Finding a backpack that makes the grade when it comes to their child’s comfort and safety is an important first assignment for parents. Lewis First, MD, Chief of Pediatrics at the University of Vermont Children’s Hospital and Chair of the Department of Pediatrics at UVM’s Larner College of Medicine , offers his advice for avoiding injury by picking – and packing — right. 

How to Choose a Backpack

To reduce back and neck strain, look for the following features:

  • Lightweight. The backpack shouldn’t add considerable weight to the child’s shoulders.
  • Two shoulder straps that are wide and padded to go over the shoulders to prevent nerve pain.  
  • Padded waist or chest belt to distribute weight more evenly.
  • Padded back so sharp objects do not poke through.
  • Multiple compartments to distribute the weight of the load. 
  • Width of the pack should be no greater than the child’s torso.
  • Not too large. A backpack should not hang down more than four inches below the waist.

How to Wear a Backpack

  • Wear two straps. Studies suggest that if an older student carries a heavy load wearing only one strap of their pack on their shoulder, then serious neck, shoulder and back pain will result. No similar study has been done in younger children, but we see that young children who wear one shoulder strap do alter their posture and gait, or how they walk, making them susceptible to back, shoulder and neck discomfort. 
  • Lighten the load. The American Academy of Orthopedic Surgeons and the American Physical Therapy Association recommend that backpacks contain no more than 10 to 15 percent of a child’s body weight.
  • Organize the backpack. Pack the heaviest items low in the pack and close to the body to help balance the load.

Signs of Overload

My rule of thumb is that if your child complains of back, neck or shoulder pain during the week, and it gets better over the weekend, you’re right to be suspicious of their backpack. To remedy, make a weight or shoulder strap adjustment or reduce the contents of the backpack. I find that storing some of those heavy books in a locker rather than carrying them around in a backpack all day helps, not to mention removing overdue library books!

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