Hey everyone, I’m back with another back to school tip – spreading backpack awareness.

I don’t know about you guys, but when I was in grade school, I was always carrying a huge trapper planner, my lunch box, thermos, school supplies, and a few library books in my bookbag. The bag honestly was SO heavy. But it seemed normal. My shoulders would hurt, and the skin would be a little red from the weight. The only time that the weight of my bookbag came into question was at my annual pediatrician appointment, when they checked for scoliosis. While I did not have scoliosis, or an abnormal curvature of my spine, my doctor did educate us on how the weight of the bag can cause strain and poor posture.

The American occupational therapy association (AOTA) deemed the third Wednesday of September to be “Backpack Awareness Day.” As Occupational Therapists, we have knowledge about the anatomy and physiology of the body, ergonomics, and child development. Your child’s backpack should change in size and function as your child grows. But wearing the backpack incorrectly, making it too heavy, and/or wearing the wrong size can gradually affect your child’s body over time.

A child’s shoulders and neck have many muscles, nerves, and blood vessels. If restricted or compressed by a heavy backpack, it can cause numbness, tingling, and/or pain down their arms. Carrying a heavy load can also cause a compressive force on the spine, making the space between the intervertebral discs smaller, and it can distort the natural curvature of the spine.

The body often tries to compensate for the weight of the backpack, and can force kids to lean forward when they walk if they bag is too heavy. For some children, it can increase their risk of falling.

In some cases, children will wear a backpack using one strap. This creates an uneven weight distribution and can cause a child to lean to the opposite side to compensate for the uneven weight. This leaning strains neck and shoulder muscles.

The key factors to keep in mind are: the type of book bag your child has, the bookbag’s size/dimensions and how that relates to wearing the bag, and how to pack the bag.

There are many different types of backpacks and names for them. Some of the more common options are as follows:

• Standard backpack– this is the most standard type of backpack. It usually has two straps, one large opening, and potentially one smaller compartment in the front. Two straps mean that the weight of the bag is more evenly distributed.
• Sling bag/messenger bag– this usually has one single strap that goes over the shoulder, and the pockets are smaller. It is meant for lightweight items and quick trips, not books and heavy loads. By having only one strap, the weight of the backpack is not evenly distributed across your child’s upper body and torso. This is not an ideal choice of a backpack.
• Functional Backpack– similar to the standard backpack except it has more features. Features usually include more pockets, and are reinforced and have more structure. Many of the compartments have designated slots and pockets for specific items; some include a key ring for your child’s keys, pencil holders, and water bottle holders. Having two reinforced and padded straps, this is a good choice for a child’s backpack.
• Rucksack– this is also similar to a standard backpack but it can have additional straps (like a chest strap). They usually has a main compartment that closes with a buckle flap versus a zipper, and they are usually able to carry more weight comfortably.  By having extra straps that can go around your child’s chest and/or their waist, this can help to prevent the shoulder straps from slipping, and provides better weight distribution. The only potential downside is if the main compartment of the back pack closes with a buckle instead of a zipper, the contents of the bookbag may not be secure. This could be a good choice for some children.
• Drawstring backpack– lightweight bag, with one major compartment and a drawstring closure. It is not sturdy, and does not have padded straps to distribute weight. This bag is flimsy and is meant for lightweight items; this is not an ideal school bookbag.
• Rolling backpack– Similar to a functional backpack, but it has an extendable handle and wheels. It can hold heavy items and won’t put added weight on your child’s body. However, it can be difficult to pull around the school building (especially stairs), and can be a tripping hazard. This may be a good choice for some students.

Key added features to think about when choosing a backpack:

• Sternum strap– a strap that can be worn across the chest to connect shoulder straps and keep them from sliding back and off the shoulders.
• Hip strap– a strap that can be worn across the hips to provide additional support and weight distribution.
• Mesh panels– on the area of the bag that makes contact with your child’s back can provide ventilation to prevent your child’s back from getting too sweaty.
• Waterproof– to help keep your child’s belongings protected in the rain, or if their water bottle spills.
• The number of pockets-having multiple pockets can be helpful with organizing, but too many can make it easy to lose items in the bag.
• Laptop compartment– is your child carrying a tablet or laptop? Consider having a bag with a padded, separate laptop compartment to protect it.
• Fasteners– Be mindful of fasteners, can your child do these? You want to foster independence, so either ensure that their backpacks have fasteners they can manipulate and/or practice with your child so that they can become more independent with the back pack.

Size and dimensions

Ever look at a child carrying a bookbag and think to yourself that the bookbag is bigger than them?!?! Well, in some cases, you might have been right; they were wearing the wrong size.

When choosing a backpack you should be mindful of the dimensions. Backpacks should not be longer than a child’s back. There are two measurements that are important; maximum height and maximum width. To determine maximum height measure the distance between the top of your child’s shoulders and to their waist (around their belly button) then add two inches. Your child’s back will have different dimensions at different points. Therefore, you want to measure the space between your child’s shoulder blades (when they are relaxed, not when they are pulling their shoulders back), and then add an inch or two. The back pack should be able to be centered between their shoulder blades, can be a few inches below their waist (belly button area), and the shoulder straps should be snug but comfortably rest on the shoulders. You do not want the straps to be too tight and restrict their range of motion, but you also do not want them to be too loose and allow the bookbag to hang too low on the body.

Packing the bookbag

There are several important factors to consider when packing your child’s backpack.

• First off, your child’s backpack should not weigh more than approximately 10% of their body weight. In other words, if your child is 50 pounds, the backpack should not be heavier than 5 pounds.
• As often as you can, at least once a week, check your child’s backpack to ensure that they are only carrying items that they need for that day at school, and for that night to do homework. Any unnecessary items, take them out.
• Is your child allowed to have a water bottle in school? Consider having them pack an empty bottle, and fill the bottle up with water in school.
• Instead of packing their lunch box and putting it inside of their backpack, encourage your child to carry it in their hand to decrease the weight on their back.
• When packing the bag, load the heaviest items closest to your child’s back. Having heavier items closer to your child’s body helps them to maintain an optimal posture and balance when wearing the backpack. Conversely, the lighter items should be at the front of the backpack, and sharp items should also be away from the back (like scissors).
• When arranging the items in the bag try to pack it so that the items will not shift and slide around when moving.
• Once you establish the ideal way and amount of things that need to go into your child’s bag, teach your child how to pack their bag. While you can help them pack it before school, your child’s teacher may not be able to help them pack it before they leave school. If your child has difficulty remembering how to pack it, take a picture of it ideally packed and tape it to the inside of the bag. You can also try color coding and numbering the items. For example, does your child like rainbows? Put a red sticker and/ or a #1 on the item that belongs closest to their back. Put an orange sticker and or a number 2 on the next item, etc. 
• Modeling and practice should also be included for putting your child’s backpack on and taking it off. Especially practicing the fasteners! 
• Lastly, if your child’s teacher insists on your child carrying heavy items to and from school, consider talking to them about the 10% body weight rule, and see if they are open to reconsidering the daily necessary academic items.

Check out our handout for a quick and easy summary of the information above. Thanks for reading!