When school comes around each September, you’re probably helping your child get ready for the school year by purchasing book bags and lunch boxes, selecting new fall fashions, and scheduling hair cuts. Of course, all of these activities are important, but while purchasing pens, pencils, and calculators, don’t forget to prepare for your child’s physical well-being at school—especially if he has a chronic ailment, special need, or requires routine medication.
The American Academy of Pediatrics recommends annual physicals for all children. “Annual exams ensure that your child continues to be well, has developmentally appropriate skills and does not bring disease into the school or community,” says Dr. Wayne Yankus, former chairperson for the section on school health for the American Academy of Pediatrics and past president for the New Jersey chapter of the American Academy of Pediatrics. “These physicals also make sure your child has the strength, stamina and physical well-being to perform in the classroom.”
“An annual physical is a time to react to anything out of the ordinary and take care of it before the school year begins,” says Dr. David Meckler, a pediatrician at Tri-County Pediatrics, Inc., located in Southampton, Cheltenham and Philadelphia, PA. “Try to take care of any existing physical issues, like getting glasses, before September so you don’t disrupt the school year. If your child has any special issues, advise the school in advance.”
For allergic children, going back to school in September might result in absences due to problems related to hay fever. “Allergic symptoms range from sneezing, runny noses and itchy eyes, to skin rashes and raspy throats,” says Dr. Richard Bonforte, a spokesperson for the American Academy of Pediatrics, a pediatric pulmonologist and Medical Director for Children’s Hospital for Hudson County, NJ.
“Allergies sap people’s energy level,” says Dr. Bonforte. “Kids with allergies are often uncomfortable in school, which makes it difficult for them to concentrate. Their symptoms might prevent them from sleeping well at night, which affects their performance the next day.”
If your child suffers from allergic symptoms, Dr. Bonforte suggests trying steroid nasal inhalers, available by prescription, which work particularly well for eye and nasal allergies. “If you know that your child has bad allergies beginning in August, start administering the inhaler 4 – 6 weeks in advance of the season,” recommends Dr. Bonforte. According to Dr. Bonforte, antihistamines can also be effective treatments for allergies.
Common indoor allergies that might affect kids at school vary from animal dander (from class pets) and plants, to dyes, latex (found in balloons) and mold, depending on the school’s ventilation system.
According to Dr. Bonforte, the best way to reduce allergy symptoms is to avoid the allergens, which means your child’s teacher might need to move Fluffy the hamster to another classroom. However, when you can’t avoid the allergen, medications are often necessary.
According to The Food Allergy and Anaphylaxis Network, an estimated 2 million school-age children suffer from food allergies. Symptoms of food allergies can affect the skin (hives, swelling of lips, tongue and face); the gastrointestinal tract (abdominal pain, vomiting); and can even cause heart failure. If left untreated, these symptoms can potentially be fatal.
In order to ensure that your child has a safe school year, The Food Allergy and Anaphylaxis Network suggests that you arrange a meeting with the school staff several weeks before class to discuss your child’s food allergy. Make sure to bring any medications your child needs to the meeting. Demonstrate the use of the epinephrine kit (EpiPen®) if your child needs it. Work with the school staff to have an emergency system in place for when an allergic reaction occurs. “Involve your child early in becoming a self manager,” says Dr. Janis Hootman, PhD., R.N., NCSN, and president of the National Association of School Nurses (NASN). “For example, teach your child not to share foods, practice what foods he should avoid and know what signs might indicate a need for help.”
“You must let the school staff know if your child is asthmatic, and instruct them about what to do if your child has an asthma attack,” says Dr. Bonforte. “Asthma symptoms include a frequent cough, increased breathing and difficulty breathing. Children suffering from asthma often don’t get enough oxygen, which can affect their behavior, their participation in sports and their ability to pay attention in the classroom.”
According to Dr. Bonforte, drug treatments for asthma must be closely monitored, and taken or administered properly. “Anyone with serious asthma must have a care plan designed by the child’s physician,” says Dr. Bonforte. You can obtain asthma action plan forms from your local American Lung Association office.
Bringing Medications to School
“Every time your child needs medication administered in school, she will probably be required to bring a medical form signed by your child’s doctor,” says Dr. Meckler. “These forms give school nurses important information about the drug, such as the medication’s name, strength, form, and potential side effects. It also lists the name of your child’s condition, as well as the reason it is being administered.”
While some school nurses are authorized to administer non-prescription medications, others can’t even give children Tylenol without a medical form from your doctor. Forms vary according to the school district where you live. Parents are often required to sign permission forms giving the school nurse authorization to administer the medication.
“Take medicines to school in their original labeled containers, whether prescribed or over-the-counter products,” says Dr. Hootman. “Before taking the medication to school, check with the school about its policies for doctor’s directions or any limitations as to what type of medications can be legally administered at school. Monitor when a new supply of medication is needed at school and take it to school so your child does not miss a dose.”
“If your child has a chronic condition, like asthma, allergies, diabetes, heart problems, or other health conditions that require routine medication, meet with the school nurse the first week of school, or prior to registration,” says Marie Dempsey, R.N., a school nurse in Feasterville, PA.
Recent Medical Developments
According to Dr. Meckler, Ritalin, which is given to kids with ADD and ADHD, is one of the most common drugs prescribed for school students today. Fortunately, time-released formulations of this medication have recently been developed, which enables many kids to avoid seeing a school nurse for their medication.
“As opposed to Ritalin’s original 2 to 3 times a day dosing, its new time-released formulations enable kids to take it once in the morning and once late in the afternoon after school,” says Dr. Daniel Hussar, Professor of Pharmacy at the Philadelphia College of Pharmacy in Philadelphia.
In addition to Ritalin, many antihistamines today offer few side effects and work for long durations of time, as opposed to the antihistamines we took when we were kids that caused sedation and often had to be administered four times a day. According to Dr. Hussar, Claritin and Zyrtec, both approved for school-aged children, offer once-a-day dosing.
Since many antibiotics can be administered once or twice a day, your child can usually return to school after being sick without visiting the school nurse for a dose of antibiotics. “I will go out of my way so a kid doesn’t need medicine in school by giving a medication that is dosed less frequently,” says Dr. Meckler.
“Parents should always talk to their medical provider about ways to arrange the schedule of taking medications or using a type of medication that will help them take most, and better yet, all medications at home,” says Dr. Hootman.
Establish a Healthy Routine
“A child’s sleep directly affects his school performance,” says Dr. Yankus, who currently serves as a school physician and has his own pediatric practice in Midland Park, NJ. “Younger children require 10–12 hours of sleep and most adolescents need to sleep at least 8–9 hours. Unfortunately, today, parents come home late from work, which often results in children going to sleep late. It is vitally important to establish a good cycle of sleep before the school year begins.”
Studies have proven that when schools provide universal breakfasts and lunches, students’ grades improve and SAT scores go up. “But today, everyone is in such a rush that kids usually eat something fast with lots of sugar,” says Dr. Yankus. “It is important to give your child plenty of time in the morning so he can eat a good, nutritious breakfast.”
According to Dr. Yankus, 90% of kids today are constipated because they don’t have enough time in the bathroom in the morning before they leave for school. “Give your child the time she needs in the morning to physically prepare for the day ahead,” says Dr. Yankus. “Remember that healthy kids learn better.”#