Early brain development lays the foundation for lifelong health and success. But disruptions to a child’s early environment can leave a long-lasting imprint on their development and success.
For example, research shows that babies who are born during disasters or pandemics are at an elevated risk of experiencing developmental delays and having poor mental health and brain development into adulthood.
We also know from studies of prenatal stress that when a mother is stressed, the stress signals her body releases can cross the placenta and affect fetal development. Postnatal stress can also affect a parent’s ability to provide sensitive and attentive care to their infants.
Exposure to stress signals in the womb can also change how the stress response system works in children. This makes them more vulnerable to later mental health and neurodevelopment difficulties.
The COVID-19 pandemic undoubtedly created massive disruptions to prenatal care and babies’ early experiences. Parents also experienced high levels of distress during the pandemic which, for many, went untreated and persisted well into the postpartum period.
Given the effects early-life stress exposure has on a child’s development, many people worried the pandemic would create a generation of children who wouldn’t achieve their potential. But the most recent evidence suggests that pandemic babies are doing better than anyone expected.
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Canada’s pandemic babies
Several weeks after the World Health Organization declared COVID-19 a global pandemic, we launched the Pregnancy During the COVID-19 Pandemic study to assess the effects of the crisis on pregnant people and babies born during the pandemic. Our pan-Canadian study, which is still ongoing, follows around 7,000 families. It mainly focuses on the psycho-social and neuro-developmental well-being of pandemic babies and their caregivers.
Contrary to expectations, we found that most pandemic-born babies were on track for developmental milestones. This provided reassurance that most children were doing well.
However, we did find a one to two per cent increase in the number of children at risk of developmental delay compared to babies born before the pandemic.
Likewise, most children born during the pandemic continued to develop normal language skills. However, infants born during the first wave of the pandemic and girls born at any time during the pandemic had a three to six per cent increase in language difficulties at age two compared to infants born prior to the pandemic.
But all of these differences are small — showing that most pandemic-born children have been remarkably resilient to the disruptions caused by COVID-19.
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Our research has also showed that the SARS-CoV-2 virus itself was not associated with children’s developmental outcomes. This suggests that COVID-19 infections were not a driving force behind developmental delay.
Rather, it may be that these developmental delays are partly explained by brain changes caused by exposure to stress in the womb. Research shows that prenatal distress due to the pandemic was associated with changes to infant brain connectivity in areas related to behaviour and mental health. This suggests that exposure to stress in the womb may make babies somewhat more vulnerable to later mental health problems.
Risk and resilience
The severity of the stress that a child is exposed to in early life is a primary contributor to poor developmental outcomes. Although the pandemic was a universal stressor, certain pre-existing factors either reduced or amplified this stress for people — such as socioeconomic status, food insecurity, ethnicity, partner support and community support.
Parents with access to more resources, such as income, workplace benefits or social supports, were better equipped to provide an enriched environment for their children.
For instance, parents who had a stable income and more partner support during the pandemic were better protected from the effects of stress — and so were their infants. This finding extended to the infant’s brain connectivity. The more social support a mother had during pregnancy, the less likely her child was to exhibit brain alterations related to in-utero stress exposure.
Our data also suggests that infants from lower socioeconomic status households had the highest risk for developmental delay. Although this association in not unique to the pandemic, the increased challenges posed by COVID-19 exacerbated the effect.
Decreased opportunities for social contact and play, both of which are essential for normal social and language development, may also have put children at risk of developmental delays.
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But perhaps the most striking observation regarding the effects of the pandemic on children’s development is their remarkable resilience. Despite disruptions to their early environment, most babies born during the pandemic continue to develop normally.
Preparing for the future
For the children who have been more severely affected by the pandemic, there’s still ample opportunity to shift their developmental outcomes.
Children who are struggling to meet developmental milestones need to be identified early. It’s important they have access to pediatric specialists (such as speech and language pathologists and early childhood educators) so they achieve their potential. It may also be the case that these children simply need more opportunities to practise any skills they’re lacking.
But the real-world test of how pandemic-born babies are doing will become more apparent in the coming year as they enter education. Although pandemic babies have proven to have remarkable resilience, there will still be more children than usual requiring support in an already-strained system.
In the future, it will be important for governments to better address the needs of parents and young children in emergency planning. It will also be important for plans to ensure that pregnant people have access to mental health help during public health emergencies given the impacts stress can have on developing infants.
One of the most meaningful ways of increasing the resilience of children and families is to provide affordable, high-quality child care — and to ensure all children have their basic needs consistently met.
