The happy sounds of summer include children laughing and playing. When back-to-school time arrives, those sounds can change due to the many lifestyle changes that accompany this time of year. I've compiled a list of some of the sounds of back-to-school and ways to address them for a happy and healthy year.

Moan - the sound of a child with painful constipation
It's not unusual for kids to choose to "hold it in" instead of using school bathrooms. In a Pedia-Lax survey of boys and girls ages 6-11, nearly two-thirds (64.6 percent) said that they rarely or never poop in school bathrooms. In fact, nearly 40 percent always or often choose to withhold bowel movements rather than go at school.

When kids can't or won't use the bathroom, the colon absorbs water from the stool, making it hard and dry, and leaving your child with constipation.

What can you do about it?
Talk to your child's teacher to find out about a variety of rules - including when it's OK to use the bathroom. If you alert the teacher to your child's problems with constipation, he or she may be more flexible and help create an environment that is more comfortable for your child to "go."

If your child does start to show signs of constipation, you can take proactive steps to provide relief. Remember to increase fiber in their diet. Encourage him or her to drink plenty of water, and if necessary, use a product like Pedia-Lax which offers a variety of kid-friendly laxatives for quick, overnight or gradual relief.

Yawn - the sound of a child during the school day
Many children get used to sleeping in on lazy summer mornings and find it hard to adjust to waking up early and going to school. It's also not unusual for a child to lose energy and get sleepy after an intense day of studies.

What can you do about it?
The National Sleep Foundation recommends 10 to 12 hours of sleep per night for elementary-age children. This is essential for kids to learn effectively and pay attention. If your child is not getting enough sleep or has had a "relaxed" bedtime during the summer, you should transition to a regular sleep routine, including an earlier bedtime and a consistent wake-up time at least two weeks prior to the start of the school year.

Growl - the sound of a child's tummy
Is your child hungry before lunch and again before he or she gets home? This may be caused by what they are eating - or perhaps what they are leaving out.

What can you do about it?
A good breakfast provides your child with the fuel they need to start the day off right and a healthy lunch keeps the momentum going. A 2003 study demonstrated that children who eat breakfast show improved cognitive function, attention, and memory (Wesnes KA, Pincock C, Richardson D, Helm G, Hails S. "Breakfast reduces declines in attention and memory over the morning in schoolchildren." Appetite 2003;41(3):329-31). However, some breakfasts are better than others when it comes to staying power. Sugary cereals cause a peak in blood-sugar levels, but those levels fall dramatically after several hours. Whole grains like oatmeal are absorbed slowly, giving your child enough energy to last through the morning.

When it comes to packing a school lunch, you can pack something very healthy, but it doesn't matter if your child decides to trade it for something sugary. Instead, try to involve kids in the process. Create a formula for packing the lunch box and let them select what goes in. For instance, you can have the child pick a protein (i.e. turkey sandwich or peanut butter and jelly), a fruit (i.e. apple or grapes) or vegetable (i.e. carrots or green pepper strips) and a "wild card" (i.e. pudding or potato sticks). They may be less likely to trade something they actually picked out themselves.

Ouch - the sound of a child with back pain
Studies have reported that up to 64% of children suffer from back pain (Negrini S, Carabalona R and Sibilla P (1999). Back pain as a daily load for school children. The Lancet 354: 1974). Is your child's backpack making the grade? If it's causing pain, the answer is a resounding "no"!

What can you do about it?
Ideally, your child's backpack should have two straps, a waist strap and a chest strap. It should be lightweight with a padded back and padded straps.

Sometimes the problem isn't the backpack, but rather how the child is using it. It's important that they wear both straps so that the weight is evenly distributed. The backpack should also rest evenly in the middle of the back so that it is positioned over the strongest mid-back muscles.

According to the American Physical Therapy Association, American Academy of Orthopedic Surgeons, and the American Chiropractic Association, the following are recommended weight limits for backpacks:

• A 60 lbs. child can carry a maximum backpack weight of 5 lbs.
• 60-75 lbs. can carry 10 lbs.
• 100 lbs. can carry 15 lbs.
• 125 lbs. can carry 18 lbs.

When the school bell officially rings in the start of the school year, I hope these tips ensure that you hear nothing but happy children, excited and ready to learn.

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