We interviewed 25 mothers who were primarily first generation immigrants born in China (96%) and preferred interviews in Mandarin (80%; Table 2). About half (52%) of infants were in early infancy (1–7 months) and 48% in later infancy/early toddlerhood (8–15 months). Almost a third (32%) of mothers delivered their baby during the height of the pandemic in New York City (March–May 2020 ). The most common parent job descriptions were restaurant worker (e.g. cashier, food delivery person, server), manicurist, or home health aide. Forty percent of mothers mentioned unemployment impacting themselves or a partner, predominantly in the restaurant industry.
Broadly, we found that although the COVID-19 pandemic heightened overall family hardship (Theme 1) and altered daily infant routines with developmental consequences (Theme 2), families developed coping mechanisms in response to material hardship and stress (Theme 3). Tables 3, 4, and 5 display example quotations (Q) by theme and are numbered consecutively.
Theme 1: Heightened Family Hardship; “I’m Having a Hard Time Finding a Job While also Being Worried About the Risks”
Mothers described increased household material hardship and resultant psychosocial stress (Table 3). Economic recession impacted families through job loss (Q1, Q2) and fluctuating prices of everyday goods (Q3, Q4), “It was difficult to buy powdered milk, and the prices continued to fluctuate.” One mother recounted how she used to discard old vegetables and expressed a stressful sentiment where she “didn’t dare to waste food anymore” (Q4).
Travel restrictions disrupted transnational (US-China) childcare arrangements that some lower-income families relied on to accommodate extended work hours incompatible with accessible childcare resources. One mother stated: “Most of Chinese parents here are far from their parents. If they have a child, one of the couple has to stop working. My husband and I wanted to earn money, so we sent our baby back to China.” Due to COVID-19 travel restrictions, families noted being delayed in bringing infants to China and subsequently delayed in obtaining employment (Q5, Q6). The emotional response to this delay was a tension between increased financial stress and relief at the opportunity to “raise our children by ourselves” (Q6). Relatedly, mothers spoke about delays in reuniting with older children currently in China (Q6, Q7). One mother communicated distress around her older toddler, a US citizen living in China with developmental delay, expressing urgency to “bring him back [to the US] as soon as possible.” (Q7).
Families reported a diversity of responses to inconsistent COVID-19 information from conflicting sources. Some mothers expressed increased uncertainty. One stated: “Her grandparents in China were very anxious as they heard from the news that the epidemic was out of control in the US. It made us very nervous about hospital conditions when the baby came… We didn’t know if there were Covid-19 patients, if they would be close to me, what protective measures to take, or how to safely take the baby home.” Other families mentioned mistrust, with one mother relaying her family’s resolve to use personal protective equipment despite “mixed messages” from national and local political leadership (Q8).
Experiences of racism in the community occurred while performing everyday activities. At an annual car inspection, one mother recounted an interaction where people “immediately zipped their uniforms and covered their faces” (Q9) upon seeing them. Leaving the house was “a challenge” because families felt they were treated differently and even shunned, as one mother recalled that people would rather “stand in a long line rather than stand behind us” (Q10).
Theme 2: Altered Infant Routines and Developmental Consequences; “Because He’s Too Young to Wear a Mask”
Protective measures permeated everyday parenting experiences from birth to toddlerhood. The consequences of these protective measures triggered increased stress and feelings of loss. Throughout infancy, mothers outlined challenges in daily infant care tasks with the incorporation of personal protective equipment. When leaving the house, there was a delicate tension between adequate protection and infant comfort when selecting protective gear (Q11). Mothers mentioned older infants refusing masks, and some mothers purchased small hats with face shields and kept backup cleaning methods such as hand wipes (Q12). When bringing infants to clinic for routine vaccinations, mothers detailed anxiety about whether the clinic was “clean enough or if her [the baby’s] resistance was strong enough” (Q14).
Mothers worried about the socio-emotional consequences of social distancing protective measures. For young infants, mothers quarantining at home felt bothered about the loss of outdoor experiences for their child and the dreariness of home confinement (Q15). One mother described: “I would take my babies out to feel the breeze at dusk if there was no epidemic. Or I would take them out to feel the sunshine in the morning. But now we have no connection with the outside.” Another mother worried that the social isolation would stunt a baby’s “ability to interact with others, making them solitary” (Q16, 17). Families tried to protect infants by having parents who worked in high contact jobs live separately (Q13). In these situations, mothers would describe strained parent–child relationships, with one sharing: “His father cannot live with us since he works [in food service]… it’s dangerous… It’s been like this in the past 2 months because we are scared… He [the baby] doesn’t recognize his father very well.”
Theme 3: Coping Strategies: “We Care More About the Baby. We Can Just Eat Whatever Food, It’s Okay”
To cope with material hardship and to manage resource scarcity, families stockpiled infant essentials, adapted family diets, and prioritized infant’s dietary needs, “we can just eat whatever food, it’s okay.” Mothers discussed checking store inventory daily and stockpiling diapers in case of prolonged store closures (Q18). Families also stocked powdered milk over liquid due to its longer shelf life (Q19) and simplified their own diets to conserve resources, stating that “Our food lacked variety and our diet was quite simple.”
To mitigate feelings of stress, mothers gathered information from friends in China to be prepared because it was “just a matter of time that it was going to happen here” (Q20). To sustain relationships, families used video calls to communicate with geographically separated family members (Q21, Q22). Mothers also made efforts to feel gratitude (Q23) and maintain positive thoughts, with one stating: “I’m having a hard time finding a job… but it is what it is. There is no difficulty, which we cannot come over. Life goes on, anyway.”