Children's Health | Mount Sinai Today

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.

Advice on Distance Learning for Individuals with Hearing Loss

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

According to UNESCO, school closures in response to the COVID-19 pandemic have impacted approximately 1.4 billion students. Children in pre-primary through high school, as well as adults in collegiate and graduate education are now engaged in “distance” or “remote” learning. While this allows education to continue despite school closures, it is not without drawbacks. Poor audio quality is an impediment for learners at all levels, and can be especially difficult for those with hearing loss. Maura Cosetti, MD, Director of the Ear Institute of New York Eye and Ear Infirmary at Mount Sinai and David Spritzler, MED, Education Specialist at the Ear Institute, share guidance for distant learners with hearing loss.

Guidance for All Distance Learners

As with a classroom setting, individuals with hearing loss have specific needs related to online education. These steps will improve auditory access for all participants in distance learning.

Request that the presenter uses a wearable microphone and is well-lit throughout the lesson.

Using a built-in mic on tablets or computers can produce muffled audio. A wearable microphone doesn’t have to be anything fancy; a Bluetooth headset or the headphones that come free with a phone will significantly improve sound quality.

Additionally, presenters should be well-lit throughout so that students can speech read their mouths.

Ask for a sound check before the lesson and that student microphones are muted throughout the lesson.

A sound check will ensure that the audio is working on both ends. Teachers or presenters can do this by asking each student a different open-ended question, such as, “What’s the last movie you saw?”

Also, having other learners mute their microphones prevents students from talking over each other and introducing distracting background noise to the lesson. Teachers can have students use a signal, such as waving or holding a thumbs up, when they want to speak.

Reduce background noise.

Turn off music, TV, and loud appliances and be sure to close windows and doors. If your child must share space with other people during lessons, ask everyone to try to be as quiet as possible.

Let the teacher know when you cannot hear.

Adults are likely to know when they are having trouble hearing, and what to do about it. However, children are often unaware that they are not hearing well and may be shy about speaking up when there is a problem. Help your child learn to identify problems by encouraging them to ask themselves if they understand what is being said and to let an adult know if they cannot.

Guidance for Children Who Are Distance Learning

Children with hearing loss have additional challenges regarding distance learning. Parents and guardians should adhere to the following tips to ensure that their child has the best experience while distance learning.

Ask for hearing assistive technology from your child’s school.

Ask your child’s school to send home their hearing assistive technology. This equipment, commonly referred to as “FM”, is usually used to improve the signal-to-noise ratio in the classroom, but it can also be used to connect the audio output from a laptop or tablet directly to a child’s hearing aids or cochlear implants, greatly improving sound quality. Some hearing devices can also connect via Bluetooth, ask your child’s audiologist.

Check your child’s hearing equipment.

Make sure your child’s hearing equipment has been freshly charged and that replacement batteries are on hand.

Additionally, do daily “listening checks”: while standing behind your child, ask them to repeat various letter sounds (could try the “Ling” sounds) in random order, then answer open-ended questions.

Request accommodations from the teacher.

Ask that teachers use captioning for videos and that they send presentations and other materials in advance. This will allow you to “pre-teach” new words and familiarize your child with new content.

Also, get in touch with your child’s teacher of the deaf and educational audiologist. They can help troubleshoot problems as they arise and can provide support to you and your child.

Make sure your child takes a break.

Listening through technology is hard work! Give your child plenty of time to rest in between lessons.

Even in the best of times, children with hearing loss have to work harder than their peers to learn, and commonly experience “listening fatigue” from the increased expenditure of energy. Distance learning is proving to be much more challenging than regular school for all students, and the added stresses of not seeing friends or playing outside make it even harder for kids to pay attention and learn. Therefore, it’s not reasonable to expect children to do the same work that they would in normal circumstances. In order to learn, children need to be presented with activities that are challenging, but achievable. Stress is counterproductive. If your child is resistant to doing schoolwork or participating in distance learning, discuss ways to adjust expectations with teachers.

Watch Mount Sinai's COVID-19 Facebook Live series

How to Talk to Your Child About COVID-19

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

Discussing difficult topics with children can be uncomfortable and this pandemic is no exception. Aliza Pressman, PhD, co-Founding Director and Director of Clinical Programming for the Mount Sinai Parenting Center, shares information parents and guardians can use as they care for children during the time of COVID-19.

Should I let my children watch the news?

If you want to give age-appropriate information to your kids, I recommend reading articles from reputable sources—either to them or with them—and then talking about the information. You may want to stick with resources that do not show images as it can be hard for children—and adults—to get images out of their minds.

We don’t want our children to see difficult images that we cannot control. For that reason, I would recommend turning off the news completely in front of younger children. In fact, older children and teenagers don’t really need those images either. Ideally, you should set aside time to watch the news to when you are alone or with other adults. This will also help manage your own stress because you will be limiting the amount of time you spend taking in this information.

I would discourage people of all ages from watching the news too much. Having the news on 24/7 heightens stress in the household and sends the message that you’re scared to turn the news off because you’re afraid you’ll miss something.

How do I help my child understand why they cannot see their friends and loved ones?

It can be hard for children to be unable to visit friends and loved ones, like grandparents, who they might be accustomed to seeing regularly. Try to empathize with your child and help them come up with proactive ways to connect with grandparents or other loved ones whom they cannot see.

This is the time to take advantage of social media and digital devices to empower your child to forge a connection with someone when they are not in the same room. Help turn sadness into productive action by encouraging your child to write letters, send notes, call, and video chat. These are beautiful ways to connect and show children that there is something they can do to help a person they love feel better.

If your child doesn’t have someone to connect with, there are organizations that can help you reach out, write letters, and draw pictures for elderly and vulnerable people who are currently isolated.

Should I tell my child if a loved one is seriously ill?

No matter how old your child is, it’s important to be honest and give your child the information needed. How you explain the situation depends on the child’s age.

For younger children, if a close family member is ill and you know how that illness is progressing, you can tell your child that the person tested positive for COVID-19. Explain the care that person is receiving and that you need to support them from afar.

If the person is very ill and you do not know what the outcome will be, it’s okay to express that to your child. Explain that the person is receiving great care and that you will keep in touch to see how things are going. You do not want to tell your child that everything is fine and then, all of a sudden, the person’s condition deteriorates.

On the other hand, if the person is asymptomatic and has tested positive, you don’t necessarily need to tell your children.

What if I or my partner becomes ill?

If you or your partner are sick, you need to tell your child what is going on. Explain that COVID-19 is very contagious. Explain that, in order to keep their body healthy and their parent’s body healthy, you will need to be separated for 14 days. You can make a calendar as a visual reminder of how long you will be apart. This can work well for the whole family as even adults can benefit from being able to check off each day of quarantine as it passes.

When you explain anything to children, be sure to check in first. See what they know already and then you can see where to begin with the explanation.

Dr. Pressman is the host of parenting podcast Raising Good Humans. Recently, she and Mariel Benjamin, LCSW, from The Mount Sinai Parenting Center, answered questions from health care providers and staff on the front lines to help support their parenting curing COVID-19. Additionally, The Mount Sinai Parenting Center maintains a COVID-19 resources page for parents, caregivers, and health care workers.

Managing Your Child’s Anxiety Caused By COVID-19

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

The COVID-19 pandemic is incredibly stressful for adults and can be puzzling and frightening for children. Aliza Pressman, PhD, co-Founding Director and Director of Clinical Programming for the Mount Sinai Parenting Center, shares advice for parents and guardians on how to manage your child’s anxiety as we navigate the uncertain times of COVID-19.

Are there steps I should take to help my child’s mental health?

This is a very confusing time for adults and kids. Typically, when kids are going through a new experience it is one that we, the adults, have been through. We’ve worked through it, we’ve grown up, and we’ve come out the other side. In this case, none of us have ever been through this and so our kids can’t look to us for that safe secure feeling. We don’t have a road map.

Be honest with your kids. Tell them that you know this is a new experience for all of us. Tell them that you understand if it feels scary or if they are worried. Remind them that you are right there with them.

How should I respond to my child’s anxiety?

Give your child permission to talk about what they are feeling and worrying about. Acknowledge their anxiety even if it has nothing to do with COVID-19 or is only slightly related to the pandemic. For instance, children may feel stress because they miss their friends or aren’t allowed to celebrate an event like a graduation or birthday. Try not to diminish their feelings or say ‘we have bigger things to worry about than your birthday party.’ Instead, tell them that you know it’s really hard. Let them know that you are aware that this is a big change. Assure them that you can figure out how to have celebratory experiences, even if they are not quite how you originally planned them.

This is a very challenging time for everyone. You can explain to children that they are being asked to be health superheroes. Through the practice of social distancing and by washing their hands thoroughly, they are keeping themselves safe and helping to protect others who are more vulnerable. This is a wonderful, empowering message that does not scare children.

Is it important that I keep my child’s routines going?

Although it can be hard to keep routines going during a time that has very few routines, kids and adults thrive on knowing what to expect each day. So, try to set up a flexible routine for the coming weeks or months.

I encourage writing out a plan for your children. If they are younger, you can draw a picture of the routine of the day or use photos from magazines to help them understand what to expect. Ask older children to come up with what they think is a good daytime routine. You want to make sure they are comfortable with the schedule, but you also want to get certain boxes checked about what needs to happen each day. Make sure that it includes something healthy for their bodies, something healthy for their brain, something healthy for their relationships, and so forth.

It’s also important to let children have some enjoyment. Allow them to be happy about getting out of some obligations they had prior to practicing social distancing. Your kids might be a little bit happy about spending more time at home with their parents. Let them know that it’s okay to have mixed feelings.

Also, allow yourself to embrace the new normal and accept that there may not be a completely perfect routine and predictable day-to-day experience. Children need to know what to expect, but they’re also very flexible if you explain clearly that there may come a time when the unexpected will arise. Children can take in new information and, if you are consistent, they will understand that you are there for them. Finally, if you are having any concerns about you or your child’s health and wellbeing, be sure to reach out to your health care provider for guidance and support.

Dr. Pressman is the host of parenting podcast Raising Good Humans. Recently, she and Mariel Benjamin, LCSW, from The Mount Sinai Parenting Center, answered questions from health care providers and staff on the front lines to help support their parenting curing COVID-19. Additionally, The Mount Sinai Parenting Center maintains a COVID-19 resources page for parents, caregivers, and health care workers.

Is it Time to Take My Child to the Doctor?

Oct 21, 2019 | Children's Health, Cold and Flu, Your Health

Fall is in swing, kids are back in school, and now everyone seems to have the sniffles. While you may be tempted to book an appointment with a pediatrician at the sight of a runny nose, several symptoms can be managed with at-home remedies and over-the-counter medications. Beth B. Kantrowitz, MD, a pediatrician at Mount Sinai Doctors-Brooklyn Heights, explains what can be done at home, when you need to see the doctor, and how best to protect your child during cold and flu season.

Help, my child is sick! What can I do about it?

First off, don’t panic. Many symptoms can be managed or treated at home without taking a trip to the pediatrician.

If your child has nasal congestion with or without cough, try using saline drops or nasal spray along with a humidifier or steam from the shower or bath. The humid and moist air along with the saline help to loosen congestion and allow mucus to drain. For children not old enough to blow their nose, use a nasal aspirator or bulb suction to clear away the mucus.

Should I use over-the-counter medications?

Forgo traditional “cough and cold” medicines as studies show they are neither effective nor safe, especially in children under six years old. Additionally, ingredients in many of these combination medicines overlap, putting children at greater risk for overdosing. If your child has a cough, honey is a helpful soother, although it is not safe in infants under one year.

Fever can be treated with acetaminophen for any child older than two months and ibuprofen for any child older than six months. Be sure to check the medication’s label—or consult a pediatrician—as dosing will depend on your child’s weight.

What is considered a fever? When should I be concerned?

A fever is defined as a temperature of 100.4°F or higher. It is helpful to know your child’s exact temperature as the trend of temperatures can help indicate whether the illness is improving or worsening.

Be sure to accurately check your child’s temperature. Remember, feeling his or her forehead with your hand will not give a sufficient measurement. A rectal temperature should be done for any baby six months of age and under. Rectal thermometers provide the most accurate temperature until age five; however, after six months it is okay to use a forehead (temporal) or ear (tympanic) thermometer. Oral thermometers should only be used after age five.

Seek medical help immediately if your child has a fever above 104°F or one that does not respond to fever-reducing medication.

When does my child need to see the doctor?

If your baby is under two months old and has a fever, they need to be taken to the emergency room. A fever in babies this young is taken very seriously and needs an evaluation that goes past what a doctor can do in the office. Between two and three months old, a baby with a fever should always be seen, but can first be evaluated by a pediatrician rather than going directly to the emergency room. For older babies and children, a fever lasting two days or more should be checked by the doctor.

In addition, although congestion and cough do not always need to be seen in the office, any child with difficulty breathing as well as these symptoms needs to be checked.

When in doubt, it is best to have your child checked by the doctor. Call your pediatrician if there are ever any questions about when to come in.

How can I prevent my child from getting sick?

The best way to protect your child from illness is to keep up to date on immunizations, including the annual influenza vaccine. While immunizations do not prevent all childhood illnesses, they protect against many serious infections as well as the dangerous complications that may arise from some of these infections.

Frequent hand washing, either with soap and water or with an alcohol-based hand sanitizer, is also an important way to prevent illness. When washing with soap and water, scrub for at least 20 seconds and rinse soap fully.

Finally, if your child is in school, preschool, or daycare, please keep them home if they are sick. Coughing, sneezing, and runny noses can linger from an illness so it is not imperative that these symptoms be fully resolved before returning to activities. However, children should be fever-free for 24 hours and back to their usual energy and activity level before returning to school. This will prevent further spread of illness in their classroom.

Beth B. Kantrowitz, MD

Pediatrician, Mount Sinai Doctors Brooklyn Heights

Dr. Kantrowitz has a particular interest in well child-care, newborn medicine, breastfeeding, asthma, childhood nutrition and obesity, infant colic, and developmental screening. She sees patients at Mount Sinai Doctors Brooklyn Heights at 300 Cadman Plaza West from Monday through Saturday.

Make an appointment with Dr. Kantrowitz

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What Are the Early Signs of Hearing Loss in Babies?

Updated on Aug 16, 2023 | Children's Health, Your Health

Hearing is critically important for a baby and is closely linked to language development in the first few years of life. Because of this, it is important to identify potential hearing loss as soon as possible so that early intervention can be arranged. Maura Cosetti, MD, Director, Otology/Neurotology, Mount Sinai Downtown, Associate Director, Ear Institute, New York Eye and Ear Infirmary of Mount Sinai (NYEE), and Aldo Londino, MD, Assistant Professor of Pediatric Otolaryngology at the Mount Sinai Health System and Chief of the Division of Pediatric Otolaryngology at the Mount Sinai Kravis Children’s Hospital, detail what parents need to know about spotting—and addressing—hearing loss in babies.

How common is pediatric hearing loss and what are the causes?

Approximately two to three infants per 1,000 are born deaf or with severe to profound hearing loss. Causes range from hereditary hearing loss to improper development of the inner ear. Hearing loss can also occur after birth and may be related to infections or other medical problems that occurred around the time of delivery.

How and when are babies tested for hearing loss?

All newborns are given a mandatory hearing test before leaving the hospital. This non-invasive screening helps identify babies who are deaf or hard of hearing by monitoring for either an ear or a brain response to a sound.

What does it mean if my baby “fails” the newborn hearing screening?

There are many reasons that your baby may have failed the newborn screening test. Because it is a screening, failing does not always mean your child has permanent or severe hearing loss. It is important to have a trained audiologist perform additional testing to assess your baby’s condition.

If hearing loss—whether permanent or temporary—is suspected, follow up testing with a pediatric audiologist is necessary to determine the amount of hearing loss and the appropriate interventions. Interventions may range from observation, to hearing aids, and even cochlear implant evaluations.

My baby did not fail the newborn hearing screening. What are the signs of potential hearing loss as my child develops?

Signs and symptoms of hearing loss in babies vary, as children may reach milestones at different ages. However, the earlier hearing loss is diagnosed, the earlier it can be treated and the better the outcome for your child’s future development. Be aware of the following age-related guidelines to help gauge your child’s progress:

From birth to three months, your baby should:

React to loud sounds with a startle reflex
Turn their head to you when you speak
Be awakened by loud voices and sounds

From three to six months, your baby should:

Look or turn toward a new sound
Respond to “no” and changes in tone of voice
Begin to produce their own voice

From 6 to 10 months, your baby should:

Respond to their own name
Understand words for common items or phrases (mama, dada, milk, bottle, bye-bye)
Make babbling sounds

From 10 to 15 months, your baby should:

Look at familiar objects or point to people when asked to do so
Say simple words and sounds; may use a few single words meaningfully
Enjoy games like peek-a-boo and pat-a-cake

What steps should I take if my baby begins exhibiting signs of hearing loss?

If you feel that your baby is not meeting their developmental milestones to speak, play, or communicate, you should ask your pediatrician for a referral to a pediatric ear, nose, and throat specialist. Since hearing loss can affect your child’s ability to develop speech, language, and communication skills, it is of the utmost importance that your child receive appropriate services and treatment, which may include hearing aids, as soon as possible.

Maura K. Cosetti, MD

Director, Otology/Neurotology, Mount Sinai Downtown and Associate Director, Ear Institute

Dr. Cosetti specializes in the diagnosis and treatment of pediatric and adult hearing disorders, facial nerve disorders, and other complex conditions, as well as cochlear implantation, endoscopic ear surgery, and skull base surgery.

Make an appointment with Dr. Cosetti

Aldo Londino, MD

Assistant Professor of Pediatric Otolaryngology and Chief, Division of Pediatric Otolaryngology, Mount Sinai Kravis Children’s Hospital.

Dr. Londino specializes in the treatment of children with complex medical problems of the ears, nose, and throat.

Make an appointment with Dr. Londino

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