Children's Health | Mount Sinai Today

Should I Wait to Have My Child’s Vision Checked?

Oct 26, 2020 | Children's Health, COVID-19, Ophthalmology, Your Health

This academic school year—in addition to the usual school supply lists and purchasing of new shoes—parents must think about COVID-19 positivity rates, appropriate face coverings, and reliable in-home internet access. Whether your child will be learning in the school room or remotely, their eye health is important and should not be overlooked. Douglas R. Fredrick, MD, Professor of Ophthalmology and Pediatrics at the Icahn School of Medicine at Mount Sinai, explains what parents need to know about their child’s vision.

Should I wait until after the COVID-19 pandemic to get my child’s vision checked?

Please do not delay having your children examined. It is important to make sure their vision is sharp and their eyes are healthy. Most of our sensory connection to the world is through our eyes. Children who do not see properly can have difficulty developing academically and socially. If we catch and correct vision problems early, we can improve children’s day-to-day life and functioning in school. We can also detect eye conditions that could lead to further problems down the line.

While COVID-19 is still of great concern, Mount Sinai Health System has gone to extraordinary lengths to make sure every patient receives the best possible care in a safe environment. We have developed stringent protocols to protect your family and our community. For instance, face coverings are mandatory and social distancing is enforced throughout the Health System. Additionally, we disinfect continually and regularly test our staff for COVID-19.

How often should I have my child’s eyes checked?

The American Academy of Ophthalmology and the American Academy of Pediatrics recommend that pediatricians and family practitioners examine the eyes and check vision in newborns, age two months, six months, one year, then annually until age six, then every other year until age 18. Most pediatricians check vision every year during their annual exam, and many school districts perform screening each year, beginning at age five or six.

What are the signs that my child has vision issues?

If you notice your child squinting or tilting their head to see objects that are far away, rubbing their eyes after reading, or if their eyes drift toward the nose or outward—as though they are trying to see their ears—you should schedule an appointment with your child’s pediatrician for a vision exam. The same is true if your child complains about fuzzy or foggy vision. I also recommend that parents check in with their child’s teacher as they may see vision impairment related behaviors in the classroom.

My child is struggling with vision issues. How can I help?

The first step is to see your child’s primary care provider who will check for any other health conditions that may be contributing to your child’s difficulties. If the pediatrician finds decreased vision on a screening exam or has any other concerns, they will refer you to a pediatric ophthalmologist. These ophthalmologists have additional training in caring for children and often have specialized equipment and child-friendly offices.

During the examination, the ophthalmologist will do a thorough exam of your child’s eye—probably using dilating eye drops. If the doctor finds that your child is nearsighted or has another vision issue, they may prescribe glasses. If the examination is completely normal but your child is still having a problem with reading or learning, your primary care provider may refer you to an educational specialist or school learning specialist to test for learning disorders and make recommendations.

My child will be learning remotely this school year and I am concerned about eye strain. I’ve heard that blue light glasses can help with this issue. Is this true?

Blue light glasses are special eyewear that block or filter the high-energy blue light coming from computer, tablet, and phone screens. It is not clear that they help with eye strain or eye disease. A recent study performed at the State University of New York School of Optometry found that these glasses did not decrease eye strain with “near work”—activities that require near vision such as reading, writing, and watching television.

While it won’t hurt to use these glasses, there are better ways to reduce eye strain. For instance, have your child hold their reading material, laptop, or tablet at the appropriate distance and make sure they have enough light to see—but not so much it causes glare on the screen. It can also help to have your child take breaks every 20 to 30 minutes when they are doing screen work. I recommend giving your child a task that gets them on their feet and their eyes off the screen, like feeding your pet or taking out the trash.

Should I limit how much time my children spend on screens?

All children will be spending more time with their eyes on the screen this year than in the past and that is going to make it hard to limit screen time to the typical recommendation of two hours a day. This year, instead of enforcing strict limits, try to keep track of what they’re doing with their screen time. Although most of their screen use should be educational, you’ll need to allow time for play—both to relax and to enable them to have social time with friends. Physical activity should also be a part of their daily routine. The key is finding a balance. For more on how—or whether—to limit your child’s screen time, read this blog post from Mount Sinai pediatrician Micah Resnick, MD.

How Mount Sinai Is Keeping Patients Safe

My Child May Have Trouble Hearing. Will Remote Learning Hurt Their Progress in School?

Oct 8, 2020 | Children's Health, COVID-19, Ear Nose Throat, Your Health

This academic year, many children have returned to school virtually. While remote education may be a safer option for some, it is not without its drawbacks—particularly for children who are hearing impaired.

Enrique R. Perez, MD, MBA, an expert in managing adult and child’s hearing disorders and Director of Otology at The Mount Sinai Hospital, provides advice for parents who are concerned about their child’s hearing when learning remotely.

What are the signs my child may have trouble hearing?

To figure out if your child has hearing issues, I recommend that parents or guardians ask themselves a series of questions:

Do you find yourself raising your voice or calling out your child’s name several times before they respond?
Is your child not startled by loud noises?
Do you notice that your child often turns their head or shifts their body position when listening to others or the TV?
Does your child raise the volume on the television, computer, or their phone to an uncomfortable level?
Is your child struggling with academic work?
Is your toddler not learning to speak at the expected rate?
Does your child have a history of recurring ear infections?

If the answer to any of these questions is yes, your child may be struggling to hear. Pediatricians often perform routine screening for hearing loss and they may be able to uncover even subtle degrees of hearing loss.

I am concerned about taking my child for a check-up during the COVID-19 pandemic. Can I delay their hearing exam?

Deciding whether to seek medical care during the pandemic can be difficult, but delaying care always comes with some risk. Delaying a hearing check-up is especially worrisome for children with significant hearing loss who are not being aided with a hearing aid or other hearing device. This is true for children of all ages. Young children, learning to speak may experience delays in achieving appropriate communication milestones, and those who are speaking well but cannot hear properly may fall behind in school. Studies have shown that these setbacks may be irreversible and may limit your child’s academic achievement.

However, I understand the concern, especially if your child has a condition that makes them more vulnerable to COVID-19. Fortunately, most healthcare facilities follow strict guidelines to screen for and minimize the risk of contracting the virus. If you are apprehensive, I suggest that you contact the facility and ask about their protocols.

How can I help my child who is struggling with hearing issues?

The first step in helping your child is to schedule a proper evaluation by a doctor. You might start with your child’s pediatrician, who can screen for hearing issues, and then, if appropriate, can refer you to a specialist for diagnosis and treatment.

Additional ways that you can help a child struggling with hearing issues include:

Minimizing background noise when you are speaking to your child.
When talking to your child, face them directly and speak slowly and clearly. Try not to shout as that can distort your speech and make your child feel uncomfortable.
Make sure your child’s teachers and school are aware of your child’s hearing issue so that they can help.
Address any insecurity your child may feel regarding their hearing issues as stigma could prevent them from using devices, such as hearing aids. You want to help your child to be comfortable and confident when used a hearing assistive device, especially during these formative years.

How should I set up my child’s space for remote learning?

Remote learning can create new challenges—and some opportunities—for educating children with difficulty hearing. With the proper set-up and equipment, remote learning may be easier than in-person schooling for a child with hearing difficulties.

The first step is to give your child a quiet area in the home for schooling. They will also need a computer with a reliable internet connection and the ability to adjust the volume.

A strong, stable connection enables your child to see the teacher clearly. Importantly, it allows them to see visual cues—such as facial expressions—which are important communication tools for everyone, especially those with hearing loss. And, being able to adjust the volume enables your child to mute other students, allowing them to focus on the teacher. Your child may also benefit from using headphones, including noise cancelling ones, which are normally not allowed in a classroom.

How else can I help my child with remote learning?

I encourage parents and guardians to build a relationship with their child’s teacher. Often, teachers are the first to notice that a child may be struggling to hear. But fostering a connection with your child’s teacher may be easier with in-person schooling than remote learning. Additionally, it helps to stay involved with your child’s education so that you don’t miss any of the early signs of hearing loss that could compromise their ability to learn.

How Mount Sinai Is Keeping Patients Safe

How Do I Prepare My Child to Go Back to School?

Sep 10, 2020 | Children's Health, COVID-19, Mental Health, Psychiatry, Your Health

As children head back to school—whether in person or virtually—parents may have some concerns about how they will adapt to a new, potentially stressful academic year. Aliza Pressman, PhD, Co-Founding Director and Director of Clinical Programming for the Mount Sinai Parenting Center, answers some of your questions.

How can I address my children’s anxiety about going back to school in person?

Start by making sure that you are calm and not imposing your own anxiety onto the conversation. Your children will pick up on your energy and you want to be focused on their concerns. Also, remember that your anxiety—and your child’s anxiety—is very reasonable at this challenging time. If your child is anxious, don’t try to get rid of that anxiety. Instead, validate their feelings. Tell them that what they are feeling makes sense. Children have been out of school for a long time and for months have been hearing about the importance of staying away from people. Now they’re going to head back into a building full of people. Of course they are nervous.

Once you’ve validated your child’s emotions, explain that you would not send them back to school if you did not think they would be safe. Go over the precautions that the school is taking to protect teachers and students and, for younger children, remind them about what COVID-19 is and what individual measures they can take to keep themselves safe while at school.

Will my child’s learning be affected by having their teachers wear masks?

This is a natural concern. Our facial expressions are part of how we communicate and masks obscure half the face. One way to prepare your child is to practice communicating and reading people’s emotions when they are wearing a mask. Make a game of it. Have everyone at home wear a mask and guess what each person is trying to say by just using body language. Once your kids go back to school, you can reinforce the lessons they are receiving in the classroom; for instance, have them read to you. You’ll probably pick up cues from your children about what they need, and you can adjust accordingly. Remember, kids are incredibly adaptable, more so than adults.

How can I help my child connect with their friends while attending school remotely?

If your child is attending school remotely, they will probably miss spending time with their friends, and interactive screen time is a great way for them to safely connect. Since screen time may be your child’s only opportunity to socialize, you might even want to allow more screen time than you permitted before the pandemic. Just make sure it doesn’t interrupt family mealtime, homework, or replace outdoor activity.

Also, remember that some kids don’t enjoy online interaction. Some children enjoy a more passive interaction like being in the same virtual room as a friend while doing an art project. This allows children to chat with each other without the pressure of an ongoing conversation. As kids get older, they will be able to tell you how they want to connect with their friends. It may be through a video game, taking an exercise class together, or watching a movie together. Or, they may just want to talk on the phone or text.

How do I talk to my child about what is happening in the world?

Before you talk with your child about current events, make sure that you have come to terms with your own state of mind. You don’t want to enter the conversation with the weight of your own feelings. When you are ready to talk, determine what you want to discuss before beginning the conversation. Whether it is COVID-19, social unrest, or something else, begin by asking what they know and what they’re thinking about regarding the topic. You want to be your child’s first resource with any questions and concerns. Be prepared to explain your opinions.

When should I seek professional help?

If you or your child cannot manage to sleep or eat or are feeling out of control, consider seeking the guidance of a mental health professional. It is completely reasonable to feel overwhelmed; this is an enormously stressful time. And, remember, if your child sees that you are willing to seek help, they will know that it is okay for them to do the same.

Can I Delay Getting My Child Immunized Until After the COVID-19 Pandemic?

Updated on Jun 30, 2022 | Children's Health, COVID-19, Your Health

Starting at birth, children routinely receive immunizations against a variety of dangerous diseases. But due to the COVID-19 pandemic, parents may be waiting to begin—or resume—immunizations. Amy DeMattia, MD, MPH, Clinical Professor in Pediatrics at the Icahn School of Medicine at Mount Sinai, explains why it is important not to delay most immunizations and answers questions about the safety of the doctor’s office.

My child is very healthy. Why do they need to be immunized?

Immunizations are safe, very effective, and a routine part of pediatric health care. There are a number of important reasons to get your child immunized. First—and arguably most important—it can save your child’s life. We immunize children against 14serious diseases, including whooping cough, diphtheria, tetanus, mumps, measles,rubella, rotavirus, polio, chickenpox, hepatitis B, and meningitis.

Some of the conditions we immunize against can cause serious illness, complications such as loss of hearing or brain damage, or even death. The danger is not just in the developing world. In the United States, measles, mumps, and whooping cough infect and cause severe illness in children each year.

In addition, immunizations enable us to help protect each other. Some children cannot be safely immunized, including those who are too young, are immunocompromised, or are taking certain medications. If enough people are immunized against a disease, it means there is significantly less chance anyone will become infected. This is called “herd immunity.” The number of people who must be immunized depends on how contagious that condition is.

How do immunizations work?

Vaccines work by teaching the human body to recognize and fight off potentially harmful diseases. We give (either by mouth or through injection) a small amount of a weakened or dead virus or bacteria (called a pathogen) into the body. The body recognizes these pathogens as “foreign invaders” and responds by creating antibodies. Because the pathogens in the vaccine are already weakened or dead, they can’t hurt you. But the antibodies your body has developed can fight the infection—and “remember” the pathogen. Then, if the pathogen enters the body again, the antibody is already there, ready and able to fight it off. Some vaccines require more than one full dose to “teach” your child’s body to recognize and defend against the disease.

Can I delay getting my child immunized until after the pandemic?

The U.S. Centers for Disease Control and Prevention (CDC) developed the current immunization schedule based on how children’s immune systems respond to vaccines at various ages and how likely your child is to be exposed to a particular disease. It is important to follow the schedule so that your child is fully protected before possible exposure. Infants, like older people and those who are immunocompromised, are considered especially vulnerable. We want to get them the protection they need when they need it.

Is there any flexibility on delaying or spacing out vaccinations?

If you have any questions about vaccination scheduling, talk to your pediatrician first. Your doctor will know if there are any conditions that could affect your ability to delay an immunization.

In general, children under the age of two years require timely vaccination without any significant delay. There is more flexibility for children over age two, but this depends on the specific vaccination—not all can be delayed—and your family’s individual situation. For instance, in most cases you can take your child in for their second MMR vaccine anytime after four weeks from their first dose, though most children receive this vaccine between the ages of four and six years. Of note, however, many schools in New York State require two doses of the vaccine in order to attend. After one dose of the MMR vaccine, about 93 percent of people are immune to measles; the second dose raises that to 97 percent. While this might not seem like a big difference, it is significant in the world of immunology.

Is it safe to take my child to a doctor’s office?

We are fully committed to the safety of our patients and staff. While we understand that you may feel nervous, please know that we have put stringent protocols in place to protect every person, regardless of age.

How Mount Sinai is Keeping Patients Safe

How Can Parents Safely Get Children Outdoors This Summer?

Updated on Jun 30, 2022 | Children's Health, COVID-19, Your Health

As the number of COVID-19 positive cases continue to decrease across New York State, many families are wondering how to resume activities in their children’s lives. We spoke with Catherine Spaulding, MD, a pediatrician at Mount Sinai Urgent Care, to get advice on how parents can safely host playdates, have children attend summer camp, and otherwise get their children outdoors.

Overnight camps have officially been cancelled in New York State for this summer. What precautions should parents take if they are sending children to a day camp?

The New York Health Department has laid out a number of measures for day camps and other child care facilities to follow to ensure children’s safety. These steps include but are not limited to social distancing practices—such as having fewer campers together at a time—staggering drop off and pick up times, limiting non-essential employees and visitors to the camp, and mandating that all employees and campers wear a face mask when they are less than six feet apart. Other mandatory practices include enhanced cleaning and hygiene practices, improved access to hand sanitizer throughout the camp, and encouragement of frequent hand washing during the day.

Camps are also required to screen all employees, vendors, visitors, and children for symptoms or known exposure to a person with confirmed COVID-19 within the past 14 days. However, you can also keep your children and others safe by watching for signs of illness in your child. If you think they are getting sick for any reason, keep them at home, inform the camp, and talk with your doctor about next steps.

For more information about day camps in New York, check out these guidelines from the New York State Office of Children and Family Services.

How can parents safely organize playdates and trips to the playground?

The Centers for Disease Control and Prevention still recommends against playdates with children from other homes. However, if you choose to host a playdate, it is best to keep the group of kids as small as possible. Encourage outdoor playtime and handwashing for at least 20 seconds with soap and water throughout the day, especially after being in a public setting such as a playground. If the playdate involves transportation, try to space the kids as far from one another as possible in the car and drive with the windows down. As in any public space, it is always recommended that any child above the age of two wears a face covering.

Now that larger gatherings are allowed, can children attend birthday parties, cookouts, or other get-togethers?

Large gatherings are safest if they can be held outdoors and if social distancing is respected. A face covering should be worn, and everyone should use hand sanitizer or wash hands frequently throughout the event. If your child has any signs of illness, such as a cough or fever, they should stay home and avoid contact with other children. If you are hosting an event, it may be helpful to talk with other parents beforehand and encourage them to keep their kids at home if they have any symptoms.

Also, it is important to keep in mind that different parts of New York are in different phases of reopening, which changes the number of people allowed at one time. For instance, Phase One allowed ten-person gatherings while in Phase Three allows up to 25 people to gather. Before organizing any event, find out what phase of reopening your region is currently in on the New York Forward site.

If parents are uncomfortable connecting with other families for playdates or get-togethers, what outdoor activities can parents arrange to keep their children active?

Keeping your kids active and promoting time outdoors is really important for their physical and mental health. Outdoor activities such as riding a bike, going for a walk or run, or taking a hike are great ways to keep your children healthy and safe while simultaneously encouraging physical activity. It is best to avoid group activities like basketball or football since these sports require close contact with other kids. However, kicking a soccer ball around is a great option for outdoor play—just remember to wipe the ball clean before and after use.

For more ideas about how to safely engage in outdoor activities, check out this piece from HealthyChildren.org, a website from the American Academy of Pediatricians.

How Mount Sinai is Keeping Patients Safe

My Child’s MMR2 Vaccine Has Been Delayed Due to COVID-19. Should I Be Concerned?

Updated on Jun 30, 2022 | Children's Health, COVID-19, Health Hub, Your Health

The novel coronavirus (COVID-19) pandemic has postposed many important events, including your child’s immunizations. The MMR2—the second shot of the measles, mumps, and rubella vaccine—is particularly important for New York area parents who remember the past year’s measles outbreak. Stephen Turner, MD, Medical Director, Mount Sinai Doctors Brooklyn Heights, explains why parents need not worry if their child’s vaccination has been postponed.

Should I be concerned about delaying my child’s second MMR?

Fortunately, we do not have any measles circulating in the population at this time. So, it is a very reasonable option to delay the second MMR until a parent feels comfortable going to the physician’s office and getting the vaccine. The second dose, although most frequently given at age four, is recommended to be given between ages four to six according to the Centers for Disease Control and Prevention immunization schedule, which gives a lot of flexibility for your child to be fully vaccinated on time.

Will delaying the second MMR put my child at any increased risk?

The second MMR is not a booster dose; it is to increase the immunity rate among the population. After one dose of MMR, approximately 92 percent of people are immune to measles. The second dose increases the immunity rate to 97 percent or higher. Therefore, a child who has received one MMR is very likely already immune.

How long can the vaccine be delayed?

There is no limit to how long the MMR2 vaccine can be delayed. In general, vaccines have a minimum spacing but not a maximum spacing. So, if a second dose of a vaccine is supposed to be two months later, for example, and you came back in two years, you pick up where you left off and get the second dose. Your child will not have to restart the vaccine series.

« Older Entries

Next Entries »