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That ringing you hear in the distance is the sound of the school bell. And it’s getting louder.

In much of the country, school starts right after Labor Day — even sooner in some areas — so now’s the time to make sure the kids are rested and ready to tackle the books in good health.

USA TODAY spoke to experts in child health — Atlanta pediatrician and author Jennifer Shu, medical editor of the American Academy of Pediatrics’ healthychildren.org; Kate Cronan, a pediatrician at Nemours/A.I. duPont Hospital for Children in Wilmington, Del., medical editor at Kidshealth.org, and Louisville allergist James Sublett, chairman of the American College of Allergy, Asthma and Immunology’s Indoor Environment Committee. They offered advice on setting the stage for a healthy school year:


All states require that children starting school be vaccinated against specific illnesses, such as measles, mumps, polio and other infectious diseases. State laws vary, and exemptions may be allowed for medical or religious reasons. Check with your doctor, the school or your health department for specifics.

But don’t think vaccines are just for little ones, says Cronan. Middle-school and high-school students also should be up-to-date on vaccines, including MCV4 (meningococcal vaccine), starting at age 11 with a booster at 16, the HPV (human papillomavirus) vaccine, a series of three shots starting at age 11-12 for both boys and girls, and Tdap (tetanus, diphtheria and acellular pertussis) at 11 or older.

Don’t forget the annual flu vaccine. School-age children have the highest rates of flu, and while some seasons are milder than others, this highly contagious disease can rage through schools, causing absenteeism among staff and students. The Centers for Disease Control and Prevention recommends flu vaccine, either shots or nasal spray, for everyone six months of age and older, unless there are medical reasons to avoid it. Flu season usually starts in October and can continue through May.


About one in four children has allergies, says Sublett, and half of those have allergies that are moderate to severe. About 10% of all children have asthma, and many are undiagnosed. “Asthma and allergies are the main reason kids miss school,” he says. Often, parents “misidentify kids as just having a lot of colds, but by preschool or kindergarten, if they’re still having a lot of colds and bronchitis, you’d better rule out allergies.”

Allergy triggers may include animals in the classroom or even exposure to classmates who have pets at home, along with mice and cockroaches, chalk dust, mold and poor ventilation, pollen and insect stings on the playground. “These are all things parents don’t have control over,” he says. If a child is having symptoms, it’s important to see an allergist, identify the triggers and develop a plan for allergy shots, medication or avoidance of the problem. Many schools permit students to carry inhalers and other needed medications, but, Sublett says, communication between parent and school is key. There will be records to share and forms to fill out, so “don’t wait till school starts to let them know,” he says. “Allow a couple weeks to get this done.”


During the long days of summer, children may go to bed later and rise later than at other times of the year, so start now making the transition to school-appropriate sleep patterns, Cronan advises. It’s hard for all ages, but middle- and high-school kids may be worse off — they often have to be up by 6 a.m. to get ready for an early bus pick-up. Cronan says a gradual approach is best: “If they’re going to bed at midnight, you can’t just say on Aug. 15, ‘you’re going to bed at 9,’ ” she says. “Inch back (the bedtime), so the first week, go to bed by 11, then every few days move it back by half an hour. It’s not rigid, but you can’t do it the night before school starts.”

Ditto for morning — try to wake them up a little earlier each day. “You have to work both ends,” she says. Talk about it with the student and make a plan. “It’s not going to be easy,” she says. “Who wants to think about the end of summer? But think of it as, ‘you’re going into training because you must get a good amount of sleep during the school year.’ “

How much sleep do they need? A rule of thumb:

• Teens: 9 to 9½ hours each night.

• Middle school: 9½ to 10 hours.

• Elementary: at least 10 hours.


To avoid back problems, make sure the backpack fits and is not too heavy, says Shu. That means adjusting straps so the child can put both of them on with the heaviest weight carried in the back. A loaded backpack should weigh no more than 10% to 20% of the child’s weight. “I encourage using e-books as much as possible, and online studying,” she says. “Some schools will have state textbooks available online. Definitely ask.”

Food and water

When kids are overtired and racing for the bus, breakfast is the last thing they want. Plan your strategy. Stock up on healthy foods — dried fruit, trail mix, yogurt cups, small cups of cereal that they can eat dry, whole fruits. Peanut butter and banana on bread or a quick fruit smoothie takes just a few minutes to prepare. “Get input from the kids about both breakfast and lunch, and if you can get them to help (fix meals) the night before, you’ll know they’ll eat it. Get buy-in from the kids,” she says.

Another tip: Pack water. “Kids get dehydrated during the school day,” Cronan says. “Going to the water fountain is not enough.” Parents can encourage kids to buy water at lunch, or pack an ice-cold or frozen reusable water bottle in the lunchbox and let it defrost during the day. If kids say they don’t want plain water, flavor it with a bit of juice. “If they’re not hydrated, kids come home and they’re dizzy and don’t feel good,” she says.

To and from school

Think of safety before and after school, Shu says. Questions to consider: Is there supervision on the walking route and at the bus stop? Who is going to pick the child up at the end of the school day, and what is the plan if the designated adult doesn’t arrive on time? Is there after-care at school? Who should a child call in an emergency? Talk about bus safety: Don’t run in front of the bus, use caution getting on and off the bus, watch for cars, stay seated when the bus is moving and use seat belts if they’re available. “Those are life-and-death things,” Shu says.

First-day jitters

The first day of school can be a time of tears and fears for many children. For little ones, it may be the first time away from home and family for a full day. They may have to ride a bus full of children they don’t know. It can be daunting for child and parent.

For older children, the transition from elementary to middle or middle to high school, or the first days at a school in a new community, can be equally stomach-churning. Just finding the path to classrooms through unfamiliar hallways, being in corridors full of much bigger kids, coping with combination locks and lockers is confusing and sometimes scary.

“In the summer, take your child to the school, show him the main classrooms, and see if you can meet the teacher,” says Cronan. Many schools have new-student orientations. Take advantage of those opportunities, but if they’ve already passed, see if you can arrange a visit, just to walk through the school.

If families are moving and going to a new school, she says, ask to be put in touch with parents of other students in the school, and arrange for them to meet, so on the first day, there’s at least one familiar face in the classroom. “If you’re new to school, new to the bus, start to prepare the child now,” Cronan says. “Say, ‘it’s going to be great!’ Be positive.”

Older children may be worried about the social culture in a new school, and especially the potential for bullying. Talk about how to handle situations and make sure your child knows how to report concerns. “You definitely want to make sure the school has guidelines in place for anti-bullying,” says Shu, “and know what the procedure is if you suspect or witness bullying.”

Other tips: During the trial visit, locate the bathroom, homeroom, gym and offices of the school nurse, principal and counselors. Find out about bus routes, and be prepared for things not to go perfectly during the first few days. Whatever parents can do ahead of time to prepare the child can help defuse anxiety, Shu says.

“Let them know they’re not the only one having a first day,” she says. “A lot of people are in the same boat. They’re not alone.”

(c) 2012 USA TODAY