eBurgmoms | 2020 Fall

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Serving Ellensburg, Ronald, Roslyn, Cle Elum, South Cle Elum, Kittitas, Thorp, Easton & Vantage | Fall 2020

A supplement to the Daily Record

COVID lessons: Sometimes a house just needs a puppy Our plan to work and teach from home blew up ‘I want a divorce trending during COVID Mayo Clinic Q And A: Preparing children for back to school


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Kittitas County’s resource just for parents

CONTENTS 4

Kids Are missing critical windows for lead testing due to pandemic

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Mayo Clinic Q And A: Preparing children for back to school

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Early morning adventure with daughter proves insomnia can have a bright side

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‘I want a divorce trending during COVID

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Our plan to work and teach from home blew up

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COVID lessons: Sometimes a house just needs a puppy

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Healthy food for at-home students starts with this

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That COVID-19 baby boom might be more of a bust

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Kids Are missing critical windows for lead testing due to pandemic Brie Zeltner Kaiser Health News CLEVELAND — Families skipping or delaying pediatric appointments for their young children because of the pandemic are missing out on more than vaccines. Critical testing for lead poisoning has plummeted in many parts of the country. In the Upper Midwest, Northeast and parts of the West Coast — areas with historically high rates of lead poisoning — the slide has been the most dramatic, according to the Centers for Disease Control and Prevention. In states such as Michigan, Ohio and Minnesota, testing for the brain-damaging heavy metal fell by 50% or more this spring compared with 2019, health officials report. “The drop-off in April was massive,” said Thomas Largo, section manager of environmental health surveillance at the Michigan Department of 4

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Health and Human Services, noting a 76% decrease in testing compared with the year before. “We weren’t quite prepared for that.” Blood tests for lead, the only way to tell if a child has been exposed, are typically performed by pricking a finger or heel or tapping a vein at 1- and 2-year-old well-child visits. A blood test with elevated lead levels triggers the next critical steps in accessing early intervention for the behavioral, learning and health effects of lead poisoning and also identifying the source of the lead to prevent further harm. Because of the pandemic, though, the drop in blood tests means referrals for critical home inspections plus medical and educational services are falling, too. And that means help isn’t reaching poisoned kids, a one-two punch, particularly in communities of color, said Yvonka Hall, a lead

poisoning prevention advocate and co-founder of the Cleveland Lead Safe Network. And this all comes amid COVID-related school and child care closures, meaning kids who are at risk are spending more time than ever in the place where most exposure happens: the home. “Inside is dangerous,” Hall said. The CDC estimates about 500,000 U.S. children between ages 1 and 5 have been poisoned by lead, probably an underestimate due to the lack of widespread testing in many communities and states. In 2017, more than 40,000 children had elevated blood lead levels, defined as higher than 5 micrograms per deciliter of blood, in the 23 states that reported data. While preliminary June and July data in some states indicates lead testing is picking up, it’s nowhere near as high as it would need to be to catch up on the kids who missed appointments in


the spring at the height of lockdown orders, experts say. And that may mean some kids will never be tested. “What I’m most worried about is that the kids who are not getting tested now are the most vulnerable — those are the kids I’m worried might not have a makeup visit,” said Stephanie Yendell, senior epidemiology supervisor in the health risk intervention unit at the Minnesota Department of Health. LIFELONG CONSEQUENCES There’s a critical window for conducting lead poisoning blood tests, timed to when children are crawling or toddling and tend to put their hands on floors, windowsills and door frames and possibly transfer tiny particles of lead-laden dust to their mouths. Children at this age are more likely to be harmed because their rapidly growing brains and bodies absorb the element more readily. Lead poisoning can’t be reversed; children with lead poisoning are more likely to fall behind in school, end up in jail or suffer lifelong health problems such as kidney and heart disease. That’s why lead tests are required at ages 1 and 2 for children receiving federal Medicaid benefits, the population most likely to be poisoned because of low-quality housing options. Tests are also recommended for all children living in high-risk ZIP codes with older housing stock and historically high levels of lead exposure. Testing fell far short of recommendations in many parts of the country even before the pandemic, though, with one recent study estimating that in some states 80% of poisoned children are never identified. And when tests are required, there has been little enforcement of the rule. Early in the pandemic, officials in New York’s Erie County bumped up the threshold for sending a public

health worker into a family’s home to investigate the source of lead exposure from 5 micrograms per deciliter to 45 micrograms per deciliter (a blood lead level that usually requires hospitalization ), said Dr. Gale Burstein, that county’s health commissioner. For all other cases during that period, officials inspected only the outside of the child’s home for potential hazards. About 700 fewer children were tested for lead in Erie County in April than in the same month last year, a drop of about 35%. Ohio, which has among the highest levels of lead poisoning in the country, recently expanded automatic eligibility for its Early Intervention program to any child with an elevated blood lead test, providing the opportunity for occupational, physical and speech therapy; learning supports for school; and developmental assessments. If kids with lead poisoning don’t get tested, though, they won’t be referred for help. In early April, there were only three referrals for elevated lead levels in the state, which had been fielding nine times as many on average in the months before the pandemic, said Karen Mintzer, director of Bright Beginnings, which manages them for Ohio’s Department of Developmental Disabilities. “It basically was a complete stop,” she said. Since midJune, referrals have recovered and are now above pre-pandemic levels. “We should treat every child with lead poisoning as a medical emergency,” said John Belt, principal investigator for the Ohio Department of Health’s lead poisoning program. “Not identifying them is going to delay the available services, and in some cases lead to a cognitive deficit.” PANDEMIC COMPOUNDS WORRIES One of the big worries about the

drop in lead testing is that it’s happening at a time when exposure to lead-laden paint chips, soil and dust in homes may be spiking because of stay-at-home orders during the pandemic. Exposure to lead dust from deteriorating paint, particularly in high-friction areas such as doors and windows, is the most common cause of lead exposure for children in the U.S. “I worry about kids in unsafe housing, more so during the pandemic, because they’re stuck there during the quarantine,” said Dr. Aparna Bole, a pediatrician at Cleveland’s University Hospitals Rainbow Babies & Children’s Hospital. The pandemic may also compound exposure to lead, experts fear, as both landlords and homeowners try to tackle renovation projects without proper safety precautions while everyone is at home. Or the economic fallout of the crisis could mean some people can no longer afford to clean up known lead hazards at all. “If you’ve lost your job, it’s going to make it difficult to get new windows, or even repaint,” said Yendell. The CDC says it plans to help state and local health departments track down children who missed lead tests. Minnesota plans to identify pediatric clinics with particularly steep drops in lead testing to figure out why, said Yendell. But, Yendell said, that will likely have to wait until the pandemic is over: “Right now I’m spending 10-20% of my time on lead, and the rest is COVID.” The pandemic has stretched already thinly staffed local health departments to the brink, health officials say, and it may take years to know the full impact of the missed testing. For the kids who’ve been poisoned and had no intervention, the effects may not be obvious until they enter school and struggle to keep up. fb/eburgmoms

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Mayo Clinic Q And A: Preparing children for back to school From Mayo Clinic News Network Mayo Clinic News Network (TNS) DEAR MAYO CLINIC: I have two children, ages 6 and 12. Our family has been wrestling with what to do in terms of sending our children back to school as our local school district has given us several options that include in-person and online learning. Do you have any advice for how we can make the best choice and any extra safety measures we can take if they return to school in-person? ANSWER: Going back to school this year has taken on new meaning and a new set of worries for parents. Schools must balance the educational, social and emotional needs of their students along with the health and safety of students and staff in the midst of the evolving COVID-19 pandemic. As you shared, many school districts have several options for opening the new school year: Distance schooling. All instruction is done remotely in this model, using technology and other tools. In-person schooling. This model is similar to the traditional schooling, with enhanced health and safety precautions and procedures. Hybrid schooling. This model includes elements of both distance and in-person schooling. As it is still not clear how easily COVID-19 spreads among children, being prepared for a variety of schooling environments can empower you and your child, reduce anxiety and minimize risk. In each case, there are steps you can take to reduce the risks of COVID-19, help your child feel safe and make informed decisions during the COVID-19 pandemic. During the COVID-19 pandemic, the U.S. Centers for Disease Control and Prevention (CDC) and World Health Organization (WHO) recommended adoption of three specific practices to help reduce the spread of infection: social distancing, wearing a mask that covers both your nose and mouth, and proper hand 6

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hygiene. Talk to your children about the importance of these practices to reduce their risk of illness. Take time to review with your children any plans for social distancing that your school district has shared. For instance, if plexiglass shields or partitions are being installed to separate teachers and students, show pictures (especially to your younger child) and explain how their work space may look different this year. Talk about how recess or lunch might be different if your school plans to keep children with their classes. Given that social distancing is not always feasible, many schools are implementing protocols for when students will be required to wear a mask, such as on the bus, at recess or when transitioning to and from class. Talk with your child about the expectations for masks and allow them to select masks in their favorite color or with a pattern/character they like. Depending upon your child’s age, practice properly putting on and taking off cloth face masks with your child while avoiding touching the cloth portions. You also may have them practice putting masks on their dolls or toys. It is also a good time to remind your children to avoid touching their eyes, nose and mouth. And remind them to cover their mouths and noses with their elbows or tissues when they cough or sneeze, and then wash their hands. Consider these additional tips before school starts: Have multiple cloth face masks available for your child. Send your child with a clean mask and backup mask each day, and provide a clean, resealable bag for them to store it when they can’t wear it, such as at lunch. Plan to label your child’s mask clearly so it’s not confused with another child’s. Remind your child that masks are not for sharing with their friends. Discuss with your child why some people may not be able to wear face masks for medical reasons. You also may want to find out what your school will require should there be pos-

itive cases or exposure to someone with COVID-19. Depending upon your children’s reaction to these in-person issues, you may want to explore at-home learning. While social distancing and masking will not be required in the home setting, taking time to understand how teaching will occur will be important. Some questions to consider: How long will children be online daily? Will your child be able to sit still for an extended period of time and focus on the lessons or do they need continuous engagement? What are the technology requirements, such as computer, printer and software? Are there opportunities for one-on-one support if your children need additional assistance? Take time to discuss as a family the scenario that will best fit your children, understanding that you may still end up with a hybrid. If you choose to send your children back to school, don’t forget to have a backup care plan as no child should be attending in-person school if they are sick or have symptoms of any illness.


Early morning adventure with daughter proves insomnia can have a bright side By Maria Martin The Kansas City Star It seems like everyone’s having trouble sleeping these days. I’m no exception, and I’m now more familiar with the wee morning hours than I ever expected to be. In the early days of quarantine, I found myself wishing for bedtime out of sheer boredom. I sometimes crawled into bed at 9 p.m., hoping for entertaining dreams to save me from the doldrums. But one can only sleep so much, and early bedtimes led to insomnia. I’m guilty of wasting the hours when I’m awake, fighting to get to sleep. I spend this time trying to coerce sleep, scrolling the internet, or even worse, ruminating over every concern, and wallowing in anxiety over the trivial. Recently I found myself yawning in the early evening hours, yearning for bed, but I didn’t want to spend the second half of the night wishing I was asleep. I made myself a deal. I would allow myself to go to bed, but if I woke up, I would not waste that time. Rather than doing nothing, I would do anything that could loosely be considered productive. I predictably awoke at 3:40 a.m. At 4 a.m., sleep had not returned, so I slipped on my flip flops and made my way to the kitchen. I kept my promise to myself, and unloaded the dishwasher. My 14-year-old daughter appeared, startling me. She had also gone to bed too early and couldn’t sleep any more. We wiped the counters together and discussed possible next steps. One idea led to another, and soon we decided that we would watch the sun rise. Large oaks surround our home, blocking views of celestial happenings such as sunrises, so we aimed to find a better vantage point. “We could go to the lake and watch from the sailboat,” my daughter suggested. We recently purchased a small sailboat. Getting to the boat requires a 30-minute drive, then rowing ourselves out in our small, inflatable kayak. The temperature was unseasonably chilly, and we would undoubtedly get wet. To watch the sun

rise, we’d have to do this all in the dark. The plan seemed impractical. “OK,” I agreed. An impractical plan seemed infinitely better than no plan. We stopped for fast food coffee and hash browns on the way. Instead of going straight to the boat, we stopped at a dock that provided a better view of the eastern sky. Fog rose above the water and steam rose from our coffee cups into the chilly air. Herons flew by, ducks quacked, and toads hopped across the path as the sky filled with pink, silver and gold before melting to blue. Early-morning kayakers sliced through the still water. We chatted, taking in nature’s early morning beauty. We drove past raccoons and deer on the way to our normal launch, where we inflated our kayak. We paddled around the cove, exploring shallow areas and watching fish jump. We kayaked to our sailboat, organized a few items in the cabin, then watched other boats come in from overnight outings. We chatted about friends, family and the upcoming school year. Our impractical adventure only lasted a few hours, and we were home in time for more coffee and scrambled eggs. Several times she’s mentioned that she enjoyed our adventure, and thanked me. That time was precious, and completely within reach. All we had to do was plan to do something unplanned.

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‘I want a divorce’ trending during COVID By Joseph Wilkinson New York Daily News They’re taking the “co” out of COVID. People are speaking with divorce lawyers and entering divorce-related searches on the internet much more this year than last year. “It’s really been nonstop these past few weeks,” Vincent Stark, an attorney with Davis Friedman in Chicago, told the Daily News. “A lot of lawyers I know, the last two to three weeks we’ve all become very, very busy. We’re busy with the Zoom hearings and depositions, then you’ve got new clients calling, and you’re trying to schedule meetings.” The coronavirus pandemic stressed a lot of relationships with lockdowns, job losses and salary cuts. Experts have been predicting a divorce rate increase since the pandemic hit the U.S. in March. Nationwide divorce rate data is not yet available, but divorce-related searches on the internet support the case for an increase. Data analytics company SEMrush found that divorce-related keyword searches are up 11% this year, with nearly twice as many people searching, “file for divorce online” and 14% more people typing, “I want a divorce.” “It’s probably related to stay-at-home orders and the amount of time people spend at home in this closed environment,” SEMrush’s Chief Strategy and Corporate Development Officer Eugene Levin told the Daily News. “There’s an idea floating

around that people see this year as a time to change things.” Divorce-related searches increased back in March and have held steady since, according to SEMrush data. Stark and other lawyers, however, have only seen an increase in real life clients in recent weeks. Stark said that gap may be a result of economic situations stabilizing in recent months after the dramatic impacts of coronavirus in March. Lawyers, after all, are not cheap, and the search “how much does a divorce lawyer cost” is up 18% this year. “At the beginning of COVID, people were locked up and kind of apprehensive,” Stark said. “Now that we’re coming out of it a little bit and some people are starting to go back to work, I think people are a little more financially confident to go forward with the process.” The divorce rate is also impacted by the worldwide increase in domestic violence during the pandemic. Levin noted that domestic violence-related searches also spiked back in March. For some, the coronavirus pandemic likely pushed their relationship to a place it was already headed. Dating.com vice president and dating expert Maria Sullivan said that people may benefit long term from their pandemic relationship trials. “If your relationship ended during the COVID-19 crisis, it is likely a blessing in disguise,” Sullivan said. “This is a unique window of time that uncovers the strength of our relationships, whether we like it or not. We can use this year to determine if we really like who we are with and, if not, make necessary changes.” fb/eburgmoms

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Our plan to work and teach from home blew up By Joshua Emerson Smith The San Diego Union-Tribune SAN DIEGO — The headline on July 13 — Los Angeles and San Diego Schools to Go Online-Only in the Fall — hit our household like a lightning bolt. I cursed loudly in the small sunroom-turned-office of our rented house in Southeast San Diego. “I just read it,” my wife called back telepathically from the kitchen, where she was making lunch for our two boys, ages five and six. Like so many working parents, we were counting on K-12 schooling to provide not only education but indispensable childcare. Online distance learning, on the other hand, required intense adult supervision for our soon-to-be kindergartener and first grader. The lightning strike sparked an at-times thunderous debate: Should one of us quit our job and go on unemployment? Could our extended family help? Could we afford a tutor to oversee distance learning? Would the kids even follow a tutor’s instructions? None of those seemed like great options. So last week we finally decided that I 10

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would take emergency family leave, a temporary program created by Congress in March under the Families First Coronavirus Response Act. There’s no data yet on how many people are using the program, but the need is obvious. A recent New York Times survey found that more than half of parents plan to help their kids distance learn while also holding down paid work. And four out of five parents said they had no in-person help, such as from relatives, nannies or tutors. “A big problem is so many people don’t know about” the federal leave program, said Netsy Firestein, senior fellow at UC Berkeley’s Center for Labor Research and Education. “It should be better advertised.” The Families First act guarantees that parents and guardians of school-aged children can take up to 12 weeks of leave at two-thirds of their regular pay, capped at $200 a day, if local schools and daycares are physically closed due to the pandemic. We knew about the program because my wife had been using it for the last 10 weeks. She enrolled after her employer, a local homeless services nonprofit, forced

its employees to return to the office. Taking leave limited her potential exposure to the virus, while allowing me to continue working for the Union-Tribune through the summer. Employers must foot the bill, although those costs can be recouped through a dollar-for-dollar refundable tax credit under the law. The rules only apply to businesses with 50 to 500 employees. The amount of time off workers are eligible for is reduced by any leave they took in the last 12 months under the Family Medical Leave Act, such as to care for a newborn baby. The emergency-leave program expires on Dec. 31. Before the pandemic, we would often feel guilty for not spending more time with our kids. The younger one went to preschool from 8 a.m. to 5:30 p.m. and the older one to first grade from 9 a.m. to 3:30 p.m., remaining on campus in the San Diego Unified School District’s aftercare program, PrimeTime, until around 6 p.m. Over weekend beers, we’d commiserate with other parents about how little time we spent with our kids. “I couldn’t even


tell you what they do at school,” was a common refrain. We were granted our wish for more family time through a Faustian bargain. At first, working from home was a novelty. I cranked out stories from the sunroom — many of them about the pandemic — while my wife, who hadn’t taken leave yet, worked from the table in the living room. We cultivated a sense of camaraderie around trying to survive the pandemic, hoping it wouldn’t last more than a few months. We recognized that many didn’t have the luxury of working remotely. Nurses, grocery-store clerks and other essential workers have, for months, been forced to seek out childcare wherever they could find it. In San Diego, the YMCA provides a service that connects desperate parents to licensed daycare providers.

CHARM FADED FAST

However, the charm of our situation faded fast. My wife routinely struggled to get our 6-year-old to complete his online school assignments, hampered by the distraction of his preschool-aged brother lollygagging about. The kids increasingly bounced off the walls and yelled over our phone and video calls. My older son at one point ripped a mounted shelf out of the drywall in our bedroom, creating a weekend’s worth of spackling and painting for me. Our jobs — which usually require 40 or more hours a week of undivided attention — are just too demanding to try to pile on basic childcare and schooling. Eventually, we succumbed to controlling them with long stretches of screen time, comforting ourselves with the fact that our oldest child, the youngest kid in his class, could repeat first grade. That’s when my wife’s employer informed its workers they could no longer work from home and would have to report to the office. It felt like salt in a gaping wound. We had toiled for weeks, juggling home and work life, in many ways sacrificing our children’s education for our jobs, only to discover it wasn’t good enough. In response, my wife signed up for the emergency family-leave program. Taking the reduced pay wasn’t an easy decision, especially since she makes about $75,000 a year, compared to my annual salary of roughly $63,000. But she wanted to postpone the dangers of returning to an office environment during a pandemic. We are lucky to be able to survive without my wife’s full check. Many people, especially those making minimum wage, cannot afford the pay cut, said Jenya Cassidy, director of the nonprofit California Work & Family Coalition. “To be honest, I am just really scared that there’s just not enough of a support system or safety net in place for working parents right now,” she said. It seemed, though, that we might scrape by. School was slated to start right around the time my wife’s leave expired. Then came the news that fall classes would be conducted online. We quickly reached out to our friends with young children to form a childcare “pod.” We hired two young women to oversee about half a dozen kids at a park from 1 to 4 p.m.

While it’s costing us about $500 a month, our boys have benefited tremendously from the social interaction. Still, that didn’t solve the issue of distance learning. One of the parents in our pod, Kinsee Morlan, suggested that our families share a tutor three mornings out of the week, for roughly $800 a month each. She said trying to work and teach her and her husband’s two boys during the spring was completely overwhelming. “Our family was falling apart,” she said. “I know that sounds dramatic, but that’s how bad it was.” Morlan is now building a makeshift classroom in their backyard. She purchased a large shade structure, school desks and moved their dining room table outside. “We have no idea if this will work,” she said. “The cost are slowly but surely mounting up, and that’s been pretty impactful.” With my wife’s leave about to expire, we decided I would take the emergency leave before hiring a tutor. Bringing on extra help would require us to eat into our modest savings. Plus, I’m not sure how my boys would react. I’m not even sure whether they’ll listen when I try to make them do schoolwork. Recently, there’s been talk that in-person classes could resume in San Diego if the region continues to keep its infection rates down. However, I can’t bank on that. Even if our school does open, there’s no guarantee it will stay open, especially if we start seeing outbreaks in classrooms. I’m now mentally preparing for the next three months to be completely exhausting. Although, with a little luck and elbow grease, it’ll also be a chance for the Smith boys to bond.

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COVID lessons: Sometimes a house just needs a puppy By Debra-Lynn B. Hook Tribune News Service After decades of being the default manager of birds, fish, cats having cats (oops) and dogs, I was done with animals in the house. The kids were gone, so were the animals. But then my son moved home. And soon after, came the isolation of COVID to help him make his case. “Come on, Mom,” said Chris. “New life in the house could be good for us. “Besides, you won’t have to do anything. It’ll be my dog. “I’ll do everything.” Uh-huh. I’d heard those words before, when Chris was 15, and his siblings 8 and 12, when they swore on their Beanie Babies they would take sole responsibility for a puppy. This time, he’s 31. This time, he would be the one laying out the Venmo for the pedigree, which would put him squarely in the position of CEO with vested interest. Still, I’d gotten used to a house without fur balls and the faint scent of flea collars. Having spent the last three decades raising three humans and their attendant menagerie, I liked the feeling of not being responsible for anybody’s well-being but mine. To be sure, this was a position colored by our most recent family pet relationship. A much-loved and adorable cocker, Toby, circa 2004-2016, decided I was the go-to in the family for all his needs even though I couldn’t touch him. Allergic to his dander, I was relegated to all work and no cuddles, the food dispensary when everybody else forgot mom, the nag about baths and fleas mom, the let the dog in, let the dog out all day long because I’m the one with the home office mom, and when in his last months, he had a battle with fleas, the allergic to fleas on Toby mom. A good and beloved dog, regardless, Toby died four years ago, with me saying never again. Their dad and I separated not long after that; he took the cat. The kids finished growing up, and left, too. And then, in February, Chris moved back home from Washington, D.C., where he’d lived the last decade, to help with some family matters. I knew that Chris would be giving up a lot, trading his big-city digs for life back in the little Midwest town where he grew up, that when COVID came, he was stuck, which is why when he first started working the puppy angle in March, I did not say 12 fb/eburgmoms

“Absolutely not!” I simply groaned, which surprised us both, as we both knew from experience the door was not closed. By April when there was no sign of letting up, either COVID or the dog bargaining, I further surprised myself by engaging in casual conversations about breeds. By May, when we had been on lockdown together for two months, it occurred to me that a happy puppy in the house might be just what Fauci ordered. In June, Chris put down a deposit on a springer spaniel. This week, we picked up Rosie, a living, breathing love ball with ears that flop when she runs, who licks our faces with no knowledge of COVID, who is so fresh to this weary world she doesn’t know a shoe from a bone. She has to be taught, which becomes one of the most delightful and unexpected surprises — watching my loving son papa a puppy, also hearing yips in the middle of the night and knowing I don’t have to do a thing Her first 24 hours with us, she threw up, ate a Mac cord and peed on the floor three times. And I got to stay in bed, while my son seemed gratified to take up the mantle once relegated to me. Apparently, this is the story of pets. They show us things we weren’t expecting. They aren’t just pee machines dropping fur all over the house. They are ambassadors of love, connectors of humans and the catalyst for an unyielding mom to rethink her decrees. Never say never. Sometimes a house just needs a puppy.


Healthy food for at-home students starts with this she doesn’t have to stress about coming up with an idea. She also cooks whenever her schedule allows. “Just because you eat at 6 doesn’t mean you have to cook at 5:30.” For drinks, each daughter has her own water bottle. “I’ll cut up lemons and limes. If they want to put those in there, they can. If they don’t, they don’t have to. But they sip off of the water bottle all day, and then it saves me in not having wash a ton of cups.” Dr. April Spencer, a surgeon in private practice in Atlanta, is the primary caregiver for Taylor, 10, and Tye, 8. The kids offer ideas for snacks, which might include bowls of fruit or kid-friendly charcuterie, or grazing boards, with fruit, cheese and protein. (You can see an example on Spencer’s Instagram feed.) Is being in charge of your own choices overwhelming to a kid? “Not really,” said Taylor, a self-assured fifth grader. “I kind of miss school lunches because we get, like, a lot of options,” she acknowledged. “But I like having home school, because we can just, like, go to our refrigerator or our pantry to get any snacks we want.” She particularly likes the veggie burgers her mom makes for lunch. The family’s success fits with Wood’s professional advice. “The goal, in a nutshell, is to try to control the environment. But not the child.” And, she added: “Cut yourself some slack.” If you have questions or comments about this story, please email editor@heart.org.

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American Heart Association News You’re trying to work. Your kids are attempting online learning. Everyone wants something to eat. And you’re losing your mind. Experts say one ingredient can make all the difference in this situation. Grace. “You know, this is not easy,” said Caree Cotwright, an assistant professor in the University of Georgia Department of Foods and Nutrition in Athens. “Even with all the skills I have as a registered dietitian, there’s a lot of planning and a lot of volleying between Mom and Dad that has to go on in order for the kids to keep a schedule and be able to have things that are healthy.” Alexis Wood, assistant professor of pediatrics-nutrition at Baylor College of Medicine in Houston, agreed. “Parental stress and guilt is not going to help anything,” she said. “It’s going to make it worse, if anything.” Wood and Cotwright speak from both professional expertise and personal experience. Wood, lead author on a recent American Heart Association report about how to help children develop healthy eating habits, has a daughter, 4, and son, 7. Figuring out meals hasn’t been easy. When the pandemic started, she tried to do it all. She focused on her children all day until 3:30 p.m., when her boyfriend would take over so she could work. “Then I would cook dinner and serve it. Put the kids to bed. Clean the house. Prepare the homeschooling for the next day.” She made it work for several weeks but was burning out. Now, rigorous planning helps everyone stay on track. And she follows the advice in the report she helped write – which says the best way to help children develop their own healthy eating habits is to focus her energy on providing an environment that “covertly” sets boundaries around food, such as keeping regular meal times and deciding what child-friendly foods her children have access to. Wood combats unhealthy snacks by restricting the grocery list. Then, she lets her kids make choices from the healthy options that do make it home. By keeping mostly healthy foods in the house, children can “do the work” by selecting and serving foods – and this has freed up some of her responsibility. Dinner times look different than before the pandemic, but she’s learned “that for kids, not only do they not mind if you just put random foods on the table – they actually love it.” One desperate evening, Wood set out leftover chicken, fruits, cheese and whole-grain bread and let her kids build their own plates. “And they thought it was the greatest.” Cotwright has daughters who are 6, 4 and 2. When making her shopping list, she asks her girls what fruits they’d like. Those become snacks for the week. But Cotwright, who has written about ways for daycare providers to encourage healthy eating, said it’s important to have realistic expectations for healthy eating. She had to adjust her own approach during the early days of the lockdown, when she thought she needed to cook a full, hearty breakfast each day. By 10 a.m., her girls still wanted snacks. She realized, “There is no way I can keep this up.” So, she asked her kids what they liked. Breakfast now might include a whole-grain cereal with low-fat milk or a boiled egg. Planning helps ease the stress of meal preparation, Cotwright said. Mondays might be good for weekend leftovers; Tuesday is always Taco Tuesday. “My kids love it. My kids eat it. Doesn’t take me long.” And

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That COVID-19 baby boom might be more of a bust By Bethany Ao The Philadelphia Inquirer When stay-at-home orders were announced in the spring, some people wryly speculated about a COVID-19 baby boom. Social media users even came up with a few suggestions for what this new generation should be called — “coronials” to start, followed by “quaranteens,” being two popular ideas. But as COVID-19 drags on, economists and epidemiologists don’t really know how the pandemic will affect birth rates. While some forecast a loss of up to half a million births due to job losses and anxiety about public health, others say other factors unique to the pandemic complicate the situation. In June, Brookings, the public policy nonprofit, published a report that predicted a decline of between 300,000 and 500,000 births as a result of the pandemic. To arrive at that number, the researchers looked at how birth rates were affected after both the Great Recession of 2008, which led to a 9% drop in births over the next four years, and the 1918 Spanish flu pandemic, which resulted in a 12.5% decline. Phillip Levine, a co-author of the report, said the theory that birth rates will go up as a result of the pandemic is inconsistent with the economics of fertility. “We decided to investigate and draw our own conclusions,” said Levine, an economics professor at Wellesley College. “We concluded the exact opposite. … The main takeaway we should be expecting out of this is a significant decline in the number of births next year.” One could argue that COVID-19 will result 14

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in an even bigger decline in births than that after the 1918 pandemic, Levine said. During the Spanish flu, economic activity didn’t slow down because the U.S. was fighting a war, he noted. Factories needed to remain open because “the tools of war needed to be produced.” “The only situation that was occurring at the time was anxiety associated with the public health threat,” Levine said. “The other thing that is remarkable is that contraception was not available at the time, so for women to be having that many fewer children, that requires a greater effort than it takes now.” A Guttmacher Institute survey of 2,009 women between the ages of 18 and 49 in early May found that more than 40% of women had changed their plans about when to have children or how many children to have because of the pandemic. In contrast, 17% of women surveyed reported wanting to have more children, or expand their families sooner. But there are competing elements at work, said Jennifer Horney, an epidemiology professor at the University of Delaware. “We do expect to see a reduction in fertility when we have a reduction in work-life balance, which many people are probably seeing,” Horney said. “And there has been an increase in uncertainty around the economy. But we also have increasing rates of STDs in some places, which lead us to believe people are having more unprotected sex with different partners.” While Horney categorized COVID-19 as a public health emergency, the pandemic’s length makes it quite different from other major disasters that she has researched in the past, like hurricanes.

“The stress and the mental and physical health effects of this are going to be really longstanding,” she said. “For example, the response of some employers to what’s happened with the economy has been to reduce and stop contributions to employees’ retirement plans. That may set people back in their plans for a family.” For those seeking fertility services, demand has remained steady throughout the pandemic, said Allison Bloom, an attending physician at Main Line Fertility. “People we work with have wanted to be pregnant years and months ago,” Bloom said. “Waiting a month isn’t really an option for some of them. And now we know this is not really going to go away, so people who want to start their family aren’t delaying treatments.” When Main Line Fertility paused services in March, Bloom said, some patients became more anxious. “We’re dealing with a special group of patients though, and that’s important to keep in mind,” she said. “People seek us out and what we do is time sensitive.” While economists and epidemiologists are still waiting to see how the pandemic will ultimately affect global birth rates in the long run, patterns are already emerging. Premature births have fallen, in some cases drastically, in multiple countries. The Philadelphia region has seen an increase in scheduled inductions. Either way, there will be important implications for what happens to the world’s population, said Levine. “The baby boomers have had influence throughout their lives,” he said. “This generation will be the same way.”


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