New Delhi: Dry eyes, an acute vitamin D deficiency, poor sleep, nightmares, temper issues and speech delay — this is how the impact of Covid-19 on the well being of children is becoming noticeable.
While several discussions have been ongoing over the mental impact of Covid-19 on the children, paediatricians have started observing a spike in the physical health issues due to the closure of schools, restricted mobility and sedentary lifestyle.
“Weight gain due to lack of exercise, sedentary lifestyle and binge eating is one of the most common observations where cases of diseases associated with obesity and abnormal eating patterns have increased among children,” said Shilpa Aroskar, former president of the Indian Association of Pediatrics (IAP), Navi Mumbai and consultant at Reliance Hospital, Navi Mumbai.
Aroskar said almost half of the cases she consults every day are diagnosed as an impact of Covid-19 induced “sedentary lifestyle” among children.
Other issues are stemming from excessive use of mobile phones, computers and laptops. “More than required screen time is leading to lesser interaction at home, speech delays in toddlers and many behavioural issues like temper tantrums, hyperactivity or lack of interest in food in the under 5 years age group,” she said.
Bengaluru-based Dr K.N. Harsha, paediatrician at Aster RV Hospital, supported the observation about increasing use of gadgets among children.
“I have been seeing cases where children are becoming more aggressive if parents ask them to stop playing on cell phones. They are complaining of dry eyes, back pain and neck pain as a result of spending more time on their digital devices.” On a daily basis, he diagnoses about two to three cases.
Dry eyes is a condition where the eyes don’t get adequate lubrication and cause discomfort in the form of redness and burning sensation.
Children — who would typically be expending their energy outdoors playing, running and climbing — are now having to readjust to online classes, which can be difficult as they have to sit still for long periods of time looking at the screen. “There have also been some cases of hand cramping due to increased use of gadgets,” said Dr Harsha.
The number of emergency cases have also increased as parents try to juggle work from home and “irritability” among children.
“There has also been an increase in emergency cases where children have been playing with something dangerous or they swallow some items like magnets or buttons which need to be immediately attended to,” said Dr Harsha, who is also a paediatric intensivist.
An intensivist is a certified physician who provides special care for critically ill patients.
Other doctors are witnessing similar emergencies. “There is a sudden increase in injuries such as burns, cuts, fractures and fall among children,” said Dr Parvinder Singh Narang, associate director, paediatric, Max Super Specialty Hospital, New Delhi.
Vitamin D deficiency, poor sleep and appetite
The World Health Organization (WHO) predicted that due to the closure of schools — as part of necessary measures — children may no longer have that “sense of structure and stimulation that is provided by that environment, and now they have less opportunity to be with their friends and get that social support that is essential for good mental well-being”.
However, as children are locked inside homes, the significant physical issues such as acute Vitamin D deficiency have started surfacing.
According to Dr Pradeep Kumar Sharma, senior consultant and head, paediatric ICU, Sri Balaji Action Medical Institute, “While Vitamin D deficiency is not new among Indian children, in the last two months, such cases have gone up where I have treated children with severe Vitamin D deficiency for which we had to give them injection for calcium through veins.
“Generally a child needs 800 to 1,000 units of Vitamin D per day but due to the Covid-induced lifestyle, their intake has reduced (due to limited exposure under sun) which is not good for their bone health, muscle building and mental health.”
Dr Narang from Max Hospital has been seeing cases where children are suffering from “poor sleep including nightmares, poor appetite, physical discomfort, agitation and inattention, clinginess, and separation anxiety.”
Dr Kumar Salvi, who heads the paediatrics department at Fortis Hiranandani Hospital, Vashi, near Mumbai, shared a similar experience. “The top complaints are Vitamin D deficiency, obesity and eye irritation, even among toddlers.”
Child development clinics are also seeing increase in enquiries from parents who are anxious over behavioural changes among their children.
“We have received more registrations for our online home program as compared to pre-Covid level. Due to which, we have been able to provide therapy to more than 5,000 special needs children during the lockdown,” said Dr Anil Sharma, clinical director at Mom’s Belief, a Gurgaon-based child development clinic.
Sharma’s firm is helping these children follow a structured routine, and keep them engaged in activities that are cognitively stimulating.
Why children should have physical activity
Generally, children are very active. According to WHO, in order to improve cardiorespiratory and muscular fitness, bone health, and cardiovascular and metabolic health biomarkers, children aged above five years should spend at least 60 minutes of moderate- to vigorous-intensity physical activity daily.
“Amounts of physical activity greater than 60 minutes provide additional health benefits,” it said.
According to Australia’s Physical Activity and Sedentary Behaviour Guidelines, for children aged between 1 to 5 years, they should be physically active for at least three hours a day.
For children aged 5 to 12 years, at least 60 minutes of moderate to vigorous physical activity every day is recommended.
Health experts say that physical activity doesn’t have to always be a sport, but activities such as fast walking, climbing, dancing, riding a bike provide the kind of rigorous movement children need.
What parents can do
Parents have to be more attentive than before, doctors advised.
“Parents should try to manage to go out with children following every required precaution, especially in open spaces with natural ventilation,” said Dr Sharma from Sri Balaji Action Medical Institute, while adding that children should be encouraged to take part in physical activities and follow healthy active lifestyles as much as possible.
Also, keeping their Vitamin D level tested is important.
“It is advisable to supplement vitamins such as Vitamin D and iron,” Dr Narang said.
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