Healthy kids make better students

Kindergartners Collin Le, 6, and Tiana Thompson, 6, play during recess at Silver Beach Elementary in Bellingham in June 2015.
Kindergartners Collin Le, 6, and Tiana Thompson, 6, play during recess at Silver Beach Elementary in Bellingham in June 2015. The Bellingham Herald

Good health is key to learning readiness.

“Children need to feel their best in order to learn,” says Dr. Louis Z. Cooper, president of the American Academy of Pediatrics. “So it is well worth the time it takes to make sure each child’s health and medical requirements are anticipated and covered for the upcoming school year.”

Starts at home

According to the Centers for Disease Control and Prevention, nearly 22 million school days are lost each year nationally due to colds alone, 38 million school days are lost due to the influenza virus, and 40 percent of children age 5 to 17 missed three or more school days in the past year because of illness or injury.

Added up, that equals more than 164,000 collective years of missed school in the United States.

By one statistic, 67 percent of parents with school-age children said their kids were sick within one month of returning to school after summer break.

Researchers James A. Morone, Elizabeth H. Kilbreth, and Kathryn M. Langwell, in a study entitled “Back to School: A Healthcare Strategy for Youth,” wrote: “American youth face enormous health care needs. We found ourselves sobered by the scope of the problem.”

It starts at home.

Bellingham parents Amber and Rob Rivinius have two boys, 12 and 15.

“It’s been challenging to find an affordable health-care plan that is easy to understand and flexible for each child and family’s needs,” said Amber Rivinius.

The key to her kids’ health, and their subsequent learning readiness, has not been about waiting on a perfect health-care or insurance plan, or even depending on the six full-time nurses currently employed by Bellingham Public Schools to accommodate students’ health-care needs.

“We do a lot to stay pretty healthy,” she said, noting that the focus in their family is on proper diet, good hygiene, and adequate exercise. “Kids need to learn this stuff at home, and unfortunately they don’t.”

Dr. Julie Cheek, a pediatrician at Interfaith Community Health Center in Bellingham, agrees.

“It’s true,” she said. “Families need to be conscious of their kids’ health.”

As she sees patients throughout the year, there are specific areas of concern she likes to highlight for parents and young children. Now, with the new school year just started, she said giving attention to health care is more important than ever.

More exercise

As school-age patients file into Cheek’s office throughout the year, she’ll turn to a growth chart – a diagram of percentile curves representing the distribution of selected body measurements in children. As she reviews a child’s growth chart, she can determine key factors of his or hers health according to their body mass index, or weight-to-height ratio.

“To be honest, sometimes a kid looks good,” Cheek said, “ but when you look at the data, you see they may actually be overweight for their age and their height. We’re not talking obese, here, but to a degree that’s not healthy.”

According to the CDC, more than one-third of all American children were overweight or obese in 2012.

Several factors account for that, including a less-than-ideal routine of daily physical exercise and improper eating habits.

The American Academy of Pediatrics recommends 60 minutes of exercise every day.

“They’re generally not going to get it at school,” Cheek said, “so they’re going to have to work on it at home.”

The reason: Kids think better when they move. Studies show that physical exercise boosts brain activity, particularly attentional inhibition – that is, the ability to block out irrelevant information and focus on the task at hand.

That, fortified with a good diet, makes good students.

“Kids are given lots of sugar,” Cheek said. “It’s everywhere. People think Gatorade and other sports drinks are good for you. Kids don’t need to be drinking that stuff.”

Cheek also made a case against “screen time” and the link between a child’s overuse of electronic devices and potential health challenges.

The average 8-year-old, according to the American Academy of Pediatrics, spends eight hours a day using various forms of media – about six hours more than they should be spending.

Another study showed that children with a TV in their bedroom were about twice as likely to have high levels of fat mass — defined as levels in the top 25 percent — compared to those without a TV in their room.

“As a result,” said Cheek, “(kids) are not stimulating parts of their brain; physical activity is stunted because they’re not active, and it will disrupt their sleep cycles. Some kids get severe headaches.”

Reappropriating large chunks of that time to exercise and physical activities, Cheek said, will improve a child’s overall health, and likely their academic performance.

As well, Cheek said there are little things parents might not think about that can have a dramatic effect on their child’s health.

“I came from Florida,” she said. “No lack of sunshine and vitamin D there.”

Here, though, she said vitamin D deficiency is a common problem that can result in weakening bones – thanks, in part, to the weather. She sees it all the time in Bellingham.

“Kids should be getting about 400 international units of vitamin D a day,” Cheek said.

That’s about 30 ounces, or four glasses, of milk.

“That’s a lot of milk,” she said, “and most people don’t drink that much, but most multivitamins cover that, and it can be supplemented in other foods, such as fish and shellfish.”

Dental hygiene

Cheek adds that back-to-school health-care considerations should include dental care.

“Dental care is slowly integrating into primary care now, because we are more conscious of how bad oral care can affect the rest of the body,” she said. “Chronic medical problems can stem from circulating bacteria due to bad dental hygiene.”

It can cause cardiovascular issues, not to mention causing a blow to a child’s mental health as they battle low self-esteem.

Dr. Chad Galbraith, of Galbraith Mountain Pediatric Dentistry, can draw a straight line between a child’s dental care and how well they are doing in school.

“Statistically, there are a lot of missed days of school nationwide because of pain, bad oral health, and dental neglect,” he said.

According to the National Children’s Oral Health Foundation, an estimated 17 million children in America go without dental care each year, and more than 25 percent of children age 2 to 5, and half of those age 12 to 15, suffer from tooth decay. As a result, more than 51 million school hours are lost each year due to dental disease, leading to increased educational disparities and decreased productivity.

With Bellingham not fluoridating its water, Galbraith said it’s especially important for parents to be shrewd regarding their child’s dental health and hygiene.

“They stopped putting fluoride in the water around here, and it of course leads to an increase in decalcification and decay,” Galbraith said. “So if they’re not getting the preventative stuff taken care of on a regular basis, such as cleanings, it can really lead to problems.”

Galbraith and his wife, Darcy, are both dentists in Bellingham. Every night, they help their 2-, 4- and 6-year-olds brush their teeth properly.

“I used to say it’s good to do that until your child can write in cursive,” he said, “but I was recently informed they don’t even teach cursive in school anymore.”

It’s good to co-pilot your child’s tooth brushing routine until he or she is about 7 or 8 years old, he said.


According to the World Health Organization, immunization prevents 2 million to 3 million deaths a year in all age groups from diphtheria, tetanus, pertussis (whooping cough), and measles. It is considered one of the most successful and cost-effective public health interventions.

Dr. Cheek said she regularly screens her patients for up-to-date immunizations.

“A lot of people aren’t immunizing around here,” she said, “and it’s actually rather concerning.”

In Bellingham, before a student can attend school, parents must provide proof of full immunization, proof that a schedule of immunization has been started, or a certificate of exemption, according to Bellingham Public Schools.

“Vaccination is the norm for families across Washington,” said Washington Secretary of Health John Wiesman, “and we want to continue to support parents to get the right shots at the right time to fully protect kids and schools.”

However, the Washington Department of Health also observed that a concerning number of kindergarteners in Whatcom County were without various immunizations and vaccinations: More than 1,460 were incomplete in at least one vaccination, and 124 were given an exemption for medical, personal or religious reasons. An additional 207 were out of compliance with state and school requirements, totaling nearly 1,800 kindergarteners who had not been fully immunized. Or not at all.

Schools across the state report immunization coverage each fall to the state Department of Health – a snapshot of rates at the beginning of the school year. With kindergarten the first entry into the school system for many children, kindergarten rates are considered the benchmark for school vaccination data.

More schools turned in reports this year than in previous years, the Department of Health reported, but there was also more data missing.

In Washington, all recommended vaccines are available at no cost for kids younger than 18. State Health Officer Dr. Kathy Loft said it’s important to take full advantage of that provision.

“Now is the time to make sure you and your kids are fully vaccinated,” she said. “Immunizations are the best tool we have to protect students from serious diseases that can spread quickly through schools.”

With Whatcom County schools beginning this month, an opportunity for families presents itself: to start the school year off with an upper hand on their children’s health.

If kids feel good, they learn well.

Staying active

Children and adolescents should do one hour or more of physical activity a day.

Aerobic: Most of the 60 or more minutes a day should be moderate or vigorous aerobic physical activity, such as hiking, biking, rollerblading, or brisk walking, and should include vigorous physical activity at least three days a week, such as martial arts, running, jumping rope, soccer, hockey, basketball, canoeing, or pushing a lawnmower.

Muscle-strengthening: As part of their 60 or more minutes of daily physical activity, children and adolescents should include muscle-strengthening physical activity at least three days of the week, such as rope or tree climbing, tug-of-war, swinging on playground equipment and bars, modified pushups with knees on the floor, and climbing walls.

Bone-strengthening: As part of their 60 or more minutes of daily physical activity, children and adolescents should include bone-strengthening physical activity at least three days of the week, with such activities as running, hopscotch, basketball and tennis.

Eat healthy

Nutrition for kids is based on the same principles as nutrition for adults. Everyone needs the same types of nutrients — vitamins, minerals, carbohydrates, protein and fat. Children, however, need different amounts of specific nutrients at different ages. Here are some tips for a balanced diet:

Balancing Calories

▪ Enjoy your food, but eat less.

▪ Avoid oversized portions.

Foods to Increase

▪ Make half your plate fruits and vegetables.

▪ Make at least half your grains whole grains.

▪ Switch to fat-free or low-fat (1 percent) milk.

Foods to Reduce

▪ Compare sodium in foods like soup, bread, and frozen meals, then choose foods with lower numbers.

▪ Drink water instead of sugary drinks.

By the numbers

60 million

School days (or, 164,000 collective years) of school missed nationally each year due to sickness, such as the common cold or influenza.


Percent of parents nationally say their kids get sick within one month of returning to school.

17 million

Kids go without dental care in America every year.

51 million

School hours are lost each year in the U.S. due to dental disease.

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