Dr. Chad Perlyn (Host): Welcome to the For Peds Sake podcast, a Nicklaus Children's podcast that is all about putting children at the heart of healthcare. I'm your host, Dr. Chad Perlyn, a pediatric plastic surgeon and father of two boys. And we are very excited to host a very important episode of the podcast today.

Today, we're going to talk about something that affects so many of our patients, but in particular, young girls and adolescent women. And on the show today, we have a wonderful guest, Dr. Marina Villani Capo, one of our psychologists here from Nicklaus Children's. Dr. Villani Capo, thank you for joining us.

Dr. Marina Villani Capo: Thank you so much for having me, Dr. Perlyn. I'm so excited to talk about this subject, because it's so relevant and I'm excited to go.

Host: I know you are. And when we were talking a little bit before the show, you do so much incredible work here, helping so many children across our health system, along the issues of self-confidence, body image, and other type things. And often that's related, as our conversation before, to children with differences, whether it's craniofacial differences or other.

But in this case, what we're going to talk about today is really healthy kids, but who are being affected by what they're seeing on social media. Tell us a little bit about this topic and what you want our audience to hear.

Dr. Marina Villani Capo: So, I always like to start by telling everybody that social media is not the root of all evil. I know it's, you know, contrary to popular belief, a lot of people think that because of social media, we're having all this resurgence of mental health difficulties, and our youth is having so many significant mental health issues. But in reality, social media can be a very fascinating tool that we can utilize. For example, here at our hospital, we utilize different platforms and social media to teach our community about health subjects, like nutrition or when to take your child to a pediatrician or a mental health counselor. So, it can be very useful.

Also, I tell parents, you know, hobbies. It teaches kiddos and even adults how to bake or how to create a new hobby. So, I always like to start off by saying it's not the root of all evil. However, like everything in life, right? If it's not supervised, if we go into it without the right education or the right tools, it can become a source of a lot of issues, especially in our young girls.

Host: And when you've seen these issues affecting the young girls, what are you seeing? How are they being affected and what should parents watch out for?

Dr. Marina Villani Capo: Yes. So, I used to be a young teenager. And when I was young, social media was barely starting off with, for example, MySpace. So, we didn't grow up with that. But nowadays, young kids, early as nine, ten years old, I'm seeing kiddos using different, you social media platforms. And what I see and when the problem becomes a significant problem is when they go and they spend so much time out of their day utilizing social media consuming media without having open-ended conversations with anybody that can guide them.

And I always tell parents the problem is when communication is impacted. For example, you come from school, you don't have conversations in the dinner table, you don't have those conversations maybe in the car ride from home. And these girls specifically, they're utilizing social media so much that comparison starts to bloom in a way that it's really hurtful, because for example, how many likes, how many views do I get if I post something? Their self-worth is directly linked to how others react towards their content. And that's one part, right? The second part is we start comparing ourselves as very young people to unrealistic expectations of what women or young girls should be, how you should act, how you should be looking. And that, you know, comparison is a thief of all joy. And when you have that, yourself to compare to others 24/7 with no real conversation about what's real and what's not, then we have a problem because these young girls are creating their identity through other's eyes and not necessarily their own.

Host: Say that quote again. I loved what you said. Comparison is the thief of all joy.

Dr. Marina Villani Capo: And that is not my own. I cannot, for the life of me, recall who said it, but I always utilize it. When you compare yourself endlessly to others, you're robbing yourself from all joy because you're never going to be that other person and that's what I try to teach people.

Host: Great quote to share in the appropriate way with our kids and along the lines also of helping children understand that social media is a highlight reel, right? It's the best of the best. The jumping catch in the end zone, not all the effort spent in practice or the ball is dropped, right?

Dr. Marina Villani Capo: Yes, and it's a lot of editing as well.

Host: Yeah. The editing also I think is important when we talk about self confidence and body image in young women is the ability to edit, make skin better, acne skin, something that affects our teenagers, soften the skin. The amount of work that goes, of course, into the photos before they get shared. And I think it is important as you bring up for teens to say this. Do you have any advice for parents? I liked how you said about the hobbies for kids who are using social media. And we've had a lot of conversations before about should kids use it or when? And at the end of the show, we'll mention some new tools that the hospital is working on to help guide families along that.

But, you know, you mentioned hobbies, so maybe your 14-year-old daughter is looking at hobbies or sports, but then the feed changes. And the more that I've learned this with my kids, you know, you linger on one post for three seconds longer than the other posts, and the next thing you know, your content is shifting. How do we talk to our kids about that and prepare them for that so what we as parents think they're seeing remains what they are seeing to the best that we can control it?

Dr. Marina Villani Capo: That's a great question, actually, and we get that question a lot from parents that come see us. I think the first thing we have to highlight is communication. Healthy communication is key for anybody growing up. Girls, boys, anybody who's growing up needs open communication with their caregivers. And I know nowadays it's so hard to engage them, especially the teenagers, in conversations because they, you know, tend to avoid. You asking open-ended questions and they will reply with a short, very short sharp answer. And so, we as caregivers feel defeated in that communication process. But maintaining those lines of communication open is very, very important. Don't be discouraged by your teenager's lack of conversation. You're the caregiver, you're the adult, and we have to model what we want that open communication to be.

So, my first advice, keep those pathways of communication as open as you can. My second is, have conversations with them about social media. Like, what are you seeing? For example, I have a little girl that's really into robots and robotics. And instead of saying, "Don't do social media, focus more on robotics," I had the parents engage with her in a session on different websites about robotics and how to build your own robot. And now, the dad is super into it as well. So when it regards to hobbies, that could be a great, great tool to do more activities as a family and not spend so many time individually in social media. Engage with them.

Host: I like that. I like that. That's a great suggestion. I think one other thing I want to just bring up is we as parents sometimes have a sense of security. If our kids aren't on social media, they don't have a login, they don't have a password. But YouTube, watching my kids interact with YouTube, a lot of our concerns on social media can rise through YouTube short videos as well. And you don't have a login or a password. The access is less restricted. So just a tidbit for parents listening.

I want to focus a little bit on one of the key concerns that we've seen at the hospital around self-confidence, body image, and girls, and that's on eating disorders and weight. Talk to us about what you've seen there and your expertise in this area.

Dr. Marina Villani Capo: So yes, it all comes back to those unrealistic expectations of what girls should be looking like and should be eating or exercising. So, the relationship between their bodies and food, for example, becomes one that is not healthy. There's a lot of people out there that like to call themselves like health coaches or nutrition coaches, things like that. But we have to make sure we empower young ladies to become social media savvy, to not be naive about the content that they're consuming.

So for example, if you are crossing your family room and you see a girl viewing a video or a reel about a nutritional fact, like, "Oh, you need more protein or less calorie deficit," things like that, those are key words that the algorithm, the thing that you were talking about, that if you're three seconds more, they will promote more videos surrounding that subject, it's really important, so we have to try and make them technologically savvy and social media savvy and saying, "Hey, I'm seeing that you are consuming a lot of videos about nutrition and exercise. Do you have any questions about that? And if you do, let's talk to your pediatrician about it. Let's see if they have any referrals for nutritionists in the community that can help us navigate this concern that you have," because we cannot assume that our girls are not having all these issues. We grew up, right? We were comparing ourselves like boys not being athletic enough or girls not being thin enough. So, it's really important that don't avoid the subject. Make sure that if you see, and this comes back to supervision, you have to see what your kids are watching. You have to enter, for example, one platform and go into the algorithm and see what videos they've seen. And if you see a trend or a pattern, have that open conversation with your child and say, "Hey, what about if we go to someone in the community and find some real facts that can really be relevant to you? Because remember, everybody's different and everybody's body is different. So if you have any questions, let's go to the right people."

Host: And we'll highlight it for our show listeners, this importance of communication, which I think becomes even more important in the older kids. We've been talking mainly about girls, but even in boys, there will be content that our children will consume that we don't see or that we don't know they're seeing and don't want them to be seen. But the reality from all the studies that are out there, the adult content that's out there, and again, how this affects body image and expectations, what is normal, what is not normal, there was just a large article in the New York Times about exactly this subject that I would encourage listeners to look at about normalcy on adult content that's being viewed by teens and how this is affecting them.

So, this notion of communicating with your kids, if you can see and be a part of the content, obviously the better is it sounds like what you're saying, right? Talk them through it and be a part of it, if the kids are going to be on social media. And if we can't or don't know what they're seeing, still have that conversation, because it's probably one way or another being, being consumed that content.

Dr. Marina Villani Capo: Yes, we can't avoid, like, for example, some parents tell me, "Oh, we're not giving them the phone. So therefore, I know they're not consuming social media." And I giggle a little bit inside because I'm like, kids are so savvy nowadays. They go to school, their friends are going to have an iPhone, they're going to have social media, and then you're not going to be able to access any material that they're accessing themselves. So just because we don't see it doesn't mean it goes away, right? So,, having those conversations are crucial. And through those conversations, you can really instill your family values. Those are the opportunities that we have as caregivers to instill our value system onto our young children instead of social media doing that for us.

Host: I love it. As one of your partners in psychology once said, mindful mentoring as we teach our kids about this subject. Let me switch gear in the few final minutes we have together and talk about the initiative, which I know you are a part of, between Nicklaus Children's Hospital and the Digital Safety Alliance, the Safe and Sound program, something that we are so excited about and so committed to. We'll put some additional information in the show notes and the link to the website, but tell us a little bit about this and some of, again, the messages that our families can get from it.

Dr. Marina Villani Capo: So, this new alliance really is about giving families the tools that they need to navigate these difficult topics and conversations. So in the information box you will see below, you can access it and hopefully in the future we can go into more depth about it.

Host: That's great. And thank you. And you know, these podcasts are short and focused into the point, but really what we're trying to do through experts like yourself is to raise awareness of these key subjects, let the community know the resources are out there, encourage our families to talk with your kids and communicate, and always let our listeners know that we are here as a resource.

So if your children, particularly today's theme around young girls, adolescent women, are having issues, concerns, reach out to your pediatrician first. Get the baseline information from there. And our team and the rest of the mental health team across South Florida is always here for our kids. So, thank you so much for being with us today.

Dr. Marina Villani Capo: Thank you so much.

Host: This concludes this episode of the For Peds Sake podcast. We look forward to having another wonderful guest on our next episode. And thank you for listening.