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Entering a new grade or a new school or starting school for the first time makes some children fearful. Although a few butterflies are normal in any new situation, a minority of children develop real physical symptoms associated with the start of school.

"A seasonal spike in abdominal pain and other stomach complaints corresponds with the start of the academic year," says Roy Proujansky, MD, a pediatric gastroenterologist.

With any new or potentially frightening situation, allow your child time to adjust, advises pediatric psychologist David Sheslow, PhD. Talk to your child about what worries him, and offer reassurance: Is he afraid he won't make new friends? Is the thought of schoolwork stressing him out? Is he worried about school violence or the bully from last year?

To increase your child's comfort level with going back to school, you may want to consider adjusting your schedule to make the transition smoother for him. Dr. Sheslow suggests it's especially beneficial for parents to be home at the end of the school day for the first week. But many working parents just don't have that flexibility. If you can't be there when school lets out, try to arrange your evenings so that you are able to give your child as much time as he needs, especially during those first few days, Dr. Sheslow says.

Feeling Inactive

As fall descends, you may find your family lapsing into inactivity, especially with all the toys and distractions found in a typical American home, including computers, video games, cable television, and VCRs.

Do your family a favor and turn the appliances off from time to time, says Sandra Hassink, MD, director of a pediatric weight management program. Studies published by the American Academy of Pediatrics have shown a correlation between excessive television viewing and obesity. According to the American Academy of Pediatrics the average American child watches 3 to 4 hours of television per day!

Making time for exercise is difficult for many families, but the benefits of regular physical activity are multiple. Active and physically fit children not only have fewer health problems, they also, on average, do better in school and feel better about themselves than students who aren't fit. Establishing an exercise routine is one of the best things parents can do for and with their children, Dr. Hassink says.

Brown-Bagging It

Although the government has improved school lunch nutritional standards, many parents send their children to school with bag lunches (about 48% of public school students). Whether your child buys lunch or brown-bags it, try the following suggestions:

• Read the school lunch menu ahead of time. If certain items on the menu appear to be generous with fat, salt, or sugar, your child might be better off brown-bagging it that day.
• Fat should be limited to about 30% of total calories at lunch (and every meal). Ask your child's school district about the fat content of their cafeteria lunches. Most schools are doing the best they can with limited budgets. Low-fat alternatives are often not cost-effective or included in the government-subsidized foods schools receive.
• If you're sending a bag lunch, try to achieve balance, variety, and moderation. Pack fresh fruit or vegetables with yogurt dip. Instead of chips, candy, or soft drinks, send string cheese, low-fat granola bars, rice cakes, dry cereal, yogurt, gelatin, carrot or raisin bread, low-fat or nonfat milk, and juices.
• If your child seems to eat nothing but peanut butter and jelly, try some kid-pleasing variations on traditional sandwiches. Roll roast beef, chicken, or turkey in a tortilla or stuff a pita pocket with cheese, lettuce, tomato, and a little ranch dressing. But don't worry too much if your child wants the same thing day after day, as long as it's reasonably nutritious. Kids' tastes do change, sometimes overnight!

Skills Improvement

If you feel your child's skills in certain areas are not what they should be, make his new teacher aware of any perceived difficulties. Academic weaknesses left unaddressed may become cumulative, according to Thomas Sicoli, EdD.

Children who are weak in math, for example, may avoid situations in which they have to make calculations, Dr. Sicoli says. He suggests the following tips:

• Review your child's homework and class exercises nightly.
• Maintain open communication with the teacher and don't hesitate to ask for extra help for your child in the classroom.
• Additional time and attention will improve performance for many students, but your child's school should inform you and provide appropriate intervention if more specialized assistance is needed.

Sneezing and Wheezing

For some allergy-prone children, the end of summer marks the beginning of allergy season. Sneezing, a stuffy nose, and itchy, watery eyes are probable signs of seasonal allergic rhinitis, commonly called hay fever. Pollen from weeds is a leading cause of fall allergies. Symptoms usually decrease by the beginning of October. However, mold spore levels remain high until the first frost.

Children sensitive to dust mites may have increased allergy symptoms in the fall as they spend more time indoors with the onset of cool weather. Be sure to dust rooms, especially the child's bedroom, thoroughly; consider purchasing dust-proof, plastic encasings for his mattress, box spring, and pillows.

Your child's doctor may recommend an over-the-counter or prescription medication that contains an antihistamine or a decongestant. Medication does not cure the allergy but reduces symptoms to a tolerable level. The doctor may also suggest you visit an allergist, who may give your child allergy shots.

The return of cool weather, along with more time spent indoors, also signals the start or resumption of asthma symptoms for many children. Asthma triggered by cool dry air, allergens such as dust, or respiratory infections often makes a comeback in the fall. Monitor the subtle seasonal changes and how they affect your child's health. If medication is prescribed to prevent or alleviate symptoms, be sure to adhere strictly to the recommendations of your child's doctor. Most children with even severe asthma can remain active if they follow doctor's orders and take their medicine as directed. If you have a child with asthma, don't smoke in the house. Environmental tobacco smoke puts children at higher risk for wheezing and asthma.

Source: KidsHealth, Nemours Center for Children's Health Media, The Nemours Foundation.

Reviewed by: Steve Dowshen, MD
Date reviewed: July 2001

Note: All information is for educational purposes only.For specific medical advice, diagnoses, and treatment, consult your doctor.

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