The first two years of life are a time of astonishing brain growth. What has that meant for the toddlers who have only known a world with COVID?

 

Two years is a long time in any child’s life. It’s half of high school and most of middle school, time enough for a grade schooler to notch several inches on the kitchen doorframe and for toddlers to leap from first words to conversations. For the babies born in March 2020, just as the pandemic was declared, two years make up their whole lives.

From the minute these children were born in empty maternity wards to now—as their parents are cautiously approaching their second-birthday celebrations, and the world is observing the pandemic’s anniversary—life has been unpredictable and unsettling. For adults, anyway. It’s less clear what the experience has been like for the kids, who have been limited in their interactions like everyone else—but who are engaged in a time of astonishing brain growth, when the foundations are laid for everything from language to friendship and resilience.

I talked with six families whose babies were born just as the pandemic descended. Some of those kids have yet to meet their grandparents, aunts, or uncles. Some have spent months on end playing only alone or with siblings. Parents have grieved missed milestones: A joyous baptism celebration turned into a few masked people spread out in a church; first birthdays consisted only of immediate family and cake. They have also experienced beautiful moments: extra time snuggled together over books, or hiking and biking with an infant in tow.

Everyone I spoke with knew from the beginning that their babies were entering a changed world. When Mychael Schilmoeller walked into the hospital in Edina, Minnesota, to have a Cesarean section on March 17, a few days after the governor announced a state of emergency, sheets of plastic draped the hallways. There was not one other patient to be seen. A nurse standing 20 feet away put up her hands to stop Schilmoeller, a real-estate agent, from coming any closer. “Why are you here?” she asked. “To have a baby.”

Handwritten signs directed her to the maternity ward. There and everywhere else, rules were changing rapidly. Parents only. No doulas. No, you don’t need a mask. Yes, you need a mask, but don’t lose it; there are no extras. The mothers I spoke with, even those who had a C-section or serious complications, were sent home as fast as possible. The message from the hospital was “You shouldn’t be here,” Schilmoeller told me.

At home, friends and family who would have helped with child care couldn’t come. Parents were desperate for support, but also desperate to stay safe. In New York City, where COVID cases soared early on, Kristin Force didn’t leave her Brooklyn apartment for months except to go to the pediatrician. “I was terrified of taking this fresh little baby out,” she told me. Force wore a mask and rubber gloves for the eight-minute walk. “It was like I dressed for surgery just going to the pediatrician’s office.” People thought the pandemic would last for two weeks, then two months. Never two years.

So much time spent isolating together in those early days was exhausting—and, sometimes, a blessing. While Force’s then-4-year-old son, Owen, attempted remote school in a corner of the living room, Force hovered nearby with her newborn, Nora, bouncing or breastfeeding her while trying to guide Owen through his Zooms. Her husband, Phil Kocher, was working remotely in the opposite corner of the living room, and stepped in to help as needed. He worried about Owen, but not Nora. “Because she was so young,” he told me, and “so well taken care of, I think she was almost benefiting.” He’s probably right. In the first year of life, babies need quality interaction to build secure attachments—to form close bonds with caregivers and learn to trust that those adults will continue to be there. Attentive care can help kids learn, too. A study of families in 13 countries found that shared reading time during the pandemic was correlated with certain vocabulary gains.

Schilmoeller, who took home a healthy daughter—Rowan—after her C-section, had a similarly intense, “privileged yet stressful” maternity leave, which stretched from eight weeks into five months at home. “It was wonderful in one sense,” she told me. “It was just quality one-on-one time.” But the disruption to routine was very difficult for her then-14-year-old daughter, Maggie, who is autistic. Many days felt like chaos. In August 2020, Rowan started group child care; Schilmoeller had to return to work full-time, but she also wanted Rowan to interact with other children. “Because I have a profoundly disabled daughter, I’m more acutely aware of developmental milestones,” Schilmoeller told me. She knew her children could get COVID, but she felt child care was worth taking that chance.

The risk calculus was different for other parents. Force didn’t return to work at a nearby shop for fear of infection, and when she finally felt that it was safe to take Nora to the playground near their apartment, in the fall of 2020, she wiped down the swing and anything else Nora wanted to touch with sanitizing wipes. Mostly, she tried to bring the outdoors inside, filling their apartment with new gear—a trampoline, a swing that hangs in a doorway, a foam couch that doubles as building blocks. “We don’t have space for this stuff, but whatever is going to make them feel like they’re not missing out,” Force told me. At one point they put artificial turf on the fire escape so Owen could play with his toys outside.

The loss of time with extended family—who lived far away, who wouldn’t get vaccinated, who waved from the end of the driveway—was one of the hardest-to-bear disappointments for the parents I spoke with. Force’s mother FaceTimes with the children every day but has been to visit only three times. Each time, Kocher borrowed a car and drove to collect her in upstate New York, a nine-hour round trip. (It was “the right thing to do” but also “an escape,” he admits.) On the first visit, when Nora was six months old, the happiness and heartbreak of the reunion was overwhelming. “[My mother] cried so hard when we opened the door that it scared my daughter,” Force told me. “Nora was afraid of her for the first two days.”

An early fear of strangers is common, but some parents told me they worry it has been amplified during the pandemic—that their children haven’t learned to socialize. Nora has come to adore her grandmother, but with other adults, she seems to warm up only after they lower their masks so she can see them smile. And with other toddlers, she can be standoffish. For very young children, though, spending time with peers is a relatively recent phenomenon. “Years ago, most kids were not in preschool programs. They had peer interactions with siblings, with neighbors,” but many spent their first couple of years in an environment of adults, Jack Shonkoff, a pediatrician and the director of the Center on the Developing Child at Harvard, told me.

Social interaction becomes more meaningful in the second and third years of life, as children learn to separate from their grown-ups and see themselves as individuals. “If children haven’t had [social] experience when they enter into preschool, they need some extra scaffolding from their teachers and parents to learn … about taking turns and sharing and solving conflicts,” the psychologist Nancy Close, of the Yale Child Study Center, told me. No toddler is good at those things—and for children who have interacted very little with others, it may take a little more time. Force suspects that Nora will be one of those who need extra help. She tells her daughter, “There’s other people out there in the world.”

These 2-year-olds don’t just have to learn how to interact with peers—they also have to master the intricacies of pandemic etiquette. Even Rowan, who has been in group child care, has been practicing with her stuffed animal. “She will feed her fox and give her sippy cup to the fox, and now she will put her little mask on his face,” Schilmoeller told me. In therapy, Close has had children reenact COVID tests on baby dolls. Incorporating masks and tests into their play “is their way of controlling something that might feel overwhelming,” she said.

It’s a complicated time to be 2—to never have known a world without masks, to miss out on playgrounds and playgroups. Yet even when adults’ lives are abnormal, a very young child’s life may not feel that way. What they really need is “responsive, nurturing” relationships, Shonkoff said. If parents are doing that, it is “money in the bank for basically a good outcome.”

Still, not every child born in these past two years will emerge unscathed. “What we know about children and their development is they do as well as the adults in their lives are doing,” Close told me. Parents of very young children have been under extraordinary strain—especially those who were already struggling to make ends meet. A small number of early studies have found that children born during the pandemic are at increased risk of developmental delays, and some researchers think parents’ stress, both during pregnancy and after children are born, may be at least partially responsible. One or two studies can’t provide a conclusive answer, but experts do expect to see increases in mental-health issues and developmental delays as this group ages. “We’d better fasten our seat belts for what’s to come,” Shonkoff told me.

Researchers are particularly worried about the effects of prenatal parental stress in the earlier stages of pregnancy, which is known to cause lower birth weights and other problems. A study from Columbia University Irving Medical Center found that babies born during the pandemic scored lower on tests of gross-motor, fine-motor, and social skills at six months compared with babies born earlier. The largest effects were found in mothers in New York City who were in their first trimester early in the pandemic—when case rates were rising precipitously and uncertainty was at its highest. (In utero COVID infections had no effects.) Of course, only so much can be gleaned when babies are so young, and increased risk doesn’t tell us what will happen in the future; delays caught early can be headed off with intervention.

Nonetheless, Dani Dumitriu, a pediatrician and professor at Columbia’s medical school and one of the study’s leaders, told me that “if our data were to generalize to all the babies born during the pandemic, that could mean something like a triple increase in babies that need to be referred” for intervention. Being proactive will be key. If you have concerns about your child, Shonkoff told me, “asking for help is a sign of strength.”

Dumitriu’s research only adds to mounting evidence of how important mental health is during and after pregnancy. Many pandemic mothers suffered from postpartum depression, in part because they had so little support, especially in the first year: no playdates, no get-togethers with other mothers, and only limited, virtual appointments with their own doctors. For several of the families I spoke with, what helped most was finding people to commiserate with, even if only virtually. Close, the Yale psychologist, led a support group for parents who work at the university. She’s found that it doesn’t really matter what she says; for these parents, just being around people who understand their exhaustion is meaningful.

As for these 2-year-olds, they won’t get back what they’ve lost. But because they won’t remember this early time, they probably won’t be haunted by it, either. Schilmoeller comforted herself with that thought as she decided to forgo Rowan’s second birthday party. “She’s only 2 and not going to look back and think, My parents deprived me of this,” she told me. “When she’s older and hoping to see friends and family, I hope we can do that for her. I sincerely hope by her third birthday, we’re in a much better place.”