Podcast: A Pediatrician Answers Kids’ Questions

Courtney: Recently, I was at the Teddy Bear Clinic – an event hosted by NewYork-Presbyterian in partnership with the Seaport, where I caught up with Dr. Vince Uy, a pediatric emergency medicine doctor at the Children’s Hospital of New York.

Dr. Vince Uy:  We are at the Seaport and we are running a Teddy Bear Clinic today. We want our children to be more comfortable with their doctor’s visits. Our goal is to guide them through several stations, where our NYP experts will be helping these kids give their teddy bear a checkup.

Courtney: Kids were given their own teddy bear and doctor’s coat and staff from the Children’s Hospital of New York showed them how to use tools like a stethoscope and blood pressure cuff. Kids also got to tour a NewYork-Presbyterian ambulance.  

While I was at the clinic, I had the chance to ask kids what they want to know about their health. So today we invited Dr. Robert Hagerty, a general pediatrician at Children’s Hospital of New York, to tackle these topics, everything from screen time to shots. And he even addressed some of their parents’ biggest concerns.

Courtney: Hi, Dr. Hagerty. Thank you so much for being with us here today.

Dr. Robert Hagerty: Happy to be here. Thanks for having me.

Courtney: So you’re a pediatrician and I imagine you’re pretty used to answering all kinds of questions from parents and kids. And I was recently at the Teddy Bear Clinic, hosted by NewYork-Presbyterian and the Children’s Hospital of New York, and we met some kids there who had some questions for you. So, here’s one of their questions.

Peyton: I’m Peyton, I’m four. Is it okay if I don’t like healthy foods?

Courtney: Is it ok Peyton that doesn’t like healthy foods?

Dr. Robert Hagerty: If Peyton were here with us right now, I would, I’d probably say, Peyton, you’re, you’re not alone. Many kids I talk to say they don’t like some healthy foods and I think it’s pretty normal. And what I usually like to do is I sit down and we talk about what kind of foods they don’t like, what kind of foods they do like. Sometimes, you’re like, okay, well, I’m never going to eat spinach. I just think it tastes the worst, but I like to eat broccoli. And I can tell all of the families and all of the kids, like there’s lots and lots of vegetables out there. See if you find one that you do like, and then it’s okay if you don’t like certain other ones.

Courtney: So for parents, let’s give us a baseline to work from. What are healthy eating habits for kids?

Dr. Robert Hagerty: So first of all, for any parent, I say, being picky, especially around four, like three, four, is really common all the way through, when you get a lot older and so, you just keep offering children the foods you’re eating. But the biggest thing you can do to help your child not be a picky eater is eat healthy foods yourselves. You’re the example that your kids are going to follow. The kids, as much as they have their own personalities, they are really learning almost everything from their parents. And parents who are eating healthy foods, that’s the best possible thing you could do to get your kids to a place where they’re eating lots of fruits and vegetables.

People like to mix their healthy foods in with other things. Like you make a sauce for a pasta and you, like, chop up some vegetables and sort of mix it in with some marinara. Other things are like when you make a smoothie, if you put like some banana or some dates in there, it almost doesn’t matter if you have kale and spinach and everything else in there, it will taste like bananas and dates and little kids will drink it. It has lots of iron and has lots of delicious, like, healthy nutrients and antioxidants. So those are kind of fun easy ways to add some things in.

Courtney: We also talked to Austin at the Teddy Bear Clinic. Let’s hear from him on another common question.

Austin: Hi, my name is Austin, and I’m five years old. And why do I need to sleep so much?

Courtney: Why do I need to sleep so much?

Dr. Robert Hagerty: A great question, Austin. Sleeping is how we grow. Sleeping is how we get smarter. Sleeping is how we can do well in school. Sleeping is part of how we can feel good about ourselves and some of the emotions that we have. We need to be able to sleep so we can handle being angry or we can handle being sad. And, I think, the impression that children and I would say probably many parents I see is that sleep doesn’t have sort of an obvious function.

And we can lose track of how important it is. But for children we want to maximize their ability to grow. A lot of our hormones, like growth hormone that cause the bones to grow in the body are released at night while we’re sleeping. A lot of the growth of our brain, emotional regulation, healthy eating, like all of those things become easier when you have a good night’s sleep.

So it’s one of the main things that I talk to families about, especially when they’re young. I almost never see kids who are sleeping too much. A four year old who’s, the parents, like, well, they just, they just sleep so long. They’ll sleep 12 hours at night, 13 hours. And they take a nap too. And I’m like, beautiful. Continue to create that space for them to sleep. It is so valuable for them.

Courtney: Something I’m always struck when I hear advice for children is how much it seems like it can apply to adults. Like I think you said, when you sleep, you can handle being sad better, you can handle being mad better. Which feels so accurate for an adult too. So, how much sleep do kids actually need to be getting?

Dr. Robert Hagerty: Little, little babies, let them sleep as much as they can. And it’s fine, anywhere 15, 16, 17 hours a day is all totally normal. When we get older into, like, the twos and threes, if I was thinking about it, it’s probably still 12 or 13, 14 hours, somewhere in that zone would be totally normal. Certainly over 10 hours a day, definitely. And we usually continue to say, get at least over 10 hours all the way up until you’re about 13, 14, when you’re hitting puberty. And then we say, okay, well, try to get at least 8 hours.

Courtney: So we’ve talked about how valuable sleep is. What are the best ways to encourage healthy sleep habits?

Dr. Robert Hagerty: I would say the biggest challenge that I think people face to their sleep today is screens. And a lot of people are in a place where they want to, like, watch TV or play games as they’re falling asleep. They don’t like the idea of laying in bed with nothing to do. Very true for children. Teenagers frequently, that’s the time where they, like, call their friends or face time and do, you know, and those connections are important too. So I don’t want to minimize what they’re doing with that time.

But I would say that’s the thing I see most commonly blocking people from getting good sleep. That and, for littler kids, just having a good sleep routine. The CDC has, like, a list of things that they recommend for  how to get good sleep. But the number one thing that’s recommended is just go to bed at the same time every night. So if you just wanted to pick one thing to help your child sleep well and really, like, get things steady, go to bed at the same time and that includes the weekends.

Courtney: So you talked about screen time. We actually got a question about that from a kid at the Teddy Bear Clinic too:

Leo:  My name is Leo, and my question is, is it true that screen time is not good for your brain?

Courtney: So what would you say to parents and kids who are wondering about screen time and how much is appropriate?

Dr. Robert Hagerty: If your child’s under two years old, try to avoid all screen time. And then I’ll say after two years old, less than two hours a day. I just want to acknowledge first of all that for a lot of little children and parents who have limited resources, using screens as a way to keep their child distracted so that they can take care of themselves, take care of the home, do things that help take care of the child, screens become part of their caregiving.

And it’s not because they’re bad parents. It’s the option that they’ve got. And I frequently reassure parents, like, your child is going to be okay. Let’s talk about, like, the real reason screens are problematic. It’s not that they’re evil in and of themselves. Honestly, if you spent all day staring at a screen, but you were spending that time like talking to family on FaceTime or talking to friends, making emotional connections with people, you were maybe trying to learn another language or you’re taking some classes or something, you’re probably going to be okay.

There’s a sense of if you’re just watching, sort of, addictive, dopamine inducing things, that can create some real challenges. But then there’s also the fact that we are facing, like, a real health epidemic in our country of obesity and a big part of that is not moving, not exercising. And so screens are also going to be something that typically keep you from moving your body around. And so that’s where they can also cause problems.

Courtney: But I hear what you’re saying. It’s like the quality of what you’re doing. Like I know if I’m on my phone, maybe I’m texting a close friend and we’re sharing something funny, that’s much more uplifting than just kind of doom scrolling. And I imagine it’s similar for a child in different ways.

Dr. Robert Hagerty: Exactly.

Courtney: So we have another question from the Teddy Bear Clinic.  

Colton: Hi, my name is Colton. I am seven years old. And my question is, why do I need to get shots?

Dr. Robert Hagerty: Yeah.

Courtney: It’s a big one.

Dr. Robert Hagerty: Shorts are, shots… Yeah. And they’re the scariest part of going into the pediatrician. For little kids, I mostly just say this is how we protect you from getting sick. Your body has the tools to, if it can see some of the stuff that’s coming, if it can see a little bit of the future, it’s better prepared to keep you safe. And we’re just trying to give your body some of the tools to keep you safe.

Courtney: So in that vein, I know maybe some parents feel like it’s too early to be giving babies vaccines as newborns and at two months old. Can you lay out why vaccination schedules are structured this way.

Dr. Robert Hagerty: When they build these vaccination schedules, their goal is to protect everybody as best as we can. So what we’ve learned is there’s certain diseases that cause tons of trouble and we found ways to create vaccines that really have no risk.

And we’ve been doing that for many, many years all over the world. And we found that these vaccines are very safe. I always recommend the normal schedule for everybody because why wouldn’t you want to do the thing that has been done to the most people without problems, as soon as you start changing things up, it’s like, we don’t know exactly what’s going to happen.

If you do the thing that everybody’s been doing for a really long time and not having problems, it’s better. That’s how I would handle with my own child. But, so for the hepatitis B vaccine, and we give it to a baby, like, as soon as they’re born. If you vaccinate a baby when they’re born, they’re much less likely to get hepatitis B, which they’ll have to have for their entire life. And the drawback is we have to poke them with a needle and they’ll probably cry for a little bit. That’s not a big enough drawback to make us not want to protect them. So this kind of early protection is really important.  

In some ways, every time you get vaccines, you’re walking into an opportunity to send, like, a deep message to, like, the psyche of your child, that they’re safe with you. I will protect you and take care of you.

Courtney:  I’m honestly so touched hearing you say that. What an opportunity to just be there for your child and help make them stronger. So, speaking of all these appointments, some kids really don’t like going to the doctor and will cry when they know they have to go. Do you have any advice to make it less intimidating?

Dr. Robert Hagerty: I’ll just say, I think it’s similar to what we talked about with the vaccines. If you can, as a parent, see it as an opportunity to work with your child on emotional regulation. And see if you can, when they’re very afraid, see if you can come very calmly to them and kind of hold their emotions for them a little bit in these hard moments. And say, okay, I know you’re afraid. I know this is, like, a scary thing. It’s really important. And we have to go. And as they navigate through difficult things that’s, like, part of how they learn that things will be okay. That’s how they learn to, like, self soothe by your example.

Courtney: And I continue to be struck for how this is good advice for adults too. I’m like, I got to work on my emotional regulation. You’re right.

Dr. Robert Hagerty: I mean adults are just big children.

Courtney: Yeah, [laughs] So, what’s the best way for parents to protect themselves and their families from colds, the flu, COVID, and norovirus? I mean, there’s so much out there.

Dr. Robert Hagerty: It’s hard. I mean, we’re in New York City where you just see a lot of people. When we were in the middle of COVID and people were wearing masks all the time, the rates of, like, all of these diseases went way down.

If you want to wear masks, you can. Certainly if you’re sick, it’s helpful to wear a mask so you don’t give it to other people. Washing your hands is huge, especially if you have one of these, like, GI bugs that’s been going around where there’s a lot of, like, diarrhea, things like that, like, wash your hands a lot.

And then, I highly recommend getting all of the regular vaccines. It also helps if you get them yourself, everybody who goes out into the world and then comes back to be with a child is somebody who can potentially bring something to them. And so if you’re protecting yourself by washing your hands, by getting your vaccines, you protect your child.

Courtney: Dr. Hagerty, thank you so much for joining us today, and thank you for answering all those great questions from the Teddy Bear Clinic. This was so helpful. Thank you for all this great information.

Dr. Robert Hagerty: Thanks for having me.

Courtney: Our many thanks to Dr. Robert Hagerty. I’m Courtney Allison.  

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