COVID in Babies and Kids: Symptoms and Prevention
It is important for parents and kids to take every possible safety precaution and understand all risks and symptoms related to COVID-19.
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 COVID-19 symptoms in children, how to keep babies and kids safe, the risk infected children may pose to others, and an overview of MIS-C, an uncommon but serious condition that may be related to exposure to the virus.
What should parents know about coronavirus variants in babies and children?
Coronavirus variants, including the very contagious omicron variant, continue to spread, particularly in areas with low rates of community COVID-19 vaccination and among populations such as children under 5 who cannot yet be vaccinated.
For children too young to be vaccinated (and adults who have not received coronavirus vaccines) it is important to follow proven COVID-19 precautions such as mask wearing when in public, indoor places to reduce the chance of becoming infected with the coronavirus.
“Indoor activities are riskier than outdoor activities, but risk can be reduced by masking, distancing, hand washing, and improved ventilation,” Milstone says.
Parents and caregivers should understand that children infected with the coronavirus can develop complications requiring hospitalization, and can transmit the virus to others.
In rare cases, children infected with the coronavirus can develop a serious lung infection and 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.
Can newborns and babies get COVID-19?
It appears that women infected with the coronavirus can, in very rare cases, pass the disease to her baby. Infants can also become infected shortly after being born. According to the U.S. Centers for Disease Control and Prevention (CDC), most newborns who test positive for the coronavirus have mild symptoms or none at all, and recover, but serious cases have occurred. Pregnant women should take extra precautions, including talking to your doctor about getting a COVID-19 vaccine, to avoid the coronavirus.
There is no evidence that the virus causing COVID-19 is present in breast milk but because there is a possibility of spreading COVID-19 during breastfeeding through respiratory droplets, it is very important to follow safety guidelines. Learn more about COVID and breastfeeding.
COVID symptoms in babies, toddlers and children?
Generally, COVID-19 symptoms in kids and babies are milder than those in adults, and some infected children may not have any signs of being sick at all.
COVID-19 symptoms for children and adults include:
- Fever or chills
- Shortness of breath or difficulty breathing
- Muscle or body aches
- Sore throat
- New loss of taste or smell
- New fatigue
- Nausea or vomiting
- Congestion or runny nose
Some symptoms of COVID-19 and the flu are shared and it may be difficult to determine which of either might be present.
“People with flu-like symptoms should be careful about exposing other people and should get tested to see if they have COVID,” says Milstone. “Testing for influenza virus can also be important, as available medicines can help reduce symptoms in those with influenza.”
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.
Children with COVID-19: When to Call 911
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
Hand-washing and Coronavirus Prevention for Children
Risk Factors for Serious COVID-19 in Children
Data from the CDC study indicate that some children may be at a higher risk for a serious case of COVID-19, 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
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, and follow their instructions carefully regarding isolation and testing.
Multisystem Inflammatory Syndrome in Children (MIS-C)
Doctors have noted that some children may experience a condition called multisystem inflammatory syndrome in children, or MIS-C after an infection with the coronavirus.
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
Children with Medical Conditions
How can immunocompromised kids get the care they need?
Lexie DeLone, a child life specialist at Johns Hopkins Children’s Center, says, “Your child’s care team is your go-to resource. It’s OK to ask your child’s doctor about what specific steps they are taking to provide treatment for your child while preventing COVID-19 and if getting your child vaccinated is appropriate,” she says.
Some office visits and follow-ups may be able to shift to telemedicine, but other treatments require your child’s physical presence. “Parents can remind children that their treatment is important to keep them healthy, DeLone says. “Older children and teens might be aware of the fact that their bodies could have a harder time fighting the virus if they encounter it.
Parents can reassure them that hospitals are aware of patients’ vulnerabilities, and are prepared and using precautions.”
Asthma: Children with asthma may have more severe symptoms from COVID-19 or any other respiratory disease, including the flu. 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.
How to Protect Your Kids from the Coronavirus and COVID-19
Have your child vaccinated for COVID
Experts, including those at Johns Hopkins, believe that there are many benefits to vaccinating children for COVID-19. The CDC recommends vaccines for children 5 and older.
“The omicron variant is very contagious leaving unimmunized people at high risk of infection,” says Milstone. “Vaccination reduces risk of infection, but most importantly, significantly reduces the risk of hospitalization and death from this and other variants.”
Children age 12 or older who have received both required doses of the Pfizer-BioNTech vaccine at least five months ago can receive a booster shot. The Pfizer-BioNTech vaccine is the only vaccine and booster authorized for individuals ages 12–17.
Children age 5 and older who have certain medical conditions associated with immunosuppression can receive an additional dose 28 days after their second dose.
Learn more about the COVID-19 vaccine and what parents need to know.
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Protecting Younger Kids from COVID-19
While a vaccine may be authorized for children under 5 in the next few months, until that happens, Milstone says that the best way to keep them safer is to avoid exposing them to people who are (or who might be) sick with the coronavirus, 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. Very contagious coronavirus variants are circulating. Mask wearing prevents virus spread and outbreaks. This is one reason why the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics recommend masking for children in grades K-12, even for those who are fully vaccinated. Data continue to support the value of masking in schools to prevent infections. Milstone suggests that parents help younger children practice wearing masks before returning to school so kids are comfortable wearing them in class.
Hand hygiene. 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.
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.
5 Tips Kids Need to Know about Covid-19
Kids and families can reduce coronavirus risk together
Though in most cases COVID-19 seems to have less serious health consequences for children than for adults, it is important to avoid infection among children. Here’s how parents and guardians can help:
Get all your shots. Ensure that all family members receive COVID-19 vaccinations as soon as they are eligible, and the same goes for flu shots and other vaccinations.
Know the signs and symptoms of COVID-19 and be on the lookout for serious disease in kids.
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.
Address anxiety and stress. Talking 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.
What you need to know from Johns Hopkins Medicine.