Stay Healthy Tips for Kids in School
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Stay Healthy Tips for Kids in School

Your kids may be bringing home more than high marks from school.

Stay-Healthy Tips

The start of a new school year exposes children to many things -- new friends, wonderful teachers, and lots and lots of bugs. "Schools are a living laboratory for most epidemics and diseases," says Wayne Yankus, M.D., a pediatrician in Midland Park, New Jersey, and chair of the American Academy of Pediatrics' school health committee. "Flu epidemics come from kids in school and we know most of our seasonal epidemics will come from schools." According to the National Institutes of Health, families with school-age children have a higher rate of illness than other families and the number of illnesses per child can be as high as 12 a year.

The most common illnesses that plague schools are strep throat, colds, influenza and chicken pox. Head lice are also a familiar problem (especially among elementary school children), and school nurses rarely have a year without seeing cases of pink eye and Fifth Disease.

Since it's virtually impossible to escape the bugs in schools, the key is to learn how to keep these illnesses at bay. The good news: it's easy. Adequate sleep, regular hand washing, and eating breakfast every day will help protect your child from many contagious illnesses. Here's why:


Experts say children and teenagers need at least nine hours of sleep a night to ensure good health. Warren Jones, M.D., president-elect of the American Academy of Family Physicians, says parents of students need to make sleep a priority. "Study after study shows that our kids are not getting a good night's sleep," he says. One common culprit: TVs and computers in bedrooms. To get your kids accustomed to a school night schedule, Dr. Jones recommends enforcing an earlier bedtime a few weeks before classes begin. This will give your child's body clock time to adjust, and help make the transition easier.

Hand Washing

One of the most common ways people catch a cold is by rubbing their nose or eyes after their hand has been contaminated with the cold virus. For that reason, the best insurance policy against colds and the flu is teaching your kids to wash their hands before they eat and after they use the bathroom. No exceptions.


It may sound cliche, but eating a healthy breakfast gives your student a head start. Studies have shown that children who eat breakfast learn better, participate in class more often, behave better, and attend school more often. They even visit the school nurse less frequently.

Breakfast also helps them with a less delicate problem: constipation. A lot of kids go to the nurse's office with stomach pain, and it's often because they did not have a bowel movement at home and don't want to use the school bathroom, says Dr. Yankus. "The body is ready to stool within a half hour of eating breakfast, but most kids don't leave enough time in the morning for that," he explains. "I urge middle and high school kids to get up early enough to eat, shower, and sit on the toilet before they go to school."

Classroom Contagions

Here are the symptoms of and treatments for the most common illnesses in schools:

Strep Throat

The bacterium streptococcus causes this often-painful infection.

Symptoms: Symptoms generally come on suddenly and include sore throat, chills, fever, headache, nausea and sometimes vomiting. The throat is red and tonsils are swollen. Lymph nodes may also be swollen.

Diagnosis/treatment: A strep test at the doctor's office can quickly diagnose the illness, and a 10-day course of antibiotics is typically prescribed. At many schools, students are allowed to return to school after 24 hours or more of physician-prescribed medication, but check with your school first.

Head Lice

This is one of the most common -- and easy-to-catch -- problems that plague schools today. Children who play together or share hats or combs are susceptible.

Symptoms: A child will experience an extremely itchy scalp. Sometimes lymph glands in the back of the neck can become swollen.

Diagnosis/treatment: Female lice lay shiny white eggs in hair, which can be seen upon close inspection. (It may even look like dandruff.) If you suspect lice, call your child's doctor -- he'll likely prescribe a medicated shampoo. You also must wash all bedding and clothing (and don't forget stuffed animals) that have come in contact with your child in the last 48 hours to prevent re-infection.

Fifth Disease

Most kids are exposed to this viral disease before kindergarten, but it always seems to appear in elementary schools. It's believed to be caused by a parvovirus.

Symptoms: The hallmark sign is sudden bright red patches on both cheeks -- it looks as though the person has been slapped. The rash may come and go for weeks.

Diagnosis/treatment: Because the infection is viral, there isn't much you can do besides relieve the symptoms. Your child can spread the disease from person to person with the cold-like symptoms that precede the rash, but once the rash appears, she is no longer contagious.


Colds are caused by common viruses and are transmitted from person to person through the air or via hand-to-hand contact. The flu is an acute respiratory infection caused by a virus. It is spread through airborne droplets of respiratory fluids when a person coughs or sneezes.

Symptoms: Cold symptoms include congestion, runny nose, fever, headache, cough, sore throat or fatigue. Signs of the flu are fever, muscle aches and pains, dry cough, runny nose, congestion, headache and fatigue.

Diagnosis/treatment: There is no cure for either, but be sure your child gets plenty of rest and drink lots of fluids. A few days home from school may be in order. There is an influenza vaccine, but it is not recommended for children unless they already have a chronic health problem, such as asthma.


Also known as pink eye, this highly contagious condition is spread by contaminated fingers, wash clothes or towels that touch the eye.

Symptoms: The white part of the eye turns red and gritty. A discharge of yellow pus is also common and a crust may form on the eye at night.

Diagnosis/treatment: Treatment depends on the cause. If a bacterium has caused the infection, your doctor will likely prescribe antibiotic eye drops. If the pink eye is a viral infection, the eye will clear up on its own.

Chicken Pox

Chicken pox is one of the most common and recognized childhood illnesses. It's also very easy to get. Since airborne droplets spread the disease of moisture that contain the varicella-zoster virus, a simple cough can infect dozens.

Symptoms: The first signs of chicken pox appear 10 to 21 days after infection. A red rash of fluid-filled blisters appear. They itch and eventually develop a crust on them.

Diagnosis/treatment: Your doctor will take one look and know its chicken pox. Most mild cases only require treating the symptoms. The Varicella vaccine can prevent chickenpox. Talk to your doctor for more information.

Sick-Day Signs

Deciding whether to send your child to school or let them stay in bed can be a tough call. Here's what the experts say: Keep your child home from school if he has a fever of 100 degrees or higher, vomits or has diarrhea. Also, if he has been diagnosed with the flu or has severe cold symptoms (constant coughing, sneezing, etc), you probably should keep him home so he doesn't spread the illness to others. --Martha Miller

Ready for School

What can you do before school starts to make sure your child is prepared for a healthy year ahead? The experts we talked to recommended five things that every parent can do. It's best to start early, but it's never to late to do any of them.


Every state has immunization requirements that apply to all public and private schools. The reason vaccinations are required by law: they work. In Colorado, where it's relatively easy for parents to request exemption from school-entry immunization requirements, researchers found that children ages 3 to 18 years who were never immunized were 22 times more likely than immunized children to get measles and nearly six times more likely to develop whooping cough. For elementary school-age children (ages 3 to 10), the risks were greater: children who were not immunized were 60 times more likely to get measles and 16 times likelier to come down with whooping cough.

Your doctor's office does a good job of reminding you about shots, but it's helpful to keep a list at home. If you aren't certain what shots are needed and when, check out's Immunization Chart.

Eye Exams

One in four children has an undetected eye problem that may lead to difficulties in learning, reports the Better Vision Institute. Kids may think they are seeing the same thing as their peers and not tell their parents, so it's best to schedule an eye exam. School-age children should see an eye-care practitioner at about age 6, and every two years after that if they have no problems. If your child wears glasses, annual visits should be scheduled. Don't rely on the school vision screens that most elementary schools do. They only detect 20 to 30 percent of vision disorders and aren't meant to replace a complete eye exam.

Some signs your little scholar may have a vision problem:

  • Consistently sitting too close to the TV or holding a book too close
  • Losing his place while reading or using a finger to follow along while reading
  • Squinting or tilting his head
  • Frequent eye rubbing or sensitivity to light

Foot Measurements

Start the year off with a new pair of shoes. Odds are the ones your child has been living in all summer are getting tight. According to the American Orthopaedic Foot and Ankle Society, children between the ages of 4 and 9 should have their feet measured every four months. Once past age 10, feet should be measured every six months. Shoes for school-age children should be flexible and made of breathable leather or canvas. If you have a brand that already fits your child well, stick with it.

Backpack Weight

Kids cram way too much stuff in their packs, and as a result their spines are suffering. Since 1997, there has been an increase in the number of children in hospital emergency rooms complaining of back pain, says Dr. Yankus. "Sixth-graders tend to carry the heaviest backpacks," he adds.

The general rule: A child's backpack shouldn't weigh more than 15 to 20 percent of his weight. For example, if a child weighs 80 pounds, she should carry 12 pounds or less in her backpack. If you can afford it, Dr. Yankus recommends buying an extra set of schoolbooks so your child will have a set at home. If that's not feasible, see if they can do homework on a computer disk and transport the disk back and forth between home and school. Other tips:

  • Buy a backpack with well-padded straps and tell your children to always use both straps.
  • Make sure the backpack is sturdy and sized appropriately. Some manufacturers sell special child-sized versions for children ages 5 to 10. These packs weigh less than a pound and have shorter back lengths and widths so they do not slip around on the back. A well-fitting backpack should sit two to four inches above the waist.
  • Teach your child to clean out her pack regularly to lighten her load. "You don't need to carry around September's papers in your binder in March," Dr. Yankus says.
  • Always pack out, not up.
  • Consider buying a backpack with wheels, but do your homework first. Having your child pull their book bag may seem like the answer, but not if they take several buses, Dr. Yankus says. The wheeled packs can be difficult for younger children to maneuver up stairs and curbs -- and they can hurt their arms. Also, some schools consider the packs a fire hazard because they clutter hallways. Most wheeled backpacks don't crush down and, as a result, won't fit in a locker.

Communicate with the School

It's one of the simplest things parents can do, but the most important, says Judy Robinson, Ph.D., a former school nurse who now directs the National Association of School Nurses. Before the first bell rings, she advises the following:

  • Be sure that the school nurse or a school official (not every school has it's own nurse) knows about any allergies or health concerns your child has.
  • Double-check that the school has the proper medical and contact information. "Parents often change addresses, work numbers or doctors and they never let the school office know that those numbers have changed," she says. If something happens to your child, the school has to spend valuable time trying to track down Mom or Dad.
  • If your child has a serious illness, call the school nurse before school starts and talk to her about any special needs your child may have. Better yet, stop in and see her in person. That way a nursing care plan can be put in place before classes start.