HopeHealth: Back-To-School

story by Michael K. Foxworth, MD, HopeHealth

For more than a year schools have been disrupted because of the coronavirus pandemic and it is more important than ever to be prepared for getting back to school. Vaccination requirements, sleep schedules, anxieties, and nutrition are all areas that can benefit from a little summer planning. “Summertime, before school starts, is a great time to make sure that vaccines are up to date and sports physicals and well-child checks are scheduled,” said Dr. Michael K. Foxworth II, a HopeHealth pediatrician in Florence.

Vaccinations

Keeping your child’s vaccinations up to date is one of the best ways to protect their future and many schools require certain vaccines for admittance. Immunization requirements for school entry generally follow the Centers for Disease Control and Prevention Advisory Committee on Immunization Practices guidelines. In South Carolina, that means: • Rising 7th graders are required to have received one dose of Tdap which protects from bacterial infections such as tetanus, diphtheria, and pertussis (whooping cough). • All 11- and 12-year-olds should also be vaccinated with a meningococcal conjugate vaccine (recommended booster dose at age 16.) • Beginning at age 11, the HPV vaccination is also recommended to protect against HPV infections that can cause cancer. A booster dose is recommended after 6-12 months.

• Teens and young adults (16-23 years) also may be vaccinated with a serogroup B meningococcal vaccine. Dr. Foxworth also recommends children age 12 and older get the COVID-19 vaccine. “The abundance of scientific evidence continues to support the facts: Vaccines are safe. Vaccines are effective. Vaccines save lives.”

While the Moderna vaccine administered at HopeHealth is not yet approved for those younger than 18, the Department of Health and Environment Control online vaccine locator can help you find where to get your child vaccinated for COVID-19 in your community: vaxlocator.dhec.sc.gov.

Sleep Schedule Getting back into a daily school routine is always important – and easier if you plan ahead and start adjusting your child’s sleep schedule a week or more before school starts, said Foxworth.

Inadequate sleep can cause daytime sleepiness and has been found to have a significant negative effect on school performance, cognitive function, and mood. “You don’t want the first day your child wakes up at 6 a.m. to be the first day back at school,” he said. To help your child be successful, the appropriate length and quality of sleep are also important. The National Sleep Foundation recommends: • preschoolers (3-5yo) – 10-13 hours per night • school-aged children (6-13yo) – nine-11 hours per night • teenagers (14-17yo) – eight-10 hours per night.

Anxiety Children can experience anxiety at the start of any school year, especially if starting a new school. Anxiety may look differently based on developmental age. The following information is a guide for what anxiety may look like based on a student’s age. Those in preschool-5th grade are concrete thinkers and may have trouble identifying or naming abstract feelings such as anxiety. Often, they do not have emotional or verbal skills to communicate what they are feeling. Watch for symptoms such as: • hyperactivity • thumb sucking or other self-soothing behaviors • easily distracted • sickness (stomach issues) • crying • difficulty with separation from a caregiver • bedwetting or daytime accidents Older students in 6–12th grade can usually think abstractly and understand more complex emotions such as anxiety but may lack coping skills. Symptoms of anxiety may include: • irritability • defiance • poor grades • concentration issues “Observe, listen, and be available for your child; simply being present and available can provide a forum for them to share their experiences,” said Toni Marie Wilson, behavioral health counselor at HopeHealth. “Avoid dismissing those feelings by saying things like, ‘There’s nothing to be nervous about!’ or ‘You shouldn’t feel scared.’ Instead, acknowledge their feelings are valid, and that they will be okay. Reassurance and understanding can go a long way.” Covid-19 can also cause anxiety. Remind your child to continue with good hand hygiene and wearing a mask at school. “It’s important they understand that if they want to wear a mask it is ok, even if others are not,” said Foxworth.

• trouble sitting still • sleep issues • isolation Nutrition

Skipping breakfast can be detrimental to your child’s day. Studies show children who eat breakfast perform better, have better concentration, and more energy. Caitlin Guess, a registered dietician nutritionist at HopeHealth, said a healthy breakfast that provides the necessary fuel to stay focused through the morning should include protein and whole grains. Ideas include: • Whole grain tortilla with nut butter and sliced banana • Fruit cup (packed in its own juice) and a boiled egg • Whole grain cereal (such as Cheerios or Corn Flakes) with low-fat milk, topped with fruit and nuts • Cheese toast and your favorite fruit • Whole grain toaster waffle topped with peanut butter/ vanilla yogurt mixture and berries

Well Child Visits & Physicals “All children should be seen by a medical provider every year for a Well Child Visit where they can discuss any concerns, complete physical exam forms for participation in sports, and receive other important guidance and immunizations,” said Dr. Foxworth. These visits should take place in a medical home, not in an emergency department or urgent care clinic. “Partnering with your child’s school and pediatrician, you can help ensure they have a successful and productive year,” he said.

1920 2ND LOOP RD. FLORENCE 843.432.3700 HOPE-HEALTH.ORG

Dr. Michael K. Foxworth II is a pediatrician and pediatric infectious disease specialist who practices at HopeHealth Pediatrics in Florence.