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Sanjay Gupta MD
Getting Healthy Kids Ready for School
Aired August 28, 2004 - 08:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DREW GRIFFIN, ANCHOR: Two men have been arrested in New York in an alleged plot to bomb a subway station in Manhattan. The station is near Madison Square Garden. That's where the Republican convention begins Monday. But authorities are saying they can find no evidence the men planned to disrupt the convention. They say the two tried to get explosives to bomb that station but failed. The A.P., "New York Times" both reporting this story this morning.
The FBI is taking a close look at the Pentagon. Sources say that the agency has evidence a Pentagon employee may be spying for Israel. The person is said to work in a high level office there. Israeli -- Israel denies the allegation, saying it would never do anything to hurt ties with the U.S.
Secretary of State Colin Powell will stay in Washington this weekend. He's canceling a trip to Athens for the closing ceremony of the Olympics tomorrow. Athens has been the scene of the anti-American protest, but U.S. officials say that did not prompt Powell's decision. They say he's busy dealing with events in Iraq and Sudan.
And just in from Russia, security officials now say they found traces of explosives in the wreckage of a second doomed airplane. They found similar traces in the other plane earlier. Both jets crashed within minutes of each other on Tuesday.
That's news. HOUSE CALL with Dr. Sanjay Gupta begins now.
DR. SANJAY GUPTA, HOST: Good morning. Welcome to HOUSE CALL.
Well, summer is almost over, and children are heading back to school. But being prepared for class is about much more than just having the right school supplies. Is your child emotionally and physically ready for the strain of a brand new school year?
Christy Feig looks at one way to get your kids rested and ready to go.
(BEGIN VIDEOTAPE)
CHRISTY FEIG, CNN MEDICAL CORRESPONDENT (voice-over): Although school hasn't started yet for their children, the Ambaye family is already trying to develop a routine to make the transition smooth.
MEKONEN AMBAYE, FATHER: Cut the TV hours. They cut their play hours and more into study, more into drawing, more into reading and more into nights (ph).
FEIG: Like many children, the Ambaye boys visited their doctor for a back to school checkup and any shots they might need.
But the hardest part is getting kids who spent the summer staying up late ready to start waking up early.
AMBAYE: They got in at 8:30. And 8:45 the school started. And at 3 p.m. they finished.
FEIG: Doctor Fissera Tekle-Wolo recommends beginning a new sleeping schedule about two weeks before school starts. Otherwise it could affect their performance.
DR. FISSERA TEKLE-WOLO, WASHINGTON HOSPITAL CENTER: They cannot concentrate. A mind that has no place to relax (ph) is not going to learn the next day.
FEIG: To switch your child's sleeping schedule, she recommends putting your child in a quiet place like their bedroom by 8 p.m. Make sure there is no TV there to distract them. And if possible, use that time for reading.
Christy Feig, CNN, Washington.
(END VIDEOTAPE)
GUPTA: Thanks, Christy.
A recent survey by the National Sleep Foundation found 15 percent of children under 18 reported falling asleep at school, and 60 percent said they were tired during the day.
Not surprisingly, we received lots of questions about this topic. Joining us to help answer your questions about all matters related to back to school health, Dr. Seema Tsukas. She's a pediatrician from children's health care of Atlanta. That's one of the top children's hospitals in the country.
Thanks for joining us.
DR. SEEMA TSUKAS, PEDIATRICIAN: Pleasure to be here.
GUPTA: You're a pediatrician and you have three children of your own. They're already back in school. How is it going?
TSUKAS: It's going OK. A little tough at first, but we're getting there.
GUPTA: Sleeping OK?
TSUKAS: They're trying.
GUPTA: That's a big topic, sleep. And let's try to get to lots of questions coming on that. Let's get to one of them right away. This is -- a roving camera found this mom who is concerned about how many hours of sleep her child should be getting.
(BEGIN VIDEO CLIP) UNIDENTIFIED FEMALE: Some guidelines to follow to get them in a better bedtime routine and what the guidelines are as far as when -- as they get up in the years.
(END VIDEO CLIP)
GUPTA: So guidelines and as they get older, do those guidelines change?
TSUKAS: Well, I think in general kids need anywhere between 10 to 12, 13 hours a sleep, which sounds like a lot but for kids, definitely something that they need.
The school age kids, the younger kids, probably looking at more in the 12 to 13 hour range. The older kids, the adolescents, you're maybe looking more in the 10 or 11 hour range.
GUPTA: I wish I got that much sleep myself. Is it -- you know, they've been staying late -- staying up late all summer long. How do you get them back on the schedule?
TSUKAS: Well, you try to do it before the school day starts. Maybe a week, maybe several weeks in advance.
And the idea is to -- between the parent and child, you have to know what the bedtime is. And once you've established what the bedtime is, then you know, you set a pattern. You do quiet things before its bedtime. This is not the time to be watching TV with an action show.
GUPTA: Right.
TSUKAS: This is a time to read to your child, maybe some quiet music, something to help calm them down as they get ready for sleep.
GUPTA: Some tough love, but that may pay off later on in the year.
The American Academy of Pediatrics has some more back to school basics to ensure your child is physically ready for school.
At the top of the list, vaccinations and making sure your child is up to date. We have a sort of little image there of what vaccinations your child should be getting: measles, mump and rubella; diphtheria, tetanus and pertussis; and the polio vaccine.
You recommend all of these?
TSUKAS: Yes, these are the vaccines that are recommended by the American Academy of Pediatrics. Traditionally, these would be given between age 4 and age 6.
GUPTA: There is some controversy over these vaccines. Maybe some of that has gone away now. But there was a concern that they could be related to autism.
TSUKAS: Yes, I think the more recent research has kind of swayed away from that particular problem.
GUPTA: Any reason not to get these vaccines?
TSUKAS: No. Definitely not. As a result of these vaccines, we've kind of almost eliminated a lot of diseases, and it's certainly very important for kids to have them.
GUPTA: All right. Next up, is well, get the eye doctor and dentist appointments done now to catch any problems before classes start. Also if your child is going to participate in sports, most schools require physicals before the season starts.
Make sure to alert the school about any chronic conditions your child has, such as asthma or if your child has to take a medication during the school day. That can be tough sometimes, medications for children. Is there a program, a method to make sure they get those medications during the day?
TSUKAS: I think it's important if your child is on a medication that they need to be taking at school, talk to the school, talk to the principal. If there's a nurse at the school, they need to be informed on what the medications are. You will probably need a note from your physician that says that it's OK to take this particular medicine, as well as permission from the parent.
GUPTA: And again, obviously, do that all well in advance, right?
TSUKAS: Yes, definitely.
GUPTA: All right. As kids go back to school, they will inevitably catch some of the cold and flu bugs that are going around. We hear about those.
According to the Mayo Clinic, the average child comes down with as many as 10 infectious diseases a year. But there are ways to help your child stay healthier.
Encourage them to wash their hands. I know we always say that, but it's important. Don't necessarily share cups, foods, things like that. And use tissues as much as possible.
What else can they do? You know, these kids, they always strike me as sort of being germ factories. They're running around. Anything else they can do to try and cut down on the number of colds and flus?
TSUKAS: Well, certainly, beginning of the school year is the toughest time, because they've been away from each other all summer. And all of a sudden, you're in an environment with all the kids in one little place. It is hard.
And the things you recommend, washing hands is the No. 1 way to prevent those kinds of things. I think it's also good to encourage kids, when they come home from school, have them wash their hands, change their clothes so they're not bringing those germs home to the family.
GUPTA: Do you recommend those alcohol based washing lotions?
TSUKAS: I think those are fine on a short-term basis. Eventually, they do start to dry out your hands.
GUPTA: OK.
TSUKAS: So if you have no soap and water available, those are great alternatives.
GUPTA: All right. Really good advice.
We're talking to Dr. Seema Tsukas. We've talked about keeping your child's body healthy. Coming up, we'll be talking about keeping their spirits strong, as well. Plus, many more of your e-mail questions and answers. All of that straight ahead.
(BEGIN VIDEO CLIP)
ANNOUNCER: They're carrying the weight of the world, or at least homeroom. How backpacks could be hazardous to your child's health.
Plus, when your little one is having a difficult time letting go. How to keep your child and you cool, calm and collected on the first day of school.
But first, take our "Daily Dose" quiz. How many American children are home schooled? The answer when HOUSE CALL returns.
(COMMERCIAL BREAK)
(BEGIN VIDEO CLIP)
ANNOUNCER: Taking the "Daily Dose" quiz. We asked how many American children are home schooled? According to the U.S. Census Bureau, about 850,000 children stay home for school. That's two percent of all kids age 5 to 17.
(END VIDEO CLIP)
GUPTA: Well, some children can be uncertain or even frightened when the time comes to head off to school for the first time. But as CNN's Holly Firfer reports, there are ways to alleviate the back to school blues.
(BEGIN VIDEOTAPE)
HOLLY FIRFER, CNN MEDICAL CORRESPONDENT (voice-over): Anna is like any other 5-year-old, a happy child starting kindergarten. And just like some other kids being left by their parents for first time, Anna is having bouts of separation anxiety from her parents.
LORIE, MOTHER: When I leave her every day, and she's in tears, it just -- it eats at me all day. So I can't really think about anything else, and I'm wondering what she's doing, and my stomach has been in knots. FIRFER: According to child psychologist Ann Hazzard, about four percent of kids going to school or going back to school experience distress. And she adds although a little anxiety is natural, parents must be aware of when it can become a serious problem.
ANN HAZZARD, EMORY CHILD PSYCHOLOGIST: When it gets to the point that the child doesn't want to go to school or the child has difficulty settling down and enjoying school and learning, once the parent is gone, that it would become a significant concern.
FIRFER: But for most, small reassurances are all that are needed to help a child adjust to time away from home.
HAZZARD: Keep the good-bye fairly brief. Often parents hope that if they provide continued reassurance, that will be helpful. But sometimes that just prolongs the agony, really.
FIRFER: If a child is strongly attached to one parent, it might to help to have someone else handle the transition to school: the other parent for a baby-sitter.
Giving a transitional object like a locket or a photo or something of the parents to the child to hold onto while he or she is away can be helpful, as can developing a rewards system. For every morning the child makes it to school without crying, he or she earns points, and they add up to a special activity with the parent on the weekend.
Most importantly, the parent needs to remain calm and in control. As many moms and dads know it can be extremely tough.
Holly Firfer, CNN, Atlanta.
(END VIDEOTAPE)
GUPTA: Holly, thank you.
The back to school blues can be hard to navigate. So joining us again to help navigate is pediatrician Dr. Seema Tsukas to answer all of your questions. Lots of e-mails coming in on this topic, as well. Let's try and get to as many as we can.
Michael in Vermont asks, "My 3-year-old daughter is switching preschools this autumn." Very young. She's attached, it seems, to a couple of teachers at the old school. What do you suggest to make the transition easier for her?
TSUKAS: It is a difficult time. And I think the thing that's going to help you the most is having information.
So go to the new school, find out about the school, meet the teachers, take your child with you. Let her get introduced to the teachers. If possible, let her spend a few hours there, just to get a feel for what it's going to be like.
GUPTA: Good advice. Of course, kids aren't the only ones that have problems saying good-bye when it comes time to go back to school. We have this e-mail from James in Ontario.
He asks, "My wife is really anxious about our daughter going to kindergarten, to the point that it is preventing her from performing her daily chores. What can she and I do to ease her tension and prepare her for the inevitable?"
So this is the anxiety on the parental side on the parental side, as well.
TSUKAS: Same kind of thing. You want them to have information, visit the school. And the nice thing about kindergarten and at any school age is parents can get involved. You don't have to separate from your child. You can be involved with the school, participate in activities is a great way to keep up with what's going on with your child.
GUPTA: Short good-byes, Holly mentioned in the piece. Important to do that?
TSUKAS: I think so. I think the longer you prolong the good- byes, it's harder for both of you. So say your good-byes and wish them the best of luck during the day.
GUPTA: Right. We have another e-mail question coming in about older kids having school anxiety. Russ in Leesburg, Virginia, asks, "I have a 13-year-old about to enter the ninth grade in high school. I was wondering if there was anything I could do to calm her fears, besides telling her that everything will be OK?"
TSUKAS: Similar kind of thing. You want them to possibly go to the school, meet the teachers, get a feel for the neighborhood. There may be other kids in the neighborhood who are going there. Introduce your child to other kids in the neighborhood. If they have specific interests, music, sports, get them involved in those activities at school. That's a great way to meet new friends.
GUPTA: How do you know when it's -- when it's just not going well. At what point should they, you know, start seeing somebody, a psychologist or somebody about the problem?
TSUKAS: I think, you know, you need to make sure that your child is talking to you. You ask questions. Make sure the counselor is available, something you can discuss with the counselor at the school, as well. And that will probably help you with some guidance. And then talk to your pediatrician.
GUPTA: So sometimes that is going to be necessary.
TSUKAS: Definitely.
GUPTA: When you get to school, one of the things you and I have seen are those heavy backpacks.
TSUKAS: Yes.
GUPTA: That can be a problem as well. Heavy backpacks can be more than a pain for your kids. They could actually be injuring them for life. Details on that coming up, as well.
(BEGIN VIDEO CLIP)
ANNOUNCER: A healthy lunch is food for the brain.
UNIDENTIFIED MALE: I think I've had a problem now because I've had nachos every day at school and it's starting to get to my stomach a little bit.
ANNOUNCER: But how do you get your child to eat well at school? Some tips on that.
But first, here's a tip for you from the Bod Squad.
UNIDENTIFIED FEMALE: Imagine being able to train your mind so that you will actually crave regular exercise and healthy food. That's exactly what David Kirsch promises to do.
DAVID KIRSCH, PHYSICAL TRAINER: (NO AUDIO)
UNIDENTIFIED FEMALE: All for a mere $275 an hour for each personal session.
These days it's not enough to have a trainer hovering over you in the gym as you sweat and flex your way to body beautiful.
KIRSCH: (NO AUDIO)
UNIDENTIFIED FEMALE: His principles are based on the idea of building a sound mind and sound body, the very title of his book, where he maps out his version of the food and fitness gospel.
Here, sauteed equals sinful, steamed says wholesome.
Kirsch's commitment to success extends beyond the studio. For $60 a day his food delivery service will drop off gourmet style low fat meals at your door.
Holly Firfer, CNN.
(END VIDEO CLIP)
(COMMERCIAL BREAK)
GUPTA: They seem harmless enough, but your child's backpack could be more than a pain in the neck. Carrying a heavy backpack can lead to problems later in life.
Here are some hints to keep your child healthy.
First of all, pack light. The backpack should never weigh more than 10 percent of your child's body weight.
Use both shoulder straps. Slinging a backpack over one shoulder may look cool, but it can strain muscles and can increase the curvature of the spine. Also, tighten the straps when the pack is close to the body. The straps should hold the pack two inches above the waist.
Organize the backpack, as well, to use all of its compartments. Pack heavier items closer to the center of the backpack.
You see a lot of these types of injuries?
TSUKAS: Definitely. We had a lot of kids coming in, complaining about neck pain, shoulder pain. Very common to see with all the books that they're carrying.
GUPTA: What sort of -- Is that the sort of advice you typically give them?
TSUKAS: Yes, I think it's good advice. You want to make sure you find a backpack that's an appropriate size for your child, one that's fairly lightweight, because it's going to have a lot of books in it as it is.
Rolling backpacks are very popular these days.
GUPTA: Yes.
TSUKAS: Another great way to manage that. Although keep in mind, if you have stairs in your school, you're still going to have to pick it up and carry it.
GUPTA: Right. Ten percent, that's a good sort of rough number.
TSUKAS: Yes.
GUPTA: All right. From heavy backpacks to eating lighter, we had several questions about kids and school nutrition, including this one from Ora in New York: "How do you introduce a healthier diet and lifestyle to children without making them feel punished?"
So they've been getting chocolate and candy all summer long and all of a sudden they've got to eat healthy, right?
TSUKAS: Well, the idea is not to think that this is a punishment, that eating healthy is a good thing. You want to make sure it's part of your everyday life. There's nothing wrong with chocolates and other things, but you want to keep it to a minimum.
I think, you know, if the parents are enjoying it, it's not something they're forcing on the kids but giving them an option to try those things.
GUPTA: And practice what you preach, right?
TSUKAS: Definitely.
GUPTA: Don't be sneaking ice cream on your kids.
Even kids had some concerns about this topic of nutrition. We have this e-mail from Shalim in New Jersey. She says, "I am 12 years old and perfectly healthy. What do I need to know about school lunches and how not to eat too much unhealthy food?"
A 12-year-old wants to know.
TSUKAS: I commend a 12-year-old for asking a question like that. That's wonderful. In today's times we're seeing so much of childhood obesity. That is a very good question and something that needs to be addressed.
You want to make sure that you know what's being served in school. I think schools in general are making more of an effort to provide healthier meals.
The biggest offender, I think, is drink machines. You certainly want to try to stay away from the soda machines as much as possible. You know, healthy alternatives, water, fruit juices, those kinds of things.
Look at the menu that the school is offering. If it's not something you like, think about bringing something from home.
GUPTA: You mention these vending machines. They're -- they're a huge problem, I think, in some ways when you have the -- there are kids who never had sugary sodas, for example, and all of a sudden you have all these things available to them.
Any advice you can give to either children or their parents about trying to stay away from those?
TSUKAS: I think if children are given alternatives, then they're going to choose things that they're comfortable with. Low fat milk is available in the school. Water is available in the school, as well. So there are alternatives. As long as that's the case, then hopefully you talk to your child and encourage them to pick -- pick the right alternatives.
GUPTA: Encourage the water instead of the soda pop.
All right. Some back to school food for thought, that's coming up straight ahead.
(BEGIN VIDEO CLIP)
ANNOUNCER: Staying informed and staying healthy, a look at some sources for parents and kids.
But first, a look at some of this week's medical headlines in this edition of "The Pulse."
FEIG: Drinking sugary beverages increases a woman's risk of developing Type 2 diabetes, says a new study in the "Journal of the American Medical Association."
The study followed more than 50,000 women over a nine-year period and found that those who drank one or more sugary sodas or juices a day had double the risk of developing Type 2 diabetes.
And the number of Americans with high blood pressure is on the rise, according to a report by the American Heart Association. The study reports that 33 percent of Americans have high blood pressure, up from just 25 percent in 1990.
Major risk factors for high blood pressure include old age, obesity and lack of physical activity.
Christy Feig, CNN.
(END VIDEO CLIP)
(COMMERCIAL BREAK)
GUPTA: For more information about getting your child ready for school, check out the American Academy of Pediatrics web site. That's at AAP.org. Also, logon to MayoClinic.com. Both those web sites have special features about getting your child back to school healthy.
Very interesting show. We've got one -- we've got time for one more final e-mail question. This comes from Latha in Illinois. She says, "My daughter will be the youngest child in her first grade class. Although she is academically well advanced, I am a little concerned about her ability to interact socially with her peers. What does a parent need to keep in mind?"
TSUKAS: I think at that age there are going to be differences in how that child interacts with other kids.
Again, talk to your child, explain what's going to be happening in school. Find out from your child how did the school day go so you can get some feedback from your child in their opinion.
GUPTA: Do you think it's a good idea in general for -- for kids to skip grades, to sort of go along a little faster than their peers?
TSUKAS: I think that depends. It depends on the child. Just having the ability to do the work is not everything. Maturity is important. And that's a decision the parents have to make...
GUPTA: Right.
TSUKAS: ... with the teachers and the counselors, figure out what's best for their child.
GUPTA: It's not always a good idea, maybe?
TSUKAS: Not always.
GUPTA: We've been talking to Dr. Seema Tsukas. Any final thoughts you'd like to leave with all of our viewers today?
TSUKAS: Yes, I think safety is something to think about. School year has started.
People have to know to slow down when they're in school zones, observe the speed limits in the school zones.
Kids who are riding bikes to school, make sure they're wearing their bike helmets. Kids who are riding the bus, make sure when they're on the bus, they're sitting down and when they're off the bus, that the bus driver can see them until they've gotten to where they need to get to.
GUPTA: Really good advice. Safety first, as always, right?
TSUKAS: Definitely.
GUPTA: All right. Well, that's all the time we have for today. Tune in next week for a look at some medical myths: the good, the bad and the ugly, how you could be hurting yourself with medical misinformation.
Thanks for watching. And thanks to Dr. Seema Tsukas, as well. Thanks to all of you at home for your questions. Stay tuned now for more news on CNN.
BETTY NGUYEN, ANCHOR: Well, good morning from the CNN Center here in Atlanta. This is...
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Aired August 28, 2004 - 08:30 ET
THIS IS A RUSH TRANSCRIPT. THIS COPY MAY NOT BE IN ITS FINAL FORM AND MAY BE UPDATED.
DREW GRIFFIN, ANCHOR: Two men have been arrested in New York in an alleged plot to bomb a subway station in Manhattan. The station is near Madison Square Garden. That's where the Republican convention begins Monday. But authorities are saying they can find no evidence the men planned to disrupt the convention. They say the two tried to get explosives to bomb that station but failed. The A.P., "New York Times" both reporting this story this morning.
The FBI is taking a close look at the Pentagon. Sources say that the agency has evidence a Pentagon employee may be spying for Israel. The person is said to work in a high level office there. Israeli -- Israel denies the allegation, saying it would never do anything to hurt ties with the U.S.
Secretary of State Colin Powell will stay in Washington this weekend. He's canceling a trip to Athens for the closing ceremony of the Olympics tomorrow. Athens has been the scene of the anti-American protest, but U.S. officials say that did not prompt Powell's decision. They say he's busy dealing with events in Iraq and Sudan.
And just in from Russia, security officials now say they found traces of explosives in the wreckage of a second doomed airplane. They found similar traces in the other plane earlier. Both jets crashed within minutes of each other on Tuesday.
That's news. HOUSE CALL with Dr. Sanjay Gupta begins now.
DR. SANJAY GUPTA, HOST: Good morning. Welcome to HOUSE CALL.
Well, summer is almost over, and children are heading back to school. But being prepared for class is about much more than just having the right school supplies. Is your child emotionally and physically ready for the strain of a brand new school year?
Christy Feig looks at one way to get your kids rested and ready to go.
(BEGIN VIDEOTAPE)
CHRISTY FEIG, CNN MEDICAL CORRESPONDENT (voice-over): Although school hasn't started yet for their children, the Ambaye family is already trying to develop a routine to make the transition smooth.
MEKONEN AMBAYE, FATHER: Cut the TV hours. They cut their play hours and more into study, more into drawing, more into reading and more into nights (ph).
FEIG: Like many children, the Ambaye boys visited their doctor for a back to school checkup and any shots they might need.
But the hardest part is getting kids who spent the summer staying up late ready to start waking up early.
AMBAYE: They got in at 8:30. And 8:45 the school started. And at 3 p.m. they finished.
FEIG: Doctor Fissera Tekle-Wolo recommends beginning a new sleeping schedule about two weeks before school starts. Otherwise it could affect their performance.
DR. FISSERA TEKLE-WOLO, WASHINGTON HOSPITAL CENTER: They cannot concentrate. A mind that has no place to relax (ph) is not going to learn the next day.
FEIG: To switch your child's sleeping schedule, she recommends putting your child in a quiet place like their bedroom by 8 p.m. Make sure there is no TV there to distract them. And if possible, use that time for reading.
Christy Feig, CNN, Washington.
(END VIDEOTAPE)
GUPTA: Thanks, Christy.
A recent survey by the National Sleep Foundation found 15 percent of children under 18 reported falling asleep at school, and 60 percent said they were tired during the day.
Not surprisingly, we received lots of questions about this topic. Joining us to help answer your questions about all matters related to back to school health, Dr. Seema Tsukas. She's a pediatrician from children's health care of Atlanta. That's one of the top children's hospitals in the country.
Thanks for joining us.
DR. SEEMA TSUKAS, PEDIATRICIAN: Pleasure to be here.
GUPTA: You're a pediatrician and you have three children of your own. They're already back in school. How is it going?
TSUKAS: It's going OK. A little tough at first, but we're getting there.
GUPTA: Sleeping OK?
TSUKAS: They're trying.
GUPTA: That's a big topic, sleep. And let's try to get to lots of questions coming on that. Let's get to one of them right away. This is -- a roving camera found this mom who is concerned about how many hours of sleep her child should be getting.
(BEGIN VIDEO CLIP) UNIDENTIFIED FEMALE: Some guidelines to follow to get them in a better bedtime routine and what the guidelines are as far as when -- as they get up in the years.
(END VIDEO CLIP)
GUPTA: So guidelines and as they get older, do those guidelines change?
TSUKAS: Well, I think in general kids need anywhere between 10 to 12, 13 hours a sleep, which sounds like a lot but for kids, definitely something that they need.
The school age kids, the younger kids, probably looking at more in the 12 to 13 hour range. The older kids, the adolescents, you're maybe looking more in the 10 or 11 hour range.
GUPTA: I wish I got that much sleep myself. Is it -- you know, they've been staying late -- staying up late all summer long. How do you get them back on the schedule?
TSUKAS: Well, you try to do it before the school day starts. Maybe a week, maybe several weeks in advance.
And the idea is to -- between the parent and child, you have to know what the bedtime is. And once you've established what the bedtime is, then you know, you set a pattern. You do quiet things before its bedtime. This is not the time to be watching TV with an action show.
GUPTA: Right.
TSUKAS: This is a time to read to your child, maybe some quiet music, something to help calm them down as they get ready for sleep.
GUPTA: Some tough love, but that may pay off later on in the year.
The American Academy of Pediatrics has some more back to school basics to ensure your child is physically ready for school.
At the top of the list, vaccinations and making sure your child is up to date. We have a sort of little image there of what vaccinations your child should be getting: measles, mump and rubella; diphtheria, tetanus and pertussis; and the polio vaccine.
You recommend all of these?
TSUKAS: Yes, these are the vaccines that are recommended by the American Academy of Pediatrics. Traditionally, these would be given between age 4 and age 6.
GUPTA: There is some controversy over these vaccines. Maybe some of that has gone away now. But there was a concern that they could be related to autism.
TSUKAS: Yes, I think the more recent research has kind of swayed away from that particular problem.
GUPTA: Any reason not to get these vaccines?
TSUKAS: No. Definitely not. As a result of these vaccines, we've kind of almost eliminated a lot of diseases, and it's certainly very important for kids to have them.
GUPTA: All right. Next up, is well, get the eye doctor and dentist appointments done now to catch any problems before classes start. Also if your child is going to participate in sports, most schools require physicals before the season starts.
Make sure to alert the school about any chronic conditions your child has, such as asthma or if your child has to take a medication during the school day. That can be tough sometimes, medications for children. Is there a program, a method to make sure they get those medications during the day?
TSUKAS: I think it's important if your child is on a medication that they need to be taking at school, talk to the school, talk to the principal. If there's a nurse at the school, they need to be informed on what the medications are. You will probably need a note from your physician that says that it's OK to take this particular medicine, as well as permission from the parent.
GUPTA: And again, obviously, do that all well in advance, right?
TSUKAS: Yes, definitely.
GUPTA: All right. As kids go back to school, they will inevitably catch some of the cold and flu bugs that are going around. We hear about those.
According to the Mayo Clinic, the average child comes down with as many as 10 infectious diseases a year. But there are ways to help your child stay healthier.
Encourage them to wash their hands. I know we always say that, but it's important. Don't necessarily share cups, foods, things like that. And use tissues as much as possible.
What else can they do? You know, these kids, they always strike me as sort of being germ factories. They're running around. Anything else they can do to try and cut down on the number of colds and flus?
TSUKAS: Well, certainly, beginning of the school year is the toughest time, because they've been away from each other all summer. And all of a sudden, you're in an environment with all the kids in one little place. It is hard.
And the things you recommend, washing hands is the No. 1 way to prevent those kinds of things. I think it's also good to encourage kids, when they come home from school, have them wash their hands, change their clothes so they're not bringing those germs home to the family.
GUPTA: Do you recommend those alcohol based washing lotions?
TSUKAS: I think those are fine on a short-term basis. Eventually, they do start to dry out your hands.
GUPTA: OK.
TSUKAS: So if you have no soap and water available, those are great alternatives.
GUPTA: All right. Really good advice.
We're talking to Dr. Seema Tsukas. We've talked about keeping your child's body healthy. Coming up, we'll be talking about keeping their spirits strong, as well. Plus, many more of your e-mail questions and answers. All of that straight ahead.
(BEGIN VIDEO CLIP)
ANNOUNCER: They're carrying the weight of the world, or at least homeroom. How backpacks could be hazardous to your child's health.
Plus, when your little one is having a difficult time letting go. How to keep your child and you cool, calm and collected on the first day of school.
But first, take our "Daily Dose" quiz. How many American children are home schooled? The answer when HOUSE CALL returns.
(COMMERCIAL BREAK)
(BEGIN VIDEO CLIP)
ANNOUNCER: Taking the "Daily Dose" quiz. We asked how many American children are home schooled? According to the U.S. Census Bureau, about 850,000 children stay home for school. That's two percent of all kids age 5 to 17.
(END VIDEO CLIP)
GUPTA: Well, some children can be uncertain or even frightened when the time comes to head off to school for the first time. But as CNN's Holly Firfer reports, there are ways to alleviate the back to school blues.
(BEGIN VIDEOTAPE)
HOLLY FIRFER, CNN MEDICAL CORRESPONDENT (voice-over): Anna is like any other 5-year-old, a happy child starting kindergarten. And just like some other kids being left by their parents for first time, Anna is having bouts of separation anxiety from her parents.
LORIE, MOTHER: When I leave her every day, and she's in tears, it just -- it eats at me all day. So I can't really think about anything else, and I'm wondering what she's doing, and my stomach has been in knots. FIRFER: According to child psychologist Ann Hazzard, about four percent of kids going to school or going back to school experience distress. And she adds although a little anxiety is natural, parents must be aware of when it can become a serious problem.
ANN HAZZARD, EMORY CHILD PSYCHOLOGIST: When it gets to the point that the child doesn't want to go to school or the child has difficulty settling down and enjoying school and learning, once the parent is gone, that it would become a significant concern.
FIRFER: But for most, small reassurances are all that are needed to help a child adjust to time away from home.
HAZZARD: Keep the good-bye fairly brief. Often parents hope that if they provide continued reassurance, that will be helpful. But sometimes that just prolongs the agony, really.
FIRFER: If a child is strongly attached to one parent, it might to help to have someone else handle the transition to school: the other parent for a baby-sitter.
Giving a transitional object like a locket or a photo or something of the parents to the child to hold onto while he or she is away can be helpful, as can developing a rewards system. For every morning the child makes it to school without crying, he or she earns points, and they add up to a special activity with the parent on the weekend.
Most importantly, the parent needs to remain calm and in control. As many moms and dads know it can be extremely tough.
Holly Firfer, CNN, Atlanta.
(END VIDEOTAPE)
GUPTA: Holly, thank you.
The back to school blues can be hard to navigate. So joining us again to help navigate is pediatrician Dr. Seema Tsukas to answer all of your questions. Lots of e-mails coming in on this topic, as well. Let's try and get to as many as we can.
Michael in Vermont asks, "My 3-year-old daughter is switching preschools this autumn." Very young. She's attached, it seems, to a couple of teachers at the old school. What do you suggest to make the transition easier for her?
TSUKAS: It is a difficult time. And I think the thing that's going to help you the most is having information.
So go to the new school, find out about the school, meet the teachers, take your child with you. Let her get introduced to the teachers. If possible, let her spend a few hours there, just to get a feel for what it's going to be like.
GUPTA: Good advice. Of course, kids aren't the only ones that have problems saying good-bye when it comes time to go back to school. We have this e-mail from James in Ontario.
He asks, "My wife is really anxious about our daughter going to kindergarten, to the point that it is preventing her from performing her daily chores. What can she and I do to ease her tension and prepare her for the inevitable?"
So this is the anxiety on the parental side on the parental side, as well.
TSUKAS: Same kind of thing. You want them to have information, visit the school. And the nice thing about kindergarten and at any school age is parents can get involved. You don't have to separate from your child. You can be involved with the school, participate in activities is a great way to keep up with what's going on with your child.
GUPTA: Short good-byes, Holly mentioned in the piece. Important to do that?
TSUKAS: I think so. I think the longer you prolong the good- byes, it's harder for both of you. So say your good-byes and wish them the best of luck during the day.
GUPTA: Right. We have another e-mail question coming in about older kids having school anxiety. Russ in Leesburg, Virginia, asks, "I have a 13-year-old about to enter the ninth grade in high school. I was wondering if there was anything I could do to calm her fears, besides telling her that everything will be OK?"
TSUKAS: Similar kind of thing. You want them to possibly go to the school, meet the teachers, get a feel for the neighborhood. There may be other kids in the neighborhood who are going there. Introduce your child to other kids in the neighborhood. If they have specific interests, music, sports, get them involved in those activities at school. That's a great way to meet new friends.
GUPTA: How do you know when it's -- when it's just not going well. At what point should they, you know, start seeing somebody, a psychologist or somebody about the problem?
TSUKAS: I think, you know, you need to make sure that your child is talking to you. You ask questions. Make sure the counselor is available, something you can discuss with the counselor at the school, as well. And that will probably help you with some guidance. And then talk to your pediatrician.
GUPTA: So sometimes that is going to be necessary.
TSUKAS: Definitely.
GUPTA: When you get to school, one of the things you and I have seen are those heavy backpacks.
TSUKAS: Yes.
GUPTA: That can be a problem as well. Heavy backpacks can be more than a pain for your kids. They could actually be injuring them for life. Details on that coming up, as well.
(BEGIN VIDEO CLIP)
ANNOUNCER: A healthy lunch is food for the brain.
UNIDENTIFIED MALE: I think I've had a problem now because I've had nachos every day at school and it's starting to get to my stomach a little bit.
ANNOUNCER: But how do you get your child to eat well at school? Some tips on that.
But first, here's a tip for you from the Bod Squad.
UNIDENTIFIED FEMALE: Imagine being able to train your mind so that you will actually crave regular exercise and healthy food. That's exactly what David Kirsch promises to do.
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UNIDENTIFIED FEMALE: All for a mere $275 an hour for each personal session.
These days it's not enough to have a trainer hovering over you in the gym as you sweat and flex your way to body beautiful.
KIRSCH: (NO AUDIO)
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Here, sauteed equals sinful, steamed says wholesome.
Kirsch's commitment to success extends beyond the studio. For $60 a day his food delivery service will drop off gourmet style low fat meals at your door.
Holly Firfer, CNN.
(END VIDEO CLIP)
(COMMERCIAL BREAK)
GUPTA: They seem harmless enough, but your child's backpack could be more than a pain in the neck. Carrying a heavy backpack can lead to problems later in life.
Here are some hints to keep your child healthy.
First of all, pack light. The backpack should never weigh more than 10 percent of your child's body weight.
Use both shoulder straps. Slinging a backpack over one shoulder may look cool, but it can strain muscles and can increase the curvature of the spine. Also, tighten the straps when the pack is close to the body. The straps should hold the pack two inches above the waist.
Organize the backpack, as well, to use all of its compartments. Pack heavier items closer to the center of the backpack.
You see a lot of these types of injuries?
TSUKAS: Definitely. We had a lot of kids coming in, complaining about neck pain, shoulder pain. Very common to see with all the books that they're carrying.
GUPTA: What sort of -- Is that the sort of advice you typically give them?
TSUKAS: Yes, I think it's good advice. You want to make sure you find a backpack that's an appropriate size for your child, one that's fairly lightweight, because it's going to have a lot of books in it as it is.
Rolling backpacks are very popular these days.
GUPTA: Yes.
TSUKAS: Another great way to manage that. Although keep in mind, if you have stairs in your school, you're still going to have to pick it up and carry it.
GUPTA: Right. Ten percent, that's a good sort of rough number.
TSUKAS: Yes.
GUPTA: All right. From heavy backpacks to eating lighter, we had several questions about kids and school nutrition, including this one from Ora in New York: "How do you introduce a healthier diet and lifestyle to children without making them feel punished?"
So they've been getting chocolate and candy all summer long and all of a sudden they've got to eat healthy, right?
TSUKAS: Well, the idea is not to think that this is a punishment, that eating healthy is a good thing. You want to make sure it's part of your everyday life. There's nothing wrong with chocolates and other things, but you want to keep it to a minimum.
I think, you know, if the parents are enjoying it, it's not something they're forcing on the kids but giving them an option to try those things.
GUPTA: And practice what you preach, right?
TSUKAS: Definitely.
GUPTA: Don't be sneaking ice cream on your kids.
Even kids had some concerns about this topic of nutrition. We have this e-mail from Shalim in New Jersey. She says, "I am 12 years old and perfectly healthy. What do I need to know about school lunches and how not to eat too much unhealthy food?"
A 12-year-old wants to know.
TSUKAS: I commend a 12-year-old for asking a question like that. That's wonderful. In today's times we're seeing so much of childhood obesity. That is a very good question and something that needs to be addressed.
You want to make sure that you know what's being served in school. I think schools in general are making more of an effort to provide healthier meals.
The biggest offender, I think, is drink machines. You certainly want to try to stay away from the soda machines as much as possible. You know, healthy alternatives, water, fruit juices, those kinds of things.
Look at the menu that the school is offering. If it's not something you like, think about bringing something from home.
GUPTA: You mention these vending machines. They're -- they're a huge problem, I think, in some ways when you have the -- there are kids who never had sugary sodas, for example, and all of a sudden you have all these things available to them.
Any advice you can give to either children or their parents about trying to stay away from those?
TSUKAS: I think if children are given alternatives, then they're going to choose things that they're comfortable with. Low fat milk is available in the school. Water is available in the school, as well. So there are alternatives. As long as that's the case, then hopefully you talk to your child and encourage them to pick -- pick the right alternatives.
GUPTA: Encourage the water instead of the soda pop.
All right. Some back to school food for thought, that's coming up straight ahead.
(BEGIN VIDEO CLIP)
ANNOUNCER: Staying informed and staying healthy, a look at some sources for parents and kids.
But first, a look at some of this week's medical headlines in this edition of "The Pulse."
FEIG: Drinking sugary beverages increases a woman's risk of developing Type 2 diabetes, says a new study in the "Journal of the American Medical Association."
The study followed more than 50,000 women over a nine-year period and found that those who drank one or more sugary sodas or juices a day had double the risk of developing Type 2 diabetes.
And the number of Americans with high blood pressure is on the rise, according to a report by the American Heart Association. The study reports that 33 percent of Americans have high blood pressure, up from just 25 percent in 1990.
Major risk factors for high blood pressure include old age, obesity and lack of physical activity.
Christy Feig, CNN.
(END VIDEO CLIP)
(COMMERCIAL BREAK)
GUPTA: For more information about getting your child ready for school, check out the American Academy of Pediatrics web site. That's at AAP.org. Also, logon to MayoClinic.com. Both those web sites have special features about getting your child back to school healthy.
Very interesting show. We've got one -- we've got time for one more final e-mail question. This comes from Latha in Illinois. She says, "My daughter will be the youngest child in her first grade class. Although she is academically well advanced, I am a little concerned about her ability to interact socially with her peers. What does a parent need to keep in mind?"
TSUKAS: I think at that age there are going to be differences in how that child interacts with other kids.
Again, talk to your child, explain what's going to be happening in school. Find out from your child how did the school day go so you can get some feedback from your child in their opinion.
GUPTA: Do you think it's a good idea in general for -- for kids to skip grades, to sort of go along a little faster than their peers?
TSUKAS: I think that depends. It depends on the child. Just having the ability to do the work is not everything. Maturity is important. And that's a decision the parents have to make...
GUPTA: Right.
TSUKAS: ... with the teachers and the counselors, figure out what's best for their child.
GUPTA: It's not always a good idea, maybe?
TSUKAS: Not always.
GUPTA: We've been talking to Dr. Seema Tsukas. Any final thoughts you'd like to leave with all of our viewers today?
TSUKAS: Yes, I think safety is something to think about. School year has started.
People have to know to slow down when they're in school zones, observe the speed limits in the school zones.
Kids who are riding bikes to school, make sure they're wearing their bike helmets. Kids who are riding the bus, make sure when they're on the bus, they're sitting down and when they're off the bus, that the bus driver can see them until they've gotten to where they need to get to.
GUPTA: Really good advice. Safety first, as always, right?
TSUKAS: Definitely.
GUPTA: All right. Well, that's all the time we have for today. Tune in next week for a look at some medical myths: the good, the bad and the ugly, how you could be hurting yourself with medical misinformation.
Thanks for watching. And thanks to Dr. Seema Tsukas, as well. Thanks to all of you at home for your questions. Stay tuned now for more news on CNN.
BETTY NGUYEN, ANCHOR: Well, good morning from the CNN Center here in Atlanta. This is...
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