WEBVTT - COVID-19 Q&A: From Pregnancy to Playdates! 0:00:00.480 --> 0:00:03.240 Welcome to Katie's Crib, a production of My Heart Radio 0:00:03.360 --> 0:00:13.320 and Shondaland Audio. Hi, guys, thank you so much for 0:00:13.360 --> 0:00:16.400 listening to Katie's Crib. I have a big episode for 0:00:16.440 --> 0:00:19.000 you guys today. We are in the middle of a 0:00:19.079 --> 0:00:21.840 global pandemic. Actually I just said middle, and I don't 0:00:21.840 --> 0:00:23.079 even know if we're in the middle. We don't know 0:00:23.120 --> 0:00:24.960 if we're in the middle close to the end, at 0:00:24.960 --> 0:00:27.080 the beginning, we don't know. A lot of things are 0:00:27.120 --> 0:00:30.600 out of our control. We are here, we are quarantining, 0:00:30.760 --> 0:00:35.640 we are facing COVID nineteen. And since the start of 0:00:35.760 --> 0:00:38.199 the shutdown, I have been getting so many texts and 0:00:38.280 --> 0:00:42.080 emails from friends and friends of friends about how to 0:00:42.360 --> 0:00:45.520 mom during this time, how to keep our kids safe. 0:00:45.800 --> 0:00:48.080 And I was like, you, guys, Katie's Crib, we got 0:00:48.080 --> 0:00:51.400 to get you some answers. So I'm really excited about 0:00:51.440 --> 0:00:54.800 today's episode and bringing you guys some up to date information. 0:00:54.880 --> 0:00:58.080 And I have to say that, as you know, information 0:00:58.160 --> 0:01:02.680 is changing daily on this disease, so what we have 0:01:02.800 --> 0:01:05.319 right now is up to date, but also could be changing. 0:01:06.480 --> 0:01:09.960 I have two awesome doctors on today's episode. The first 0:01:10.040 --> 0:01:14.840 is Dr Rushmi Raw. She is absolutely wonderful, and she 0:01:15.000 --> 0:01:20.560 came on to discuss pregnancy and COVID. She is the 0:01:20.680 --> 0:01:23.800 high risk doctor in the Department of Obstetrics and Gynecology 0:01:23.880 --> 0:01:26.520 at U c l A Health. I also have on 0:01:27.160 --> 0:01:30.840 my New York City pediatrician, Dr Danielle Taylor to come 0:01:30.880 --> 0:01:34.800 on and talk to us about COVID and our tiny humans. So, 0:01:34.880 --> 0:01:38.440 without further ado, let's welcome Dr Rushmi Raw. Let's get 0:01:38.520 --> 0:01:40.399 right into it and get some of these I have 0:01:40.480 --> 0:01:44.480 a great list of text and emails from personal friends, family, 0:01:44.600 --> 0:01:47.240 and from a ton of our awesome Katie's crib listeners. 0:01:48.040 --> 0:01:53.520 So pandemic or not, people are trying to conceive during 0:01:53.520 --> 0:01:56.520 this time, like that is happening? Um, we have one 0:01:56.560 --> 0:01:59.320 listener at Danielle and Collins writes, if I'm wanting to 0:01:59.360 --> 0:02:01.280 have another child, should I wait for some sort of 0:02:01.320 --> 0:02:04.960 resolution to the pandemic or vaccine? Seems like an awful 0:02:05.000 --> 0:02:07.360 time to bring another child into the world, but we 0:02:07.400 --> 0:02:11.040 want to expand our family. Have you been having clients 0:02:11.080 --> 0:02:15.280 asked this question? What's your consensus on this? So, yeah, Katie, 0:02:15.360 --> 0:02:18.640 thank you so much for having me. I really appreciate it. Um. 0:02:18.680 --> 0:02:22.160 So these are really great questions. UM and absolutely right. 0:02:22.200 --> 0:02:25.200 This is a question I get asked almost daily. You know, 0:02:25.200 --> 0:02:27.720 what I tell patients is, from a medical standpoint, I'm 0:02:27.760 --> 0:02:31.040 not advising against pregnancy. I'm not telling them to hold 0:02:31.080 --> 0:02:34.320 off on pregnancy. UM. At this time, there really isn't 0:02:34.400 --> 0:02:37.560 much data to support and increased risk to a woman 0:02:37.639 --> 0:02:40.560 or her future child, so much so that getting pregnant 0:02:40.720 --> 0:02:44.880 is considered a contradication. UM. From a personal standpoint, I 0:02:44.919 --> 0:02:47.120 think that there's a lot of things to consider. There's 0:02:47.639 --> 0:02:50.680 financial stressors right now, there's a lot of community stressors 0:02:50.760 --> 0:02:53.800 right now, and I think that those are definitely important 0:02:53.840 --> 0:02:56.040 things to consider. But I think those are personal and 0:02:56.120 --> 0:02:59.960 not so much from a medical standpoint. Yeah, that's great 0:03:00.000 --> 0:03:02.120 to know. We have another listener by the name of 0:03:02.160 --> 0:03:04.160 Rebecca who wrote in that she was really wanting to 0:03:04.200 --> 0:03:08.959 have a baby, but because things saying it's a personal choice, 0:03:08.960 --> 0:03:10.920 Like if you can look at your pregnancy as maybe 0:03:10.919 --> 0:03:13.440 not being able to have the village you imagined having, 0:03:13.480 --> 0:03:15.920 it takes a village, right, Like maybe your parents can't 0:03:15.919 --> 0:03:18.440 fly in, maybe you you can't go to the baby 0:03:18.440 --> 0:03:20.400 classes you wanted to go to, Maybe you can't take 0:03:20.400 --> 0:03:22.799 a tour of the hospital in advance. To put your 0:03:22.880 --> 0:03:28.680 anxiety at ease. So it's really it's a personal question 0:03:28.720 --> 0:03:34.280 of how you deal with anxiety, finances all of these things. Right. Absolutely, 0:03:34.320 --> 0:03:36.200 you bring up a really good point there, and we 0:03:36.240 --> 0:03:38.680 are actually seeing a lot of an increased in terms 0:03:38.680 --> 0:03:43.760 of anxiety and even PTSD type symptoms. UM, anxiety is 0:03:43.800 --> 0:03:46.520 worse than by isolation. And essentially we're asking a lot 0:03:46.560 --> 0:03:48.560 of our women to be isolated. We're asking a lot 0:03:48.600 --> 0:03:51.840 of people to be isolated. It absolutely takes a village 0:03:51.840 --> 0:03:55.680 from both a professional and personal standpoint, I agree with that. 0:03:56.360 --> 0:03:58.920 And we are in a time right now where it's 0:03:58.920 --> 0:04:01.200 hard to have a village when we're asking everyone to 0:04:01.240 --> 0:04:03.840 stay kind of quarantine. So these are these are really 0:04:03.880 --> 0:04:06.880 important things to consider and think about how you would 0:04:06.920 --> 0:04:10.320 handle that if you were to get pregnant in the future. UM. 0:04:10.360 --> 0:04:12.800 And so I think that these are really reasonable things 0:04:12.800 --> 0:04:14.320 to consider, and those are the things that I would 0:04:14.320 --> 0:04:18.440 tell my patients. Just think about before you make the decision. Great, 0:04:19.120 --> 0:04:26.800 can COVID nineteen be sexually transmitted? So, as of right now, 0:04:26.880 --> 0:04:30.400 COVID nineteen is not considered to be a sexually transmitted virus. 0:04:30.640 --> 0:04:34.360 COVID nineteen is a respiratory virus UM. It's mainly transmitted 0:04:34.360 --> 0:04:39.120 by respiratory droplets and secretions. UM. So as of right now, 0:04:39.160 --> 0:04:44.719 that is not something that we have any medical data for. UM. 0:04:44.760 --> 0:04:46.640 This is huge. I have a lot of friends asking this, 0:04:46.680 --> 0:04:51.160 does COVID nineteen effect male fertility? Do we know? Very 0:04:51.200 --> 0:04:53.960 good question. We don't. Short answers, we don't know. There 0:04:53.960 --> 0:04:58.000 has been COVID nineteen found in sperm in some case reports. UM. 0:04:58.080 --> 0:05:02.800 But what that means mackerel landing. So what that means 0:05:02.880 --> 0:05:06.960 in terms of whether that causes issues with future pregnancies 0:05:07.120 --> 0:05:09.640 or um. Again, we have no data that that can 0:05:09.640 --> 0:05:12.719 be transmitted UM. If you guys remember Zeca from back 0:05:12.720 --> 0:05:15.320 in the day that was also found to be instpirmed, 0:05:15.360 --> 0:05:18.320 but that really didn't mean a whole lot of issues 0:05:18.360 --> 0:05:22.640 in terms of transmission or in terms of men giving 0:05:22.680 --> 0:05:25.040 it to women. But we did at that point advise 0:05:25.120 --> 0:05:27.640 against um, you know, men and women having sex at 0:05:27.640 --> 0:05:29.800 that time, but that was a very different virus for 0:05:29.880 --> 0:05:32.880 equividing team where we just don't have any data right now. 0:05:34.120 --> 0:05:38.480 Can it affect female fertility? Again, no data? UM. You know, 0:05:38.520 --> 0:05:40.279 if we think about and this is I should have 0:05:40.440 --> 0:05:42.720 actually just opened up with this, which is that this 0:05:42.800 --> 0:05:45.200 is such a new virus. We're really five to six 0:05:45.240 --> 0:05:49.080 months into this UM and no, nobody can really be 0:05:49.120 --> 0:05:52.080 an expert at this point because data takes lots of 0:05:52.200 --> 0:05:55.320 time and takes lots of reports and numbers in order 0:05:55.360 --> 0:05:58.200 for us to make conclusions that really I would feel 0:05:58.200 --> 0:06:01.560 comfortable saying, yes, this is absolutely what we know and 0:06:01.600 --> 0:06:05.160 what we don't know UM. And with COVID nineteen being 0:06:05.360 --> 0:06:07.880 on the United in the United States for five to 0:06:08.000 --> 0:06:11.200 six months, we don't have data on women who or 0:06:11.240 --> 0:06:13.320 men who have been trying to get pregnant for a 0:06:13.360 --> 0:06:16.240 prolonged period of time and starting to see issues with 0:06:16.279 --> 0:06:20.200 fertility UM and so based off of just the time 0:06:20.240 --> 0:06:22.279 the limited time period, I would say we just don't 0:06:22.279 --> 0:06:27.920 know yet. M hm okay, I have Nikki rights, Hi. 0:06:28.240 --> 0:06:31.400 I love your show, Thanks Nikki, and have listened to 0:06:31.480 --> 0:06:33.560 it way before I knew I was trying for a baby. 0:06:33.680 --> 0:06:35.920 I am currently thirteen weeks pregnant and I am a 0:06:35.960 --> 0:06:39.320 teacher in NYC school district. Is it high risk for 0:06:39.400 --> 0:06:42.960 pregnant women to work in schools even with social distance protocols? 0:06:43.200 --> 0:06:45.880 Should the schools allow teachers to work from home? I 0:06:46.000 --> 0:06:48.279 heard they are hearing now that pregnant women are considered 0:06:48.360 --> 0:06:53.160 higher risk. Is this true? Why or why not? Yeah, Nikki, 0:06:53.200 --> 0:06:54.760 you've got a lot of questions. I hear you, girl, 0:06:55.120 --> 0:06:59.000 We all do. So. Yeah, there's a lot to unpack 0:06:59.040 --> 0:07:01.520 in that in that question. And um, so let me 0:07:01.520 --> 0:07:04.640 try and break that down. So are pregnant women considered 0:07:04.720 --> 0:07:08.520 higher risk? So, in general, pregnant women are considered to 0:07:08.520 --> 0:07:12.080 be an immunocompromised population, meaning that they tend to get 0:07:12.440 --> 0:07:15.400 UM infections at a higher rate than people who have 0:07:15.560 --> 0:07:19.840 a competent immune system. So prior stars and Mirrors and 0:07:19.880 --> 0:07:23.320 even the influence of IRUs definitely affected pregnant women UM 0:07:23.400 --> 0:07:26.360 at more severe rates. What we are seeing right now 0:07:26.440 --> 0:07:30.000 is that that's not necessarily true with CoV two, which 0:07:30.040 --> 0:07:33.440 is COVID nineteen. However, the CDC did just put out 0:07:33.480 --> 0:07:37.400 a publication back in the end of June, so just recently. 0:07:38.000 --> 0:07:40.440 UM their data show that pregnant women did have an 0:07:40.480 --> 0:07:44.040 increased risk of hospitalization and an increased risk of ic 0:07:44.240 --> 0:07:48.160 YOU admission and an increased risk of mechanical ventilation, but 0:07:48.560 --> 0:07:51.920 not an increased risk of death. With that being said, 0:07:51.960 --> 0:07:54.280 there is a caveat that the CDC data that we 0:07:54.320 --> 0:07:57.200 did get had a very low percent of the people 0:07:57.240 --> 0:08:00.800 who responded or they were notified, um who we had 0:08:00.840 --> 0:08:03.520 a answer on whether or not they were pregnant. We 0:08:03.520 --> 0:08:06.440 don't know if our denominator was accurate. So with that 0:08:06.480 --> 0:08:08.960 being that, I think it's hard to make conclusions based 0:08:08.960 --> 0:08:11.680 off of that particular study, and they mentioned that in 0:08:11.760 --> 0:08:14.720 their report as well. So I think that what we 0:08:15.000 --> 0:08:17.640 know for sure is that pregnant women can get sick, 0:08:18.560 --> 0:08:20.600 whether they are going to be at increased risk for 0:08:20.680 --> 0:08:24.200 having severe disease or have an increased risk of fatality 0:08:24.320 --> 0:08:26.720 or death. I think that still remains to be seen, 0:08:26.920 --> 0:08:30.720 and we're not necessarily seeing even from my practice, and 0:08:30.800 --> 0:08:32.760 you know from what we're seeing out there, that that's 0:08:33.080 --> 0:08:36.199 happening in large numbers. So yes, I what I tell 0:08:36.280 --> 0:08:39.560 my God, thank God for that exactly. So what I'm 0:08:39.600 --> 0:08:42.640 telling my patients is, you know, pregnant women can get sick. 0:08:43.000 --> 0:08:45.840 I don't want you to get sick. So if you know, 0:08:45.920 --> 0:08:48.480 we can be at work. I mean everyone needs to work, 0:08:48.520 --> 0:08:50.439 Everyone needs to be functional and try and be in 0:08:50.480 --> 0:08:53.520 the society and make this whole you know, stressful time 0:08:53.520 --> 0:08:56.360 work for us. But with that being said, it has 0:08:56.400 --> 0:08:58.400 to be within reason and it has to be safe. 0:08:58.440 --> 0:09:00.800 So you have to have the protective here, you have 0:09:00.920 --> 0:09:03.520 to be socially distanced, you have to have availability to 0:09:03.559 --> 0:09:07.120 wash your hands and stay safe. If we feel like 0:09:07.200 --> 0:09:09.480 that's not the case, then I would say the option 0:09:09.559 --> 0:09:14.040 to work from home should be allowed for pregnant women. Awesome, 0:09:14.520 --> 0:09:18.120 that's great. Um, oh, this is huge. I've been reading 0:09:18.160 --> 0:09:21.360 a lot about this. Next question, communities of color are 0:09:21.400 --> 0:09:25.440 being hit disproportionately hard by COVID in examining the cases 0:09:25.480 --> 0:09:28.440 of pregnant women. What is the data showing thus far 0:09:29.160 --> 0:09:31.840 and can like what can public health officials do to 0:09:31.920 --> 0:09:35.560 combat this? This upsets me more than any I'm like, 0:09:35.960 --> 0:09:40.040 beside myself, this is such an important question. So I 0:09:40.120 --> 0:09:43.920 completely agree that the data so far does support that 0:09:44.559 --> 0:09:48.120 women of color, specifically Hispanic and Black women are being 0:09:48.320 --> 0:09:52.720 disproportionately affected by COVID. Nineteen prior to COVID, we actually 0:09:52.760 --> 0:09:55.480 we're seeing that, and I'm sure that's something that's on it, 0:09:55.600 --> 0:09:58.760 you know, everyone's radar as well. But maternal mortality was 0:09:58.840 --> 0:10:01.600 a lot higher in the black population and women of 0:10:01.640 --> 0:10:04.200 color as well, So this isn't something that's new to us. 0:10:04.240 --> 0:10:06.480 And now that we've got COVID, we're seeing the same 0:10:06.520 --> 0:10:09.560 thing that women of color, Hispanic and Black women are 0:10:09.559 --> 0:10:13.000 just proportionately affected. We do have data for this. Similarly, 0:10:13.000 --> 0:10:15.880 in that CDC report that I mentioned, what it showed 0:10:15.880 --> 0:10:17.640 was that out of all the women who had COVID, 0:10:17.720 --> 0:10:24.600 nineteen percent were Hispanic women, were Black women, were white women. 0:10:24.840 --> 0:10:27.200 But when you contrast that with the rates of births 0:10:27.240 --> 0:10:31.640 into Gusen nineteen Hispanic women only made Black women only 0:10:31.679 --> 0:10:36.080 made fifteen percent. So they're disproportionately being affected. So that 0:10:36.200 --> 0:10:38.400 data is real. Are we are seeing that and even 0:10:38.520 --> 0:10:41.440 from my own personal experience, we are seeing that Hispanic 0:10:41.520 --> 0:10:45.400 women I practice in California. Hispanic women are disproportionately affected here. 0:10:46.280 --> 0:10:49.560 So this is an incredibly important topic and something that 0:10:49.600 --> 0:10:52.280 I want to stress that we all from a medical standpoint, 0:10:52.360 --> 0:10:55.120 need to be paying attention to. Um What can we 0:10:55.160 --> 0:10:58.040 do about this? I think medical and public health communities 0:10:58.080 --> 0:11:01.080 first need to examine their own employe that bias and 0:11:01.160 --> 0:11:04.520 work on re examining how you can resolve this, because 0:11:04.520 --> 0:11:06.720 if you don't recognize what's happening, it's going to be 0:11:06.760 --> 0:11:09.360 impossible to fix it. So that's number one. I think 0:11:09.440 --> 0:11:11.679 number two you have to be transparent with data. You 0:11:11.720 --> 0:11:13.960 have to examine your own data. You have to see 0:11:14.000 --> 0:11:16.400 what's really happening and be able to tackle what where 0:11:16.480 --> 0:11:18.960 the need is UM. And then you know what you 0:11:19.000 --> 0:11:20.400 do once you have the data is you have to 0:11:20.440 --> 0:11:26.040 commit to future research and treatment addressing and eliminating that disparity. UM. 0:11:26.120 --> 0:11:28.800 To give you an example, you know, it's it's things 0:11:28.840 --> 0:11:30.920 like Priority, which I'm going to talk about, which is 0:11:30.960 --> 0:11:34.200 an organization that is looking at research and pregnancy and COVID. 0:11:34.600 --> 0:11:37.520 They may announce that they're working on a reproductive Health 0:11:37.520 --> 0:11:42.240 Equity and Birth Justice core looking at exactly this is unbelievable. 0:11:42.320 --> 0:11:44.000 I want to do I mean, this is a side 0:11:44.000 --> 0:11:46.040 note and you I want to do a whole episode 0:11:46.040 --> 0:11:48.480 about this. I just think this is insane and I 0:11:48.520 --> 0:11:51.160 want to hear more in depth about the work Priority 0:11:51.280 --> 0:11:55.960 is doing. Absolutely, it's so important. It is so time. 0:11:56.120 --> 0:11:59.880 Yeah no, no, I totally agree with you. And so essentially, 0:12:00.000 --> 0:12:03.400 you know, we're looking at trying to increase our recruitment efforts, 0:12:03.440 --> 0:12:07.559 particularly in the Black, Indigenous and people of color. UM. 0:12:07.600 --> 0:12:11.520 If you don't have these people involved in your research, UM, 0:12:11.559 --> 0:12:14.439 and you have to actually reach out to these communities 0:12:14.600 --> 0:12:16.680 to have them be the ones who tell us what 0:12:16.880 --> 0:12:19.840 is important. We can't just be doing research what we 0:12:19.920 --> 0:12:22.240 think is important. We have to reach out to all 0:12:22.280 --> 0:12:24.959 of these communities and have them involved and then make 0:12:25.080 --> 0:12:27.880 special efforts to try and address these situations. So I'm 0:12:27.920 --> 0:12:32.520 so glad you brought it up. It is so incredibly important. Wow. 0:12:32.920 --> 0:12:38.360 Um okay. At Nikki Friedlin writes what could happen to 0:12:38.400 --> 0:12:42.239 a pregnant mom if she gets COVID? Have any newborns 0:12:42.280 --> 0:12:44.920 had COVID and what are the symptoms? Okay, I know 0:12:45.000 --> 0:12:47.120 a little bit about this answer, but I probably don't 0:12:47.120 --> 0:12:51.280 know the up to date stuff you know. Okay, So, yes, 0:12:51.360 --> 0:12:53.680 pregnant women can get COVID, and there have been case 0:12:53.760 --> 0:12:57.520 reports of newborns who have COVID as well. Um, it 0:12:57.640 --> 0:13:00.720 is it follows very similar to the general population in 0:13:00.760 --> 0:13:03.520 that of pregnant women who will get COVID will have 0:13:04.000 --> 0:13:09.320 mild or asymptomatic symptoms or disease. Um may have severe 0:13:09.600 --> 0:13:13.040 issues with COVID, and five percent may be critical. Um, 0:13:13.080 --> 0:13:15.719 and that's about the percentages And that's not exactly that's 0:13:15.720 --> 0:13:18.199 about the percentages we're seeing in pregnancy as well. So, 0:13:18.280 --> 0:13:21.320 like I mentioned, pregnant women can get COVID. So I 0:13:21.360 --> 0:13:23.520 tell all of my patients to to follow all of 0:13:23.520 --> 0:13:27.319 the CDC recommendations and stay home and stay safe. Newborns 0:13:27.400 --> 0:13:30.120 can get COVID. We have seen that happen, whether it's 0:13:30.120 --> 0:13:33.679 happening because it's being vertically transmitted, meaning going from mom 0:13:33.720 --> 0:13:36.320 to baby, or if it's happening after the baby is 0:13:36.360 --> 0:13:38.640 born in the immediate exposures that they get once the 0:13:38.640 --> 0:13:41.640 baby is born. That piece of it is not completely 0:13:41.679 --> 0:13:44.160 ironed out yet, although we are getting data as you mentioned, 0:13:44.240 --> 0:13:48.160 day by day. Um. So you know, most of the newborns, 0:13:48.240 --> 0:13:51.839 most of children who get it have very very mild symptoms. Um. 0:13:51.840 --> 0:13:53.600 But in a in a newborn it would be and 0:13:53.640 --> 0:13:56.080 I'm not the experts, I would defer to the pediatricians 0:13:56.080 --> 0:13:58.840 on this one, but on in newborns it's usually fever 0:13:59.400 --> 0:14:02.200 um sometimes as it can be what was actually reported 0:14:02.240 --> 0:14:06.319 out in the France study with some neurologic symptoms. Yes, 0:14:06.679 --> 0:14:09.680 there was a study that came out in France that 0:14:09.760 --> 0:14:13.800 it was transferred through the placenta from a COVID positive 0:14:13.840 --> 0:14:16.760 mom too. I don't know how many, but a baby 0:14:16.840 --> 0:14:19.600 or some babies, but a few, okay, one great one 0:14:19.640 --> 0:14:21.880 baby dies I have a doctor on this show. She 0:14:21.920 --> 0:14:25.720 knows UM and the baby, I guess for like two weeks. 0:14:25.880 --> 0:14:28.120 I'm putting this in Katie speak, you guys, but the 0:14:28.120 --> 0:14:30.400 baby for two weeks had some respiratory issue and some 0:14:30.840 --> 0:14:35.480 inflammatory brain stuff, which is horrifying and terrifying. But after 0:14:35.560 --> 0:14:41.000 two weeks, the baby they seem to be okay correct 0:14:41.200 --> 0:14:43.840 so far, but like, we don't know if there's long 0:14:43.960 --> 0:14:46.240 term effects, but at the moment, the baby seems to 0:14:46.240 --> 0:14:49.120 have made it full circle, not going would thank God 0:14:49.160 --> 0:14:52.320 didn't die or something, you know like that. This one. 0:14:52.360 --> 0:14:55.120 I get asked a lot for people who are trying 0:14:55.120 --> 0:15:00.240 to conceive or are very early has COVID proven We 0:15:00.280 --> 0:15:03.880 probably don't know you, But has has COVID caused miscarriage? 0:15:05.400 --> 0:15:08.160 That is also a question that I get on the daily. Um, 0:15:08.200 --> 0:15:10.640 I think, but we're seeing right now the data that's 0:15:10.640 --> 0:15:13.960 that's currently being quoted. Again, this is just preliminary stuff 0:15:13.960 --> 0:15:16.000 and things are evolving every single day. But what we're 0:15:16.000 --> 0:15:18.160 seeing right now is miscarriage rate is on the order 0:15:18.200 --> 0:15:22.760 of about two so not incredibly high growth restriction, which 0:15:22.800 --> 0:15:25.280 is you know, when you get COVID or any infection, 0:15:25.560 --> 0:15:29.040 you often have issues with babies growing well. That rate 0:15:29.120 --> 0:15:31.360 is about ten percent, which is on the order of 0:15:31.400 --> 0:15:33.680 what we've seen in a general population, but the preterm 0:15:33.720 --> 0:15:36.600 birth rate is higher. Um And again this is data 0:15:36.640 --> 0:15:38.640 we have from women who are super sick with COVID, 0:15:38.720 --> 0:15:40.920 people who end up in the I c U. But 0:15:41.000 --> 0:15:44.680 we are seeing a ventilators on eventilator exactly. But we 0:15:44.720 --> 0:15:46.600 are seeing that the pre term birth rates can be 0:15:46.640 --> 0:15:51.840 on the order oh god, okay, so if okay, So 0:15:52.120 --> 0:15:54.400 what we're seeing is if you have a really bad 0:15:54.440 --> 0:15:58.960 case of COVID, we're delivering babies really early, really early, 0:15:59.080 --> 0:16:02.160 really to actually means less than thirty seven weeks. That's 0:16:02.200 --> 0:16:05.680 considered preturn. But yes, in my experience and what I've 0:16:05.680 --> 0:16:08.000 seen so far in the literature, it is that if 0:16:08.000 --> 0:16:10.440 a woman ends up being super sick to the point 0:16:10.480 --> 0:16:13.000 where she is in the I see you and on eventilator, 0:16:13.400 --> 0:16:31.120 we do seem to be delivering those women sooner. I've 0:16:31.120 --> 0:16:36.560 only heard these dramatic, mythical stories of women delivering with COVID, 0:16:36.680 --> 0:16:40.400 and like, I refuse to actually google because I'm horrified 0:16:40.400 --> 0:16:41.480 and i don't want to know, but I'm going to 0:16:41.560 --> 0:16:44.880 find out now. Guys, You're welcome, but like women, what 0:16:45.040 --> 0:16:47.880 happens when they deliver with COVID. I've heard these stories 0:16:47.880 --> 0:16:51.400 of like women being put out and the baby coming 0:16:51.400 --> 0:16:54.720 out through cesarean and then they have to isolate from 0:16:54.720 --> 0:16:57.200 each other for two weeks while a mommy's pumping and 0:16:57.320 --> 0:16:59.800 comes to and then meets their baby at fourteen days 0:16:59.880 --> 0:17:02.200 or whatever. Can you tell me about this? Is this 0:17:02.320 --> 0:17:04.600 even true? Is this a movie I've made up in 0:17:04.640 --> 0:17:07.199 my head because I'm a dramatic actress in Hollywood, Like, 0:17:07.280 --> 0:17:11.720 tell me what happens if you deliver with COVID? So 0:17:11.800 --> 0:17:16.520 I think it's not entirely incorrect, but I think of 0:17:16.560 --> 0:17:19.919 COVID as what I had mentioned before, Right, eighty percent 0:17:19.960 --> 0:17:21.720 of women who have COVID are either going to be 0:17:21.760 --> 0:17:26.639 completely asymptomatic or have extremely mild disease. So for those people, 0:17:26.760 --> 0:17:29.359 and you know, a lot of institutions are testing every 0:17:29.400 --> 0:17:32.240 COVID or I'm sorry, I'm testing every pregnant woman who 0:17:32.240 --> 0:17:35.119 shows up to labor and delivery for their delivery. So 0:17:35.160 --> 0:17:36.879 a lot of the times we're picking up things that 0:17:36.920 --> 0:17:39.680 people had zero idea that they had COVID, and we're like, hey, 0:17:39.760 --> 0:17:42.440 you know, actually you are one of those asymptomatic people 0:17:42.480 --> 0:17:45.720 who have COVID, So what happens to them, they are 0:17:45.720 --> 0:17:48.000 not going to have this dramatic you know, of course 0:17:48.040 --> 0:17:50.960 as you as you delivery. Yeah, so what what's going 0:17:51.000 --> 0:17:52.960 to happen to them is that they're going to be 0:17:53.040 --> 0:17:56.240 for the most part, kind of restricted in terms of delivery, 0:17:56.359 --> 0:17:57.600 in the sense that they're not going to have a 0:17:57.600 --> 0:17:59.439 ton of people in their room. They're going to be 0:17:59.480 --> 0:18:02.359 restricted to the bare minimum, and everyone is going to 0:18:02.400 --> 0:18:05.600 be wearing full protective fear for their delivery. They do 0:18:05.640 --> 0:18:07.560 not need to wear a mask, although you know, we're 0:18:07.600 --> 0:18:09.119 going to try to have them wear a mask as 0:18:09.200 --> 0:18:12.560 much as they can, but obviously during the time of delivery, 0:18:12.560 --> 0:18:15.399 when they're pushing, UM, it is not reasonable to be 0:18:15.440 --> 0:18:18.040 wearing a mask. So we don't have our pregnant women's 0:18:18.040 --> 0:18:22.720 who are COVID positive UM wearing a mask. Not necessarily. Um, 0:18:22.760 --> 0:18:24.959 they are going to that just here or is that 0:18:25.040 --> 0:18:27.520 everywhere in the country? Do we know? You know, I 0:18:27.600 --> 0:18:32.359 think that people have gotten very creative in in barriers 0:18:32.400 --> 0:18:34.879 and things like that. People can use, you know, little 0:18:35.000 --> 0:18:37.400 shields that they try to have the pregnant women wear. 0:18:37.440 --> 0:18:42.080 But masks, I think are are physically almost impossible to do. 0:18:42.119 --> 0:18:44.760 I mean, it is, it's really hard to labor in. 0:18:44.760 --> 0:18:47.120 And I know I pushed. Yeah, I was like, if 0:18:47.119 --> 0:18:49.199 I had a mask on, I would have lost my 0:18:49.280 --> 0:18:53.080 dang mind. Yeah, yeah, absolutely not. I think it's incredibly hard. 0:18:53.160 --> 0:18:55.120 I think it's the best of intentions. You could try 0:18:55.119 --> 0:18:56.639 and have a woman wear a mask, but it's not 0:18:56.680 --> 0:18:59.240 going to stay on while she's pushing UM. But you know, 0:18:59.280 --> 0:19:02.119 I think she woman can expect a restricted kind of 0:19:02.440 --> 0:19:07.359 visitor scenario UM providers who are wearing full protective gear. 0:19:07.520 --> 0:19:10.040 It may feel a little bit scientific, but it is 0:19:10.080 --> 0:19:13.119 really just to protect everybody involved in that. Once the 0:19:13.160 --> 0:19:17.440 baby is born, the neonatal team will probably assess the baby, 0:19:17.480 --> 0:19:20.280 but the baby isn't gonna get whisked away. The baby 0:19:20.520 --> 0:19:23.320 is going to now, especially there's new data to say that, 0:19:23.560 --> 0:19:25.800 you know, we probably think the baby should stay with 0:19:25.840 --> 0:19:29.719 the mom, but mom should, you know, have as much 0:19:30.240 --> 0:19:32.320 kind of the same kind of hygiene that we would 0:19:32.320 --> 0:19:35.400 recommend for somebody who has COVID, so lots of hand 0:19:35.440 --> 0:19:39.560 washing masks when she's around the baby, um, you know, 0:19:39.680 --> 0:19:42.359 changing clothes if she's been wearing the clothes for a 0:19:42.359 --> 0:19:45.159 long time, when she's going to breastfeed. Um. There have 0:19:45.359 --> 0:19:48.360 been you know, therefore this there were some talks about 0:19:48.440 --> 0:19:51.560 completely isolating mom and baby. That is not reasonable, and 0:19:51.600 --> 0:19:55.680 now we're seeing data that that's actually probably not necessary. Um. 0:19:55.720 --> 0:19:58.280 Now that's for a woman who's asymptomatic, we're doing well. 0:19:58.359 --> 0:20:01.560 For somebody who's sick in the i c U on 0:20:01.720 --> 0:20:04.840 a ventil later, um, it probably would be something like 0:20:04.880 --> 0:20:06.840 you you would like you mentioned, you know, they would 0:20:06.880 --> 0:20:10.720 probably get delivered via csarian section. Not necessarily because they 0:20:10.760 --> 0:20:12.720 absolutely had to. But in a lot of the times 0:20:12.720 --> 0:20:15.280 when moms aren't having good oxygen, the babies aren't getting 0:20:15.280 --> 0:20:17.600 good oxygen, and their heart rates starts to do things 0:20:17.600 --> 0:20:20.400 that make us worry, and so we want to get 0:20:20.480 --> 0:20:22.679 them out of that situation in a situation where we 0:20:22.680 --> 0:20:25.919 can give them, um, better oxygen, better nutrition, and so 0:20:25.960 --> 0:20:29.120 those tend to be cecerean deliveries. UM. But it's not 0:20:29.200 --> 0:20:32.040 like it's not an. Absolutely doesn't mean that just because 0:20:32.080 --> 0:20:33.640 you have COVID and you're in the I c you're 0:20:33.640 --> 0:20:36.480 gonna end up with a C section. Um, But they 0:20:36.520 --> 0:20:39.800 probably don't know their delivery because they're intubated, and you know, 0:20:39.840 --> 0:20:42.720 they haven't they're not awake and like a mom who 0:20:42.840 --> 0:20:45.600 is you know, healthy and doing well. So those would 0:20:45.600 --> 0:20:47.720 be a little bit more dramatic, I suppose where moms 0:20:47.720 --> 0:20:50.640 would probably get delivered and and meet their babies sometime 0:20:50.680 --> 0:20:56.560 down the line. My goodness. But you know, all I 0:20:56.680 --> 0:21:01.320 hear is like, as much as that's the shittiest thing ever, 0:21:01.640 --> 0:21:05.239 I can't even fathom it. All I hear on the 0:21:05.240 --> 0:21:07.480 other side is like, yeah, but they all survived, do 0:21:07.560 --> 0:21:09.240 you know what I mean? Like, I'm just like when 0:21:09.240 --> 0:21:12.760 I hear these things, I'm like, okay, but like even 0:21:12.800 --> 0:21:14.719 if it's the worst working days of your life, like 0:21:14.840 --> 0:21:17.639 you're still walking out of hospital with your baby, like, 0:21:18.160 --> 0:21:21.480 and it makes me like, like take a breath. Um. 0:21:21.520 --> 0:21:23.600 I mean I think it makes all of us cringe too. 0:21:23.760 --> 0:21:26.040 I mean, we our hearts go out to all of 0:21:26.080 --> 0:21:28.439 these people who you know, whether it's pregnant or not, 0:21:28.560 --> 0:21:31.760 who are in the guy see you alone because visitors 0:21:31.760 --> 0:21:35.000 are restricted. It is heartbreaking. And you know, I think 0:21:35.000 --> 0:21:37.760 that we all are trying to look at the end goal, 0:21:37.840 --> 0:21:40.080 which is trying to get everybody home, trying to get 0:21:40.119 --> 0:21:44.480 everybody alive, and although things like separation and not being 0:21:44.520 --> 0:21:47.840 awake when your baby is born sound absolutely terrible. I'm 0:21:47.920 --> 0:21:50.639 so thankful that you mentioned that we are at least 0:21:50.760 --> 0:21:53.080 trying to get them to be alive and go home 0:21:53.080 --> 0:21:55.120 with their children at some point. So that's I think 0:21:55.160 --> 0:21:59.480 the anal Yeah, like that's got to be the I mean, 0:21:59.720 --> 0:22:01.760 I'm I can only say that looking from outside of 0:22:01.760 --> 0:22:05.280 the experience. Obviously I can't even imagine going through it. 0:22:05.320 --> 0:22:08.960 But I just uh that, Yeah, I'm just relieved that 0:22:09.000 --> 0:22:12.560 these horror stories are like not ending in terrible um 0:22:12.920 --> 0:22:16.560 outcomes at Mrs b h O writes, I'm scared of 0:22:16.600 --> 0:22:20.159 not being able to have my husband speaking of restricted 0:22:20.240 --> 0:22:23.240 things in the delivery room with me if quarantine requirements 0:22:23.240 --> 0:22:27.960 become strict again. She's due September twenty one. Tell me 0:22:28.000 --> 0:22:30.919 about that ship show that when Yeah, yeah, yeah, I 0:22:30.920 --> 0:22:33.440 mean that's a reasonable concern, right, I mean, I think 0:22:33.480 --> 0:22:36.600 that it's exceedingly hard for a woman to be expected 0:22:36.640 --> 0:22:40.760 to deliver by herself, especially when she's not sick. Um. 0:22:40.840 --> 0:22:44.000 With that being said, I think it's very institution dependent, 0:22:44.080 --> 0:22:47.320 it's very hospital dependent. And we all heard of what 0:22:47.400 --> 0:22:49.679 happened in New York, and I think that you know, 0:22:49.840 --> 0:22:52.400 for what was going on at that time, they felt 0:22:52.400 --> 0:22:54.399 as I was the right decision, and by no means 0:22:54.440 --> 0:22:57.360 do I question that, But I do think it's exceedingly 0:22:57.400 --> 0:22:59.320 hard for a woman to deliver a loan when she's 0:22:59.359 --> 0:23:02.320 not sick. So with that being said, I think most 0:23:02.480 --> 0:23:06.480 places now are are at least allowing a partner in 0:23:06.520 --> 0:23:10.320 the room significant other for the delivery and for the 0:23:10.359 --> 0:23:14.399 postpartum time period. UM. Where I'm working, they definitely allow 0:23:14.600 --> 0:23:17.080 a partner in the room for the whole entire stay, 0:23:17.119 --> 0:23:20.480 which is through labor and delivery and postpartum as well. UM, 0:23:20.520 --> 0:23:23.600 it's gotten better with the more testing that we have, 0:23:23.720 --> 0:23:26.600 the better we feel about testing all the women who 0:23:26.720 --> 0:23:29.080 come through and knowing that if they're negative, their partners 0:23:29.080 --> 0:23:32.199 are likely negative. And it's not just about you know 0:23:32.240 --> 0:23:35.080 their particular situation, right. If you imagine a partner comes 0:23:35.119 --> 0:23:37.600 in and then walks out in the hallway and goes 0:23:37.640 --> 0:23:39.440 in touch with something, and it comes back in the room, 0:23:39.520 --> 0:23:41.200 and the next partner goes out in touch or something, 0:23:41.240 --> 0:23:44.000 it's it's we're trying to keep everybody safe, and it's 0:23:44.040 --> 0:23:46.480 not a small order, and so that's why we try 0:23:46.520 --> 0:23:48.640 the best we can. But I would say that that's 0:23:48.640 --> 0:23:51.560 a reasonable concern and if things start getting crazy and 0:23:51.600 --> 0:23:54.680 whatever location at you know, she is in, I would 0:23:54.680 --> 0:23:56.880 have her just reach out to her physician, reach out 0:23:56.880 --> 0:24:01.240 to her hospital early and find out what the situation is. Right. 0:24:02.320 --> 0:24:06.359 Speaking of this, when this was all going down in 0:24:06.400 --> 0:24:09.600 New York, I had a few friends deliver. Especially it 0:24:09.680 --> 0:24:11.359 was my heart goes out to a lot of women 0:24:11.359 --> 0:24:14.080 who were first time, you know, first time ever going 0:24:14.119 --> 0:24:18.000 through this without their loved one with them um and 0:24:18.040 --> 0:24:21.000 how stressful that is. And I also can only say 0:24:21.040 --> 0:24:23.680 that we just understand the disease more. I mean, if 0:24:23.680 --> 0:24:25.680 I do, then obviously all the doctors dukes, That's where 0:24:25.680 --> 0:24:29.520 I'm getting my information. But so there are ways to 0:24:29.640 --> 0:24:32.679 get that one person in there for the whole time 0:24:33.200 --> 0:24:35.600 and keep everyone separated. It's so funny. I keep having 0:24:35.640 --> 0:24:37.520 flashbacks when my son was born and we were like 0:24:37.880 --> 0:24:40.560 walking down the hallways with other people who had given 0:24:40.600 --> 0:24:42.600 birth and meeting their babies, you know what I mean. 0:24:42.600 --> 0:24:47.840 It was just so like communal almost. I yeah, I remember, 0:24:47.880 --> 0:24:49.159 I was just talking about this the other day. I 0:24:49.200 --> 0:24:51.200 remember when there was a whole families in the waiting 0:24:51.240 --> 0:24:54.320 room cheering after the baby was. My entire family was 0:24:54.359 --> 0:24:57.680 there one minute after I had Albie and we had 0:24:57.680 --> 0:24:59.159 our loan time for a couple of hours. Then as 0:24:59.200 --> 0:25:01.240 soon as we moved, my whole family came. They brought 0:25:01.760 --> 0:25:04.879 to go. I always regret what I picked. I ate salmon, like, 0:25:04.960 --> 0:25:07.080 what a dumb thing to I mean, I love my 0:25:07.160 --> 0:25:08.520 duelist so much, but she was like, you need to 0:25:08.600 --> 0:25:11.280 replenish your body. I should have had a burger and fries. 0:25:11.359 --> 0:25:15.560 That was so dumb. I should have had what I wanted. Um, 0:25:15.600 --> 0:25:18.240 but I've I had some friends make the choice to 0:25:18.320 --> 0:25:22.920 have birth at home during this time. What are I mean? 0:25:23.440 --> 0:25:27.000 I know that I think that statistically speaking, a home 0:25:27.040 --> 0:25:30.280 birth death rate is higher than a hospital one. Is 0:25:30.280 --> 0:25:33.040 that correct? Have you had patients that have been like, 0:25:33.080 --> 0:25:36.600 I'm not doing this, I'm doing this at home. Um, 0:25:36.640 --> 0:25:40.320 there's a new wave of this. What's your opinion on that? Yeah, 0:25:40.440 --> 0:25:42.840 you're spot on, Katie. Yeah, you know it is. It 0:25:43.000 --> 0:25:47.119 is increased risk to deliver at home just in general. Right, 0:25:47.119 --> 0:25:49.600 there's a very particular candidate who would be considered an 0:25:49.640 --> 0:25:53.440 appropriate home birth candidate. Somebody who is considered low risk 0:25:53.560 --> 0:25:57.480 doesn't have any risk factors. Um, you know, maternal mortality 0:25:57.560 --> 0:25:59.280 is a real thing, and so we don't and so 0:25:59.440 --> 0:26:02.320 is new and it mortality. So we really don't want 0:26:02.400 --> 0:26:05.399 people thinking that home births are the way to go. 0:26:06.040 --> 0:26:08.560 But I understand where people were coming from. You know, 0:26:08.640 --> 0:26:11.920 it's it sounded and it looked crazy. Um. The only 0:26:11.960 --> 0:26:14.200 thing that I in my opinion about this is it's 0:26:14.240 --> 0:26:17.280 it's definitely safer to deliver in a hospital than at home, 0:26:17.520 --> 0:26:21.080 especially if you are a higher risk patient. And sometimes 0:26:21.119 --> 0:26:23.200 you don't know if you're higher risk, if you haven't 0:26:23.200 --> 0:26:26.000 had prenatal care, if you haven't been kind of following up, 0:26:26.000 --> 0:26:27.800 and a lot of people have been scared to go 0:26:27.880 --> 0:26:30.320 to OBI appointments, have been scared to be you know, 0:26:30.400 --> 0:26:33.000 followed up in a hospital setting or in a clinic setting. 0:26:33.440 --> 0:26:35.920 So I would just caution people if they think about 0:26:36.040 --> 0:26:38.919 deliverering at home, to really make sure that they are 0:26:38.920 --> 0:26:41.440 an appropriate candidate, to make sure they have an appropriate 0:26:41.480 --> 0:26:44.199 certified midwife who would be available to them, and that 0:26:44.280 --> 0:26:48.879 appropriate certified midwife has a hospital that's backing them up 0:26:48.920 --> 0:26:51.000 and has a physician who's backing them up, because in 0:26:51.040 --> 0:26:54.240 the event of an emergency UM within a couple of minutes, 0:26:54.280 --> 0:26:56.600 things can go very wrong. And so you know, it's 0:26:56.600 --> 0:27:00.320 really for me, it's very it's it's scared for me 0:27:00.359 --> 0:27:03.160 to think about all those people who have made those choices. 0:27:03.359 --> 0:27:05.119 From the most part, I'm sure most of them do. 0:27:05.240 --> 0:27:07.760 Find But if you know we can prevent one mom 0:27:07.800 --> 0:27:10.280 from dying or one baby from dying by having them 0:27:10.280 --> 0:27:13.000 in a hospital, especially a hospital that has spent a 0:27:13.000 --> 0:27:16.120 lot of time and energy to make sure the infection 0:27:16.200 --> 0:27:19.199 prevention protocols are safe, then I would be in support 0:27:19.240 --> 0:27:24.440 of that. M hm, can you take us through, um 0:27:24.480 --> 0:27:27.560 what routine OBI appointments look like? Now, I think you 0:27:27.680 --> 0:27:29.720 just touched on that a little bit, so it came 0:27:29.760 --> 0:27:33.359 to my head. But um ore, OBI appointments just far less. 0:27:33.400 --> 0:27:36.000 Are women having to have their temperature taken before they 0:27:36.040 --> 0:27:39.800 walk in? Like I'm sure the waiting rooms are emptier, 0:27:40.359 --> 0:27:42.800 like everyone's got a mask on. Is that is that 0:27:42.920 --> 0:27:47.040 sort of the new wave of how we're doing things? Yeah, Katie, 0:27:47.040 --> 0:27:49.280 and you you barely need me, you know, you know 0:27:49.359 --> 0:27:52.040 all the others. Well, I think when you're a host 0:27:52.080 --> 0:27:55.680 of a mommy podcast, I text about this stuff a lot. 0:27:55.720 --> 0:27:59.000 I have a lot of phone calls. But that's what 0:27:59.080 --> 0:28:03.600 I'm hearing. Yeah, I'm guessing that people just go to 0:28:03.600 --> 0:28:06.480 the doctor less. And is that okay, So we try 0:28:06.520 --> 0:28:10.200 to eliminate all the non critical visits for whatever that means. 0:28:10.480 --> 0:28:13.160 You know, if you don't necessarily need to come in 0:28:13.280 --> 0:28:15.520 and see a physician, we try to do things over 0:28:15.600 --> 0:28:18.800 the phone or over telehealth. But we're still looking at you. 0:28:18.840 --> 0:28:22.040 But you know, we're not necessarily having you come in. UM. 0:28:22.440 --> 0:28:25.119 With that being said, we we still think it's exceedingly 0:28:25.160 --> 0:28:28.160 important to keep your obi appointments. UM. There's a reason 0:28:28.200 --> 0:28:30.359 that we see people as much as we do, and 0:28:30.359 --> 0:28:33.080 there's things that we're kind of looking out for. Um, 0:28:33.119 --> 0:28:34.720 And sometimes you just need to come in to get 0:28:34.720 --> 0:28:37.320 a blood pressure check and make sure that the baby 0:28:37.359 --> 0:28:39.880 looks okay. And so for all of those reasons, I 0:28:39.880 --> 0:28:42.080 would say, you know, just just go with the guidance 0:28:42.120 --> 0:28:45.040 of what your physician or your institution is saying to 0:28:45.040 --> 0:28:48.000 to make sure we don't miss anything that's important. UM. 0:28:48.040 --> 0:28:49.920 But yeah, you're right, that's what it looks like. You've 0:28:49.960 --> 0:28:51.800 got you know, and I can only speak from my place, 0:28:51.880 --> 0:28:54.960 but you know, we've got screeners downstairs who make sure 0:28:54.960 --> 0:28:58.520 they're screening everybody both through symptoms and through thermal scanners 0:28:58.600 --> 0:29:02.560 or temperature checks. UM. Visitors are limited only for the 0:29:02.640 --> 0:29:05.440 essential appointments, So waiting rooms are bare, and we do 0:29:05.520 --> 0:29:07.080 that on purpose so that there's not a lot of 0:29:07.080 --> 0:29:09.880 people in the waiting rooms. We want to socially distance everybody. 0:29:10.480 --> 0:29:13.400 Um and everyone is a mass. So that's that's pretty 0:29:13.480 --> 0:29:17.520 much fat on, That's exactly what's happening. Yes, I think 0:29:17.560 --> 0:29:20.960 I feel like it would be scary at first. I 0:29:20.960 --> 0:29:23.800 don't know. Man, women are so fucking resilient. I can't 0:29:23.840 --> 0:29:27.440 even believe it. I thank god women are that we're 0:29:27.440 --> 0:29:30.880 the people doing this, because I don't. I mean, I mean, 0:29:30.960 --> 0:29:35.400 it's crazy. What do you think about opening pods when 0:29:35.480 --> 0:29:38.560 women are pregnant? Like if there's a pregnant woman and 0:29:38.640 --> 0:29:41.320 she's got a toddler and there's no school and like 0:29:41.480 --> 0:29:44.600 she's losing her mind, Like, what do you think about 0:29:45.720 --> 0:29:47.840 opening up to and you know, there's all these like 0:29:48.000 --> 0:29:50.600 this is my quarantine or this is my bubble or 0:29:50.640 --> 0:29:55.040 whatever that is. Like are you having your pregnant patients 0:29:55.080 --> 0:29:58.240 completely isolate or you allowing them to open up to 0:29:58.320 --> 0:30:03.720 their discretion? I think that it's totally unreasonable to completely isolate. 0:30:03.800 --> 0:30:05.800 And as I mentioned before, I worry a lot about 0:30:05.800 --> 0:30:09.000 complete isolation and what that does to you or anybody 0:30:09.040 --> 0:30:12.120 for that matter. UM, but I do I do say, 0:30:12.200 --> 0:30:14.240 you know, if you're going to have a quarantine or 0:30:14.280 --> 0:30:17.360 a pod. While I think it's totally reasonable, I think 0:30:18.200 --> 0:30:21.400 really making sure that the other members of that team 0:30:21.440 --> 0:30:23.640 are doing kind of the same thing that you're doing 0:30:23.640 --> 0:30:26.720 and take it as seriously as you are, and you know, 0:30:26.760 --> 0:30:30.280 making it really open and um okay to say, hey, 0:30:30.360 --> 0:30:32.120 you know, I have a sniffle e nose today, I 0:30:32.120 --> 0:30:34.120 don't think I'm gonna come in and you know, not 0:30:34.240 --> 0:30:36.520 making that be an issue down the line. I think 0:30:36.600 --> 0:30:40.080 opening up those lines of communication and really um, having 0:30:40.120 --> 0:30:42.560 everybody on the same page and be just as safe 0:30:43.080 --> 0:30:46.120 um that that is reasonable, and really limiting it to 0:30:46.160 --> 0:30:48.600 as much as possible. And then just following kind of 0:30:48.600 --> 0:30:51.360 the general guidelines, which is always where a mask if 0:30:51.400 --> 0:30:55.000 you can, if you're outside, things are safer than whether 0:30:55.040 --> 0:30:58.560 you're inside and closed doors, UM, still staying a little 0:30:58.600 --> 0:31:02.360 bit distance from each other, frequent hand washing, and then 0:31:02.400 --> 0:31:05.760 the most important thing is if there's any signs of anything, 0:31:05.800 --> 0:31:08.000 whether it's a sniffle, a nose or a sort of 0:31:08.040 --> 0:31:10.880 throat or I just haven't smelled very much in the 0:31:10.960 --> 0:31:14.400 last couple of days, even that you know, um really saying, 0:31:14.440 --> 0:31:16.160 just so I start every day, I take a sip 0:31:16.160 --> 0:31:18.240 of my tea and I take a whiff and a swallow, 0:31:18.240 --> 0:31:21.600 and I'm like, yep, taste and smell. We still got it, okay. 0:31:22.320 --> 0:31:24.680 Like all my friends who got COVID, which I have 0:31:24.720 --> 0:31:29.480 a lot, that was a huge symptom for most of them. Um, 0:31:29.520 --> 0:31:33.360 what about women who have multiple children and are pregnant 0:31:33.880 --> 0:31:37.240 and they need to send their child to daycare because 0:31:37.240 --> 0:31:39.560 they have to work or they have to get their 0:31:39.640 --> 0:31:41.560 kid to some I know a lot of public schools 0:31:41.600 --> 0:31:43.720 are not opening in the fall, but they need some 0:31:43.800 --> 0:31:46.600 sort of childcare. Is that safe? What are you recommending 0:31:46.600 --> 0:31:51.040 to your pregnant patients about schools or daycares if it's 0:31:51.040 --> 0:31:54.440 at how possible to avoid while we're in a surge, 0:31:54.480 --> 0:31:57.160 I think that that's probably the way to go. But 0:31:57.280 --> 0:31:59.320 with that being said, you gotta do what you gotta do. 0:31:59.400 --> 0:32:01.160 So if your kids have to go because you've got 0:32:01.160 --> 0:32:02.680 to go to work, then that's what you do. And 0:32:02.760 --> 0:32:04.560 you just try to have them go to a place 0:32:04.600 --> 0:32:06.960 that's taking it as seriously as you are, who are 0:32:07.000 --> 0:32:11.200 following all of the guidelines. And then frequent handwashing, you know, 0:32:11.360 --> 0:32:15.000 frequent frequent handwashing, which is really hard for kids, um 0:32:15.080 --> 0:32:17.760 and for adults frankly, but you know, really kind of 0:32:17.800 --> 0:32:22.080 making that just become the every day, all the time. Um, 0:32:22.120 --> 0:32:24.880 that's the way to go. We need to do a 0:32:24.880 --> 0:32:27.640 whole episode on how to make handwashing fun for toddlers 0:32:27.680 --> 0:32:32.920 because my toddlers disgusting and he hates washing. I mean, 0:32:32.920 --> 0:32:34.960 we wash his hands so much more than we used to, 0:32:35.120 --> 0:32:40.320 and it is a struggle every Yeah, it's the worst. 0:32:41.120 --> 0:32:44.479 I need soap, I need dinosaurs swimming in there, I 0:32:44.520 --> 0:32:47.640 need I need like all that. Okay, please tell me, 0:32:48.160 --> 0:32:51.880 Please tell me that the that the not washing down 0:32:52.160 --> 0:32:55.760 of delivery boxes and take out for a pregnant woman 0:32:56.080 --> 0:32:59.160 that almost killed me in the first few weeks of quarantine. Like, 0:32:59.240 --> 0:33:01.720 are we recommend pregnant women don't have to do this anymore? 0:33:02.000 --> 0:33:04.760 Should they still be doing it? I think that, you know, 0:33:05.080 --> 0:33:08.480 wiping down boxes are probably not necessary. But what I 0:33:08.520 --> 0:33:10.800 do think is, you know, when you get anything from 0:33:10.840 --> 0:33:13.480 the outside, if it's fruit or something that's going to 0:33:13.560 --> 0:33:16.280 go directly into your mouth, wash that. But if it's 0:33:16.280 --> 0:33:18.600 going to be something that you take out of a container, 0:33:18.960 --> 0:33:21.000 you don't have to wash the container. Take things out 0:33:21.000 --> 0:33:23.920 of the container, then wash your hands really well before 0:33:23.960 --> 0:33:26.400 you eat it. That's what I would say. Um, and 0:33:26.440 --> 0:33:28.760 you can throw the container away, But wiping down the 0:33:28.800 --> 0:33:30.960 container and then taking it out and then what I mean, 0:33:31.000 --> 0:33:32.640 you just still just need to wash your hands before 0:33:32.640 --> 0:33:34.240 you eat your food. So I think, you know, just 0:33:34.320 --> 0:33:37.200 making sure that you limit as much contact with the 0:33:37.200 --> 0:33:39.719 container and everything in the house, but then just wash it. 0:33:39.720 --> 0:33:42.440 Taking everything out of the containers and then throwing the 0:33:42.440 --> 0:33:45.480 containers away and washing your hands is probably more than enough. 0:33:46.200 --> 0:33:51.560 When do you think we're gonna have a vaccine everybody? 0:33:52.080 --> 0:33:54.560 I would dream of a six month vaccine, but I 0:33:54.600 --> 0:33:59.000 think more realistically we're looking at twelve to eighteen months. Yeah, 0:33:59.280 --> 0:34:04.200 that's what I hear. Buckle up, people. The information on 0:34:04.280 --> 0:34:07.440 coronavirus and its impacts on pregnant women is rapidly changing. 0:34:07.440 --> 0:34:11.719 We've discussed this a lot um and meaningful data. The 0:34:11.760 --> 0:34:13.560 more that we collect, the better, and U c l 0:34:13.600 --> 0:34:16.719 A Health recognized that early, thank you very much, and 0:34:16.800 --> 0:34:21.480 launched a national registry which you touched on, called Priority 0:34:21.520 --> 0:34:28.040 Study or Pregnancy Coronavirus Outcomes Registry. Can you give the listeners, 0:34:28.120 --> 0:34:30.480 let's circle back. You touched on it. A little bit previously. 0:34:30.520 --> 0:34:34.000 A quick synopsis of Priority, Who qualifies to participate, what 0:34:34.120 --> 0:34:36.160 sort of data is being collected that they may be 0:34:36.280 --> 0:34:39.040 missing from the c d C where they can register. 0:34:39.160 --> 0:34:41.319 I mean this is so crucial, Like you, if you're 0:34:41.360 --> 0:34:44.960 listening to this podcast and you're pregnant, like you can 0:34:45.080 --> 0:34:50.560 really help other pregnant women through this organization. Yes, yeah, 0:34:50.560 --> 0:34:52.759 thank you so much for bringing this up. So I 0:34:52.760 --> 0:34:55.080 am so proud of my colleagues who have really kind 0:34:55.080 --> 0:34:58.880 of blaze the way in in getting this going in 0:34:58.960 --> 0:35:03.400 collaboration with uc SF. So Priority is basically a nationwide study. 0:35:03.640 --> 0:35:06.279 It's across the whole nation. We're looking at pregnant and 0:35:06.360 --> 0:35:09.839 recently pregnant women who either have had COVID or under 0:35:09.880 --> 0:35:12.920 investigation for having COVID, and the goal is really to 0:35:12.960 --> 0:35:17.200 better understand how pregnancy and postpartum, how women are really 0:35:17.239 --> 0:35:20.080 affected by COVID and their symptoms and what the impact 0:35:20.200 --> 0:35:23.400 is on pregnancy and delivery. There's three approaches to it, 0:35:23.480 --> 0:35:25.879 So one is that we are kind of doing questionnaires 0:35:25.920 --> 0:35:29.400 and its patient reported outcomes. Another aspect of it is 0:35:29.440 --> 0:35:32.200 that we are asking access to medical records for some 0:35:32.320 --> 0:35:35.040 proportion of the people. And then third we're looking at 0:35:35.040 --> 0:35:38.040 actual biospecimens, so like plus CENTA and you know, trying 0:35:38.040 --> 0:35:40.280 to answer some real science to try to figure out 0:35:40.600 --> 0:35:43.840 UM what goes on UM. And again, like I mentioned, 0:35:43.920 --> 0:35:46.640 we're trying to make a real big effort in including 0:35:46.680 --> 0:35:50.719 all racial and ethnic backgrounds and really trying to take 0:35:50.760 --> 0:35:56.240 away the disparity issue. And truthfully, anybody can be enrolled. 0:35:56.280 --> 0:35:59.239 You just have to be over thirteen years old UM, 0:35:59.360 --> 0:36:01.680 and it's any one who's either been pregnant or had 0:36:01.719 --> 0:36:04.480 been pregnant within the last six weeks. And we really 0:36:04.480 --> 0:36:07.799 welcome everybody to please to please, please please reach out 0:36:07.800 --> 0:36:10.880 to us. And you can UM reach out at Priority 0:36:10.960 --> 0:36:14.040 dot you, CSS dot edu. That's the website and it's 0:36:14.040 --> 0:36:16.520 a very very easy website. You can just go in 0:36:16.560 --> 0:36:19.040 and then roll through the website and someone will reach out. 0:36:19.840 --> 0:36:22.400 And one more time, you said, it's Priority dot U, C, 0:36:22.840 --> 0:36:24.880 S F dot E D. We're going to link to 0:36:24.920 --> 0:36:27.960 this and when I post this UM episode, I'll put 0:36:27.960 --> 0:36:32.840 a link to I mean, we really can't know anything 0:36:33.239 --> 0:36:37.719 until we study women who are going through this right now, 0:36:37.760 --> 0:36:42.520 so your experience is crucial to helping pregnant women in 0:36:42.520 --> 0:36:45.720 the future. Do you have any last piece of advice 0:36:45.840 --> 0:36:47.799 or things you want to say, Dr Rushmi Raw, this 0:36:47.840 --> 0:36:52.160 has been so eye opening and completely horrifying in some ways, 0:36:52.239 --> 0:36:58.160 but then also very relieving in other ways. UM. So yeah, 0:36:58.400 --> 0:37:02.560 I've taken some nice deep breaths. Are my friends out there? Um? 0:37:02.680 --> 0:37:05.640 Is there any last piece of word of advice? Yeah? 0:37:05.680 --> 0:37:07.560 I think you know number one. Thank you so much 0:37:07.560 --> 0:37:10.480 for having me. I think having um these informational and 0:37:10.600 --> 0:37:14.480 educational sessions are are key. UM. And just my last 0:37:14.480 --> 0:37:16.840 advices and message really is that there's a lot of 0:37:16.880 --> 0:37:22.080 people out there who are just really um interested and 0:37:22.120 --> 0:37:24.600 committed to taking care of women and taking care of 0:37:24.600 --> 0:37:27.799 pregnant women and children. And UM, I would say that 0:37:27.840 --> 0:37:29.959 we're just gonna work really hard until this is over. 0:37:30.160 --> 0:37:32.720 And if there's anything that we can do for you guys, 0:37:33.080 --> 0:37:35.600 or if there's any way you anything you need from us, 0:37:35.600 --> 0:37:38.720 just please don't hesitate to reach out. That's so nice 0:37:38.960 --> 0:37:41.759 and wonderful. See, even if you guys feel alone, you're 0:37:41.800 --> 0:37:45.719 not alone. Thank you, Dr rush me Ral. Thank you 0:37:45.760 --> 0:37:49.120 for all of your advice and intelligence and and bringing 0:37:49.120 --> 0:37:52.759 the information to the Katie's Crib listeners. You guys, thank 0:37:52.800 --> 0:37:56.920 you for listening. And up next we have Dr Daniel Taylor, 0:37:57.239 --> 0:37:59.360 who's a pediatrician from New York City who's going to 0:37:59.440 --> 0:38:03.640 give us a lot lot of information on COVID and kiddos. 0:38:05.160 --> 0:38:18.000 So thank you so much, thank you. Next, we have 0:38:18.120 --> 0:38:20.520 Dr Daniel Taylor here to answer all of our questions 0:38:20.520 --> 0:38:26.040 about kids and COVID. You guys, I am so thrilled 0:38:26.760 --> 0:38:31.000 to have Dr Danielle Taylor on and just selfishly speaking, 0:38:31.080 --> 0:38:34.960 she is my pediatrician and now she's the person I 0:38:35.040 --> 0:38:38.080 text when I need to be talked off a COVID ledge. 0:38:39.920 --> 0:38:44.040 But also it's thank I mean, I try, I try, 0:38:44.080 --> 0:38:47.160 but um, you guys. Katie's crib community also knows her 0:38:47.160 --> 0:38:50.640 because Dr Daniel Taylor was featured on one of the 0:38:50.640 --> 0:38:55.400 episodes last season where we talked about developmental milestones of 0:38:55.480 --> 0:38:57.520 a one year old and it was an episode with 0:38:57.600 --> 0:39:05.760 Nicolette Um, Robinson right yep and Jamie Yes, Jamie yes, um, 0:39:05.840 --> 0:39:10.120 So thank you for taking the time of course. Um. 0:39:10.280 --> 0:39:12.279 Also to give you guys a visual, she's wearing her 0:39:12.440 --> 0:39:20.239 very cool teenage Sons gaming headset. It's all I had. Well, 0:39:20.280 --> 0:39:23.319 I'm in my closet, so you know. So have you 0:39:23.360 --> 0:39:28.160 actually personally seen any pediatric COVID cases. Um, it's a 0:39:28.160 --> 0:39:31.000 little bit of a loaded question. Um. When COVID first 0:39:31.000 --> 0:39:33.520 came to New York, it was you know, we were 0:39:33.560 --> 0:39:36.680 the epicenter in the United States. We didn't have a 0:39:36.680 --> 0:39:39.400 lot of testing, We didn't have a lot of a 0:39:39.440 --> 0:39:42.440 lot of things. So we saw what we were calling 0:39:42.480 --> 0:39:45.600 presumed COVID. So we have a lot because we're at 0:39:45.440 --> 0:39:49.680 a university medical center, we had a lot of physicians 0:39:49.840 --> 0:39:52.960 who could get tested and then their children would have 0:39:53.000 --> 0:39:56.040 fevers and they would have COVID and I would we 0:39:56.080 --> 0:39:59.000 would have seen them or children looking back, who it 0:39:59.160 --> 0:40:01.719 wasn't the flu lasted a really long time. It wasn't 0:40:01.719 --> 0:40:04.440 anything we could figure out, and then they just kind 0:40:04.440 --> 0:40:08.439 of recovered. Um. So now when we're testing kids, were 0:40:08.440 --> 0:40:11.279 typically testing them if they're really sick or going to 0:40:11.320 --> 0:40:13.480 the hospital. So we have had patience in my practice 0:40:13.480 --> 0:40:16.160 that have tested positive for sure. And for children, is 0:40:16.200 --> 0:40:18.400 it the same as adults? Is it a nose swab? 0:40:18.480 --> 0:40:21.080 Because I've had it that test twice and that is 0:40:21.160 --> 0:40:25.600 hard to My toddler would lose his dang mind with 0:40:25.680 --> 0:40:29.239 that saying up his yes, it's not fun. So for 0:40:29.320 --> 0:40:31.520 little er kids, we try to do it quickly. It 0:40:31.680 --> 0:40:35.040 works better if you do it slower UM and kind 0:40:35.040 --> 0:40:37.360 of try to avoid the midline a little bit. But 0:40:37.400 --> 0:40:39.239 with little kids, they just they want to get out, 0:40:39.280 --> 0:40:40.960 so you do it. You it's like a shot, you 0:40:41.000 --> 0:40:43.440 go and you go out. UM. But yeah, it's not 0:40:43.600 --> 0:40:46.279 it's not a fun test. And what do parents have 0:40:46.360 --> 0:40:49.279 to look for symptom wise? I mean everywhere on the 0:40:49.320 --> 0:40:53.720 internet we can see the baseline symptoms for adults, you know, fever, cough, 0:40:53.840 --> 0:40:56.360 shortness of breath, those are the serious ones. Is it 0:40:56.440 --> 0:41:01.120 the same for toddlers and young little kids? It is? 0:41:01.239 --> 0:41:03.440 But what we're finding is, UM, a lot of them 0:41:03.440 --> 0:41:07.680 are are asymptomatic or or not having a lot of symptoms. UM. 0:41:07.719 --> 0:41:10.799 In most cases children's are not as sick as adults are. 0:41:10.840 --> 0:41:13.880 In most cases UM and usually it's about two to 0:41:13.960 --> 0:41:16.800 fourteen days after an exposure where they'll come down and 0:41:16.880 --> 0:41:20.479 symptoms fever. I always say the top three symptoms or fever, fever, 0:41:20.560 --> 0:41:23.920 and fever. So we're really looking for fever. And what 0:41:24.040 --> 0:41:27.560 does constitute a fever for you? Like a hundred we 0:41:27.680 --> 0:41:30.439 say call it a hundred. It's really a hundred point four, 0:41:30.480 --> 0:41:33.759 which comes from thirty eight degrees celsius um, but it's 0:41:33.800 --> 0:41:36.600 really a hundred point four rectal temperature. But you know, 0:41:36.760 --> 0:41:39.880 if you're you know, when your kids warm um and 0:41:39.920 --> 0:41:42.279 then you just kind of keep monitoring them and then 0:41:42.360 --> 0:41:45.480 cough and shortness of breath are signs that we look for. UM. 0:41:45.640 --> 0:41:49.160 Kids have more g I symptoms now that we're finding um, 0:41:49.200 --> 0:41:53.319 abdominal in belly paine um diarrhea more than adults. We're 0:41:53.320 --> 0:41:55.520 seeing some of that too. Not that you need to 0:41:55.520 --> 0:41:57.960 freak out when your kid has diarrhea, but it's just 0:41:58.360 --> 0:42:01.800 you know, we've seen some called some skin manifestations the 0:42:02.120 --> 0:42:05.160 dermatologists are telling us about, you know, covid toes or whatever, 0:42:05.200 --> 0:42:08.759 different rashes that we're seeing. So once again in linked 0:42:08.760 --> 0:42:12.120 to this secondary inflammatory disease which I want to get to. 0:42:12.360 --> 0:42:15.560 It can be the abdominal symptoms certainly are seen in there, 0:42:15.600 --> 0:42:18.200 but it can also be presenting symptom of we've seen 0:42:18.200 --> 0:42:20.520 nothing else. We're just not sure about a lot of it. 0:42:21.320 --> 0:42:24.080 So when you say covid toes, is that just super 0:42:24.160 --> 0:42:26.400 red like it just looks like they look like it 0:42:26.440 --> 0:42:30.080 looks like frost bite from what they've they've described to me, 0:42:30.600 --> 0:42:32.839 But it's not. It's like or it can be little 0:42:32.880 --> 0:42:37.479 dots like on the tip of the toes. I've seen pictures. See. 0:42:37.520 --> 0:42:40.080 I had a friend who's toddler two years old tested 0:42:40.080 --> 0:42:42.920 positive for COVID and the only thing she had, like 0:42:42.960 --> 0:42:46.080 you said, fever, fever fever. She had twelve hours of 0:42:46.120 --> 0:42:51.000 A hundred and two and they took her in and um, 0:42:51.040 --> 0:42:52.719 they honestly thought it was like a U t I 0:42:52.760 --> 0:42:55.040 because they were potty training her and she was holding 0:42:55.080 --> 0:42:57.439 a lot and or they thought it was everything else. 0:42:57.440 --> 0:42:59.120 And the doctor was like, should we test for COVID? 0:42:59.160 --> 0:43:01.440 And honestly everyone was like, I mean should we? We've 0:43:01.480 --> 0:43:04.480 been completely quarantined, haven't seen anybody. And they did run 0:43:04.520 --> 0:43:06.799 the test and she did have it, but that, thank god, 0:43:06.920 --> 0:43:10.480 was all she had. We hear stories like that a lot. 0:43:10.880 --> 0:43:14.480 So I was talking to a mom today with a rash. 0:43:14.760 --> 0:43:18.160 Could it be COVID? Sure, but if once again, if 0:43:18.200 --> 0:43:20.800 your child's okay, comfortable, you're not rushing to the hospital 0:43:21.320 --> 0:43:25.319 if it's COVID, okay, But let's you know, let's let's 0:43:25.360 --> 0:43:27.600 just leave her and see what happens and see if 0:43:27.640 --> 0:43:29.480 she gets sicker, because we don't want to we also 0:43:29.520 --> 0:43:31.600 don't want to alarm everybody and how I went rushing 0:43:31.600 --> 0:43:34.800 the hospital. Right. We don't want to be putting our children. 0:43:34.840 --> 0:43:36.759 I know. I've never been on such high alert for 0:43:36.880 --> 0:43:39.839 my kid falling. Like he's such a toddler. He's such 0:43:39.880 --> 0:43:42.640 a beast right now and a monster physically, and I'm 0:43:42.680 --> 0:43:45.680 just like, now is not the time to crack your head. 0:43:45.719 --> 0:43:47.960 I don't want to go to the hospital. I don't 0:43:48.000 --> 0:43:49.759 want to go to the hospital. I don't want to 0:43:49.800 --> 0:43:52.040 go to the hospital. My daughter got stitches in the 0:43:52.040 --> 0:43:54.279 middle of March or the end of March, and I 0:43:54.360 --> 0:43:58.520 was I was beside myself. No, not about stitches, because 0:43:58.560 --> 0:44:00.920 kids get stitches, but you know, know, just to be 0:44:01.080 --> 0:44:05.120 around the hospital when you when it's scary, when there's 0:44:05.120 --> 0:44:08.240 things that are contagious there right now. But the pediatric hospitals, 0:44:08.239 --> 0:44:12.040 to be honest with you, are pretty tame because kids 0:44:12.040 --> 0:44:16.080 are not getting as severe symptoms. They're actually not and 0:44:16.200 --> 0:44:18.799 they're taking all the precautions now, more than you know 0:44:19.719 --> 0:44:22.839 late February early March when we knew nothing. I think 0:44:22.880 --> 0:44:24.839 we're taking a lot more precautions now. So if your 0:44:24.880 --> 0:44:28.200 child does have to go to the hospital, go right, right, 0:44:28.280 --> 0:44:32.560 right right. That's why aren't kids getting it like adults. 0:44:32.600 --> 0:44:36.080 Such a good question and when that I have no 0:44:36.200 --> 0:44:39.719 answer to. UM, they don't know, they don't know. There's 0:44:39.760 --> 0:44:41.839 a lot of theories. I'm not sure I even want 0:44:41.840 --> 0:44:44.680 to talk theories. We don't even need it, but we 0:44:44.719 --> 0:44:48.880 don't know. We don't know. UM, can you explain this 0:44:49.040 --> 0:44:54.839 secondary inflammatory disease that it sounds like the majority of 0:44:55.040 --> 0:44:59.920 toddler and children COVID cases, thank god, have been manageable, 0:45:00.280 --> 0:45:03.520 the majority of them. But then there's this awful thing 0:45:03.600 --> 0:45:05.520 that you know more about because I read a lot 0:45:05.560 --> 0:45:08.160 about it in cases in New York of kids weeks 0:45:08.280 --> 0:45:11.680 after they had had COVID symptoms, they get some sort 0:45:11.680 --> 0:45:15.120 of secondary inflammatory disease. What does that look like? So 0:45:15.360 --> 0:45:18.000 I just want to say, and you set it beautifully, 0:45:18.040 --> 0:45:22.600 it's so rare. It's really really very rare. UM. And 0:45:22.960 --> 0:45:26.040 the case reports came out kind of weeks after UM 0:45:26.080 --> 0:45:29.319 and they kind of pieced it together as to associated 0:45:29.320 --> 0:45:32.560 with COVID and UM it is, you know, three to 0:45:32.680 --> 0:45:37.040 six weeks after either a positive swab the horrible swab 0:45:37.080 --> 0:45:41.160 we talked about, or antibodies or an exposure to covid UM. 0:45:41.280 --> 0:45:46.600 And what we're seeing very rare is the same thing, um, fever, 0:45:47.080 --> 0:45:50.440 abdominal pain, um. But these are kids that get much 0:45:50.480 --> 0:45:52.480 much sicker and probably need to go, you know, to 0:45:52.560 --> 0:45:58.080 the hospital. Rash, red eyes, mucous membrane involvement, some neurocognitive 0:45:58.160 --> 0:46:03.920 like confused headache, lethargy, confusion, UM, some respiratory symptoms, and 0:46:03.960 --> 0:46:06.080 the g I symptoms. Was the thing that was surprising 0:46:06.680 --> 0:46:09.200 is sometimes he's you know, fever, but fever for four days. 0:46:09.680 --> 0:46:11.359 I mean I saw some kids with diarrhea. I call 0:46:11.400 --> 0:46:13.399 the air. They said, no, we need really really need fever. 0:46:13.880 --> 0:46:16.000 We need them to have a fever, fever, fever fever. 0:46:16.719 --> 0:46:18.920 You know it's I didn't know until I was a 0:46:18.960 --> 0:46:23.320 mom myself, but I was one of those moms, um 0:46:23.400 --> 0:46:27.560 that went to the pediatrician like you a lot, text 0:46:27.640 --> 0:46:30.400 you a lot. Like it took me a while to 0:46:30.480 --> 0:46:35.080 get my mommy muscle strong to know the difference between 0:46:35.920 --> 0:46:38.920 he's having an off day and something's actually going on. 0:46:39.640 --> 0:46:43.240 And I really have to like implore all you moms listening, 0:46:43.719 --> 0:46:46.840 you've got it. Like I know when my kid feels 0:46:46.840 --> 0:46:49.240 hot and has a fever. I know when he's acting 0:46:49.280 --> 0:46:53.160 not himself. I know when he's just not interested in 0:46:53.200 --> 0:46:56.080 dinner that night, or is actually like not eating and 0:46:56.120 --> 0:46:58.839 not acting like himself and his lethargic. It's happened only 0:46:58.880 --> 0:47:00.680 a few times in his two an half years, but 0:47:00.719 --> 0:47:03.560 it was clear that he was not himself. It's the 0:47:03.640 --> 0:47:06.720 question I always ask, what does your guts say? Because 0:47:06.719 --> 0:47:08.879 I can't. You're with them, you know your child. I'm 0:47:08.920 --> 0:47:11.160 on the phone or on telehealth or maybe even in 0:47:11.200 --> 0:47:12.920 the office, but you know your child. What does your 0:47:12.920 --> 0:47:15.960 guts say is going on? And it's not a frivolous 0:47:16.040 --> 0:47:18.080 or a throwaway, it's it's really I want to it's 0:47:18.120 --> 0:47:20.239 really they really know your kid, like when they're not 0:47:20.520 --> 0:47:22.719 when you're doing something with them that they love to 0:47:22.760 --> 0:47:25.840 do and they have no interest, right, they're just like 0:47:25.880 --> 0:47:28.200 they can't even get you know. It's like, okay, we're 0:47:28.239 --> 0:47:31.680 in a mode here that things need to be looked at. Um, 0:47:31.719 --> 0:47:34.839 how can it affect newborns? Is there again not much 0:47:34.920 --> 0:47:37.120 info on there's not a lot of information on it. 0:47:37.200 --> 0:47:40.560 I mean, um, so because you're getting admitted to the 0:47:40.560 --> 0:47:43.839 hospital when you're pregnant and having a baby, they test you. 0:47:44.360 --> 0:47:46.760 And actually it was a shocking number when we were 0:47:46.800 --> 0:47:49.840 at the peak, A shocking number of asymptomatic moms, pregnant 0:47:49.880 --> 0:47:53.759 women who were testing positive that had no idea. Some 0:47:53.840 --> 0:47:56.160 of them had some symptoms and some didn't. UM. But 0:47:56.239 --> 0:47:59.239 then we subsequently test the fathers and the babies and 0:47:59.280 --> 0:48:02.200 really we haven't seeing a lot of transmission. There are 0:48:02.239 --> 0:48:06.399 isolated cases, very few once again of transmission, but they're 0:48:06.400 --> 0:48:09.200 not sure what it means if it happens, but we 0:48:09.200 --> 0:48:11.719 are testing the babies in it for now. The newborns 0:48:11.880 --> 0:48:14.680 seam okay. Once again, such a small sample size. This 0:48:14.840 --> 0:48:18.400 is also new um and just not a lot of cases. 0:48:19.640 --> 0:48:23.640 Should all kids be in masks at all times? No, 0:48:24.360 --> 0:48:28.160 if you're if your home and you're with your family, 0:48:28.239 --> 0:48:30.520 that's your kind of bubble. Of course, you don't need 0:48:30.520 --> 0:48:34.919 to be in a mask. UM. The recommendations is are 0:48:34.960 --> 0:48:38.800 over two years old outside in the environment, you should 0:48:38.840 --> 0:48:41.560 be in a mask. So if you're if you're outside 0:48:41.600 --> 0:48:44.800 or if you're you know, close to other people, UM, 0:48:44.880 --> 0:48:47.399 you should be in a mask over if you're over two. 0:48:47.920 --> 0:48:51.400 And this is a listener's question that I'm gonna jump to. 0:48:51.680 --> 0:48:56.680 But this mask wearing and toddlers, is it doing damage 0:48:56.719 --> 0:48:59.200 to their psyche? Is the I mean or do we not? 0:48:59.440 --> 0:49:01.320 I mean look is it. It's just more important to 0:49:01.400 --> 0:49:03.680 keep them not sick. Mental health is I think is 0:49:03.960 --> 0:49:06.360 going to be the huge kind of lingering thing, and 0:49:06.400 --> 0:49:08.600 not because of mask wearing. I think it's because of 0:49:09.280 --> 0:49:10.840 you know, I think I think we're gonna have to 0:49:10.880 --> 0:49:13.360 make sure our kids are okay, make sure they're mentally okay, 0:49:13.400 --> 0:49:16.440 make sure they're comfortable, and make sure they feel good. Um. 0:49:16.480 --> 0:49:17.960 I don't think the mask is going to do it. 0:49:17.960 --> 0:49:20.880 It's very funny. I have patience. I now know that 0:49:20.920 --> 0:49:24.080 babies can see you smile even when you have a 0:49:24.120 --> 0:49:26.120 mask on. They look at your eyes. I can smile 0:49:26.160 --> 0:49:28.200 at a baby with them and I wear like full 0:49:28.239 --> 0:49:30.719 on and they can they smile back. They look at 0:49:30.719 --> 0:49:33.080 your eyes. It's amazing and incredible and something I actually 0:49:33.120 --> 0:49:36.479 didn't know. Oh wow, that's comfortable, and they still smile. 0:49:36.520 --> 0:49:38.400 They don't seem to be you're either they're trying to 0:49:38.400 --> 0:49:41.200 grab it off your face, which which happens to or 0:49:41.239 --> 0:49:43.880 there you know, and they can see you smile. So 0:49:43.920 --> 0:49:46.200 I don't think that's the issue. I don't think we're 0:49:46.239 --> 0:49:49.440 doing damage their psyche. And of course you can explain, 0:49:49.480 --> 0:49:51.359 you know, this is something we do. We're not trying 0:49:51.400 --> 0:49:53.520 to spread, just like washing your hands using they love 0:49:53.560 --> 0:49:56.240 pure l. So I think if you love to yourls 0:49:56.239 --> 0:49:58.360 love purel. So if the whole thing is, how do 0:49:58.400 --> 0:50:01.160 I convince him not to suck his after I've pure it? 0:50:01.320 --> 0:50:03.680 Like because I'm purelling in the car, you know, if 0:50:03.719 --> 0:50:06.799 we've you know, we have my pot open to just 0:50:06.880 --> 0:50:08.920 my brother and if we like, go there or I 0:50:08.960 --> 0:50:11.200 don't know, like whatever we're doing. We're purelling all the 0:50:11.280 --> 0:50:16.319 day time. And then you you soap in water. Yeah, 0:50:16.480 --> 0:50:18.439 and then get him, get him a substitution, something else 0:50:18.440 --> 0:50:23.000 you can suck on. Yeah, yep, yes, see listen to this. 0:50:23.000 --> 0:50:27.040 This is why she is um the best in your opinion? 0:50:27.840 --> 0:50:30.520 When will we have a vaccine for kids? Oh? Another 0:50:30.600 --> 0:50:33.439 another question? I love. It's funny. A couple of days ago, 0:50:33.480 --> 0:50:36.319 I would have said two years, eighteen months to two years, 0:50:36.360 --> 0:50:39.920 but it looks like they're fast tracking some things. But um, 0:50:40.680 --> 0:50:43.800 kids are going to be last, right, which, in all fairness, 0:50:43.960 --> 0:50:45.960 they're not getting as sick. So kids are going to 0:50:46.040 --> 0:50:48.960 be last because when we have vaccines, they have to 0:50:49.040 --> 0:50:51.560 be you know, tried it, and usually it's a the 0:50:51.600 --> 0:50:55.279 adult population first before they can so, so kids will 0:50:55.280 --> 0:51:00.160 be the last ones but eighteen months, twelve to eighteen months, 0:51:00.640 --> 0:51:03.440 it's not going to be tomorrow. No, So we have 0:51:03.520 --> 0:51:06.680 to really Yeah, the mom's out there who are really 0:51:06.760 --> 0:51:08.839 like leaning on it's going to be over soon. It's 0:51:08.840 --> 0:51:11.320 going to be over soon. Should really figure out mental 0:51:11.480 --> 0:51:14.279 health ways to let that idea go. Yeah, I mean 0:51:15.200 --> 0:51:17.560 it once again though, it's it's not touching your face. 0:51:17.600 --> 0:51:19.560 It's wearing a mask, it's not touching your face, is 0:51:19.560 --> 0:51:22.359 washing your hands, it's just being diligent and being kind 0:51:22.400 --> 0:51:25.600 to your neighbor, not coughing and sneezing on your friends. 0:51:25.880 --> 0:51:31.520 I mean, there's a lot of basic obviously like yeah, yeah, yeah, 0:51:31.680 --> 0:51:33.960 are you worried? This is this is what I talked 0:51:33.960 --> 0:51:35.880 about with a lot of my friends. When we the 0:51:36.000 --> 0:51:40.360 kids do go back to school, are we completely freaked 0:51:40.400 --> 0:51:43.719 about the regular stuff? Like I feel like in my household, 0:51:44.080 --> 0:51:48.320 knock on wood, no one has gotten a cold, pink eye, diarrhea, 0:51:48.600 --> 0:51:54.000 all the usual things that we would have in cycles 0:51:54.040 --> 0:51:56.160 all the time last year because my kid was on 0:51:56.200 --> 0:51:58.000 play dates, or he was in a toddler and me 0:51:58.160 --> 0:52:01.520 class and you know, or I had three friends and 0:52:01.520 --> 0:52:03.600 their kids over and this one got pink eye in 0:52:03.640 --> 0:52:06.320 their class and now we all have it, like, because 0:52:06.360 --> 0:52:10.040 there's been such a stop to all of the other 0:52:11.080 --> 0:52:15.960 toddler Petrie dish in school situations, what the hell is 0:52:16.000 --> 0:52:18.120 that going to look like when we're back. I'm scared. 0:52:18.880 --> 0:52:22.000 I mean those things are seasonal anyway, So I don't 0:52:22.000 --> 0:52:24.200 think one or two years not getting a cold or 0:52:24.200 --> 0:52:25.799 not getting pink eye. You know, if you don't get 0:52:25.800 --> 0:52:27.560 pink eye this year, you'll get it in two years. 0:52:28.000 --> 0:52:30.640 I don't think it's gonna and you would have anyway 0:52:30.719 --> 0:52:33.000 because none of that can you know, you don't get 0:52:33.000 --> 0:52:36.239 immunity for more than about a year for that stuff. Um, 0:52:36.320 --> 0:52:39.000 So I don't think a year of kids not getting 0:52:39.160 --> 0:52:41.400 and we're seeing believe it or not, even people that 0:52:41.440 --> 0:52:45.640 are healthy, we're still seeing Coxsackie. We're still seeing rosiola, 0:52:45.760 --> 0:52:48.959 which we don't really. People are shocked. They're like, we've 0:52:49.000 --> 0:52:51.399 we've got nowhere, We've seen nowhere. How are they still 0:52:51.440 --> 0:52:54.839 getting this? That is a mystery. Um, either they're not 0:52:54.920 --> 0:52:57.720 as safe as they believe to be, or it's something 0:52:57.800 --> 0:53:00.600 latent that just comes out that's just they or you 0:53:00.640 --> 0:53:02.840 know when it is. I think kids are going to 0:53:02.920 --> 0:53:04.920 get sick, whether you you know you have a sibling 0:53:04.920 --> 0:53:07.960 and you get sick when you're six months old, or 0:53:08.040 --> 0:53:10.880 you don't see anybody till you're in kindergarten and you 0:53:10.920 --> 0:53:13.040 get sick when you're in kindergarten. I think one year 0:53:13.080 --> 0:53:19.080 of not having the Petri dishes. Okay, Okay, see guys, ha, 0:53:19.480 --> 0:53:22.319 I just took a really nice collective breath because I'm 0:53:22.360 --> 0:53:25.920 just so like, whenever my kid does go back to school, 0:53:26.200 --> 0:53:28.359 we are going to be sick for two years. Like 0:53:28.480 --> 0:53:31.080 I'm like, I mean, the flues and the colds and 0:53:31.120 --> 0:53:33.280 the caves and the sore throats and the strep throats 0:53:33.320 --> 0:53:35.680 and all that garbage. But I guess it'll just pick 0:53:35.760 --> 0:53:38.600 up and be normal. Like it'll be really good hands 0:53:39.040 --> 0:53:43.480 oh that's true, feel really good at covering their silver lining. 0:53:43.600 --> 0:53:45.680 They'll be good handwashers, will be good at covering their 0:53:45.719 --> 0:53:48.600 mouths um, and they'll they'll be a little bit like 0:53:48.760 --> 0:53:51.280 stand back, you know, they'll be a little bit probably 0:53:51.680 --> 0:53:56.200 better at it. That's very true. Um. A lot of 0:53:56.280 --> 0:53:59.600 listeners have school and daycare questions that I'm going to 0:53:59.680 --> 0:54:02.000 get you right now. And thank you all you awesome 0:54:02.040 --> 0:54:04.160 listeners for getting back to us and being part of 0:54:04.160 --> 0:54:08.040 the Katie's crib community and asking these awesome questions. So, um, 0:54:08.120 --> 0:54:11.120 Shelly asks, I have three year old twins. One twin 0:54:11.160 --> 0:54:14.160 has chronic asthma. The twins are supposed to start preschool 0:54:14.160 --> 0:54:17.319 in September. My son's allergists said the social benefits of 0:54:17.320 --> 0:54:20.400 preschool outweigh the risks of him getting COVID and impacting 0:54:20.480 --> 0:54:25.160 his asthma. Thoughts, Um, I think it depends on where 0:54:25.200 --> 0:54:27.680 you live. So you have to look at the numbers. 0:54:27.840 --> 0:54:30.120 You know, right now New York is really low, other 0:54:30.160 --> 0:54:32.600 places are really high. I think what they've laid out 0:54:32.600 --> 0:54:34.920 for when they're going to start stuff, and what percent 0:54:34.960 --> 0:54:37.600 of people need to be negative or represent need to 0:54:37.600 --> 0:54:40.040 be positive, and how quickly that goes up. You know, 0:54:40.080 --> 0:54:42.359 you've got twins, so I feel like the socialization isn't 0:54:42.520 --> 0:54:44.319 kind of already there because you've got two of them. 0:54:44.800 --> 0:54:47.880 But that's true if your allergist is saying it. So 0:54:47.920 --> 0:54:50.200 I don't know the severity of the asthma or anything 0:54:50.239 --> 0:54:53.680 like that, but um, I think you listen to your doctors, 0:54:53.760 --> 0:54:56.480 look at ask your preschool what they're doing. If they're like, wow, 0:54:56.600 --> 0:54:59.239 just come back in, then maybe you look again. And 0:54:59.280 --> 0:55:01.359 if they have a if they have an actual plan. 0:55:01.840 --> 0:55:04.600 They're looking at filters, They're looking you know, filters in 0:55:04.600 --> 0:55:06.839 the areation. If they're going to be outside a lot 0:55:06.840 --> 0:55:08.239 of the time, if they're going to have like a 0:55:08.680 --> 0:55:10.920 what they're calling cohorts or bubbles of kids that they 0:55:11.000 --> 0:55:14.080 keep together, they have to have a plan. I think, 0:55:14.520 --> 0:55:16.640 I think you just want to know. I've been feeling 0:55:16.680 --> 0:55:19.680 that a lot with my group, with my mom friends, 0:55:19.760 --> 0:55:22.600 and that a lot of people who because I Albi 0:55:22.640 --> 0:55:24.920 hasn't started preschool yet, and I looked at a bunch 0:55:24.960 --> 0:55:27.480 and so you guys know like in l A and 0:55:27.520 --> 0:55:29.680 not everyone has this, but a lot of the preschools 0:55:29.719 --> 0:55:33.880 are moving completely outdoors, no indoor classes for a while, 0:55:34.360 --> 0:55:37.200 and then they're splitting the playyards so that kids are 0:55:37.200 --> 0:55:40.200 sort of split into like four to six kids pods 0:55:40.880 --> 0:55:42.520 um that they will stick with the whole time. And 0:55:42.560 --> 0:55:44.960 then and then a bunch of the preschools have like 0:55:45.680 --> 0:55:48.840 put in running rivers in the front of soap and water, 0:55:49.280 --> 0:55:52.280 like like kids are washing their hands every thirty minutes, 0:55:52.400 --> 0:55:55.680 or what's their plan for potty breaks? You know, like 0:55:55.719 --> 0:55:58.080 who's cleaning the bathroom in between each person? Like these 0:55:58.120 --> 0:56:02.399 are the questions I've slowly learned through friends to ask like, um, 0:56:02.400 --> 0:56:06.040 how are they cleaning the inside? With what you have 0:56:06.160 --> 0:56:08.920 to trust? You're gonna have to trust your kids, bestie also, 0:56:09.000 --> 0:56:11.279 because those are the people that are going to be 0:56:11.480 --> 0:56:13.320 putting you at risk or not putting at risk. I 0:56:13.320 --> 0:56:15.120 think you have to have you can have conversations with 0:56:15.320 --> 0:56:17.960 you know, we're in the same pod. We gotta we 0:56:17.960 --> 0:56:19.560 gotta do this, we gotta do the right thing, And 0:56:19.600 --> 0:56:21.920 I think that's an important conversation to have as well. 0:56:22.280 --> 0:56:26.359 It's a lot like safe sex. It's so insane, like 0:56:26.719 --> 0:56:29.960 because we've only opened our pod to one other family. Um, 0:56:30.000 --> 0:56:32.880 they live around the corner. The mother is eight and 0:56:32.880 --> 0:56:35.359 a half months pregnant, which is really scary because she 0:56:35.920 --> 0:56:37.840 we all want to keep her protected and her daughter 0:56:37.880 --> 0:56:41.239 is six weeks younger than my son. And we're the 0:56:41.280 --> 0:56:43.919 parents are very very good friends, and we it took 0:56:43.960 --> 0:56:47.600 weeks of deliberation where we felt like, hey, these are 0:56:47.600 --> 0:56:49.719 the rules. I'm going to tell you if I've seen 0:56:49.719 --> 0:56:51.719 anybody else, and then you can decide if you want 0:56:51.760 --> 0:56:55.440 to take a fourteen daybreak from plate dates. It's a 0:56:55.440 --> 0:56:59.320 trust thing, but it's literally like who how many partners 0:56:59.360 --> 0:57:02.680 have you had? How to use protection. It's like insane, 0:57:02.760 --> 0:57:06.960 It's like, oh my gosh. Absolutely, Hi Katie, this is 0:57:07.000 --> 0:57:10.080 from Renee. I live in a dense area of Boston. 0:57:10.280 --> 0:57:13.480 I'm a mom of four little ones. Wow, bravo to you, 0:57:13.800 --> 0:57:17.080 ages six to five months. When my daughter's school opens 0:57:17.080 --> 0:57:18.440 in the fall and she goes to first grade, what 0:57:18.480 --> 0:57:20.120 are some ways I can keep the babies at home 0:57:20.160 --> 0:57:22.320 healthy from the school germs. So you brings home. All 0:57:22.360 --> 0:57:24.840 three older kids share one room in our twelve square 0:57:24.840 --> 0:57:27.120 foot department. Oh and then I just have to add 0:57:27.160 --> 0:57:29.240 this part. She wrote, You're my favorite actress. Thank you 0:57:29.280 --> 0:57:31.520 for being there for me during long lonely post part 0:57:31.600 --> 0:57:33.880 of days in the form of scandal and through this podcast. 0:57:33.880 --> 0:57:36.480 So much love, Renee. Yeah, I love you, Renee. That 0:57:36.480 --> 0:57:39.120 it's so nice of you sending so much love to you. 0:57:39.360 --> 0:57:43.400 That's wonderful. Okay, I forgot the question. No, I'm kidding. 0:57:44.720 --> 0:57:46.680 So she has an older kid that she wants to 0:57:46.760 --> 0:57:48.520 go back to school, and then she has little ones. 0:57:48.600 --> 0:57:50.800 Oh God, what do you do there? Um? You know, 0:57:50.920 --> 0:57:52.800 So it's it's what I do. So I go to work. 0:57:52.880 --> 0:57:56.040 I go to work every day. Um, I've been wearing scrubs. 0:57:56.120 --> 0:57:58.720 I love them. Um, I changed when I get home. 0:57:58.760 --> 0:58:00.200 I watched my The first thing I do when I 0:58:00.200 --> 0:58:03.120 get to work is wash my hands. The first thing 0:58:03.200 --> 0:58:05.120 I do when I get home is wash my hands 0:58:05.520 --> 0:58:08.320 and take a shower. Um, So I think it's I mean, 0:58:08.720 --> 0:58:11.520 I think when she comes home, you can you can 0:58:11.520 --> 0:58:14.800 have home clothes or you know, hang out pajamas if 0:58:14.800 --> 0:58:16.960 you really want to be safe. Since they're so so close, 0:58:17.280 --> 0:58:19.640 make sure she washes her hands. Um, you can give 0:58:19.640 --> 0:58:21.160 her shaff you, but make make sure you do it 0:58:21.160 --> 0:58:23.280 once over on her. I'm assuming she's the oldest or 0:58:23.320 --> 0:58:25.720 the eldest, so not touching her face, not coughing, she 0:58:25.720 --> 0:58:27.439 shouldn't have to wear a mask in her own house. 0:58:27.520 --> 0:58:31.040 I don't. I think that's reasonable. But I think if 0:58:31.040 --> 0:58:33.320 she comes home and washes her hands and washes her face, 0:58:33.400 --> 0:58:35.600 and we talked about not coughing, and and then as 0:58:35.640 --> 0:58:38.400 soon as you see an inkling of you know, maybe 0:58:38.400 --> 0:58:41.640 a fever something, then you can call your pediatrician. Maybe 0:58:42.320 --> 0:58:44.040 put her a little bit to the side. Yeah, from 0:58:44.080 --> 0:58:48.200 the other kids, So let me ask about that sort 0:58:48.240 --> 0:58:52.240 of leads us into visitors and at natural ce Levine, 0:58:53.680 --> 0:58:56.280 she asks, I will deliver second baby in October. The 0:58:56.320 --> 0:58:58.760 first child turns through in November. How do I manage 0:58:58.760 --> 0:59:01.040 parents and in laws that want help with both kids 0:59:01.040 --> 0:59:03.680 but won't have been in our COVID bubble beforehand. One 0:59:03.680 --> 0:59:06.240 set is local, one set will travel across the country. 0:59:06.280 --> 0:59:09.800 Do we enforce a fourteen day quarantine everyone gets tested? Help? 0:59:09.960 --> 0:59:12.920 This is a huge hot topic question for everyone I 0:59:12.960 --> 0:59:18.160 know pregnant at the moment and really needing assistance and 0:59:18.280 --> 0:59:21.760 help in their home with either family that lives close 0:59:21.760 --> 0:59:24.360 by or a night nurse, or like, how do people 0:59:25.480 --> 0:59:29.200 deal with family immediate family and getting them in their 0:59:29.240 --> 0:59:32.800 bubbles for when the baby comes. So I'll answer the 0:59:32.800 --> 0:59:35.640 easy question first, which is people that live in your 0:59:35.640 --> 0:59:38.640 hometown and local people. You certainly I think it's reasonable 0:59:38.640 --> 0:59:43.120 to ask to quarantine for fourteen days. Um. Yeah, people 0:59:43.160 --> 0:59:45.080 that are flying across the country, I think it's a 0:59:45.080 --> 0:59:48.480 little more difficult. It's you know, they're going to be flying, 0:59:48.520 --> 0:59:50.200 they're going to be on a plane, they're gonna be 0:59:51.200 --> 0:59:53.720 in the universe. So I think, you know, asking them 0:59:53.720 --> 0:59:56.520 to get tests when they get local, um, but having 0:59:56.520 --> 0:59:59.600 them safe or reasonable enough time. So that's that's a 1:00:00.080 --> 1:00:02.680 thing to do. But I think it's doable and the 1:00:02.800 --> 1:00:06.040 risk reward of having your family close and being able 1:00:06.080 --> 1:00:09.080 to help is important as well when you're a new mom. 1:00:09.120 --> 1:00:12.800 And do you think people who are flying should get 1:00:12.840 --> 1:00:16.560 tested and quarantine for fourteen days? If that's even a reality? 1:00:16.600 --> 1:00:18.520 I mean, who who can take off? You know? Good 1:00:18.600 --> 1:00:20.840 Lord like that? I mean that would be perfection, But 1:00:21.120 --> 1:00:24.400 I think it's probably going to be one or the other. Yeah. Um. 1:00:24.480 --> 1:00:28.919 In reality from Panama, she says, thank you for opening 1:00:29.000 --> 1:00:33.280 up this space my pleasure. Um. This is from Alejandra 1:00:33.400 --> 1:00:35.560 and she says, I'm a teacher. I'm a mommy of 1:00:35.560 --> 1:00:38.280 three little ones, nine, five and six months old. Like 1:00:38.360 --> 1:00:40.560 any mom, my biggest concern is if I get sick, 1:00:40.600 --> 1:00:42.760 who cares for my little ones? Especially a baby who's 1:00:42.760 --> 1:00:45.200 still nursing? Which brings me to my question. If you 1:00:45.240 --> 1:00:48.000 test positive for coronavirus and have to self isolate, can 1:00:48.080 --> 1:00:50.840 you continue nursing? Does testing positive mean you need to 1:00:50.880 --> 1:00:52.760 be away from your children for two weeks while you 1:00:52.800 --> 1:00:56.200 stop being positive? Many thanks for providing the space for 1:00:56.240 --> 1:01:01.160 worried mommies like me. So the guidelines are to take precautions, 1:01:01.320 --> 1:01:04.320 wear a mask, wash your hands, wash all your tubing, 1:01:04.360 --> 1:01:08.560 and your breast pump stuff really well. Um, and they 1:01:08.600 --> 1:01:11.160 haven't seen I mean, once again, the data is so 1:01:11.240 --> 1:01:14.480 little for you know, a positive you know, but they 1:01:14.480 --> 1:01:19.200 haven't seen a lot of transmission. Um. But take precautions 1:01:19.040 --> 1:01:23.160 as you would if you were in you know, outside 1:01:23.240 --> 1:01:25.720 or with someone who is who you thought might be positive. 1:01:25.760 --> 1:01:30.480 So masks, handwashing, and and keeping separate when you're not, 1:01:30.840 --> 1:01:33.280 you know, for for a little while until you're negative. Yeah, 1:01:33.320 --> 1:01:37.040 maybe fourteen days of like staying away and only being 1:01:37.120 --> 1:01:41.640 near the baby while breastfeeding exactly. Yeah, I wonder pumping, Yeah, 1:01:41.800 --> 1:01:44.720 pumping or you like wear gloves and a mask, mask 1:01:44.840 --> 1:01:48.160 and do mostly pumping and a few breastfeeds a day, 1:01:48.200 --> 1:01:51.080 depending on how many feeds you're doing a day exact. 1:01:51.080 --> 1:01:54.160 They're hoping they're antibodies that way too, because usually nursing 1:01:54.160 --> 1:01:57.520 their anabo where they're hoping that that's transmissible, but studies 1:01:57.520 --> 1:02:02.680 aren't conclusive yet. So gosh, Dr Daniel Taylor, you are 1:02:03.480 --> 1:02:07.800 just everyone everyone feel her vibe. See it's so for me, 1:02:08.000 --> 1:02:11.440 it's like to have a calm pediatriction is like a 1:02:11.680 --> 1:02:17.640 perfect yin to my yang. Any partying bits of advice 1:02:17.880 --> 1:02:21.160 or wisdom or just you want to talk me off 1:02:21.160 --> 1:02:25.240 a ledge in front of everybody. Sure sure, UM, I, 1:02:25.360 --> 1:02:28.000 just as a healthcare provider want to say, don't don't 1:02:28.000 --> 1:02:32.240 miss your appointments, vaccinate on time. Don't feel like we're open. 1:02:32.840 --> 1:02:36.640 We're we're you can call and ask what we're doing. 1:02:36.680 --> 1:02:39.880 We're seeing babies in the morning, younger kids in the afternoon. 1:02:40.040 --> 1:02:43.320 In six spots are just very little. We're separating everybody. 1:02:43.360 --> 1:02:45.760 But keep your appointments and vaccinate because we don't want 1:02:45.760 --> 1:02:47.520 this to end and then have a pandemic of something 1:02:47.560 --> 1:02:50.960 else that's you know, kids could get vaccinated for. So 1:02:51.080 --> 1:02:54.240 make sure you keep those appointments. UM call us talk 1:02:54.320 --> 1:02:57.720 to us, UM call before find out what's an emergency. 1:02:57.800 --> 1:03:00.400 Don't freak out on your own. Don't just run to 1:03:00.440 --> 1:03:06.840 the emergency. Call us and trust us UM to answer questions. UM. 1:03:07.040 --> 1:03:11.400 Follow the rules, wear masks, wash your hands, limit your 1:03:11.440 --> 1:03:15.040 contacts UM because it's it's the easiest way to have 1:03:15.080 --> 1:03:17.360 all of this. Be a little bit more behind us. 1:03:17.760 --> 1:03:21.800 Be patient, Be patient with your doctors, Be patient with yourself. 1:03:21.880 --> 1:03:24.480 Be patient with the new rules. Sometimes only one parent 1:03:24.560 --> 1:03:26.520 can come in sometimes I mean be patient that we're 1:03:26.520 --> 1:03:30.280 doing it too to protect everybody. And if if our 1:03:30.320 --> 1:03:32.280 guidelines are different one day than they were the next. 1:03:32.320 --> 1:03:35.040 Stay to be patient with that too, because it's all new. 1:03:35.680 --> 1:03:39.080 This is really you're bringing up such great points I had. 1:03:39.120 --> 1:03:42.280 I was pushing my Albie's two and a half year 1:03:43.000 --> 1:03:45.919 check up and pushing it and pushing it, and then 1:03:46.000 --> 1:03:48.560 I called and asked the doctor like a million questions, 1:03:48.560 --> 1:03:50.640 like how are you keeping separate? And they only had 1:03:50.680 --> 1:03:53.200 appointments for non sick kids in the morning, and they 1:03:53.200 --> 1:03:55.760 were super spaced out. I didn't see anybody, and it 1:03:55.880 --> 1:03:59.320 was so great and so well handled. And I'm sure, like, 1:04:00.000 --> 1:04:02.479 how many doctors are doing that at like you said 1:04:02.520 --> 1:04:05.920 you are. And then I think that the that pediatricians 1:04:05.920 --> 1:04:10.240 in general like have just been so wonderful at moving 1:04:10.400 --> 1:04:14.520 so many medical things to phone calls, questions and tele medicine. 1:04:14.560 --> 1:04:17.560 Like so if you're having that gut sort of twinge 1:04:17.640 --> 1:04:21.000 that something's not right, it's like I can send photos 1:04:21.040 --> 1:04:23.640 like in this time, my son's tooth has turned gray 1:04:24.040 --> 1:04:28.720 from a fall. He's had weird broken capillaries on his 1:04:28.800 --> 1:04:32.160 face from a crying fit he had, And I'm just 1:04:32.240 --> 1:04:35.360 like sending close up photos with my actor audition ring 1:04:35.440 --> 1:04:38.200 light to my you know, to you oh, I sent 1:04:38.320 --> 1:04:42.960 you pictures of his gray tooth, because but like I 1:04:43.040 --> 1:04:47.320 just feel like we really have to call on our pediatricians, 1:04:47.360 --> 1:04:49.680 like you're saying, ask a lot of questions, use the phone, 1:04:49.920 --> 1:04:54.720 use FaceTime, email, pictures like whatever, so that you can 1:04:54.840 --> 1:04:57.760 stay on top of any symptoms you see. Um, but 1:04:57.800 --> 1:05:00.400 also keep caring for your kid, because they do other 1:05:00.400 --> 1:05:02.720 stupid stuff that has nothing to do with COVID, A 1:05:02.760 --> 1:05:05.800 lot of false a lot of trampoline stuff. Um, there's 1:05:05.920 --> 1:05:10.280 there's actually a pitch the American Academy of Pediatrics AP 1:05:10.680 --> 1:05:13.600 hashtag call your pediatrician. I mean, it's just call us. 1:05:13.600 --> 1:05:15.200 We're here, we want we want to talk to you. 1:05:15.240 --> 1:05:17.360 We want to talk to you after ledge. Thank you 1:05:17.400 --> 1:05:19.360 so much for being on Katie's crib and for being 1:05:19.360 --> 1:05:23.560 a voice of reason during this very epic, intense stressful 1:05:24.240 --> 1:05:27.800 time for new moms, for moms of toddlers, for moms 1:05:27.800 --> 1:05:31.920 with multiple kids, and at Katie's crib. This is the 1:05:31.920 --> 1:05:36.280 info we have right now on COVID. Thanks for having me. 1:05:36.720 --> 1:05:40.560 Thank you, Dr Daniel Taylor. Thank you guys so much 1:05:40.600 --> 1:05:44.160 for listening. I hope that helped calm some of your nerves. 1:05:44.200 --> 1:05:48.200 Stay calm, carry on, You got this subscribe, tell your friends, 1:05:48.280 --> 1:05:51.439 follow us on all the socials at Katie's Crib, and also, 1:05:51.520 --> 1:05:53.520 if you have any thoughts or ideas of things you'd 1:05:53.520 --> 1:05:55.280 like to hear more about, you can email me at 1:05:55.360 --> 1:05:59.560 Katie's Crib at Shonda land dot com. Thanks guys, till 1:05:59.600 --> 1:06:09.560 next time, ka Katie's Crib is a production of iHeart 1:06:09.640 --> 1:06:12.560 Radio and Shonda Land Audio. For more podcasts from I 1:06:12.640 --> 1:06:15.680 Heart Radio, visit the I heart Radio app, Apple Podcasts, 1:06:15.800 --> 1:06:19.240 or wherever you listen to your favorite shows. I'm coming 1:06:19.320 --> 1:06:24.680 for you, I Want You, Want You, Want You