Children’s Dental Health Month – Practice Taking Precautions during Pandemic: Don’t Postpone Your Child’s Dental Care
by guest contributor Rosie Kickish, DMD, Inspiration Dental in Riverview, FL Everyday life looks different…
As COVID-19 arrived in the U.S., governments at all levels were quick to issue the same guidance: stock up on two weeks of essential supplies, including groceries. What sounds like sound advice was actually rife with complications for millions of Americans, from the sudden shortages at local grocery stores to families without the financial means to “stock up and save.”
According to the United States Department of Agriculture, about 7 percent of U.S. households – roughly 2.7 million households – with children qualify as “food insecure.” A food insecure household is one that at some point throughout the year struggled to provide all family members with sufficient food based on financial resources. These numbers present data from 2018, which was measuring the impact on families compared to “pre-recession” levels; given the economic shocks of the last month based on COVID economic impacts, the figures are assuredly higher though unable to be measured at this time.
Families that struggle to provide adequate food and nutrition likely faced tremendous barriers to being able to stockpile based on a lack of financial liquidity at the beginning of the crisis and may be experiencing significant anxiety related to meal provision.
Even among families who receive food and nutrition benefits, the road has not been easy. Among food insecure families, over half utilize one of the three largest food access programs. Each of these programs has experienced changes in order to meet the needs of families as we navigate this crisis:
Supplemental Nutrition Assistance Program (SNAP, formerly food stamps): SNAP is the largest food access program in the county, serving about 40 million people in any given year, the majority of whom are children. As an expert from the Robert Wood Johnson Foundation explains in their in-depth blog on the program during this crisis, “The SNAP benefits—which could be a couple hundred dollars a month—really could mean the difference between a child having three meals per day versus maybe only two or one. Particularly for young kids, food is fuel for their development—their developing bodies, but also their developing minds.” The Foundation highlighted several changes to SNAP in the wake of the current crisis, including the suspension of work requirements and time limits temporarily, and expansion of SNAP benefits to households where children usually receive school meals.
Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is a program serving pregnant, postpartum, and breastfeeding women and children up to age 5 who meet income and other eligibility requirements. WIC recipients receive vouchers for specific items meant to meet nutritional needs (states are increasingly moving to benefits cards for WIC administration). WIC is an important nutritional resource for families with young children, particularly through its access to formula for those families who choose not to breastfeed; however, the program limits participants to very specific items (see “packages” for adults/children and for infants). Many families reported difficulty in obtaining the specific items they were allowed after grocery stores experienced increase demand from “stockpile” shoppers. The New York Times shared the harrowing story of one family who was unable to find the specific formula their baby needs because of a food allergy in the quantities approved by WIC. The National WIC Association reports that many states have since expanded the items which are covered by WIC benefits to allow participants more flexibility during this time of grocery stockpiling, and also issued a call which was popular on social media for non-WIC participants to read the shelf labels at stores to ensure they are not hoarding a WIC-approved items which may be another family’s only option. More information on this flexibility by state and tribal nation is available on the USDA’s website.
The National School Lunch Program provides meals for students at certain income levels at no or reduced costs during the school day, as well as through the USDA’s Summer Meals program. The USDA has issued a number of waivers in recent weeks to allow states and district to adapt to current needs, including the ability to distribute food in ways to reduce the risk of crowding and transmission; utilizing existing delivery options from summer programs; and to allow states to let parents/guardians pick up meals without the child present, assuming there are accountability methods, to reduce child exposure to the virus. Twenty-three states have provided information on where eligible families can pick up “to go” meals for kids to this USDA search tool; if your state is not on the list, it is best to connect directly with your school district to assess options.
When we consider the history of in-school meals as a way to fight hunger and bolster childhood nutrition, the urgency of this matter during the COVID-19 pandemic really comes to the forefront. The Food Research and Action Center’s (FRAC) August 2019 brief School Meals are Essential for Student Health and Learning assertsthat “school breakfast availability reduces low food security and very low food security among elementary school children. For school lunch, participation is associated with a 14 percent reduction in the risk of food insufficiency among households with at least one child receiving a free or reduced-price school lunch. Conversely, research shows that rates of food insecurity and food insufficiency among children are higher in the summer — a time when students do not have access to the school meal programs available during the academic year.” The closer we can get to a sense of community eligibility – allowing high-poverty schools/districts to provide meals to all students, rather than establishing eligibility for each individual household – for the duration of school closures in each locality, the better we are able to serve children most immediately in need.
ChildTrends developed a list of flexible distribution options which may help schools keep students fed during the “new normal.” Grab-and-go meals at designated pick-up sites
While districts have already developed plans to respond to the needs of families, they should be sure to revisit their arrangements as this crisis goes on to be sure there are no unintended consequences. For example, the decision to allow parents to pick up meals without the child present came only after several well-publicized media accounts of families finding this a barrier to access. Given that the geographic areas most impacted by this crisis may shift over time, policymakers should stay in touch with those they serve to gauge changing needs.
Community food banks are reporting tremendous demand at the same time they face many of the same challenges as other non-profits, including the need to encourage staff and volunteers to isolate at home and threats to their own financial futures. Each food bank is unique in how it determines who is eligible and what they may access, with many committed to a “no one is turned away” philosophy which serves those who are not eligible for the government programs but still face a struggle. Traditionally, food banks generally stock “shelf stable” pantry items like pasta, rice, and canned goods – all of which are helpful for emergency supplies but do not fully address the recommendations for a balanced diet. (For those who need to find food assistance, one place to start is Feeding America’s search feature – however, not all food banks are affiliated with them, so it may be helpful to search “foods banks” + your state name for a more comprehensive list. DO contact the food bank before visiting (some have changed hours or distribution practices in response to COVID).
In addition to the challenges of food access, families are likely still experiencing some of the usual challenges with picky eaters and mealtime battles, with children perhaps “doubling down” even more than usual based on their own feelings of stress and confusion. If self-isolation and three family meals per day are turning your kitchen into a warzone with a picky child, experts say to try not to let it get to you. Experts quoted in The New York Times said it’s okay to rely on favorite “comfort foods” if you know your child will eat them. While it’s important to continue making available nutritious options like fruit and vegetables, experts note that “Nutrition-wise, you can trust that a few weeks of less-balanced eating won’t cause long-term damage” (perhaps welcome advice for those adults turning to comfort food at this time as well). They place higher value at this time on continuing (or developing, with a new temporary schedule) family mealtimes as a way to connect with family and foster a sense of normalcy.
As much as possible, kids benefit from choices and playing a role, which allows them to exert control over a small part of their world during a time of chaos. This can be offering two different (parent-approved!) snack options, asking them to help plan or prepare meals, and choosing the side dish for the whole family. These challenges are, of course, exacerbated for families whose options are limited. For families with a special dietary need or allergy, they may find usual staples sold out at the grocery store; the Times experts recommend stocking up when possible, speaking with store management to learn when more may come in and teaming up with neighbors who may be able to keep an eye out.