Screen Time, Bedtime, and Picky Eaters – PediaCast 606

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Show Notes

Description

Dr Sarah Adams visits the studio as we consider screen time, bedtime, and picky eaters. These are frequent challenges for moms and dads. We share strategies for building healthy routines that lower the stress. We hope you can join us!

Topics

Screen Time
Bedtime
Picky Eaters
Healthy Family Routines

Guest

Dr Sarah Adams
Parenting at Mealtime and Playtime Program
Ohio Chapter – American Academy of Pediatrics

Links

Growing Up with Dr. Sarah (Apple Podcasts) (YouTube) (Spotify)
Ohio Chapter – American Academy of Pediatrics
Parenting at Mealtime and Playtime (Ohio AAP)
Resources for Families (Ohio AAP)
Resources for Providers (Ohio AAP)
Family Media Plan (AAP)
Healthy Children (AAP Parenting Website)
Center of Excellence for Social Media and Youth Mental Health (AAP)

Episode Transcript

[Dr Mike Patrick]
This episode of PediaCast is brought to you by the Ohio chapter of the American Academy of Pediatrics and Nationwide Children's Hospital. 

[MUSIC]

[Dr Mike Patrick]
Hello, everyone, and welcome to another episode of PediaCast. We are a pediatric podcast for moms and dads.

This is Dr. Mike coming to you from the campus of Nationwide Children's Hospital. We're in Columbus, Ohio. It's episode 606.

We're calling this one screen time, bedtime, and picky eaters. I want to welcome all of you to the program. We are so happy to have you with us again.

You know, raising healthy kids can feel overwhelming, especially when it comes to the things I mentioned, screen time, sleep, meals, and daily routines. Today, we're talking about what really works, for real, not in theory, but practical tips to make life a little less stressful for parents. That's our goal anyway.

As I think about the days when my kids were toddlers, my wife and I used to joke that our lives were full of lies, bribes, and threats, but there are better ways. You know, lies, bribes, and threats come with their own complications. So says our guest today, Dr. Sarah Adams. She's a pediatrician at Akron Children's Hospital and medical director of the Parenting at Mealtime and Playtime Program at the Ohio chapter of the American Academy of Pediatrics. And she also hosts her own podcast called Growing Up with Dr. Sarah. She's here to share strategies aimed at helping families build healthy habits related to screen time, bedtime, and picky eating.

We'll also explore how programs and digital tools from the Ohio chapter of the American Academy of Pediatrics can support families as they face challenges with everyday activities and maybe help us avoid all those lies, bribes, and threats. Before we get to her, I do want to remind you that the information presented in every episode of our podcast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals.

If you're concerned about your child's health, be sure to call your health care provider. Also, your use of this audio program is subject to the PediaCast Terms of Use Agreement, which you can find at Pediacast.org. So, let's take a quick break.

We'll get Dr. Sarah Adams settled into the studio, and then we will be back to talk about screen time, bedtime, and picky eating. It's coming up right after this. 

[MUSIC]

[Dr Mike Patrick]
Dr. Sarah Adams is a pediatrician at Akron Children's Hospital. She's also an executive board member and medical director of the Parenting at Mealtime and Playtime Program with the Ohio chapter of the American Academy of Pediatrics. She is also an ambassador for the Center of Excellence for Social Media and Youth Mental Health with the National American Academy of Pediatrics. And she also hosts a podcast called Growing Up with Dr. Sarah. Today, she's going to help us navigate screen time, bedtime, and picky eating. Before we dive in, though, let's offer a warm PediaCast welcome to our guest, Dr. Sarah Adams. Thank you so much for stopping by the studio today.

[Dr Sarah Adams]
Thank you, Dr. Mike. It's an honor to be on the podcast today and to share with your audience things that I talk about all the time in my practice.

[Dr Mike Patrick]
Yeah, they're such important things, especially for families with young children at home. I mean, they're also important for older kids. But I think right out of the gate, you know, when you're just used to being a couple without kids, you don't have to think about these things.

And suddenly you're thrown into it and they become really, really important as we think about screen time, bedtime, and mealtime. Let's start with screens and sleep. There's a connection there, right?

Why does it matter that we think about screens in association with sleep for young kids and older kids, too?

[Dr Sarah Adams]
Sleep affects everything in a child's day, from getting out of bed to performing in school or interacting with others and their playtime and regulates their mood. And when kids don't get enough sleep, it definitely impacts them, but also parents. And then if they're in school, teachers and kind of the flow of their day.

Screens play a major role here when it comes to sleep, not just because they can be a distraction, but it's that blue light exposure which delays melatonin. So, let's talk about melatonin for a second. So, melatonin is something that our body naturally produces when it is dark.

When I talk to families in my practice, I think about like the cavemen, like before electricity, we didn't have alarm clocks and lights to kind of wake us up. So, when the sun came out, melatonin production goes down in our body and then we become awake and we get energy and go on with our day. And when the sun goes down, melatonin is now produced and it helps us fall asleep.

So, let's go back to the screens, right? So, the screens, they have that light exposure, which kind of tricks your brain into thinking that it's daytime and you should be awake and alert and ready for the day. So, it makes it much harder to fall asleep.

On top of that, you know, the content too. So, it's the light, it's the content itself. It can be so stimulating and keeping our brains active when really, we should be winding down.

A helpful approach is something I call powering down to power up. When kids reduce screens before bed, they're more likely to get the rest that they need to be focused, to be present, and to really power up and be their best the next day. And this goes for any age.

[Dr Mike Patrick]
Yeah, yeah. And really that sleep is so important as we think about kids with ADHD, kids who may have learning differences and difficulty in school. Getting that good night's sleep is just so important to our brain functioning at its best level, right?

[Dr Sarah Adams]
Absolutely. Often when I am working up a child who may have ADHD or even anxiety, we talk about sleep because sleep affects our concentration. So, is it ADHD or is there something we can do to help with sleep?

Are they anxious because they're not getting enough sleep? It also affects our appetite. So even concerns about weight and how we eat through the day, it's all affected by sleep.

We don't give sleep enough credit is what I always say.

[Dr Mike Patrick]
Yeah, yeah, that is so true. Now, it used to be we would say, you know, an hour or two of screen time every day is enough and then kids need to play, and we need to socialize with our kids, and we need to sit down with meals with our children. But that's becoming way more difficult as a lot of our daily life moves to screens.

I mean, we may be using screens as kids do school. You know, they're connecting with maybe grandparents that live across the country, you know, through screens and social media. They're keeping up with their friends.

And that's all before we think about entertainment and movies and TV and video games and all of those things. So, what should we consider as normal these days? And when should parents start to think, maybe I'm not using screens appropriately for my family?

[Dr Sarah Adams]
You know, the best answer to this is there's no one size fits all definition of what we call normal screen time. Some kids and parents manage it really well, while others need definitely more structure and boundaries. When parents should pay attention is when screen starts to crowd out important parts of life, like sleep.

We talked about schoolwork. Maybe what they're seeing is that academics are going down. Absolutely.

Family time. It crowds out that and social interaction, whether it's online or offline. So, some warning signs are, is there a change in their mood?

Are they irritable, especially after screen use or sneaking devices? I get concerned when a child is really afraid to show you what they're looking at or what app they are on. And that can show some really red flags that are more concerning than we think.

Also, difficulty transitioning off screens. I remember so often, especially with gaming, my child would be like five more minutes and then five more minutes turned into 30 minutes. And even with myself, I'm like, I'm just going to play this game online a couple times, you know, just to kind of power down my brain.

Sometimes I use it for that. And so, we have to pay attention to how are we transitioning off? One of the most concerning things to be watching for is losing interest in those offline activities, like playing outside or spending time with family.

You know, teens specifically, if I could mention, they're going to use media to distract, to procrastinate, to space out a bit and to take some risks. And that can be developmentally normal. So, I kind of consider some of that silly use.

And it's not the same as problematic use. When we talk about problematic use, we're really talking about risky, excessive, impulsive in nature, again, leading to like adverse life consequences. So, is it changing them specifically physically, emotionally, social or functional impairment?

So, it's really the key is not how much time, but the content that they are absorbing and what the time is actually replacing.

[Dr Mike Patrick]
Yeah, yeah. So just really being in tune with what is happening and how is it impacting everything else. Now, for a lot of families, we get into habits and very common.

And so, a lot of kids, you know, part of their habit may be scrolling on their phone as in bed right before they go to sleep or they might have a TV in their bedroom. And it can almost seem like punishment to say, OK, we're going to change things because I want you to get a better night's sleep. I want you to fall asleep sooner.

I don't want all the stimulation of bedtime. And so, we're going to take away your phone or we're going to take the TV out of your bedroom. Like when you're in that habit of just doing that, it can seem like, you know, your mom and dad are against what I'm doing and I'm maybe being bad, but I want to continue to use these screens.

So, what are some realistic ways that parents can sort of reset screen time, especially around bedtime?

[Dr Sarah Adams]
That is such a great question. And the most important thing to do is to really start small because trying to overall overhaul everything all at once, it often backfires. And it does seem punitive.

So, we want to get away from that one way. Like you gave an example about using screens right before bed. And we talked earlier about how that can affect your ability to fall asleep.

So, if your goal, ultimate goal, is to have the phone or the TV out of the room. OK, let's just talk about the phone. So, let's say you want the phone out of the room completely before they go to bed.

Why don't we start with maybe like just putting it on the dresser instead of right next to them? So, starting something small so that it doesn't feel like, oh, my gosh, like that. It's almost like a part of me is now gone.

And now I can't fall asleep because I'm thinking about it. So, starting small and being consistent and kind of work with your child on what they feel is realistic for them and sustainable. Right.

If they have some agency in this, if they buy into these opportunities to really change some habits and reset their screens. I think getting kids involved as young as they can, absolutely, then they're going to be more likely to try it. I want to bring up the family media plan, which is a plan that is provided by the American Academy of Pediatrics.

And so, if somebody goes to AAP.org and they can look up the family media plan, it is such a great tool for the whole family, including the parents. So basically, you go there, you fill in each child's name, your whole family, each parent, anybody else that's in the home. And everybody kind of helps design what their habits are going to be.

And the other thing that I want to remind people is this is fluid. So, you try something and you need to be flexible, revisit it. I have a family, they came up with this idea, not me, where every Sunday they look at their media plan and kind of go over, at least they did this in the beginning until they kind of had some nice, consistent routines that worked for them.

But in the beginning, what they did is on Sunday nights, they would go over their media plans and talk about what worked and where some opportunities were for change.

[Dr Mike Patrick]
Yeah, so important. And that family media plan from the American Academy of Pediatrics, I'll put a link to it as well in the show notes for this episode over at pediacast.org so folks can find it really easily. Now, as we think about changing habits and sort of changing our routines as a family, it can quickly become a battle and not only regarding screen time and bedtime, but really, you know, with meals, with screens, with anything, any change.

There can be a sort of resistance from your kids, and it just feels like a battle. And I know for a lot of parents, it just feels like every decision is just like one battle after another. Why does that happen and what can we do about that?

[Dr Sarah Adams]
It's so true. You know, the mental load of being a parent, the struggle is real. We've heard that comment before.

And especially when you're in a battle or there's a stressful moment, it's even harder to think. So, when I am helping parents create simple habits and building strategies so that these habits can stick, actually stick, I tell them start with one habit at a time. So, let's look at what your goals are.

Is it going to be sleep? Is it something around meals or more movement through the day or even reading, something that has to do with education? The idea is that you pair a new habit with something that already exists.

So, I'll give you an example. After brushing your teeth, which hopefully everybody's doing every day, if one of your goals is to have your child read and be more consistent with their reading, what you do is you habit stack what is a consistent routine with something that's new. So, they brush their teeth and then a child might read for five to ten minutes afterwards.

And you just work on that habit for anywhere between one to three weeks to get it to really stick and see how it's working. And this stacking helps the new behavior come part of an existing one. And celebrate the wins.

You know, small wins build momentum. We all, especially kids, feel good when we're doing something and they really want to please their parents. They do, even though it always seems like there's a battle.

So, make progress visible, whether it's like a chart or a reminder or just simply tracking and then celebrate the effort, not the perfection.

[Dr Mike Patrick]
Yeah, yeah. And I feel like kids, a lot of times the battle starts when they feel like they've lost control. Like for all of us as humans, we want some autonomy.

As you said, we want some agency. And so, with the example that you gave, you know, maybe the new habit is going to be after you brush your teeth, we're going to have some reading time. But you get to pick which book, you know, and maybe it's a selection.

But like so that there are some choices that the kids can make within limits. But I think that that helps to start that new habit as they are able to have some choices in the matter.

[Dr Sarah Adams]
Absolutely. Autonomy is part of their development. They want that.

And especially, I mean, we talk about the different age ranges. I always say toddlers are so much like teenagers. And we know scientifically their brain is very similar and they just they want to have some more responsibility.

And so, yes, giving them choice is so important. And that's where kind of buying in like, hey, I'd really like to maybe even ask them. I'd really like to make 10 minute of reading time something that's enjoyable for you.

What are your thoughts about brushing your teeth and doing some reading right after or coming up with another habit that they do every day? Maybe it's the snack after school or something similar to that. But giving them choices, they're going to stick with it.

They're going to buy in.

[Dr Mike Patrick]
Yeah. And do you have kids read on their own or is it OK for parents to read to children as part of that reading time?

[Dr Sarah Adams]
Oh, I'm always about connection. That's something I'm so passionate about. So, parents, if you have time and you can read with them, whether they're reading to you or you're reading to them, that those are precious moments.

They really are. It's such a great opportunity to put your screens down, both of you, and spend time together. Let's say I do want to bring up screens for a moment, too, because I really think that also what helps with screen time is doing screen time together.

So, whether that's a little video that you're watching or something that they're doing online that has to do with school, ask the kids to join in, follow along with them, talk about the apps, for example, that they're that they like and what they like about it. Really having that connection time is so important.

[Dr Mike Patrick]
Yeah. And as kids become better readers, as they're getting a little bit older, you can do a combination of both of those things. I remember of them reading themselves and also reading to them.

I remember when my kids were preteens and early teenagers. It was like right when the Harry Potter series was really, really big. And my wife would read the Harry Potter books to them.

And I mean, even though they were, you know, 11, 12, 13, around those ages, they loved it. I mean, you know, and then as you said, that was connection time. But then they also like to read stuff on their own as well.

Speaking of connection, a term that I know you like to use is connected parenting rather than perfect parenting. What does connected parenting look like?

[Dr Sarah Adams]
You know, it's about, to me, it's about being present. And especially now that we have all these screens, these media, this device, it's really being able to be where your feet are and to be present. And it doesn't have to look perfect.

You know, it's really focusing on that connection. Then it really is about doing everything right. So we don't need to be perfect.

We just need to be present. And my sister-in-law once asked me when both of our kids were young, she said, because you're a pediatrician, are you the perfect parent? And I was like, are you kidding me?

You know, my kids didn't read any of the books that I read, or they didn't come out with the manual. And every child is different. And so, their needs are different as well.

And so really trying to be present. One tip I tell people, especially when it's so hard to put that phone down, for example, or that iPad when you're engaging with your kids, is one of the best ways to stay connected is through communication. So, let's say you need to stop for a moment and check a text or look up something or check an email because it's timely.

I use the example with my granddaughter. So, I now am a grandma, and I spend time with her, and we have a lot of fun. But I know if I need to look at my phone, I always communicate with her.

So, I'll say to her, I need to look at this text because grandpa is reaching out at a specific time. And the reason I do that is because when we're using our devices, especially when we should be connecting and being present with our kids, that sends a signal to them that the device is more important than your time with them. And so, what I do is just communicate, hey, I'm going to pick it up for just a second, so they know why I'm using it.

And I really advise parents do the same because there are times when you need to use your phone. So just tell them when you're having time with your child. I think first, if you can have screen-free zones and screen-free time, that's what we choose.

But again, presence over perfection. So, what I mean by that, sometimes you have to. So, if you do, just tell them why so that they're not thinking that you're just distracted.

[Dr Mike Patrick]
Yeah, yeah. I could see that being really important. You know, let's move to mealtime here real quick.

A lot of parents pull their hair out over mealtime, especially when kids and young toddlers can be really picky eaters. They're not growing as much. So, they may not have as much of an appetite.

And suddenly this kiddo who used to eat great suddenly doesn't eat very much at all. You know, what are some differences when we think about picky eaters of what's sort of normal, what parents can expect? And then when there really is a problem.

[Dr Sarah Adams]
Picky eating is so common, as you said, and it definitely is part of a normal developmental phase. I feel like nutrition and feeding your family is like a roller coaster. So sometimes it's going really well, you're smooth and everything's going, then all of a sudden, it's just bam, you know, you're tanking on that.

So, the most important thing to keep in mind is when you're looking at how much your child is eating, try not to focus on one meal or just one day. You want to focus on maybe two or three days at a time, especially when you're thinking about that toddler who just doesn't seem to be eating much. Like an example might be one day they'll eat three really good meals and then the next day they're really only eating one and then the next day it's better.

So, if you don't focus on just one meal and you look at maybe two, three, four days of what their habits were and how much they took in, you'll realize that, wow, they did better than I thought they did. And so, concerns start to arise when like eating habits affect their growth. So, if for some reason a child who's growing all of a sudden is now starting to not grow as quickly and their growth chart, if you're looking at it with your pediatrician, is starting to really trail down as opposed to staying on that line that they've so beautifully been staying on.

Energy levels, maybe they're all of a sudden not as energetic throughout the day or they're sluggish or really tired. So those are some things to be watching for and can be significant cause for stress and anxiety. Other things are like extreme restriction or fear of eating, and that could be anywhere from just fear of gaining weight or body image, etc.

But even like I've had children who struggled with fear of eating because of choking. Like if they choked one time, now all of a sudden, they don't want to eat because they're afraid, they're going to do it. So those are the patterns that parents really want to look at.

And a helpful mindset is really just to realize that as parents we provide and the kids decide. So, we provide the food and the structure, and the child ultimately decides what and how much to eat. And just like reading and asking them what they would like to read or how they would like to spend their 10-minute time reading.

Get kids involved in making, deciding recipes or making the grocery list or coming to the grocery store. And when again, they're more involved and have some choices, they're going to be more likely to try new things. So, we really want to encourage parents, again, keep in as a dialogue, but look for those things such as growth, energy, for example, or restriction or fear.

Those are the main things that you want to bring up to your pediatrician for sure.

[Dr Mike Patrick]
Yeah. And I think that's a really important point because it's likely that your pediatrician has dealt with other families who have had similar issues and they may have some ideas of what has worked for other families and some things that maybe didn't work, but, you know, might work for your family. And so, they're going to give you some ideas that you may not have thought of just because they're working with so many different families.

And these are common problems, right?

[Dr Sarah Adams]
They are. They really are. I always say that I had a picky eater, and I worried about him so much, but he was growing and he was developing and he is such a great eater now.

He tries all kinds of things. So, it might take a lot of different exposures. There are other things that you can do to kind of help, because when kids feel forced, then that makes it so stressful for everyone.

[Dr Mike Patrick]
Yeah, yeah. My wife and I used to joke that our lives when our kids were young felt like lies, bribes, and threats. Like everything was either a lie, a bribe, or a threat.

And we didn't necessarily like that. But I'm sure a lot of folks out there who are listening right now can understand exactly what I'm talking about. You know, you may say like, well, if you don't eat your carrots, your vision's going to go bad or, you know, which is a lie.

Or you may bribe them like, well, you know, you can't play with such and such a toy until you eat this food. Why is it that the lies, the bribes, and the threats tend to backfire? And what can we do instead?

[Dr Sarah Adams]
You know, pressure, that pressure really creates that negative association with food or meal or whatever it is that we're trying to get them to do. As parents, you know, we focus on our kids and making sure they're healthy and thriving. And when it comes to eating, sleeping, and pooping, those are three things that kids just, we can't make them do.

So, but if they're eating, sleeping, and pooping, we feel as parents and even providers that everything's good, we're doing good. So really kind of walking or going towards not feeling forced, but making mealtime less stressful, for example, and really focusing on trust and getting the kids involved in that so that they buy in, like I said before. Those things backfire because they're onto us.

I really believe kids are a lot smarter than we give them credit for. And sometimes those things like lies and bribes are really hard to be consistent as well. And so, finding consistent, realistic tools, habits, routines, that's really what you're shooting for.

So, some things that you can do are like pairing a safe or a food that they already enjoy with something new and teaching them to be good tasters. Just taste it and tell me how it makes you feel versus having that what I call a two-bite tango, you know, two more bites and three more bites. You know, I remember playing that, you know, dancing that two-bite tango so often with my child.

But really just saying, you know, what I would really love for you to do is just taste it, smell it. Maybe all that they can do right now is just taste it or touch it. So, use the senses to help them.

And it might take, Dr. Mike, like 20 to 30 times to introduce a new food before a child would accept it. So being patient is also the key to not making mealtime or meals or things that we want our kids to do. Not being patient backfires for sure.

[Dr Mike Patrick]
Yeah, yeah. And being persistent and just knowing, well, you know, they may reject it this time again, but maybe 20 times down the road they're going to end up liking it. And it's funny because my kids, now that they're older, they were both pretty picky eaters, really.

And part of that was probably my wife and my fault because we didn't introduce, you know, you kind of you want everyone to be happy. And so, you sort of gravitate toward what they do like. And maybe we weren't quite as pushy about having them try.

And maybe it was a few fights that then made us not want to try anymore. But just, you know, my daughter now is almost 30 and she just realized, you know what, I do like cherries. Like as a 30-year-old and like all this time, you know, she avoided cherries.

Oh, I don't like those. But it is a really good point to just keep being persistent, keep trying. And it may end up that they have to be 30 years old before they try it and like it.

Same thing with my son, you know, with onions or with sauerkraut, you know, eventually they're going to try it and like it. And we just have to be persistent and not push things too much. Right.

[Dr Sarah Adams]
Absolutely. I have two boys and one was picky and one would eat everything. So, I didn't want to become a short order cook, cooking things for one child and something else for another.

So, one of the things that really helped our family was considering like flexible options. So, we would do taco bars, pasta bars, salad bars, potato bars, like build your own meals so that the kids can choose within the boundaries of what I provided. And I'm going to tell you, that made things so much easier because it saved me time.

It saved me struggle. And they both got to choose what they liked to put on their plate.

[Dr Mike Patrick]
These are important considerations that aren't always science based. Like a lot of us in pediatrics, we really do like to look at science. We like to be evidence based.

We want to, you know, let parents know that vaccines are good and this is what the research shows. But when we're talking about kids behavior stuff like sleep time and screens and mealtime, there's not as much research about that. And parents get a lot of conflicting advice.

So, you know, you've offered a lot of advice during this episode. I have offered some. You're also going to have grandma and grandpa offering advice, aunts and uncles, the neighbors do something different with their kids.

How can parents decide what's best for their family, even though they're getting lots of different advice from lots of different places? And we don't necessarily know what's better or what's not so good, you know?

[Dr Sarah Adams]
Yes. And there's so much noise out there, if you've heard that expression. And it's really hard to cut through that noise.

Really starting with a trusted source, like I mentioned, the American Academy of Pediatrics, and talking it over with your provider. Don't be afraid. They want to help you cut through this noise.

And conflicting advice. I mean, even things change so quickly. I remember one time with my kids that the one child slept on their tummy because that's what we did.

But by the time the other child was born, we knew that it was better for babies to sleep on their back. So, you bring up grandparents, for example, or what people will in my day, I used to do this. And so, it's common.

I want to tell families that it's very common to get conflicting advice. One of the things that I try to focus on when it comes to even the decisions that I make for myself or for my family is if it sounds too good to be true or promises a quick fix, it probably is too good to be true. So good advice should feel realistic, sustainable.

And when we go to sources such as social media, which can be an excellent source of information as well, it's not individualized care. So, keep that in mind. What works for one child or family might not work for another.

So always consider whether this advice fits your child, your specific situation, and when in doubt, talk to your pediatrician.

[Dr Mike Patrick]
Yeah, yeah, absolutely. And you mentioned some great sources of information, like the American Academy of Pediatrics has a HealthyChildren.org. It has just tons of advice and ideas for parents.

You could just do a search for just about any topic. And that's going to be good, trustworthy, and evidence-based when there is evidence of what we should be doing. And so just kind of checking yourself against their guidelines is a good idea.

Any local children's hospital that's near you, if you don't have one, you can always use Nationwide Children's, and they're going to have lots of information that come across. And that's going to be trustworthy. Your pediatrician may, on their website, a lot of pediatric practices have ideas and, you know, what we can do to help kids through development when they're young and with screen time and bedtime and eating.

They may have advice on their website that is going to be trustworthy. And so, you just want to make sure that the information that you're getting, you know, look in lots of different places, but make sure that they're trustworthy places. That's going to be really important.

Because you can find just about anything to support whatever you want to do. And whether that's going to be good or bad, you know, you can't always tell.

[Dr Sarah Adams]
That's absolutely true. And also, resources like this podcast and the podcast that I have growing up with Dr. Sarah. We started this because we knew that we needed to kind of fill in the gap between when they're in the office and in their everyday situation.

And helping parents apply those evidence-based advice to their routines that's relatable and also making it a little easier to access because we know that we need to reach parents where they're at. So, podcasts, apps, educational programs like I'd like to bring up one from the Ohio chapter of the American Academy of Pediatrics. We talked a lot today about nutrition and picky eating and connection.

This app is an amazing tool that just really provides age specific advice on movement and on practical real-life tips, nutrition for real life parents. And so, app users can opt in. We have monthly healthy monthly health newsletters and they're simple.

Like we're not talking about long, you know, drawn out things to read, but things like healthy recipes and seasonal tips and tricks. And it's really to provide information that's relevant about really what's going on in public health right now. What's also really cool is that if you go to the app, you can create an account and their child's birth month.

If you enter that in a year, we can keep up to date with their developmental milestones and ways to promote their health for their child specifically. Yeah. And what's the name of that app?

How can parents find it? So, it's called Parenting at Mealtime and Playtime app. And you can find it at the app store, whether you have whatever your device is.

So, it's available that way.

[Dr Mike Patrick]
And we'll put some links in the show notes so folks can find it easily as well. We've been talking a lot today about how to change behaviors and how to change habits and how to, you know, what's healthy in terms of screen time, bedtime, mealtime. Is there a way to, you know, let's say you have a newborn at home as your child is traveling through their first thousand days, you know, the first two or three years.

Are there some things that we can do to make our jobs easier down the road? You know, as you're in the midst of those battles, sometimes with your kids, you do think back like, what should I have done differently? And to maybe avoid this, what can parents do sort of right out of the gate to make their lives a little easier down the road?

[Dr Sarah Adams]
Yeah, those first 1,000 days of life are really that period of rapid growth and development and their brain and their nervous system is really growing and changing. So, during this time, really having some foundational habits around sleep, around nutrition, around movements and relationships, like that's when all of those things are forming. And so, these early experiences really shape their long-term health, their behavior, and of course, their development.

So, what I recommend is just, again, start small, create routines, remember that it doesn't need to be perfect, you just need to be present. And realizing that variety, whether it's variety in movement, variety in what you offer to them nutritionally, and being consistent with sleep because kids thrive so much on routines. And interaction, not just on screens, like be with them when you're interacting.

Like in those first 18 months specifically, you mentioned like FaceTime or the online ability to connect with other people, that's probably the only thing that they're really going to relate to, for example. So those first 18 months, I think the only screens they really need are ones that are interactive with other family members, like FaceTime, for example, or depending on what your device offers. And then after that, slowly start to build in things that you do together, where you're continuing to do things together.

But things if you're going to use media, do it together, watch it together. And again, keeping in mind the content, how your child responds to it, and as they get older, continuing to communicate. And then trying different foods, like I mentioned, so that hopefully you won't have a picky eater, but that's developmentally normal as well.

And like you said, one day they might eat everything in sight, and the next day they don't, and that's okay. And then trying different things so that they can use their hands and move their bodies in big ways. And I know it's a lot to think about, but just one day at a time and start small.

[Dr Mike Patrick]
Yeah, and that's again where presence over perfection is going to be so important, because we're not going to do everything right in those really early years. And so, we've got to give ourselves a little bit of a break. You know, we can say we only want screen time to be when you're connecting with someone else, especially in those young years.

But there are going to be sometimes when like you're trying to get things done, and you know that the TV is going to get your kids' attention, and they're going to sit there and watch it so you can get things done. But maybe, you know, you have the TV where you're working, and then as you're doing things, you can comment on the show. So, there are ways to still be present, but also maybe utilize the entertainment for keeping your kids still just for a little bit while you're trying to get some things done around the house.

[Dr Sarah Adams]
Yes, flexibility is the key. And remembering that change is possible as they grow. It's these early patterns that just kind of set the stage for them.

[Dr Mike Patrick]
Yeah, yeah, absolutely. Well, we are going to have a lot of great links again in the show notes. So, if folks go over to pediacast.org, you will find links to Growing Up with Dr. Sarah, the podcast. We'll have links to the Ohio chapter of the American Academy of Pediatrics, the Parenting at Mealtime and Playtime app, lots of resources from the Ohio AAP. And then we'll also put links to the Family Media Plan from the National American Academy of Pediatrics and also their Healthy Children website. So, lots of places for you to find out more information as we think about screen time, bedtime and mealtime, all very important things for parents.

And once again, Dr. Sarah Adams, medical director of the Ohio AAP Parenting at Mealtime and Playtime program. Thank you so much for stopping by and chatting with us today.

[Dr Sarah Adams]
It has been such an honor. We're just here to help families navigate these challenges in real time.

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[Dr Mike Patrick]
We are back with just enough time to say thanks once again to all of you for taking time out of your day and making PediaCast a part of it. We really do appreciate your support. Also, thanks again to our guest this week, Dr. Sarah Adams, with the Parenting at Mealtime and Playtime program with the Ohio chapter of the American Academy of Pediatrics. Don't forget, you can find PediaCast wherever podcasts are found. We're in the Apple podcast app, Spotify, iHeartRadio, Amazon Music, Audible, YouTube and most other podcast apps for iOS and Android. And I'd bring that up because there may be an easier way for you to listen and subscribe and make sure that you don't miss an episode.

We also have a landing site over at pediacast.org that has our entire archive of past programs, all 606 of them. We also have show notes for each of the episodes, our terms of use agreement and the handy contact page if you would like to suggest a future topic for the program. Reviews are also helpful wherever you get your podcasts.

We always appreciate when you share your thoughts about the show and we love connecting with you on social media. You'll find us on Facebook, Instagram, Threads, LinkedIn, X and Blue Sky. Simply search for PediaCast.

If you are a pediatric provider, we do have a podcast for you. It's called PediaCast CME. It's similar to this program.

We turn the science up a couple notches, and we do offer free continuing medical education credit for those who listen. It's category one credit. And not only for physicians, but we also offer credit for nurse practitioners, physician assistants, nurses, pharmacists, psychologists, social workers and dentists.

And it's because Nationwide Children's is jointly accredited by all of those professional organizations that we can offer the credits you need to fulfill your state's continuing medical education requirements. Shows and details are available at the landing site for that program. It's PediacastCME.org.

You can also listen wherever podcasts are found. Simply search for PediaCast CME. And then a third podcast that I host is called FAMEcast.

This one's a faculty development podcast from the Center for Faculty Advancement, Mentoring and Engagement at the Ohio State University College of Medicine. If you're a teacher in academic medicine or a faculty member in any of the health sciences, then this is a podcast for you. And you can find FAMEcast at Famecast.org and wherever podcasts are found. Just search for you got it, FAMEcast. Thanks again for stopping by. And until next time, this is Dr. Mike saying stay safe, stay healthy and stay in fall with your kids. So long, everybody.

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