Did Covid-19 slow down our babies' growth milestones?
If there existed a battle for pandemics, two would stand out — the 1918 Spanish Influenza and Covid-19.
The two have almost similar experiences in terms of virulence and the nature of disease.
However, little is spoken about the underlying effects such pandemics have on children. Studies show that children born during the Spanish Flu had a likelihood of developing diabetes, kidney issues and heart related diseases if their mothers were infected.
“The 1918 influenza was unusual in the vigour with which it affected young adults, but other populations were not spared—including foetuses in uterus,” said a study published in the JAMA Network.
“Carrying a pregnancy to birth did not ensure that newborns avoided the effects of influenza. Rates of congenital malformation and premature birth increased during all waves of the pandemic, contributing to increased infant mortality rates during the spring 1919 wave,” they explained
For Covid-19 babies on the other hand, studies show that some of the children born during the pandemic are likely to have delayed development milestones.
A Facebook post by an influencer called Mamake Bobo recently gained traction as over 200 Kenyan mothers shared their frustrations regarding glaring delayed milestones for their children aged averagely 2.5 to three years.
A study published by the scientific journal BMJ Archives of Diseases in Childhood shows that the lockdown seemingly locked out children from blooming as they should.
“Stringent lockdown, used to control the Covid-19 pandemic, has led to babies and their families spending more time at home than babies from previous years. Fewer babies from the Covid birth cohort had achieved one definite and meaningful word, the ability to point and the ability to wave bye-bye compared with babies from a comparable historical cohort,” said the study.
The researchers explained that having social engagement plays a big part in a baby’s social communication.
“Because of lockdown measures, it is likely that Covid-19 era babies heard a narrower repertoire of language and saw fewer unmasked faces speaking to them. As babies spent most time during the lockdown in their familiar neighbourhoods, they were less likely to encounter new items of interest, which might prompt pointing,” said the study.
Another study published by the journal JAMA Paediatrics early last year shows that babies born to women who were in their first trimester on the onset of the pandemic had the lowest scores in gross motor and fine motor skills.
The Frontiers of Psychology journal explains that gross motor refers to muscle movements like crawling, walking, running and sitting. Fine motor on the other hand is when a child learns to grasp objects and hold a pen to draw.
Researchers explain that both gross and fine motor skills play a part in a child’s foster language development from a tender age.
“Data from numerous cohort studies have demonstrated that prenatal perceived stress, loneliness and objective stress, especially during early gestation, are associated with an increased risk for adverse neurodevelopment in children.”
Some of the stress triggers for expectant mothers during the pandemic include job loss, food insecurity, loss of housing and the pandemic itself that contributed to anxiety and depression.
“The observed association between birth during the pandemic and neurodevelopmental status, regardless of maternal SARS-CoV-2 status, suggests a potential pathway involving maternal pandemic-related distress that warrants future investigation,” said the study.
Researchers from the Columbia University who earlier thought that children from mothers who had the virus during pregnancy were highly susceptible to having delayed milestones found the opposite result after the study.
“We were surprised to find absolutely no signal suggesting that exposure to Covid while in utero was linked to neurodevelopmental deficits. Rather, being in the womb of a mother experiencing the pandemic was associated with slightly lower scores in areas such as motor and social skills, though not in others, such as communication or problem-solving skills. The results suggest that the huge amount of stress felt by pregnant mothers during these unprecedented times may have played a role,” said Dr Dani Dumitriu, professor of paediatrics and psychiatry who was also a lead researcher of the study.
Dr Walter Otieno, head of Department Paediatrics and Child Health at Maseno University, told Healthy Nation that he had not observed cases of delayed milestones from pandemic babies that he attends to.
“It is not normal for babies to have delayed milestones unless there was a problem during pregnancy with the mother. Mothers with hypertension are likely to have such problems,” he explained.
“For others, the first stage of labour if not well taken care of may affect the baby. Some babies may miss getting enough oxygen during delivery, which ends up affecting the functioning of the brain. It is, however, normal for babies to bypass some developmental stages like crawling,” said Dr Otieno.
He advised pregnant women to ensure that they visit a gynaecologist as soon as they learn that they are expectant.
Faith Kamula, a physiotherapist at Stellar physio Health and Wellness Centre, noted that a number of children born during and post-pandemic have recorded a number of developmental delays, which sounds the alarmbell since a fraction of them seem to be taking a lot of time in achieving the main motor function skills such as social smile, growth of the first tooth, rolling over, sitting without support, standing and walking while holding on to furniture and even delayed speech.
“If a child is not able to speak or utter words at the age of two years, the parents should be concerned and seek help. Tongue ties should be ruled out before diagnosing them with delayed speech.
“Girls are, however, known to speak way earlier than boys at the age of nine months compared to one year or so for boys,” she said.
The physiotherapist pointed out that speech rehabilitation takes time depending on when the parent has identified the problem. She said the main aim of speech therapy is to bring the child up to speed with what they are supposed to be able to say with comprehension at the exact age they are during and after diagnosis.
On the connection between the pandemic and milestones delay, she said that although not scientifically proven, there have been concerns among many parents and health care practitioners who come across cases of children whose functional development and motor skills are delayed.
Healthy Nation team spoke to mothers who believe that their children had delayed milestones.
Pauline Skelly
Skelly, a foreign language teacher, enjoyed her pregnancy journey in the period before the pandemic. At 42 weeks, her doctor asked to assess her situation because she was almost hitting the post-term category, where a baby is born after the recommended period of 37 to 42 weeks. At the time, the country was already on lockdown and she had to get admitted to hospital. She was a bit apprehensive about the new rules and the strange disease. Fortunately, her first child was born in good shape on March 29, 2020. At six months, her child was jovial and achieved the milestones she ought to have at her age. As she grew older, her mother noticed that her baby was different.
Pauline Skelly
“My baby’s development was sluggish, I am told that children should walk when they get to 10 months. It took my training, which enabled her to move at about one year and two months,” Skelly says.
The child, who turned three on the day that we interviewed her mother, can only say a few words, which cannot make up a full sentence. The delayed milestones made her research to find out if other women had a similar fate. She learnt through social media that she was not alone.
“My baby couldn’t interact with as many children so she was mostly alone. As such, she was glued to the television watching the children’s famous cartoon show, Cocomelon that is usually presumed to teach a child. I later learnt that this pattern of screen addiction would have an adverse influence on her speech development” she says.
She mentions it’s hard for a child to learn when not speaking as communication is one sided.
Skelly then decided to take her to a playgroup when she was two. The caregiver told her that the child may be suffering from separation anxiety, one which Skelly was told manifests when a child clings to the mother rather than being open to socialising with other children or the caregiver. She attributes her child’s reserved nature to lack of a social life due to the pandemic and thus had been more attached to her.
“We were advised to buy her books since she’s a quiet girl and the books would help as she looked at pictures of other children. In turn, this would make her interested in playing with her mates” she says.
Skelly has not opted to visit a therapist since she has been advised that different children grow at their own pace and finally get to speak. She has now opted to take her child where she can interact with many children and slowly by slowly, her speech is picking up.
Catherine Kerubo
Kerubo’s child was born in May 2020. When Kerubo was pregnant, she lost seven about seven kilogrammes due to the anxiety that came with the pandemic. Her child’s birth was okay. At seven months, she could crawl and support herself on sofas.
Catherine Kerubo
Kerubo was certain that by nine to 11 months, the baby would walk on her own, but this milestone would delay by two months until she was one year old, when she walked perfectly.
“Speech became a struggle, she would mumble things only her mates understood and an adult would not make out what she said,” she says. Kerubo has the idea that by eight months a child should utter the magical words ‘Baba or Mama’. As a concerned mother, she thought that by age two, her child would be able to speak comfortably.
At one year and seven months, Kerubo decided to take her to a playgroup and this greatly impacted her speech as she was at least able to construct a sentence.
“Teachers expressed that the improvement was due to her age mates talking out to her and she had no option but to try and grasp the one worded responses” she says. Her child is never exposed to cartoons and is mostly playing.
“I believe every child has their own milestone. I stopped comparing my child with the neighbours’ even when they would comment on my child’s speech delay” she says.
Kerubo’s child, who turns three in May, goes to school and can chant 1-10, but still cannot speak fully.
Jane Gakeni
Jane Gakeni’s child was born in November, 2020. More than two years later, she still cannot speak. He only mutters the inaudible baby sounds. While expectant, Jane was in distress as she was isolated and stayed indoors due to the pandemic. While her labour was tough since her water broke a week earlier, her delivery was devoid of any complications. At six months, her son was not playful and was rather dull.
This was unlike her second child who was born months later. As a first time mum then, she had no idea on how to make her child lively. At one and a half years, the child walked and all other developmental milestones were okay. At two, however, she noticed something was amiss.
“He would hear, take instructions and resist anything that he perceived as wrong, but talking was a difficult task,” Janet says. Her child is not a big fan of cartoons or watching on YouTube as such she cannot attribute the speech delay to screen addiction.
The delayed speech forced her to visit the hospital and after assessment, she was told he had no health issues and the speech delay was a result of lack of social interaction. Therapy was recommended, which he now attends after going to playground level of schooling. The mother of two is worried about her child’s condition since the improvement of his speech even with therapy is still minimal. The therapist, however, believes that Gakeni’s child is improving by the day.
Lilian Kamene
Her child uttered his first word “Mum” and his older brother’s name at one year and nine months. Before then, the child, who was born in April, 2021, could take instructions and listen to words when spoken but could not respond. Lilian was told that she had placenta previa, a condition where a placenta is on the lower side of the uterus. Her baby was born healthy, regardless.
Unlike some of his age mates, his son walked aged one and a half.
Lilian Kamene
Lilian is uncertain about the link between interaction and also screen time because her child had people to interact with and she did not allow him to have longer hours of screen time.
The mother of two has not been to therapy. Two months ago when he would not say even a word, she was really troubled by that speech regression. It bothered her but she would not afford to go see a specialist. She was, however, relieved when he voiced his brother’s name and her’s in February.
“Currently, he is trying to express himself through babbling ,” she says.
Teresa Atieno
When the pandemic hit, Teresa had just two months to give birth to her son. She went into labour a month earlier and gave birth to her son. The indicators of growth were evident as he sat and his motor skills developed. He then walked a month before one year but he did not crawl.
Teresa Atieno
“My son is not verbal; he does not speak as he looks to turn three. He only manages to mumble “Mama or Baba” without referring to anyone in particular. It is hard to get his attention and he doesn’t take instruction quite well,” she says.
“After going for a therapist checkup, he was diagnosed as autistic” she adds. The expert recommended she takes him to an integrated school and visit occupational, speech therapists.
“There was no surety that he would speak someday rather the experts said he knows what to say and nowadays he communicates in some way,” says Teresa.
Teresa says failure to interact with children his age for almost two years might have had a major effect on his social skills. Teresa’s child goes to a playgroup at the moment as he mingles with other kids.
Neurodevelopment health expert on the pandemic and a child’s development
Emmanuel Masheti, a psychologist and neurodevelopmental health expert at the Ministry of Education, tells Healthy Nation that a child’s experiences in the early months and years of life affects their health and well-being for the rest of their life.
«Your caring, nurturing, and safe parenting contributes to your child’s healthy development,» he says.
He says that understanding a child’s development can help you know what to expect and what you can do to help your child grow in a healthy way.
Emmanuel notes that in the early years of life, a child’s behaviour communicates their needs and how they are changing and growing. He advises that listening to your child’s unique cues can help you support them through their years of very rapid growth and development.
He explains that socialising plays an important role in the growth and development of children. It gives them an opportunity to learn to share and hone their language skills. But with social distancing that happened during the pandemic, many children missed out on opportunities to play and it negatively affected their growth and development.
During the pandemic most childcare programmes closed while outdoor activities that would stimulate growth and development were halted. As a result, children did not get the cognitive and social stimulation that they would normally get outside their home.
“But for children, a delay in social skills may not be the only consequence of the pandemic. With many parents undergoing financial stress, children face higher rates of housing and food insecurity. And others are subject to rising rates of neglect and household dysfunction – all of which can affect a child’s growth and development,” he says.
Children who have neurodevelopmental delays may have delayed speech development, walking difficulty, intellectual disability, memory loss, learning difficulties, developmental delays, stuttering or stammering, problems with social interaction and communication. They may also have hypotonia (weak muscle tone), seizures and behavioural problems. BY DAILY NATION
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