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1/6/22 blog post

omicron COVID and children under 5 - what should parents do?

a pediatrician gives the best advice for protecting and treating covid in younger children


The Omicron variant of COVID-19 is sending children to the hospital at record rates. Dayton Children’s pediatrician, Dr. Lisa Ziemnik, says the population being threatened by COVID has drastically changed over the last two years. Now that adults and elderly populations are largely vaccinated, COVID-19 is seeking out the most vulnerable population to infect. Unfortunately, that is children under the age of 5 who are unable to be vaccinated against COVID-19.   

Doctors are now seeing that COVID is more prevalent in children than ever before and the reactions to these infections vary greatly. While some children may have mild cases, there are times when a COVID infection may land a child in the hospital, and there are few discernable differences for why it happens to one child over another. That makes this an uncertain and scary time for families, especially with children within this age group. 

How can I protect my children under the age of 5?  

Dr. Ziemnik offers four ways to keep your children safe:  

  1. The number one way you can protect your children, is to be vaccinated and make sure the eligible people in your home and who come in contact with your child are also vaccinated.  

  1. Second, focus on decreasing exposure. Make the choice to leave your child at home when you can and limit the number of public places they’re in. 

  1. If your child must be out in public the third thing you can do is encourage mask wearing. Over time, we’ve seen that children have proven to be better at mask wearing than some of their older counterparts. If you can make wearing a mask fun for your child, you can offer them another layer of protection.  

  1. Finally, while your children are out and about with others, encourage good hand hygiene, keeping hands out of faces and limiting physical contact with others. Try teaching your children other acceptable ways of greeting than a hug. Elbow bumps and waves are the safest way to go!  

What should I do if I think my child under age 5 is sick?  

If you are concerned that your child is sick or may become sick, it is important during this season to be very observant of their behaviors.  

“If your child is rambunctious and active, although this may be hard for your energy levels, this is a great sign of their health,” says Dr. Ziemnik. “A child who is showing signs of fatigue and wanting to lay down or be held constantly should be considered more closely.” 

When should I test my child for COVID? 

A day or more of symptoms like coughing, fever, running nose, and fatigue should prompt you to do an at-home test. Consistent testing is not necessary for children in this age group but consider testing your child if they have a known exposure and are exhibiting consistent symptoms.  If the at-home test is positive, you do not need to test again.  If it is negative, you may want to do an at-home or PCR test again in a few days if they are still symptomatic.  

If their test comes back positive, what should I do? 

It can feel scary if your child’s test comes back positive for COVID. But knowing the proper process to take to help them feel better and stop the spread will empower you to make the next best choices.  Here are some tips for doing that: 

  •  Treat your child not the test.  Most COVID infection in children are mild and with minimal complications. If your child's test is positive, you can treat the infection like a cold or the flu and do the following for these symptoms:

    • discomfort: It's important to make sure your child gets plenty of fluids. It's also acceptable to administer Tylenol or Motrin to treat any discomfort.  However, doctors do not recommend over-the-counter cough and cold medications for children under 5.

    • congestion: If your child is feeling congested, try nasal saline, a warm bath, or a shower.  Now is also the time to teach them how to blow their nose when needed. 

  • Prioritize rest! Your children need to stay home until they are feeling better. They should also have had at least 24 hours free from fever without the help of Tylenol and Motrin. It’s also important that your child isolates according to CDC guidelines.   

  • If your child's behavior shows that they are getting worse instead of better, or you have concerns about their lungs or ears- you should take them to your pediatrician as soon as possible.  

At the end of the day, despite our best efforts, we can only do so much to prevent COVID infections. That’s why Dayton Children’s Hospital and its urgent care clinics are here when all else fails. When in doubt: bring your child in for testing. Don’t be afraid to call your pediatrician and ask questions. Your child's pediatrician likely knows them and their medical history the best and can provide answers to your concerns from a personal place. Rely on Dayton Children’s professionals to go above and beyond for your child’s health during these uncertain times. 


Lisa Ziemnik, MD, FAAP

program director urgent care
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