No Bag Day: Follow Golden Rule of 10 percent of child's body weight

Recently the state Department of Public Instruction (DPI) announced ‘No Bag Day’ will be implemented once a week in all schools from the next academic year. Experts believe this can help reduce frequent back problems in children but is it enough?

BENGALURU: It is common these days to see children lugging heavy school backpacks. As the education system becomes more competitive, students are forced to carry a hefty bunch of study materials including standard texts, notebooks, assignments, projects and their lunch boxes and water bottles. These causes mechanical burden on the bones, joints, and spine of the growing child.
Many scientific studies have been conducted looking into the role of heavy backpacks and childhood back pain. Individuals who experience back pain in childhood are more likely to have chronic back pain in adult life, a leading cause of disability. In one particular study, almost 40 per cent of 11 – 14-year-olds reported back pain, an alarming figure which is close to what we see in the adult population. More than 80per cent of these children reported that heavy backpacks are a causative factor.

The likely sufferers
Girls are more likely to suffer back pain due to their lower body weight. They are also likely to carry heavier backpacks on average than boys. Most experts agree that the maximum permissible safety limit for school backpacks is 10 per cent of the child’s weight, though staying well below this limit is desirable.
Children from urban areas face many challenges including over-exposure to unhealthy foods, demanding academic curriculum, long commutes to school, and lack of space and facilities for exercise. Carrying heavy backpacks adds to this list of adverse health risks. Parents need to ensure that the backpack never exceeds 10 per cent of the child’s weight.

The issue of children carrying heavy backpacks worries many parents but at the same time the demanding school curriculum in Indian cities discourage parents to allow leaving of books at school. The incidence of back pain in children appears to be on the rise.

Are backpacks responsible?
Our society is going through an immense change within a short span of time. While children enjoy the benefits of this knowledge era, they are also at greater risk of health problems due to its negative consequences. Lack of urban spaces for aerobic exercise and sports, reduced exposure to sunlight, poor posture whilst using portable gadgets and a gruelling academic schedule that places emphasis on scholastic performance are driving children towards a sedentary lifestyle.

Consequences
This results in weight gain, low muscle strength, and poor exercise tolerance.  Children who have experienced lower back pain are more likely to become adults who suffer from chronic back problems. It makes sense that parents, schools and health professionals need to work together to combat this public health problem.

We are also seeing an increasing number of otherwise healthy children complain of back pain affecting their activities and lifestyle. The most effective strategy is prevention.

What can be done

The backpack should be carried on both shoulders. Schools can help by providing lockers and encouraging children to carry essential materials only.
Try to keep the weight of the school bag to less than 10 per cent of the child’s body weight. You may need to discard unwanted items. -Trolley bags are a suitable alternative. Children should carry the backpack with both shoulder straps fastened securely.
Newer ideas such as a semester curriculum in school and combining subjects in a single textbook will certainly help.
Engage your children in moderate intensity sports such as swimming or field sports. Enrolment in a sports class outside of school improves the health and social skills of children.
Discourage poor postures when using portable electronic devices. A desktop with a straight back chair is a much better idea than using a laptop on a bed or sofa. Restrict mobile phone use in children.
Check your child’s weight and BMI regularly. Discuss with your pediatrician if you are concerned.
Regular school health checks must be introduced to identify children who are at risk of lifestyle diseases so that early corrective action can be instituted.

The author is a paediatric orthopaedic surgeon at Rainbow Children’s Hospital

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