Back to School (and the List in My Head)

A non-exhaustive list of ways we keep our kids safe(r), from a public health mom

This morning, my kids went back to school. I am the proud mama of freshly-minted third and fourth graders.

Do you all remember that iconic Staples back-to-school commercial where the dad was gleefully dancing around the store set to “it’s the most wonderful time of the year” while the kids drag their feet and scowl?

It was the opposite vibe in my household. My kids were so excited to see their friends and their teachers and get back into a routine. I, on the other hand, found it quite bittersweet. Their excitement made me excited, but if I squinted my eyes a bit, I swear I could picture them getting dressed for high school graduation – and then suddenly someone started chopping onions! It is all happening so quickly. The school mindset made me think about some kid-related safety topics and things we’re doing to keep our little ones happy and healthy. This is certainly not an exhaustive list, and not all of it will be relevant to all ages, but I hope it is helpful.

So, what’s on my mind heading into this school year? Let’s discuss…

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1. Respiratory season

I write a lot about vaccines (and have a lot more in the works), so I’ll be brief on this topic. We are entering respiratory illness season, and our entire family will be getting this season’s updated flu and COVID-19 vaccines, just as we do every year. We make sure to get our flu shots before Halloween (you can remember this with “flu before boo”), which usually lands in late September or early October for us. We typically get our COVID-19 shots at the same time as our flu shots, but we are monitoring local levels and if they climb fast, we may get them sooner.

First Q&A post in a new series launched in collaboration between Unbiased Science and CIDRAP. Original post can be found on the Unbiased Science and CIDRAP social media pages.

We also wear high-quality masks in pediatric (and all medical) waiting rooms, especially during peaks, since that waiting room is a small enclosed space full of sick children (aka a petri dish). We open windows when the weather allows, at home and in the car. If cases spike locally, we avoid crowded indoor spaces whenever possible. It is all helpful at reducing risk.

2. Helmets, on anything with wheels

Helmets are non-negotiable in our household (strictly enforced by my ER doc hubby). The best evidence we have is a meta-analysis of 179 effect estimates from 55 studies, which found helmets reduce head injury by 48%, serious head injury by 60%, and traumatic brain injury by 53%, with the same benefit for kids as for adults.

To help with compliance, we had both kids pick out their own helmets and covered them in stickers, so it’s their helmet rather than something we’re making them wear. (Fit matters more than decoration, so it should sit level and low on the forehead, about two finger-widths above the eyebrows, with the side straps forming a V just under the ears.)

On a related note… let’s talk e-bikes, because we see people zooming all over town! A new UC San Diego analysis of statewide California collision data found e-bike crashes rose from 2 in 2018 to 1,506 in 2024, with more moderate-to-severe injuries than traditional bikes. And among people hurt in each type of crash, kids 14 and under made up a bigger share of e-bike injuries (15.6%) than traditional bike injuries (10.2%). The researchers noted low helmet use among injured riders, and that the higher speeds generate crash forces closer to a motorcycle than a bicycle. We’re not doing e-bikes at these ages, though I understand the families who do, especially when it’s how a teenager gets to school.

3. Water, in a few different ways

Gut-wrenching news broke this week that an eight-year-old in Louisiana died after swimming in a lake. That case involved Naegleria fowleri, an amoeba that lives in warm fresh water and causes infection when water gets forced up the nose. It’s horrifying, but still extraordinarily rare, with roughly 180 confirmed US cases between 1937 and 2025.

Warm water in late summer holds all sorts of organisms (bacteria and amoebas among them), and different water carries different risks. Brackish water, meaning the part-fresh, part-salt mix you get in estuaries and marshes and anywhere a river meets the ocean, is where Vibrio lives, bacteria that can cause severe infection when they get into a break in the skin. We ran into this in June on a quick trip to Acadia. The kids wanted to wade into a warm, shallow brackish stretch, and doctor dad took one look and said nope.

Photo taken by Jess Steier at Acadia National Park.

Louisiana has reported nine cases and five deaths this year against a 10-year average of about seven cases and one death, all from wounds exposed to seawater and all in people with underlying health conditions. Fresh water brings its own issues, including cyanobacteria blooms that can make kids and dogs very sick.

Practically speaking, you can check your state or county advisory page before you take a dip in the lake, and keep kids out of the water if they have any open wounds. The tricky part is that you often can’t see skin breaks (documented entry points include a scrape from a dock, a broken blister from new water shoes, an unhealed tattoo, and even freshly shaved legs). Wash any cut that happens in the water with soap and clean water. (And it’s a good idea to take a shower when you get home!) If a wound that’s been in brackish or salt water turns red, swollen, warm, or painful, get it looked at quickly and tell the clinician about the water exposure, because that detail changes what they’re thinking about. If kids are jumping in or dunking each other in warm, shallow, slow-moving fresh water in late summer, nose clips or hand pinching the nose shut is a good idea, and it helps to stay off the bottom where sediment gets stirred up.

If we’re talking about swimming, we also need to talk about swim safety and drowning prevention. Drowning is the leading cause of death for children ages 1 to 4, and it doesn’t look anything like it does on screen. There’s typically no splashing, no waving, and no yelling, because a child who is drowning usually can’t call out at all. What it actually looks like is a body upright in the water and facing shore, head tilted back with the mouth right at water level, and arms doing something like climbing an invisible ladder, and it can take as little as 30 seconds.

A staggering 88% of child drownings happen with at least one adult present, and half happen within 25 yards of a parent. Both of my kids have taken lessons and swim well, but good swimmers still drown. We don’t leave the kids unattended in water despite them being strong swimmers.

The National Drowning Prevention Alliance frames prevention as five layers that work together: barriers and alarms, supervision, water competency, life jackets, and emergency preparation (meaning CPR and a phone within reach). They’re layered because any one of them can fail. Ours look like a designated adult whose only job in that moment is watching the water with the phone down (they recommend rotating that role every 15 minutes), touch supervision for anyone who isn’t a strong swimmer, no swimming alone, and Coast Guard-approved life jackets whenever we’re out on a boat.

Drowning remains a major risk across all age groups, so supervision style should evolve with a child’s development rather than stopping entirely.

4. Teeth

We snuck in dental appointments earlier this week before we had to compete with school schedules. (On the way out, I scheduled appointments for February and March 2027. Does everyone else just arbitrarily accept the date and time because the future date doesn’t seem “real” yet?) Everyone in our household gets cleanings every six months. Our son is excellent about brushing but considerably less excellent about flossing, which has led to some cavities. The dentist had a great suggestion at the end of the visit. He said that sternly telling kids to “floss every day” right away can feel overwhelming. Instead, he said work it into the routine once a week to start and then add on a day of flossing every week that passes. This makes it more approachable and doable.

Cavities are still the most common chronic disease of childhood and most of them are preventable. We stay on top of fluoride varnish at checkups, sealants on the molars where the grooves trap food, and the daily part, brushing twice with fluoride toothpaste (a rice-grain smear under age 3, a pea-sized amount after that) and flossing.

Given everything going on with community water fluoridation, one note: if your water supply has changed, or if you’re on a well, ask your dentist whether that changes anything for your kid in terms of varnish frequency or supplementation.

Full post can be found on the Unbiased Science social media pages.

5. Fiber, greens, and getting the kids in the kitchen

Every meal in our house has fiber and something green in it. It’s an addition rather than a substitution and there’s no lecture attached. Most Americans (kids included) fall short on fiber (a whopping 90-95%), so it’s a good idea to work in more beans, whole grains, fruit with the skin left on, and vegetables in whatever form they’ll actually eat.

We do not do “good food” and “bad food” framing in our household. It comes down to overall dietary habits and making sure you get enough fiber and nutrients. There’s room for sweets and snacks, and in my experience making a food forbidden mostly makes it more appealing.

What’s helped most is having them in the kitchen. Kids who help shop, wash, chop, and cook are more willing to eat what comes out of it, and they’re picking up a skill they’ll need eventually anyway. Growing food does something similar, since a kid who watched a tomato go from green to red is more willing to eat it than one who found it in a plastic clamshell. Our outdoor season here is short, so we keep herbs going indoors through the winter (hot tip: basil, mint, and scallions are nearly impossible to kill).

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There are a zillion other things I could have included, so this may well become a series. I’d love to hear the things you’re thinking or wondering about in the comments.

This school year will be messy and it will bring its challenges, and we’ll get through it. It’s maybe good to remind ourselves that our kids aren’t the only ones doing this for the first time. I have never been the mom of a third grader and a fourth grader before. Every phase they enter is one I am entering right alongside them, and we are all just doing our very best.

Stay Curious,

Unbiased Science