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(KNSI) – With the first day of school just a few weeks away, one item on the supply list deserves more attention than it usually gets, the backpack.

Dr. Jessica Najarian-Bell, a pediatrician at CentraCare Pediatrics and medical director of the outpatient pediatric clinic at CentraCare Plaza in St. Cloud, says even in an era of fewer textbooks, kids are still hauling more weight than they should. She says backpacks that are too heavy or worn the wrong way remain a common cause of back and shoulder pain in school-age children, changing posture and straining muscles in ways that can spill over into classwork and activities.

Her first rule is a number parents can actually check. “You try to keep a loaded backpack no more than like 10% of your child’s body weight. So say you have a 70 pound child, that should be no more than seven pounds. You can weigh it on your bathroom scale if you’re not sure.”

The bathroom scale is the easy part. The harder question is what is making the bag heavy in the first place. Najarian-Bell recommends cleaning it out every week. “There’s always going to be items in there weighing it down that we don’t really need. Forgotten snacks or little toys, trinkets those kinds of things. Sweatshirts, sometimes I find three sweatshirts in my kid’s backpack, and that does add up.”

Beyond weight, Najarian-Bell says packing matters. Heavy items should ride closest to the child’s back and centered, not sagging at the bottom away from the body. Spreading items across the different compartments keeps the load from pulling in one direction. She also says most teachers give kids locker space, so students should carry only what they need for the day.

Then there is how it is worn. Both straps, always, even though slinging it over one shoulder becomes the cooler option as kids get older. Straps should be adjusted snug against the back, with the bottom of the pack sitting no lower than waist or hip level. She says straps should be at least an inch wide, adjustable and padded, and a waist or chest strap is worth using on a heavier bag. Parents should also skip the oversized adult pack and buy something sized to the child.

The long-term picture is what worries her. Najarian-Bell says research has found compression in the lumbar discs among kids carrying heavy loads over long stretches, and one study of more than 1,000 adolescents linked heavy backpack use to back pain. Sore backs sideline kids from the sports and activities they want to be in, and she says pain that starts this young often does not stay in childhood.

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