It’s that time again. The pool hours are shortening. Book bags are on sale. You’re rummaging through you kids’ closets to see what still fits them from last year. School is back in session. Whether you have a first-time kindergartner on your hands or a teenager returning to high school, we’ll cover a few topics in this post that are the most common questions I get from parents when it’s “Back to School” season.
Let’s start with one of my favorite topics-nutrition, specifically breakfast. We’ve always heard it’s the most important meal of the day, right? Why? Breakfast is just that-breaking of a fast, a fast we undergo while sleeping. While we may not have a huge appetite in the morning, it’s important that we eat something because our brains rely on it to function well. More importantly, our kids’ brains rely on breakfast to function, especially for that first period calculus quiz. Breakfast, whether big or small, is a great opportunity to get key nutrients in.
Key nutrients include glucose, which comes in the form of carbohydrates. Most of us have no problem meeting this nutrient, but carbohydrates paired with a protein or healthy fat is best. Some examples of this are waffles with a nut butter, oatmeal or whole grain cereal with milk or yogurt, or eggs with toast. Eggs and nut butters are a great source of protein and some fat. Let’s face it-sometimes our kids don’t always eat those well-balanced meals I mentioned. Pop-tarts and sugary cereals are probably not the best choice every day of the week but once a week is a reasonable compromise and helps keep those simple carbohydrates in moderation.
I don’t support caffeine in children less than 18yo regularly as it begins to impact their energy levels and sleep, but I realize some kids would rather “drink” their breakfast on the go. My word of caution with these breakfast shakes is to check the ingredients for sugar, protein, and fat content. Often, these instant shakes are higher in trans fat and simple sugars which aren’t as helpful. Cow’s milk is still a great alternative. Children can drink whole milk usually up till preschool age unless there is a concern for obesity which your pediatrician can discuss you with. Otherwise, reduced fat milk is fine. With regards to milk alternatives like almond or soy milk, I recommend checking the calcium and vitamin D content. Vitamin D helps with calcium absorption which is why it is often incorporated into orange juices that add calcium.
What about lunch? Lunch at school can be difficult for parents to give up control of how much they eat. At home, we can provide our kids a variety, and we can see how much they’re eating. Whether your child buys lunch or packs it at home, a good recommendation for how their plate or lunchbox should look is www.myplate.gov (pictured below). It’s all about balance, even if you pack a yogurt and a piece of fruit, but they purchase their main entrée at the cafeteria. Remember, a child won’t starve him or herself if they’re truly hungry.
Germs, Illnesses, and Medications:
Undoubtedly, when you have multiple children enclosed in a single room, building, or space, there will be a spread of germs. Hand foot mouth disease and stomach viruses in the young, the common cold in school age children, along with strep and mono in teenagers are the more common illnesses. Each have a different treatment course and duration of illness, but in addition to vaccinating for any of the preventable fatal childhood diseases, there are other measures I highly recommend when it comes to decreasing the spread of viral and bacterial particles-particularly, hand washing. Yes, even now, this is still the golden rule.
You don’t have to teach your child to wash his or her hands compulsively, but definitely emphasize key times that it matters: when coming in from playing outside, before eating, and after using the bathroom. The best practice is to teach them a song to sing (ABC’s, row your boat, happy birthday) while they lather to ensure no one is skimping! Alcohol sanitizers, while frequently convenient, don’t do as good of a job as hand washing surprisingly. Many gastrointestinal viral particles aren’t eliminated by sanitizers which is why it’s such a particularly contagious bug when it hits schools. When it comes to coughs and colds, I recommend teaching your child to not cover their mouth and face with their hand because it will only spread the illness more when they hold hands or open doors. Instead, teach them to turn their face away and cough into their elbow-much less risk of spreading germs!
At your back to school physical, be sure to discuss with your pediatrician what warning signs and red flags to look out for if your child does get sick with whatever particular bug is spreading through the school. Parents tend to focus on how much children are eating when ill or how high the fever is. Your pediatrician might point you towards more telltale tips: how much your child is drinking, the number of wet diapers, their activity levels, etc.
So we’ve discussed a bit about all the germs your child can potentially bring from school back home, but what about things they need to bring to school? I’m talking about medications! If your child needs to keep an emergency medication like epi-pen or has ADHD and requires an afternoon dose, reach out to the school nurse earlier rather than later to review the medication and how and when it should be given. If you have any questions, make sure to ask your child’s pediatrician who can help guide you!
Most parents are familiar with the 8 hour recommendations for sleep. Very few of us actually get that due to our busy lives, but for kids, you actually want a little more than that. School age children and even teenagers need closer to 9-11 hours of sleep. (I give more insight on importance and obstacles regarding sleep recommendations in pediatric patients in an upcoming blog post.). If you’re reading this and your child is on the summer time sleep routine-ie, going to bed close to or after midnight and sleeping in until close to noon, start making changes before the first day of school! It will be hard for you child to make a big switch and adjust their circadian rhythms. I advise slowly moving up bedtime for teenagers and younger kids and getting them in a little earlier each day until they reach their ideal school night bed time.
With the start of new routine, you can expect some twists and turns in your child’s behavior. The first question I ask parents when their child is struggling in school, misbehaving, having difficulty paying attention, or throwing tantrums, is how they are sleeping so make sure you read my tips for sleep above! Tantrums in children can be very normal, and for kindergartner, this is a massive transition. Kindergarten has been hyped up for your child, and until he or she experiences that first day, he or she will have no idea what to expect. The start of the school year is exhausting! Not only is it a long day but it’s a day filled with lots of “new.” Trying to figure out where and how you fit in is a lot, and unlike being home in a familiar environment for the summer, there is no place to decompress and have some space...until your child comes home. Children feel comfortable letting their guard down and showing their true emotions and feelings in their home. Those feelings of overwhelming excitement and fatigue can translate to tantrums.
My suggestions? Try not to take your child’s behavior personally; consider that they are physically and emotionally spent after a full day of activities. Make sure you have an afterschool snack ready that includes something to keep them hydrated-milk, 100% fruit juice, or my personal favorite-water. Trust me: Things will get easier as your kindergartner gets used to their new routine.
Older children and teenagers may show more signs of anxiety with the start of the school year. That can present as symptoms of upset stomach, headaches, fatigue, difficulty or restless sleep. Anxiety is tricky because it can be motivating for students to study for tests, but when it begins to interfere with day to day activities and results in school avoidance, then it is a problem and should be brought to your pediatrician’s attention. If you’re child is beginning classes at a new school, meeting the new teachers and students can help to alleviate some of the stressors. Talking children through the routine for the next morning helps children with anxiety: what time they’ll wake up, what they’ll wear, what they plan to have for breakfast, etc. If anxiety and stress persists beyond the first few days or weeks of school, it’s worth reaching out to your child’s pediatrician to prevent school avoidance occurring.
Communicating with your child is incredibly important during the school year. Those car rides to and back from school are great opportunities to check in! Try to keep the radio, music, and screens at bay and talk to you son or daughter about how his or her day went. This is a good time to tell them about your day as well. It’s important to be able to talk and not necessarily complain about the stresses we face in our day to day lives. Relate to your teenager, and they will appreciate that empathy. The more you understand your child, the more insight you have to really help with their stressors. Ask your child what the best and worst parts of their day was, how they helped someone that day, what they’re looking forward to tomorrow. This encourages mindfulness not only for your child but also for you as the parent. Personally, I also feel like this is a great way to check in regarding the topic of bullying which is becoming more and more of an issue. Children may not be likely to bring the unpleasant things that happened in a day to an adult’s attention if they’re not directly asked. Reminding our children how to talk to others will also prevent them from becoming the future bully.
So there you have it! A board certified pediatrician’s guide to helping your child (and you the parent!) navigate the back to school season. We can all survive this time of transition together! Remember, your child doesn’t need perfection, they need you!