Whether your child is starting preschool or their last year of high school, use our back to school health tips to start strong:

Sleep

Even if school started for your child, you have time to change their summer sleep schedule. You can adjust it to fit their school year sleep needs.

Take a week or so to gradually dial back their bedtime. Otherwise, they will spend the first week of school jet lagged. The right amount of sleep for your child is whatever amount it takes them to wake naturally or to awaken with minimal prompting . Some kids need 8- 9 hours of sleep, others require 11-12 hours.

Beds are for sleeping only: no playing, studying, phone scrolling, or completing homework in bed. Teach them to “let go” of the day and associate their bed with drifting off to sleep.

Make sure kids of all ages get some exercise, preferably outside, to ward off insomnia at bedtime. On the other hand, exercise too close to bedtime will wind a child up.

For kids who drink coffee, tea, soda or any caffeine containing drinks- avoid these beverages any later than noon. Caffeine can last in the body for up to 24 hours and interferes with sleep.

Visit the bathroom

We know many kids who “hold it” all day in school, despite what we otherwise advise. Remind your children to stop by the potty at least once during the school day. If they claim they don’t need to urinate, they may be dehydrated. Send them in with a water bottle to school. Dr. Lai is fond of saying “You wouldn’t walk around with a baggie full of pee on the outside. So don’t walk around with one on the inside.”

Eat

Pack healthy snacks. Remind your kids that candy has no nutritional value.

Instead of only packing carbohydrates, try giving sliced carrots/celery/peppers and supply hummus, peanut butter, or cream cheese for dipping. Consider packing apple or pear slices along with nut butters or a slice of cheese.

Milk can be a good drink to send along with snacks-even if your child does not eat, they will get some protein as well as carbs from the milk.

Give your child enough time to eat breakfast in the morning. Pack a well balanced lunch, and offer the above snacks after school in addition to packing them for the school day.

Immunize

Flu shots are available by late August/early September each year and some pharmacies already carry them. New this year, some health insurance companies will allow parents to administer the nasal FluMist vaccine at home to their children-ask your pediatrician if your child medically qualifies for this. Otherwise, take them to their pediatrician, school health clinic, or local pharmacy for their annual flu vaccine.

Covid vaccines are safe and effective for children. They reduce the chance of severe Covid complications that would require hospitalization, reduce death from Covid, and also prevent long-Covid symptoms such as months of cough and/or fatigue. The American Academy of Pediatrics (AAP) recommends Covid vaccines for all children this year if they have never had one.

Be sure all of their vaccines are up to date. These include vaccines that prevent meningitis, pneumonia, whooping cough (the “100 day cough,”) measles, mumps (can cause sterility and deafness), and polio.

Stock of up these items to help your child if they get a back-to-school cold:
Honey, nasal saline, tylenol or ibuprofen

And just in case, remind yourself of what to do if the boogers begin to flow by reading our “back-to-school cold” post.

Have a wonderful school year!

Julie Kardos, MD and Naline Lai, MD
©2025 Two Peds in a Pod®

Your child went back to school a couple of weeks ago, you’ve been to back to school night, and now, right on time, many of your children have… THE BACK TO SCHOOL COLD. What to do with this cold?

Whether caught from the toddler room or from the middle school hallway, most back to school colds look the same. Your child will start with a day of extra grumpiness or vague complaints about feeling tired or having a sore throat, followed by a runny nose
the next day, and then a cough a couple of days later. If your child has a fever from a cold, it starts during the first or second day. Some kids get watery eyes or a small amount of mucus from their eyes, to match their runny noses. To add insult to injury, some kids produce loose stools or vomit mucus. Many lose their appetites. In general symptoms build on days 0-2, peak at days 3-5, gradually get better days 6-7, and linger for the next week.

Colds are viruses and do not improve with antibiotics, but it is important to be on the look out for superimposed bacterial infections. In other words, cold viruses can irritate the body and make the body more susceptible to  bacterial infections (pus producing infections) like ear infections or pneumonias. Unlike colds, bacterial infections can be eradicated with the help of antibiotics.

Here is what you can expect from a back to school cold and how you can help your child feel better:

Sore throat

• Expect sore throat for at least the first 2-3 days.
• Treat pain so that your kid hydrates without pain on swallowing. You can give acetaminophen (i.e. Tylenol) or ibuprofen (i.e. Motrin, Advil).
  We have a post devoted to ways to soothe a sore throat here. And this post can help you decide whether your child needs to be tested for strep throat.

Fever

• Expect fever to start within the first 2 days of cold symptoms and to last at least 2-3 days. If it lasts more than 4-5 days, call your child’s doctor.
• Treat discomfort with fever reducing medicine if needed. Read helpful information about fever here.

Runny/stuffy nose

• Expect your child to have a runny, stuffy nose for as long as 2-3 weeks. Sinus infections are explained here.
• Treat your baby or young child’s stuffy nose with suction and saline (salt water) nose drops to help clear mucus. Although older kids can blow their nose, they can also use saline nose drops and take long warm showers to relieve nasal congestion. See other ways to treat cold symptoms here.

Cough

• Expect the cough to get worse on days 3, 4 and 5 of the cold, and to last for as long as 2-3 weeks. Here is our post on how to tell if your child is handling her cough or if the cough is a harbinger of asthma or pneumonia.
• Treat cough with extra fluids, and you can give honey if your child is over one year old. If your child has asthma, follow their  asthma treatment plan. Remember to stay away from over-the-counter cough medications.

Sorry, we don’t have a vaccine against the many viral germs that cause the common cold. But we do have one against the viral germ called influenza, better known as “the flu.” The flu is much more severe than a cold, so if your child is miserable from their cold, imagine how they will feel if they catch the flu (read here to tell the difference between colds vs flu).

Who knows, maybe this back to school cold will be the last cold of the school year. Here’s to hoping!

Julie Kardos, MD and Naline Lai, MD
©2018 Two Peds in a Pod®