Top tips from integrative practitioners on dealing with back-to-school health concerns

Back-to-school season is upon us, and with that comes a multitude of concerns from both parents and young patients about mental and physical health.

Today, children are not only dealing with the specific stresses that come with going back to school, but they are also forced to process society’s overarching issues like COVID-19, gun violence, and economic stress. We asked family practitioners about the most common back-to-school health concerns they get from parents, and their methods of addressing them.

Anxiety relief

“What I always see when it comes time to return to school is an increase in anxiety, and I would have to say that in the years since the pandemic it’s become even more of a concern,” said Kathleen Farah, MD.

Farah is the associate clinical director at The Center for Mind-Body Medicine in Washington D.C. and practices integrative and holistic family medicine in Glenwood City, Wisconsin. When it comes to going back to school, Farah said many of her young patients express worries about their new teacher, new classes, fitting in, doing well academically as well as stresses around extracurricular activities like trying out for a fall sport.

Specifically in the last few years, Farah said she’s seen an uptick in mental health struggles among her younger patients. She attributes this to an inconsistent schedule due to the COVID-19 pandemic, which moved many schools online, as well as children picking up on the stresses of their parents at home.

“Kids oftentimes pick up on if their parents are not agreeing or if there's money issues," said Farah. "Certainly with the economy and the prices of things now, I think kids feel that pretty intensely, especially as parents may have difficulty with their own emotions.”

When addressing stress in children, Farah said she not only teaches her young patients coping strategies, but also their parents, who are often experiencing anxiety as well. One of Farah’s favorite methods for stress relief is teaching her patients breathing exercises.

“If it’s a little kid I have them imagine that their belly is a balloon and as they inhale, the balloon in their belly rises then falls,” said Farah. “For the older kids I may have them count their number of breaths, but either way, I encourage the parents to do it with them.”

Lawrence Rosen, MD, founder of The Whole Child Center in Oradell, New Jersey, has also noticed a significant increase in anxiety among his young patients, especially teenagers, which coincides with national trends.

“We’re seeing a significant rise in emotional and mental health conditions diagnosed in children, particularly in adolescents ages 13 through 18,” said Rosen. “The isolation of the COVID pandemic and our response to it accelerated the deterioration we were already witnessing in teen mental health, especially for historically marginalized families.”

According to Rosen, the reasons for this increase in anxiety among teenagers is multilayered and has a lot to do with not only their personal problems, but the state of the world which kids are being constantly reminded of due to social media.

“There are a number of social determinants that play a complex role in what we’re seeing: hopeless and helplessness about a variety of issues, like climate change, political polarization and stagnation, increasing financial inequity, racism, gun violence and violence against LGTBQ+ youth,” said Rosen. “What I hear from many kids today is that they are really, really existentially in despair about their future. Social media and tech addiction may not be the cause but certainly they are amplifying the pressure.”

Rosen said these problems can be helped through encouraging families to live a healthy lifestyle.

“Foundational preventive health principles: eat real food, move your body, build your stress coping toolbox, nurture real-world in-person relationships, connect to what really matters to you, these are basics of creating and sustaining optimal health and wellbeing, and truly flourishing,” said Rosen. “These are strategies every parent and child can work on, together, as a family, especially with the right coaching support.”

To prevent children from getting overwhelmed, Rosen recommended that families participate in activities that are grounding whether that be growing and cooking food or playing outdoors. In addition, Rosen said community service is a great way to remind kids that there are things they can do to help with societal problems on a community level.

Kim Furtado, ND, who is in private practice in Lewes, Delaware, and has a special interest in children’s health, agreed with Rosen. She said screen time can impair mental health, and the number one way to prevent that is getting kids outside.

“The value of getting children outdoors and able to simply play can't be understated in how it protects them from doom scrolling on the Internet,” said Furtado.

When kids are online, Furtado said parental controls can protect against harmful Internet activity. Also, she said sharing websites with kids that focus on good news can help counteract the negative news they consume.

In addition to outdoor play, Furtado said creative arts like painting, sculping, writing, drawing, and jewelry making are all offline activities that can help relieve stress and clear the mind.

“Whatever parents can do to teach a child to trust their intuition and know how to quiet the mind is a great gift and preparation for the fear-based realities of the world,” said Furtado.

According to Rosen, parents should cultivate an open and honest dialogue with their children as well as discuss stress coping strategies. Most importantly, he said, parents need to demonstrate positive stress coping behaviors in their own lives.

Farah agreed. She said parental stress can easily trickle down to children and significantly affect their mental health.

“I would say that one of the best things in terms of anxiety is to make sure that parents and guardians are taking care of themselves as well as taking care of their own anxiety, or their own emotional health, because it really does play a role in how their children are responding not only to school life, but what’s going on in the family,” said Farah.

Avoiding illnesses

During back-to-school season, kids are often exposed to more germs, putting them at risk for contagious illnesses like the common cold, the flu, and COVID-19.

When recommending ways to prevent their children from getting sick, Farah said she tries to keep it as simple as possible. She said some of the most effective ways to avoid germs is to make sure children are washing their hands, wearing a mask in high-risk situations, and having a consistent sleep schedule.

According to Furtado, sleep is critical for good immune function. She recommends gentle support like passionflower at bedtime for the first few weeks of school to help transition kids to the earlier bedtimes and the earlier mornings.

“Establishing a good structure and transition to new school schedule will go a long way for immune health,” said Furtado.

In addition, Farah said it’s important for parents to be feeding their kids a healthy diet filled with fruits and vegetables. She said avoiding sugar is critical as sugar can impact the immune system’s ability to fight off germs.

Furtado said parents should be encouraged to monitor their children’s fiber intake to make sure they’re getting the micronutrients and antioxidants they need as well as making sure they’re getting enough fiber for their immune system to thrive.

For supplements, Furtado recommended zinc, vitamin C, vitamin D, and immune system tonics like elderberry.

Brain health

With today’s technology, children are being overstimulated, making it harder for them to focus. To help kids stay on track with their schoolwork, Farah said movement is essential. Studies have shown, Farah said, that exercise helps increase activity in the part of the brain responsible for thinking and responding to questions.

Not everyone is cut out for a competitive sport, explained Farah, but even playing at recess or being active in nature can help kids get their energy out and maintain better focus during class. 

These simple holistic practices, Rosen explained, can help kids feel competent in taking care of themselves both emotionally and physically. According to Rosen, who works with a nonprofit called WholeHealthED to promote the idea of a national public wellness infrastructure, a whole-person, holistic approach to children’s health should be incorporated into public school systems, so children of all socioeconomic backgrounds can benefit from these practices from a young age.

“If we apply what we’ve learned in integrative health and apply whole-health solutions to the educational environment, we start to see a way forward,” said Rosen.