A Diet Plan for Teens

Need a diet plan to help your teen make healthier choices when they eat?

Have your teenagers picked up some bad eating habits and put on a little extra weight during the pandemic?

A Diet Plan for Teens

To get them back on track, in addition to encouraging them to be more active, it might help to teach them some healthy eating habits.

So no, this isn’t about putting your teen on a diet…

It’s about a diet plan that can lead to a lifetime of healthy eating, an active lifestyle, and a healthy weight.

It’s a diet plan that:

  • focuses on eating and drinking a variety of nutrient dense vegetables, fruits, grains (half should be whole grains), dairy products (can include fortified plant based alternatives to cow milk), protein foods, and oils
  • advises we stick within calorie limits and avoid oversized portions
  • limits added sugars (should be less than 10% of calories per day), saturated fat (should be less than 10% of calories per day), and sodium intake (should be less than 2,300mg per day)
  • goes along with an hour of more of daily moderate-to-vigorous physical activity for an hour or more with a mix of aerobic, muscle training, and bone-strengthening activities

Sounds easy, right?

It’s actually not that hard.

A customized MyPlate Plan will help you find your child’s food group targets so that you will both know what and how much your child should eat to stay within their calorie allowance each day.

Sound too easy?

Well, maybe it is… After all, we often already have some idea of what we should and shouldn’t be eating, that we need to be more active, and if we are eating too many things unhealthy things.

The real trick is getting motivated to eat healthier and be more active!

Need some easy things to start your path to a healthier lifestyle?

  • avoid soda, fruit drinks, and other drinks with added sugar and little or no nutrition
  • get more exercise and physical activity than you have been, even if you start with just 15 minutes a day
  • eat smaller snacks and be more mindful of how many calories you are getting from your snacks
  • don’t skip meals
  • eat your meals at the table, avoiding mindless snacking while you are on a screen
  • decrease your screen time if you are frequently on a screen
  • avoid adding high-calorie, high-fat dressings and toppings to all of your food, some of which might have started out fairly healthy
  • eat more meals at home, which has likely gotten easier during the pandemic
  • take supplements if you aren’t confident that you are getting enough calcium, vitamin D, and iron from the foods you are eating each day
  • if you have been gaining too much weight, consider decreasing your portion sizes, as you are almost certainly getting too many calories each day

And then once you are on a healthier path, you can try to follow an age appropriate MyPlate Plan! Or if still need some reinforcement and more tips for healthy eating, read these articles:

And of course, your pediatrician and/or a registered dietician can also be a good source of help for your teen who needs a healthy eating plan.

More on Teen Healthy Eating Plan

Is Handwashing Drying Your Child’s Skin?

A rash on their hands might mean that you have to change how your kids wash their hands and not that they have to wash less often.

Do your kids get dry, red, and itchy hands, especially during the winter months when it gets cold?

Hand sanitizier and handwashing may be drying your child's skin.

Believe it or not, it’s probably because they are washing their hands very frequently, which is a good thing these days.

Is Handwashing Drying Your Child’s Skin?

Of course, many other things could be causing a rash on your child’s hands, but if the rash is on both hands, is worse each winter, and there are no other symptoms, then it is probably from handwashing.

Is it from excessive handwashing?

Not necessarily.

“The best way to prevent the spread of infections and decrease the risk of getting sick is by washing your hands with plain soap and water, advises the Centers for Disease Control and Prevention (CDC). Washing hands often with soap and water for at least 20 seconds is essential, especially after going to the bathroom; before eating; and after coughing, sneezing, or blowing one’s nose. There is currently no evidence that consumer antiseptic wash products (also known as antibacterial soaps) are any more effective at preventing illness than washing with plain soap and water. In fact, some data suggests that antibacterial ingredients could do more harm than good in the long-term and more research is needed.”

Q&A for Consumers | Hand Sanitizers and COVID-19

You might just need to change up how your child washes their hands, making sure that they:

  • use a moisturizing soap (Dove, Basis) or soap-free cleanser (Cetaphil, Vanicream Free & Clear), avoiding harsher, antibacterial soaps
  • apply moisturizers (Aquaphor, Vanicream, Cetaphil, Cerave, Eucerin) within a few minutes of washing, keeping in mind that greasy ointments typically are the best, followed by creams, and then lotions, although kids sometimes don’t like the feel of greasy ointments
  • avoid the frequent use of hand sanitizers, as they contain high concentrations of alcohol and can be drying, so limit the use of hand sanitizers to when soap and water isn’t available and even then, try to use a hand sanitizer with a moisturizer

But what if your child’s hands do get red and irritated? Simply applying a moisturizer probably isn’t going to be much help then, is it?

Probably not, so that’s when it’s time to also apply a steroid cream to calm the flare up. While you can start with over-the-counter hydrocortizone cream twice a day (don’t apply at same time as the moisturizers), you might need a medium strength prescription steroid cream for all but the mildest cases. In some cases, a more potent steroid might even be needed for a short time.

And of course, you should think about what else might be causing a rash on your child’s hands, especially if they aren’t quickly getting better with steroids and moisturizers:

  • does your child also have ulcers in their mouth or a rash on their feet, which might indicate Hand Foot and Mouth disease?
  • has your child recently been bitten by a tick?
  • does your child have a honey colored crusty rash on one hand, a sign of impetigo?
  • is your child working with new chemicals, solvents, wearing gloves, or doing anything else that could be triggering an allergic reaction or contact dermatitis on their hands?
  • do other people in the house have an itchy rash on their hands and arms, which could be a sign of scabies?

Fortunately, hand dermatitis from excessive hand washing and cold winter weather is typically easy to diagnosis and treat and isn’t often confused with other pediatric conditions.

More on Hand Dermatitis

Are Baby Foods Tainted With Dangerous Levels of Heavy Metals?

Review easy ways to reduce your child’s risk from heavy metals in baby food.

Why do some parents think that baby foods are tainted with dangerous levels of toxic metals?

A staff report from the US House of Representatives showed that "commercial baby foods are tainted with significant levels of toxic heavy metals, including arsenic, lead, cadmium, and mercury."

It’s likely because they recently read articles and posts about a staff report from the US House of Representatives which showed that “commercial baby foods are tainted with significant levels of toxic heavy metals, including arsenic, lead, cadmium, and mercury.”

A report that was prompted by a study last year, What’s in my baby’s food?, that found 95% of baby food tested contained lead, arsenic, mercury or cadmium.

Are Baby Foods Tainted With Dangerous Levels of Heavy Metals?

Wait, what?

Commercial baby foods really are “tainted with significant levels of toxic heavy metals, including arsenic, lead, cadmium, and mercury?”

Yes, it seems that they are.

As compared to the maximum allowable levels in bottled water that are set by the FDA, the latest report found that baby foods and their ingredients tested at up to 91 times the arsenic level, up to 177 times the lead level, up to 69 times the cadmium level, and up to 5 times the mercury level.

How has this happened?

“FDA HAS FAILED TO CONFRONT THE RISKS OF TOXIC HEAVY METALS IN BABY FOOD. THE TRUMP ADMINISTRATION IGNORED A SECRET INDUSTRY PRESENTATION ABOUT HIGHER AMOUNTS OF TOXIC HEAVY METALS IN FINISHED BABY FOODS.”

Baby Foods Are Tainted with Dangerous Levels of Arsenic, Lead, Cadmium, and Mercury

We have been hearing about arsenic in rice and baby food for nearly 10 15 years, so it is hard to make this a Trump problem…

“In the context of arsenic in baby food, there are only two FDA regulations for specific products—an unenforceable draft guidance issued in July 2013, but never finalized, recommending an action level of 10 ppb for inorganic arsenic in single-strength (ready to drink) apple juice, and an August 2020 final guidance, setting an action level for inorganic arsenic in infant rice cereals at 100 ppb.”

Baby Foods Are Tainted with Dangerous Levels of Arsenic, Lead, Cadmium, and Mercury

How about we just look at it as a problem that needs to be fixed?

Do you want the FDA to add more regulations for baby foods, ensuring that they are all safe and free of heavy metals?

To understand why that wouldn’t be a quick fix, you have to understand how these baby foods likely became tainted with heavy metals. After all, it’s not like the baby food manufacturers are adding them as an ingredient…

The problem is that the rice, vegetables, and fruits that they use to make baby food are actually tainted with arsenic and other heavy metals!

“Step one to restoring that trust is for manufacturers to voluntarily and immediately reduce the levels of toxic heavy metals in their baby foods to as close to zero as possible. If that is impossible for foods containing certain ingredients, then those ingredients should not be included in baby foods.”

Baby Foods Are Tainted with Dangerous Levels of Arsenic, Lead, Cadmium, and Mercury

Yes, let’s hope that the companies stop making baby food that is contaminated with heavy metals and if they don’t, let’s set high FDA standards for baby food to make sure that they do.

Either way, we are going to need a food supply that isn’t tainted with heavy metals…

“On August 1, 2019, FDA received a secret slide presentation from Hain, the maker of Earth’s Best Organic baby food, which revealed that finished baby food products contain even higher levels of toxic heavy metals than estimates based on individual ingredient test results. One heavy metal in particular, inorganic arsenic, was repeatedly found to be present at 28-93% higher levels than estimated.”

Baby Foods Are Tainted with Dangerous Levels of Arsenic, Lead, Cadmium, and Mercury

And no, simply switching to organic foods isn’t the answer.

What Parents Should Know About Heavy Metals in Baby Foods

So what should parents do?

One obvious thing is to keep pressure on politicians and the companies that make baby food to fix this problem.

But that’s a long term fix…

Right now, you should understand that while baby foods do likely contain these heavy metals, it is not at toxic levels that will cause immediate harm.

And understand that many of the studies on exposure to heavy metals and risks for children were not necessarily specific to baby foods, but were often on general environmental exposure.

Children are exposed to heavy metals from many sources, including parents who smoke, lead in paint and water, and mercury in seafood, etc.
Children are exposed to heavy metals from many sources, including parents who smoke, lead in paint and water, and mercury in seafood, etc.

Still, you should work to decrease your child’s risk of exposure to heavy metals from food by:

  • avoiding apple juice, as like rice, apples can take up arsenic in the soil they are grown in, although keep in mind that infants shouldn’t be given any juice anyway
  • feeding your kids a variety of rices and grains, including oatmeal, barley, multi-grain rice, basmati rice, millet, and quinoa, etc. – remembering that iron-fortified cereals are a good source of iron, so typically shouldn’t be avoided all together
  • looking for rice-free baby snacks and limiting how many rice crackers and rice cakes your older kids eat
  • avoiding teething biscuits, as they are typically made with rice flour
  • offering your baby a variety of vegetables, understanding that carrots and sweet potatoes are often the ones that are most heavily contaminated with heavy metals, so continue to give since they are also high in nutrients, but mix in with a lot of other veggies
  • offering a variety of plant based milks if your older child has a milk allergy (giving breastmilk or an iron fortified infant formula until 12 months), so that they aren’t just drinking rice milk

What else can we do?

“Chemicals are part of our daily life. All living and inanimate matter is made up of chemicals and virtually every manufactured product involves the use of chemicals. Many chemicals can, when properly used, significantly contribute to the improvement of our quality of life, health and well-being. But other chemicals are highly hazardous and can negatively affect our health and environment when improperly managed.”

Action is Needed On Chemicals of Major Public Health Concern

We can focus on real risks, instead of the never ending parade of things that we might be told to worry about, from pesticide residues and sunscreen ingredients to vaccines and GMOs.

Instead of allowing yourself to be overwhelmed and scared of made up risks, focus on things that really might affect your kids, like this news about heavy metals in baby foods.

But even then, understand that the risk isn’t so high that you have to throw out of the jars of baby food you just bought and start making your own. Just give your child a good variety of foods, so that they don’t get too many of the same foods that might contain heavy metals.

And no, you don’t have get your kids tested for heavy metals if your main concern is exposure to heavy metals in baby food…

More on Heavy Metals in Baby Foods

How Many People Have Really Died With COVID-19?

There were at least 322,306 more deaths in 2020 than in 2019, which is about the number of deaths attributed to COVID-19.

Why do some people still not understand just how many people have died with COVID-19?

Why do some folks continue to push the idea that people aren't really dying with COVID-19?
Why do some folks continue to push the idea that people aren’t really dying with COVID-19? It makes it easier to convince you that you don’t need to wear a mask or get a COVID-19 vaccine…

The usual suspects…

How Many People Have Really Died With COVID-19?

If you are confused or doubt just how deadly COVID-19 has been, one easy way to estimate how many people have died with COVID-19 is to compare year-to-year total deaths.

Just over 2.8 million people died in 2018 and 2019.

For example, just over 2.8 million people died in 2018 and 2019.

In 2019, a total of 2,854,838 resident deaths were registered in the United States—15,633 more deaths than in 2018.

How does that compare to 2020?

Before you say that there were 2,913,144 deaths in 2020, keep in mind that this data doesn't include January 2020...
Before you say that there were 2,913,144 deaths in 2020, keep in mind that this data doesn’t include January 2020…

Not surprisingly, there were far fewer deaths in 2018 and 2019…

We add these 264,000 deaths from January 2020 to the 2,913,144 deaths from February to December 2020 to get our total for the year.
We add these 264,000 deaths from January 2020 to the 2,913,144 deaths from February to December 2020 to get our total for the year.

Using complete year counts:

  • 2019 total deaths – 2,854,838
  • 2020 total deaths – 3,177,144

Leaving you with 322,306 more deaths in 2020 than in 2019.

Which is just about the count of COVID-19 deaths that experts have posted.

If you still aren’t convinced that these deaths have been caused by COVID-19, if not COVID-19, then what has caused all of these extra deaths?

“Excess deaths provide an estimate of the full COVID-19 burden and indicate that official tallies likely undercount deaths due to the virus.”

Estimation of Excess Deaths Associated With the COVID-19 Pandemic in the United States, March to May 2020

The count is even more startling if you understand that many experts think that we are under-counting COVID-19 deaths!

“Simon and colleagues suggest that it is critical to consider that for every death, an estimated 9 family members are affected, such as with prolonged grief or symptoms of posttraumatic stress disorder. In other words, approximately 3.5 million people could develop major mental health needs. This does not account for the thousands of health care workers in hospitals and nursing homes who have been witness to the unimaginable morbidity and mortality associated with COVID-19.”

Excess Deaths and the Great Pandemic of 2020

What else?

Many people are underestimating their risk of what could happen if they get COVID-19. Or if one of their family members get COVID-19.

Sure, COVID-19 is much more deadly if you have risk factors, but many people still underestimate their risks of getting and dying from COVID-19.

With a case-fatality rate between 1 and 3% in the United States, that means a lot of people with COVID-19 have been dying.
With a case-fatality rate between 1 and 3% in the United States, that means a lot of people with COVID-19 have been dying.

The bottom line is that COVID-19 is indeed deadly, with the possibility of serious long-term effects for many who survive.

“While most persons with COVID-19 recover and return to normal health, some patients can have symptoms that can last for weeks or even months after recovery from acute illness.”

Long-Term Effects of COVID-19

And since we now have safe and effective COVID-19 vaccines that can help end the pandemic, you know what to do.

Over 500,000 people have now died with COVID-19 in the United States.
Over 500,000 people have now died with COVID-19 in the United States.

It’s time to get vaccinated and protected.

More on COVID-19 Deaths

The Latest COVID-19 Treatment Regimens

The latest COVID-19 treatment regimens do not include zinc, vitamin C, vitamin D, CBD oil, azithromycin, or hydroxychloroquine.

As cases surge once again, let’s do an update on COVID-19 treatment regimens, after all, you have likely been hearing about cures and treatments for months now, right?

This doc also has a daily "immune booster" regimen that has you taking zinc, aspirin, vitamin B12, vitamin D3, NAC, vitamin C, probiotics, CBD oil, and Elderberry, in addition to taking hydroxychloroquine, azithromycin, budesonide, methylprednisolone, losartan, and ivermectim when you get sick with COVID-19.
This doc also has a daily “immune booster” regimen that has you taking zinc, aspirin, vitamin B12, vitamin D3, NAC, vitamin C, probiotics, CBD oil, and Elderberry, in addition to taking hydroxychloroquine, azithromycin, budesonide, methylprednisolone, losartan, and ivermectim when you get sick with COVID-19.

Unfortunately, despite the “treatments” that some folks are pushing, there still isn’t a cure and there aren’t any treatments that are very effective for COVID-19.

Sure, the FDA has granted emergency use authorization (EUA) for some treatments, including monoclonal antibodies, convalescent plasma, remdesivir, bamlanivimab, baricitinib, and casirivimab and imdevimab, but most are either for patients with severe COVID-19 or who are progressing to severe COVID-19.

The Latest COVID-19 Treatment Regimens

But why wouldn’t you take over a dozen medicines if someone on the Internet tells you they read a bunch of well designed studies, he has the support of “America’s Frontline Doctors,” and he has his own statistics proving they work?

Take home point - don't trust a health care provider who says that masks and lockdowns do nothing.
Take home point – don’t trust a health care provider who says that masks and lockdowns do nothing.

Because it all quickly falls apart if you really take a close look at what he is doing.

Consider Dr. Procter’s comparison of “death rates”…

He is trying to talk about the case fatality rate, but fails to mention any of the things that would cause his practice to have lower rates than the rest of the world, especially younger patients without many co-morbid conditions who aren’t yet hospitalized.

How many of Dr. Procter's patients are over age 65?
How many of Dr. Procter’s patients are over age 65?

And the bias in his data aside, there is evidence that shows his recommended treatments don’t work.

Some are even dangerous.

“The results of an observational study suggest that delayed viral clearance may be a concern in patients with non-severe COVID-19 who are receiving corticosteroids without antiviral drugs. Corticosteroids have also been associated with delayed viral clearance and/or worse clinical outcomes in patients with other viral respiratory infections.”

Therapeutic Management of Patients with COVID-19

So you should likely avoid these medications and unless you have a vitamin deficiency (zinc and vitamin C deficiency are very uncommon in developed countries), there is likely no good reason to take extra or high doses of vitamins to try and prevent or treat COVID-19.

The latest NIH recommendations for treating COVID-19 in hospitalized patients.
The latest NIH recommendations for treating COVID-19 in hospitalized patients.

You should certainly make sure you are getting plenty of all of these important nutrients, especially vitamin D, but there are no treatments for COVID-19 if you aren’t hospitalized. And understand that no treatments that will keep you from requiring hospitalization.

Mostly understand that the kind of multi-drug COVID-19 treatment regimens you might see some doctors pushing are not proven, are not recommended, and likely won’t help you get better any faster.

And again, some are harmful!

So why do some people think they work?

“Garlic is a healthy food that may have some antimicrobial properties. However, there is no evidence from the current outbreak that eating garlic has protected people from the new coronavirus.”

Coronavirus disease (COVID-19) advice for the public: Mythbusters

Probably the same reason that some folks think that eating garlic works against COVID-19 – it is a highly variable disease and some people have very mild symptoms and get better quickly. If you are lucky enough to be one of these people and you tried some alternative treatment, you will likely associate your quick recovery with that treatment, even if it was just a coincidence.

“New symptoms are usually due to the virus rather than side effects of medications.”

Brian Procter, MD

And if you are really lucky when following one of these treatment regimens, you won’t suffer any side effects as you try to recover from your COVID-19 symptoms. Especially if you are being treated by a doctor who might ignore those side effects…

More on COVID-19 Treatment Regimens

Where is COVID-19 Spreading Now?

Since SARS-CoV-2 is spreading wherever a lot of people are getting together, you must adapt to life with COVID-19 now, so that you will still be around when COVID-19 is finally gone.

As cases start to surge again and countries are reentering lockdown, you might be asking yourself just who is spreading COVID-19 around now?

Is it political rallies, protestors, or kids going to school?

Where is COVID-19 Spreading Now?

In addition to very large gatherings, like political rallies, some folks might be surprised to learn that COVID-19 is now spreading:

  • after religious events and holidays
  • in daycare centers and schools
  • among recreational, high school, and college sports teams
  • at very large gatherings (>50 people), including funerals and weddings, some of which turn into superspreading events
  • at large gatherings (>10 people) of family and friends

Not surprisingly, SARS-CoV-2 is spreading wherever a lot of people are getting together.

Hopefully, understanding that can help us all avoid getting sick with COVID-19!

“Regardless of the origin of superspreading, we emphasize the particular fragility of a disease in which a major part of infections are caused by the minority. If this is the case, the disease is vulnerable to mitigation by reducing the number of different people that an individual meets within an infectious period. The significance is clear; Everybody can still be socially active, but generally only with relatively few – on the order of ten persons. Importantly, our study further demonstrates that repeated contact with interconnected groups (such as at a work-place or in friend groups) is comparatively less damaging than repeated contacts to independent people.”

Superspreaders provide essential clues for mitigation of COVID-19

Remember, the pandemic isn’t over yet.

If anything, we are heading into another big wave in most parts of the world.

And although COVID-19 vaccines are on the way, they won’t be hear quick enough to stop it.

A positive COVID-19 rapid test.
A positive COVID-19 rapid test.

Only you can stop it by social distancing from others as much as possible (stay at least 6 feet away), wearing a mask (yes, masks still work despite the new study some folks are talking about), and washing your hands regularly.

Most importantly, understand that:

  • someone can be contagious for up to two days before they develop symptoms of COVID-19 or they test positive and will continue to be contagious for at least 10 more days, their isolation period
  • if exposed to someone with COVID-19, you should avoid others and go into self-quarantine for at least 14 days after your last contact, as that is the incubation period (the time from exposure to when you might develop symptoms)
  • in addition to those who are sick before they develop symptoms (pre-symptomatic), some are contagious even though they never develop symptoms (asymptomatic transmission)
  • you can’t test out of your quarantine after being exposed
  • there are no good treatments and there is definitely no cure for COVID-19

And know that COVID-19 can be life-threatening, especially for folks who are in high risk groups, including those who are elderly and anyone with chronic health problems.

What does all of this mean?

That you have to adapt to life with COVID-19 now, so that you will still be around when COVID-19 is finally gone.

More on the Spread of COVID-19

Does Your Child Have Dyspraxia?

Could your clumsy child with delayed milestones have dyspraxia?

Have you ever thought that your child might have dyspraxia?

“Developmental dyspraxia is a disorder characterized by an impairment in the ability to plan and carry out sensory and motor tasks. Generally, individuals with the disorder appear “out of sync” with their environment. Symptoms vary and may include poor balance and coordination, clumsiness, vision problems, perception difficulties, emotional and behavioral problems, difficulty with reading, writing, and speaking, poor social skills, poor posture, and poor short-term memory. Although individuals with the disorder may be of average or above average intelligence, they may behave immaturely.”

Developmental Dyspraxia Information Page

Probably not, as most people have never even heard of it.

Confusing things even more, dyspraxia has also been known by other terms, including clumsy child syndrome, sensory integration disorder, and developmental coordination disorder.

Does Your Child Have Dyspraxia?

Dyspraxia is a disorder of movement coordination, but it can also affect your child’s language, speech, and learning.

You might think about getting your child evaluated for dyspraxia if they have delayed early motor development. More common in boys, it is thought that at least 5-6% of children could have dyspraxia.

“In the preschool child, common features reported by parents include a history of delayed developmental milestones, particularly crawling, walking and speech, difficulty with dressing, poor ball skills, immature art work and difficulty making friends.”

Dyspraxia or developmental coordination disorder? Unravelling the enigma

Does your child:

  • have poor balance
  • have trouble pedaling a tricycle or bicycle
  • have bad handwriting because they have difficultly gripping their pen or pencil
  • avoid playing with toys like Lego blocks and jigsaw puzzles

Is your child:

  • clumsy, often falling or bumping into people and things
  • a messy eater because they have trouble using spoons and forks, etc.
  • delayed in learning to button clothes or tie their shoes, etc.

Was your child extra fussy as a baby? That’s another sign of children with dyspraxia.

Dyspraxia isn’t just about these motor issues though.

Childhood dyspraxia is included in the DSM-V manual, with clear diagnostic criteria.
Childhood dyspraxia is included in the DSM-V manual, with clear diagnostic criteria.

Either because dyspraxia can also be associated with ADHD, learning disorders, or autism, or just because the signs and symptoms occur as a part of dyspraxia, these children might have many other signs and symptoms, including speech delays, sensory issues, and problems with concentration and comprehension.

More common in infants who are born premature, dyspraxia is thought to be caused by immaturity in neuron development.

Talk to your pediatrician if you suspect that your child has dyspraxia, as early intervention with occupational therapy and speech therapy can be helpful. A pediatric neurologist can also be helpful in getting your child evaluated for dyspraxia.

More on Dyspraxia

Mask Exemptions for Kids During the COVID-19 Pandemic

If your child doesn’t want to wear a face mask, your pediatric provider might be able to offer more help than just an exemption.

Some parents who don’t want their kids to wear a mask at school might think about asking their pediatrician to write a mask exemption for their kids.

You can easily spread what you don't know you have... Remember, you can be contagious a few days before you have symptoms of COVID-19, which is why mask exemptions for kids aren't a good idea unless they are medically necessary. #BeInformed
You can easily spread what you don’t know you have… Remember, you can be contagious a few days before you have symptoms of COVID-19, which is why mask exemptions for kids aren’t a good idea unless they are medically necessary. #BeInformed

Before they do, they might understand that there are very few real medical reasons for these types of exemptions for wearing a mask.

Masks Control the Spread of SARS-CoV-2

More and more, we are learning that masks can help prevent the spread of SARS-CoV-2, the virus that causes COVID-19, protecting both the person wearing the mask and the people around them.

“The prevention benefit of masking is derived from the combination of source control and personal protection for the mask wearer. The relationship between source control and personal protection is likely complementary and possibly synergistic, so that individual benefit increases with increasing community mask use.”

Scientific Brief: Community Use of Cloth Masks to Control the Spread of SARS-CoV-2

Still, that doesn’t mean that everyone has gotten used to wearing them…

Hopefully, most folks do now understand why they are important though.

Wait, why are they important, especially if you are healthy and the people around you don’t have COVID-19?

Mostly it is because people with COVID-19 can be contagious:

  • up to two days before they start to show symptoms
  • up to two days before they test positive, even if they don’t have any symptoms

So if you are waiting to put on a mask until people around you have symptoms, then you will eventually get exposed, probably without even knowing it, and you might get sick, ending up in isolation, not being able to go to school or work.

And if you wait to put on a mask until you start to show symptoms, then you will likely eventually expose other people to the SARS-CoV-2 virus.

The alternative, if you want to reduce your risk of getting sick, is to just wear a mask any time that you can’t social distance (stay at least six feet apart) from other people.

Mask Exemptions for Kids During the COVID-19 Pandemic

So what are the medical reasons that kids, like adults, can’t wear a mask all day while they are at school?

“The Department supports actions by the airline industry to have procedures in place requiring passengers to wear masks in accordance with the CDC Order, CDC guidance, and TSA SD. At the same time, the ACAA and Part 382, which are enforced by OACP, require airlines to make reasonable accommodations, based on individualized assessments, for passengers with disabilities who are unable to wear or safely wear a mask due to their disability.”

Notice of Enforcement Policy: Accommodation by Carriers of Persons With Disabilities Who Are Unable to Wear Or Safely Wear Masks While On Commercial Aircraft

In general, a child over age two years should wear a face mask unless:

  • they have a physical or intellectual condition that would keep them from being able to remove their face mask by themselves
  • they can’t tolerate wearing a face mask because they have a condition such as autism spectrum disorder, intellectual disability, or a mental health disorder
  • they have a physical or intellectual condition and wearing a cloth face mask gets in the way of their ability to communicate

But shouldn’t these kids just do virtual school if they can’t wear a mask, instead of getting an exemption?

While that might be an option for some kids, others need the extra services that they get at school, which they can’t get with at home schooling.

In addition to a face mask exemption, some things that might work in some situations when a child won’t wear a mask include:

  • a face shield
  • a transparent face mask
  • using different fabrics for the mask
  • trying a bandana or gaiter
  • try to desensitize your child to wearing a mask

What about asthma?

In general, most kids with well controlled asthma should be able to wear a face mask. If your child’s asthma is so severe that it is made worse by wearing a face mask, then they likely need an evaluation by a pulmonologist and it might be best to avoid being around others during the pandemic.

If your child can wear a face mask, but just doesn’t want to, then it might help to allow them to pick their own mask, with a comfortable fabric and fit, maybe even getting a mask with a favorite character on it.

“Model it! Make it familiar by wearing a mask too.”

Getting Your Child to Wear a Mask

And don’t expect your child to want to wear a mask at school if you don’t wear a mask when you go out or if you don’t believe that wearing a mask is necessary.

More on Mask Exemptions

Health Supervision Guidelines for Children With Extra and Special Needs

In addition to the routine recommendations for preventative pediatric health care that all kids need, there are specific health supervision guidelines for children with special needs.

In addition to the routine recommendations for preventative pediatric health care that all kids need, there are some extra things that kids with special needs should get at their well child check ups.

Health supervision for children with Down Syndrome.
The American Academy of Pediatrics has published health supervision guidelines for children with Down Syndrome.

There might also be extra things that need to be done for kids who have been diagnosed with various chronic conditions, from cystic fibrosis and diabetes to immunodeficiency syndromes and tuberous sclerosis.

Health Supervision Guidelines for Children With Extra and Special Needs

Being aware of and following these guidelines can help to make sure these kids get all of the screening tests, referrals to specialists, and other things that are necessary to keep them safe and healthy.

There are also AAP guidelines to help pediatric providers care for children in other special situations:

Guidelines that help pediatric providers care for all of their kids, no matter their needs.

More on Health Supervision Guidelines for Children

Why Can’t You Test Out of Your COVID-19 Quarantine?

You can’t test out of your 14 day COVID-19 quarantine after you have been exposed to someone with COVID-19.

Breaking News – new CDC guidelines do offer options for ending quarantine early. (see below)

Most people understand that they can’t test out of quarantine, right?

A quick reminder that close contacts of someone with COVID-19 need to quarantine for 14 days.
A quick reminder that close contacts of someone with COVID-19 need to quarantine for 14 days.

After all, if they are around others before their quarantine is over, they could end up exposing others to COVID-19!

Why Can’t You Test Out of Your COVID-19 Quarantine?

But why can’t you just test out of your COVID-19 quarantine?

Basically, if you have a negative COVID-19 test early in your quarantine period, it doesn’t mean that you can’t develop symptoms or test positive later on.

“If you are tested and the test is negative, do you still have to be quarantined?
Yes. Someone exposed to a person with COVID-19 needs a 14-day quarantine regardless of test results. This is because COVID-19 can develop between two and 14 days after an exposure.”

Coronavirus Questions and Answers

Testing negative doesn’t get you out of quarantine.

A negative test simply means that you don’t have an active infection. It doesn’t mean that the SARS-CoV-2 virus isn’t still incubating inside you. And no, we can’t test for that.

So why get tested?

“If you do not have symptoms, it is best to get tested between 5-7 days after you’ve been in a high-risk situation.  If your test is negative, get tested again around 12 days after the event. It can take 2-14 days for COVID-19 to develop, so even if you test negative once, you could still develop COVID-19 later and spread it unknowingly.”

Symptoms and Testing: COVID-19

Getting tested can be helpful because some people can test positive even if they don’t have symptoms, they can still be contagious, and this can help with contact tracing and can help you warn others that you exposed them to COVID-19.

Ideally, since you are in quarantine, you would not have exposed anyone else though…

And if you test positive?

Well, technically that does get you out of quarantine, but only to move you to a period of isolation, which is basically a stricter form of quarantine and lasts at least 10 days.

New Options to Test Out of Quarantine Early

And although it is not without risk, the CDC has suggested some alternatives to the traditional 14 quarantine after being exposed to someone with COVID-19.

This includes ending quarantine after day 7 if you have tested negative within 48 hours and you have no symptoms, understanding that you will have to continue to monitor yourself for symptoms each day and that this strategy has a 5-12% risk of failure (you might still develop COVID-19).

Or even ending quarantine after day 10 without testing if you have no symptoms, understanding that you will have to continue to monitor yourself for symptoms each day and that this strategy has a 1-10% risk of failure (you might still develop COVID-19).

“Persons can continue to be quarantined for 14 days without testing per existing recommendations. This option maximally reduces risk of post-quarantine transmission risk and is the strategy with the greatest collective experience at present.”

Options to Reduce Quarantine for Contacts of Persons with SARS-CoV-2 Infection Using Symptom Monitoring and Diagnostic Testing

For most people, 14 days of quarantine will likely still be the safest option.

More on Testing out of Quarantine