Speaker 1: Welcome to Katie's Crib, a production of My Heart Radio
Speaker 1: and Shondaland Audio. Hi, guys, thank you so much for
Speaker 1: listening to Katie's Crib. I have a big episode for
Speaker 1: you guys today. We are in the middle of a
Speaker 1: global pandemic. Actually I just said middle, and I don't
Speaker 1: even know if we're in the middle. We don't know
Speaker 1: if we're in the middle close to the end, at
Speaker 1: the beginning, we don't know. A lot of things are
Speaker 1: out of our control. We are here, we are quarantining,
Speaker 1: we are facing COVID nineteen. And since the start of
Speaker 1: the shutdown, I have been getting so many texts and
Speaker 1: emails from friends and friends of friends about how to
Speaker 1: mom during this time, how to keep our kids safe.
Speaker 1: And I was like, you, guys, Katie's Crib, we got
Speaker 1: to get you some answers. So I'm really excited about
Speaker 1: today's episode and bringing you guys some up to date information.
Speaker 1: And I have to say that, as you know, information
Speaker 1: is changing daily on this disease, so what we have
Speaker 1: right now is up to date, but also could be changing.
Speaker 1: I have two awesome doctors on today's episode. The first
Speaker 1: is Dr Rushmi Raw. She is absolutely wonderful, and she
Speaker 1: came on to discuss pregnancy and COVID. She is the
Speaker 1: high risk doctor in the Department of Obstetrics and Gynecology
Speaker 1: at U c l A Health. I also have on
Speaker 1: my New York City pediatrician, Dr Danielle Taylor to come
Speaker 1: on and talk to us about COVID and our tiny humans. So,
Speaker 1: without further ado, let's welcome Dr Rushmi Raw. Let's get
Speaker 1: right into it and get some of these I have
Speaker 1: a great list of text and emails from personal friends, family,
Speaker 1: and from a ton of our awesome Katie's crib listeners.
Speaker 1: So pandemic or not, people are trying to conceive during
Speaker 1: this time, like that is happening? Um, we have one
Speaker 1: listener at Danielle and Collins writes, if I'm wanting to
Speaker 1: have another child, should I wait for some sort of
Speaker 1: resolution to the pandemic or vaccine? Seems like an awful
Speaker 1: time to bring another child into the world, but we
Speaker 1: want to expand our family. Have you been having clients
Speaker 1: asked this question? What's your consensus on this? So, yeah, Katie,
Speaker 1: thank you so much for having me. I really appreciate it. Um.
Speaker 1: So these are really great questions. UM and absolutely right.
Speaker 1: This is a question I get asked almost daily. You know,
Speaker 1: what I tell patients is, from a medical standpoint, I'm
Speaker 1: not advising against pregnancy. I'm not telling them to hold
Speaker 1: off on pregnancy. UM. At this time, there really isn't
Speaker 1: much data to support and increased risk to a woman
Speaker 1: or her future child, so much so that getting pregnant
Speaker 1: is considered a contradication. UM. From a personal standpoint, I
Speaker 1: think that there's a lot of things to consider. There's
Speaker 1: financial stressors right now, there's a lot of community stressors
Speaker 1: right now, and I think that those are definitely important
Speaker 1: things to consider. But I think those are personal and
Speaker 1: not so much from a medical standpoint. Yeah, that's great
Speaker 1: to know. We have another listener by the name of
Speaker 1: Rebecca who wrote in that she was really wanting to
Speaker 1: have a baby, but because things saying it's a personal choice,
Speaker 1: Like if you can look at your pregnancy as maybe
Speaker 1: not being able to have the village you imagined having,
Speaker 1: it takes a village, right, Like maybe your parents can't
Speaker 1: fly in, maybe you you can't go to the baby
Speaker 1: classes you wanted to go to, Maybe you can't take
Speaker 1: a tour of the hospital in advance. To put your
Speaker 1: anxiety at ease. So it's really it's a personal question
Speaker 1: of how you deal with anxiety, finances all of these things. Right. Absolutely,
Speaker 1: you bring up a really good point there, and we
Speaker 1: are actually seeing a lot of an increased in terms
Speaker 1: of anxiety and even PTSD type symptoms. UM, anxiety is
Speaker 1: worse than by isolation. And essentially we're asking a lot
Speaker 1: of our women to be isolated. We're asking a lot
Speaker 1: of people to be isolated. It absolutely takes a village
Speaker 1: from both a professional and personal standpoint, I agree with that.
Speaker 1: And we are in a time right now where it's
Speaker 1: hard to have a village when we're asking everyone to
Speaker 1: stay kind of quarantine. So these are these are really
Speaker 1: important things to consider and think about how you would
Speaker 1: handle that if you were to get pregnant in the future. UM.
Speaker 1: And so I think that these are really reasonable things
Speaker 1: to consider, and those are the things that I would
Speaker 1: tell my patients. Just think about before you make the decision. Great,
Speaker 1: can COVID nineteen be sexually transmitted? So, as of right now,
Speaker 1: COVID nineteen is not considered to be a sexually transmitted virus.
Speaker 1: COVID nineteen is a respiratory virus UM. It's mainly transmitted
Speaker 1: by respiratory droplets and secretions. UM. So as of right now,
Speaker 1: that is not something that we have any medical data for. UM.
Speaker 1: This is huge. I have a lot of friends asking this,
Speaker 1: does COVID nineteen effect male fertility? Do we know? Very
Speaker 1: good question. We don't. Short answers, we don't know. There
Speaker 1: has been COVID nineteen found in sperm in some case reports. UM.
Speaker 1: But what that means mackerel landing. So what that means
Speaker 1: in terms of whether that causes issues with future pregnancies
Speaker 1: or um. Again, we have no data that that can
Speaker 1: be transmitted UM. If you guys remember Zeca from back
Speaker 1: in the day that was also found to be instpirmed,
Speaker 1: but that really didn't mean a whole lot of issues
Speaker 1: in terms of transmission or in terms of men giving
Speaker 1: it to women. But we did at that point advise
Speaker 1: against um, you know, men and women having sex at
Speaker 1: that time, but that was a very different virus for
Speaker 1: equividing team where we just don't have any data right now.
Speaker 1: Can it affect female fertility? Again, no data? UM. You know,
Speaker 1: if we think about and this is I should have
Speaker 1: actually just opened up with this, which is that this
Speaker 1: is such a new virus. We're really five to six
Speaker 1: months into this UM and no, nobody can really be
Speaker 1: an expert at this point because data takes lots of
Speaker 1: time and takes lots of reports and numbers in order
Speaker 1: for us to make conclusions that really I would feel
Speaker 1: comfortable saying, yes, this is absolutely what we know and
Speaker 1: what we don't know UM. And with COVID nineteen being
Speaker 1: on the United in the United States for five to
Speaker 1: six months, we don't have data on women who or
Speaker 1: men who have been trying to get pregnant for a
Speaker 1: prolonged period of time and starting to see issues with
Speaker 1: fertility UM and so based off of just the time
Speaker 1: the limited time period, I would say we just don't
Speaker 1: know yet. M hm okay, I have Nikki rights, Hi.
Speaker 1: I love your show, Thanks Nikki, and have listened to
Speaker 1: it way before I knew I was trying for a baby.
Speaker 1: I am currently thirteen weeks pregnant and I am a
Speaker 1: teacher in NYC school district. Is it high risk for
Speaker 1: pregnant women to work in schools even with social distance protocols?
Speaker 1: Should the schools allow teachers to work from home? I
Speaker 1: heard they are hearing now that pregnant women are considered
Speaker 1: higher risk. Is this true? Why or why not? Yeah, Nikki,
Speaker 1: you've got a lot of questions. I hear you, girl,
Speaker 1: We all do. So. Yeah, there's a lot to unpack
Speaker 1: in that in that question. And um, so let me
Speaker 1: try and break that down. So are pregnant women considered
Speaker 1: higher risk? So, in general, pregnant women are considered to
Speaker 1: be an immunocompromised population, meaning that they tend to get
Speaker 1: UM infections at a higher rate than people who have
Speaker 1: a competent immune system. So prior stars and Mirrors and
Speaker 1: even the influence of IRUs definitely affected pregnant women UM
Speaker 1: at more severe rates. What we are seeing right now
Speaker 1: is that that's not necessarily true with CoV two, which
Speaker 1: is COVID nineteen. However, the CDC did just put out
Speaker 1: a publication back in the end of June, so just recently.
Speaker 1: UM their data show that pregnant women did have an
Speaker 1: increased risk of hospitalization and an increased risk of ic
Speaker 1: YOU admission and an increased risk of mechanical ventilation, but
Speaker 1: not an increased risk of death. With that being said,
Speaker 1: there is a caveat that the CDC data that we
Speaker 1: did get had a very low percent of the people
Speaker 1: who responded or they were notified, um who we had
Speaker 1: a answer on whether or not they were pregnant. We
Speaker 1: don't know if our denominator was accurate. So with that
Speaker 1: being that, I think it's hard to make conclusions based
Speaker 1: off of that particular study, and they mentioned that in
Speaker 1: their report as well. So I think that what we
Speaker 1: know for sure is that pregnant women can get sick,
Speaker 1: whether they are going to be at increased risk for
Speaker 1: having severe disease or have an increased risk of fatality
Speaker 1: or death. I think that still remains to be seen,
Speaker 1: and we're not necessarily seeing even from my practice, and
Speaker 1: you know from what we're seeing out there, that that's
Speaker 1: happening in large numbers. So yes, I what I tell
Speaker 1: my God, thank God for that exactly. So what I'm
Speaker 1: telling my patients is, you know, pregnant women can get sick.
Speaker 1: I don't want you to get sick. So if you know,
Speaker 1: we can be at work. I mean everyone needs to work,
Speaker 1: Everyone needs to be functional and try and be in
Speaker 1: the society and make this whole you know, stressful time
Speaker 1: work for us. But with that being said, it has
Speaker 1: to be within reason and it has to be safe.
Speaker 1: So you have to have the protective here, you have
Speaker 1: to be socially distanced, you have to have availability to
Speaker 1: wash your hands and stay safe. If we feel like
Speaker 1: that's not the case, then I would say the option
Speaker 1: to work from home should be allowed for pregnant women. Awesome,
Speaker 1: that's great. Um, oh, this is huge. I've been reading
Speaker 1: a lot about this. Next question, communities of color are
Speaker 1: being hit disproportionately hard by COVID in examining the cases
Speaker 1: of pregnant women. What is the data showing thus far
Speaker 1: and can like what can public health officials do to
Speaker 1: combat this? This upsets me more than any I'm like,
Speaker 1: beside myself, this is such an important question. So I
Speaker 1: completely agree that the data so far does support that
Speaker 1: women of color, specifically Hispanic and Black women are being
Speaker 1: disproportionately affected by COVID. Nineteen prior to COVID, we actually
Speaker 1: we're seeing that, and I'm sure that's something that's on it,
Speaker 1: you know, everyone's radar as well. But maternal mortality was
Speaker 1: a lot higher in the black population and women of
Speaker 1: color as well, So this isn't something that's new to us.
Speaker 1: And now that we've got COVID, we're seeing the same
Speaker 1: thing that women of color, Hispanic and Black women are
Speaker 1: just proportionately affected. We do have data for this. Similarly,
Speaker 1: in that CDC report that I mentioned, what it showed
Speaker 1: was that out of all the women who had COVID,
Speaker 1: nineteen percent were Hispanic women, were Black women, were white women.
Speaker 1: But when you contrast that with the rates of births
Speaker 1: into Gusen nineteen Hispanic women only made Black women only
Speaker 1: made fifteen percent. So they're disproportionately being affected. So that
Speaker 1: data is real. Are we are seeing that and even
Speaker 1: from my own personal experience, we are seeing that Hispanic
Speaker 1: women I practice in California. Hispanic women are disproportionately affected here.
Speaker 1: So this is an incredibly important topic and something that
Speaker 1: I want to stress that we all from a medical standpoint,
Speaker 1: need to be paying attention to. Um What can we
Speaker 1: do about this? I think medical and public health communities
Speaker 1: first need to examine their own employe that bias and
Speaker 1: work on re examining how you can resolve this, because
Speaker 1: if you don't recognize what's happening, it's going to be
Speaker 1: impossible to fix it. So that's number one. I think
Speaker 1: number two you have to be transparent with data. You
Speaker 1: have to examine your own data. You have to see
Speaker 1: what's really happening and be able to tackle what where
Speaker 1: the need is UM. And then you know what you
Speaker 1: do once you have the data is you have to
Speaker 1: commit to future research and treatment addressing and eliminating that disparity. UM.
Speaker 1: To give you an example, you know, it's it's things
Speaker 1: like Priority, which I'm going to talk about, which is
Speaker 1: an organization that is looking at research and pregnancy and COVID.
Speaker 1: They may announce that they're working on a reproductive Health
Speaker 1: Equity and Birth Justice core looking at exactly this is unbelievable.
Speaker 1: I want to do I mean, this is a side
Speaker 1: note and you I want to do a whole episode
Speaker 1: about this. I just think this is insane and I
Speaker 1: want to hear more in depth about the work Priority
Speaker 1: is doing. Absolutely, it's so important. It is so time.
Speaker 1: Yeah no, no, I totally agree with you. And so essentially,
Speaker 1: you know, we're looking at trying to increase our recruitment efforts,
Speaker 1: particularly in the Black, Indigenous and people of color. UM.
Speaker 1: If you don't have these people involved in your research, UM,
Speaker 1: and you have to actually reach out to these communities
Speaker 1: to have them be the ones who tell us what
Speaker 1: is important. We can't just be doing research what we
Speaker 1: think is important. We have to reach out to all
Speaker 1: of these communities and have them involved and then make
Speaker 1: special efforts to try and address these situations. So I'm
Speaker 1: so glad you brought it up. It is so incredibly important. Wow.
Speaker 1: Um okay. At Nikki Friedlin writes what could happen to
Speaker 1: a pregnant mom if she gets COVID? Have any newborns
Speaker 1: had COVID and what are the symptoms? Okay, I know
Speaker 1: a little bit about this answer, but I probably don't
Speaker 1: know the up to date stuff you know. Okay, So, yes,
Speaker 1: pregnant women can get COVID, and there have been case
Speaker 1: reports of newborns who have COVID as well. Um, it
Speaker 1: is it follows very similar to the general population in
Speaker 1: that of pregnant women who will get COVID will have
Speaker 1: mild or asymptomatic symptoms or disease. Um may have severe
Speaker 1: issues with COVID, and five percent may be critical. Um,
Speaker 1: and that's about the percentages And that's not exactly that's
Speaker 1: about the percentages we're seeing in pregnancy as well. So,
Speaker 1: like I mentioned, pregnant women can get COVID. So I
Speaker 1: tell all of my patients to to follow all of
Speaker 1: the CDC recommendations and stay home and stay safe. Newborns
Speaker 1: can get COVID. We have seen that happen, whether it's
Speaker 1: happening because it's being vertically transmitted, meaning going from mom
Speaker 1: to baby, or if it's happening after the baby is
Speaker 1: born in the immediate exposures that they get once the
Speaker 1: baby is born. That piece of it is not completely
Speaker 1: ironed out yet, although we are getting data as you mentioned,
Speaker 1: day by day. Um. So you know, most of the newborns,
Speaker 1: most of children who get it have very very mild symptoms. Um.
Speaker 1: But in a in a newborn it would be and
Speaker 1: I'm not the experts, I would defer to the pediatricians
Speaker 1: on this one, but on in newborns it's usually fever
Speaker 1: um sometimes as it can be what was actually reported
Speaker 1: out in the France study with some neurologic symptoms. Yes,
Speaker 1: there was a study that came out in France that
Speaker 1: it was transferred through the placenta from a COVID positive
Speaker 1: mom too. I don't know how many, but a baby
Speaker 1: or some babies, but a few, okay, one great one
Speaker 1: baby dies I have a doctor on this show. She
Speaker 1: knows UM and the baby, I guess for like two weeks.
Speaker 1: I'm putting this in Katie speak, you guys, but the
Speaker 1: baby for two weeks had some respiratory issue and some
Speaker 1: inflammatory brain stuff, which is horrifying and terrifying. But after
Speaker 1: two weeks, the baby they seem to be okay correct
Speaker 1: so far, but like, we don't know if there's long
Speaker 1: term effects, but at the moment, the baby seems to
Speaker 1: have made it full circle, not going would thank God
Speaker 1: didn't die or something, you know like that. This one.
Speaker 1: I get asked a lot for people who are trying
Speaker 1: to conceive or are very early has COVID proven We
Speaker 1: probably don't know you, But has has COVID caused miscarriage?
Speaker 1: That is also a question that I get on the daily. Um,
Speaker 1: I think, but we're seeing right now the data that's
Speaker 1: that's currently being quoted. Again, this is just preliminary stuff
Speaker 1: and things are evolving every single day. But what we're
Speaker 1: seeing right now is miscarriage rate is on the order
Speaker 1: of about two so not incredibly high growth restriction, which
Speaker 1: is you know, when you get COVID or any infection,
Speaker 1: you often have issues with babies growing well. That rate
Speaker 1: is about ten percent, which is on the order of
Speaker 1: what we've seen in a general population, but the preterm
Speaker 1: birth rate is higher. Um And again this is data
Speaker 1: we have from women who are super sick with COVID,
Speaker 1: people who end up in the I c U. But
Speaker 1: we are seeing a ventilators on eventilator exactly. But we
Speaker 1: are seeing that the pre term birth rates can be
Speaker 1: on the order oh god, okay, so if okay, So
Speaker 1: what we're seeing is if you have a really bad
Speaker 1: case of COVID, we're delivering babies really early, really early,
Speaker 1: really to actually means less than thirty seven weeks. That's
Speaker 1: considered preturn. But yes, in my experience and what I've
Speaker 1: seen so far in the literature, it is that if
Speaker 1: a woman ends up being super sick to the point
Speaker 1: where she is in the I see you and on eventilator,
Speaker 1: we do seem to be delivering those women sooner. I've
Speaker 1: only heard these dramatic, mythical stories of women delivering with COVID,
Speaker 1: and like, I refuse to actually google because I'm horrified
Speaker 1: and i don't want to know, but I'm going to
Speaker 1: find out now. Guys, You're welcome, but like women, what
Speaker 1: happens when they deliver with COVID. I've heard these stories
Speaker 1: of like women being put out and the baby coming
Speaker 1: out through cesarean and then they have to isolate from
Speaker 1: each other for two weeks while a mommy's pumping and
Speaker 1: comes to and then meets their baby at fourteen days
Speaker 1: or whatever. Can you tell me about this? Is this
Speaker 1: even true? Is this a movie I've made up in
Speaker 1: my head because I'm a dramatic actress in Hollywood, Like,
Speaker 1: tell me what happens if you deliver with COVID? So
Speaker 1: I think it's not entirely incorrect, but I think of
Speaker 1: COVID as what I had mentioned before, Right, eighty percent
Speaker 1: of women who have COVID are either going to be
Speaker 1: completely asymptomatic or have extremely mild disease. So for those people,
Speaker 1: and you know, a lot of institutions are testing every
Speaker 1: COVID or I'm sorry, I'm testing every pregnant woman who
Speaker 1: shows up to labor and delivery for their delivery. So
Speaker 1: a lot of the times we're picking up things that
Speaker 1: people had zero idea that they had COVID, and we're like, hey,
Speaker 1: you know, actually you are one of those asymptomatic people
Speaker 1: who have COVID, So what happens to them, they are
Speaker 1: not going to have this dramatic you know, of course
Speaker 1: as you as you delivery. Yeah, so what what's going
Speaker 1: to happen to them is that they're going to be
Speaker 1: for the most part, kind of restricted in terms of delivery,
Speaker 1: in the sense that they're not going to have a
Speaker 1: ton of people in their room. They're going to be
Speaker 1: restricted to the bare minimum, and everyone is going to
Speaker 1: be wearing full protective fear for their delivery. They do
Speaker 1: not need to wear a mask, although you know, we're
Speaker 1: going to try to have them wear a mask as
Speaker 1: much as they can, but obviously during the time of delivery,
Speaker 1: when they're pushing, UM, it is not reasonable to be
Speaker 1: wearing a mask. So we don't have our pregnant women's
Speaker 1: who are COVID positive UM wearing a mask. Not necessarily. Um,
Speaker 1: they are going to that just here or is that
Speaker 1: everywhere in the country? Do we know? You know, I
Speaker 1: think that people have gotten very creative in in barriers
Speaker 1: and things like that. People can use, you know, little
Speaker 1: shields that they try to have the pregnant women wear.
Speaker 1: But masks, I think are are physically almost impossible to do.
Speaker 1: I mean, it is, it's really hard to labor in.
Speaker 1: And I know I pushed. Yeah, I was like, if
Speaker 1: I had a mask on, I would have lost my
Speaker 1: dang mind. Yeah, yeah, absolutely not. I think it's incredibly hard.
Speaker 1: I think it's the best of intentions. You could try
Speaker 1: and have a woman wear a mask, but it's not
Speaker 1: going to stay on while she's pushing UM. But you know,
Speaker 1: I think she woman can expect a restricted kind of
Speaker 1: visitor scenario UM providers who are wearing full protective gear.
Speaker 1: It may feel a little bit scientific, but it is
Speaker 1: really just to protect everybody involved in that. Once the
Speaker 1: baby is born, the neonatal team will probably assess the baby,
Speaker 1: but the baby isn't gonna get whisked away. The baby
Speaker 1: is going to now, especially there's new data to say that,
Speaker 1: you know, we probably think the baby should stay with
Speaker 1: the mom, but mom should, you know, have as much
Speaker 1: kind of the same kind of hygiene that we would
Speaker 1: recommend for somebody who has COVID, so lots of hand
Speaker 1: washing masks when she's around the baby, um, you know,
Speaker 1: changing clothes if she's been wearing the clothes for a
Speaker 1: long time, when she's going to breastfeed. Um. There have
Speaker 1: been you know, therefore this there were some talks about
Speaker 1: completely isolating mom and baby. That is not reasonable, and
Speaker 1: now we're seeing data that that's actually probably not necessary. Um.
Speaker 1: Now that's for a woman who's asymptomatic, we're doing well.
Speaker 1: For somebody who's sick in the i c U on
Speaker 1: a ventil later, um, it probably would be something like
Speaker 1: you you would like you mentioned, you know, they would
Speaker 1: probably get delivered via csarian section. Not necessarily because they
Speaker 1: absolutely had to. But in a lot of the times
Speaker 1: when moms aren't having good oxygen, the babies aren't getting
Speaker 1: good oxygen, and their heart rates starts to do things
Speaker 1: that make us worry, and so we want to get
Speaker 1: them out of that situation in a situation where we
Speaker 1: can give them, um, better oxygen, better nutrition, and so
Speaker 1: those tend to be cecerean deliveries. UM. But it's not
Speaker 1: like it's not an. Absolutely doesn't mean that just because
Speaker 1: you have COVID and you're in the I c you're
Speaker 1: gonna end up with a C section. Um, But they
Speaker 1: probably don't know their delivery because they're intubated, and you know,
Speaker 1: they haven't they're not awake and like a mom who
Speaker 1: is you know, healthy and doing well. So those would
Speaker 1: be a little bit more dramatic, I suppose where moms
Speaker 1: would probably get delivered and and meet their babies sometime
Speaker 1: down the line. My goodness. But you know, all I
Speaker 1: hear is like, as much as that's the shittiest thing ever,
Speaker 1: I can't even fathom it. All I hear on the
Speaker 1: other side is like, yeah, but they all survived, do
Speaker 1: you know what I mean? Like, I'm just like when
Speaker 1: I hear these things, I'm like, okay, but like even
Speaker 1: if it's the worst working days of your life, like
Speaker 1: you're still walking out of hospital with your baby, like,
Speaker 1: and it makes me like, like take a breath. Um.
Speaker 1: I mean I think it makes all of us cringe too.
Speaker 1: I mean, we our hearts go out to all of
Speaker 1: these people who you know, whether it's pregnant or not,
Speaker 1: who are in the guy see you alone because visitors
Speaker 1: are restricted. It is heartbreaking. And you know, I think
Speaker 1: that we all are trying to look at the end goal,
Speaker 1: which is trying to get everybody home, trying to get
Speaker 1: everybody alive, and although things like separation and not being
Speaker 1: awake when your baby is born sound absolutely terrible. I'm
Speaker 1: so thankful that you mentioned that we are at least
Speaker 1: trying to get them to be alive and go home
Speaker 1: with their children at some point. So that's I think
Speaker 1: the anal Yeah, like that's got to be the I mean,
Speaker 1: I'm I can only say that looking from outside of
Speaker 1: the experience. Obviously I can't even imagine going through it.
Speaker 1: But I just uh that, Yeah, I'm just relieved that
Speaker 1: these horror stories are like not ending in terrible um
Speaker 1: outcomes at Mrs b h O writes, I'm scared of
Speaker 1: not being able to have my husband speaking of restricted
Speaker 1: things in the delivery room with me if quarantine requirements
Speaker 1: become strict again. She's due September twenty one. Tell me
Speaker 1: about that ship show that when Yeah, yeah, yeah, I
Speaker 1: mean that's a reasonable concern, right, I mean, I think
Speaker 1: that it's exceedingly hard for a woman to be expected
Speaker 1: to deliver by herself, especially when she's not sick. Um.
Speaker 1: With that being said, I think it's very institution dependent,
Speaker 1: it's very hospital dependent. And we all heard of what
Speaker 1: happened in New York, and I think that you know,
Speaker 1: for what was going on at that time, they felt
Speaker 1: as I was the right decision, and by no means
Speaker 1: do I question that, But I do think it's exceedingly
Speaker 1: hard for a woman to deliver a loan when she's
Speaker 1: not sick. So with that being said, I think most
Speaker 1: places now are are at least allowing a partner in
Speaker 1: the room significant other for the delivery and for the
Speaker 1: postpartum time period. UM. Where I'm working, they definitely allow
Speaker 1: a partner in the room for the whole entire stay,
Speaker 1: which is through labor and delivery and postpartum as well. UM,
Speaker 1: it's gotten better with the more testing that we have,
Speaker 1: the better we feel about testing all the women who
Speaker 1: come through and knowing that if they're negative, their partners
Speaker 1: are likely negative. And it's not just about you know
Speaker 1: their particular situation, right. If you imagine a partner comes
Speaker 1: in and then walks out in the hallway and goes
Speaker 1: in touch with something, and it comes back in the room,
Speaker 1: and the next partner goes out in touch or something,
Speaker 1: it's it's we're trying to keep everybody safe, and it's
Speaker 1: not a small order, and so that's why we try
Speaker 1: the best we can. But I would say that that's
Speaker 1: a reasonable concern and if things start getting crazy and
Speaker 1: whatever location at you know, she is in, I would
Speaker 1: have her just reach out to her physician, reach out
Speaker 1: to her hospital early and find out what the situation is. Right.
Speaker 1: Speaking of this, when this was all going down in
Speaker 1: New York, I had a few friends deliver. Especially it
Speaker 1: was my heart goes out to a lot of women
Speaker 1: who were first time, you know, first time ever going
Speaker 1: through this without their loved one with them um and
Speaker 1: how stressful that is. And I also can only say
Speaker 1: that we just understand the disease more. I mean, if
Speaker 1: I do, then obviously all the doctors dukes, That's where
Speaker 1: I'm getting my information. But so there are ways to
Speaker 1: get that one person in there for the whole time
Speaker 1: and keep everyone separated. It's so funny. I keep having
Speaker 1: flashbacks when my son was born and we were like
Speaker 1: walking down the hallways with other people who had given
Speaker 1: birth and meeting their babies, you know what I mean.
Speaker 1: It was just so like communal almost. I yeah, I remember,
Speaker 1: I was just talking about this the other day. I
Speaker 1: remember when there was a whole families in the waiting
Speaker 1: room cheering after the baby was. My entire family was
Speaker 1: there one minute after I had Albie and we had
Speaker 1: our loan time for a couple of hours. Then as
Speaker 1: soon as we moved, my whole family came. They brought
Speaker 1: to go. I always regret what I picked. I ate salmon, like,
Speaker 1: what a dumb thing to I mean, I love my
Speaker 1: duelist so much, but she was like, you need to
Speaker 1: replenish your body. I should have had a burger and fries.
Speaker 1: That was so dumb. I should have had what I wanted. Um,
Speaker 1: but I've I had some friends make the choice to
Speaker 1: have birth at home during this time. What are I mean?
Speaker 1: I know that I think that statistically speaking, a home
Speaker 1: birth death rate is higher than a hospital one. Is
Speaker 1: that correct? Have you had patients that have been like,
Speaker 1: I'm not doing this, I'm doing this at home. Um,
Speaker 1: there's a new wave of this. What's your opinion on that? Yeah,
Speaker 1: you're spot on, Katie. Yeah, you know it is. It
Speaker 1: is increased risk to deliver at home just in general. Right,
Speaker 1: there's a very particular candidate who would be considered an
Speaker 1: appropriate home birth candidate. Somebody who is considered low risk
Speaker 1: doesn't have any risk factors. Um, you know, maternal mortality
Speaker 1: is a real thing, and so we don't and so
Speaker 1: is new and it mortality. So we really don't want
Speaker 1: people thinking that home births are the way to go.
Speaker 1: But I understand where people were coming from. You know,
Speaker 1: it's it sounded and it looked crazy. Um. The only
Speaker 1: thing that I in my opinion about this is it's
Speaker 1: it's definitely safer to deliver in a hospital than at home,
Speaker 1: especially if you are a higher risk patient. And sometimes
Speaker 1: you don't know if you're higher risk, if you haven't
Speaker 1: had prenatal care, if you haven't been kind of following up,
Speaker 1: and a lot of people have been scared to go
Speaker 1: to OBI appointments, have been scared to be you know,
Speaker 1: followed up in a hospital setting or in a clinic setting.
Speaker 1: So I would just caution people if they think about
Speaker 1: deliverering at home, to really make sure that they are
Speaker 1: an appropriate candidate, to make sure they have an appropriate
Speaker 1: certified midwife who would be available to them, and that
Speaker 1: appropriate certified midwife has a hospital that's backing them up
Speaker 1: and has a physician who's backing them up, because in
Speaker 1: the event of an emergency UM within a couple of minutes,
Speaker 1: things can go very wrong. And so you know, it's
Speaker 1: really for me, it's very it's it's scared for me
Speaker 1: to think about all those people who have made those choices.
Speaker 1: From the most part, I'm sure most of them do.
Speaker 1: Find But if you know we can prevent one mom
Speaker 1: from dying or one baby from dying by having them
Speaker 1: in a hospital, especially a hospital that has spent a
Speaker 1: lot of time and energy to make sure the infection
Speaker 1: prevention protocols are safe, then I would be in support
Speaker 1: of that. M hm, can you take us through, um
Speaker 1: what routine OBI appointments look like? Now, I think you
Speaker 1: just touched on that a little bit, so it came
Speaker 1: to my head. But um ore, OBI appointments just far less.
Speaker 1: Are women having to have their temperature taken before they
Speaker 1: walk in? Like I'm sure the waiting rooms are emptier,
Speaker 1: like everyone's got a mask on. Is that is that
Speaker 1: sort of the new wave of how we're doing things? Yeah, Katie,
Speaker 1: and you you barely need me, you know, you know
Speaker 1: all the others. Well, I think when you're a host
Speaker 1: of a mommy podcast, I text about this stuff a lot.
Speaker 1: I have a lot of phone calls. But that's what
Speaker 1: I'm hearing. Yeah, I'm guessing that people just go to
Speaker 1: the doctor less. And is that okay, So we try
Speaker 1: to eliminate all the non critical visits for whatever that means.
Speaker 1: You know, if you don't necessarily need to come in
Speaker 1: and see a physician, we try to do things over
Speaker 1: the phone or over telehealth. But we're still looking at you.
Speaker 1: But you know, we're not necessarily having you come in. UM.
Speaker 1: With that being said, we we still think it's exceedingly
Speaker 1: important to keep your obi appointments. UM. There's a reason
Speaker 1: that we see people as much as we do, and
Speaker 1: there's things that we're kind of looking out for. Um,
Speaker 1: And sometimes you just need to come in to get
Speaker 1: a blood pressure check and make sure that the baby
Speaker 1: looks okay. And so for all of those reasons, I
Speaker 1: would say, you know, just just go with the guidance
Speaker 1: of what your physician or your institution is saying to
Speaker 1: to make sure we don't miss anything that's important. UM.
Speaker 1: But yeah, you're right, that's what it looks like. You've
Speaker 1: got you know, and I can only speak from my place,
Speaker 1: but you know, we've got screeners downstairs who make sure
Speaker 1: they're screening everybody both through symptoms and through thermal scanners
Speaker 1: or temperature checks. UM. Visitors are limited only for the
Speaker 1: essential appointments, So waiting rooms are bare, and we do
Speaker 1: that on purpose so that there's not a lot of
Speaker 1: people in the waiting rooms. We want to socially distance everybody.
Speaker 1: Um and everyone is a mass. So that's that's pretty
Speaker 1: much fat on, That's exactly what's happening. Yes, I think
Speaker 1: I feel like it would be scary at first. I
Speaker 1: don't know. Man, women are so fucking resilient. I can't
Speaker 1: even believe it. I thank god women are that we're
Speaker 1: the people doing this, because I don't. I mean, I mean,
Speaker 1: it's crazy. What do you think about opening pods when
Speaker 1: women are pregnant? Like if there's a pregnant woman and
Speaker 1: she's got a toddler and there's no school and like
Speaker 1: she's losing her mind, Like, what do you think about
Speaker 1: opening up to and you know, there's all these like
Speaker 1: this is my quarantine or this is my bubble or
Speaker 1: whatever that is. Like are you having your pregnant patients
Speaker 1: completely isolate or you allowing them to open up to
Speaker 1: their discretion? I think that it's totally unreasonable to completely isolate.
Speaker 1: And as I mentioned before, I worry a lot about
Speaker 1: complete isolation and what that does to you or anybody
Speaker 1: for that matter. UM, but I do I do say,
Speaker 1: you know, if you're going to have a quarantine or
Speaker 1: a pod. While I think it's totally reasonable, I think
Speaker 1: really making sure that the other members of that team
Speaker 1: are doing kind of the same thing that you're doing
Speaker 1: and take it as seriously as you are, and you know,
Speaker 1: making it really open and um okay to say, hey,
Speaker 1: you know, I have a sniffle e nose today, I
Speaker 1: don't think I'm gonna come in and you know, not
Speaker 1: making that be an issue down the line. I think
Speaker 1: opening up those lines of communication and really um, having
Speaker 1: everybody on the same page and be just as safe
Speaker 1: um that that is reasonable, and really limiting it to
Speaker 1: as much as possible. And then just following kind of
Speaker 1: the general guidelines, which is always where a mask if
Speaker 1: you can, if you're outside, things are safer than whether
Speaker 1: you're inside and closed doors, UM, still staying a little
Speaker 1: bit distance from each other, frequent hand washing, and then
Speaker 1: the most important thing is if there's any signs of anything,
Speaker 1: whether it's a sniffle, a nose or a sort of
Speaker 1: throat or I just haven't smelled very much in the
Speaker 1: last couple of days, even that you know, um really saying,
Speaker 1: just so I start every day, I take a sip
Speaker 1: of my tea and I take a whiff and a swallow,
Speaker 1: and I'm like, yep, taste and smell. We still got it, okay.
Speaker 1: Like all my friends who got COVID, which I have
Speaker 1: a lot, that was a huge symptom for most of them. Um,
Speaker 1: what about women who have multiple children and are pregnant
Speaker 1: and they need to send their child to daycare because
Speaker 1: they have to work or they have to get their
Speaker 1: kid to some I know a lot of public schools
Speaker 1: are not opening in the fall, but they need some
Speaker 1: sort of childcare. Is that safe? What are you recommending
Speaker 1: to your pregnant patients about schools or daycares if it's
Speaker 1: at how possible to avoid while we're in a surge,
Speaker 1: I think that that's probably the way to go. But
Speaker 1: with that being said, you gotta do what you gotta do.
Speaker 1: So if your kids have to go because you've got
Speaker 1: to go to work, then that's what you do. And
Speaker 1: you just try to have them go to a place
Speaker 1: that's taking it as seriously as you are, who are
Speaker 1: following all of the guidelines. And then frequent handwashing, you know,
Speaker 1: frequent frequent handwashing, which is really hard for kids, um
Speaker 1: and for adults frankly, but you know, really kind of
Speaker 1: making that just become the every day, all the time. Um,
Speaker 1: that's the way to go. We need to do a
Speaker 1: whole episode on how to make handwashing fun for toddlers
Speaker 1: because my toddlers disgusting and he hates washing. I mean,
Speaker 1: we wash his hands so much more than we used to,
Speaker 1: and it is a struggle every Yeah, it's the worst.
Speaker 1: I need soap, I need dinosaurs swimming in there, I
Speaker 1: need I need like all that. Okay, please tell me,
Speaker 1: Please tell me that the that the not washing down
Speaker 1: of delivery boxes and take out for a pregnant woman
Speaker 1: that almost killed me in the first few weeks of quarantine. Like,
Speaker 1: are we recommend pregnant women don't have to do this anymore?
Speaker 1: Should they still be doing it? I think that, you know,
Speaker 1: wiping down boxes are probably not necessary. But what I
Speaker 1: do think is, you know, when you get anything from
Speaker 1: the outside, if it's fruit or something that's going to
Speaker 1: go directly into your mouth, wash that. But if it's
Speaker 1: going to be something that you take out of a container,
Speaker 1: you don't have to wash the container. Take things out
Speaker 1: of the container, then wash your hands really well before
Speaker 1: you eat it. That's what I would say. Um, and
Speaker 1: you can throw the container away, But wiping down the
Speaker 1: container and then taking it out and then what I mean,
Speaker 1: you just still just need to wash your hands before
Speaker 1: you eat your food. So I think, you know, just
Speaker 1: making sure that you limit as much contact with the
Speaker 1: container and everything in the house, but then just wash it.
Speaker 1: Taking everything out of the containers and then throwing the
Speaker 1: containers away and washing your hands is probably more than enough.
Speaker 1: When do you think we're gonna have a vaccine everybody?
Speaker 1: I would dream of a six month vaccine, but I
Speaker 1: think more realistically we're looking at twelve to eighteen months. Yeah,
Speaker 1: that's what I hear. Buckle up, people. The information on
Speaker 1: coronavirus and its impacts on pregnant women is rapidly changing.
Speaker 1: We've discussed this a lot um and meaningful data. The
Speaker 1: more that we collect, the better, and U c l
Speaker 1: A Health recognized that early, thank you very much, and
Speaker 1: launched a national registry which you touched on, called Priority
Speaker 1: Study or Pregnancy Coronavirus Outcomes Registry. Can you give the listeners,
Speaker 1: let's circle back. You touched on it. A little bit previously.
Speaker 1: A quick synopsis of Priority, Who qualifies to participate, what
Speaker 1: sort of data is being collected that they may be
Speaker 1: missing from the c d C where they can register.
Speaker 1: I mean this is so crucial, Like you, if you're
Speaker 1: listening to this podcast and you're pregnant, like you can
Speaker 1: really help other pregnant women through this organization. Yes, yeah,
Speaker 1: thank you so much for bringing this up. So I
Speaker 1: am so proud of my colleagues who have really kind
Speaker 1: of blaze the way in in getting this going in
Speaker 1: collaboration with uc SF. So Priority is basically a nationwide study.
Speaker 1: It's across the whole nation. We're looking at pregnant and
Speaker 1: recently pregnant women who either have had COVID or under
Speaker 1: investigation for having COVID, and the goal is really to
Speaker 1: better understand how pregnancy and postpartum, how women are really
Speaker 1: affected by COVID and their symptoms and what the impact
Speaker 1: is on pregnancy and delivery. There's three approaches to it,
Speaker 1: So one is that we are kind of doing questionnaires
Speaker 1: and its patient reported outcomes. Another aspect of it is
Speaker 1: that we are asking access to medical records for some
Speaker 1: proportion of the people. And then third we're looking at
Speaker 1: actual biospecimens, so like plus CENTA and you know, trying
Speaker 1: to answer some real science to try to figure out
Speaker 1: UM what goes on UM. And again, like I mentioned,
Speaker 1: we're trying to make a real big effort in including
Speaker 1: all racial and ethnic backgrounds and really trying to take
Speaker 1: away the disparity issue. And truthfully, anybody can be enrolled.
Speaker 1: You just have to be over thirteen years old UM,
Speaker 1: and it's any one who's either been pregnant or had
Speaker 1: been pregnant within the last six weeks. And we really
Speaker 1: welcome everybody to please to please, please please reach out
Speaker 1: to us. And you can UM reach out at Priority
Speaker 1: dot you, CSS dot edu. That's the website and it's
Speaker 1: a very very easy website. You can just go in
Speaker 1: and then roll through the website and someone will reach out.
Speaker 1: And one more time, you said, it's Priority dot U, C,
Speaker 1: S F dot E D. We're going to link to
Speaker 1: this and when I post this UM episode, I'll put
Speaker 1: a link to I mean, we really can't know anything
Speaker 1: until we study women who are going through this right now,
Speaker 1: so your experience is crucial to helping pregnant women in
Speaker 1: the future. Do you have any last piece of advice
Speaker 1: or things you want to say, Dr Rushmi Raw, this
Speaker 1: has been so eye opening and completely horrifying in some ways,
Speaker 1: but then also very relieving in other ways. UM. So yeah,
Speaker 1: I've taken some nice deep breaths. Are my friends out there? Um?
Speaker 1: Is there any last piece of word of advice? Yeah?
Speaker 1: I think you know number one. Thank you so much
Speaker 1: for having me. I think having um these informational and
Speaker 1: educational sessions are are key. UM. And just my last
Speaker 1: advices and message really is that there's a lot of
Speaker 1: people out there who are just really um interested and
Speaker 1: committed to taking care of women and taking care of
Speaker 1: pregnant women and children. And UM, I would say that
Speaker 1: we're just gonna work really hard until this is over.
Speaker 1: And if there's anything that we can do for you guys,
Speaker 1: or if there's any way you anything you need from us,
Speaker 1: just please don't hesitate to reach out. That's so nice
Speaker 1: and wonderful. See, even if you guys feel alone, you're
Speaker 1: not alone. Thank you, Dr rush me Ral. Thank you
Speaker 1: for all of your advice and intelligence and and bringing
Speaker 1: the information to the Katie's Crib listeners. You guys, thank
Speaker 1: you for listening. And up next we have Dr Daniel Taylor,
Speaker 1: who's a pediatrician from New York City who's going to
Speaker 1: give us a lot lot of information on COVID and kiddos.
Speaker 1: So thank you so much, thank you. Next, we have
Speaker 1: Dr Daniel Taylor here to answer all of our questions
Speaker 1: about kids and COVID. You guys, I am so thrilled
Speaker 1: to have Dr Danielle Taylor on and just selfishly speaking,
Speaker 1: she is my pediatrician and now she's the person I
Speaker 1: text when I need to be talked off a COVID ledge.
Speaker 1: But also it's thank I mean, I try, I try,
Speaker 1: but um, you guys. Katie's crib community also knows her
Speaker 1: because Dr Daniel Taylor was featured on one of the
Speaker 1: episodes last season where we talked about developmental milestones of
Speaker 1: a one year old and it was an episode with
Speaker 1: Nicolette Um, Robinson right yep and Jamie Yes, Jamie yes, um,
Speaker 1: So thank you for taking the time of course. Um.
Speaker 1: Also to give you guys a visual, she's wearing her
Speaker 1: very cool teenage Sons gaming headset. It's all I had. Well,
Speaker 1: I'm in my closet, so you know. So have you
Speaker 1: actually personally seen any pediatric COVID cases. Um, it's a
Speaker 1: little bit of a loaded question. Um. When COVID first
Speaker 1: came to New York, it was you know, we were
Speaker 1: the epicenter in the United States. We didn't have a
Speaker 1: lot of testing, We didn't have a lot of a
Speaker 1: lot of things. So we saw what we were calling
Speaker 1: presumed COVID. So we have a lot because we're at
Speaker 1: a university medical center, we had a lot of physicians
Speaker 1: who could get tested and then their children would have
Speaker 1: fevers and they would have COVID and I would we
Speaker 1: would have seen them or children looking back, who it
Speaker 1: wasn't the flu lasted a really long time. It wasn't
Speaker 1: anything we could figure out, and then they just kind
Speaker 1: of recovered. Um. So now when we're testing kids, were
Speaker 1: typically testing them if they're really sick or going to
Speaker 1: the hospital. So we have had patience in my practice
Speaker 1: that have tested positive for sure. And for children, is
Speaker 1: it the same as adults? Is it a nose swab?
Speaker 1: Because I've had it that test twice and that is
Speaker 1: hard to My toddler would lose his dang mind with
Speaker 1: that saying up his yes, it's not fun. So for
Speaker 1: little er kids, we try to do it quickly. It
Speaker 1: works better if you do it slower UM and kind
Speaker 1: of try to avoid the midline a little bit. But
Speaker 1: with little kids, they just they want to get out,
Speaker 1: so you do it. You it's like a shot, you
Speaker 1: go and you go out. UM. But yeah, it's not
Speaker 1: it's not a fun test. And what do parents have
Speaker 1: to look for symptom wise? I mean everywhere on the
Speaker 1: internet we can see the baseline symptoms for adults, you know, fever, cough,
Speaker 1: shortness of breath, those are the serious ones. Is it
Speaker 1: the same for toddlers and young little kids? It is?
Speaker 1: But what we're finding is, UM, a lot of them
Speaker 1: are are asymptomatic or or not having a lot of symptoms. UM.
Speaker 1: In most cases children's are not as sick as adults are.
Speaker 1: In most cases UM and usually it's about two to
Speaker 1: fourteen days after an exposure where they'll come down and
Speaker 1: symptoms fever. I always say the top three symptoms or fever, fever,
Speaker 1: and fever. So we're really looking for fever. And what
Speaker 1: does constitute a fever for you? Like a hundred we
Speaker 1: say call it a hundred. It's really a hundred point four,
Speaker 1: which comes from thirty eight degrees celsius um, but it's
Speaker 1: really a hundred point four rectal temperature. But you know,
Speaker 1: if you're you know, when your kids warm um and
Speaker 1: then you just kind of keep monitoring them and then
Speaker 1: cough and shortness of breath are signs that we look for. UM.
Speaker 1: Kids have more g I symptoms now that we're finding um,
Speaker 1: abdominal in belly paine um diarrhea more than adults. We're
Speaker 1: seeing some of that too. Not that you need to
Speaker 1: freak out when your kid has diarrhea, but it's just
Speaker 1: you know, we've seen some called some skin manifestations the
Speaker 1: dermatologists are telling us about, you know, covid toes or whatever,
Speaker 1: different rashes that we're seeing. So once again in linked
Speaker 1: to this secondary inflammatory disease which I want to get to.
Speaker 1: It can be the abdominal symptoms certainly are seen in there,
Speaker 1: but it can also be presenting symptom of we've seen
Speaker 1: nothing else. We're just not sure about a lot of it.
Speaker 1: So when you say covid toes, is that just super
Speaker 1: red like it just looks like they look like it
Speaker 1: looks like frost bite from what they've they've described to me,
Speaker 1: But it's not. It's like or it can be little
Speaker 1: dots like on the tip of the toes. I've seen pictures. See.
Speaker 1: I had a friend who's toddler two years old tested
Speaker 1: positive for COVID and the only thing she had, like
Speaker 1: you said, fever, fever fever. She had twelve hours of
Speaker 1: A hundred and two and they took her in and um,
Speaker 1: they honestly thought it was like a U t I
Speaker 1: because they were potty training her and she was holding
Speaker 1: a lot and or they thought it was everything else.
Speaker 1: And the doctor was like, should we test for COVID?
Speaker 1: And honestly everyone was like, I mean should we? We've
Speaker 1: been completely quarantined, haven't seen anybody. And they did run
Speaker 1: the test and she did have it, but that, thank god,
Speaker 1: was all she had. We hear stories like that a lot.
Speaker 1: So I was talking to a mom today with a rash.
Speaker 1: Could it be COVID? Sure, but if once again, if
Speaker 1: your child's okay, comfortable, you're not rushing to the hospital
Speaker 1: if it's COVID, okay, But let's you know, let's let's
Speaker 1: just leave her and see what happens and see if
Speaker 1: she gets sicker, because we don't want to we also
Speaker 1: don't want to alarm everybody and how I went rushing
Speaker 1: the hospital. Right. We don't want to be putting our children.
Speaker 1: I know. I've never been on such high alert for
Speaker 1: my kid falling. Like he's such a toddler. He's such
Speaker 1: a beast right now and a monster physically, and I'm
Speaker 1: just like, now is not the time to crack your head.
Speaker 1: I don't want to go to the hospital. I don't
Speaker 1: want to go to the hospital. I don't want to
Speaker 1: go to the hospital. My daughter got stitches in the
Speaker 1: middle of March or the end of March, and I
Speaker 1: was I was beside myself. No, not about stitches, because
Speaker 1: kids get stitches, but you know, know, just to be
Speaker 1: around the hospital when you when it's scary, when there's
Speaker 1: things that are contagious there right now. But the pediatric hospitals,
Speaker 1: to be honest with you, are pretty tame because kids
Speaker 1: are not getting as severe symptoms. They're actually not and
Speaker 1: they're taking all the precautions now, more than you know
Speaker 1: late February early March when we knew nothing. I think
Speaker 1: we're taking a lot more precautions now. So if your
Speaker 1: child does have to go to the hospital, go right, right,
Speaker 1: right right. That's why aren't kids getting it like adults.
Speaker 1: Such a good question and when that I have no
Speaker 1: answer to. UM, they don't know, they don't know. There's
Speaker 1: a lot of theories. I'm not sure I even want
Speaker 1: to talk theories. We don't even need it, but we
Speaker 1: don't know. We don't know. UM, can you explain this
Speaker 1: secondary inflammatory disease that it sounds like the majority of
Speaker 1: toddler and children COVID cases, thank god, have been manageable,
Speaker 1: the majority of them. But then there's this awful thing
Speaker 1: that you know more about because I read a lot
Speaker 1: about it in cases in New York of kids weeks
Speaker 1: after they had had COVID symptoms, they get some sort
Speaker 1: of secondary inflammatory disease. What does that look like? So
Speaker 1: I just want to say, and you set it beautifully,
Speaker 1: it's so rare. It's really really very rare. UM. And
Speaker 1: the case reports came out kind of weeks after UM
Speaker 1: and they kind of pieced it together as to associated
Speaker 1: with COVID and UM it is, you know, three to
Speaker 1: six weeks after either a positive swab the horrible swab
Speaker 1: we talked about, or antibodies or an exposure to covid UM.
Speaker 1: And what we're seeing very rare is the same thing, um, fever,
Speaker 1: abdominal pain, um. But these are kids that get much
Speaker 1: much sicker and probably need to go, you know, to
Speaker 1: the hospital. Rash, red eyes, mucous membrane involvement, some neurocognitive
Speaker 1: like confused headache, lethargy, confusion, UM, some respiratory symptoms, and
Speaker 1: the g I symptoms. Was the thing that was surprising
Speaker 1: is sometimes he's you know, fever, but fever for four days.
Speaker 1: I mean I saw some kids with diarrhea. I call
Speaker 1: the air. They said, no, we need really really need fever.
Speaker 1: We need them to have a fever, fever, fever fever.
Speaker 1: You know it's I didn't know until I was a
Speaker 1: mom myself, but I was one of those moms, um
Speaker 1: that went to the pediatrician like you a lot, text
Speaker 1: you a lot. Like it took me a while to
Speaker 1: get my mommy muscle strong to know the difference between
Speaker 1: he's having an off day and something's actually going on.
Speaker 1: And I really have to like implore all you moms listening,
Speaker 1: you've got it. Like I know when my kid feels
Speaker 1: hot and has a fever. I know when he's acting
Speaker 1: not himself. I know when he's just not interested in
Speaker 1: dinner that night, or is actually like not eating and
Speaker 1: not acting like himself and his lethargic. It's happened only
Speaker 1: a few times in his two an half years, but
Speaker 1: it was clear that he was not himself. It's the
Speaker 1: question I always ask, what does your guts say? Because
Speaker 1: I can't. You're with them, you know your child. I'm
Speaker 1: on the phone or on telehealth or maybe even in
Speaker 1: the office, but you know your child. What does your
Speaker 1: guts say is going on? And it's not a frivolous
Speaker 1: or a throwaway, it's it's really I want to it's
Speaker 1: really they really know your kid, like when they're not
Speaker 1: when you're doing something with them that they love to
Speaker 1: do and they have no interest, right, they're just like
Speaker 1: they can't even get you know. It's like, okay, we're
Speaker 1: in a mode here that things need to be looked at. Um,
Speaker 1: how can it affect newborns? Is there again not much
Speaker 1: info on there's not a lot of information on it.
Speaker 1: I mean, um, so because you're getting admitted to the
Speaker 1: hospital when you're pregnant and having a baby, they test you.
Speaker 1: And actually it was a shocking number when we were
Speaker 1: at the peak, A shocking number of asymptomatic moms, pregnant
Speaker 1: women who were testing positive that had no idea. Some
Speaker 1: of them had some symptoms and some didn't. UM. But
Speaker 1: then we subsequently test the fathers and the babies and
Speaker 1: really we haven't seeing a lot of transmission. There are
Speaker 1: isolated cases, very few once again of transmission, but they're
Speaker 1: not sure what it means if it happens, but we
Speaker 1: are testing the babies in it for now. The newborns
Speaker 1: seam okay. Once again, such a small sample size. This
Speaker 1: is also new um and just not a lot of cases.
Speaker 1: Should all kids be in masks at all times? No,
Speaker 1: if you're if your home and you're with your family,
Speaker 1: that's your kind of bubble. Of course, you don't need
Speaker 1: to be in a mask. UM. The recommendations is are
Speaker 1: over two years old outside in the environment, you should
Speaker 1: be in a mask. So if you're if you're outside
Speaker 1: or if you're you know, close to other people, UM,
Speaker 1: you should be in a mask over if you're over two.
Speaker 1: And this is a listener's question that I'm gonna jump to.
Speaker 1: But this mask wearing and toddlers, is it doing damage
Speaker 1: to their psyche? Is the I mean or do we not?
Speaker 1: I mean look is it. It's just more important to
Speaker 1: keep them not sick. Mental health is I think is
Speaker 1: going to be the huge kind of lingering thing, and
Speaker 1: not because of mask wearing. I think it's because of
Speaker 1: you know, I think I think we're gonna have to
Speaker 1: make sure our kids are okay, make sure they're mentally okay,
Speaker 1: make sure they're comfortable, and make sure they feel good. Um.
Speaker 1: I don't think the mask is going to do it.
Speaker 1: It's very funny. I have patience. I now know that
Speaker 1: babies can see you smile even when you have a
Speaker 1: mask on. They look at your eyes. I can smile
Speaker 1: at a baby with them and I wear like full
Speaker 1: on and they can they smile back. They look at
Speaker 1: your eyes. It's amazing and incredible and something I actually
Speaker 1: didn't know. Oh wow, that's comfortable, and they still smile.
Speaker 1: They don't seem to be you're either they're trying to
Speaker 1: grab it off your face, which which happens to or
Speaker 1: there you know, and they can see you smile. So
Speaker 1: I don't think that's the issue. I don't think we're
Speaker 1: doing damage their psyche. And of course you can explain,
Speaker 1: you know, this is something we do. We're not trying
Speaker 1: to spread, just like washing your hands using they love
Speaker 1: pure l. So I think if you love to yourls
Speaker 1: love purel. So if the whole thing is, how do
Speaker 1: I convince him not to suck his after I've pure it?
Speaker 1: Like because I'm purelling in the car, you know, if
Speaker 1: we've you know, we have my pot open to just
Speaker 1: my brother and if we like, go there or I
Speaker 1: don't know, like whatever we're doing. We're purelling all the
Speaker 1: day time. And then you you soap in water. Yeah,
Speaker 1: and then get him, get him a substitution, something else
Speaker 1: you can suck on. Yeah, yep, yes, see listen to this.
Speaker 1: This is why she is um the best in your opinion?
Speaker 1: When will we have a vaccine for kids? Oh? Another
Speaker 1: another question? I love. It's funny. A couple of days ago,
Speaker 1: I would have said two years, eighteen months to two years,
Speaker 1: but it looks like they're fast tracking some things. But um,
Speaker 1: kids are going to be last, right, which, in all fairness,
Speaker 1: they're not getting as sick. So kids are going to
Speaker 1: be last because when we have vaccines, they have to
Speaker 1: be you know, tried it, and usually it's a the
Speaker 1: adult population first before they can so, so kids will
Speaker 1: be the last ones but eighteen months, twelve to eighteen months,
Speaker 1: it's not going to be tomorrow. No, So we have
Speaker 1: to really Yeah, the mom's out there who are really
Speaker 1: like leaning on it's going to be over soon. It's
Speaker 1: going to be over soon. Should really figure out mental
Speaker 1: health ways to let that idea go. Yeah, I mean
Speaker 1: it once again though, it's it's not touching your face.
Speaker 1: It's wearing a mask, it's not touching your face, is
Speaker 1: washing your hands, it's just being diligent and being kind
Speaker 1: to your neighbor, not coughing and sneezing on your friends.
Speaker 1: I mean, there's a lot of basic obviously like yeah, yeah, yeah,
Speaker 1: are you worried? This is this is what I talked
Speaker 1: about with a lot of my friends. When we the
Speaker 1: kids do go back to school, are we completely freaked
Speaker 1: about the regular stuff? Like I feel like in my household,
Speaker 1: knock on wood, no one has gotten a cold, pink eye, diarrhea,
Speaker 1: all the usual things that we would have in cycles
Speaker 1: all the time last year because my kid was on
Speaker 1: play dates, or he was in a toddler and me
Speaker 1: class and you know, or I had three friends and
Speaker 1: their kids over and this one got pink eye in
Speaker 1: their class and now we all have it, like, because
Speaker 1: there's been such a stop to all of the other
Speaker 1: toddler Petrie dish in school situations, what the hell is
Speaker 1: that going to look like when we're back. I'm scared.
Speaker 1: I mean those things are seasonal anyway, So I don't
Speaker 1: think one or two years not getting a cold or
Speaker 1: not getting pink eye. You know, if you don't get
Speaker 1: pink eye this year, you'll get it in two years.
Speaker 1: I don't think it's gonna and you would have anyway
Speaker 1: because none of that can you know, you don't get
Speaker 1: immunity for more than about a year for that stuff. Um,
Speaker 1: So I don't think a year of kids not getting
Speaker 1: and we're seeing believe it or not, even people that
Speaker 1: are healthy, we're still seeing Coxsackie. We're still seeing rosiola,
Speaker 1: which we don't really. People are shocked. They're like, we've
Speaker 1: we've got nowhere, We've seen nowhere. How are they still
Speaker 1: getting this? That is a mystery. Um, either they're not
Speaker 1: as safe as they believe to be, or it's something
Speaker 1: latent that just comes out that's just they or you
Speaker 1: know when it is. I think kids are going to
Speaker 1: get sick, whether you you know you have a sibling
Speaker 1: and you get sick when you're six months old, or
Speaker 1: you don't see anybody till you're in kindergarten and you
Speaker 1: get sick when you're in kindergarten. I think one year
Speaker 1: of not having the Petri dishes. Okay, Okay, see guys, ha,
Speaker 1: I just took a really nice collective breath because I'm
Speaker 1: just so like, whenever my kid does go back to school,
Speaker 1: we are going to be sick for two years. Like
Speaker 1: I'm like, I mean, the flues and the colds and
Speaker 1: the caves and the sore throats and the strep throats
Speaker 1: and all that garbage. But I guess it'll just pick
Speaker 1: up and be normal. Like it'll be really good hands
Speaker 1: oh that's true, feel really good at covering their silver lining.
Speaker 1: They'll be good handwashers, will be good at covering their
Speaker 1: mouths um, and they'll they'll be a little bit like
Speaker 1: stand back, you know, they'll be a little bit probably
Speaker 1: better at it. That's very true. Um. A lot of
Speaker 1: listeners have school and daycare questions that I'm going to
Speaker 1: get you right now. And thank you all you awesome
Speaker 1: listeners for getting back to us and being part of
Speaker 1: the Katie's crib community and asking these awesome questions. So, um,
Speaker 1: Shelly asks, I have three year old twins. One twin
Speaker 1: has chronic asthma. The twins are supposed to start preschool
Speaker 1: in September. My son's allergists said the social benefits of
Speaker 1: preschool outweigh the risks of him getting COVID and impacting
Speaker 1: his asthma. Thoughts, Um, I think it depends on where
Speaker 1: you live. So you have to look at the numbers.
Speaker 1: You know, right now New York is really low, other
Speaker 1: places are really high. I think what they've laid out
Speaker 1: for when they're going to start stuff, and what percent
Speaker 1: of people need to be negative or represent need to
Speaker 1: be positive, and how quickly that goes up. You know,
Speaker 1: you've got twins, so I feel like the socialization isn't
Speaker 1: kind of already there because you've got two of them.
Speaker 1: But that's true if your allergist is saying it. So
Speaker 1: I don't know the severity of the asthma or anything
Speaker 1: like that, but um, I think you listen to your doctors,
Speaker 1: look at ask your preschool what they're doing. If they're like, wow,
Speaker 1: just come back in, then maybe you look again. And
Speaker 1: if they have a if they have an actual plan.
Speaker 1: They're looking at filters, They're looking you know, filters in
Speaker 1: the areation. If they're going to be outside a lot
Speaker 1: of the time, if they're going to have like a
Speaker 1: what they're calling cohorts or bubbles of kids that they
Speaker 1: keep together, they have to have a plan. I think,
Speaker 1: I think you just want to know. I've been feeling
Speaker 1: that a lot with my group, with my mom friends,
Speaker 1: and that a lot of people who because I Albi
Speaker 1: hasn't started preschool yet, and I looked at a bunch
Speaker 1: and so you guys know like in l A and
Speaker 1: not everyone has this, but a lot of the preschools
Speaker 1: are moving completely outdoors, no indoor classes for a while,
Speaker 1: and then they're splitting the playyards so that kids are
Speaker 1: sort of split into like four to six kids pods
Speaker 1: um that they will stick with the whole time. And
Speaker 1: then and then a bunch of the preschools have like
Speaker 1: put in running rivers in the front of soap and water,
Speaker 1: like like kids are washing their hands every thirty minutes,
Speaker 1: or what's their plan for potty breaks? You know, like
Speaker 1: who's cleaning the bathroom in between each person? Like these
Speaker 1: are the questions I've slowly learned through friends to ask like, um,
Speaker 1: how are they cleaning the inside? With what you have
Speaker 1: to trust? You're gonna have to trust your kids, bestie also,
Speaker 1: because those are the people that are going to be
Speaker 1: putting you at risk or not putting at risk. I
Speaker 1: think you have to have you can have conversations with
Speaker 1: you know, we're in the same pod. We gotta we
Speaker 1: gotta do this, we gotta do the right thing, And
Speaker 1: I think that's an important conversation to have as well.
Speaker 1: It's a lot like safe sex. It's so insane, like
Speaker 1: because we've only opened our pod to one other family. Um,
Speaker 1: they live around the corner. The mother is eight and
Speaker 1: a half months pregnant, which is really scary because she
Speaker 1: we all want to keep her protected and her daughter
Speaker 1: is six weeks younger than my son. And we're the
Speaker 1: parents are very very good friends, and we it took
Speaker 1: weeks of deliberation where we felt like, hey, these are
Speaker 1: the rules. I'm going to tell you if I've seen
Speaker 1: anybody else, and then you can decide if you want
Speaker 1: to take a fourteen daybreak from plate dates. It's a
Speaker 1: trust thing, but it's literally like who how many partners
Speaker 1: have you had? How to use protection. It's like insane,
Speaker 1: It's like, oh my gosh. Absolutely, Hi Katie, this is
Speaker 1: from Renee. I live in a dense area of Boston.
Speaker 1: I'm a mom of four little ones. Wow, bravo to you,
Speaker 1: ages six to five months. When my daughter's school opens
Speaker 1: in the fall and she goes to first grade, what
Speaker 1: are some ways I can keep the babies at home
Speaker 1: healthy from the school germs. So you brings home. All
Speaker 1: three older kids share one room in our twelve square
Speaker 1: foot department. Oh and then I just have to add
Speaker 1: this part. She wrote, You're my favorite actress. Thank you
Speaker 1: for being there for me during long lonely post part
Speaker 1: of days in the form of scandal and through this podcast.
Speaker 1: So much love, Renee. Yeah, I love you, Renee. That
Speaker 1: it's so nice of you sending so much love to you.
Speaker 1: That's wonderful. Okay, I forgot the question. No, I'm kidding.
Speaker 1: So she has an older kid that she wants to
Speaker 1: go back to school, and then she has little ones.
Speaker 1: Oh God, what do you do there? Um? You know,
Speaker 1: So it's it's what I do. So I go to work.
Speaker 1: I go to work every day. Um, I've been wearing scrubs.
Speaker 1: I love them. Um, I changed when I get home.
Speaker 1: I watched my The first thing I do when I
Speaker 1: get to work is wash my hands. The first thing
Speaker 1: I do when I get home is wash my hands
Speaker 1: and take a shower. Um, So I think it's I mean,
Speaker 1: I think when she comes home, you can you can
Speaker 1: have home clothes or you know, hang out pajamas if
Speaker 1: you really want to be safe. Since they're so so close,
Speaker 1: make sure she washes her hands. Um, you can give
Speaker 1: her shaff you, but make make sure you do it
Speaker 1: once over on her. I'm assuming she's the oldest or
Speaker 1: the eldest, so not touching her face, not coughing, she
Speaker 1: shouldn't have to wear a mask in her own house.
Speaker 1: I don't. I think that's reasonable. But I think if
Speaker 1: she comes home and washes her hands and washes her face,
Speaker 1: and we talked about not coughing, and and then as
Speaker 1: soon as you see an inkling of you know, maybe
Speaker 1: a fever something, then you can call your pediatrician. Maybe
Speaker 1: put her a little bit to the side. Yeah, from
Speaker 1: the other kids, So let me ask about that sort
Speaker 1: of leads us into visitors and at natural ce Levine,
Speaker 1: she asks, I will deliver second baby in October. The
Speaker 1: first child turns through in November. How do I manage
Speaker 1: parents and in laws that want help with both kids
Speaker 1: but won't have been in our COVID bubble beforehand. One
Speaker 1: set is local, one set will travel across the country.
Speaker 1: Do we enforce a fourteen day quarantine everyone gets tested? Help?
Speaker 1: This is a huge hot topic question for everyone I
Speaker 1: know pregnant at the moment and really needing assistance and
Speaker 1: help in their home with either family that lives close
Speaker 1: by or a night nurse, or like, how do people
Speaker 1: deal with family immediate family and getting them in their
Speaker 1: bubbles for when the baby comes. So I'll answer the
Speaker 1: easy question first, which is people that live in your
Speaker 1: hometown and local people. You certainly I think it's reasonable
Speaker 1: to ask to quarantine for fourteen days. Um. Yeah, people
Speaker 1: that are flying across the country, I think it's a
Speaker 1: little more difficult. It's you know, they're going to be flying,
Speaker 1: they're going to be on a plane, they're gonna be
Speaker 1: in the universe. So I think, you know, asking them
Speaker 1: to get tests when they get local, um, but having
Speaker 1: them safe or reasonable enough time. So that's that's a
Speaker 1: thing to do. But I think it's doable and the
Speaker 1: risk reward of having your family close and being able
Speaker 1: to help is important as well when you're a new mom.
Speaker 1: And do you think people who are flying should get
Speaker 1: tested and quarantine for fourteen days? If that's even a reality?
Speaker 1: I mean, who who can take off? You know? Good
Speaker 1: Lord like that? I mean that would be perfection, But
Speaker 1: I think it's probably going to be one or the other. Yeah. Um.
Speaker 1: In reality from Panama, she says, thank you for opening
Speaker 1: up this space my pleasure. Um. This is from Alejandra
Speaker 1: and she says, I'm a teacher. I'm a mommy of
Speaker 1: three little ones, nine, five and six months old. Like
Speaker 1: any mom, my biggest concern is if I get sick,
Speaker 1: who cares for my little ones? Especially a baby who's
Speaker 1: still nursing? Which brings me to my question. If you
Speaker 1: test positive for coronavirus and have to self isolate, can
Speaker 1: you continue nursing? Does testing positive mean you need to
Speaker 1: be away from your children for two weeks while you
Speaker 1: stop being positive? Many thanks for providing the space for
Speaker 1: worried mommies like me. So the guidelines are to take precautions,
Speaker 1: wear a mask, wash your hands, wash all your tubing,
Speaker 1: and your breast pump stuff really well. Um, and they
Speaker 1: haven't seen I mean, once again, the data is so
Speaker 1: little for you know, a positive you know, but they
Speaker 1: haven't seen a lot of transmission. Um. But take precautions
Speaker 1: as you would if you were in you know, outside
Speaker 1: or with someone who is who you thought might be positive.
Speaker 1: So masks, handwashing, and and keeping separate when you're not,
Speaker 1: you know, for for a little while until you're negative. Yeah,
Speaker 1: maybe fourteen days of like staying away and only being
Speaker 1: near the baby while breastfeeding exactly. Yeah, I wonder pumping, Yeah,
Speaker 1: pumping or you like wear gloves and a mask, mask
Speaker 1: and do mostly pumping and a few breastfeeds a day,
Speaker 1: depending on how many feeds you're doing a day exact.
Speaker 1: They're hoping they're antibodies that way too, because usually nursing
Speaker 1: their anabo where they're hoping that that's transmissible, but studies
Speaker 1: aren't conclusive yet. So gosh, Dr Daniel Taylor, you are
Speaker 1: just everyone everyone feel her vibe. See it's so for me,
Speaker 1: it's like to have a calm pediatriction is like a
Speaker 1: perfect yin to my yang. Any partying bits of advice
Speaker 1: or wisdom or just you want to talk me off
Speaker 1: a ledge in front of everybody. Sure sure, UM, I,
Speaker 1: just as a healthcare provider want to say, don't don't
Speaker 1: miss your appointments, vaccinate on time. Don't feel like we're open.
Speaker 1: We're we're you can call and ask what we're doing.
Speaker 1: We're seeing babies in the morning, younger kids in the afternoon.
Speaker 1: In six spots are just very little. We're separating everybody.
Speaker 1: But keep your appointments and vaccinate because we don't want
Speaker 1: this to end and then have a pandemic of something
Speaker 1: else that's you know, kids could get vaccinated for. So
Speaker 1: make sure you keep those appointments. UM call us talk
Speaker 1: to us, UM call before find out what's an emergency.
Speaker 1: Don't freak out on your own. Don't just run to
Speaker 1: the emergency. Call us and trust us UM to answer questions. UM.
Speaker 1: Follow the rules, wear masks, wash your hands, limit your
Speaker 1: contacts UM because it's it's the easiest way to have
Speaker 1: all of this. Be a little bit more behind us.
Speaker 1: Be patient, Be patient with your doctors, Be patient with yourself.
Speaker 1: Be patient with the new rules. Sometimes only one parent
Speaker 1: can come in sometimes I mean be patient that we're
Speaker 1: doing it too to protect everybody. And if if our
Speaker 1: guidelines are different one day than they were the next.
Speaker 1: Stay to be patient with that too, because it's all new.
Speaker 1: This is really you're bringing up such great points I had.
Speaker 1: I was pushing my Albie's two and a half year
Speaker 1: check up and pushing it and pushing it, and then
Speaker 1: I called and asked the doctor like a million questions,
Speaker 1: like how are you keeping separate? And they only had
Speaker 1: appointments for non sick kids in the morning, and they
Speaker 1: were super spaced out. I didn't see anybody, and it
Speaker 1: was so great and so well handled. And I'm sure, like,
Speaker 1: how many doctors are doing that at like you said
Speaker 1: you are. And then I think that the that pediatricians
Speaker 1: in general like have just been so wonderful at moving
Speaker 1: so many medical things to phone calls, questions and tele medicine.
Speaker 1: Like so if you're having that gut sort of twinge
Speaker 1: that something's not right, it's like I can send photos
Speaker 1: like in this time, my son's tooth has turned gray
Speaker 1: from a fall. He's had weird broken capillaries on his
Speaker 1: face from a crying fit he had, And I'm just
Speaker 1: like sending close up photos with my actor audition ring
Speaker 1: light to my you know, to you oh, I sent
Speaker 1: you pictures of his gray tooth, because but like I
Speaker 1: just feel like we really have to call on our pediatricians,
Speaker 1: like you're saying, ask a lot of questions, use the phone,
Speaker 1: use FaceTime, email, pictures like whatever, so that you can
Speaker 1: stay on top of any symptoms you see. Um, but
Speaker 1: also keep caring for your kid, because they do other
Speaker 1: stupid stuff that has nothing to do with COVID, A
Speaker 1: lot of false a lot of trampoline stuff. Um, there's
Speaker 1: there's actually a pitch the American Academy of Pediatrics AP
Speaker 1: hashtag call your pediatrician. I mean, it's just call us.
Speaker 1: We're here, we want we want to talk to you.
Speaker 1: We want to talk to you after ledge. Thank you
Speaker 1: so much for being on Katie's crib and for being
Speaker 1: a voice of reason during this very epic, intense stressful
Speaker 1: time for new moms, for moms of toddlers, for moms
Speaker 1: with multiple kids, and at Katie's crib. This is the
Speaker 1: info we have right now on COVID. Thanks for having me.
Speaker 1: Thank you, Dr Daniel Taylor. Thank you guys so much
Speaker 1: for listening. I hope that helped calm some of your nerves.
Speaker 1: Stay calm, carry on, You got this subscribe, tell your friends,
Speaker 1: follow us on all the socials at Katie's Crib, and also,
Speaker 1: if you have any thoughts or ideas of things you'd
Speaker 1: like to hear more about, you can email me at
Speaker 1: Katie's Crib at Shonda land dot com. Thanks guys, till
Speaker 1: next time, ka Katie's Crib is a production of iHeart
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