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Early years vulnerable children worst hit by COVID restrictions

Food security has worsened as a result of Covid-19, both globally and in the UK, according to an evidence review of the impact of pandemic life on physical development in the early years.

Young children in their early years have been adversely impacted by the restrictions implemented as a result of the Covid-19 pandemic, such as lockdown and the closure of services, across a range of physical development domains.

The rapid review, which focused on children aged 0–5 years old, by the Early Intervention Foundation found relatively little evidence which specifically examined the impact of the Covid-19 pandemic on children aged 0–5 years in the UK. Much of it focused on older children and was conducted outside of the UK, which will have had similar but not identical impacts.

“Across each factor influencing physical development the evidence is clear in showing that the Covid-19 pandemic has disproportionately and adversely impacted vulnerable children, meaning they are at greater risk of adverse physical development outcomes as a result of the pandemic. This is the case for each factor individually, and when considered in combination,” said the report.

The report examined physical activity, food security, vaccinations, sleep, breastfeeding, oral health and diet and micronutrient deficiency.

Food security and diet

All the studies identified indicate that food security has got worse due to Covid-19, both globally and in the UK. Children who access free school meals and children from low-income households were at greater risk of food insecurity during the Covid-19 pandemic.

Evidence from other countries on older children suggests that during the Covid-19 pandemic, children from poorer families were more likely to rely on cheap, shelf-stable food that is often high in calories and low in nutritional value, meaning their dietary nutrition worsened. The review found no evidence overall on nutrient deficiencies in the UK but did find international evidence on vitamin D deficiency, which has implications for children with darker skin tones in the UK who are at greater risk of vitamin D deficiency.

The rapid review identified no UK-based evidence aimed at understanding the impact of the Covid-19 pandemic on children’s physical activity in their early years. Studies from other countries suggests a decline in physical activity as a result of the pandemic, which is consistent with evidence from England and elsewhere which indicates there has been a decrease in physical activity levels among children older than.

There was also evidence from older children that confidence in taking part in sporting activity has decreased, as well as a decrease in positive attitudes towards physical activity, particularly among minority ethnic pupils.

There was evidence to suggest that having inadequate space to play at home, such as children living in apartment blocks, as well as having all adults working from home, was associated with worse physical activity levels. Conversely, living with other children appeared to have a protective effect with greater physical activity levels reported for families where more children were present in the home.

There was little evidence found on the impact of the pandemic on physical activity among vulnerable children aged 0–5, with none from the UK. For older children in England, the report by Sport England showed falls in both the proportion of children and young people (aged 5–16 years) who reported being active, and confidence in taking part in sporting activity.

Whilst all groups have been impacted, the impact was greater for some groups than others:

• Gender: Whilst boys are traditionally more active than girls, they saw a significant decrease in activity, especially for boys aged 9 and older.

• Income: Activity levels remained lower for those from less affluent families than for those from the most affluent families.

• Ethnicity: Pupils from Black and mixed backgrounds, and to a lesser extent Asian and other backgrounds, saw significant decreases in activity level over the summer term, mainly driven by boys within these groups. Worryingly, these decreases were accompanied by decreases in positive attitudes to physical activity.

Breastfeeding

In the UK, women with lower educational attainment, Black and Asian women, and women from minority ethnic groups, women living in more challenging living circumstances, women with suspected Covid-19, and women with worsening perinatal mental health faced additional challenges in relation to breastfeeding during the pandemic, making it more difficult for them to maintain breastfeeding.

Evidence indicates more negative experiences of breastfeeding and higher cessation rates among women from UK ethnic minority groups, and those living in more challenging circumstances.

Qualitative analysis identified five factors that made breastfeeding more difficult:

  • Lack of face-to-face support
  • Lack of social support
  • Increased stress and isolation caring for older children
  • Overwhelming focus on breastfeeding
  • Lack of experience breastfeeding in public.

These findings were reflected in the USA data where women reported reduced access to family and friend support, including child-care arrangements, had increased postnatal stress and feelings of isolation, making it more difficult to breastfeed and care for their infants.

There is evidence to indicate that routine vaccinations in infants saw a significant reduction as a result of the Covid-19 pandemic in the UK and elsewhere. At the height of the pandemic, evidence suggests that some families in England were unaware that routine vaccinations should continue, and some had difficulty accessing vaccination appointments.

Furthermore, evidence suggested that oral healthcare for infants declined as a result of the Covid-19 pandemic, both in the UK and elsewhere. None of the studies looked at the causes or consequences of reduced oral healthcare

Vulnerable children

While no UK-based evidence on sleep was identified, there were number of studies from other countries. Some of these reported improvement in sleep, however the majority reported decreases, notably for sleep quality.

All of these issues were worst felt among vulnerable children and families: “Available evidence suggests the physical development of young children is likely to have been negatively impacted by the consequences of the Covid-19 pandemic, particularly in the case of vulnerable groups, namely children from low-income families, and those from UK minority ethnic families,” said the report.

“Without prioritisation of evidence-based policies and services aimed at supporting physical activity and promoting food security, good quality diet and nutrition, breastfeeding, oral health, immunisations and sleep, the long-term impacts of the pandemic are likely to hinder the early physical development of this generation of young children and lead to increased health risks and inequalities in later life,” the report concluded.

Growing up in the Covid-19 pandemic: An evidence review of the impact of pandemic life on physical development in the early years

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