The kids are finally back to school. You have gotten them back to their normal bedtime and regular routine. Now that you no longer need to focus on their back to school supplies, you are free to worry about all of the health concerns associated with them being back in school. With wellness visits, immunizations, childhood obesity, overweight backpacks, allergies and germs, there are a lot of things to consider when it comes to your child's health this time of year.

Routine Physicals and Immunizations Every state has vaccination requirements by age, and public schools in those states will not allow students to attend who are not up to date on their vaccines unless that student has a valid vaccination exemption. You can go to the Centers for Disease Control and Prevention website for a full immunization schedule, requirements & laws, and lots of helpful information regarding vaccines (http://www.cdc.gov/vaccines/default.htm).  The Advisory Committee for Immunization Practices (ACIP) recommends the immunization schedule for persons 0 through 18 years of age. For these NYS Immunization Requirements, click here.  Beginning September 1, 2016 all public and private school students entering 7th or 12th grades in New York State are required to be vaccinated against meningococcal disease.

While there are no such regulations that require a routine physical, it is still a very good idea for your child to have a physical every year for their own health and safety. Most Public schools will require a child to have a yearly physical to participate in sports. If you still haven't scheduled a physical for your child and would like to do so, visit Community Care Physicians  for info on the Community Care practices that can offer your child pediatric services and family care services nearest you.

Nutrition, Rest, and Exercise  Childhood obesity is quickly becoming an epidemic in this country. Many health experts recommend at least an hour of physical activity a day. Exercise is vital to keeping your child active, alert, and focused while also burning off those extra calories. Eating breakfast is also a good way to help your child focus. Students who eat breakfast in the morning are more alert in class than students who do not. If breakfast isn't the most important meal of the day, it's certainly in the top three. Eating healthy throughout the rest of the day and getting lots of rest will help your child to fight off infections and stay healthy.

Backpack Every year at this time a discussion emerges as to whether backpacks are good for children, or if they are bad for their backs. Backpacks, when used properly, are actually good for kids to wear. They are specifically designed for the purpose of carrying many heavy things and distributing that weight in a way that is easy and effortless to carry. The problem is backpacks are not always worn properly, with both straps over the shoulders and properly tightened. They are also often overloaded with too much weight (most doctors recommend the weight be only 10-20% of your child's body weight with 10-15% of their body weight being the preferred weight). Our very own Dr. Barbara Morris talked to the Times Union about this very issue. So when your child leaves for school in the morning, tell her/him to use both straps. And while you're at it, remind him/her to stand up straight and stop slouching, too!

Cooties!  Kids and germs go hand in hand, which is why they need to wash said hands so often. Washing their hands with soap and water for a minimum of 10 seconds is the best way to avoid the spread of germs. Hand sanitizer would be a practical alternative for when your child can't make it to the bathroom to wash their hands. Speaking of the bathroom, everyone knows they can be cesspools for germs, which is why they are cleaned so often. Chances are, your child will pick up germs from a place that is cleaned much less frequently, like a water fountain or lunch tray, than they will from the bathroom which gets cleaned on a regular basis. Germs also contribute to a lot of illnesses your child may come home with early in the school year. Here are some of the more common illnesses to look forward to:

• Common cold  By far the most common illness, thus the name. Colds are annoying and gross but generally are not overly debilitating and run their course in a couple of weeks. Sometimes a cold will indirectly lead to a sinus infection that may require antibiotics, although doctors try not to prescribe antibiotics too often since they can increase bacterial resistance over time.

• Allergies Ragweed, dust mites, and mold inside or outside of school can all contribute to allergies this time of year. Allergies can sometimes mimic symptoms of the common cold, but itchy eyes and sneezing fits are usually a good indicator your child is suffering from allergies. If needed, your child's doctor may be able to prescribe an allergy relief medication, or recommend an over the counter alternative.

• Pink Eye AKA conjunctivitis. Pink eye is highly contagious…sometimes. It is hard to tell if the red itchy eyes and mucus discharge is from a virus or bacteria or if it just a symptom of allergies. For a bacterial infection, a doctor may prescribe eye drops. But if the cause is viral or allergies, you may just have to let it run its course. If it is contagious, be sure your child washes his/her hands often and does not share personal items such as towels, pillows or eye patches.

• Head Lice Head lice is also highly contagious. Head lice is mostly harmless aside from the constant itching, but it is very hard to get rid of. Consult your pharmacist about an FDA approved over the counter treatment. To try and prevent the spread of head lice be sure not to share any hair brushes, combs, pillows, or hats. And if you need to put your heads together for any reason, please only do so metaphorically.

• Stomach Flu The stomach flu (or stomach bug) is just the worst. It is uncomfortable with the diarrhea and vomiting and constant exhaustion. It is also a virus and highly contagious. Hand washing also helps stop the spread of stomach flu. Be sure your sick child gets plenty of rest and stays hydrated. Be sure to see a doctor if symptoms such as fever or abdominal pain are also present, as these could be related to a more serious condition. (remember the stomach flu is not the same thing as influenza).

• Strep Throat Strep throat is different from most sore throats as it is a contagious bacterial disease and not a virus. Symptoms of Strep throat include fever, swollen lymph nodes in the neck, red swollen tonsils, white spots at the back of the throat and severely sore throat. It is important to complete a course of antibiotics to treat strep and to prevent more serious conditions later such as Scarlet Fever or rheumatic heart disease. When it comes to Strep throat, seeing the doctor is a must.

• Asthma Asthmatics know all too well how easy it can be to set off an asthma attack, whether it's from that awful perfume that girl was wearing in homeroom, or from pollen, or just laughing too hard. If your child has asthma, make sure they have a nebulizer or inhaler with the school nurse and an inhaler with them at all times, especially if your child plays sports.

Hopefully the kids will strap up their backpacks, eat right, get plenty of rest and exercise, and avoid these illnesses like the plague to have a happy and healthy school year! But in the event they do need to see a doctor, Community Care Physicians Division of Pediatrics and Division of Family Care are here to help!