Good to Know

The American Academy of Pediatrics wants moms and dads to call their pediatrician. With lives upended by the pandemic and national data showing immunization rates dipping to dangerously low levels, the group is urging parents to call their pediatricians to schedule check-ups and vaccines for children of all ages. “Parents have a lot on their minds right now. We want them to know pediatricians are open for business, and we are ready to schedule visits to make sure their children are fully immunized,” said AAP president Dr. Sally Goza. “We want to reassure parents that pediatricians have taken every step to make these visits safe.”

Pediatricians around the country are worried that while staying home for the COVID-19 pandemic, children may be at an increased risk for drowning. The AAP urges families to add extra layers of protection to keep children safe around all sources of water in the home this summer, as caregivers may be distracted by work and other responsibilities. Resources on drowning prevention can be found at aap.org/drowning.

Multigenerational households are on the rise in Massachusetts. That’s according to a new study by SmartAsset, which found the Bay State No. 7 on their list of states where multigenerational households are becoming more common. Almost one in every 25 households in America consists of three or more generations living under the same roof, they found.

Ready to resume playdates? Here’s CDC tips for staying safe

As the country begins to reopen and restrictions are lifted, some parents are beginning to also have less restrictions on their children having play dates with their neighbors and classmates.

Here are the Centers for Disease Control and Prevention’s recommendations for playdates with friends: • Limit social interactions: Encourage older children to meet friends outside rather than inside. It’s easier to keep and maintain space between others in outdoor settings like parks. • Practice social distancing: If you do have small meetups, consider hanging out with another family or friend who is also taking extra cautious measures to distance themselves from others like you. Always try to maintain a 6-foot distance from each other. • Clean hands often: Make sure children practice preventive behaviors every day like washing their hands often with soap and water for at least 20 seconds. This is especially important every time you are in a public place. • Open spaces: Families can organize small play dates in big open spaces like parks. Encourage children to take turns and not play simultaneously on equipment.

Fish and pregnancy: benefits outweigh the risks, new study says

To eat or not to eat fish is a question that has long concerned pregnant women. Now, a new study shows that children whose mothers ate moderate amounts of fish during pregnancy were more likely to have a better metabolic profile -- despite the risk of exposure to mercury -- than children whose mothers ate fish rarely.

The research, published in JAMA, looked at 805 mother and child pairs from five European countries participating in a collaborative research project known as the HELIX study, which is following women and their children from pregnancy onwards.

During their pregnancy, the women were asked about their weekly fish consumption and tested for mercury exposure. When the children were from 6 to 12 years old, they underwent a clinical examination with various measurements including waist circumference, blood pressure, high-density lipoprotein cholesterol, triglyceride levels and insulin levels. These measures were combined to calculate a metabolic syndrome score.

The study found that moderate fish consumption during pregnancy was associated with less inflammation as well as improvement in the metabolic profile of children. Exposure to high levels of mercury, however, had the opposite association.

“Results of this study suggest that moderate fish intake consistent with current health recommendations during pregnancy was associated with improvements in the metabolic health of children, while high maternal mercury exposure was associated with an unfavorable metabolic profile in children,” said the author.

Pregnant and breastfeeding women should eat 8 to 12 ounces (that's two to three servings) of low-mercury fish every week, according to the Environmental Protection Agency (EPA) and the Food and Drug Administration (FDA).

Spotting the signs of adolescent anxiety

BY MELISSA ERIKSON

In today’s world kids have a lot to handle, so it’s not surprising that some adolescents have trouble coping. High expectations to succeed, the constant pressure of social media and a global pandemic are just some of the factors contributing to stress and anxiety levels.

Anxiety can overwhelm and paralyze children, whether from separation anxiety or vague fears of the future to concerns with friends or being afraid of the dark.

Nearly 1 in 3 adolescents will experience an anxiety disorder, according to the National Institutes of Health.

The number of children diagnosed with anxiety disorder is increasing and has been for years. A new study by the American Academy of Pediatrics found that over a 10-year period, the percentage of children who showed up in hospital emergency rooms for mental health disorders rose by 60 percent, while visits for self-harm increased by a staggering 329 percent.

But are more children affected by anxiety or is society now doing a better job paying attention?

“Historically, a few decades ago it was thought that anxiety and depression didn’t even affect children,” said Dr. Sarah O’Rourke, pediatric psychologist with Duke Health in Durham, North Carolina.

A greater recognition of anxiety and other mental health issues in children began in the 1980s and ’90s. In the 2010s research showed that high school students were twice as likely to see a mental health professional than in the 1980s, O’Rourke said.

“I think the increase in recognition is great because it allows children who are struggling with these issues to get

the help they need,” she said.

Ask the right questions

Anxiety is normal, and everyone has it to some degree. Healthy feelings of anxiety can protect a person from danger, O’Rourke said.

When anxiety becomes a disruption to a child’s everyday life in school, at home or with family or peers, parents may see avoidance behaviors, O’Rourke said.

All children have fears and worries, but most are able to move forward and deal with their anxiety. Kids with anxiety disorder may have one or two things they will avoid such as large dogs, sleepovers or speaking in front of the classroom.

Common childhood fears are age-related, O’Rourke said. For example, fear of being left with a babysitter is typical for a toddler, but not for an 8-year-old.

Talking about a child’s anxiety can help a child cope. If parents start to see a pattern of behavior they can bring it up in a caring, non-judgmental, matter-of-fact way, O’Rourke said.

“A child may be relieved to talk about it or they may feel embarrassed, but it’s good to talk about their feelings,” she said.

When parents notice a problem brewing they can ask gentle questions to allow a child to think through the situation for themselves, O’Rourke said. If a child is afraid a parent won’t pick them up after a playdate, a parent may ask: Has that happened to you or anyone you know? What are the chances it will happen? What are some possible reasons I may be late?

Anxiety leads us quickly to worst-case scenarios, but a parent’s guidance can help a child think about a situation in a more balanced way, O’Rourke said. Learning to face fears helps a child learn how to cope, she said.

When to seek help

A parent’s first instinct will be to solve a problem, but don’t feed them the answers. Letting a child work it out on their own helps them recognize their ability to take control and build resilience, O’Rourke said. Practicing these behaviors increases their independence.

Maintaining healthy habits, including getting enough sleep and exercise and eating a balanced diet, can help support emotional regulation, O’Rourke said.

It’s time to seek professional help if a child is missing school or if the anxiety is causing changes to a family’s daily routine to accommodate a child’s worry, O’Rourke said. Ask your pediatrician, or to find a specialist visit the Society of Clinical Child & Adolescent Psychology (effectivechildtherapy.org) or the Association for Behavioral and Cognitive Therapies (abct.org).