Back to School! Are You Ready?

Healthy practices for children before school starts will get the year off to a great beginning

/ Author:  / Reviewed by: Robert Carlson, M.D

The time for school halls to be teeming with chattering students is approaching. While shopping for school supplies, families shouldn't neglect to check on kids' health too.

The new school year can mean that a variety of health issues needs to be addressed with kids. From making sure they are up to date with their vaccines to preparing for school sports. August is a great time for a check-up with the pediatrician.

It's also good to be aware of other health issues that can influence a child's success and happiness in the coming school year.

"Children's schedules have been more lenient, and they may not be used to getting up so early," said Dr. Seman, MD, a pediatrician at North Shore Pediatrics in Danvers, Mass.

"They have been active, but most have not been so in a disciplined way, such as the beginning of sports camps and regular schedules," he said. "It is time to get back into a good schedule and routine."

Below are several big areas that families should think about and possibly take action to address before the first school bell rings.

Be Up to Date on Immunizations

Children get the bulk of their vaccines before they hit preschool, but that doesn't mean they're done with them. All the way through high school, children need boosters to protect them against a range of infectious diseases.

One of the most important boosters for kids is the Tdap, the vaccine that protects against tetanus, diphtheria and pertussis (whooping cough).

Although tetanus and diphtheria are somewhat rare, whooping cough rates are at an all-time high in the US for the past 50 years. More than 10,000 cases have been reported through July 2013, according to the US Centers for Disease Control and Prevention (CDC).

Another disease making a minor comeback is measles, which the MMR (measles-mumps-rubella) vaccine protects against.

Preteens and teens may be due for the HPV shot and the meningitis shot. The HPV vaccine protects against human papillomavirus, a sexually transmitted infection that can cause cervical cancer, neck and throat cancer, penile or anal cancer.

The meningitis shot is required for many teens who will be heading off to college, so check with your doctor on your state's guidelines and whether the vaccine may be recommended for your child.

The full recommended immunization schedules are available at the CDC's website for children up to age 6 and then for preteens and teens aged 7 to 18.

Most vaccines are paid for by insurance plans as part of preventive health. Those who do not have insurance may be eligible for free vaccines through the Vaccines for Children program.

Plan for Healthy Diets

Stories about the rise of childhood obesity over the past decade can be found all over. Fortunately, researchers have learned a lot about what contributes to obesity — and therefore what can reduce kids' risk of being overweight.

One of the big culprits is sugar-sweetened drinks like soft drinks, sports drinks, energy drinks and even juice.

Liquid calories don't fill kids up like solid food does, but the calories do add up over time and can add pounds.

Another contributor to obesity is screen time — the amount of time kids spend watching TV and movies or on the computer.

The problem does not appear to be the time the kids are sitting down while watching TV. Instead, they tend to eat while they watch, and they are exposed to commercials that can make them hungry or thirsty for unhealthy foods.

As the days grow shorter and darker, find activities that keep kids engaged without parking in front of the TV or computer for long periods after school.

Another way to keep kids healthy with their diets is to ensure they eat a good breakfast each morning. Skipping breakfast has been shown to be more common among overweight and obese children, so a protein-heavy breakfast will help get kids off to a great start and help them focus throughout the school day.

Finally, make sure you know what your children are eating for lunch and that they don't have access to unhealthy high-calorie food with extra sugar or sodium while at school.

The US Food and Drug Administration (FDA) has passed new restrictions on what can be sold at schools in vending machines, but all school lunches are still not as healthy as they need to be.

"Reviewing the daily hot school menu each week and recommending options that provide the best nutrition within the child's tastes can be helpful," Dr. Seman said. "Furthermore, the child can quickly order his/her meal and have more time to eat and socialize."

Educate your children about what a healthy, balanced meal includes and, if possible, pack them nutritious lunches from home rather than relying on school cafeteria offerings.

"Good nutrition involves a wide variety of foods, including complex carbohydrates such as whole grains to promote a steady glucose, and therefore energy, supply," Dr. Seman said. "If the child brings his/her lunch, then it should meet the requirements as well."

Get Ready to Move

Physical activity has not been shown to have much influence on children's weight, but that does not mean it's not important to a healthy lifestyle.

Youth aged 6 to 17 are recommended to get at least an hour of physical activity every day. That activity can be school or community sports, brisk walking, riding their bikes or a number of other activities.

Engaging in enough physical activity each day has been shown to improve children's moods and to improve their concentration, attention and classroom behavior, according to the CDC.

"Sports become an important social and bonding time," Dr. Seman said. "The parent must make sure that the coach is qualified and is willing to limit children who are injured."

If some of that physical activity comes from intense sports like soccer or football, be sure that you, your child and your child's coaches and athletic trainers are aware of the risks and treatment for concussions.

Nearly 175,000 children are seen in US emergency departments each year for concussions, and thousands more never end up going to the hospital for their concussion.

Being knocked unconscious can be a symptom of a concussion, but concussions do not require loss of consciousness. Dizziness, disorientation, nausea and difficulty concentrating are all possible symptoms of a concussion, even hours after the head impact occurred.

The best treatment for a concussion is rest. If you suspect your child has gotten a concussion, take them to a healthcare provider and plan to keep them out of the game for the time their doctor recommends.

"Recognizing the long term impact of concussion in children is very important," Dr. Seman said. "There are several tests that can be performed to help with those children who have trauma to the head."

He said a common one, called IMPACT testing, is reliable for children aged 12 and older and is given before the season begins.

"Should the child incur a concussion, then he/she can be retested when he/she is thought to be cleared," he said. "The test, done on the computer, evaluates the child's intellectual processing and information manipulation, which may take longer to recover than the physical aspects of concussion."

Sweet Dreams Means Better Days

Finally, don't forget that after a day full of physical activity and nutritious meals, the best thing a young person can do is lay their head down on a pillow and get some shut-eye.

It's tempting for kids to stay up late watching TV or playing on smart phones, tablets or computers. However, the light from these devices has been shown to make it more difficult for children to fall asleep.

It's thought that the blue light given off by such devices can interfere with melatonin, the natural hormone the body releases to tell your brain it's time to sleep.

Having a consistent bed time for younger children is also important. It has been linked to better behavior and fewer problems concentrating at school.

But getting sufficient sleep is important for all young people, from preschool up through high school.

Getting too little sleep, especially for teenagers, has been linked to a higher risk for being overweight or obese. Without enough sleep, teens have more time to eat more calories, and the sleep deprivation appears to interfere with the hormones that tell teens they're no longer hungry.

"Several weeks before school starts, children should be gradually brought back to the recommended school year bedtime," Dr. Seman said. "A minimum of nine hours is recommended for all children through high school, so the bedtime should be adjusted accordingly."

While nine hours may seem like a lot for the older kids, getting enough sleep is important for cognitive functioning throughout the day.

Kids of all ages think more clearly, concentrate better, have better memory and can focus and learn more easily when they have had a good night's rest.

Dr. Seman mentioned two other tips that can help parents and children prepare for the new school year.

"Transitioning to a new school or entering middle or high schools can be difficult," he said. "The older students often create 'turf wars' with the younger ones, 'putting them in their places.'"

Although this practice can be common, he said it should not be tolerated. "Parents should review what is acceptable behavior in either the younger or new child as well as the older or established child," he said.

In addition, he suggests setting students up for success with homework and study time.

"Once school starts, make sure the child has one or two places to study that are relatively quiet," he said.

"Some music or noise is okay, but studies show that visual stimuli such as television or computer screens are more distracting to a person and will only delay and distract the student," Dr. Seman said. "Occasionally 'pop in' where the child is to make sure that he/she is staying on track."

Reviewed by: 
Review Date: 
August 14, 2013