COVID-19 pandemic stresses are increasing anxiety, depression, frustration, substance abuse and even overeating and weight gain in children.

Stress due to remote learning, concerns of getting ill and isolation from their peers are affecting kids physically and mentally, said Dr. Daniela Moscarella, pediatric nurse practitioner and pediatric clinical instructor at Rutgers School of Nursing.

She said children are routine-oriented. Now these kids have been taken out the school environment for almost a year. Kids are acting depressed and anxious and parents may not be picking up on these signs and symptoms.

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Moscarella said the first thing parents need to do is ask their children questions. Find out if they are eating for the right reasons. Is it out of hunger or just boredom? Questioning children about what they may be feeling can be difficult because some children may not feel comfortable discussing concerns with their parents, so using a therapist may be the next step, she said.

Parents need to make sure their kids are getting enough sleep and exercise. Encourage healthy eating routines. Children who attend virtual learning should have structured mealtimes and should not be allowed to snack all day.

While it can be difficult to structure exercise during the winter, parents can consider creative ways to encourage movement, like shoveling snow and dancing or stretching to music.

Moscarella suggested having healthy options with portion control on hand for snacks. Try carrot sticks with dip or popcorn instead of potato chips. It's OK if the child wants cereal, but have a small bowl. Avoid mindless eating, such as eating in front of the television or while doing schoolwork.

She also said it's important to separate eating times from other activities to lower the chances of overeating.

If it's not too much, try making a menu every day. Choose a selection of healthy snacks for the day, maybe make a basket of snacks that kids can choose from to make it a bit more fun.

Parents and primary care physicians should not make a child feel bad for gaining weight because that could have severe emotional impacts on them. Moscarella said it's important to let them know that the concern over weight gain is about their long-term health. Obesity in children could lead to heart disease and diabetes as they get older.

A behavioral health provider can also assess a child for a binge eating disorder due to anxiety and depression and provide appropriate treatment.

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