Wednesday , November 20 2019


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Back to School Hygiene

Summer vacation is coming to a close, and now it is time to focus on the transition back to school. Facing the unknowns of what the new school year will bring can be both exciting and stressful for children and parents alike. But fear not! There are several things that you can do to help your child be ready for school and be successful in their academic pursuits. While many things in life are out of your control, the areas outlined below are just a few examples of how you can have a strong, positive impact.

Sleep:
It cannot be overstated how important sleep is for your child’s general health. But, it is also crucial that your child get enough sleep so that they can perform well in school, both academically and socially. A general rule of thumb is that those in elementary school get 10-12 hours of sleep, those in middle school get 8-10 hours of sleep, and those in high school get at least 8 hours of sleep each night. Weekends should not be shifted more than 2 hours from the typical weekday schedule.

It is very common over the summer for children of all ages to go to bed later, as there is typically more flexibility in when they have to wake up the following morning. If your child’s bedtime has been pushed back, a gentle way to get your child back on track is to shift bedtime forward by 15 minutes every 3-4 days. This method does take time, but it allows for a more natural transition of sleep cues. Another way to help your child with bedtime is to be consistent with their bedtime routine. For younger children, this may include bath time, followed by reading a book in a dim, quiet room. For older children with phones or other electronic devices, it is strongly recommended that there is no screen time starting 2 hours before bedtime. Late night screen time can interfere with the release of the hormone melatonin, which is your body’s natural sleep cue.

If your child has a hard time falling asleep despite a healthy routine and cutting out screen time, he/she may see benefit from supplemental melatonin. Typical dosing is 1-5mg, depending on age, given one hour before bed; however, this should be discussed with your child’s pediatrician. If your child consistently has difficulty falling or staying asleep, then he/she should be evaluated for other contributing medical conditions.

Hydration:
Keeping up with fluids throughout the day is a good way to help your child feel alert, comfortable, and energized for the entire school
day. Most children benefit from taking a water bottle to school, as relying on the water fountains at school is typically insufficient. For elementary school students, 40 oz. a day is appropriate. For middle school students, 60 oz. a day is a good goal. And for high school students, 80 oz. a day is ideal. The majority of this fluid intake should be water. Keeping your body hydrated can optimize your blood volume, which improves blood flow to your organs, including your brain. This amount of fluid intake has also been shown to help prevent headaches and migraines. Many children end up avoiding water at school because they do not want to use the restrooms
at school. This is a serious issue and should not be ignored. If your child is avoiding public facilities, it is important to find out what the barriers or concerns are so that they can be addressed with the school. Don’t be afraid to speak up for your child, as this is often an embarrassing issue for them to tackle alone.

Meals:
It is an age-old adage that breakfast is the most important meal of the day. While this is partly true, there is good evidence that not skipping meals in general can promote optimal school performance and reduce the chance of headaches. Starting the day off with a good breakfast can be challenging when the day starts early, and there is often a rush to get out the door on time. Do not feel like breakfast needs to be complicated or special. The basic rule is there should be a balance of protein, fat, and carbohydrate. For those where time is the challenge, try making “overnight oats” the night before, or make hard-boiled eggs for the week on Sunday. One easy and wholesome grab-and-go breakfast is a hard-boiled egg and a granola bar or piece of fruit. Many children often do not feel hungry first thing in the morning, and for those children, a simple, portable breakfast is a great option so they can eat just before school starts, after they have been awake for 1-2 hours.

The struggle does not end with breakfast. A common complaint from children is that they do not like school lunch. While it is best to try and encourage your child to eat during lunch, one alternative is to take 1-2 solid snacks for the school day, similar to portable breakfast options, and then have a light lunch option for your child to eat as soon as they get home from school. This can be very helpful for a child that tends to be a picky eater. Avoiding large swings in blood sugar during the school day can be very helpful in reducing emotional and behavioral outbursts, and provides your child the nutrients necessary to feed their brain and promote learning.

A word of caution, however, there needs to be balance between catering to an unsustainable, unhealthy, restrictive diet and encouraging growth in your child’s culinary prowess.

Lastly, dinner should not be ignored. While this meal should
be as nutritious as the first two, its importance stems more from the social benefits. A family dinner is a great time to model appropriate and expected behaviors. Can you start a conversation about some obstacle you were challenged with at work? What about how you dealt with an awkward social encounter with a colleague? While sitting around the table as a family is awesome, this goal does not work for every family, especially those with alternate work hours or those with after school extra-curricular activities. Just because you cannot all eat together does not mean that your child has to miss out on the benefits of a family dinner. Find ways to engage your child about their day, and you will build their problem-solving skills. You may even be the one to prevent cyber bullying or a dangerous copycat challenge.

Screen time:
The American Academy of Pediatrics released recent guidelines regarding appropriate amounts of screen time. In general, the goal is fewer than
1-2 hours per day, and certainly minimal screen time before the age of 2 years. This recommendation has to be adapted to the individual circumstance, as older children typically have schoolwork that is completed on a computer or tablet. In general, the minimal screen time goal should be applied to use of cell phones, playing video games, watching videos or TV, and surfing the Internet. The main reasons a parent should be concerned with screen time include: 1) exposure to unrealistic social expectations, 2) disruption of circadian rhythms when used at night, 3) vulnerability to cyber-bullying and malicious grooming tactics, and 4) near constant instant gratification that interferes with typical social development. Yes, times are changing, and technology is advancing at a rapid pace. It would be bad advice to recommend ignoring technology and blocking all screen time. However, responsible oversight is appropriate, and clear boundaries should be established early on so that your child is safe and understands the difference between real life and on-line interactions.

Exercise:
Last but not least, exercise is the final area of focus for back to
school hygiene. There are mounds of data supporting the benefits of exercise in our everyday lives, and this is no exception for children. A straightforward goal is 30 minutes a day, 5 days a week, of cardiovascular activity. This does not have to be overly strenuous, but the aim should be elevating the heart rate to the point where conversation starts to become more difficult. For those in organized sports, this goal is usually not hard to accomplish. But even for those not athletically inclined, this goal should still be a priority. Find an activity that is fun, so that your child is more likely to do it. Take the dog out for a brisk walk, or create a new version of tag with your child. Maybe you can learn a new sport together? Whatever you choose, your child is more likely to persist if they see you making a commitment to your health as well.

As summer winds down and the focus shifts back towards school, keep an eye on these 5 areas and your child will be off to a great start. Don’t be discouraged if one goal is more challenging than another; like most things in life, healthy living is a work in progress.

Dr. Jennifer Martelle Tu is the Medical Unit Director at the Frederick Regional Outpatient Center and is Associate Director of Education of Child Neurology for Children’s National Medical Center.

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