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28 August 1998

Vol. II, No. 4

Health Matters

Back to school: keeping your child healthy

My six year-old son is starting first grade in September. What health problems is he likely to encounter, and what can I do to prevent them?

Keeping your children healthy once they begin school full-time is difficult, but certainly not impossible. Viruses and bacteria are easily spread in the close quarters of the schoolroom, but there are some measures you can take to halt transmission.

According to Howard Bauchner, M.D., director of the division of general pediatrics at Boston Medical Center and associate professor of pediatrics at Boston University School of Medicine, you should start your child's school year on a healthy note with a complete medical examination to test hearing and vision, general health, development, and emotional well-being.

At the appointment, check to see that your child is up-to-date on immunizations and boosters. School-bound children need to receive their final DTP (diphtheria, tetanus, pertussis), polio, and MMR (measles, mumps, rubella) boosters between the ages of four and six. (The MMR booster may be given to children from 11 to 12 instead, so it may be helpful to know your pediatrician's preference.)

In addition, you may want to consider immunizing your child against chicken pox. Although not required by school districts, the varicella vaccine is available for protection against this common childhood scourge. "At the moment the vaccine is not universally recommended by all pediatricians, but the evidence for its usefulness is growing," Bauchner says. For further information, consult your doctor.

Once given a clean bill of health, children may reduce the risk of catching or spreading a cold or flu by washing their hands often, especially after sneezing, and avoiding rubbing their eyes. Good hygiene will prevent the spread of enteric, or intestinal, pathogens, which may cause diarrhea.

Viruses common in the schoolroom often trigger asthma attacks. Children using inhalers should bring them to school, and every day parents should observe if their child is having difficulty breathing.

On a general note, a balanced breakfast -- consisting of cereal, toast, milk, and fruit juice -- and lunch is essential for children to give them energy for the demanding school day. Also, encourage them to eat healthy snacks such as vegetables and fruits instead of candy and chips. Ease them into an earlier bedtime so getting up early for school won't be so difficult. Finally, talk to your children each day about their experiences at school. The dividends from this will go far beyond keeping your child physically healthy.

If your child does become ill, keep in mind that an antibiotic is not necessarily warranted. "Antibiotics are not indicated for viral infections. Inappropriate antibiotics will increase the risk of your child acquiring resistant bacteria," Bauchner says. The medical profession has been trying to combat the growing problem of resistance, a condition in which drugs lose their effectiveness in battling bacteria. To preserve their potency, antibiotics must be used less frequently.

With these points in mind, you will be prepared to watch your child thrive when he starts school.

"Health Matters" is written in cooperation with staff members of Boston Medical Center. For more information on keeping your child healthy or other health matters, call 638-6767.