It’s likely the closest we’ve come to a “normal” back-to-school since 2019. So we checked back in with Dr. Erica Waddington, this time at her office in UConn Health’s family medicine practice in Canton, to find out what she’s telling families — both the students and the parents who worry about them — to help them get a healthy start to the 2022 school year.
(Dr. Erica Waddington, Chris DeFrancesco, August 2022)
Chris: We are back to talking back-to-school. Today on the Pulse, what better way to get families ready for the return to school than with a family medicine expert?
This is the UConn Health Pulse, a podcast to help you get to know UConn Health and its people a little better, and hopefully leave you with some health information you’ll find useful. I’m Chris DeFrancesco. Now it’s that time of year again, and some schools already are back in session. We’re on location today at UConn Health in Canton, where the family medicine practice is, and with us is Dr. Erica. Waddington, one of our family medicine physicians. Thank you for joining us, Dr. Waddington.
Dr. Waddington: Oh, you’re welcome.
Chris: You and I spoke a year ago at this time to talk about getting ready for back-to-school. And I wanted to talk to you as a family medicine practitioner, because you have parents who are your patients, but also their children quite often, and I think that puts you in a position to kind of get the whole family dynamic on how to get ready for this, what could be a challenging, time of year, and probably made more challenging by what we’ve gone through for the last couple of years. So I guess let’s start with, what are you hearing from your patients? What kind of questions are you getting to help parents and their children get ready for back to school?
Dr. Waddington: Yes, I’ve had a lot of parents and the children as well, asking about whether they should wear a mask or not. That’s probably the biggest thing that they’re asking, because right now there’s no mask mandate in the state of Connecticut. But there are some family considerations to take into account, whether we’re gonna ask our kids to wear a mask or not. So if we have family members that are immunocompromised, then it may be a good idea to ask our kids to wear a mask when we go back to school. Or if we have kids that get sick a lot or have asthma, or have any other sort of inflammatory conditions, allergies, it may be a good idea to ask them to wear a mask. And also of course, wash your hands. We saw during the pandemic, initially a huge drop in influenza, in strep, because not only were we wearing masks, but we were washing our hands a lot. So buying those small little hand sanitizers and putting them in their backpacks is probably a great idea.
Chris: All right. We can go back to some COVID related things momentarily, but one of the other considerations this time of year in getting ready for school re afall sports. What is some advice that you have for families as they’re getting ready for that part of it?
Dr. Waddington: So as you’re getting ready for fall sports, taking into consideration that some of our kids haven’t really done a lot of exercise over the summer. So if you have a child that’s sort of been a bit of a couch potato, it’s fine; have them do lots of warmups and slowly loosen up their muscles. Because what we see often is we take a child that hasn’t really been doing much and then ask him to overexert himself, and that’s when the injuries happen. So working with the athletic directors at your schools and high schools, they’ll have good warmups for them to do. And I think reminding our kids that warmups and stretching are as important as doing the physical activity, whether it be running, playing basketball, football.
Chris: And maybe you’re not a varsity athlete, or if you’re in middle school, there’s no varsity team. For whatever reason, you don’t find yourself in an organized sports setting, but still ways to find exercise would be important for even that group, I would imagine.
Dr. Waddington: Oh yes, definitely, 30 minutes of exercise every day for adults, and they say an hour every day for kids is good for your body, good for your mind. It’s great for your metabolism. You end up sleeping better. It’s just really, it’s good for all of us to do. It’s like a medicine.
Chris: And if I had kept myself organized and gotten to you several weeks before today, one of the things I would’ve asked you about, and we could still talk about it, is sleep. By the time people are hearing this, a lot of schools already started, but, generally the strategy, as I understand it, is, you want to kind of start tapering back gradually that bedtime, especially the adolescents with the whole circadian rhythm and the sleep-phase shift and all that. But I think if nothing else, what is that strategy for getting back to the back-to-school sleep schedule? And why is it so important as it relates to classroom performance?
Dr. Waddington: Yes, so sleep in our kids — and adults, but kids — is so important. And in the summertime, our sleep schedule will change a little bit, and when we’re getting ready to go back to school, it’s important to sort of shift back your sleep time every night by, you can only do 30 minutes at a time. So say for example, you’re trying to go to bed for nine o’clock or eight o’clock at night, and you’re used to going to bed at 11, you can really only go back 30 minutes a night. So slowly over a week or 10 days is the best course to do in order to get your rhythm back to where it should be, going to bed at eight or nine, and then getting up and making sure that a child has somewhere between 10 and 11 hours of sleep a night. Because that’s going to help their brain grow, it’s going to help their performance in school, it’s going to help their appetite. And so just like exercise, sleep is like a medicine. It’s really important and a valuable thing to respect and make a space for in your home.
Chris: The 10-to-11- hour recommendation, does that have any variance as we go from like kindergarten, first, second grade and make a way through adolescence and into high school?
Dr. Waddington: So kindergarten and elementary school kids really need about 12 hours of sleep. And then as we travel through adolescence and closer to adulthood, it goes to about 10, 10 to 11 hours of sleep. And then after the age of 25 is sort of when the seven to eight hours of sleep is adequate.
Chris: All right, and some of our students, middle school and high school especially, are going to have the additional challenge of putting their phones away at a reasonable hour and kind of getting it wound down before going to sleep. What would be ideal for, let’s say high school student, what time is lights out and what time is the last time you look at your screen?
Dr. Waddington: You should put the phone down two hours before you anticipate falling asleep. So in my house, we go to sleep around nine o’clock and the phones are off at seven. And that way my children have time to just unwind, their brain can start to settle down, because even if you use the blue light filter on your phone, your brain is still stimulated by using an electronic. So it’s a lot different than watching a television using your phone. There’s a lot more stimulation on your phone than their is with a television screen. So putting it away two hours before anticipated sleep is the best thing to do.
Chris: Now I have to imagine that that is not a popular position to be taking. If you have mom and teenager in the room together, and you’re having that discussion, how does that go?
Dr. Waddington: Yes, that’s true, because I have a lot of patients, because I do family medicine, I’ll have patients that I take care of that are adults, and then I take care of their children as well. So this comes up pretty much every well-child visit is how to help manage, how to help the child manage, electronics. And so I encourage parents to have access to the child’s phone, because that’s just a good safety measure so that they can know who they’re talking to, what websites they go to what’s they have had access to in the past. And I think kids need to negotiate with their parents and come up with a rule within that house that’s gonna work for everybody.
Chris: Let’s go back to COVID for a minute. Different age groups, have different recommendations for boosters. How do you keep track of all that? How do your families keep track of all that? And is there a general recommendation that you can make regardless of school, just where we kind of stand with what we know about how we can. Prevent the spread of this?
Dr. Waddington: Right, so as of right now, everybody who’s five and above should have gotten a booster. It remains to be seen if there’s going to be a second booster for adults and children in the fall. And as of right now, ages six months to five years could get the full course of vaccination. So I’m recommending both of those courses for my patients.
Chris: What about other vaccinations? I mean, I know flu shot’s a popular one, and we haven’t had to deal with flu as much the last couple years because of all the other measures we’ve been taking. But I would imagine that’s still the recommendations and what’s what about the flu shot and the timing of that?
Dr. Waddington: Yep, so influenza is a very popular vaccine to get in the fall and the winter. Usually we’ll see influenza spiking in Connecticut anytime after December. So we encourage our patients to get the influenza vaccine as soon as it’s available, which usually is sometime in September. We’ll be having flu clinics here at UConn Health in Canton, and there’ll be flu clinics also in every city I’m sure in the state of Connecticut.
Chris: Now the last couple of years, school has looked different for almost everybody. It seems like we started to try to get a little more back to normal last year, but it’s still, it hasn’t been a normal school situation for a good while now. What kind of impact do you think that has on just a child with a developing brain, the changes to what the approach to school has been, what school has looked like over last couple of years. And could this finally be the year where we get some of that back, do you think?
Dr. Waddington: Yeah, I really think this year we’re going to see a little bit more of a shift within the school experience for kids back to what we had pre-COVID, which I think will be nice. It’s nice that there are still options to have remote learning, because the younger generations are used to acquiring knowledge through electronics. And so that’s a benefit of what has come out of COVID that there’s alternative ways of learning. But I think, I really think this year, things are going to be a little more of what we’re used to. And in the end that’s gonna help kids sort of settle back in, maybe not be as anxious, not be as worried. We saw a lot of anxiety and mood disorders spike in kids, and adults, when COVID first started. And part of that is fear of the unknown, and part of that is just everything that is your norm is changing. And the fact that it’s shifting back, I think is having a positive effect on everybody.
Chris: It almost seems like because we’ve been dealing with this for so long now, that initial terror of getting sick and the unknowns associated with that — I mean, we seem to know a lot more about COVID-19 than we did in 2020, but then there’s that risk of complacency, of course. So as a physician, how do you advise your patients to balance that?
Dr. Waddington: Well, again, because I do family medicine and I know most of the families and the medical history within them of people that I take care of, if I know that there’s somebody that’s home that’s immunocompromised or their immune system doesn’t work so well, then I encourage patients and their families to be a little more diligent. So maybe wear a mask more often than not, and of course, make sure you wash your hands and have some sort of alcohol-based hand washing available for you in your purse, in your car, in your lunchbox, because that’s gonna be a huge help in stopping the transmission of many diseases, including COVID.
Chris: All right, so as far as the “preparing to get back to school checklist” in the couple minutes we have left here — we’ve covered quite a range of things — what have I missed that you might find yourself talking to parents about, or the kinds of questions that you’re getting that we haven’t discussed here yet?
Dr. Waddington: So I think one thing that has come up lately with talking with patients and their parents is, the adolescent brain really is still immature. The brain doesn’t fully mature until the age of 25. And so we put a lot of pressure on our kids to act older and be adults, and we give them a lot of responsibility. And I encourage parents to remember that the brain chemistry is not the same as ours. And so take that into consideration when you are giving your child more responsibility or letting them do things that are a little bit out of your control. And there are kids that will be able to make the right decision all the time, but their stressors are gonna be different than ours. So I think it’s important to just sort of remember that and remind parents that even if the child is upset with them about a decision they’ve made, not letting them do something, that’s OK. We’re not gonna be their best friend all the time. We’re here to sort of guide them and teach them how to make good choices in that path to adulthood.
Chris: Thank you for that. And right before we say goodbye just one last question: For someone who might not be in a family medicine-type relationship, can you just briefly explain a little bit about kind of how that works, as far as like, if the teenager comes to see you, is that still kind of like a level of privacy and confidentiality that mom doesn’t necessarily hear about? How does that work, or does that vary by family, the boundaries that are set?
Dr. Waddington: Usually when I see my pediatric population, I’ll usually see them with the adult in the home initially. And most of the time, after puberty, so say somewhere between ages of 12 and 14, I offer the patient and the parent to have one-on-one time with the kid in the room with me alone, so that they can feel unhindered to ask me questions about their mood, their sleep, their body that’s changing, just so they have sort of a private space. And nine times out of 10, the parents are happy that I do that because it just gives the child an opportunity to ask something freely in the room. And most of the time the kids will take me up on it and we’ll talk about something. But as far as what I’m a mandated reporter on, I tell the child everything in this room stays private with me unless you’re gonna hurt yourself or somebody else. I mean, if that’s the case, then I need to involve your mom and dad. And so there’s a level of privacy, which I think is nice.
Chris: Excellent. That’s Dr. Erica Waddington, who practices family medicine at UConn Health in Canton. And we’ll have information on how to learn more about UConn Health’s family medicine practice in the show notes of this program.
Dr. Erica Waddington, thank you so much for your time.
Dr. Waddington: You’re so welcome. Thanks for coming.
Chris: And that is our program for this month for Dr. Erica Waddington, I’m Chris DeFrancesco. Thank you for listening to the UConn Health Pulse. Be sure to subscribe so you can catch us next time, and please share with a friend.