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Scott Webb: Hiking with our kids can be adventurous and fun. But did you remember the sunscreen, bug spray or maybe a change of clothes? Joining me today to help us plan for safe and enjoyable hiking experiences with our kids is Dr. Julia Pederson. She's a pediatrician with Stanford Children's Health.

This is Health Talks from Stanford, Children's Health. I'm Scott Webb. So doctor, thanks so much for your time today. This is a really cool topic. I know you've recently been hiking with your daughter. So let's talk about our expectations maybe versus reality when we're hiking with our kids.

Dr. Julia Pederson: When I think of hiking with kids, I think one of the most important things that we can do as parents when we're planning that hike is really to adjust our expectations. You know, pre-kids, we might be able to do a four or five-mile hike up to a beautiful scenic overlook And, you know, post-kids, we really have to remember that the journey is really the destination. If you make it a hundred yards and your kid loved every minute of it, who really cares what that original plan was? I think adjusting those expectations can really help to make it a positive experience for everyone involved.

Scott Webb: Yeah, it definitely can. And as you say, when we were sort of childless, before kids, if you will, versus young kids and then older kids, let's talk about sort of tailoring the adventure to our child's age or developmental stage.

Dr. Julia Pederson: I think any age can really get outside. When I think of little ones like infants, you know, starting really simple, taking them on a walk during their nap time at your local regional park, or bringing a blanket and having tummy time under an oak tree. Those are really great sensory experience for kids and infants as they're developing, you know, their vision and their hearing and their sense of smell. And they're easy for you to do as you're a, you know, recovering mom or first-time parents. You don't have to set your expectations too high.

I'm in the toddler stage myself with my little two-year-old. And I find that if she sees a rock in the distance, that's where she's going. Focusing on climbing rocks and fun trees and wading in small creeks. The toddlers just love those sensory experiences. They like to use their whole body and work on their balance and climbing. And that's really what toddlers love to do developmentally.

Scott Webb: They do.

Dr. Julia Pederson: And then as we move kind of older into the school age kids, we're trying to have little adventures, getting them excited for maybe that waterfall at the end of a mile-hike or maybe they might see a condor in Pinnacles National Park or teaching them how to fish or wade across the river. Those are great things for school age.

And then as we get into our teens and our tweens, teens and tweens really, it's great to get outdoors and have them experience that sense of awe and that sense of something bigger than themselves. As we all know, teens, it's all about figuring out their identity and who they are. And so when they have that moment be outdoors, and feel the bigger world and that they're just kind of a small part, that can be incredibly profound for teenagers. And so this is when you can do those kind of longer hikes or adventures, like going on a kayaking day trip or a rafting trip up on the Russian River, or maybe planning your first backpacking trip and that can really help them to find their joy in the outdoors.

Scott Webb: Yeah, definitely. A few years ago, I went rafting with my son and I'd never really been rafting, not like that anyway. And he was kind of young and at one point, he started to leave the raft. The water began to take him out of the raft and dad saved him. And so now to this day, I remind him, "Remember that time I saved your life?" And he does, you know, and as you say, it's just that sense of adventure. It is something so fun to share with our kids.

And also the senses, I can remember when I was a kid, I was in Boy Scouts and one of the things we would do is, you know, you would go out and you would just sort of sit by yourself, out in the middle of nowhere and you would take notes. And I remember just being able to close my eyes and just listen, listen to nature, listen to the birds, listen to the wind. And so I want you to have you talk a little bit about just ways that we can appreciate the outdoors when we're on those hikes.

Dr. Julia Pederson: You know, and all of us are a bit different in that way. Some of us really like to focus on a destination or some of us might be interested in birding or plants or figuring out the geography. I think one of the best things that we can do is help kids hone in on those senses. What can you hear? What can you smell and see and taste and feel when you take a little water break? That's a great time to kind of help them understand their surroundings.

For little kids, sometimes distraction works really well. Singing a favorite tune or making up your own song. I find that when I'm on hikes, it's one of the times that we always break out into song and there's something really nice about that collective spirit and singing when you're outside. Other things that you can do is play a game of I Spy or try to find all the different colors of the rainbow outside. And then what you described is something that I really do, you know, bring a notebook, bring a pencil. When we have time to kind of let our minds go, this is when our observational skills are really developed and when our creativity flourishes. And so having that notebook and pencil to write down your ideas or sketches can be really beautiful. Even my two-year-old already does that. And it's really inspiring to me. Now, I bring my own notebook and pencil along too.

Scott Webb: That's great.

Dr. Julia Pederson: You know, and then for older kids, binoculars, magnifying glass, bringing maybe a local guide book or Pocket Naturalist book. There are also some really good apps. One of my really close friends and her girls love the Seek app, which is done by the California Academy of Sciences and iNaturalist. And it helps you to identify all the different insects and plants and animals and trees. And I think she's identified over 300 different species just in our local area alone, which is pretty neat too.

Scott Webb: That's so cool. You know, it makes me think about what kinds of things should we bring? Like, how do we plan and prep for a successful outing? Obviously, you got to bring your phone because you can use that for navigation and pictures and these apps and all of that. But what else do we need to bring?

Dr. Julia Pederson: Yeah, that is such a good question. You know, preparation is really key to these outings going smoothly because any little thing can make it a tough experience and sometimes even a risky experience. Many people that are in backpacking and hiking have heard of the 10 essentials. So that's definitely something that you can Google and make sure you have those if you're going on kind of a longer outing.

In my adventure bag, I always carry definitely extra food and water. I do carry a small first aid kit, you know, one that can kind of cover cuts and blisters, a little ACE wrap for ankle sprains, a pair of tweezers in case you get any ticks, bug spray, and then emergency blanket in case, you know, someone has a bad fall and you have to go get help and keep them there.

And then, you know, in California we're lucky to have good weather, but that comes with some pretty serious heat sometimes. And so protecting for the sun can be really important. I always have a sun hat and some sunblock and sunglasses. And then on the other hand, sometimes we go out and it's a beautiful day, we take maybe the wrong trail and it takes a little bit longer than we realize, and it gets cool in the evenings. And so, always have an extra layer, even if you're going out at high noon and you're only expecting to be an hour, always bring an extra layer of warmth with you. I throw a little knit hat in for my daughter as well.

And then again, kind of planning for, you know, in case someone hurts their ankle or something. It's good to have a flashlight, a little mini one is perfect; a whistle and even a map. So, some of these regional parks have a lot of like intertwining trails and it can be tough sometimes, so having that map with you can really help you figure out how to get back to your car. And then, I find that kids will get dirty no matter what. So throwing in maybe an extra t-shirt or a pair of clothes, especially if they're under the age of five, you'll probably end up using it. And then if they're in the diaper category, definitely, you know, extra diapers, wipes, anti-bacterial, soap and something to carry a dirty diaper back out of the wilderness as well. Yeah, that's my list.

Scott Webb: Yeah, and it's such a great list. And when we talk about preparation and I know I'm dating myself here, but you mentioned maps, so some of our listeners may not be familiar with what a map is. You know, a paper with trails and directions. And I always think back to Gilligan's island, that was supposed to be a three-hour tour. And of course, they got stranded on the island. And I never want to be stranded on an island, but I do think to myself when I set out on days like this, these hiking days or outdoor time, I just think, you know, "Yeah, I'm thinking this is going to be three hours, but it might be six hours. It might be 10 hours. You just never know." So it's just so great to be prepared. And it's a great list you gave us there.

And this is something that, you know, my kids used to worry about when they were little, we'd go on hikes and things and they would worry about nature, things that would happen that would be unexpected, unexpected noises, things that jump out, things that fly out and just in general, you know, what are some of the dangers? So I want to have you go through, like, how can we stay alert to some of those dangers when we're outdoors, when we're hiking with our kids or just by ourselves?

Dr. Julia Pederson: That's kind of the fun of it too is the unexpected and the unknown. And so, you know, the way that I kind of approach teaching kids about risks of being outdoors, it's the same way that you would teach them to look both ways before they cross the street, you know, to stop at a green light. There's just some kind of safety 101 type things when you're in the outdoors. There's a lot of teachable moments when you're on a hike too. And this can be kind of done in a pretty safe, reassuring kid-friendly way without scaring them too much.  

Some of the most common questions that I receive from parents tend to be related to poison oak rashes, tick exposures, maybe an ankle sprain or bug bites. Those are pretty common. I think one of the biggest things that I would recommend is opting for easy trails at the start, flat, wide, easy trails, especially for the little ones. And then I cannot tell you the number of times that I've started hiking down a trail and realized it was a little bit tougher than I anticipated. And you have to have that humility to say, "You know, maybe another time."

Scott Webb: Yeah, "This was a good start. Let's put a pin in this one and we'll come back to this one later." Yeah.

Dr. Julia Pederson: Exactly, you know, and I think it also makes for memorable stories for reasons that you turned back. But picking the trail that's right for you. Also staying on trail, you know, there's a lot of effort that's put into these trails and they're there for certain reasons and they're in the kind of safer areas usually. And then, little ones love to run up ahead of you and you just don't know what's around that corner, so trying to keep up with them is a good idea. And it helps to avoid, you know, things like cliffs or hazards. There are snakes or rattlesnakes in that Northern California area. Very rare to get a snake bite, but if you would, you know, that would be a pretty serious issue and something I would immediately pick up that phone that you have in your pocket and call 911 and get off that trail, but pretty rare.

What I see a lot of is poison oak exposure. Poison Oak is just abundant in the California Hills. Especially under our oak woodlands and in our ravines, even along the coast. So I think what can be kind of fun, especially if you're new to hiking is really hunting for poison oak, kind of trying to find it on every hike because you'll be able to find it and teaching your kids what it looks like and it's different variations. Right now, it's starting to turn a little bit red in my area. And I've started to point the color changes out to my daughter, so she's aware of it. And my favorite saying is the "Leaves of three, let it be. Unless it's hairy, then it's a berry."

Scott Webb: Oh, I love it. That's great.

Dr. Julia Pederson: Yeah, there are some wild California blackberries that can look very similar to poison oak. And really hiking in long sleeves and long pants can make a big difference for preventing a poison oak exposure. There is something on the market called Tecnu. Tecnu comes in kind of wipes or a soap. And you can carry one of those little wipes in your first aid kit. If your child does get exposed to poison oak, you know, immediately use some of your water and wash it off. And if you have a Tecnu wipe, that's even better. And then, you know, if you get home, go ahead and change those clothes, take a nice big shower. And they do get a painful, itchy, rash, you know, odds are it is a poison oak exposure. It's not usually dangerous, but it can be pretty painful and itchy. So that's definitely worth a virtual visit with your pediatrician to figure out next steps and get some help along that way.

Another thing that I'm increasingly getting questions about is related to ticks. We do have ticks in California, not as common as the Northeast, but they are here in our shrub and our woodlands. Still fairly rare that a tick can carry Lyme disease. But it is important to take precautions. Just like with poison oak, you know, the basics, trying to stay on trail, wearing some long pants. Those are great preventative measures you can take.

And then I do recommend a tick check at every hike. You know, no matter where you are in California, there's a good chance that you could have gone into a habitat that had some ticks in it and especially checking kind of the scalp and the hair lines, armpits and the groin. My daughter and I love to pretend that we're little baboons at the end of the hike and I check her and she checks me and I did find a tick on her this spring, so it works. She enjoys those baboon checks and giggles a lot. If you do see a tick, you can pull out that phone and take a picture of it, that can be helpful, and then just remove it with those tweezers that are in your first aid kit immediately.

And we know if a tick is removed quickly within the first 72 hours, there is a very little risk for developing Lyme disease. If you do find a tick that maybe was on there for over 72 hours, or if it looks really swollen and engorged after removing and cleaning that area, it's a good idea to call your doctor or if your child does develop any kind of rash or fever, enlarged lymph nodes, those are kind of the signs to look out for that would warrant a medical evaluation.

So we talked about poison oak, we talked about ticks. Another thing that can be common is bug bites or bee stings. You know, most of the time, these are going to be pretty mild reactions if that happens. One of the best things you can do is if there is a stinger, to remove it as soon as possible, wash off the area of the skin with some water, and hopefully that will do the trick. If not, if your child is having, you know, some swelling or redness, you can always, take a bandana and put that in your water and kind of put a cool wash cloth around it. If you do have some Benadryl in your first aid kit, that would be good to give. Pretty rare to have a severe allergic reaction, but the things that would make you want to leave the hike would be if that swelling is getting very large, very painful, or if they're starting to have any signs of a systemic reaction. So that would be lip swelling, trouble breathing, coughing, vomiting, weakness, those would be signs of a real emergency. And I would call 911 if that happens, but hopefully not.

Scott Webb: Yeah, hopefully not. And you mentioned Benadryl and that was something that was always in my dad tool belt, if you will. I always made sure I had Benadryl with me or After Bite also, you know, because you just never know and you don't want relatively minor sting or a bite to have to have everybody pack up and go home, right?

Dr. Julia Pederson: You don't, but this is what we learn out on the trail. And I think some of my biggest flops in hiking have become the family lore. So as long as everyone gets out safe and gets the care they need, that's the most important thing for sure.

Scott Webb: Definitely, as you mentioned too, that a lot of these things can be done with pediatricians through telehealth and telemedicine. So we don't necessarily have to get into the office to be seen if we have a troublesome, you know, bite or a rash or something like that. A lot of times we can just kind of get on our phones with pediatricians and they can look and say, "Okay, move your camera over by your arm there. And let me see what we're dealing with," right?

Dr. Julia Pederson: Absolutely. It's amazing how virtual medicine can be helpful in that way. I deal with almost all poison oak now virtually. And it's great too, because oftentimes we have different ointments and creams in our medicine cabinet. And I just, you know, ask the parent to go and show me the ointment and cream, and we can kind of make a plan with what they have at home sometimes even.

Scott Webb: That's so cool. I didn't think of that. Sure. It's just like, "Well, let me scan your medicine cabinet" and then as you're looking through, "Okay, you need to throw that out and that out and never use that ever," right?

Dr. Julia Pederson: It's eye opening, but I find it really helpful. And oftentimes most people have what they need.

Scott Webb: Yeah, this has been so fun, doctor. As we get close to wrapping up here, I just want to ask you, are there any local resources that we can look out for or some great books to read? You've given us lots to think about today, great lists and preventative measures, but any other resources you want to mention?

Dr. Julia Pederson: Locally, we have so many resources. So, we have our local Audubon Society and Sierra Clubs. They often do outings and they have great resources for where to go and maybe checklists for birds or plants. Your local REI also has great information on trails in the area and which ones might be good starter trails for you if you don't really know where to start.

We have a lot of beautiful open spaces in the Bay Area. The Midpeninsula Regional Open Space Preserve is all throughout kind of the peninsula and East Bay and South Bay, and has a lot of free hiking trails. Up north, you have the Golden Gate Recreation Area. And then, there are many regional parks, which are always a great place to start for finding a good hike.

Some of my favorite books that can kind of inspire you to go outside, How to Raise a Wild Child is by Scott Samson, and I think I read that book about three times when my daughter was born. And it's just a beautiful book about kind of steps that you can take to help your kids find that joy in the outside. And then, Richard Louv is one of the foremost writers about getting kids outside. He wrote Vitamin N: The Essential Guide to a Nature-Rich Life and The Nature Principle, which I really liked. And then, going back to one of my heroes, is Rachel Carson. She wrote a little book called The Sense of Wonder, that was kind of written with her experience with one of her nephews. And it's a beautiful quick read that can inspire you to get your kids outside. So those are some good resources that I love.

Scott Webb: Such great resources today. Tips, suggestions, we had some laughs along the way. This has been really fun. Doctor, thank you so much for your time and you stay well.

Dr. Julia Pederson: You too, Scott. Thank you for having me on.

Scott Webb: For more information, go to stanfordchildrens.org, And we hope you found this podcast to be helpful and informative. If you did, please share it on your social channels and be sure to check out the full podcast library for additional topics of interest. This is Health Talks from Stanford Children's Health. I'm Scott Webb. Stay well, and we'll talk again next time.