Sydney Capers of Springfield, 25 years old, gave birth to her son, Phoenix, last November. She was an early childhood education major in college, and nannied for special needs children. She has since worked at preschools and plans to go back to teaching once her son is ready for child care himself.
Phoenix struggled in his first months and is now gaining his strength. He is attentive and stylish in the cool clothes his equally hip mother picks out for him. He doesn't smile much, preferring to offer the world a steely, critical gaze. He arrived two months early, and spent nearly five weeks at the hospital in intensive care.
Before he arrived, Capers had a troubled pregnancy. During hospital stays she was only allowed a single visitor due to COVID-19 precautions. Of course she chose her husband, Josh, but he had to work and couldn't always be there. "I spent a lot of those experiences alone in the hospital." After her son arrived, Capers endured isolation on top of isolation – being the mom of a vulnerable newborn, plus living during a pandemic.
Capers is well-versed in early childhood development and is an active parent-teacher. She and her husband read to Phoenix often and work on catching him up developmentally, as he was born months before his due date. While there's much research still in the works about how the pandemic might have long-term effects on the youngest among us, experts say it's time to start addressing potential impacts before too much time passes. We know the early years of brain development are crucial, and learning involves seeing new people and places. Both those things have been decidedly absent over the past year. But parents, doctors and educators found ways to adapt during the pandemic's harshest months, and some of those changes might be around for the long run.
Capers was relieved to finally be able to bring Phoenix home from the hospital. "It was almost like a euphoric moment, I felt like a super-mom," she said about first being home. But the baby wasn't sleeping well, and he suffered from colic – long bouts of crying. Capers also has two stepsons who live with her family part-time. That also provided challenges as the two children have high-risk conditions and travel between the Capers' home and another parent's house. "Trying to keep them close with their brother during a pandemic was way more difficult than we anticipated," due to potential COVID-19 exposures, said Capers.
Meanwhile, the newborn "still had quite a bit of issues from being a preemie. He didn't have temperature control. There were times where he would have a hard time letting go of his breath." Her life quickly became dominated by medical routines to keep her son healthy.
Capers and her husband were constantly on guard: "We couldn't miss a beat." The toll was exhaustion. Capers had to forgo a traditional baby shower. More importantly, she had fewer family coming through the home to help support her due to COVID-precautions.
"So even though everybody was supportive through texts and things like that, at the end of the day the only person I had to physically talk to was my son," said Capers. "That's when isolation really started to kick in." Capers had left her job as a preschool teacher during her pregnancy, and her husband took a job in Bloomington as an electrician. They had to adapt to a single income and her husband was spending extra time away from home due to the commute.
Capers said, at first the pandemic meant it was hard to coordinate counseling for her postpartum depression. "I went through extreme anxiety of feeling like something is going wrong with my son. I couldn't sleep because I was scared that he wouldn't be able to breathe." Having him go from being under constant care and supervision at a hospital to being home was what she had wanted, but it was a major adjustment.
Like the rest of us, babies thrive on interaction with other humans. "Social interaction is essential for the normal development of human babies," said Dr. Douglas Carlson, chair of pediatrics at SIU School of Medicine and medical director at HSHS St. John's Children's Hospital in Springfield. "That first year is particularly important as brain cells are being developed." Babies also absorb their environments and learn from new tactile experiences.
While social isolation was "essential to save lives" – the psychological effects are evident, said Carlson. He said long-term effects are unknown, although an increase of depression and other psychological illnesses during the pandemic in teens and younger kids, who are easier to study, has been documented. "We don't yet have proof that we are seeing the psychological stress in babies and toddlers," said Carlson. Still, medical experts hypothesize long-term effects negatively impacting young children are quite possible, said Carlson.
He said now that it's nice outside, parents should prioritize letting their children socialize with other kids, taking precautions and wearing masks when possible. "It is essential that we all get vaccinated, so that we can get back to normal interactions, so that we can all thrive," said Carlson.
Meanwhile, "It does seem like there is an increase in postpartum depression. And I think it goes along the lines with the generalized anxiety that is pervasive throughout our community from COVID," said Dr. Robert Abrams, director of obstetrics for the South-Central Illinois Perinatal Center in Springfield and head of the maternal-fetal medicine division at SIU School of Medicine. Parents of newborns are generally worried about their vulnerable children being exposed to germs, but mix that with a pandemic and the anxiety can worsen.
Abrams said in a typical year, moms are met with an immediate support system at the hospital where they give birth. It wouldn't be uncommon for 10 to 20 visitors to show up during a hospital stay. But with visitor limitations, that was not an option for most moms who gave birth over the past year. Even when home, many like Capers limited visitors to avoid infection, said Abrams. "That certainly would lead to an increased risk for postpartum depression, just because the support system is not as great as it typically is."
Abrams said there are silver linings in the pandemic storm cloud. Telemedicine – appointments via video and phone calls – has become more widely used. Video conferencing with doctors can increase access to health care, especially for those in more rural parts of the state. "Now telemedicine is more widely accepted from a patient's perspective," he said. That could mean lasting increased access to care for pregnant women in parts of the state where they typically would have to drive multiple hours one way for an appointment.
He also pointed to a change in the state's coverage of health care for new moms. "Illinois was the first state to expand Medicaid coverage for one year after delivery," said Abrams. "It's critical that these women have access to mental health services for at least one year after they deliver. So I'm hoping that even though the numbers of postpartum depression may be rising, the access and the availability of providers and the ability of the patients to seek care increases."
Carlson added that the pandemic has made the gap in inequitable access to health care more evident than in previous times. "We always knew it was there but the socioeconomic disparities of health care have become more apparent during the pandemic."
Child care changes
Child care centers across the state have made many adaptations over the past year. Danielle Jordan is senior master teacher at Educare Chicago, which is part of Start Early – a nonprofit that provides early childhood programming.
Jordan works at a center that has 13 classrooms for children age birth to five. The majority of families served are low-income. At the beginning of the pandemic, technology was a barrier. Instead of doing home visits to help new parents, lessons were over the internet. But not everyone had access to devices and reliable WiFi. Jordan said teachers would connect with parents in a variety of ways – phone calls or apps – whatever was easiest for them. "What we did offer is consistency and care and a routine for our families."
Jordan said routine is especially important for young children. She urges families to help create consistent schedules at home. Regular meal and bath times mean children, even babies, can come to rely on quality interaction with the adults in their lives. Parents were also sent books as a way to bond with their children and encourage their development during shutdowns. Teachers made many house calls to help address basic needs. Families were also offered regular wellness and mental health visits virtually.
While most children are back in the classroom now, the transition has come with many changes. Children are dropped off and screened by staff before making it into the classroom. Infants are especially known to exhibit symptoms similar to COVID – teething can lead to runny noses and flu-like symptoms. And that means more children are sent home sick, causing disruption in families' lives. Plus very young children are especially challenged by new situations.
"Yes, we're back, but we have to do more work now" to make sure families have information about what is going on in classrooms they might not have a chance to step inside of, due to COVID-19 precautions, said Jordan. Staff share regular updates via web applications.
Jordan said one good change is that children are doing better with literacy since the pandemic began, which she credits to the program's focus on family togetherness through methods such as reading. The pandemic has made the crucial role parents play in shaping their children's education increasingly clear.
Lauri Morrison-Frichtl is the executive director of Illinois Head Start, which offers state-funded emotional, education and social programs for young children from low-income families. Programming is heavily geared towards strengthening the bond between parents and their kids. "A mother needs all of the basics. They need a place to call home, food and security – all of that is critical." Morrison-Frichtl said Head Start, which has components focused on preparation for parenting and infants, focuses on the needs of both children and parents.
Statewide programming for the youngest children, including newborns, requires 90 minutes of home-based meetings per week, which have happened virtually due to the pandemic. "Our home-visitor staff had to be creative in ways to reach and establish those strong relationships with the mother and the infant." In-person meetings have started to resume, first with outdoor sessions.
Head Start has especially focused on mental health care for mothers during the pandemic, as it saw the need to do so. "Having a healthy baby depends on a healthy mom." She said, "What's key to the baby's development is the relationship between the baby and the mother. We know that in that first year the relationship between the mother and the child is critical."
There is hope now with vaccinations and more things opening up. Still, "It's going to be a really tough road moving forward," Morrison-Frichtl said. Re-engaging with families who may have fallen out of touch, some over fear of COVID, will be a priority.
In addition, Head Start will be focused on "trauma-informed care" – which puts a focus on mental well-being. "Families who live in poverty are especially traumatized. And it's not only COVID. It's racial tension, it's everything that's happened in our world over the last year."
Support and hope
Kim Leistner Root, of Springfield Moms – a website and online community that shares resources and events – said for many new moms, finding just one other person who is going through similar issues can be a major boost. It's the "quality of connections, not quantity," she said. SpringfieldMoms.org provides resources, including a long list of various support groups. She also points to classes where new moms and babies can socialize, such as Springfield Clinic's Baby Steps class series, which has begun meeting in person again in small groups.
Leistner Root said the pandemic has cemented a sense of online community. "Our numbers have grown in the amount of people commenting and reaching out," she said. Moms seem to be more connected online than ever before.
For Capers, finding support online was crucial. Being vulnerable about what she was going through with other parents helped her. Reaching out to her church group online was also a big help. Sometimes that support crossed over into real life, with people making drops of essential items to her home. As more opens up due to vaccinations, so does her ability to socialize with the outside world.
Capers and her husband are active in social justice work. Her son had his first protest experience in the womb, as his parents marched last summer against police brutality and systemic racism. "I have three Black sons, a Black husband and Black students. And I feel like it's my obligation to do what I can. I don't really think of it as an option," said Capers. She added that Phoenix attended his first demonstration "outside the womb" in April, during a vigil organized in response to the police killings of Adam Toledo in Chicago and Daunte Wright in Minneapolis.
Phoenix is named, in part, after the bird that represents rebirth in Greek mythology. "I've always been in love with the story of the phoenix, the idea of everything going wrong and then rising from the ashes and becoming this big, strong mythical being," said Capers.
It's fitting for a baby born into a world in the middle of a global pandemic, during a time of civil rights uprising. His mother is feeling adjusted to her new role as he gains his strength and as her support systems open up. Of the world she wants her son to grow up in, Capers said, "I don't want things to go back to normal. I want them to be better than they were before."
Contact Rachel Otwell at firstname.lastname@example.org.