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Tips for Making Your Child's Trip Back to School a Healthy One

By Lawrence S. Deutsch, MD
Red Lion Pediatrics
Frankford Hospital

 Those lazy summer days have once again drawn to a close and it’s time to convince your children to trade in their water toys and flip-flops for school clothes and book bags. What can seem like an even more daunting task during this back-to-school transition, however, is keeping your children healthy as they head to the classroom, which can be a breeding ground for cold and flu-causing bugs.

Whether or not it is your child’s first time at school, I make the following recommendations regarding the most common back-to-school health concerns:

Immunizations

For the new pre-schooler or kindergartner, the most important step toward good health is making sure he or she receives all necessary immunizations on time (see chart below). By having your child immunized on time, you can provide the best available defense against many dangerous childhood diseases. Immunizations protect children against hepatitis B, polio, measles, mumps, rubella (German measles), pertussis (whooping cough), diptheria, tetanus (lockjaw), H. influenzae type b, and chickenpox. All of these immunizations should be administered before age 2. Ask your pediatrician about scheduling your child’s immunizations, or contact your local public health clinic, which offers shots free of charge.

  • Hepatitis B – Administered in 3 doses; the first preferably between birth and 2 months, the second between 1 and 4 months, and third between 6 and 18 months.
  • Diptheria, Tetanus, Pertussis (DaPT) – Complete vaccination course includes 5 shots; the first 3 shots within first 6 months of life, boosters at 18 months and between 4 and 6 years.
  • Polio – Administered in 4 doses, series is currently given in 2 shots (IPV) at ages 2 and 4 months and 2 orals (OPV) at 12 to 18 months and 4 to 6 years. Early next year, the vaccine will be given in 4 shots, eliminating the oral preparations (except for foreign travel). This transition is the result of the virtual elimination of polio in the Western Hemisphere.
  • Measles, Mumps, Rubella (MMR) – Administered in 2 doses; the first at or after the 1st birthday, the second at 4 years of age or older. It is important to have this series begun on or after the 1st birthday.
  • H influenzae b (Hib) – Administered in a 3 or 4-shot series at 2, 4 and 6 months of age, and a booster on or after the 1st birthday.
  • Varicella (chickenpox) – The one-time shot, given at or after the 1st birthday, is 70 to 95 percent effective in preventing chickenpox. Prior to the widespread use of the vaccine in the United States, 50 to 100 children were dying of complications from chickenpox each year.

Recommended Childhood Immunization Schedule
United States, January – December 1999 

Colds and Flu
Many parents ask if their children will be sick more often when they go to school. The answer is probably yes. If it is your child's first time in day care, pre-school or kindergarten, expect two to three colds with sniffles and/or fevers each month. While you never like to see your child become ill, this is normal and actually helps build immunity. Most common colds can be treated with increased liquids and Tylenol®. If you don't see results with this treatment and feel like you don't have control, call your pediatrician and discuss the situation over the phone. He or she will usually either give you further treatment instructions or ask that you bring the child in for an examination. It's equally important to bring your children to the pediatrician when they're feeling well. "Well" visits are recommended between 2 and 4 weeks of age, at 2, 4, 6, 9, 12, 15 and 18 months, at age 2,3,4,5, and 6 years, and every other year thereafter.

Nutrition
It's not always easy to get your children to eat what you want at any meal, but it can be sometimes especially difficult at breakfast. If your child doesn't eat, don't panic. Most kids will eat something, even if it isn’t what you would prefer. It's better not to force the issue before school and instead introduce new foods a few at a time at other meals. If you feel that your child doesn't have a reasonably varied diet, you can give him or her a multivitamin. If not, it is not necessary. Unless your child has been clinically diagnosed with anemia, be careful never to select a vitamin containing iron, since these can be lethal if a child should get a hold of the bottle and take too many.

Eyesight and Hearing Tests
Testing children for eyesight and hearing deficits before they begin school can help guard against learning problems. They can be performed at your pediatrician's office, but may be offered in the day care or pre-school setting. If your child begins complaining of not being able to see the blackboard, or not being able to hear the teacher clearly, there may be a problem. It's best to bring him or her to the doctor for an examination right away. Poor school performance or uncharacteristic frustration can also be signs of a vision or hearing problem.

School Sports
To participate in formal sports programs at school, most children need to receive a physical exam to get the green light to play. Precautions also need to accompany play at home. It is a law in Philadelphia that all children wear a helmet when riding a bike. Parents risk a $25 fine if police spot a child without a helmet. I usually advise parents to begin teaching their children to wear a helmet at age 2 or 3 when they start riding tricycles and Big Wheels. Beginning this practice when children are young will make putting a helmet synonymous with riding a bike throughout their lives. With the popularity of rollerblading or inline skating comes other safety concerns. I recommend that parents invest in helmets, arm pads and knee pads designed specifically for these activities.

Emotional/Social Transition to School
With many mothers working today, an estimated 70 to 80 percent of children have had some social exposure before kindergarten in either a day care or pre-school setting. This prepares them well for kindergarten and minimizes the pangs of separation anxiety. Most kids are excited to start school and make new friends, surprising their apprehensive parents. If your child does cry or becomes upset on the first few days of school, however, it's best to leave and let the teachers handle the problem. Often the other children will also calm an upset peer, with one sometimes taking on the role of "class mother," tending to the children who miss their parents. At that point, you may be going through an adjustment phase learning that your baby is growing up.

Lawrence S. Deutsch, MD, is director of the department of pediatrics at Frankford Hospital and a pediatrician with Red Lion Pediatrics in Northeast Philadelphia. Dr. Deutsch received his medical degree from New York Medical College and performed his residency in pediatrics at the Children’s Hospital of Philadelphia. He is board certified in pediatrics and is a fellow of the American Academy of Pediatrics.

Red Lion Pediatrics is located at Frankford Hospital – Torresdale, Medical Office Building, Suite 215, Knights & Red Lion Roads, Philadelphia, PA 19114. For information, please call 1-877-808-ARIA.