Kids' Backpacks 101

Which backpacks are safest for kids? Plus, how to wear backpacks to avoid aches and pains.

From the WebMD Archives

Just about the time your child enters middle school, his or her backpack burden starts to grow. Laden with everything from textbooks to sports gear to cell phones and laptops, kids' backpacks get weighed down with some of their most prized possessions.

But do overloaded backpacks carry serious health risks? Experts give WebMD a lesson in kids' backpacks, covering their effect on your child's muscles and bones, the right backpack to look for when the new school year is about to begin, and how to pack and wear it to reduce pain and maximize comfort.

Kids' Backpacks: A Real Risk?

School backpacks are a staple, holding all the essentials kids need to make it through the day. But when the backpack starts to weigh your child down, could it be causing long-term damage?

"A lot of parents come in to my office thinking that their child might have scoliosis because of a heavy backpack," says Lori Karol, MD, a spokesperson for the American Academy of Orthopaedic Surgeons (AAOS).

In reality, explains Karol, scoliosis is not a danger. But kids' backpacks can cause back, shoulder, and neck pain when they're too heavy and worn for the better part of eight hours a day.

"Yes, your child might have pain related to a heavy backpack," says Karol, who is a pediatric orthopaedic surgeon at the Texas Scottish Rite Hospital for Children. "But parents don't need to worry that their child is going to end up with a back deformity, nor are backpacks going to create a problem that is going to need surgery."

While kids' backpacks aren't likely to cause long-term damage to muscle or bone as a result of constant wear, they do pose a more obvious risk.

"The issue I have seen is that kids fall and have an injury because their backpack is so heavy," says William Hennrikus, MD, chairman of the orthopaedic section of the American Academy of Pediatrics. "If kids are carrying a 40-pound backpack and they weigh 80 pounds, they can fall right over or not have enough stability to balance themselves throughout the day, risking wrist, arm, or leg injury, or worse."

Risk of falling aside, the right backpack -- packed and worn properly -- can be a valuable tool from elementary school all the way through college.

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Buy a Better Backpack

There are dozens of kids' backpack brands available to choose from, starting at about $10 and running upwards of $25 or more. When you're shopping for the new school year, here are some backpack basics to follow:

  • Two is better than one. While your child might beg for this because it's what all the "cool kids" are carrying, avoid the sling-style backpack, which has one strap that crosses the chest. "Using a backpack with one strap, not two, puts all the pressure on one shoulder," says Hennrikus, who is a pediatric orthopaedic surgeon at Children's Hospital in California. "It pulls the shoulder down and can cause back, neck, and shoulder pain." Look for a backpack with two straps instead, which splits the weight of the backpack across the shoulders.
  • The thicker the shoulder pads, the better. "Padded shoulder straps help prevent the straps from digging into your child's shoulders, back, and neck," says Hennrikus.
  • Wheels optional. "Backpacks with wheels definitely ease the burden of your child having to carry a lot of weight around all day," says Karol. "But many schools have stairs, which can be difficult for wheeled bags, and they might not fit in a locker." And they're pretty tough to roll in the snow. Weather permitting, check with your child's school before you buy a backpack with wheels.

The next trick is to pack the backpack properly.

Pack for Maximum Comfort

A backpack loaded with a day's worth of books and gear can be a heavy burden for your child. Before you start packing, experts recommend a simple set of guidelines to follow that will help you measure the weight of your kid's backpack against his or her body weight.

"The AAOS recommends that a child shouldn't carry a backpack that exceeds 15%-20% of their body weight," says Karol.

An easy way to test how much your kid's backpack actually weighs is to place it on your bathroom scale. While it might not be exact, it'll tell you if you're creeping into the red zone and putting your child at risk of developing back pain. But err on the side of caution, explains Hennrikus.

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"A reasonable recommendation is a 10% cutoff weight for bodyweight," he says. "This will help reduce the risk of injury related to falls and relieve pain that comes from wearing giant backpacks loaded with school supplies."

With 10% as the more conservative target, here's a breakdown by body weight for measuring how much your child should be lugging around in his backpack:

Child's Weight Backpack Weight

50 pounds 5 pounds

75 pounds 7.5 pounds

100 pounds 10 pounds

125 pounds 12.5 pounds

150 pounds 15 pounds

Wear It Well

So now you know what to buy, how to pack it, and how much your kid's backpack should weigh. But does your child know how to wear it well? Experts offer backpack tips to help kids lighten the load:

  • Always use both shoulder straps. Slinging the backpack over one shoulder can cause muscle pain in the neck, back, and shoulder.
  • Let kids figure out where it fits most comfortably, but try to tighten the straps so that the pack is close to the body. Still, don't go overboard. The straps should be not so tight that they pull on the shoulders.
  • Backpacks are teeming with pockets, and you should use them all! Distribute the load throughout all the different compartments to even out the weight, and avoid putting all of your child's books in one area so that the backpack becomes top- or bottom-heavy.
  • If your child has a locker, encourage him to drop his stuff off for the day so he isn't forced to carry around extra weight.
  • Remember that your kids' arms work, too. "Just because you have a backpack doesn't mean everything has to go in it," says Karol. "They can take one or two books out of their bags and carry them in their arms."

What does your child carry in his school backpack? Talk about it on WebMD's Parenting: Preschoolers and Grade Schoolers message board.

WebMD Feature Reviewed by Louise Chang, MD on August 25, 2008

Sources

SOURCES: William Hennrikus, MD, chairman, American Academy of Pediatrics, orthopaedic section; pediatric orthopaedic surgeon, Children's Hospital, Madera, Calif. Lori Karol, MD, spokesperson, American Academy of Orthopaedic Surgeons; pediatric orthopaedic surgeon, Texas Scottish Rite Hospital for Children, Dallas.

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