Thriving Childcare: Ensuring young children’s well-being and health during the COVID-19 pandemic

Thriving Childcare: Ensuring Young Children’s Well-being and Health During the COVID-19 Pandemic


Thriving Childcare: COVID-19 and Young Children During Flu Season

Zero to Thrive at Michigan Medicine presents a discussion for childcare providers regarding young children during the COVID-19 pandemic as we enter flu season. Featuring panelists Layla Mohammed, MB, ChB, Sharon Swindell, MD, MPH, FAAP, Michelle Richard, Erika Bigelow, and Lynette Biery, PA-C, MSc.

Thriving Childcare: Social-Emotional Health and COVID-19 Guidelines

Zero to Thrive at Michigan Medicine presents a discussion for childcare providers regarding how to ensure the well-being of young children and their caregivers in the transition back to childcare. Featuring panelists Kate Rosenblum, PhD, ABPP, Julie Ribaudo, LMSW, IMH-E (Mentor), Prachi Shah, MD, and Heidi McFadden.

Thriving Childcare: Ensuring Young Children’s Well-being and Health During the COVID-19 Pandemic

Zero to Thrive at Michigan Medicine presents a discussion for childcare providers regarding the recently signed Executive Order (EO 2020-164) requiring masks at childcare centers and camps. Featuring panelists Kate Rosenblum, PhD, ABPP, Prachi Shah, MD, Andrew Hashikawa, MD and Mark Jansen.


Mindfulness Exercises

for Kids

Returning to Childcare during the Pandemic

Helping Young Children Transition Back to Childcare

Resources for helping children get used to seeing and wearing masks:

Additional COVID-19 information and resources:


Pregnant or Breastfeeding? What You Need to Know About Coronavirus (COVID-19)

Registration for Strong Roots Core Training is open!

Are you pregnant and unsure about whether or not to take the COVID-19 vaccine? A team of experts created a decision aid to help individuals who are pregnant, lactating, or planning on becoming pregnant decide whether or not to receive an mRNA COVID-19 vaccine (in conjunction with their healthcare providers). View the decision-making tool (available in ten languages) here: COVID-19 Vaccine in Pregnancy Decision Aids

Pregnant or Breastfeeding? What You Need to Know About Coronavirus (COVID-19)

VIRTUAL Perinatal Adjustment Group

Wednesdays from 2:00-3:00pm on Zoom

The Perinatal Adjustment Group provides basic interpersonal and cognitive skills to women that can help ease the transition to new motherhood roles during pregnancy and the postpartum period.

Coping with the Coronavirus (COVID-19) Crisis

The COVID-19 pandemic is a rapidly changing situation that is creating stress and fear for pregnant and breastfeeding women and their families. Being fearful or anxious in such a stressful time can at times feel overwhelming and hard to manage. Below are some suggestions about how you might take care of yourself so that you can take care of your family:   

Take news and social media breaks Hearing about the pandemic repeatedly can be upsetting.

Care for your body Try to eat healthy, exercise regularly, get plenty of sleep, and avoid alcohol and drugs.

Make time to unwind.  Try to do some other activities you enjoy. Take a nature walk, listen to music, or draw your feelings.

Connect with othersReach out to a friend or family. Talk with people you trust about your concerns and how you are feeling.  

At times, seemingly “little things” can help us through very stressful moments, get us grounded again, and help us to cope. Breathing is essential and also a good way to help calm your mind. Try the 4 Square Breathing technique when you are super stressed:

Four Square Breathing: A Basic Exercise in Mindfulness

Four Square Breathing is a calming exercise that can be done anywhere. It can be built upon if and when you’d like. Children can also do this. Take a deep breath slowly to the count of 4, then hold that breath to the count of 4, then exhale that breath to the count of 4, and again pause to the count of 4. Repeat for as long as you can or want. Adding to 4 Square Breathing – you can practice square breathing while imagining a comforting place or listening to calming music. Try to focus relaxing attention on your neck and shoulders, back, arms, then legs.

Connecting with Others While Keeping a Safe Physical Distance

Experts are recommending that we keep space between people – at least 6 feet. This is called social distancing and is an important way to reduce the spread of the coronavirus. However, keeping physical space between people does not have to mean being lonely. In fact, staying connected to friends and family will reduce your stress. Call a loved one or check in with your neighbor while maintaining at least 6-feet of space between you and them. It can be calming to simply think about the people you care about and draw on the strength of those connections. So stay back, but keep your heart close.

These are unprecedented times.  But these times also create tremendous opportunities for us to practice our values- to care for others, connect with those we love, to find community and purpose wherever we can.   This reminds us all of how connected we are to one another—and ultimately, we get through this together.  

Although there is a lot to learn about this new virus, the majority of available information at this time suggests that healthy pregnant woman who get coronavirus will have a mild to moderate illness and will not need to be hospitalized.  For most women and infants, breastfeeding is safe.  Ask your care team and check in with the Centers for Disease Control and Prevention (CDC) website ( for the most up-to-date information.

COVID-19 vaccine during pregnancy protects newborns

While babies can’t receive the COVID vaccine themselves, they may still benefit from vaccine antibodies that pass through the placenta or breastmilk.


Resources for perinatal women to cope with the COVID-19 pandemic:

Additional COVID-19 information and resources:


Zero to Thrive COVID-19 Resources

Registration for Strong Roots Core Training is open!


COVID-19 Resource Database



Zero to Thrive Guides and Resources for:

Parents & Caregivers

Information and resources to help parents and caregivers care for themselves

Young Children

Helping children feel safer and more secure during uncertain times

Perinatal Women

Learn more about the impact of COVID-19 on pregnancy and breastfeeding

Professionals & Providers

Helping guide families through this crisis while coping with the impact themselves


COVID-19 Guides & Resources

Parent’s Guide to Coping with the COVID-19 Pandemic
Helping Kids Cope with the Coronavirus (COVID-19) Crisis
Pregnant or Breastfeeding? What you need to know about COVID-19
Telehealth Service in Infant Mental Health Home Visiting
The Importance of Routines for Kids
Helping Children Feel S.A.F.E. During COVID-19
Tips to Support Sleep During a Pandemic
Returning to Childcare during the Pandemic
Helping Young Children Transition Back to Childcare


Helping Young Kids Through the Coronavirus (COVID-19) Crisis

A New Georgie Story: A Very Different Birthday

Tender Press Books in collaboration with Zero to Thrive has collaborated again to create, “A Very Different Birthday”. Georgie is back to tell a story about how his birthday feels different in the midst of a pandemic. The new coloring book aims to help kids struggling to understand why things feel different than they once did.

Helping Young Kids Through the Coronavirus (COVID-19) Crisis

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As adults, we may tend to overlook or minimize how very young children are affected by current events. However, even very young children are watching and listening to what is happening, including how we respond emotionally. This means we need to think about how to help even very young children make sense of current realities, and it also means that our own self care is essential. In moments of stress, remember to breathe, connect with others (while keeping a safe physical distance), take a walk, or do some other thing that helps you feel better. Then think about how you can help your child feel safer and more secure.

Young children often cannot tell us about their worries in words. Instead, you might see changes in their behavior, such as:

  • Increased fussiness, crying, whining or temper tantrums
  • Increased clinginess
  • Increased hitting, biting or scratching
  • Becoming quiet or withdrawn
  • Changes in eating, toileting, or sleeping patterns, such as trouble falling or staying asleep

All of these behaviors may help you know that your child is feeling stressed. They will need more patience and guidance in managing their feelings, which can be so hard to offer when you are worried yourself.  None of us will be perfect, these are hard times. But we can strive to care for ourselves so we can care for our children.

Following are some suggestions about how you might think about helping your young child make sense of current events.   

First, be curious.

What has your child heard, and what does she think?  Little kids can have all sorts of ideas about what is happening, and why?  Sometimes when young children are trying to make sense of things they will come up with explanations that are not only wrong, but may make them feel even worse.  For example, does your child think that everyone who gets COVID-19 will die?  (Note- this is not correct. In fact, the risk of serious illness or death among in the general population is still low, and the risk for children is particularly low).   Or do they perhaps think that they are no longer going to school because they did something wrong? (Note- this may seem very illogical, but this kind of “magical thinking” is very common among young children.)

Correct misperceptions, and offer honest and realistic reassurance. 

Here are some realistic, honest, and reassuring things you might choose to share:

There are very smart people whose job it is to take care of the public’s health.  They are figuring out what we all need to do to keep people safe.  They are finding ways for us to take care that will help keep people healthy. 

Most people who have this illness are ok.  Most people only get a little bit sick and then they get better.  You could remind your child of a time she or he was sick with a cold, took care, and got better.  

You might be curious or hearing a lot about a virus called coronavirus.  Do you know what a virus is?  Viruses are like germs – different kinds of germs can cause lots of illnesses like regular colds, including colds that people in our family have had.  Even though it was not fun to have a cold or be sick, we got better.  Viruses do not happen to people because they did something wrong- no one is to blame, and our whole community is working together to try to keep people healthy and safe.  

There are a lot of helpers!   Doctors, nurses, first responders, grocery workers, garbage truck drivers, mail deliverers, teachers, religious leaders, community leaders, and more, are all working together to figure out how to help people through this hard time.  

We can share our gratitude with our kids, and that helps us all keep a more balanced perspective. 

Explain the “rules” and follow them.

To help keep most people safe and healthy, we are following the rules that scientists and doctors tell us will help. These rules include:

Washing our hands often
Trying not to touch our face with our hands
Sneezing into a tissue or our elbow
Wear a cloth face covering in common spaces (2+)

We can explain that we do this because it helps stop the virus from spreading.  Children learn by observing, so it is important that we model these behaviors consistently ourselves. 

Keep playdates safe!

Social distancing is the most critical and important factor that parents can control during this COVID-19 outbreak.

Play outside!

Kids can still get some fresh air and run around. Try to avoid playground fixtures that may transmit the virus.

Try virtual playdates

If possible, set up virtual play dates – kids can play games, dance, and interact with friends from a safe distance.

Write snail mail

Write letters, draw pictures, and create a pen pal system of friends and family so kids can stay connected.

Find your “family purpose”.  Helping others helps ourselves.  

Look for opportunities to ‘do good’—for example, leaving groceries on doorsteps of neighbors who can’t get out, or drawing pictures for loved ones, neighbors, or people who cannot have visitors at present such as residents of nursing homes.  You could work together to make “thank you” cards and pictures to people in your community who are working hard to help others.  Finding ways to “do something” helps move away from just worry to feeling more purposeful and helpful and helps strengthen our community response.

Create and keep new routines.  

Kids thrive on predictability—and school closures, work changes, and other things happening right now can really undermine that sense of predictability and routine that keeps kids (and honestly, adults, too!) feeling secure.  Plan a daily routine and make a calendar.  Include play time with you.  If possible, include time in the outdoors.  Make a list of fun activities, like “dance party time” “read a book time” or “time to draw thank you pictures”.  This also helps kids practice what they’d be doing in preschool. Dancing and playing and other fun activities can help everyone de-stress together.

Limit exposure to TV, news, and conversations among adults that might increase fear and anxiety.

We are all in this together, and parents and caregivers are understandably worried and wanting information, too.  That makes sense, but be aware that “small pitchers have big ears”—even very young children (infants and toddlers) are aware of our emotions, tone of voice, or the urgency and fear coming through the tv or radio.  Do your best to minimize children’s exposure to these things and be mindful of #1 above—care for yourself, too.

These are unprecedented times.  But these times also create tremendous opportunities for us to practice our values- to care for others, connect with those we love, to find community and purpose wherever we can.   This reminds us all of how connected we are to one another—and ultimately, we get through this together.  


Resources for parents to help children cope with the COVID-19 pandemic:

Coloring and Story Books for Kids
  • Zero to Thrive & Tender Press – A Very Different Birthday, a coloring story book to help kids understand why birthdays feel different in the midst of a pandemic.
  • Zero to Thrive & Tender Press – Georgie and the Giant Germ, a coloring story book to help kids with big feelings during COVID-19
  • Easterseals – My Social Distancing Story
Resources for Coping with School Closures and Returning to School
Guidance for Children with Behavioral Conditions

Additional COVID-19 information and resources:


Coronavirus (COVID-19): Resources for Professionals

Registration for Strong Roots Core Training is open!

Coronavirus (COVID-19): Resources for Professionals

Thriving Childcare: Ensuring Young Children’s Well-being and Health During the COVID-19 Pandemic

Members of the Zero to Thrive Translational Network have answered Governor Whitmer’s call for assistance with recommendations for guidelines on re-opening childcare facilities. To learn more about strategies to maintain the physical health and safety of children and staff while attending to the social-emotional health of infants and young children, please review the following resources:

Telehealth Service in Infant Mental Health Home Visiting

As we adapt to these unexpected and challenging times, infant mental health (IMH) home visitors around the world are faced with making the transition to technology as a medium to support families. Home visitors are being called upon to “hold” a great deal—their own feelings in these uncertain times, fears and worries about families navigating this crisis, and learning how to practice in new and unfamiliar ways. We are going through this alongside our clients and many of us are worried about finances and health, juggling the care of children or parents, and struggling to comprehend all of the ramifications of this new “not-normal” world. As a wise IMH therapist recently noted, “this is not ‘business as usual.’”

In collectively navigating these challenges, we want to remind ourselves that the things we already know and do as IMH providers remain relevant. Indeed, they are even more critical. Each of the components of IMH home visiting can be delivered in the “video” or “tele” environment.

In collaboration with professionals from the Alliance for the Advancement of Infant Mental Health, Starfish Family Services, and the Michigan Association for Infant Mental Health, the Zero to Thrive team put together an informational sheet that outlines strategies that can help IMH services be effective in the context of telemental health:

These are unprecedented times.  But these times also create tremendous opportunities for us to practice our values- to care for others, connect with those we love, to find community and purpose wherever we can.   This reminds us all of how connected we are to one another—and ultimately, we get through this together.  

External Resources:

  • COVID-19 Resources
  • Patient Mental Health
  • Provider Mental Health
  • Telehealth Guidance

Additional Zero to Thrive COVID-19 guides:


Statement against police brutality and systemic racism

Registration for Strong Roots Core Training is open!

Zero to Thrive Statement Against Police Brutality and Systemic Racism

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We at Zero to Thrive stand in solidarity with Black families across the nation, and with our colleagues, families, friends, and communities, in protest against systemic racism, violence and police brutality.  We recognize the long history of racism that was at the foundation of the establishment of our nation, and that perpetuates continued violence against Black families.   We understand that these experiences lay a foundation for the health, education, social, and economic disparities and inequities that lead to present-day profound differences in the experience of the pandemic for people of color, where mortality rates for Black people are at least three times greater than for those of White people; where Black mothers die 3-4 times more often than White mothers giving birth; Black children are about three times more likely to live in poverty than White children; and the list goes on.  In the face of this injustice, past and present, we claim our collective responsibility to contribute to the dismantling of these systems of oppression through careful listening, a commitment to self-reflection that leads to anti-racist action, and through work with our various personal and professional communities that aims to disrupt existing racist structures and promote equitable contexts and outcomes for children and families of color.  

The vision of Zero to Thrive is that from pregnancy through early childhood, all families have the well-being necessary to achieve their full potential.   This means that responsibility for raising healthy, resilient children, and for intergenerational change, rests with all of us.  We are committed to working to uncover and meaningfully address the racism that perpetuates inequities.  We strive for the day when Black mothers and fathers across the nation do not have to live with fear for the lives of the children they nurture and raise, and for a time when all our children and families live in a nation that provides the fertile soil that allows all children to grow and thrive.  

“In the face of this injustice, past and present, we claim our collective responsibility to contribute to the dismantling of these systems of oppression through careful listening, a commitment to self-reflection that leads to anti-racist action, and through work with our various personal and professional communities that aims to disrupt existing racist structures and promote equitable contexts and outcomes for children and families of color. “

For resources about supporting conversations with young children on race and racism, please visit our Parent Resources page

 We look forward to continued engagement and dialogue as a community during this important time.

In solidarity,

Zero to Thrive Leadership
  • Kate Rosenblum, PhD, ABPP, Zero to Thrive Co-Director
  • Maria Muzik, MD, MSc, Zero to Thrive Co-Director
  • Lynette Biery, PA-C, MSc, Zero to Thrive Strategic Director
  • Alison Miller, PhD, Zero to Thrive Translational Network Chair
  • Sheila Marcus, MD, MC3 Director
  • Nicole Miller, LMSW, Zero to Thrive Program Manager
  • Kate Bullard, LMSW, MPH, Perinatal Clinic Manager
  • Karen Smith, LMSW, IMH-E, Infant and Early Childhood Clinic Manager
Zero to Thrive Translational Network and Faculty Affiliates
  • Julie Ribaudo, LMSW, IMH-E, School of Social Work
  • Jenny Radesky, MD, Pediatrics
  • Prachi Shah, MD, Pediatrics
  • Richard Dopp, MD, Psychiatry
  • Paresh Patel, MD, Psychiatry
  • Dayna LePlatte, MD, Psychiatry
  • Sharon Mudd, PMHCNS-BC, NP, Psychiatry
  • Martin Heggestad, LMSW, Psychiatry
  • David Fulkerson, LMSW, Psychiatry
  • Greta Raglan, PhD, Psychiatry
  • Leslie Swanson, PhD, Psychiatry
  • Samantha Shaw, MD, Psychiatry
  • Kate Fitzgerald, MD, Psychiatry
  • Joshua Kay, PhD, JD, School of Law
  • Jennie Jester, PhD, Psychiatry
  • Megan Julian, PhD, Psychiatry
  • Melisa Schuster, LMSW, Michigan Medicine Department of Social Work
  • Natasha Pilkauskas, PhD, Ford School of Public Policy
  • Angela Johnson, PhD, Michigan Medicine
  • Nicole Gardner-Neblett, PhD, Psychology
  • Angela Fish, PhD, Psychiatry
  • Erin Hughes-Krieger, MSW, Psychiatry
  • Anne Kramer, LMSW, Psychiatry
Zero to Thrive Psychiatry Staff and Trainees
  • Rachel Waddell, LMSW, Psychiatry
  • Cherylle Hershey, Psychiatry
  • Britanny Doughty, LMSW, Psychiatry
  • Natalie Burns, LMSW, Psychiatry
  • Daniella Chavez, Psychiatry
  • Jessica Riggs, PhD, Psychiatry
  • Kathryn Forshe, Psychiatry
  • Sarah Freeman, MPH, Psychiatry
  • Alanah Hall, MPH, Psychiatry
  • Kiyah Mills, Psychiatry
  • Emily Taylor, Psychiatry
  • Hope O’Neill, Psychiatry
  • Emily Alfafara, Psychiatry


Helping Young Children and Their Caregivers Transition Back to Childcare

Helping Young Children and Their Caregivers

Transition Back to Childcare

Julie Ribaudo, LMSW, ACSW, IMH-E

Attending to the well-being of young children and their caregivers in the transition back to childcare entails attention to the physical, social and emotional health of all of those involved (children, parents, and childcare providers). Developing recommendations for infants and young children must  include strategies to maintain physical health and safety, while also being attentive to emotional health and security.  While social distancingis recommended to mitigate the spread of infection, emotional proximity is developmentally necessary for young children to feel safe and secure, especially in times of transition and uncertainty.  For infants and young children, social emotional health and well-being requires physical safety and the emotional security that comes from being able to turn to their trusted caregivers for comfort and care.

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Facilitating young children’s successful transition to child care in the midst of a pandemic will require attention to several factors, including attention to children’s emotional reactions to the separation from their family, and reunion with their teacher/friends at childcare; the need to re-establish new routines; the developmental need for the continuity of a relationship with a trusted adult; and the ability of the child care providers to meet the emotional needs of the children, while recognizing that providers are also experiencing the wide-spread effects of the COVID-19 pandemic, and also need to feel safe, secure and  supported. 

Another consideration is that children will experience the effects of this pandemic differently, and their individual responses as they return to childcare will likely vary. For some children, having more time with their parent(s) may have been a welcome experience, thus making a return to childcare a potential source of stress and sadness. For other children, the disruption of the routine and relationship with their childcare provider, may have been experienced as a loss and trauma, and the reunion with the caregiver who “abandoned them” (in the child’s eyes) may contribute to expressions of ambivalence and anger in some children upon the subsequent reunion with their caregiver/teacher. In addition, some children will have suffered other losses or endured experiences that have threatened their sense of security during the stay-at-home order. These children will require additional comfort, stability and emotional availability of their teacher/caregiver to help mitigate the negative impact of cumulative stress. 

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Finally, to ensure the well-being of the children, it is also imperative to ensure the well-being of their teachers and caregivers, and to provide them with the emotional and administrative supports necessary during this time of re-integration, and in the months ahead. As essential workers in the COVID-19 pandemic, child-care providers may have worries  about their own physical or psychological health, and the potential risk to their family members at home. Because young children internalize stress vis-à-vis the adults who care for them, it is vitally important to provide supports and services to the childcare providers to ensure their emotional well-being.  Strategies to “help the helpers” can include professional development supports such as access to behavior health consultation, and reflective consultation, which can help providers  remain emotional available, sensitive, and responsive  to the needs of the infants and young children they care for.

For Parents

Two to three days before you plan to transition your child(ren), talk with them about going back to school. Help them to recall the routines, who they liked to play with, what they liked to do and the names of staff they will see again.

For young children, masks change a person’s appearance and can be frightening. Explain to children two years and older that their teacher(s) will be wearing masks. Help them “practice” by watching you put a mask on and off. If possible, let them play with putting a mask on and off a doll or stuffed animal. Practice talking behind a mask so they can become accustomed to hearing a voice but not seeing lips. 

Explain that the teachers will be taking children’s temperature before they go into school. Let them know that this is one way that adults are keeping people safe.

Let your child know that they may not be able to play on the playground (?) and explore how they might feel about that. 

Work with your child’s teacher to understand how the drop off and pick up routine will be managed so that you can thoroughly explain it to your child. Predictability gives children a sense of control so helping them know what to expect is important to their sense of security.

Much like the beginning of a new year, you may find that your child has a range of reactions to leaving you, seeing their teacher and reuniting with you at the end of the day. You might see sadness, excitement, anger, separation anxiety, sleep issues, etc. It can be hard to see your child in distress. Reassure them that you understand their feelings, that they can talk to you about it and that you and their teacher are there to help them if they are feeling sad, scared, worried or angry. 

For children who are slow to warm up or experience worry at separation, plan for a school visit with you (if possible), and for a shortened schedule the first few days.

Watch and respond to play themes such as hide-n-seek, peek-a-boo, lost and found, etc. These “games” are often ways that children express and manage their feelings about separation. Reassure them that you will always come back for them. 

Watch and respond to play themes such as hide-n-seek, peek-a-boo, lost and found, etc. These “games” are often ways that children express and manage their feelings about separBe gentle with yourself. This has been a stressful period of time for most people. You may find you have your own mixed feelings about returning your child to childcare. You might feel like a relief, a loss, fear for their health or some other mix. A range of feelings is normal. Utilize your supports, talk to your child’s teacher or call a hotline (#?) if you find your feelings about returning your child to childcare difficult to manage.ation. Reassure them that you will always come back for them. 

For Childcare Providers

You may have mixed feelings about returning to work. It is normal and expected that you might experience a sense of relief, happiness, worry and anticipation all at the same time. We hope you have sources of support to sort through your thoughts and feelings so you can feel as “ready” as possible to re-integrate children into their days with you. They will need your steady emotional and physical availability to feel safe with you again.

Some of you may have worries about your own health, financial worries, family worries, etc. The accumulation of stress can take a toll on any of us. We encourage you and your directors work together to provide you with the emotional supports and strategies to help you retain your emotional availability for the children.

Wearing masks all day will be potentially physically uncomfortable and psychologically challenging for both you and the children. Without access to seeing “all” of you, children will need extra cues from you to know they are safe with you. Pay particular attention to your non-verbal communication including conscious attention to eye contact, reassuring voice tones and gentle touch.

Children who were previously settled in may show separation anxiety again. You may find it helpful to employ all of your “beginning of the year” strategies as you transition children into your classroom.

Children may have experienced loss, trauma, instability during stay-at-home – they may not be returning as the child they “were” when they left you at the start of the stay-at-home order. They will need your patience and understanding as they sort through difficult feelings. Some may feel that you “abandoned” them, and they may express anger or coolness toward you or be extra clingy yet hard to console. We hope you can find ways to be supported and stay emotionally strong and kind for children through this challenging and taxing time. 

What to Expect from Children

You already know that children express their thoughts and worries in a variety of ways. You may find their behavior somewhat confusing as they re-integrate to childcare. That may suggest the child sorting through their own confusion. 

Patterns of stress response you may see: 

Motoric hyperactivity, trying to hide, being giddy and seemingly out of control

Somber and withdrawn 

Actively crying and difficult to console

They are bound to be wondering about the “germ” and where it is. They may wonder why it is okay to come back to school now. They will notice and possibly react to changes, such as new routines, teachers in masks, the heightened emotions of the adults around them, loss of friends they expected to see, etc.  

Providing predictable routines and offering the reassurance of your emotional and physical presence can go a long way to help young children feel safe and secure. You can help them by building in games that deal with separation and loss, such as hide-n-seek or peek-a-boo.

When children’s behavior is confusing or upsetting, it can be helpful to pause and ask yourself, “What is the child doing? What might they be feeling? What do they need (attention, help, movement, connection with you or for you to notice and delight in them in some way)? How can I help them with their feelings and to restore their sense of emotional security and safety?” When children feel good, they usually act “good.”  It is worth the effort to sort through the meaning of their behavior, even though it is challenging for the caregiver at times. If you find yourself short-tempered or impatient, making “repair” with a child when you are calm by talking with them about what happened, apologizing if you frightened or alarmed them, and reassuring them of your care for them can help build their relationship with you.

Some children who suffered extra stress, or who have suffered earlier traumas, may be especially hard to help right now. Behavioral health consultants and/or a reflective consultant may be a source of support as you work to reassure and provide safety for these children and navigate  the challenging and uncertain days ahead.


Tips for Supporting Sleep During a Pandemic

Tips for Supporting Sleep During a Pandemic

If you’re having trouble sleeping during the COVID-19 pandemic, check out these tips to fall asleep easier and get more rest.


Make Sleep a Priority


Use bed for sleep and sex only

  • Avoid spending time in bed when not sleeping (e.g., while working or watching TV)
  • If you are working from home, move your home office away from your bed
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Pay attention to light

  • Dim light (only enough to see) within 90 minutes of bedtime, during sleep period; keep electronic devices on dimmest setting
  • Consider using orange-red light bulb (from hardware store) if you need light during the night to feed, care for baby
  • In the morning, get as much bright light (for baby and mother) as possible; sunlight is best 

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Have a 30-60 minute “wind down” zone before attempting sleep; engage in relaxing, quiet, activities in dim light 

  • Can also be helpful for baby (starting around 3-6 months of age) to have pre-bedtime routine
  • Avoid reading or watching news or social media during your wind down
  • Try soothing or calming strategies (e.g., mindful meditation) during this time 


Don’t “try” to sleep

  • Lie down to go to sleep only when sleepy
  • Get out of bed when unable to sleep; do calm, distracting activity, such as reading in low light or watching TV, until you feel sleepy


Keep a consistent wake time when possible


Scheduled naps are OK; nap in bed if possible and aim for 6 hours after wake time


Weigh the costs/benefits of breastfeeding/pumping if you are experiencing significant sleep deprivation related to feeding

Insomnia Self-help Books

The Insomnia Answer (Glovinsky & Speilman)

Online CBT for Insomnia

Free: CBT-I Coach




Z2T Translational Network Response

Registration for Strong Roots Core Training is open!

Z2T Translational Network Response to COVID-19

Dr. Alison Miller & President Schlissel and School of Public Health’s Outreach: 

Dr. Miller was part of a group of faculty from the SPH who had a conversation with President Schlissel regarding the impact of coronavirus response efforts. Please review the video of that conversation below. The SPH posted a Q & A with Dr. Miller on social distancing and mental health during the pandemic (link below) and the SPH podcasts includes Dr. Miller on 3/25/20 (link below). 


Associate Professor, Health Behavior & Health Education

Research Associate Professor, Center for Human Growth and Development

Parenting Research Brief

Dr. Shawna J. Lee from the School of Social Work has created a research brief, Stress and Parenting During the Coronavirus Pandemic.

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“Parenting is hard, even in good times. In the midst of the Coronavirus pandemic, American parents are being presented with new challenges on how best to meet their child’s needs. With schools and childcare centers closed, parents are providing more direct care for their children, with little respite from teachers and other caregivers. Furthermore, many are parenting their children under stressful conditions with a high degree of economic uncertainty. This research brief examines how parents are responding to their children during the Coronavirus pandemic.” 

‘Stay at Home’ Orders Are Stressing U.S. Families, Survey Shows

“Everybody is going to struggle in different ways, but kids are vulnerable and voiceless. Kids are going to suffer from this, too,” said Dr. Shawna Lee, associate professor of social work, whose research shows that the stress and uncertainty caused by the coronavirus is taking its toll on parents — and children are feeling the psychological and physical brunt of it.


Director, SSW Program Evaluation Group,

Associate Professor of Social Work, School of Social Work

Faculty Associate, Research Center for Group Dynamics, Institute for Social Research

MC3 and MC3 Perinatal

MC3 (led by Dr. Sheila Marcus) and MC3 Perinatal (led by Dr. Maria Muzik) provides guidance on diagnoses, medications, and psychotherapy interventions to primary care and obstetric providers throughout Michigan who are managing perinatal women and/or kids, and young adults (to age 26). MC3 and MC3 Perinatal is responding to the pandemic in the following ways: 

  • MC3 remains open for phone-based consultation, scheduled consultation and launching pilot of evening hours on Monday, April 6 . 
  • Behavioral Health Consultants are surveying enrolled practices to determine needs for guidance and support. 
  • Behavioral Health Consultants are confirming virtual access to local resources. 
  • Updated website with specific COVID-19 resources. 
  • Planning live sessions that addresses the needs of clinicians and possibly parents. 


Clinical Professor

Section Chief, Child and Adolescent Psychiatry


Associate Professor, UM Dept. of Psychiatry and Dept. of Obstetrics and Gynecology

Co-Director, Women and Infants Mental Health Program (WIMHP)


Helping Children with Big Feelings During COVID-19

Registration for Strong Roots Core Training is open!

Helping Children With Big Feelings During COVID-19

Ribaudo, J., Safyer, P., and Stein, S.

Young children often cannot tell us about their worries in words. Instead, you might see changes in their behavior, such as:

  • Increased fussiness, crying, whining or temper tantrums
  • Increased clinginess
  • An increase in self-soothing behaviors such as thumb sucking, rocking or needing their pacifier
  • Increased hitting, biting, spitting or scratching
  • Increased acting up
  • Becoming quiet or withdrawn
  • Changes in eating, toileting or sleeping patterns, such as trouble falling or staying asleep

All of these behaviors may help you know that your child is feeling stressed. They will need more patience and guidance in managing their feelings, which can be so hard to offer when you are worried yourself. You may be surprised by their new reactions and it is normal to be concerned when you see changes in their behavior. However, their changes are likely to be short term if we help them through all the changes they are experiencing (and one of the changes may be that they notice you seem different than usual).

S.A.F.E. Communication

SAFETY – Emphasize your role in keeping your child safe.

  • For babies, be a reliable source of soothing and comfort, through holding, rocking, singing and staying with them – even when they are inconsolable.
  • Young children thrive on knowing what is going to happen, so the changes in their routine can be very upsetting. Creating a routine while at home and letting them know what’s going to happen will create feelings of safety and predictability.

ACCEPTANCE – Know that you can be the best parent and yet babies and young children can still feel your stress and that of others.

  • Children’s “big” behaviors such a hitting or throwing more tantrums is their way of communicating their distress. Accepting their confusion, sadness and anger over missing friends, teachers and play dates may be difficult and frustrating at times, but it is what they need from you right now.
  • Children may also ask why you are sad (or mad or scared). You can let them know that grown- ups can feel sad and mad too but that you are okay, and that it is okay for anyone to have big feelings.
  • When little ones are anxious, they need to know that adults are strong and kind, and able to take care of them. We hope you have adults with whom you can talk so you have someone who helps you ease your worries.

FEELINGS – Put into words their feelings of fear, anger, sadness and confusion.


  • You will not make a child feel worse by acknowledging their negative feelings. When we can share our feelings with another, they often lessen… it is a bit like chewing on a piece of food until it is small enough to swallow…when feelings are acknowledged they don’t get stuck in our throat or body.
  • Tell them repeatedly that what is happening is not their fault and that there are many adults working hard to fight the germs.
  • When you see feeling such as anger or sadness saying “I know you are mad that you can’t play with your friends” lets them know you understand their feelings even if you can’t give them what they want.
  • Sometimes our children’s “big” feelings make us uncomfortable and we want to avoid them. Some of us grew up being told it wasn’t okay to express strong emotions. In some cultures, we are taught not to express emotions. In times like this, when worry can be so high, acknowledging feeling can help reduce the stress.

EXPRESSION – Help your child tell stories about what they are thinking about.

  • You can make up stories about other children (or animals!) who were scared of germs, or worried that they did something wrong to cause all the changes that are happening.
  • You can also play games like peek-a-boo and hide-n-seek to help them manage the sudden losses and uncertainty about the future.
  • Young children use play to express their feelings and try to understand what is happening, like the child who gives their doll a “shot” after a visit to the doctor. Observing how children play can also help you understand more of what is going on in their minds.
  • Dance and movement can be another way to reduce stress and create opportunities for connection and relieve stress for all of you.
  • Playing lullabies or singing their typical school day songs may induce feelings of familiarity and comfort, for them, and maybe even for you.

We hope you will reach out if you feel you are feeling alone or overwhelmed. Parenting can be challenging under the best circumstances, so be kind and gentle with yourself too.

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