Car Seat Checkup

​Using a car seat correctly makes a big difference. Even the right seat for your child’s size must be used correctly to properly protect your child in a crash. Here are car seat tips from the American Academy of Pediatrics (AAP), but you can also read about Connecticut’s car seat guidelines on the SAFE KIDS CONNECTICUT website.

Does your car have air bags?

  • ​Never place a rear-facing car seat in the front seat of a vehicle that has a front passenger airbag. If the airbag inflates, it will hit the back of the car seat, right where your baby’s head rests, and could cause serious injury or death.
  • The safest place for all children younger than 13 years to ride is in the back seat regardless of weight and height.
  • If an older child must ride in the front seat, a child in a forward-facing car seat with a harness may be the best choice. Be sure you move the vehicle seat as far back from the dashboard (and airbag) as possible.​

Is your child facing the right way for weight, height, and age?

  • All infants and toddlers should ride in a rear-facing car seat until they are at least 2 years of age or reach the highest weight or height allowed by their car seat manufacturer.
  • Any child who has outgrown the rear-facing weight or height limit for his car seat should use a forward-facing seat with a harness for as long as possible, up to the highest weight or height allowed by his car seat manufacturer.​

Is the harness snug?

  • Harness straps should fit snugly against your child’s body. Check the car seat instructions to learn how to adjust the straps.
  • Place the chest clip at armpit level to keep the harness straps secure on the shoulders.​

Does the car seat fit correctly in your vehicle?

  • Not all car seats fit properly in all vehicles.
  • Read the section on car seats in the owner’s manual for your car.​

Can you use the LATCH system?

  • LATCH (lower anchors and tethers for children) is a car seat attachment system that can be used instead of the seat belt to install the seat. These systems are equally safe, but in some cases, it may be easier to install the car seat using LATCH.
  • Vehicles with the LATCH system have anchors located in the back seat, where the seat cushions meet. All car safety seats have attachments that fasten to these anchors. Nearly all passenger vehicles and all car safety seats made on or after September 1, 2002, are equipped to use LATCH. All lower anchors are rated for a maximum weight of 65 pounds (total weight includes car safety seat and child). Check the car seat manufacturer’s recommendations for maximum weight a child can be to use lower anchors. New car seats have the maximum weight printed on their label.
  • The top tether improves safety provided by the seat. Use the tether for all forward-facing seats, even those installed using the vehicle seat belt. Tether anchors are located behind the seat, either on the panel behind the seat (in sedans) or back of the seat, ceiling, or floor (in most minivans, SUVs, hatchbacks, and pickup trucks). Always follow both the car seat and vehicle manufacturer instructions, including weight limits, for lower anchors and tethers. Remember, weight limits are different for different car seats and different vehicles.​

Is the seat belt or LATCH strap in the right place and pulled tight?

  • ​Route the seat belt or LATCH strap through the correct path. Convertible seats have different belt paths for when they are used rear facing or forward facing (check your instructions to make sure).
  • Pull the belt tight. Apply weight into the seat with your hand while tightening the seat belt or LATCH strap. When the car seat is installed, be sure it does not move more than an inch side to side or toward the front of the car.
  • If you install the car seat using your vehicle’s seat belt, you must make sure the seat belt locks to keep a tight fit. In most newer cars, you can lock the seat belt by pulling it all the way out and then allowing it to retract to keep the seat belt tight around the car seat. Many car seats have built-in lock-offs to lock the belt. Check the owner’s manual to make sure you are installing the seat correctly.
  • It is best to use the tether that comes with your car seat to the highest weight allowed by your vehicle and the manufacturer of your car seat. Check your vehicle owner’s manual and car seat instructions for how and when to use the tether and lower anchors.​​

​Has your child outgrown the forward-facing seat?

  • All children whose weight or height is above the forward-facing limit for their car seat should use a belt-positioning booster seat until the vehicle seat belt fits properly, typically when they have reached 4 feet 9 inches in height and are 8 through 12 years of age.
  • A seat belt fits properly when the shoulder belt lies across the middle of the chest and shoulder, not the neck or throat; the lap belt is low and snug across the upper thighs, not the belly; and the child is tall enough to sit against the vehicle seat back with her knees bent over the edge of the seat without slouching and can comfortably stay in this position throughout the trip.​

​Do you have the instructions for the car seat?

Follow them and keep them with the car seat. Keep your child in the car seat until she reaches the weight or height limit set by the manufacturer. Follow the instructions to determine whether your child should ride rear facing or forward facing and whether to install the seat using LATCH or the vehicle seat belt.​

Has the car seat been recalled?

  • You can find out by calling the manufacturer or the National Highway Traffic Safety Administration (NHTSA) Vehicle Safety Hotline at 888/327-4236 or the NHTSA Web site at www.safercar.gov.
  • Follow the manufacturer’s instructions for making any repairs to your car seat.
  • Be sure to fill in and mail in the registration card that comes with the car seat. It will be important in case the seat is recalled.

Do you know the history of your child’s car seat?

  • Do not use a used car seat if you do not know the history of the seat.
  • Do not use a car seat that has been in a crash, has been recalled, is too old (check the expiration date or use 6 years from date of manufacture if there is no expiration date), has any cracks in its frame, or is missing parts.
  • Make sure it has labels from the manufacturer and instructions.
  • Call the car seat manufacturer if you have questions about the safety of your seat.​

For information about Connecticut’s guidelines for car seats, please visit SAFE KIDS CONNECTICUT.


Source: Car Safety Seat Checkup (Copyright © 2017 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


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Constantly Connected: Adverse Effects of Media on Children & Teens

​Today’s children and teens are growing up immersed in digital media. They are exposed to media in all forms, including TV, computers, smartphones, and other screens.

Media can influence how children and teens feel, learn, think, and behave.
What We Know:

Here are facts about digital media use.

  • Almost 75% of teens own a smartphone. They can access the Internet, watch TV and videos, and download interactive applications (apps). Mobile apps allow photo-sharing, gaming, and video-chatting.
  • 25% of teens describe themselves as “constantly connected” to the Internet.
  • 76% of teens use at least one social media site. More than 70% of teens visit multiple social media sites, such as Facebook, Snapchat, and Instagram.
  • 4 of 5 households (families) own a device used to play video games.

Why It’s Good to Unplug:
Overuse of digital media and screens may place your child or teen at risk of

Obesity. Excessive screen use, as well as having a TV in the bedroom, can increase the risk of obesity. Teens who watch more than 5 hours of TV per day are 5 times more likely to be overweight than teens who watch 0 to 2 hours. Watching TV for more than 1.5 hours daily is a risk factor for obesity for children 4 through 9 years of age. This is in part due to the fact that viewers are exposed to advertising for high-calorie foods. Viewers are also more likely to snack or overeat while watching screen media.

Sleep problems. Media use can interfere with sleep. Children and teens who spend more time with social media or who sleep with mobile devices in their rooms are at greater risk for sleep problems. Exposure to light (particularly blue light) and stimulating content from screens can delay or disrupt sleep, and have a negative effect on school.

Problematic internet use. Children who overuse online media can be at risk for problematic Internet use. Heavy video gamers are at risk for Internet gaming disorder. They spend most of their free time online, and show less interest in offline or “real-life” relationships. 4% to 8% of children and teens may have problems limiting their Internet use, and almost 10% of US youth 8 to 18 years of age may have Internet gaming disorder. There may be increased risks for depression at both the high and low ends of Internet use.

Negative effect on school performance. Children and teens often use entertainment media at the same time that they’re doing other things, such as homework. Such multi-tasking can have a negative effect on school.

Risky behaviors. Teens’ displays on social media often show risky behaviors, such as substance use, sexual behaviors, self-injury, or eating disorders. Exposure of teens through media to alcohol, tobacco use, or sexual behaviors is associated with earlier initiation of these behaviors.

Sexting and privacy and predators. Sexting is sending nude or seminude images as well as sexually explicit text messages using a cell phone. About 12% of youth age 10 to 19 years of age have sent a sexual photo to someone else. Teens need to know that once content is shared with others they may not be able to delete or remove it completely. They may also not know about or choose not to use privacy settings. Another risk is that sex offenders may use social networking, chat rooms, e-mail, and online games to contact and exploit children.

Cyberbullying. Children and teens online can be victims of cyberbullying. Cyberbullying can lead to short- and long-term negative social, academic, and health issues for both the bully and the target. Fortunately, programs to help prevent bullying may reduce cyberbullying.

Children today are growing up in a time of highly personalized media use experiences, so parents must develop personalized media use plans for their children. Media plans should take into account each child’s age, health, personality, and developmental stage. All children and teens need adequate sleep (8-12 hours, depending on age), physical activity (1 hour), and time away from media. Put together your family media plan today!


Source: Digital Media and Your Children and Teens: TV, Computers, Smartphones, and Other Screens (Copyright © 2016 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


Breakfast for Learning

​Nearly half of all American families regularly skip breakfast. Is your family one of them? When it comes to getting your children to school, a healthy breakfast is just as important as gym shoes and sharp pencils.
How Breakfast Betters Your Child

Breakfast has been associated with everything from:

  • Better memory
  • Better test scores
  • Better attention span to decreased irritability
  • Healthier body weights
  • Improved overall nutrition

Rise & Dine
It’s easy to see how breakfast has come to qualify as one of the nutritional challenges of parenthood. Whether it’s your own parental time constraints or your child’s busy schedule, getting the whole family ready to set off to child care and/or school in the morning, play dates, or any of a whole host of other common early-in-the-day commitments, breakfast is often neglected.

If the words “slow” and “leisurely” don’t exactly describe your morning routine, we’d like to suggest that you commit a little extra time and effort to protecting the nutritional integrity of your child’s morning meal.

Breakfast-Made-Easier Tips for Parents

Whether you opt for a simple breakfast or a more elaborate one, any effort to make it nutritious is better than no breakfast at all. Whether that means a glass of low-fat milk and a piece of wheat toast or an all-out feast, the following breakfast-made-easier tips will hopefully help you rise to the occasion and overcome some of the most common barriers to a healthy breakfast.

Schedule accordingly. While we’d like to remind you that sitting down and sharing family meals is beneficial, we’re willing to bet that sitting down to a leisurely breakfast with your kids each morning simply isn’t realistic for most of you. What is realistic, however, is making sure you carve out enough time to allow your child to eat without pressure. Especially for infants and toddlers, this includes factoring in enough time in the morning’s schedule to allow for both assisted- and self-feeding.

Fix breakfast before bedtime. In other words, plan ahead. As with just about all other aspects of feeding your child, a little advance planning can go a long way toward having a wider range of healthy foods on hand. Simple examples such as hard-boiling eggs ahead of time or having your child’s favorite cold cereal dished out the night before to pair with some presliced fresh fruit can mean the difference between time for a balanced breakfast and running out the door without it (or, as is often the case, with some commercially packaged and far less nutritious alternative in hand).

Grab-and-go breakfasts. If the reality of your schedule is such that you and your kids routinely run out the door with no time to spare in the morning, then try stocking up on a variety of nutritious foods that you can prepare and prepackage for healthier grab-and-go convenience. In addition to hard-boiled eggs, consider other fast favorites like sliced apples, homemade muffins, or a bagel with low-fat cream cheese.

Make sure sleep is on the menu. Applying the age-old adage, make sure your child is early enough to bed that she rises early enough to allow time for breakfast. No matter what their age, tired kids tend to be cranky, and cranky kids are far less likely to sit down for a well-balanced breakfast. Not only that, but sleep has proven itself to be a crucial ingredient in children’s overall health.

Broaden your horizons. You’ll certainly want to keep safety in mind when figuring out what’s age-appropriate to offer your child for breakfast, but don’t let yourself be constrained by artificially imposed labels to determine what is good to serve for a morning meal. Think protein, think fruits and vegetables, and think outside the box when it comes to expanding your breakfast horizons beyond just breakfast cereals and milk.

Look for child care and school support. Be sure to check out what breakfast options your child’s school or child care provider offers. With much-deserved attention now being paid to the food our children eat in out-of-home settings, you’re more likely to find balanced breakfast options on the menu, and your child may well be more receptive to eating them if all of his friends are eating alongside him.


Source: Healthy Children E-Magazine, Back to School 2012. The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


Choosing Healthy Snacks for Kids

While meals make up the majority of a child’s nutritional intake, most children eat at least one snack per day. While many of the most commonly offered kids’ snacks tend to be of lower nutritional value than meals, snacks still can support—or even enhance—your child’s overall healthy eating plan. Here’s how:

  • Use snack times as a way to increase fruits and vegetable intake. Most kids do not eat the recommended amount of fruits and vegetables. Snack times offer a great opportunity to increase access and exposure to these nutrient-dense foods. Consider pairing them up with dairy products or dairy substitutes (such as grapes and cheese) lean proteins (such as celery and peanut butter), or whole-grain cereals and bread (such as a banana sandwich on whole grain bread).
  • Keep a range of healthy foods handy at home. It is much easier to make easy, healthy snacks when you keep a few key items stocked at home. Ideas include different types of raw vegetables and fruit, yogurt dip, hummus, and cheese sticks.
  • Avoid processed foods and added sugars. Processed foods (made in a factory and sold in bags and boxes) do not have many nutrients and often have a lot of added sugar and salt. In addition, children may become hungry faster after eating processed foods.
  • Teach your children to eat a rainbow of colors. Arrange your children’s foods to show the beauty of fresh, brightly colored foods. Talk about the farms where food comes from and the farmers who help grow it.

Source: Section on Obesity (Copyright © 2016 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

Bedtime Routines for School-Aged Children

​​​For school-aged children, a quick tidy-up is part of the bedtime routine: putting books and toys back on shelves and clothes in drawers and closets. Their room doesn’t have to be perfect, but it’s more pleasant to rest and read or listen to music and stories in a tidy environment, and mornings go more smoothly if needed objects are where they belong and thus easy to find.

By the middle-school years, the weekend routine is a bit less regimented than the one for school nights, and weekend bedtimes can be later. Lights can go out at different times for different children in the family, depending on how much sleep they need. However, while your child may sleep late the next morning, try to keep weekend wake-ups within an hour or so of the usual time, especially if your child is not a creature of habit by nature. Left to sleep too long, in only a few days a vulnerable child can shift his sleep phase (periods of waking and sleeping) in such a way that he has trouble getting back on his usual schedule. School performance may suffer because he is drowsy when awoken on school days.

Keep Bedtime Routines Manageable
Unless carefully managed, bedtime routines can be drawn out almost indefinitely, thus defeating the purpose for which they’re intended. A child quickly learns that by taking charge of the show, he can significantly delay the time of going to bed. For example, he may have to repeatedly switch his stuffed animals because he can’t find quite the right combination to make him sleepy on a particular night. Or he may desperately need the answers to questions that will keep him awake if he has to wait until morning.

Allow your child flexibility within the routine, but keep things under your control by limiting the choices available. For example, let him choose different stuffed animals for bed each night, but keep him to a fixed number. Let him choose a story and a song, but not a whole book or CD. Try to keep the bedtime routine to no longer than 30 minutes.

As your child gets older, you should gradually begin to step back and let him become more in charge of his bedtime routine. Providing these opportunities during his daily routine is also a way to help him become more self-reliant.


Source: Sleep: What Every Parent Needs to Know (Copyright © 2013 American Academy of Pediatrics) The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


School Days

“What did you do in school today?”

“Nothing.”

This is a familiar exchange between parent and child. And it can be a frustrating one for an interested parent who genuinely wants to keep abreast of a child’s activities at school and yet not appear nosy. (This issue of intrusiveness becomes more of a problem with the ten- to twelve-year-old child and certainly with adolescents.)

Youngsters will usually be more responsive about their day at school if they are asked fairly direct questions at a time that is ap­propriate. For instance, when a child first arrives home from school, he might be tired and want a snack, or want to relax or play with a friend rather than rehash the day. It might be better to talk with him about school later in the day or evening. Or begin the conversation with a statement like “You look pretty hungry. Let’s have a snack and then you can tell me about your day.”

Make your questions as focused and nonjudgmental as possible. For instance:

  • “What new thing did you learn in school today?”
  • “What questions did you ask in class?”
  • “How is that book you’ve been reading in class? What’s hap­pening in the story?”
  • “Do you have any papers or artwork in your backpack that we could look over?”
  • “Is learning long division getting a little easier?”
  • “Tell me about the spelling test. Was there a word or two you had trouble with?”

Knowing that their students may have trouble remembering everything that happened in school, teachers often communicate about class and school issues through written notes. Ask your child each night if he has any notes for you.

At times your child might want to talk about school when you’re right in the middle of something else. As much as possible, try to be responsive, perhaps saying something like “I want to hear about school, but right now I’m very busy fixing dinner. Let me get this casserole in the oven, and then we can sit down and really talk.” Or “Why don’t you hop on this stool and help me make this salad while we talk.”


Source: Caring for Your School-Age Child: Ages 5 to 12 (Copyright © 2004 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


Back to School Tips

Making the First Day Easier

  • Parents should remember that they need not wait until the first day of class to ask for help. Schools are open to address any concerns a parent or child might have, including the specific needs of a child, over the summer. The best time to get help might be one to two weeks before school opens.
  • Many children become nervous about new situations, including changing to a new school, classroom or teacher. This may occur at any age. If your child seems nervous, it can be helpful to rehearse entry into the new situation. Take them to visit the new school or classroom before the first day of school. Remind them that there are probably a lot of students who are uneasy about the first day of school. Teachers know that students are nervous and will make an extra effort to make sure everyone feels as comfortable as possible. If your child seems nervous, ask them what they are worried about and help them problem solve ways to master the new situation.
  • Point out the positive aspects of starting school to create positive anticipation about the first day of class. They will see old friends and meet new ones. Talk with them about positive experiences they may have had in the past at school or with other groups of children.
  • Find another child in the neighborhood with whom your child can walk to school or ride on the bus.
  • If it is a new school for your child, attend any available orientations and take an opportunity to tour the school before the first day. Bring the child to school a few days prior to class to play on the playground and get comfortable in the new environment.
  • If you feel it is needed, drive your child (or walk with her) to school and pick her up on the first day, and get there early on the first day to cut down on unnecessary stress.
  • Make sure to touch base with your child’s new teacher at the beginning or end of the day so the teacher knows how much you want to be supportive of your child’s school experience.
  • Consider starting your child on their school sleep/wake schedule a week or so ahead of time so that time change is not a factor on their first couple of days at school.

Eating During the School Day

  • Studies show that children who eat a nutritious breakfast function better. They do better in school, and have better concentration and more energy. Some schools provide breakfast for children; if yours does not, make sure they eat a breakfast that contains some protein
  • Most schools regularly send schedules of cafeteria menus home and/or have them posted on the school’s website. With this advance information, you can plan on packing lunch on the days when the main course is one your child prefers not to eat.
  • Many children qualify for free or reduced price food at school, including breakfast. The forms for these services can be completed at the school office. Hunger will affect a child’s performance in class.
  • Many school districts have plans which allow you to pay for meals through an online account. Your child will get a card to “swipe” at the register. This is a convenient way to handle school meal accounts.
  • Look into what is offered inside and outside of the cafeteria, including vending machines, a la carte, school stores, snack carts and fundraisers held during the school day. All foods sold during the school day must meet nutrition standards established by the US Department of Agriculture (USDA). They should stock healthy choices such as fresh fruit, low-fat dairy products, water and 100% fruit juice. Learn about your child’s school wellness policy and get involved in school groups to put it into effect. Also, consider nutrition if you child will be bringing food to eat during school.
  • Each 12-ounce soft drink contains approximately 10 teaspoons of sugar and 150 calories. Drinking just one can of soda a day increases a child’s risk of obesity by 60%. Choose healthier options (such as water and appropriately sized juice and low-fat dairy products) to send in your child’s lunch.

Before & After School Child Care

  • During early and middle childhood, children need supervision. A responsible adult should be available to get them ready and off to school in the morning and supervise them after school until you return home from work.
  • If a family member will care for your child, communicate the need to follow consistent rules set by the parent regarding schedules, discipline and homework.
  • Children approaching adolescence (11- and 12-year-olds) should not come home to an empty house in the afternoon unless they show unusual maturity for their age.
  • If alternate adult supervision is not available, parents should make special efforts to supervise their children from a distance. Children should have a set time when they are expected to arrive at home and should check in with a neighbor or with a parent by telephone.
  • If you choose an after-school program for your child, inquire about the training of the staff. There should be a high staff-to-child ratio, trained persons to address health issues and emergencies, and the rooms and the playground should be safe.

Develop a Sleep Routine

  • Getting enough sleep is critical for a child to be successful in school. Children who do not get enough sleep have difficulty concentrating and learning as well as they can.
  • Set a consistent bedtime for your child and stick with it every night. Having a bedtime routine that is consistent will help your child settle down and fall asleep. Components of a calming pre-bedtime routine may involve a bath/shower, reading with them, and tucking them in and saying good-night to them.
  • Have your child turn off electronic devices well before bedtime.
  • Try to have the home as quiet and calm as possible when younger children are trying to fall asleep.
  • Insufficient sleep is associated with lower academic achievement in middle school, high school and college, as well as higher rates of absenteeism and tardiness. The optimal amount of sleep for most younger children is 10-12 hours per night and for adolescents (13-18 year of age) is in the range of 8-10 hours per night. See Healthy Sleep Habits: How Many Hours Does Your Child Need? for more information.

Developing Good Homework & Study Habits

  • Create an environment that is conducive to doing homework starting at a young age. Children need a consistent work space in their bedroom or another part of the home that is quiet, without distractions, and promotes study.
  • Schedule ample time for homework; build this time into choices about participation in after school activities.
  • Establish a household rule that the TV and other electronic distractions stay off during homework time.
  • Supervise computer and Internet use.
  • By high school, it’s not uncommon for teachers to ask students to submit homework electronically and perform other tasks on a computer. If your child doesn’t have access to a computer or the internet at home, work with teachers and school administration to develop appropriate accommodations.
  • Be available to answer questions and offer assistance, but never do a child’s homework for her.
  • Take steps to help alleviate eye fatigue, neck fatigue and brain fatigue while studying. It may be helpful to close the books for a few minutes, stretch, and take a break periodically when it will not be too disruptive.
  • If your child is struggling with a particular subject, speak with your child’s teacher for recommendations on how you or another person can help your child at home or at school. If you have concerns about the assignments your child is receiving, talk with their teacher.
  • If your child is having difficulty focusing on or completing homework, discuss this with your child’s teacher, school counselor, or health care provider.
  • For general homework problems that cannot be worked out with the teacher, a tutor may be considered.
  • Some children need extra help organizing their homework. Checklists, timers, and parental supervision can help overcome homework problems.
  • Some children may need help remembering their assignments. Work with your child and their teacher to develop an appropriate way to keep track of their assignments – such as an assignment notebook.

From the American Academy of Pediatrics (AAP).


First Day of School Checklist

As you and your child prepare for the first day of the new school year, use this checklist to help make sure you have taken care of the necessary tasks and learned the information you need.

  • Is your child registered? (If he attended the same school the previous school year, he is already registered.
  • When is the first day of school?
  • What time does school start?
  • How is your child going to get to school? If your child is biking, does he know the school rules for bicycles? If he is walking for the first time, with whom will he walk? Have you reviewed safety precautions with him, regarding traffic and strangers?
  • Does your child know his teacher’s name?
  • What will his daily schedule be like?
  • Will he need to bring a snack? What kinds of snacks are allowed and encouraged? Does he need to bring something to drink, or can he buy something? Will water be available?
  • What time is lunch? Can your child buy it at school, and how much will it cost?
  • What clothes will your child need to wear? Are there any re­strictions on what can be worn? Will he need a different set of clothes for physical education or art classes?
  • Does your child need to bring pencils, paper, notebooks, and other supplies? (Often, the teacher will announce these require­ments on the first day.) Does your child have something in which to carry his books and supplies back and forth to school? Will he have a place (besides his desk) to keep his things at school?
  • Have you filled out all health forms or emergency contact forms that have been sent home?
  • Have any new health problems developed in your child over the summer that will affect his school day? Does the school nurse know about this condition, or is an appointment set up to discuss it?
  • If your child will need to take medication at school on the first day, have arrangements been made for this?
  • Does your youngster know where he is going after school (e.g., home, babysitter)? Does he know how he will get there? If you will not be there when he arrives, does he know who will be re­sponsible for him, what the rules are, and how to get help in an emergency?
  • Does your child have your work telephone numbers in his backpack?

Source: Caring for Your School-Age Child: Ages 5 to 12 (Copyright © 2004 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


School Lunches: You Can Make a Difference

Meal planning for schools is a complicated process. Menus have to allow for a wide range of tastes and restrictions. Budgets are limited. Foods that are available at lowest cost and require the least preparation are often high in fat, sugar, and salt.

According to the School Meals Initiative for Healthy Children set up in 1996, school lunch menus backed by federal subsidies must conform to the current guidelines for health. When it comes to fat, this means that meals may contain no more than 30% of total calories from fat and no more than 10% from saturated fat.

National School Lunch Program: School Requirements for Menu Improvement

It also means that schools taking part in the National School Lunch Program have been required to take the following practical steps to improve menus:

  • Adding more fruits, vegetables, and grains to menus
  • Balancing menus by using foods from each of the 5 groups
  • Reducing overall fat content by serving more vegetarian main courses, less beef and pork, and fewer fried foods
  • Varying menus by serving more ethnic dishes, such as pasta and tacos

Team Nutrition

To back up efforts at the lunchroom level, the US Department of Agriculture set up Team Nutrition, a program to improve children’s eating habits and raise their awareness about the links between food and health. Team Nutrition’s goal is to improve children’s lifelong eating and physical activity habits by using the principles of the Dietary Guidelines for Americans. This plan involves schools, parents, and the community in efforts to continuously improve school meals, and to promote the health and education of 50 million schoolchildren in more than 96,000 schools nationwide.

How to Get Involved & Make Your Child’s School Healthier

There’s also a push at the state and local levels to help children eat better. In many communities, children at grade-school level are learning not only how to cook food but also how to grow a variety of produce. Courses combine food production and preparation with valuable lessons about history, economics, social science, and math.

If you’re not satisfied with the choices available in your child’s school cafeteria, get involved in your school’s parent-teacher organization and brainstorm some healthful alternatives, as parents and teachers all over the country are doing.

Even if you haven’t the time or resources to revamp the school cafeteria, you may be able to see that the salad bar offers a good selection of raw vegetables and low-fat dressings. Vending machine choices can also be modified to eliminate high-fat and empty-calorie munchies and provide healthy snacks that include more fresh fruit and low-fat dairy products, as well as water and 100% fruit juice instead of sodas.

Try to get your child’s school to stock healthy choices in the vending machines. Although school administrators fear that they will lose money if they make these changes, schools that have provided healthier options have not lost money or have seen their revenue increase. ​


Source: Bright Futures: Nutrition, 3rd Edition (Copyright © 2011 American Academy of Pediatrics). The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.


Back to School, Back to the Doctor

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No matter what grade your child is about to enter, there’s the yearly back-to-school checklist of to-dos:

  • Shopping for school supplies
  • Filling out permission forms
  • Scheduling your child’s yearly pediatric well-child visit

While it may not seem as urgent, a yearly physical exam by your family’s pediatrician is an important part of your child’s health care. The back-to-school season is a convenient time for putting the exam on your family’s schedule.

Your Patient-Centered Medical Home
The American Academy of Pediatrics (AAP) advocates that every child and youth receive care through a patient-centered medical home. Within the medical home, care is provided continuously over a long period of time so that as a child ages and develops, his or her care is never interrupted.

Adolescence, for example, is a time when vital changes are taking place. It is important to have your child see the pediatrician during the transition years from later childhood to puberty.

The annual pediatric exam also offers the doctor time to provide wellness guidance and advice. In addition to monitoring heart and blood pressure and testing for diabetes, pediatricians can use this annual visit with your child to discuss diet, exercise options, pediatric vision screenings, and testing for cholesterol and anemia.

Building a Medical History
The continuity of regular physical exams is invaluable. Having a long-term history with a child or adolescent gives the doctor the awareness of the child’s progress and development over time. This helps the doctor detect emerging problems, as well as being informed by the detail of the patient’s history, such as important past illnesses or injuries the child may forget to mention on the sports physical questionnaire.

That detail includes immunization records. A school entry form will generally include a check box asking whether all vaccinations are up-to-date, requiring the parents to remember whether or not they are. The family pediatrician will have accurate records to assist you in filling out these forms.

Examining the Young Athlete
The doctor’s annual exam of a young athlete should be similar to one for any other child but most pediatricians will also address some sports-specific issues, including injuries, nutrition, training and exercise programs, and even attitudes in the course of the exam.

The other side of the exercise issue is the student athlete who is already involved in an exercise and training program. Overuse and overtraining injuries continue to be huge problems.

The Need for a Thorough Physical Exam (beyond a sports-specific exam)
Back-to-school check-ups, as they are commonly called, are often the only visit most kids and teenagers have with their pediatrician every year. The annual physical gives the pediatrician a chance to give the child a thorough physical exam and address any emotional, developmental, or social concerns. It is also a good chance to address important questions, especially with teenagers, including adolescent issues of drinking, smoking, drugs, sexual activity, and depression.

Children involved in school athletic programs often receive a sports-specific exam through the school. The time frame for getting this exam should be at least 6 weeks prior to the start of the sport’s season. This allows ample time to work up any new health concerns or rehab any lingering injuries before the season starts, without delaying clearance of the athlete. However, school sports physicals alone tend not to address the child’s overall health.

Getting the Balance Right
A healthy childhood and adolescence calls for balancing home life, school, social activities, sports, and extracurricular pursuits. This is not easy, especially during a time when the child is passing through the years of growth, learning, exploration, and emotional and physical development. This is all the more reason to set aside one day during each of those years for your child to see the pediatrician.


Adapted from Healthy Children E-Magazine, Back to School 2012. The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.