Scott Webb (Host): With each new school year, parents will have questions about vaccinations, sleep schedules, and keeping our kiddos healthy. And joining me today to help answer these questions and more is Dr. Bora Timkin. He's a pediatric hospitalist with Dignity Health.

 This is Hello Healthy from Dignity Health. I'm Scott Webb. Doctor, it's so nice to have you here today. I was mentioning to you that my kids are a little bit older, so I don't think much about vaccinations and those kinds of things anymore. But I do want to talk to you about this, and this is good for listeners who have younger kiddos because, you know, when they return to school, they're assigned vaccinations based on their age, right? So, why is that important? And maybe you could provide some insight as a pediatrician.

Dr. Bora Timkin: Vaccines are, as we all know, incredibly important. And it can be overwhelming to hear about the number of different vaccines that our children need to get, but they're all very important. There's been a lot of time and effort and consideration put into trying to determine when and which vaccines our kids need to get.

So, vaccines are important for school because, for many children, that's the first time they're exposed to large groups of other people, and on a consistent basis, so infections can spread quite easily between them. So, a lot of the vaccines that are given to our kids are designed in a way that accounts for when we expect them to be exposed to certain illnesses, and also when we expect their body's immune system to be most ready to kind of build that immune response with that vaccine.

Host: Sure. Yeah. As you say, it's the first time many of them have been exposed to large groups of people, large groups of kids and infections. They do spread in those situations, of course. So, let's talk about sleep. We always hear about the importance of sleep for children. I still worry about my 17-year-old not getting enough sleep. But help us to understand, Doctor, why bedtime routines and sleep are so important for kids.

Dr. Bora Timkin: Sleep is incredibly important, as we all know, because that's when the brain is categorizing and kind of filing into long-term memory all the things we learn throughout the day, and building better connections between all of our neurons. And that's also the time when we grow and we heal. I can't emphasize how important sleep is. But for better or for worse, our bodies don't do a good job of responding to changes in routine. Our bodies do a really good job of sticking to routine and falling into a rhythm with that. So children, especially younger kids, they rely on routine to have a safe environment to be able to thrive in. And sleep is no exception. So, setting up a routine to go to bed at a consistent time with good sleep quality is key for little kids and even teenagers to get the restful sleep that they need.

Host: For sure. Yeah. And we hear a lot, Doctor, about general nutrition and this advice for children to eat healthy, right? So, what does that mean and how can we make that easier for kids? And what are some of the essentials for their diets?

Dr. Bora Timkin: Nutrition can seem pretty complex on the surface. And I don't want to diminish the complexity that some, like, healthcare providers take into finding out the best nutrition for people. But generally speaking, there are a lot of things to look for and to do to kind of provide high quality nutrition to your kids.

So, the big issue nowadays in our society is the availability of kind of highly processed what we call "junk food" that offers not a lot of solid nutrition for the amount of calories that you're consuming. So in general, you want to emphasize what we call like whole foods or relatively unprocessed foods that are high in proteins and vitamins and minerals and basically things that you can kind of prepare in your own home. For the most part, those types of foods are the ones that you'll be looking out for.

Host: Yeah. I felt really good last night. I made our daughter, after her flag football game, a nice salad with grilled chicken and avocado. And I was like, "This is exactly what Dr. Timkin would probably recommend," right?

Dr. Bora Timkin: Exactly.

Host: Yeah. Less packaged things, a nice balance to them, protein and otherwise. Yeah, it's good stuff. And of course, it takes more work. Sometimes it takes more time. Sometimes it takes more money, but it's better for the kiddos, right?

Dr. Bora Timkin: Exactly. Yeah. So, that's the difficulty, is making that change to like these whole foods, unprocessed foods, is that you lose a little bit of convenience for sure. But it's worth it in the end.

Host: Yeah, definitely. And, Doctor, we know when kiddos go back to school, new school year brings the flu season. So, what should we be on the lookout? Like, what are the symptoms of a traditional flu?

Dr. Bora Timkin: So, flu fortunately has a pretty good set of kind of typical or classical symptoms, though the flu can present in unusual ways, but very uncommonly or rarely. So, common signs like the symptoms of the flu tend to be fever, cough, congestion, body aches, and fatigue. Those are what we call like a flu-like illness. You can see it with other illnesses, like other infections, but that's what the flu tends to embody when you have kind of a typical infection with it.

Host: So, do we know anything this year? Do you have any sense of what the flu's going to be like, and anything that we can do to prevent the sort of negative outcomes?

Dr. Bora Timkin: It's very difficult to predict how each flu season is going to be or even when it's going to start. But in general, the best thing to do is to get the annual flu vaccine. The flu happens to be the virus that mutates frequently, but we're able to stay on top of it and know exactly what about it mutates. And we can make vaccines that do a pretty good job of predicting and targeting the areas of that virus that does mutate as opposed to other viruses where we don't have good vaccines for because they mutate too much.

So, the vaccine is the most important thing to get. But other good infection avoidance practices are also important. So, avoiding people who are sick is important, which can be challenging with work and school obligations. But when possible, to stay at home and avoid other people is important as well as, you know, staying hydrated, getting enough sleep, going back to sleep. Your immune system works best when you get plenty of sleep. And washing your hands or sanitizing your hands frequently is also something that's very important to help prevent the spread of flu and other similar viruses.

Host: Yeah. My daughter's always telling me, you know, she's a senior in high school and she's always telling me that all of her friends are sick. And then, I ask her naturally, "Well, do they stay home when they're sick?" And of course not. Of course they don't. Everybody goes to school when they're sick. So as you say, it can be a challenge to avoid those that are sick and from becoming sick. But some of the things we can do, like getting better and more sleep and washing our hands and all those things, right?

Dr. Bora Timkin: Exactly.

Host: Yeah. So if our kiddo does get sick, Doctor, what should we do? Do we go to seek out pediatric care, urgent care, emergency care? Is there some common sense involved? How do we know which is the right path for us?

Dr. Bora Timkin: It's all about a matter of balancing kind of risks and benefits of seeking care. So, the big, you know, risk is by going out into the world, going to an office or a hospital, you're potentially risking exposure of your illness to other people. So, it's about finding that right moment to decide you need treatment over the risk of exposing other people.

So in general, for like mild illness where you feel a little rundown, you're not feeling your best, but you're generally able to do your daily function, like eat, drink, sleep fine, and breathe comfortably, those are all things that should let you be able to stay at home and not seek care, as this virus will naturally run its course.

But if this illness seems to be progressing such that you're having difficulty doing those things, eating or drinking, not getting sleep, having difficulty breathing, being much more fatigued or lethargic to the point where you can't take care of yourself, then that would be a good point to start to consider seeking care. Whether it's the urgent care, or the emergency department, it all kind of depends on the individual.

Host: Right.

Dr. Bora Timkin: The sicker you are, the more quickly these things like happen, the more you would kind of lean toward going to the emergency department. But you're primary care doctor's office and your urgent care are usually pretty capable of handling kind of mild to moderate illness.

Host: So, Doctor, it's been great to have you here. Great to have your expertise. All parents benefit from the experts and very nice to have you here and talk through some of these things. So, just finally here as we wrap up, if we're just sort of unsure about our child's health in general, what should we do?

Dr. Bora Timkin: It's a very, you know, broad question, but sometimes it is kind of a broad thought that we do have. The short answer is it depends. But the long answer is when in doubt, talk with a healthcare professional. So, your usual best option is your primary care doctor or your child's pediatrician for their health.

There's a lot of information online that can be very difficult to parse through, even if you go to reputable sources, which I encourage over like social media, it can still be difficult to interpret what you find there. So, having someone who is trained to interpret those things go over the important health matters is really key.

So if you're unsure about in the acutely, so if your child is getting sick over the manner of a few days to a few weeks versus more of like chronic health concerns, either condition can be reasonably addressed or have a good starting point with your primary care doctor. And depending on what conversation you guys have that can easily escalate to something like the hospital or a specialist or offer a very good level of reassurance. Sometimes reassurance is kind of the best medicine, and I think a lot of parents appreciate it when they know that their child is doing well.

Host: Yeah. That's so right. You know, sometimes you just need to hear it from an expert, right? But speak with your providers, speak with pediatricians. They're the best. I love pediatricians. You guys know everything, and you're just so nice and easy to talk to. Some of my favorite guests are pediatricians. And whether it's mental health, physical health, all the above, you know, put your faith in the experts and reach out. So, thank you so much.

Dr. Bora Timkin: Yeah, of course. Thank you so much for having me.

Host: And for more information, visit dignityhealth.org/bakersfield/peds. I'm Scott Webb. And if you found this podcast helpful, please share it on your social channels and check out the full podcast library for additional topics of interest. This is Hello Healthy, a Dignity Health podcast. Thanks for listening.