August marks our peak season for annual checkups as families proactively get their health requirements taken care of before the fall. Parents thumb through letters received from school about vaccine requirements. And I talk to parents and kids about vaccines, sleep, mood, focus and nutrition. As a board-certified pediatrician at Kaiser Permanente, I want to highlight the key health and emotional issues that every family should keep on their radar as they head into the school year.
Check your vaccinations
One of the most important steps parents can take before the school year begins is making sure their children are up to date on vaccinations. But if the school year has already started, don’t panic. Schedule an appointment with your child’s doctor to get immunizations up to date.
Vaccines protect not just your child, but the whole classroom and the community.
Starting kindergarten
DTaP, polio, MMR (measles, mumps and rubella), and varicella (chickenpox), which are essentially boosters of infant vaccines, plus all recommended infant vaccines before entering school.
Ages 9-11
HPV (Gardasil). HPV is commonly associated with sexual transmission, but we vaccinate early because the immune response is strongest at this age. Vaccination is about protecting against certain cancers later in life, not about anything happening now.
By age 11
Tdap (tetanus, diphtheria, pertussis) and the first meningococcal vaccine.
Around 16
The second meningitis vaccine is critical before kids head into college dorms or other close group living, where meningitis can spread fast and hit hard.
These life-saving vaccines have been given to children for decades. Many parents are concerned about long-term side effects, but serious side effects are extremely rare. Most children only experience minor, temporary side effects such as soreness at the injection site or mild body aches. The benefits of vaccination far outweigh these short-term side effects.
The sleep debt your kid is already carrying
By the end of summer, most kids are running on a bedtime that’s an hour or two later than the school year allows — and that debt doesn’t pay itself off on the first day of class. Sleep drives mood, focus and academic performance more than anything else parents can control.
Start easing into a school-year routine a couple of weeks before school starts. This means shifting bedtime one hour earlier every couple of days or each week until your child is back to an appropriate bedtime for the school year. If you missed this window, don’t panic. Make small adjustments to your child’s sleep schedule during the first weeks of school.
I recommend approximately nine to 10 quality hours of sleep each night for school-aged children. Quality sleep means sleeping through the night with minimal interruptions.
How do you know if your child is running on empty? The signs look different by age:
- Kindergarten (5-6 years): your child is still napping in the afternoon most days.
- Elementary school: your child seems tired all day, has trouble focusing, or frequently naps after school.
- Older kids: your teen seems unusually grumpy or struggles with their homework.
If you see any of the above signs, let your child’s pediatrician know.
Talk to your children about their sleep and encourage good sleep hygiene: no phones close to bedtime, sleeping in a cool, dark room, and having a wind-down routine an hour or so before lights out.
An extra note about phones: Research has shown that the blue light emitted from phone screens can suppress melatonin – a hormone that rises around bedtime and helps promote sleep – which is why I often advise patients to avoid screens for at least one to two hours before bedtime. Also, when limiting screens before bed, children are more likely to spend adequate time in the deeper, more restorative, stages of sleep. Set guidelines, rules and have them physically give you the phone at a certain time each night, such as 8 p.m. Kids will get upset with these rules, but they are necessary to avoid falling into a complete technology dependency.
How to address bullying
Academic success is important, but a child’s social and emotional well-being matters just as much. Unfortunately, bullying remains a challenge for many students.
Research shows that around 24% of kids will experience bullying in their K-12 years in school, and cyberbullying has only made it harder to spot; cyberbullying doesn’t stop when the school day ends. If you give your child access to phones and social media, make sure they don’t have unrestricted access.
Watch for a shift, not just a bad day:
- Being more withdrawn in social interactions and peer interactions.
- Showing a clear change in personality: a normally chatty kid goes flat, or a normally easygoing kid gets defensive fast.
- Becoming fixated on or critical of one part of their appearance, sometimes traceable to a comment online or comments from peers.
These changes do not necessarily mean your child is being bullied, but they may indicate that something is affecting them emotionally or socially. Try to build trust with your children so they come to you when problems arise.
When grades slip: Ruling in and ruling out
The first signs of a problem at school are rarely a bad report card. You may see your child losing interest in schoolwork, becoming frustrated with assignments, or expressing negative feelings about a particular class or teacher.
If their grades are dropping despite effort, try ruling out factors such as ADHD, learning differences, sleep problems, anxiety and other health concerns. Teachers are often the first to recognize when a child is struggling academically.
One useful test: Is the struggle everywhere, or just in one class? For example, if they perform well in English but struggle significantly in math, that may indicate a learning disability.
In this case, I encourage you to talk to your pediatrician and work with your child’s school to explore evaluation and support options. Early identification and help can make a significant impact on how the child succeeds academically.
Pack nutritious lunches
Good nutrition fuels learning, concentration, physical activity and overall health. The eating habits you teach your kids can influence their choices for years to come.
Set the tone inside the household for how you want them to eat, because that will affect what foods they choose when you no longer pack their lunch.
Make lunches colorful! Kids are drawn to bright colors and variety. Skip the highly processed, prepackaged snacks (chips and crackers) whenever possible and pack more whole foods.
A salad with ranch dressing and cherry tomatoes on the side, hummus and carrots, or a turkey sandwich, are all good examples of healthy lunches or snack options.
If your child ate the sandwich and left the salad untouched, don’t give up. Repeated exposure to healthy foods can help children become more comfortable with trying them over time. You may need to try a dozen times before one sticks.
The bottom line
The transition back to school is more than buying a backpack and organizing schedules. The start of the new school year is an opportunity to establish healthy habits. Vaccines, sleep, open communication, monitoring academic progress and meals that fuel a school day help set your children up for success inside and outside the classroom. If something feels off about your child’s physical, emotional, or developmental health, don’t wait for the next well visit. Reach out to your child’s doctor so we can help your child start the school year on a strong note.
More back to school help: School calendar for DC, Maryland and Northern Virginia | After school activities guide | Back to school guide
Dr. Azadeh Sami, MD, is a board-certified pediatrician with the Mid-Atlantic Permanente Medical Group. She sees patients at the Kaiser Permanente Fair Oaks Medical Center.
