“Best of” Back-to-School Health and Safety Tips 2011: Part I

It’s that time of year again… back to school. A time filled with carpools, backpacks and homework…and on many parent’s minds, a question… How can I keep my kids healthy and safe without following them around 24/7? We know they need to experience independence, learn how to develop friendships and how to make good decisions, yet we’re torn with a desire to protect them in every way possible. Unfortunately the hazards they face – bullying, gangs, drug sales, reckless drivers and predators, just to name a few – can happen before, during or after school. The best we can hope for is to make sure they are healthy before they walk out the door, ensure their trip to and from school is “uneventful”, and equip them with the tools, knowledge and resources to help them keep themselves safe and healthy until they are once again in our care.

To assist our efforts, experts provide us with articles and blog posts of “back-to-school” health guidelines and safety tips do and don’t lists. In fact there is a wealth of knowledge on the web on how to best prepare your child and send them off to school. Hello information overload! So, in an effort to save you a little time – which at this time of the year we all know is in incredibly precious – I’d like to share with you our compiled list of the best back-to-school tips we’ve been able to find. In “Back-To-School” Part I, we’ll cover everything you need before they head out the door. Part II will keep them safe until they come home. (*Please note – I am sourcing other author’s tips and will cite all references below – all copyrights, credit and thanks belong to them)

Before School Begins:

Prep for back-to-school physicals:

• Bring five questions with you to be discussed during the visit. This helps parents to start thinking about their child’s health concerns earlier which may prevent parents from forgetting topics they want to discuss.
• Be sure to know the name and dosage of all medications your child is on.
• Bring shot records with you – especially if you’re changing pediatricians as vaccine schedule recommendations can change.
• Bring sports physical forms. Pediatricians can fill these out and conduct the sports physical exam in tandem with the yearly checkup.
• Bring report cards and conduct grades. If your child has special needs or classes, bring that information in as well. This information can help pediatricians look into, and potentially address, any underlying medical reason behind low marks.

Review your back-to-school health check list:

• Immunization: Ensure your child’s preschool immunization is completed prior to entering Kindergarten to protect her against vaccine-preventable diseases. Check here for the CDC 2011 Child & Adolescent Immunization Schedules.
• Vision screening: Have your child’s vision tested before he starts Kindergarten (ideally by age three) and annually until age 18. As much as 80% of learning is visual, so ensuring children can see properly will help them reach their full potential in the classroom.
• Hearing/speech screening: If you suspect your child may have a hearing or speech problem, check with your doctor for a referral to an audiologist and/or speech specialist. An undetected problem could interfere with your child’s learning.
• Dental checkup: Regular dental checkups should begin by age three. If your child hasn’t had her teeth examined prior to starting school, now is a good time for it. Regular checkups and cleanings help detect and prevent dental problems early.
• Mental Health Check: Pediatricians are now requesting that patients and their parents fill out questioners to monitor behavior and psychological healthiness. For children ages 18 months to two years this can help doctors rule out pervasive developmental disorders such as autism. For teens and pre-teens this can help doctors determine whether the child should be treated for depression.
• Emergency contacts: Make sure the school has up-to-date emergency numbers, including contact information for parents, physicians, etc.
• Health conditions: Ensure the school has up-to-date information about any physical impairments or medical conditions your child may have, including allergies. Also inform the school about any medications your child takes. Check here for more detailed information on preparing children with asthma to return to school
• Nutrition plan: Ensure your child has a healthy breakfast before heading to school in the mornings, and help her pack a nutritious lunch. Planning meals ahead of time and involving children in planning and preparation can make this task more manageable and fun.

Conduct a Back-to-school backpack check:

• A child’s backpack should weigh no more than about 15% of his or her body weight. This means a student weighing 100 pounds shouldn’t wear a loaded school backpack heavier than about 15 pounds.
• Select a pack with well-padded shoulder straps. Shoulders and necks have many blood vessels and nerves that can cause pain and tingling in the neck, arms, and hands when too much pressure is applied.
• Adjust the shoulder straps so that the pack fits snugly on the child’s back. Wear the waist belt if the backpack has one. The bottom of the pack should rest in the curve of the lower back. It should never rest more than four inches below the child’s waistline.
• Distribute weight evenly by using both straps. Wearing a pack slung over one shoulder can cause a child to lean to one side, curving the spine and causing pain or discomfort.
• Load heaviest items closest to the child’s back (the back of the pack). Arrange books and materials so they won’t slide around in the backpack.
• Check what your child carries to school and brings home. Make sure the items are necessary for the day’s activities.
• If the backpack is too heavy or tightly packed, your child can hand carry a book or other item outside the pack. If the backpack is too heavy on a regular basis, consider using a book bag on wheels if your child’s school allows it.

Deciding when they’re too sick for school:

• Fever: Fever is a common symptom of viral infections, like influenza. If your child’s temperature is 100.4 degrees or higher, keep your kid at home. While at home, encourage your child to drink plenty of liquids. If you have concerns about your child’s health, get in touch with her pediatrician. A child should be fever-free for 24 hours (without medicine) before returning to school.
• Mild Cough/Runny Nose: If there’s no fever and the child feels fairly good, school is fine.
• Bad Cough/Cold Symptoms: Children with bad coughs need to stay home and possibly see a doctor. It could be a severe cold or possibly bronchitis, flu, or pneumonia. But when the cough improves and the child is feeling better, then it’s back to school. Don’t wait for the cough to disappear entirely — that could take a week or longer!
• Diarrhea or Vomiting: Keep your child home until the illness is over, and for 24 hours after the last episode (without medicine).
• Sore Throat: A minor sore throat is usually not a problem, but a severe sore throat could be strep throat even if there is no fever. Other symptoms of strep throat in children are headache and stomach upset. Keep your child home from school and contact a doctor. Your child needs a special test to determine if it is strep throat. He or she can return to school 24 hours after antibiotic treatment begins.
• Earache: The child typically needs to see a doctor.
• Pink Eye (Conjunctivitis): Keep the child home until a doctor has given the OK to return to school. Pink eye is highly contagious and most cases are caused by a virus, which will not respond to an antibiotic. Bacterial conjunctivitis will require an antibiotic; your doctor will be able to determine if this is the case.
• Rash: Children with a skin rash should see a doctor, as this could be one of several infectious diseases. One possibility is impetigo, a bacterial skin infection that is very contagious and requires antibiotic treatment.

Check back again soon for Part II where we’ll pick up our “Best” Back-to-School Health and Safety Tips 2011 with suggestions for what to do once they head out the door. Until next time keep them healthy…keep them safe…

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Sending out thanks and recognition to some very smart folks for some really great advice:

1. Prep for back-to-school physicals: (Texas Children’s Pediatric Associates prepare patients to go back to school by Texas Children’s Hospital, Aug 2, 2011)
2. Review your back-to-school health check list: (Back to school health checklist by Alberta Health Services)
3. Conduct a back-to-school backpack check: (Backpack strategies for parents and students by the American Occupational Therapy Association, Inc.)
4. Deciding when they’re too sick for school: (Your Child: Too Sick for School? by Jeanie Lerche Davis for WebMD September 2010)

Code Adam…Because You Don’t Have Eyes in the Back of Your Head

Sometimes, as a parent, you have to give yourself a break. Even mothers have to heed the call of nature. But with a headstrong and mischievous three-year old in tow, a parental potty break in a public building can become an exercise in surprisingly emotional fear and guilt.

I mean, we are supposed to be able to keep our children safe. We aren’t supposed to lose them! But what can any reasonable parent do wedged in a tight bathroom cubicle with a toddler and sitting in a very compromising position when the wiggle worm decides it would be the height of fun to crawl out under the stall door and run out of the bathroom? I can still feel the brush of his jeans across my fingers as I just failed to grab hold….

Thankfully, with Code Adam, a nation-wide program administered by the National Centre for Missing and Exploited Children (NCMEC), my anxiety in our local children’s museum was contained by a very orderly and confident process. Code Adam, created and named in memory of 6-year old Adam Walsh who went missing while shopping with his mother and was later found murdered, is a simple but powerful search process focused on marshaling employees of public buildings, such as stores, libraries and museums, in a systematic search for lost children in the crucial moments immediately following their disappearance.

 My Code Adam Experience:

• As soon as I could make myself decent and get out of the bathroom I approached nearby museum staff who were manning the entrance to the exhibit space we had just visited, and learned that my wayward son had not decided to return to the water or sand tables
• The staff then asked me very specific questions to compile a detailed description of my child – including his clothing and shoe color/style (I remember he was wearing those shoes with a light that flashes when he walked)
• A “Code Adam” page including this description was then given within the venue and designated staff immediately began a systematic search
• All potential exits other than the front doors were either closed or closely monitored and a member of the security staff escorted me to the front entrance to ensure my son, Elliott, did not leave the premises. I spent what felt like a wretched eternity desperately scanning the sea of kids, choking back tears, and constantly affirming to my security pal that I’d never lost my kid before…honest!

If my son wasn’t found within 10minutes, the next step would have been for security to call law enforcement. If he had been found in the company of someone other than a parent or legal guardian, the procedure would call for reasonable attempts to delay their departure until the arrival of police, without putting anyone in danger.

Thankfully, I was reunited with my wiggle worm within that timeframe, a staff member having found him obliviously and happily playing on a computer screen in another area of the museum. When he was back within arms’ reach I didn’t know what I wanted to do to him (or what would be considered the politically correct behavior)…wrap him in my arms and say “Thank God”…or berate him for running off from Mommy? So I fudged and did a little of both!

Making Use of the Code Adam Program

Code Adam originated in Walmart stores in 1994 but is now one of the largest child-safety programs in the U.S., used in around a hundred thousand establishments around the country and, since the Code Adam Act was made law in 2003, in all federal public facilities (click here for list of participants). Use of the program in a venue is proclaimed by a Code Adam decal at the building entrances. Thanks to NCMEC and its sponsors, the program is free to participants, who can apply online for a Code Adam kit, including: 

• A training video for employees
• A break-room poster explaining the program steps
• Two decals to put on entrances announcing participation in Code Adam

So what can parents and safety advocates do?

• Check building entrances for the Code Adam decal. Know whether Code Adam is used in that venue before you and your children enter.
• Know the Code Adam procedures. I’d like to say my story above is the only example of our use of Code Adam in the past eight years, but my son has triggered 2 other experiences in large retail stores. In one of these venues, the staff I located did not know the Code Adam process. Thankfully I did…and suggested they call security and institute a Code Adam page….missing child quickly found. Lesson: Don’t rely on the quality of any given store’s staff training.
• Make sure caregivers know. Even if you are very familiar with Code Adam and its procedures, what about babysitters or grandparents? How often are they out with your children in a public venue? Be sure that they also know about Code Adam and how to ensure it is appropriately implemented.
• Suggest Code Adam to local venues. If a local store or establishment with a focus on families or children does not display the Code Adam decal, consider finding the manager and suggest that they participate. They can find everything they need at www.missingkids.org (search “code adam”).  Additional information can be obtained by calling 1-800-THE-LOST (1-800-843-5678) or emailing codeadam@ncmec.org.

Should Your Child Wear a Mouth Guard?

Playing team sports are a wonderful experience for children. There are many physical and emotional health benefits.

There can also be safety and protection issues. Any sport can increase head and mouth trauma. Injury can not be completely eliminated but damage can be lessened. Mouth guards can decrease the potential for harm by up to 60%.

Besides preventing permanent loss or disfigurement of the most visible, front teeth, mouth guards can prevent a concussion.

The younger your child starts wearing a mouth guard, the more likely they are to continue wearing it through their sporting career. Custom fitting mouth guards allow your child to speak and breathe more comfortably, performing with the greatest confidence.

Benefits of a mouth guard:

• You increase the chance of damaging your teeth 60x if you don’t wear a mouth guard while playing spots
• Injuries to your teeth can result in permanent disfigurement of your most viable front teeth
• It is estimated that a lifetime dental costs to a tooth that is knocked out can be up to $20,000

As stated earlier, the habit of wearing a mouth guard is developed at an early age.  Make sure you talk to your dentist about the best type of mouth guard for your child. There are several different types available to you.

Be safe this sports season!

Kitchen Safety: Do You Know What to Do If…?

Typical, isn’t it? You’re flying between cooktop and cutting board, prepping dinner while the kids finish homework. In a moment of distraction, you grab a scorching saucepan handle or slice the tip of your finger with a paring knife … or the budding young chef in your family does. Whatever the kitchen slipup, chances are the remedy is within arm’s reach, says Dr. Jennifer Avegno, an emergency medicine specialist at the Louisiana State University Health Sciences Center in New Orleans. Here, her advice for treating everyday kitchen injuries.

1. Cuts
Food prep simply can’t happen without a sharp knife or two, not to mention a cheese grater or potato peeler — hence the packet of plastic bandages in every cook’s cabinet. In the event of a cut or abrasion, run plenty of tap water over the wound to rinse out dirt and bacteria — the source of infection — that may have been on the instrument or your skin. (Don’t use hydrogen peroxide: The solution kills contamination but can also destroy the clotting and healing cells the blood carries to the wound). Bleeding will likely stop on its own. If not, apply gentle but steady pressure to the cut with a clean cloth or bandage and keep the wound elevated. After bleeding stops, apply antibacterial ointment, and bandage the cut securely. Seek medical attention if the cut is deep, you can’t get dirt out of the wound or blood spurts from the wound or continues to flow after applying steady pressure for more than five to 10 minutes.

Watch out for swelling or redness. The wound could be infected. See a doctor as soon as possible.

2. Small Burns

We’ve all touched the back of our hand to an oven’s heating element, accidentally placed fingers near hot steam or been splattered with sizzling oil. If the burn covers the palm or crosses over a joint, seek immediate medical attention. The same holds if the burn — even a small one — is on the face. A trip to the doctor may help prevent scarring. Otherwise, you can treat it at home.

First, run the affected area under cool tap water for a few minutes to stop the burning process and remove any bits of burnt skin. Smooth on a layer of antibiotic ointment to create a barrier against infection and wrap loosely with gauze or a small bandage. Be sure to rinse the wound with water and change the dressing twice daily for a few days, says Avegno, so that it remains covered and protected until the scab is gone.

Watch out for increased pain, redness, fever, swelling or oozing. The burn could be infected. See a doctor as soon as possible.

3. Scalds

Burns from scalding water tend to cover larger areas, such as arms, feet, legs and stomach, which may make them harder to treat at home. And if the scalding is to a child, whereby a large percentage of the body is affected, call an ambulance or go to an emergency room immediately. Otherwise, start by treating the affected area the way you would a small burn: run under cool water (or use a wet towel) to stop the burning process and to clean the area, layer with antibiotic ointment, and dress with gauze or a large bandage as best you can. Even a clean and loose-fitting white T-shirt over the burn area will add some protection if you don’t have large enough bandages. Blistering is to be expected, but avoid popping the blisters, as doing so adds entry points for infection. These burns are often more painful than smaller ones, so take acetaminophen or ibuprofen. If that doesn’t block the pain, seek medical care.

Watch out for continued or worsening pain, or signs of infection (see above). In these cases, seek immediate medical attention.

4. Injuries to the Eyes

Lovers of spicy food know the painful power of capsicum, or cayenne pepper: Contact with the eyes causes a strong burning sensation. Flush out any material in the eye with water and then splash milk in the area to stop the burn. Steam, pokes to the eye or spattered oil are more serious and can cause eye damage. Rinse the eye right away to cool the area and clean out debris.

Watch out for pain, oozing or a change in vision after a few minutes of blinking and rinsing, any of which might indicate damage to the cornea. Seek immediate medical attention.

Given the increased risk of infection with cuts and burns, Avegno advises a tetanus shot if you haven’t had one in five to 10 years. Even a shot administered within a day or two after the injury will be effective, she says. Of course, when extreme injuries happen — especially when small children are involved — emergency care is critical for preventing even greater harm.

Halloween 2009 – Happy, Healthy and Safe

I start writing this and I almost feel like I want to apologize…because instead of writing about all the “scary things” our kids are going to be this Halloween, I write instead about all the scary things we need to protect them from. So I’d like to propose a deal: I’ll share with you some of the best tips I’ve found to keep our kids safe this year (…thank you Child Safety Examiner, the National Center for Missing and Exploited Children and Dr Kristie McNealy)…and then I’ll share with you my favorite not so scary safety tip that should be good for at least a few smiles…and maybe between the two, we’ll find our way to a happy, healthy and safe Halloween together. 

Trick-or-Treat…Safely

1. (CSE) Make sure your child’s costume is comfortable and manageable. Avoid top heavy costumes that could topple him, or flowing, trailing costumes that could get wound around her feet and cause her to fall. Avoid using anything around the neck that may pose a strangulation hazard.
2. (NCMEC) Make sure children are able to see and breathe properly and easily when using facial masks. All costumes and masks should be clearly marked as flame resistant. (CSE) For the littlest trick-or-treaters, you may want to avoid masks all together. Choose a fun hat or headpiece, or a dab of allergen-free makeup instead. (Pediatric Safety note: Please keep in mind that recent studies have found that many face paints have lead and other toxic ingredients, so research any face paints carefully before applying http://ow.ly/xldL )
3. (CSE) Avoid using real candles in pumpkins on doorsteps, and keep an eye out for them at homes you visit. Trailing costumes or props could get too close and catch fire, or the pumpkin could tip over. Opt for battery operated instead.
4. (CSE) If your kids will be trick-or-treating in the dark, make sure they have flashlights or glow-sticks and remind them to stay on the alert for traffic.
5. (CSE) Remind kids not to eat or drink anything that is given to them until a parent looks it over first. This includes not only Halloween treats, but any potions or weird substances that might be part of a haunted house or Halloween decorations. Make sure kids know that even though things may look like food, they might not be. Feed your kids a meal or small snack before they head out so they’ll be less tempted to sample candy along the way before you’ve had the chance to check it out.
6. (CSE) When checking kids’ loot, be on the lookout for food your child may be allergic to, as well as any recalled foods or items that may pose a choking hazard for kids under 5.

Don’t Let Food Allergies Spoil the Fun

1. (Dr McNealy) Review the Rules – If they are old enough to understand, remind your child which foods are safe, and which are not. If there are candies or treats that they should be sure to avoid, discuss that. Tell them to bring their loot to you, so you can be sure to remove anything that might be harmful. Also let them know what to do if they do eat something that they might be allergic too.
2. (Dr McNealy) Read Labels: When you check over your kid’s Halloween candy, remember to read labels. Formulations change pretty frequently, so you should even check foods that have been safe in the past. Remove anything that doesn’t have an ingredient list.
3. (Dr McNealy) Keep Your Epi-Pen or Allergy Medication Handy: Remember that accidents happen, and be prepared as usual with your child’s epi-pen, or whatever medication your doctor recommends for an allergic reaction.
4. (Dr McNealy) Keep Safe Treats on Hand: Keep some safe candy, treats or small toys on hand to replace anything you have to confiscate. If you have the chance, you can even make up a few treat bags to drop with friends or neighbors, so you’ll know that at least a few people on your trick-or-treat route will have surprises that your child can keep and enjoy.

And Unfortunately Because There are Predators Out There…

1. (NCMEC) Be sure older children TAKE FRIENDS and younger children are accompanied by a TRUSTED ADULT when “Trick or Treating.”
2. (NCMEC) Accompany younger children to the door of every home they approach and make sure parents and guardians are familiar with every home and all people from which the children receive treats.
3. (NCMEC) Teach children to NEVER approach a home that is not well lit both inside and outside and NEVER enter a home without prior permission from their parents or guardians.
4. (NCMEC) Remind them to NEVER approach a vehicle, occupied or not, unless they are accompanied by a parent or guardian.
5. (NCMEC) Children should be cautioned to run away immediately from people who try to lure them with special treats. Tell them that if anyone tries to grab them to make a scene; loudly yell this person is not my father/mother/guardian; and make every effort to get away by kicking, screaming, and resisting.

If all else fails, take man’s best friend along…

 

…that should surely chase away anything that goes bump in the night…or at least keep the kids entertained while you steal – I mean sort through all their candy. HAVE A SAFE & HAPPY HALLOWEEN!

 

 

 

 

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References:

1. Basic Safety Halloween Precautions and Tips for Adults and Kids: Oregon State Police Missing Children Clearinghouse and the National Center for Missing and Exploited Children
2.  Top 10 Halloween Safety Tips for Families: Child Safety Examiner October 28, 2009
3.  Trick-or-Treat Food Allergy Safety: Dr Kristie McNealy October 26, 200
4. Thanks also go out to PediatricSafety’s EMS Safety Expert Jim Love for our “man’s best friend” photos.

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