Healthy Classrooms, Peace of Mind

As summer ends and school buses hit the roads, a wave of familiar back-to-school anxiety settles over parents with the inevitable return of classroom germs.

Preventative wellness begins well before the first morning bell. Local pediatric experts Bijaya Karki, MD, and Manu Sharma, MD, from Cape Fear Valley Pediatric Care, and Latoya Watkins, MD, a pediatrician with Legacy Pediatrics, emphasize that true immunity is built through consistent lifestyle choices.

The first collective tip is the simplest: keep vaccinations on schedule.

"Before school starts, get your children their well-checks in the summer," Dr. Sharma said. "Getting your vaccines before school and making sure those immunizations are up to date to prevent sickness or an Emergency Department visit."

Immunizations also include the HPV vaccine for teenagers and the flu shot for all family members to prevent the typical flu surge.

Practicing good hygiene is also a critical habit to maintain.

"Lots of parents have questions about how to keep their children well during the school year, and it starts with practicing frequent handwashing," Dr. Karki said. "It is crucial to have good hygiene."

Dr. Watkins also added that sending children to school with hand sanitizer is also a good preventative measure, along with keeping hands clean with soap and water.

Habit-building practices also include establishing solid sleep schedules and nutrient-rich diets for maximum immune function.

"Eating a healthy, balanced diet, getting adequate sleep and hydrating is essential," Dr. Karki said. "And keeping your children home when they are sick!"

Knowing when to keep a sick child home and when they are cleared to return remains one of the most stressful judgment calls a parent makes, but there are some clear guidelines.

"A child must be completely fever-free for a full 24 hours without the assistance of fever-reducing medications before stepping back onto school grounds," Dr. Karki said. "You will want to keep your child home too if they are vomiting, have diarrhea, are constantly coughing or have rashes with lesions that are draining like chicken pox."

Dr. Karki said lingering non-contagious symptoms such as a residual cough or a slight runny nose is generally acceptable, especially if it is allergy-related.

If the child has energy, is eating and drinking fine, can participate in a full school day and can independently manage their hygiene, they most likely can be in school without an issue.

"What you don't want is a child not being able to handle their secretion and touching things like doorknobs," Dr. Watkins said. "If they still need Tylenol or Motrin to keep a fever at bay or if the sneezing or coughing is excessive, then they most likely need to stay at home. The run-of-the-mill childhood illnesses with flu and cold symptoms can be contagious if not contained."

Dr. Watkins also suggested getting an appointment if the parent is unsure if the child is contagious.

"If the parent is worried, then I am worried," Dr. Watkins said.

When symptoms strike after standard office hours, parents face a critical choice. Choosing to visit the Cape Fear Valley Pediatric After Hours Care clinic, which helps bridge the gap between daytime pediatricians and the ED, for mild, non-urgent viral illnesses, helps ensure that emergency staff remain available for life-threatening crises. It is designed to handle non-emergency pediatric issues such as mild abdominal pain, allergies and flu or cold symptoms when regular offices are closed.

It also helps when a child comes down with infections like strep throat to get initial doses of antibiotics before morning, which minimizes school absences.

"Children will need to be on antibiotics for 24 to 48 hours, depending on the case, but as soon as the child is fever-free and not requiring medicines to control a fever, it is more likely they can return to school," Dr. Karki said.

Dr. Karki said that some situations demand more immediate intervention and that is when a parent should choose the pediatric Emergency Department. She said some red flags include a persistent high-grade fever, faster or more difficult breathing, having trouble speaking and not eating or drinking to the point where urine output has reduced.

Regardless, she said that during times of infection, parents need to make sure their child is adequately hydrated.

"Sips of water to maintain hydration, or even Pedialyte is important," Dr. Karki said. "Hydration is important for healing and recovery, too."

By establishing an open dialogue with primary care doctors and knowing when to use alternative care locations, parents can approach the new school year with confidence. Armed with proper guidelines, families can help keep classrooms safe and homes resilient throughout the viral season.

To find a pediatrician or to learn more about the Pediatric After Hours Clinic or Cape Fear Valley Children's Emergency Department, please visit capefearvalley.com/services/pediatric-care