Corona Virus and Other Illnesses: How to Handle Sleep Training When Your Child Is Sick
With my pediatric nurse practitioner hat on... The good news for parents everywhere is that corona virus, aka COVID-19, is rare in children. Most children either have no symptoms or very mild symptoms. It is much more likely that your child will get sick with the common cold or the flu.
If your child has not yet been vaccinated against the flu, please go today for the vaccine. Getting the flu will make her more vulnerable to catching other infections, plus the flu kills children every year. She is more likely to die from the flu than from COVID-19.
Other measures you can take to protect your children: wash hands frequently. Alcohol-based hand sanitizer works well also (assuming it is at least 60% alcohol -- check the label). Keep your child home from school or daycare if he has a cold or other signs of illness. Call your doctor's office if your child looks sick -- don't just walk in!
For more information, please check out this article from the American Academy of Pediatrics. Remember to always get your health information from reliable sources such as this. Please do not trust Facebook or other popular media sources that have not been vetted.
(Sleep consultant hat on again.)
Get your child outside for daylight, fresh air, and exercise every day that you are both well. These all boost a healthy immune system. If you are concerned about contact with others, you can easily avoid playgrounds and busy parks. Find a quiet road to walk on and count squirrels, or birds, or rocks. Or play tag in the backyard for ten minutes -- this has the advantage of getting your child laughing and allowing him to "empty his emotional backpack."
And keep your child well rested. A well-rested child has a stronger immune system than an overtired one. Focus on prioritizing an early bedtime, between 6 and 7 pm for most children under six years old. Start naps on time or even early, at 12 pm for once-a-day nappers and 9 am and 1 pm for twice-a-day nappers.
What if your child is sick and you have recently sleep trained?
There are no simple answers here. Try to maintain the sleep routine as much as possible while also allowing for flexibility as needed.
For example, if your child recently weaned off milk at night, in most cases you should not offer milk again at night unless your child is vomiting or has a high fever and won't take other liquids. In that case, offering breastmilk or formula (during the first year of life) at night may make sense but you should try not to let your child fall asleep while feeding. Once the vomiting or high fever has resolved, typically in 1-3 days, you should switch to offering only water at night.
Likewise, if your child recently learned to sleep alone in his room but may have a fever, you should go into his room promptly if he wakes up and cries during the night. If he flashes a huge grin at you when you enter, you can assume he's fine and give him a quick pat and leave again. But if he's sobbing and hot to the touch, of course you should take him out of the crib and attend to his fever. You may wish to give a fever-reducer -- check with your healthcare provider on the best options -- and then rock him until he feels better. Try to put him down drowsy but awake if you can. If you can't, it's okay. Just resume your good habits as soon as possible when he's feeling better. It may take a few days but with consistency, once he's well, he'll get back to his good habits again.
If you have any concerns that your child is having difficulty breathing, please don't leave her alone. Call your healthcare provider immediately. She should have an after-hours emergency number to call. This is the time to use it! If you are worried about being a bother, the best thing you can do is to call early and don't wait for 3 am. This is what pediatricians are for. In most cases they are able reassure worried parents over the phone. In a few cases, they will advise parents to go to the emergency room. Remember that emergency rooms are full of sick people so don't go there for routine illnesses (including fever without difficulty breathing) that can wait for the pediatrician's office in the morning. Again, when in doubt, call your doctor.
For families with older children (preschool and up), please remember that this can be an anxious time for them, too. And anxiety can make it harder for them to sleep. Laura Markham at Aha Parenting has some excellent tips on addressing children's anxiety around Covid-19. These tips include: start by asking your child what they have heard and correcting any misinformation, reassure them that grownups have got this covered and that healthy children and grown ups are not at risk, turn off the TV and other news sources that your children are exposed to, and teach them good hygiene. Cough or sneeze into a tissue or your elbow not your hands. Use hand sanitizer for 20 seconds (long enough to sing Happy Birthday twice) or scrub with soap for 20 seconds, making sure that hands are wet before adding soap and that the soap is not rinsed off until after the 20 seconds are up (it may be a pet peeve of mine that folks think that adding soap to dry hands and then scrubbing under running water will optimally reduce illness transmission).
This is a scary and uncertain time in our world, no doubt about it. But keeping our children reassured and our families active and well-rested can only help us in the battle against new and old illnesses alike. For help getting your family the rest you need, schedule a free chat and look forward to optimizing your family's health and happiness.
Abby Wolfson is a pediatric nurse practitioner, certified child sleep consultant and certified life coach for parents. She divides her time between Brooklyn, NY and San Miguel de Allende, Mexico.