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Melanie Cole, MS (Host): As every parent knows, getting back into the routine and back to school season in general can be really stressful for both kids and the parents, but there are so many ways for you to help make this transition easier for your overall wellness and health. In this panel discussion with me today are Dr. Jinat Parveen—she’s a primary care physician—and Jovita D’Sourza—she’s a primary care nurse practitioner. They're both with EvergreenHealth. Dr. Praveen, I’d like to start with you. If you would, what's the best way to get our kids ready to get back into the school schedule? If we’re making a list, what goes on it?

Jinat Parveen MD (Guest): So three things is very important. First is sleep routine to transition them to regular sleep schedule. Second is like getting physical exam or, I guess, sports physical because it’s a very important time to enroll in sports team. Obviously lastly but we cannot ignore but the meal are nutritious for student which will give them focus throughout the day. So these three things are very important.

Host: Jovita, as we look at those three things and we talk to our kids and we start getting them ready to get back to school, what do you want parents to know about getting them ready and getting them mentally ready and even establishing a healthy sleep routine. Getting them to sleep a little bit earlier. I know with my teens that’s not always easy to do.

Jovita D'Souza ARNP (Guest): That’s correct. We need to help to get our parents and also importantly the students and children to get them back into a routine school and work schedule. So over the summer their routine changes. Whether it be sleeping, waking, eating, playing. It’ll be a little different when they get back to school. It is hard to transition within a few days unless we don’t start this earlier. So it’s recommended that we transition them from the summer to school a few weeks before the school starts. At least a couple weeks. One to two weeks before the school starts, try to transition them into a healthy sleep routine. Sleep is very important for children, for their growth and also for their health. So any sleep deprivation or inconsistent sleep schedule has shown to contribute to poor concentration and behavioral difficulties. It also reduces their problem solving abilities. This can affect their physical health and also result in health complications like being overweight or developing diabetes.

So we recommend that they start about two weeks before school. The parents can work with their child to return to regular school schedule and set in incremental hours. So two weeks before they can get to bed an hour earlier. Then the following week a couple hours earlier. So they get to bed every week an hour before their usual summertime. So once the school starts, they’ll be able to stick to the schedule. We don’t want to use the weekend to catch up on sleep. So it’s important the parents help the child to relax their routine, getting into bedtime. Help them unwind. So reducing their video games, limiting TV, screen time, any electronic distractions before bedtime is recommended. Also other things such as large meals, any sort of caffeine intake is recommended to be avoided before bedtime. The National Sleep Foundation recommends that school age children from the ages 6 to 13 should get about 9 to 11 hours of solid sleep a night. For high school students, should get about 8 to 10 hours of sleep. I would also like to mention that when we want to unwind them, they also want to avoid any vigorous activities right before bedtime. So it helps them to unwind and get into a sleep routine.

Host: That is a lot of information. Really great information. Dr. Parveen, when we hear Jovita tell us that they should not be using their electronics and that sort of thing…Well, according to the American Academy of Pediatrics, screen time has really changed. A lot of the kids, mine included, do their homework on the computer. So the screen time is really different than it used to be. So what are we supposed to do when they have so much homework and they're doing it on their computers or even on their phones and then it’s like 10:00 and it’s like, “Okay, come on. You really got to go to bed.” What should we do about that issue with screen time at night?

Dr. Parveen:  I know. It’s very important question. You were right Melanie. Like a guideline has changed because most of the time, even for us, like we use screen a lot. For students and children…So nowadays, the American Board of Pediatrics, they recommended like age group from two to five, they should not have screen time more than one hour. Appropriately, they should have less than one hour. For student—children going to schools—they have most of the homework on screen. Even they spend a lot of time at school doing computer work. So nowadays guideline is they should spend no more than two hours for recreational use for screen time addition to educational screen time. So that’s kind of like excluded.

Host: That’s so interesting. So we really have to kind of monitor our children in a way so that we know the difference between the screen time that they're using for homework and to write a paper and look up websites the teacher tells them versus scrolling through Facebook or Instagram or doing any of those things. Sticking with you for a second Dr. Parveen, back to school physicals, vaccinations. They're so important today. Tell us what you’d like parents to know, including the preparticipation sports physical that so many kids need before they participate in sports.

Dr. Parveen:  Yes. Like you know, annual physical exam, which is a yearly basis for students is important because it’s part of child’s healthcare. Back to school time, I think it’s a great time to putting that in on schedule because it’s a popular time to register for sports team, and sports team wants to make sure our children are in good health and vaccinations are up to date. At this visit, we also kind of monitor child development, if vaccination is up to date or not. Because of recent MMR outbreak, Washington state has law that parents cannot deny MMR vaccination for children except religious basis or if there is any allergy. So that is important to know. It also gives them a protection from diseases which they get exposed when they start school.

During physical exam or annual exam, it’s very important time even for parents if they have any concern like emotional or developmental or even social concern. What is appropriate screen time, which we just discussed.  Also like picky eater, you know. That’s a very important question for all the parents. Like how they can make picky eater to eat their important nutrient, which they need. So those are very important things during this visit. It’s also important even if children are in good health to make sure they see their doctors and providers on regular basis so we can monitor them on development. If we find any concern, we can address right away.

Host: So important. So Jovita, tell us a little bit more about the nutrition. Where does it fit into this picture? If we’re trying to figure out lunch everyday—as many parents right now are doing. What do you want us to know about breakfast, lunch, dinner so that they're really ready to study, ready to learn, and have energy?

Jovita:  Good nutrition is very important, especially for kids. Getting to school, it’s important that they get a good breakfast. It helps them to be very alert during the class. What also is important is to get the right foods to them because it will help them to [inaudible] to cover from any infections. So when we transition them from the summer to school cause during summertime we enjoy barbeques. We have potlucks, picnics and parties, on the go meals, instant foods. Even on our road trips or beach days it’s hard to have a routine. So we transition them back into a school routine where it’s important that they get off to class with the right food for breakfast and lunch. Healthy snacks, good proteins, and enough calories to get them and help them focus throughout the day.

One way that the parent could help the child is while we go grocery shopping, we can have them participate and chose and make good choices as far as what foods are nutritious, what are healthy, and how much they need to have for each of them. It can be a fun activity to do together as a family, and also a great tool for the child to learn about meal planning, which they will later need in life. Parents can also check their lunch bags and backpacks when they get back home to make sure that they're eating everything that they take with them and they don’t come home hungry. It’s a good way to have a communication with your child to ensure they're eating the right food that they need for their school because it’s important for your growth and development.

Host: So important. What great information, ladies. As we wrap up, let’s start with you Dr. Parveen. Please tell us what you’d like the listeners to take from this as far as anxiety. Even sometimes nine/ten year old’s have a little separation anxiety or a little school anxiety. They're a little nervous to go back to new classes with new people in them, new teachers. What do you want parents to know about that anxiety and how we can get them ready and get them excited so that they jump into school and they're ready to learn.

Dr. Parveen:  That’s a great question. So obviously when kids start their kindergarten—even middle school or high school—it can be very stressful for them. Obviously all schools have their orientation day or welcome day. At the same time as parents, we have responsibilities as well to kind of like ease this transition normally and smoothly. Like talk about the school and then take them to the school before welcome day and get oriented and also browse their website. That kind of takes some stress away from the children. Another thing I would like to add here regarding school stress and anxiety, it also can be related to sleep deprivation which we get during summertime from our children. Research showed that from school anxiety to presumptive ADHD diagnosis maybe can be from sleep deprivation during summer, which decrease their performance. So kind of like communicate with your children, make them understand. When they will see the main focus and what’s effecting and how they can relieve the stress during first few weeks of the school. Like having good sleep, nutrition, and getting to know the school, getting to know the teacher and know the students of the children in the class. That will help.

One more thing I would like to add. Like U.S. Department of Food and Human Service made a place on their website. If you search it, it will come up on Google. It’s to help parents and guide them how to make nutritious food and help their kids to eat well. Make sure they have grains, vegetables, fruit, daily protein, and enough hydration on daily basis. I think those are very important. As Jovita mentioned, include them like prepping the list, even cooking. I mean for my son, he’s 12. He doesn’t like egg, but when I ask him like would you like to prepare some egg, like egg scrambled? He made it. He followed online recipe, although he didn’t listen to me. He liked it. So I think that way we can kind of like make sure they're transitioning to school time appropriately just before starting the school.

Host: So true. Something every parent experiences. So Jovita, last word to you. If you were to let parents know the most important thing you’d like them to know about the whole bit, getting ready for school, all of the stress and the nutrition and the sleep and the screen time and everything we’ve talked about today, what do you want parents to know about taking care of themselves at this time of the year so that they can help their children?

Jovita:  Yes, Melanie, that is a good point. While we are getting our children ready for school, parents are a part of the child’s life. Very important is helping them grow, learn, and develop. So parents also need to take care of themselves too. They can be a good role model to the child while they themselves have a routine: sleep, awake, healthy eating, regular physical activity. It can be a good encouragement for the children too that they also need to have routines. Not only because school needs routines, but also it’s important for our health. So while they are getting back to school and they are encountering new situations, classrooms, or teachers, the parents can focus on positive things for the child that they are going to be encountering when they get to school. Parents also need to take care of themselves. So getting them all this information along with health and hygiene, which is reminding kids about hand hygiene, washing hands, and preventing germs, staying healthy, staying active is important.

Host: Wonderful information. So well said. Thank you ladies so much. As a parent, I know that they would rather look up a recipe online and learn it that way just as Dr. Parveen says, but anything we can do to help our kids eat healthier, to help them have more energy so that they are better learners. It’s going to help us all. So thank you both for joining us. That wraps up this episode of Check Up Chat with EvergreenHealth. To find a primary care provider in your neighborhood, to support your family’s health all year long, visit evergreenhealth.com. For quick and healthy weeknight meal ideas and so much more, please visit our website healthiestbest.com. If you found this podcast as informative as I did and relatable as I did, please share on your social media. Share with your friends and families. We’re all going through this right now together. We’ve just gotten really great information from the experts at EvergreenHealth. So share with people so that we can all learn together and be sure to check out all the other interesting podcasts in our library. Until next time, I'm Melanie Cole.