Scott Webb (Host): It's hard to believe, but it's time to start preparing our kiddos to go back to school. And my guest is here today to share her expertise on sleep schedules, nutrition, screen time, and so much more. Joining me today is Dr. Shivani Parikshak. She's a board-certified pediatrician with Franciscan Health.

 This is the Franciscan Health Doc Pod. I'm Scott Webb. Doctor, it's great to have you here today. It's hard to believe, but we're already thinking about and talking about going back to school already. And, you know, when I was a kid, we always started school after my birthday, which is the 29th of August. But school keeps starting earlier and earlier, so we have prepare our kiddos to go back to school. So, let's start there. Like, what are some of your recommendations for helping kids to transition back to the school year and especially their sleep schedule?

Dr. Shivani Parikshak: I recommend setting a consistent bedtime for your child and trying to stick with it every night. I understand it can be difficult to do that in the summer when school, you know, has not quite started yet. But getting enough sleep is so important for kids to stay healthy, but also be successful in school.

I think it's also important for parents to know how much sleep their kid needs so they can set an early enough bedtime for them. So for preschool-aged children, so children ages three to five, they need at least 10 to 13 hours of sleep daily, and that includes our nap time. For our grade school children, so ages more six to 12 years of age, need at least nine to 12 hours of sleep. And then, teens, you know, ages 13 to 18 also need at least eight to 10 hours of sleep as well.

Host: Yeah. I'm wondering how do we tell? Like, how do we know if our kids just aren't getting enough sleep? And what do we do about that?

Dr. Shivani Parikshak: So, not getting enough sleep can affect memory. It can affect concentration, creativity, and learning. Regular sleep deprivation can lead to irritability, difficulty concentrating, obesity, headaches, and depression. Inadequate sleep has also been linked to lower academic performance. So if these are some of the signs you're noticing or your child's teacher tells you that they're having difficulty paying attention or per se zoning out in school, you might want to address your child's sleeping patterns. Ensuring your child has a consistent bedtime, but also a consistent bedtime routine, is going to be a first step in addressing sleep concerns.

Host: Yeah, for sure. Bedtime, bed routine, sleep hygiene, all that good stuff. And as we know, as you're saying here, Doctor, from an expert, you know, sleep is important. We don't want our kids zoning out, as you say in school. So, let's talk then about some other important stuff like nutrition and breakfast. Like, how important is it that they eat breakfast before school? And really, what should a healthy breakfast include?

Dr. Shivani Parikshak: Yeah. So, you've probably heard that breakfast is the most important meal of the day, and that is true because children who eat a good breakfast function better. They do better in school, have better concentration, more energy. Parents should try to make sure their kids eat a breakfast that contains some sort of protein.

Host: Yeah. So, you say protein, and maybe as adults we kind of know what that is, but let's talk about maybe some quick and nutritious breakfast ideas. How do we get that protein into them? How do we encourage healthy eating habits? Like, what do we do? How do we do that? Because they're sleepy and they maybe don't really want to go to school and we're trying to fuel them up for the day. So, what do we do?

Dr. Shivani Parikshak: You know, eggs are a great source of protein, but that does require prep and time to eat that. So if your kid dough doesn't have time to eat, I definitely recommend sending them to school with some on-the-go breakfast, like a granola bar is a great source of protein. And then, maybe having, you know, a side of fruit, so banana or something as well.

Host: Yeah. My daughter's a big fan of the granola bars and grabbing a banana, and I feel like that's better than nothing if I don't have time to scramble eggs, of course, for her.

Dr. Shivani Parikshak: Right.

Host: So, Doctor, let's talk about screen time. We all struggle with screen time, even us adults, maybe even you, right? And trying to manage our time and put down those phones and stop staring at screens and all of that, but it's especially important for our kiddos. So, what are maybe some guidelines for managing screen time during the school year?

Dr. Shivani Parikshak: Yeah. In addition to getting enough sleep, eating healthy, physical activity, kids also need time away from screen. So, I recommend to my parents here in the clinic having media-free time, such as dinner time or homework time, or phones or other sources of media aren't present. And then, also media-free zones such as their bedrooms.

It's also important for parents just to be aware and recognize that they're own media use can have a negative impact on children. So in general, the American Academy of Pediatrics recommends two hours or less of screen time daily for children, and that's less for younger kiddos, of course. But I really try to tell parents, we should not be using screens for two hours daily just because that's the limit we have or replacing, you know, family time with screens as well.

Host: Right. Yeah. I used to tell my kids to go outside and play. And then, I'd look outside and they were standing outside on their phones, you know. And they're like, "What's the problem, dad? We're outside." I said, you know, somehow something was lost in translation here. And, Doctor, you know, one of the things I struggle with is that wind down time, you know, before bed, putting that phone down and sort of clearing my mind, trying to, I don't know, meditate a little bit or something. So, maybe you have some suggestions about that wind down time, or maybe even some educational apps and screen activities, you know, that if they're going to use their phones anyway, that use them more productively.

Dr. Shivani Parikshak: So as for kind of wind down time, bedtime, I definitely recommend having all electronic devices off at least 30 minutes before bedtime, just so our mind has that time to kind of calm down and focus. And, you know, a bedtime routine doesn't need to be anything more than 30 minutes, and that can be, you know, reading a book, tidying up a room, something just that can help kids kind of wind down and fall asleep on time. And I definitely don't recommend kids not sleeping with devices in their bedrooms. And that includes not just our phones, but TVs, computers, tablets, those can also be distracting devices just to have around in the bedroom as well.

As for educational apps or any screen activities, any apps or screen activities that promote learning physical activity or interactions with others such as a group game, would be preferred to those that limit in-person interactions. Talking to my partner earlier this week, Dr. Bowman, we were kind of talking about things that she did for her kids growing up and she said that, you know, she would maybe have games that were available on her phone for them to play, but keeping them in a different language. So, that's still promoting that kind of learning aspect of things.

Host: All right. Doctor, let's talk about extracurricular activities and overscheduling. Both of my kids played sports and were involved in a million things, and how do we strike a balance between school extracurriculars and downtime? How do we do that? How do we balance that for our kids?

Dr. Shivani Parikshak: Yeah. So, I think the big thing is for parents just to try their best to avoid overscheduling their child. So, that can happen. So, we discussed earlier about how important adequate sleep is. And so, really, extracurricular activities, you know, they're extra, they shouldn't interfere with bedtime. And then, in addition to that, making sure your kids have an ample time for homework and building that time into choices about participating in afterschool activities.

You mentioned your kids were very involved with sports. So, for the kids that play a lot of sports, different activities every day, I recommend having at least one day a week free from those activities or sports so they have time to also rest and recover.

Host: Yeah. It was usually Sunday. We had sort of a sports-free zone on Sunday. But the other six days, you know, both my kids were really driven. I'm sure that's the case for a lot of parents with their kiddos, just they just go and go and go and they push themselves. And how do we then maybe have a sense that they're just overscheduling themselves, or they're just kind of stressed out about things that maybe they're important to them, but in the big picture, maybe not as important as their homework?

Dr. Shivani Parikshak: Right. Yeah. So, you know, signs that your child might be overscheduled or stressed, overscheduling your child can lead to irritability, behavioral changes, anxiety, poor performance in school, and also those extracurriculars then. So, I definitely recommend when I'm having that discussion with my patients and the parents, extracurricular activities are great, but only if they do not sacrifice the kids' mental health and also overall wellbeing.

Host: Sure. Let's talk mental and emotional readiness. Like one of my kids loved school, the other one did not. My daughter loved school. My son dreaded school. So, are there some ways that we can help our kiddos, you know, kind of ease back to school and deal with their anxiety? I know that might be nervous about a new school or teacher or classmates. So, how do we help them ease into it?

Dr. Shivani Parikshak: Yeah. I think it's important for parents to try to point out the fun aspects of school, starting to help their kid look forward to the first day of school, such as getting to see old friends or make new friends if this is a new school or class. If your child seems nervous or anxious, ask them what they're worried about and help them kind of problem solve or rehearse their first day of school. Something that we can do to kind of rehearse their first day of school is, you know, trying to go see the new school or classroom before the first day of school so they can become more familiar and comfortable. And if they haven't met their teacher yet, let them know that their teacher also knows that they might be nervous on their first day of school, and they're going to do everything they can to make everyone feel comfortable.

Host: Yeah, it always seemed to me, and it may not be practical for all people because of the economics of it, but a new school outfit, I don't know why, but it always helped my son. Like if he felt cool on the first day school because he had some new threads, you know, as they say, some new kicks, maybe some new shoes.

Dr. Shivani Parikshak: A new backpack. Yeah.

Host: Yeah. A new backpack. Oh, absolutely. We had so many backpacks in this house. And fortunately, he was older than my daughter, so sometimes we got to hand those down. Didn't have to buy her a new one. But yeah, maybe that's a separate podcast, just the economics of sending our kids to school.

Dr. Shivani Parikshak: Sending your kid to school, yes.

Host: Yes. So, let's finish up today, doctor, and talk about just general health and safety. Are there any, health checkups or vaccinations that really should be scheduled before school starts?

Dr. Shivani Parikshak: Yeah. So if your child hasn't had their well child checkup in the last year, I would definitely recommend scheduling a back to school physical. If they're going to play a lot of sports or any sports at all, they might require a sports physical. So, making sure that's kind of check marked before we start school. And, you know, if your kid takes any medication that they're going to need at school, your pediatrician should be going over the treatment plan for that and updating any instructions for the school if necessary.

As far as vaccines, the big ones are we need our kindergarten shots before we start school and getting those up to date, and then, kind of our sixth grade vaccines before we start sixth grade. So, those are kind of the two checkpoints we use at our clinic, making sure our kids have their kindergarten vaccines and also their sixth grade vaccines before they start.

Host: Yeah, I never understood if a kiddo gets a physical and then they also play sports, why do they need a different physical for sports physicals? Maybe you could explain to parents is there a difference between them? Do you check for different things for a sports physical?

Dr. Shivani Parikshak: No, that is a great question. So, we do. So, the sports physical, here in Indiana, a designated separate form that makes sure that we're checking for different things. So, making sure your child doesn't have a murmur. So, you know, usually when we listen to a child's heart, it's with them seated on the exam table. But to really make sure that they don't have a murmur, we should be checking with them sitting up, laying down and also standing, because that kind of changes the blood flow in the body. And again, that's a lot of physiology, but sometimes murmurs can pop up and that's something we should make sure that kids don't have if they're going to be playing sports. And if they do, then we need to investigate further to see is this a true murmur, what's going on with their heart. Making sure it's healthy before they start sports.

Another thing is, you know, checking for any hernia. So, that's something else that we should make sure. Because if a child has a hernia and that's missed on a regular exam, because we might not be regularly checking for that. That's something else that we need to investigate and look into before they start sports as well.

Host: Yeah. Yeah, it's great to have your expertise, because it's not just another form that a doctor signs. There are actually some other testing or perhaps diagnosis involved. So, good stuff. Then, lastly here, Doctor, how do we keep our kids healthy during the school year? Is that possible?

Dr. Shivani Parikshak: Yeah, I mean, everything we talked about, getting enough sleep, practicing healthy eating habits, staying active, getting your routine vaccines. But most importantly, you know, in a school setting, there's lots of germs. So, washing your hands to avoid spreading germs or getting sick yourself. So, aside from our routine vaccines that we might not be getting yearly because, again, there's only so many that you can get. Making sure that kids have their annual flu vaccine when it's available. I'm not sure how it was for you last year, but you know, there are classrooms that were closed for the day due to too many kids being sick, or even teachers being sick with the flu. And trust me, you know, being sick with the flu is no fun. So, definitely want to make sure we get our yearly flu vaccine and are kind of practicing good hand hygiene as well.

Host: Yeah, we definitely learned, Doctor, during COVID just the value of washing our hands, washing our hands, you know, properly. All good stuff. Really appreciate your time and your expertise today. Thank you so much.

Dr. Shivani Parikshak: Yeah, of course.

Scott Webb: And to learn more, visit franciscanhealth.org and search Children's Health.

Host: And if you found this podcast helpful, please share it on your social channels, and be sure to check out the full podcast library for additional topics of interest. This is the Franciscan Health Doc Pod. I'm Scott Webb. Stay well, and we'll talk again next time.