Back-to-school checkup

If a back-to-school shopping list is the only list you've made for your child, you may want to get out another clipboard.

Doctors are recommending that parents accomplish items on a health to-do checklist before the first day of school so that their child can make it through the year with fewer sick days.

On that list should be everything from eye exams to new bike helmets, but the most important thing on there should be vaccinations, said Scott Goldstein, pediatrician with the Northwestern Children's Practice in Chicago.


There are about 15 diseases that are prevented by vaccines, Goldstein said — but they need to be administered before the first day of school or even before the first week of school to work properly.

"Not all childhood vaccines are produced the same, and there are differences in how they work, but in general, it takes several weeks after a vaccine is given before the body produces an adequate response," he said. "Also, most vaccines need to be given in a series of several doses over time to have optimal effect."

For example, the vaccine against whooping cough is usually given to children when they're 2, 4, 6 and 15 months, and then again at 4 years old and 11 years old. Children will still be protected if they complete one or two doses, but their protection will be better if they complete the series, Goldstein said.

The reason it's so important that a child is fully vaccinated long before starting school is that many of these diseases are highly contagious and can spread from one child to another just from being in the same room, Goldstein said.

For example, if someone has measles and is in a classroom, 90 percent of the people in the classroom who aren't immune to measles will develop it simply from being in the same area where that person with measles was, Goldstein said.

Vaccines requirements vary by state. Parents can check with their pediatrician to learn about their state's mandates, or they can search the Centers for Disease Control and Prevention's state vaccination database at

Vision, hearing

Other health exams to be administered before or soon after school begins are vision and hearing exams. Some states mandate vision and hearing exams in the schools, but not all do this, said Jeffrey Okamoto, chairman of the Council on School Health for the American Academy of Pediatrics. Some do it at certain grade levels.

Even if your child's school does eye exams, the American Optometric Association recommends that children get an additional eye exam prior to entering school, said Glen Steele, professor of pediatric optometry at the Southern College of Optometry in Memphis, Tenn.

"What is done in the schools is minimal testing to determine if the child might have difficulty seeing the chalkboard," Steele said. "Binocular function — use of both eyes together — along with sustained near point focusing and eye tracking ability must be tested to ensure the child can stay on the near point task for the time expected."

Children should also have their hearing tested before they begin school, according to the American Academy of Otolaryngology. The test could reveal mild hearing loss that the child and parent can't detect.

Helmets, book bags

In addition to medical exams prior to school, parents should also be aware of purchases that are essential to making the school year healthier.

If children are planning on biking to school, it's recommended that they wear a helmet, even if their state law doesn't require it, said Randy Swart, director of the Bicycle Helmet Safety Institute, based in Virginia.

"The other parts of your body heal pretty well, and the doctors can do wonders to put them back together," Swart said. "But when your brain breaks, it's very different."

Swart said that while helmets don't tend to expire, they need to be replaced if they've been in an accident that damaged the foam.

Many children will also be getting new backpacks this fall — but some backpacks do damage to their backs.

A study published in the Archives of Disease in Childhood found that more than 60 percent of children ages 12-17 carried backpacks that weighed more than 10 percent of their body weight, and nearly 20 percent of teens carried bags that weighed in at more than 15 percent of their weight.

As a result, 25 percent of students said they had back pain for more than 15 days during the previous year.

Goldstein said parents should look for backpacks that are as light as possible, and they should have two wide, padded straps.

Children should wear the backpack tightly so it's close to the body, and they should use all the compartments, loading heavier items in the center.

While rolling backpacks can be helpful for heavy loads, they may not be as easy to bring up stairs or to use in the snow, Goldstein said.

"Some schools provide a set of books for home and one for the school," he said, suggesting that parents check with the schools to see if they do this before buying the backpack.


Finally, it's important that students start getting a good night's sleep prior to school starting.

"School-aged children generally need more sleep than teens and adults," Goldstein said.

Children between the ages of 5 and 12 need 10 to 11 hours each night, although the increasing demands of schoolwork and extracurricular activities, combined with the pervasive influence of electronic media, lead to them often getting less sleep than they need.

"The bottom line is that if your child is tired, or if you are having to force them out of bed in the morning, then they are not getting enough sleep," Goldstein said, suggesting that parents move bedtime up 15 minutes per night in the week or two before school starts.

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