May 21, 2019

Back to School Back to Health

The start of school brings new friends, fun times and excitement at what the year holds. On the downside, it can also mean germs and viruses, sports injuries and illnesses. A few simple steps can reduce the risk of the most common health problems and ensure a productive and happy school year for your kids or grandkids.

Arm Against Germs

From the common cold to norovirus and influenza, keeping kids from getting sick can be a major battle for parents. Your biggest defense is also the simplest, says Michael Schmidt, PhD, professor of microbiology and immunology at the Medical University of South Carolina.

“Hand hygiene is the single best way to reduce the spread of illness in schools and childcare centers. Remember to wash your hands before you eat and after you use the facilities.”

Effective hand washing involves more than a pass under the faucet, however. How to know when you’ve scrubbed long enough? “Sing ‘Happy Birthday’ as you wash your hands,” says Schmidt. “When you finish the chorus, you’re done.” And be sure to dry them thoroughly, he adds—sticky, wet hands pick up and transfer microbes to others. 

Kids are never too young to learn about cleanliness. “The trick,” says Schmidt, “is to encourage toddlers to not use their hands to wipe their runny noses and to discourage them from rubbing their eyes before playing with communal toys.” Alcohol hand gel is great in a pinch, but simple soap and water is kinder to young hands than the gel’s dehydrating effects, Schmidt says. Research also shows that, ironically, excessive use of hand sanitizers can be harmful; the triclosans they often contain can make bacteria resistant to antibiotics and help create superbugs such as MRSA.

Get Fit First

Your child doesn’t have to be involved in sports to risk injury at school. Lugging backpacks full of books (which can weigh more than 25 pounds), “tech neck,” which refers to posture that comes from constantly looking down at electronic devices, and the hunched-over position many students adopt can all cause issues, says Mark A. Nutting, CSCS*D, owner/master trainer at Jiva Fitness in Easton, Pennsylvania. He adds, “Hamstrings tend to get tight because they can’t keep up with the rapidly growing bones of teens. This all adds up to a great deal of stress on the posterior of the body.”

Nutting recommends exercises that strengthen the back and postural muscles along with stretches that increase hamstring flexibility. “Exercising before school is a great way to fit it in and has also been shown to improve students’ grades,” he says.

A few good ones to try:

Superman: Lie on the floor face down with arms reaching overhead. While keeping your head in line, lift the arms and chest as high as possible, then release back down to the floor. Repeat 10 to 12 times.

Sit Talls: Sit on the front part of a chair and reach the top of the head toward the ceiling while pulling the chin in slightly as you try to lengthen your spine. Hold 10 seconds and repeat three times.

Seated Hamstring Stretches: These can be done any time in school simply by straightening one leg, flexing that foot back toward the shin, lifting the chest up and leaning forward until a stretch is in the back of the straight leg. Hold for 30 seconds and then switch sides.

Nutting advises that parents help the whole family become more physically active. “Go for walks or bike rides after dinner, play sports together, go for weekend hikes or train for and participate in events such as obstacle courses or fun runs,” he says.

Eat Smart

Getting kids to eat healthy can be a real challenge, especially once they’re at school. Use color and variety to plan nutritious snacks, says Amy Goodson, MS, RD, a Dallas-based specialist in sports dietetics. “Back-to-school snacks can be a great time to get in multiple food groups for young kids.” She suggests string cheese and whole grain crackers, a yogurt parfait with berries and granola or hummus and baby carrots. “If snacks need to be backpack-safe, try an apple with a pre-packaged peanut butter cup, a whole grain granola bar and a beef jerky stick or an almond butter-and-honey foldover sandwich,” Goodson says.

Boosting Children’s Immunity

Frequent handwashing, a healthy diet and plenty of active play form your child’s base defense against respiratory infections. In addition, immune supplements formulated especially for youngsters provide additional protection. (Always consult with your child’s practitioner first.)

For kids, flavor helps. Tasty chewables entice children to get the vitamins A, C and E that they need along with other immune boosters such as garlic, olive leaf and shiitake mushroom. What’s more, flavored lozenges help deliver zinc, along with herbs like echinacea and slippery elm, to the upper respiratory tract.

Recent research indicates that probiotics, best known for their actions in the digestive tract, inhabit the upper airway. One probiotic species that dominates the nose and throat is Streptococcus salivarius K12; chewables that include xylitol, a natural sweetening agent, also help protect children’s teeth against cavities.

Afterschool sports and other activities make for a longer day for teens and require slightly different planning. “Mini-meals can help teens fuel their day at school and practice,” says Goodson. Good choices include a protein bar and an apple, a peanut butter-and-banana sandwich or turkey-and-cheese rollups with whole grain pita chips. Homemade energy bites and bars can also be great blends of protein, fat and carbs to fuel active youth. If your teen needs more calories, foods like nuts, trail mix and nut butters are great nonperishable additions, suggests Goodson.

Sleep Tight

After a summer of lazy mornings and no fixed schedule, transitioning to early wakeup times isn’t easy. Gradually easing kids back into an earlier time schedule by planning ahead can make the transition less painful. 

“About two weeks before the first day of school, begin incrementally setting an earlier bedtime and wake time,” says neurologist and sleep specialist Allen Towfigh, MD, medical director at New York Neurology and Sleep Medicine. “This is usually 30 to 60 minutes earlier every three days until the wake time is the same as the expected time to get ready for school.” Towfigh recommends other ways to help kids sleep:

  • Limit or restrict electronics for two hours before bedtime
  • Try to create a peaceful, calming routine in preparation for bedtime
  • Make sure the bedroom is dark and comfortable and devoid of televisions, computers, phones or other distractions or light sources 
  • Make sure the temperature is comfortable
  • Avoid caffeinated products for four to five hours before bedtime

Keep in mind that teens and children require different amounts of sleep. According to the American Academy of Sleep Medicine, children 6 to 12 years of age should get between nine and 12 hours within a 24-hour period, while teens ages 13 to 18 need eight to 10 hours.

Let’s Get Physicals

A physical at the start of each school year should include checks to uncover any emotional, developmental or social concerns along with physical issues. Children involved with sports may also need a sports-specific exam prior to the start of their season.

“In general, we always look at height and weight to make sure the child is growing well,” says pediatrician S. Daniel Ganjian, MD, of Providence Saint John’s Health Center in Santa Monica, California. Not meeting established standards could be a sign of thyroid disorder or celiac disease. Blood pressure is also checked in addition to hearing and vision screening, since learning problems and headaches may be due to poor vision, says Ganjian. Obese kids often have high blood pressure as a consequence of their body weight, he adds.

Children as young as 3 to 5 may be checked for glaucoma and double vision, Ganjian says. He notes hearing loss may not be noticed by them, since they’d think it’s normal to hear as they do. “We also screen younger children for autism,” he says. For teens, sexually transmitted diseases may be part of the screening as well as depression screening and questions about their use of tobacco, alcohol and drugs. A house check for the presence of lead may also be recommended, as lead can cause developmental delays. In addition, kids should go for annual dental exams.

Moderate Media

Tweeting and posting on Facebook, Snapchat and Instagram have become a major part of kids’ lives—sometimes at the expense of their health and real-life social interactions. It’s such an important topic that the American Academy of Pediatrics (AAP) released new recommendations in 2016 designed to help families get a handle on media usage.

“Media use has been shown over and over to cause depression and decrease concentration,” says Ganjian. “Parents should have a media use plan, how much time they will be on screens and how to use screens.” The AAP suggests the goal for school-aged children and teens is to balance media use with healthy behaviors. Problems often start when media use replaces physical activity, face-to-face social interactions and hands-on exploration, activities important to learning. 

The AAP recommends children ages 2 to 5 years limit screen use to one hour a day of high-quality programming. After that parents should place consistent limits on time spent using, and types of, social media, which should not take the place of sleep, physical activity and other behaviors essential to health. “Social networks like Facebook can lead to depression, where everyone appears to be having a good time,” says Ganjian.



Time Spent Outside Helps Kids

Children once spent summer days out of doors, whether exploring the neighborhood or simply finding shapes in clouds. Today, kids are much more likely to be inside on their electronic devices.

Journalist Richard Louv is troubled by this turn of events. Louv, the author of Last Child in the Woods (Workman), has come up with the term “nature deficit disorder” to describe this phenomenon, which blames on factors such as the loss of green space, an obsession with safety, educational pressures and the fascination of screens.

Research backs him up. Obesity, depression and attention deficit hyperactivity disorder have all shown improvement when kids are exposed to nature, which also appears to help them handle stress.

One theory of why children do better living an out-of-door life lies in what’s called the attention restoration theory. Most of the time we use directed attention, which lets us focus on tasks but also fatigues with use. Natural settings often contain elements that engage what’s called involuntary attention, which is effortless; this allows directed attention to rest and recover.

Kids often need encouragement to go play outside. Last Child in the Woods lists 100 suggestions for connecting kids and nature, such as buying a truckload of dirt to play in, going for a family walk when the moon is full, planting a butterfly garden, studying animal tracking and buying field guides to birds, trees and flowers.

Louv’s book has sparked the creation of a Children and Nature Network to promote awareness of this need; you can learn more at