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It happens every year. The days get shorter, temperatures start to fall, and busses arrive to shuttle kids back to school. As summer ends, my patients’ parents often ask how to help their children stay healthy as they get ready to return to the classroom.
These are some of my favorite conversations, because there’s so much we can do to help kids feel their best, which can boost their performance in school and improve behavior at home. If we can help our kids establish helpful habits, they’ll be more likely to avoid health conditions that can cause problems now and in the future.
According to the U.S. Centers for Disease Control and Prevention (CDC), in 2022 8% of children age 5-11 missed 11 or more days of school due to illness, injury or disability. Almost 13% of children age 2-5 have obesity, and nearly 21% of children age 6-11 have the same diagnosis.
The state of children’s mental health in the U.S. has been labelled a crisis by the American Psychological Association. CDC data shows that prior to COVID-19, one in five children had a mental disorder, but only 20% of them were about to access care from a mental health provider.
Parents deserve a lot of credit for having proactive conversations with me about their child’s health. When we can keep kids healthy and prevent health conditions from taking hold, we stand an even better chance of helping them become vibrant, active adults.
With that in mind, here are some tips I share with parents to help their kids establish healthy habits that will serve them well in school and beyond.
1. Set a routine.
For almost all children, establishing routines provides a sense of predictability and structure, whether it’s in the daily steps of preparing for school or completing homework, eating, bathing, and going to bed.
Researchers studied the routines of more than 8,500 children and their families, finding that each daily ritual the families conducted equated to a 47% increase in the odds those kids would demonstrate healthy social and emotional skills.
Often, routines can get out of step in the summertime, so as kids head back to school, focus on re-establishing routines. School-aged kids need 8-12 hours of sleep depending upon their age. Keep in mind that weekends count, too—try to keep your bed-and-rise times consistent to make Mondays easier.
2. Eat three healthy meals a day.
Eating three balanced meals per day helps keep the mind and body fueled for learning and play.
Feed your children a variety of foods from these five groups:
- Vegetables: 3-5 servings per day
- Fruits: 2-4 servings per day
- Bread, cereal, or pasta: 6-11 servings per day
- Meat, poultry, and fish: 2-3 servings per day
- Milk, yogurt, and cheese: 2-3 servings per day
Remember that serving sizes are important. For instance, a serving of bread is one slice. It’s also important to limit processed foods, such as chips, fruit snacks, and cookies. Ultra-refined foods that bear no resemblance to their ingredients can harm our health. One reputable study found that s person’s risk of heart disease rises as much as 9% with each daily serving of these processed foods.
If your child prefers sweet treats, try cutting up fruits and vegetables to keep on hand. Often, snacking fills time during boredom, and kids will reach for whatever is the most convenient. Help them make a healthy choice by keeping good decisions like apple slices or carrot sticks within reach.
One of the dietary concerns parents discuss with me most often is skipping meals. It’s common for kids (and adults too) to get out of bed late and skip breakfast or decide not to have school lunch that day because it’s not appetizing. Skipping meals can lead to reduced focus and feeling “hangry” or irritable due to hunger.
3. Get a move on.
Our bodies were made for movement, so I often remind my young patients that the more they move the better they’ll feel. For younger kids, it’s important to stay active all day long. Parents can help encourage an active lifestyle by fostering play activities and outdoor time and helping young kids reduce their screen time.
For ages 6 and above, the CDC recommends at least 60 minutes of physical activity every day – but it doesn’t need to be all at once.
Most of this activity should include walking, running, and other ways to make the heart beat faster (cardiovascular exercise). Kids should do muscle-strengthening activities like climbing or bodyweight exercises three times per week and bone-strengthening movements such as jumping and running at least three days a week.
Parents, don’t count on physical education class and recess to add up to a day’s worth of activity for your child. The most important thing is to remember to encourage them move whenever possible.
4. Shut down the screens.
With computers, tablets, and smartphones becoming important education tools, it can be tough to ensure kids don’t spend the whole day plugged in. One study showed kids can become addicted to digital devices. Researchers found children as young as 10 showed addictive behaviors such as being drawn to immediate rewards despite long-term consequences.
Social media has been shown to be especially problematic for the mental health of school-aged children. According to a recent warning from the U.S. Surgeon General, teens who use social media for more than three hours per day have double the risk of reporting symptoms of depression and anxiety.
The American Academy of Pediatrics (AAP) guidelines recommend not more than two hours per day of non-educational screen time, including TV, video games, social media, etc. AAP also recommends against television and internet use in kids’ bedrooms, and some of my patients’ parents turn off the home Wi-Fi at bedtime so kids aren’t tempted to break the rules.
5. Do less if your child is over-scheduled.
Sometimes, parents of teens are concerned that their children don’t have the energy levels they should. We run tests and send a sample of blood to the lab, but the answer almost always lies in over-scheduling.
Kids are incredibly busy these days. Up in the morning and off to school, then a full day of learning before sports, music lessons, and other activities. Some of my patients don’t get home until after dinner and then it’s time to start homework. Burning the candle at both ends impacts their sleep and their health.
Overscheduled kids may feel tired and can display symptoms of anxiety and depression. Physical symptoms can include stomach aches due to stress and missed meals. They may fall behind on schoolwork, causing grades to slip and creating more stress.
Being busy is not necessarily the key to success. In fact, it can be harmful to children’s health. Encourage your kids to take on a reasonable number of after-school activities and help them make time for self-care and quality time with friends and family.
6. Stay hydrated.
Water makes up more than half of the body, and while you probably know it’s important to stay hydrated you may not realize how much volume it takes to hit that goal, even for kids.
- Ages 4-8: 40 ounces (5 cups) per day
- Ages 9-13: 56-64 ounces (7-8 cups) per day
- Ages 14-18: 64-88 ounces (8-11 cups) per day
Meeting these needs isn’t as simple as taking a water bottle along to school – but that helps. Very few of my patients stop to refill their water during the day, and most choose a sweeter beverage when it’s offered. Limit juices, sugary drinks, and flavored milks to occasional treats.
To help your kids stay hydrated, consider infusing water with berries, lemons, or cucumber to keep demand high. Keep healthy snacks like fruits and vegetables that are high in water on hand. Watermelon, strawberries, tomato, and zucchini are all great choices. Homemade popsicles with pureed fruit are great for a hydrating afternoon cool-down, too.
Individual water intake needs are different for every person, and kids who have been active outdoors may need to drink additional water to stay properly hydrated. Remember their bodies need water every day, even when they weather is cool.
Working together to benefit kids’ health.
They say an ounce of prevention is worth a pound of cure, but I think it might be worth even more than that. My work as a pediatrician allows me the opportunity to partner with parents on preventative measures to help kids stay healthy. We work together to help kids avoid outcomes like obesity, diabetes, anxiety, and depression.
Establishing routines, eating well, staying active, using screens in moderation, avoiding over-scheduling, and staying hydrated can go a long way toward helping healthy, happy kids become healthy, happy adults.