1 full week already down in 2021! Can you believe it? How are you doing with your New Year’s resolutions? Good, I hope!
I originally wrote this newsletter with plans on discussing COVID updates in relation to pregnant and lactating mothers. It’s still in this newsletter! Just scroll toward the bottom for updates. There’s also a special announcement from Dr. Waipa. 🙂
However, a lot happened on Wednesday (1/6/2021) at the Federal Capitol. So we need to talk about it. As adults, we could talk about what happened for hours, days even. Our country remains divided. Violence is NEVER the answer. Let’s come together. Remember, we’ve expressed in another newsletter that we feel everyone has a right to their opinions and beliefs. But know that we will always put your keiki first, no matter what. If there’s something we can do to benefit them, we’ll always do it, especially through advocacy, much of which happens at the political level. So while we try to avoid politics, when we fight for what’s best for children, it’s necessary to share our point of view.
But the goal of this newsletter is not to get into the gritty details of what happened this week. The goal is to focus on your keiki, and since what happened was so distressing to us as adults, we know it could also be distressing to your kids.
I’m sure you’re thinking “How do I discuss this with my children?” “What should I do as a parent to help my children navigate what’s going on in the world, even when it’s not pretty?” Know you’re not alone if you’ve had these thoughts. I’ll try to break it down by age since, as you know, the way our keiki internalize information varies depending on their level of development.
School aged-children won’t be able to understand the same complexity as teens. And even teens can’t quite comprehend in a way that doesn’t cause them to react emotionally. Not to mention, technology and news information is so easily accessible, which makes it difficult to filter what your child is exposed to.
So let’s see what we can do.
Step 1: ASK
Ask your child about their thoughts. What’s going on? Get their point of view.That’ll help you set the stage and know how to address any worries or concerns they might have.
Step 2: TALK with them in the moment.
Once your child asks what’s going on and you ask about their perspective, talk about it right then and there.
Step 3: Avoid being too vague
Being vague makes it difficult for children, especially young children, to know how the event differs from other every day events. For example, saying “people are upset and did something bad” doesn’t distinguish from the school fights, burglaries, or other protests they may be exposed to. Their view of “something bad” could simply mean that someone ate a piece of chocolate when they weren’t supposed to because they were mad they didn’t get attention. Not quite the same thing…
How to talk based on your child’s age
Preschool kiddos: The chocolate example above relates more to this younger group of children.
Use short sentences. Multiple breaks when speaking to check for understanding helps with this age group.
You can say something like “A crowd of people went into an important building when they weren’t supposed to. That building is important to our country. It got scary and dangerous.”
Let them know it’s okay if they feel scared as these young kiddos pick up on adult emotions so easily. Support them.
School-aged (6-10yrs):
Because they’re in school, they might hear about the news from other children. The conversation from one child to another may not be the most accurate. We’ve all played telephone. We know how that goes…
So if you’re able to talk with them first, fantastic.
You can use longer sentences, but still start simple and basic. These kiddos ask a lot of “why” questions. Your conversation with them will be longer than with preschool children.
They will express their own emotions. Pay attention to how they’re feeling. More on symptoms to look out for below.
This is an example of a conversation that might happen with a child in this age group.
Parent: Do you know what’s going on in our country right now?
Child: I saw pictures of people breaking into a building. I HEARD SOMEONE GOT SHOT.
Parent: Yes, that did happen (Take the time to either acknowledge or correct their interpretation)
Child: WHY?
Parent: People are angry. They weren’t happy. They wanted to express themselves.
Child: What are they angry about?
Parent: They feel that the person who won the election for President wasn’t correct. (the older kids probably already know this was happening since the election).
Child: Why?
The why’s never stop. It’s part of their development. They’re curious and as they get older, they also start to have their own opinions.Some children will ask more questions. Some may ask less. Some may start showing their emotions already.
Be cautious of media exposure. The graphic, sensitive content of people getting shot can be accessed easily. Be prepared to help them know what’s appropriate and what’s not appropriate to look at. If you already saw it as a parent, chances are your older school aged child will see it as well. Do your best to filter what’s available but also be prepared to talk about it.
Teenagers
This age group has the most access to social media and graphic, sensitive content. Therefore, the emotional spiral can be greatest.
Have the conversation with them early.
They WILL talk about it more with their friends
They WILL express their opinions and their perspectives
They WILL have an easier time feeling emotional about the current events
Remember, listen and validate. Check in with your teen in a way that lets them know you’re there to speak with them but not for them.
Hmm, they don’t want to talk to you, you say? That’s expected. They’d rather talk to their friends, honestly, which is super normal for their developmental stage, remember? Still. Let them know you’re there for them. Knowing that fact goes a long way.
Step 4: Watch for signs and symptoms of coping difficulties
Emotional distress (depression, anxiety)
Difficulty sleeping
Feeling tired
Increased headaches
Stress eating (I’m guilty)
If you have a child with special healthcare needs:
It’s important to know their limitations. Where are they developmentally? How do they normally react to unexpected situations? You know them best.
The American Academy of Pediatric’s Healthychildren.org website has a few paragraphs on helping children with disabilities and Autism navigate these difficult times. It’s short but still helpful information!
Here’s more about helping children build resilience during uncertain times!
Several weeks ago, we discussed the new COVID vaccine and how it relates to children. Here’s a quick recap:
Pfizer
Studied ages 16 and older
Ongoing studies for individuals as young as 12
2 dose series 21 days apart
Efficacy of 95% after 2nd dose
Moderna
Studies ages 18 and older
2 dose series 28 days apart
Similar efficacy as Pfizer vaccine 94.1%
The vaccine will not be available for children younger than 16 for a while. We’re all over it though and will keep you posted once that information is available!
Dr. Waipa and I both got our first shot last month and will be getting our second shot in the upcoming weeks. Our wonderful office staff got their vaccine yesterday! Yay! We’re all partially protected and will be fully protected in a matter of weeks!
I have to be honest, though I’m extremely happy and fortunate to have received the vaccine, a part of me was sad. I felt privileged, and I don’t like feeling that way. The first people I thought about were my parents, knowing that they’ll still have to wait some time to get protected. I thought about the rest of my family, my husband, my friends … all those who have to continue to wait.
I am so appreciative of the science, the thousands of individuals who enrolled in the vaccine trials, the countless hours that other nurses, physicians, RTs, and frontline workers put in day in and day out. To protect myself, my family, my patients, and my friends, I was ready once the vaccine became available.
WHAT ABOUT LACTATING MOTHERS? PREGNANT MOMS?
We’ve gotten texts, phone calls, and in-person questions about this topic quite a bit lately, and for good reason. It’s hard to decide what to do when there were zero pregnant women and zero lactating mothers enrolled in the vaccine trials for both Pfizer and Moderna.
HOWEVER, when we look at the risk benefit analysis, the risk of getting sick with COVID and potentially getting your baby or your family sick compared to the benefit of having a 95% reduction in the chances of getting severely sick from COVID (95% efficacy) is what we really need to discuss. After doing our research and after discussing with other physicians, including OBs, the benefit of getting the vaccine is much greater than the risk of getting sick with COVID and potentially getting your baby sick. Therefore, we recommend getting the vaccine if you are breastfeeding or if you are pregnant once it becomes available to you.
There is also a possibility that the antibodies you generate from the vaccine will be able to pass through to your baby via your breastmilk, so you can protect your baby too! While this isn’t proven, it’s a possibility since we know this shared protection happens when antibodies develop from other vaccines and viruses.
Here are some helpful links if you want to do more research.
Wren wanted me to let you know that she’s been promoted to big sister. We’re expecting our second child in May! We’re over the moon excited about the big change to come in our family, and being able to share the journey with you. I’m sure the leap to a family of four will be a huge one!
If all goes well, I plan to be on maternity leave from mid-May through end of June and will be back in the office in July. My wonderful colleague Dr. Honda will be covering for me, as well as our very good friend and colleague Dr. Courtney Taum, who I’m equally excited to introduce you to in a future newsletter.
Finally, I want to explain how I came to my decision to get the COVID vaccine last week, while pregnant. Like you, I was initially apprehensive and basically said, “No way, I’m not doing it. I’ll just wait until I deliver,” … that was my original thought process.
But as a physician, I felt obligated to make an educated decision, not an emotional one. So I did a deep dive into the science, the research, and, of course, asked all of my friends and colleagues to weigh in. The science of mRNA vaccines is actually AMAZING, and if you ever want to geek out about it, hit me up. The vaccine trials conducted were well-done and clinically sound. Vaccine efficacy rates of 95% are incredible. I couldn’t find any flaws in the methodology, and there’s compelling evidence that both of the approved vaccines are safe and effective; the data bears that out.
While there is still no evidence that this conclusion is true for lactating or pregnant mothers, by applying what we do know of the science and mechanism of the vaccine, it’s logical to conclude that the benefits of protection from COVID-19 far outweigh the (so far theoretical) risks of side effects from the vaccine. Also, data clearly shows that pregnant women who get COVID-19 are at much higher risk for preterm delivery and more severe outcomes than non-pregnant women. Think of it this way: No matter what you choose, you’re taking a risk, so it really boils down to which risk you’re willing to take … a personal decision.
And I’ve heard this rumor, so I thought I’d make it clear, this vaccine should have no impact on future fertility. No vaccine ever has. There’s nothing about the mechanism of the vaccine that should have any impact on fertility or reproduction. If you’re thinking of starting or growing your family, that’s no reason to delay getting your COVID vaccine if and when it’s available to you.
After my own deliberation (aka soul searching), checking in with my family and my physicians, and getting the final seal of approval from a very best friend of mine who works for the CDC and whose smarts I trust implicitly, my decision became clear. I was surprised that I changed my own mind, but I feel confident in my decision and wanted to share my thought process with you. The shot was easy to take, and I look forward to getting my final dose in a few weeks. It will make me feel safer and hopefully my family and patients as well.
If you have any questions about the COVID vaccine and need help deliberating on what to do, we’d love to talk to you about it!
Aloha,
Dr. Waipa
This newsletter was a long one, but there was so much to talk about! Huge congrats to Dr. Waipa!
As always, let us know if you need anything from us or have further questions about what we discussed. We are here for you.
