COVID-19 Update

Health

Coronavirus in Babies and Kids: Symptoms and Prevention

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As more becomes known about the new coronavirus and COVID-19, worried parents and guardians can feel better about one detail: In a majority of cases, the disease seems to be much milder in babies and children. 

However, it’s important for parents and caregivers to understand that children can be infected with SARS-CoV-2, the coronavirus that causes COVID-19, and can transmit it to others.

In rare cases, children can become very sick with COVID-19, and deaths have occurred. That’s why it is important to use precautions and prevent infection in children as well as adults.

Aaron Milstone, M.D., M.H.S., a pediatrician at Johns Hopkins Children’s Center and an infectious disease expert at The Johns Hopkins Hospital, talks about coronavirus symptoms in children, how to keep babies and kids safe, the risk infected children may pose to others, and an overview of MIS-C, a rare condition that may be related to exposure to the virus.

What are coronavirus symptoms in babies and children?

Generally, COVID-19 symptoms are milder in children than in adults, and some infected children may not have any signs of being sick at all.

Coronavirus symptoms for children and adults include:

  • Cough
  • Fever or chills
  • Shortness of breath or difficulty breathing
  • Muscle or body aches
  • Sore throat
  • New loss of taste or smell
  • Diarrhea
  • Headache
  • New fatigue
  • Nausea or vomiting
  • Congestion or runny nose

Fever and cough are common COVID-19 symptoms in both adults and children; shortness of breath is more likely to be seen in adults. Children can have pneumonia, with or without obvious symptoms. They can also experience sore throat, excessive fatigue or diarrhea. 

However, serious illness in children with COVID-19 is possible, and parents should stay alert if their child is diagnosed with, or shows signs of, the disease.

Among U.S. states reporting coronavirus cases by age, 9.1% are children. An August 2020 study from the Centers for Disease Control and Prevention finds that about 8 children out of 100,000 require hospitalization for coronavirus infection, compared with about 165 of adults. But among those children, 1 in 3 required intensive care.

Data from the CDC study indicate that some children may be at a higher risk for needing medical care in a hospital:

  • Those under age 2.
  • Black and Latino children, who can be affected by health disparities, leaving them disproportionately vulnerable to severe COVID-19 complications.
  • Children who were born prematurely.
  • Those living with obesity or chronic lung disease.

It’s important to follow guidelines if you think your child is sick with COVID-19, trust your instinct, especially if the child has a cough or fever. Contact your pediatrician, family care practitioner or urgent care clinic if you don’t have a doctor.

5 Tips Kids Need to Know about Covid-19

Can kids spread the coronavirus?

Yes, children infected with the coronavirus can transmit it to other kids and adults, but whether they spread the illness more or less than adults is not yet clear. Although for the most part, children’s COVID-19 symptoms are milder than those of older people, evidence shows that infected kids carry at least as much of the virus in their mouths and noses as adults.

Having more of the coronavirus in your body doesn’t necessarily mean you are more contagious, but researchers are looking at the role of children in coronavirus transmission, especially as it affects reopening schools.

Multisystem Inflammatory Syndrome in Children (MIS-C)

Doctors at children’s hospitals in the U.S. and the U.K. have noted that children between ages 2 and 15 may experience a condition called multisystem inflammatory syndrome in children, or MIS-C.

Call your family doctor or pediatrician right away if your child experiences a fever of 100.4 degrees Fahrenheit or more that lasts more than 24 hours and at least one of these symptoms:

  • Unusual weakness or fatigue
  • A red rash
  • Abdominal (belly) pain
  • Vomiting and diarrhea
  • Red, cracked lips
  • Red eyes
  • Swollen hands or feet

Learn more about MIS-C

What are the signs that a child with COVID-19 requires immediate emergency medical attention?

Parents or guardians should immediately seek urgent or emergency medical care if they notice these warning signs in a child:

  • Difficulty breathing or catching his or her breath
  • Inability to keep down any liquids
  • New confusion or inability to awaken
  • Bluish lips

How to Protect Your Kids from the Coronavirus and COVID-19

Milstone says that the best way to prevent children from becoming sick with COVID-19 is to avoid exposing them to people who are (or who might be) sick with the virus, including family members. Here are three of the best ways to protect your kids from infection.

Maintain physical distancing. The more people your kids come in contact with, and the longer the duration of that contact, the higher the risk of infection with the coronavirus.

  • Children should stay at least 6 feet from others outside of their household.
  • Check your kids’ day care and schools (if they are open) to ensure physical distancing measures are in place.
  • Limit in-person play with other children, and be sure the children wear masks properly.
  • Ensure that children limit close contact with children and adults who are vulnerable, such as those with health conditions.

Wear a mask. When out and about in public, adults and kids should wear a mask that covers both nose and mouth, especially in situations outside the home where physical distance isn’t possible. Milstone suggests that parents help younger children practice wearing masks before returning to school so kids are comfortable wearing them in class.

Wash hands. Kids should wash their hands after using the bathroom, sneezing, coughing or blowing their nose, before eating (even snacks) and immediately after coming inside from playing outdoors.

Hand hygiene. Milstone advises parents to teach kids to wash their hands regularly, with soap and warm water, for at least 20 seconds. “They can help keep track of time by singing the ABCs, which takes about 20 seconds to finish,” he says. If soap and water are not available, Milstone says the next best option is hand sanitizer containing at least 60% alcohol.

Kids who balk. Milstone says, “If your child is refusing to wash their hands or becoming very upset when asked to do so, it might help to give them a small reward, such as a sticker, to celebrate each time they wash their hands. Compliment them for doing a really good job while washing their hands.” It also helps when parents set an example by washing their own hands frequently.

Other Coronavirus Prevention Tips for Families

Cough and sneeze with care. “Encourage everyone in the family to cough and sneeze into their elbow, instead of their hands, and to wash their hands after each time this occurs,” Milstone says. “Throw away tissues after they are used,” he adds.

Keep hands off faces. Parents should remind children to avoid touching their face as much as possible. Milstone says it can help if kids carry a toy that will keep their hands busy, but he notes that parents should wash those toys regularly.

Keep things clean. Wipe down toys and surfaces your child touches regularly, especially when traveling or when near a person who is sick. Clean surfaces at home and store cleaners in cabinets that are either too high for your child to reach or are secured with childproof cabinet locks. (More cleaning recommendations are available from the Centers for Disease Control and Prevention.)

Address anxiety and stressTalking things over as a family can help identify specific fears and clarify the facts. It also helps for families to discuss a plan in case someone gets sick or something else happens that interrupts the normal routine.

“Children will look to you when deciding how to feel about COVID-19. If you feel calm and prepared, they are likely to feel similarly,” Milstone notes.

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Coronavirus (COVID-19) Self-Checker

Check symptoms. Protect yourself. Get information.

Children with Medical Conditions

Asthma: Children with asthma may have more severe symptoms from COVID-19 or any other respiratory disease, including the flu. As yet, there are no indications that most children with asthma experience severe symptoms due to the coronavirus, but observe them carefully and, if symptoms develop, call the child’s doctor to discuss next steps and to arrange appropriate evaluation as needed. Keep your child’s medications refilled and take extra care to avoid things that set off asthma attacks in your child.

Diabetes: Control of blood sugar is key. Children with well-managed diabetes are not expected to be more susceptible to COVID-19. But poorly controlled diabetes can weaken the immune system, so parents and doctors should watch these children carefully for signs and symptoms that may require evaluation.

Learn more about COVID-19 and Immunocompromised Kids.

Kids and families can reduce coronavirus risk together

Though much more is yet to be understood about the new coronavirus, COVID-19 seems to have less serious health consequences for children than for adults, which is encouraging news. Still, it is important to avoid infection among children, be on the lookout for serious disease in kids and help prevent the virus from spreading. Families with children can work together to reduce the risk.

Scientist carefully insets a pipette into a test tube.

Coronavirus (COVID-19)

What you need to know from Johns Hopkins Medicine.

Updated August 21, 2020