Doctors’ Notes


Back-to-School Preparation

It’s the time of the year to start thinking about going back to school — new clothes, new supplies, new backpacks, new lunch bags, new hairstyles. Lots of new things.

But it’s also a good time remember some of the old “things” as well (at least from a Pediatrician’s perspective).

Most of my patients and their families have heard my single word for good health – Balance. Here are some things to keep that balance, or maybe get it back, after relaxing schedules and habits for the summertime.

Time Adjustment

Children need at least one week prior to the first day of school to readjust to a regular schedule of “awake time” and “sleep time.” Children ages 5-11 years require 9-10 hours of sleep; ages 12-18 years require 8-9 hours. This adjustment can be a major change, because of the later nights playing outside in the lingering sunlight, and later mornings sleeping in (sometimes as much 1-3 hours past when they would normally awaken.)

School days are set time periods, and children need to keep their body’s metabolism balanced with regularity. Their minds will be energized to learn, and their bodies will more efficiently use the energy from the foods they eat if they keep a regular schedule of awake and sleep.


The human body is more efficient with digesting, metabolizing, and using energy from foods when there are three meals per day (breakfast, lunch, and dinner). This means children need to be kept on a strict meal cycle, and this should start at least 1 week before school starts.

Remember too to keep the food groups balanced with those meals. School lunches can be variable with this concept of balance, and you may consider packing lunches instead to have more control over them. Snacks are also important to limit — down to just the “bridge” between lunch and dinner. Keep  it small in portion size, typically 3-4 PM each day.


A good prediction to keep in mind is that the start of the typical viral cold season is 4-6 weeks after kids get back together for school. Start prevention now!

Get kids back into the habits of washing hands with soap and water. Teach them how to use anti-bacterial hand sanitizer —  ¼ to ½ pump, press to fill small part of palm of one hand, and then rub, rub, rub (interlocking fingers and applying sanitizer to tops of hands as well) till the hands are dry. Dry is key.

Also remember to cough or sneeze into your elbow. This position keeps your hands clean from any possible germs, and prevents you from contaminating other people or surfaces.

School is Fun!

Kids should learn from their parents that school is fun. There are friendships to develop, summer stories to tell, and catching up to do with classmates and teachers. Keep a positive outlook to the start of a new school year by instilling some optimism about what may lie ahead. As Henry Ford once said, “Anyone who keeps learning stays young.”


Continue to remind your children about being safe and feeling safe. Bullying can cause anxiety for some children even before the school year begins – so look for the warning signs. (See Terri Bailey’s Doctor’s Note on Bullying for more details and key signs/symptoms to monitor.)

For younger children (ages 4-7 years old), teach them about avoiding strangers and what to do if they should be approached. Do not assume children will always be safe, but be proactive in safety precautions.

Conditions & Hydration

Fall sports activities are gearing up with practices, and sometimes these practices can run 5 days per week or be twice per day. It’s very important that individuals condition their bodies for the intense physical workouts before the structured camps begin. It starts with gradual aerobic exercise to increase stamina and lung capacity to compensate for eventual gameplay.

Children of all ages also need to learn to “fill the tank before you play.” I often tell families this motto, as a way to help them learn to hydrate before you play. This means to drink 1-2 glasses of water in addition to what they normally would drink daily. Water is the key. Other fluids are sold to help hydrate when you exercising, but water is the most important.

One other point to remember: don’t wait to drink water until you’re thirsty. Regular water breaks are very important –- especially on hot temperature days. For more information, see Travis Lewis’ Doctor’s Note on Heat Related Illnesses.


if your child participates in any contact/collision sports or activities,d on’t forget to get a Baseline ImPACT test completed  Baseline testing is valid for up to two years, until the child is over 18 years old. Kids Plus can be a convenient office location near you to get this testing done whenever the office is open; no formal Provider visit is necessary — just a scheduled visit for the nurse to know when to expect your child. The test can becompleted in 30 minutes, and either Travis Lewis or I will review the Baseline, notify the Kids Plus staff if it’s valid, and contact the family with the results. For more information on ImPACT tests and concussions, see my Doctor’s Note.

Well Visits

The most comprehensive way of preparing children for school can be your child’s annual Well Child Visit with your pediatric Provider. The visits focus on the age-appropriate, comprehensive balance between development of mind and body. Vaccinations will be kept up-to-date, and further prevent illness. Don’t wait until the last moment (the days right before school starts) to get these physicals done — do them weeks ahead of time. School and sports forms will also be part of this visit, and can be one completed check-mark on parents’ back-to-school to-do list.

Dr. Lucas Godinez,  a Kids Plus Doc since 2004, is an expert in head injuries and a certified ImPACT test clinician.