant that they may be very tired and it may be a little bit overwhelming on their stamina. 

Sometimes parents can help prepare for a successful transition by filling up their days with activities or outings to get them used to being a little bit busier. Another option is to do half days as you transition in. Otherwise, prepare for after school to be very calm with an early bedtime. It’s important to think about energy because kids who are overtired tend to struggle a lot more with separation anxiety and can be very difficult to parent when they feel overstretched. So if we can set our kids up for success, it will make the process more pleasant for everyone involved.