Backpacks here. Backpacks there. Backpacks practically everywhere. Kids of all ages wear them – and, increasingly, so do adults. Toddlers wear them for the sake of wearing them, often empty and sometimes in the shape of cartoon characters. Older kids use them for books and sporting equipment and when hiking and traveling. For high school kids, backpacks are fashion statements; it doesn’t matter what’s in them.
Here is what parents should know:
1. Loads on backs should not exceed 20% of the child’s body weight. Lesser loads, 10 to 15%, are recommended for backpack beginners, long trips, going uphill and climbing stairs, walking on tough terrain, and in hot weather.
2. Children’s backpacks that are too heavy or worn incorrectly can cause medical problems. (However, there is no evidence that these problems result in permanent, structural spinal deformities.) In the US, more than 7000 backpack-related injuries are seen in emergency rooms (ERs) each year; many more are seen in doctors’ offices. Approximately half of the cases are in children. Upper and lower back pain and shoulder pain, sometimes severe, are the most common symptoms.
3. Function before fashion. Opt for backpacks with shoulder straps that are wide, contoured, and padded to prevent straps from digging into the shoulders. Straps should be adjustable so that the backpack rests snuggly against the child’s back, that the child can put it on and take it off without difficulty, and that the child can move his or her arms freely.
4. Waist straps help keep backpacks in their proper place. When straps are too loose, backpacks dangle uncomfortably. Ideally, the backpack should rest two inches above the waist. Padding in the backpack protects wearers from objects inside the backpack. Obviously, the lighter the backpack itself, the more weight can safely be placed in it.
5. Discourage children from wearing the backpack on one shoulder. This fad is now in vogue – and even young children are surprisingly fashion-conscious. Weight should be distributed equally. Numerous compartments simplify weight distribution. Place heavier objects at the bottom, near the center, and up against the back.
6. Tuck in straps. Some backpacks, especially ones designed for small children, have long straps to fit children of various sizes. Long straps may cause tripping, become entangled in branches or get caught in doors.
7. Watch your child for backpack “dysfunction.” The backpack is too heavy when the child has difficulty putting it on, leans to one side while wearing it, or bends forward with the head down to balance the load, potentially causing the child to topple over. Moreover, the aches and pains resulting from wearing new backpacks is not a necessary adjustment period. Discomforts ought to be investigated before they become worse. Special attention should be paid when kids have red marks on the shoulders or report tingling or numbness in their arms and legs.
8. Consider backpacks with wheels. These are becoming more popular, allowing children to roll them when and where feasible. Handles on such backpacks should be sufficiently long so that children can stand fully upright when pulling them.
9. Show children how to put on their backpacks. They should bend at the knees, not at the waist, while keeping the trunk of the body straight and stable. They should push up using their leg muscles and keep the backpack close to the body. Excessive twisting and turning may indicate that the backpack is too heavy or the wrong model. Some children find it advantageous to place backpacks on a chair or table (depending on the child’s height), before placing them on their backs.
10. Teach backpack etiquette! Many of the backpack-related accidents seen in ERs are not directly related to wearing one. Injuries are due to backpacks left lying carelessly on the floor and the owner or another person tripping over it, backpacks dropping on hands and feet, and children using them as weapons (hitting other children in the face and head with it, for example).
