Nolan Alexander (Host): This is Children's Health Checkup where we answer parents' most common questions about raising healthy and happy kids. I'm Nolan Alexander. And today, I'm joined by Kelley Smith, a pediatrician at Children's Health. We'll talk about planning a healthy summer for your kids, exploring aspects from maintaining healthy sleep and nutrition habits to staying active, safe, and mentally well. So with that, we bring on Dr. Smith. How are you today?

Kelley Smith, MD: I am good. How are you this morning?

Host: I'm doing great. I'm looking forward to summer. My kids are looking forward to summer as well. Thankfully, temperatures, are good enough where we can start to get outside. And when they run around, they seem to sleep well. So I'm interested in what you have to say today, Dr. Smith.

Kelley Smith, MD: Well, I am glad to be here this morning.

Host: Well, let's start with a big picture. What does a healthy summer look like for kids?

Kelley Smith, MD: Well, first, I think in terms of letting kids learn and explore without permanently destroying themselves or something else. So, we talk a lot about summertime safety keeping from getting cuts, breaks, abrasions, that sort of thing, or even since we are in Texas, I talk a lot about water safety, making sure that we keep kiddos healthy around the water. And then, certainly, I am the sunscreen police at all times. I am constantly, even in the middle of winter talking to my patients about putting on their sunscreen if they're going to be outside for longer than 30 to 45 minutes, and remembering to reapply.

Host: Well, let's cover the most important thing to begin with. It is just safety tips, right? You talked about water safety, sun protection, and then obviously in Texas, heat is a factor too. So, what are the biggest safety tips that parents should keep in mind during summer activities?

Kelley Smith, MD: So, I'm going to start off with the water safety, because I am pretty passionate about that. I talk about it year round. The American Academy of Pediatrics recommends that all children over the age of one year start in swimming lessons.

Now, for the younger ages, we are really talking more about survival, learning to flip face up and float. We can learn strokes later, become the next Katie Ledecky at another point in time. But for right now, I just want you purely learning to enjoy the water, but also not getting hurt.

We also recommend that for the littles or for those who don't really have strong swimming skills, that they remain within parents' reach, if not parents' direct touch, while they're in the water. And this goes for if you've got a lifeguarded pool, non-lifeguarded pool. Also, good habit to be in the habit of designating one adult as the water watcher. I have some families that will even create like a lanyard or a bracelet they can pass around and be like, "Okay. You, the adult, this is your 15 minutes. All you're doing is watching the water. You're not touching that phone, you're not getting an adult beverage. When your duty is done, you are handing off to the next adult. And then, you can go have your time as you need it." This also helps out with fatigue because sometimes when it's just mom and/or dad that are the ones watching the water, they can get real tired. So, this allows other family members who would be completely happy to take their turn. "Oh, you need me to take my turn now and I'm on duty. Perfect."

 I also like to point out that I am a giant fan of the splash pad, because the littles can get wet, but the worst thing I have to worry about is maybe a scraped knee. So, that may also be an option, especially if the adults in the family are not strong swimmers.

 Next topic. Let's talk sun and heat often go hand in hand in Texas. However, I do like to point out that even at 10:00 at night, we may still have temperatures in the upper eighties to, I remember one awful summer, it was still in the hundreds at 10:00. So, you never know what you're getting with the Texas summer.

This being said, there is something special about the direct heat of the sun down on top of you. So, one, we try to recommend that you may want to plan your activities when the sun is first rising or when the sun is setting as things are often a bit cooler. Also keep in mind that surfaces that kids are playing on can retain a lot of heat. So, I think people normally think about pavement, but depending what your playground equipment is made out of, that may also be something where you've got to really think, "Oh, is this too hot to be on?" I know a lot of our baseball and softball bleachers are metal. You may want to bring some blankets or towels to sit upon because that at least prevents any kind of burning.

And then, when kids are old enough and tall enough to be out of their car seats and booster seats, depending on the fabric of your vehicle seat, you may also need to think about covering over the leather seat or something like that, again, with the towel just to make sure that nobody gets burned sliding onto those seats.

Host: Well, in line with those safety tips, what are some easy ways to keep kids physically active during the summer months?

Kelley Smith, MD: Okay. So, summer can be great in that you don't have to be up and out the door to school and do as many activities, but also not as great because people are not on a schedule, not on a routine, that sort of thing. So, you may want to plan out, even if you're not planning on some sort of summer camp, "Okay. We're going to this week where we've got things set up. We're going to plan that we go to the pool on Monday, Wednesday, and Thursday. But hey, next week, we've got some family coming in, so maybe we're only doing our pool time Tuesday, Thursday," but kind of make some sort of scheduled time that you're planning to exercise. Because believe it or not, you are more likely to exercise if you've made it part of the schedule instead of just, "Oh, I'm going to do it three times this week."

If your kids are not so much into swimming, or a pool or splash pad is not really available to you, then maybe that means, "Okay. We're going to plan on riding our bikes, wearing our helmets or our scooters in the morning, like around 8:30 or so before it's gotten so hot, or as the sun is setting at night when it's getting a little cooler and we've got a little bit of shade to help us out."

Summertime can also be a great time for some of the classic summer sports like softball and baseball if your kids are older. Certainly, if you've got much younger ones, they're not going to be so interested in that. But that might be a great time to plan that, "Okay. Hey, it's the weekend. We might try to get out and do an early morning picnic or an evening picnic, especially if we get a summer where the weather is a little better.

I like to say it's Texas. We never know what we're getting in the summer other than hot, hot or hottest. But some summers, we manage to get in a little bit of rain and it's not quite so brutal with the heat.

Host: So Kelley, it seems like there's a balance here of having a routine but also being flexible too, to try to support activity. Good sleep and meals.

Kelley Smith, MD: Yes. One thing about being off for the summer, especially if we're talking the older school-aged kids, so I'm talking like the middles and the high schoolers, a lot of them will want to stay up as late as possible. But that also means they're getting up a whole lot later. So, that may mean that if you've got someone who is supposed to have a school time bedtime of more like nine to 10:00 at night, they may be staying up till like 1:00, 2:00 in the morning, which, okay, they are making up for that if they're sleeping later. But that can be a rough transition back-to-school. So, you may want to have as kind of the summer routine. "All right, we're going to stick to more like within an hour of our school bedtime," except for a special occasion where maybe we're having a summer party or friends over or something like that.

As far as nutrition goes, okay, I talk about vegetables year round. People do need to be eating their green leafies. Good thing about summer is a lot more things are in season. But also, with that, making sure that we are really taking the opportunity to get foods in that have a high water content, because we are sweating more so that we're losing water and salt.

So people usually think about replacing that. But you can replace that in things you are eating too. For my kids who are in the summer sports, I'll remind them, "Hey, if you like, say, grapes or watermelon or some of the kind of high water content fruits, those are great to freeze and then consume when you are taking a break from being at bat or whatever it is you've been doing." And that way, it can kind of help replace some of those fluids in a way that's not always some of those electrolyte replacement drinks, which they certainly have a place, but I do understand where sometimes families don't want as many artificial dyes and sugars. Fruit is a great way to get around that.

Host: I should be taking notes on all of this and just kind of build my own app for when something comes up. "Okay, what's the tip from Kelley Smith when I'm in this situation?"

Kelley Smith, MD: Well, I've got a lot of patients that are in all ranges. So when I am talking to my spring track kids, I'm reminding them, "Hey, yes, remember you can replace your fluids this way," because I always think of track season as hot. Even when it moves into football season, again, those guys are getting pretty hot out there and anything that we can do to help replace fluids is a great thing.

Host: Well, we focus so much of this conversation on the great joys of summer, and that's getting outside and the freedom of being a kid at times, right? Well, something else that we battle as parents these days more so than perhaps when we were growing up is screen time. And that's still a factor, right? So, what tips do you have? How can families manage screen time when kids have more unstructured time being out of school while they're at home?

Kelley Smith, MD: Okay. So, there's a few different approaches to that. And first of all, I will say to families, on the one hand, we do want to limit your screen time. But on the other hand, their best friends from school may not live in the neighborhood. So, sometimes, some of the gaming apps that allow communication or sometimes FaceTime, things like that, can help maintain friendships over the summer that may have had a hard time, being maintained because you just don't live very close.

So, one I would look at, "Well, what screen time are we having? Are we interacting with some of our friends or are we purely doing what my gen Z colleagues like to call brain rot?" Just purely this scrolling where we're maybe not having as much quality information coming our way. So, one, what's the quality of the screen we've got here? Two, we also want to make sure that at least three hours every day, folks are getting some eye break time. We are seeing from our eye doctor friends that there is a rise in nearsightedness. And it's not so great for your distance vision to be up close and personal all the time. So one, if you've got a kid who's interested in some of those sports that do require distance vision, that can be your excuse. "Hey, you want to save your eyesight for your sport? Got to make sure that we are staying off these screens. Other thing, if you've got someone just that is very into the gaming, you can support that. But also say, "Hey, remember we need some eye break time for later."

Also, I kind of vary up what I recommend screen time limit-wise based on what is the weather doing. We are having a record breaking summer where it's been 102 to a 106 to 10, 20 days in a row. "Okay. So, maybe from two to five in the afternoon when it's the hottest, that you can have screen time." "Hey we'd love it if you did something that maybe helped you learn a new skill or a new thing, but we're not going to be too heavy onto the let's-get-off-the-device in those hours. But when it's a little cooler, all right, let's take some break time."

Host: Kelley Smith, a pediatrician at Children's Health, joins us today talking about a healthy summer. And you provided us with a lot of great insight and tips as we try to build out and plan a healthy summer for our children. Just to wrap it up, is there anything else that you want to add to the topic today, regarding tips for activity and then from a mental and emotional wellbeing side for our children?

Kelley Smith, MD: As far as the activity goes, one way to kind of help maintain friendships in the school age population is to plan out some play dates. And, hey, you are more likely to exercise if you're meeting somebody. It doesn't have to be anything elaborate. Just saying, "We're going to meet at this park at this time if you are able to join us. Hey, we'll be out playing for a little bit."

Then, as far as the mental health aspect of it goes, even with the older kids who may not be so interested in going to the park and play, if you can at least say, "Hey, why don't you and your friends at least plan to walk together and meet up at Starbucks so that you can have some face-to-face time and be off some of those devices a little bit." But also, that kind of helps lift the mental health over the summer if we've got kind of some planned events to look forward to. And then, I'm just going to put in one last plug for please wear your sunscreen.

Host: We will certainly keep that in mind. Kelley Smith, thank you so much for joining us today.

Kelley Smith, MD: Thank you for having me.

Host: For more summer wellness tips, visit childrens.com/summersafety. Thank you for listening to Children's Health Checkup. If you found this podcast helpful, please rate and review or share the episode and please follow Children's Health on your social channels.