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Back to School During COVID 19

This year has been anything but ordinary. 

Usually, I would be writing a typical post about kids returning to school and the advice we might have in helping them transition back to school after a fun-filled summer. I would typically tell you to consider getting the kids a check-up, updating their immunizations, beginning to transition them back into a solid bedtime routine, and cutting back on electronic games and watching TV. I would generally encourage healthy meals and good hydration as we prepare the kids and teens to return to school. 

Don’t get me wrong. These are all good things and great advice. And if you search for suitable resources like, the American Academy of Pediatrics Parenting Website, and our website, you can find great information on any of these topics. 

But again, this year has been anything but ordinary. 

COVID-19 has taken us all on a wild ride. As health care providers, we try hard to be ready for the unexpected and prepared to help reduce suffering, provide information, offer emotional comfort, and help guide our community. Despite this, none of us were quite ready for a pandemic, even though we have studied them for years. Back at the beginning of 2020, just like families at home, we frantically tried to keep up with the constant changes and rapidly consumed all the information we could gather about this disease. We made policies that we then had to adjust every 2-3 days as new information and guidelines came forward.

At night, we went through the same struggles and constant changes with our families – worries about our kids, our parents, our community, our personal health risks, and our jobs. It seemed like we were all a little discombobulated like we were spinning in circles while trying our best to continue walking in a straight line. Some days were better than others. And some days, anxiety was the prevailing emotion.  

Unfortunately, living life and its constant changes have never really been good at soothing our anxieties. Life has always been unpredictable. Even before COVID-19, every day, the algorithm of life was uncontrollable. COVID-19 just brought the awareness of that unpredictability to all of us, almost universally, at the same time. We all collectively gasped, twisted our hands, and started to panic. We have had nearly six months to marinate in this worry, and now we are trying to pull ourselves together and help our kids go back to school. 

School is so very important. Huge actually. It needs to be right, feel right, and do right. And starting the school year, in average years, is stressful. We are worried about getting the right teacher, the right classroom, the right clothes, and shoes. We still have all of these worries, just piled on top of the COVID ones. Somehow we need to tame our anxieties and be successful this year.

So my advice today stems from a joke – a cartoon I once saw. 

A boss, sick with concern, asks his employee, “How will we achieve our goals this year?” The employee flippantly responds, “Set different goals.”

I recognize that we cannot entirely shift our worries and anxiety this year; it might not be wise to try. This year, I am trying to teach myself and my kids to acknowledge the unwanted companion named “fear,” “worry,” or “anxiety,” and then to adjust and modify our typical expectations so that we can better see our successes and build upon them. recommends, “As kids return to school, it’s important to keep an eye out for stress and anxiety in your child that could be a result of these changes. This can take shape in many different ways, including an increase in physical symptoms, changes in sleep patterns, continually seeking reassurance despite already receiving an answer, and acting out.”  

I would add that these are great warning signs for us as adults also.

The advice goes on, “It is important that adults manage their own emotions regarding the pandemic and remain calm, listen to their children’s concerns, speak kindly, and reassure them.”

When asked about the kids managing masks and the stresses of returning to school, I recently heard a pediatrician say something like, “The kids will do as well as their parents tell them they can. This has always been true.” Adults and parents managing their own emotions and remaining calm are a powerful influence on their kids. 

The article continues, “To help support your child’s mental health about the changes at school as a result of COVID-19, parents should:

  • Encourage conversation about the new protocols and safety rules
  • Acknowledge and validate the child’s feelings if they are scared or anxious
  • Reassure the child that a lot of adults are working hard to keep everyone safe.”

It is important to remember that if your child’s anxious behaviors persist despite the above interventions, contact a trusted health care provider, mental health provider, or school counselor.

You can access a lot of great information on how to talk to your kids about mask-wearing, myth busters statements about masks, and why the American Academy of Pediatrics, “Strongly advocates that all policy considerations for the coming school year should start with a goal of having students physically present in school.”, on their education site at

So as the fall season blows in, and recess bells and school traffic zones come as a sliver of a return to normality, we will try to breathe deeply and slowly. 

We will remind ourselves that the way we view things and talk about them significantly impacts our moods and our children’s moods. 

We will remember that there is hope in the idea that having to rethink everything might bring about beautiful changes we didn’t even see that we needed. 

We will rejoice in the idea that this group of kids and teens will be more flexible and resilient than they otherwise might have been and that they might value the “essential workers” with greater esteem than the generations before them. 

We hope the kids and teens will become the wise leaders of the future because of the many lessons they have learned during the pandemic – struggles, anxieties, and resilience. 

Everything You Wanted to Know About Poop but Were Too Afraid to Ask

During all my well-child visits I ask, “Are you pooping okay?” This question is frequently met with a smirk or a nervous laugh and generally some response along the lines of, “Yeah, it’s okay.” For something we do frequently, and hopefully every day, it is interesting that many parents seem more comfortable talking about the birds and the bees than talking about their child’s poop. So, in an attempt to clear the air on going number two, I would like to discuss some common myths and misconceptions about one of the most common issues in the world.

Myth#1: It is obvious when your child is constipated.

REALITY: Constipation is truly the Phantom Menace (apologies to all the Star Wars fans who liked Episode 1). It generally takes a long time for the parent and the child to become aware that an issue has developed. In one study it was found that in approximately 50% of children presenting to the ER with sudden onset severe abdominal pain, constipation was found as the cause. During the potty-training process, it is very common for children to become confused that the goal is never to have accidents instead of learning that what we really want is for poop to go into the toilet. This is what commonly leads to children holding their stool instead of learning to just “let it go”.

Alternatively, when many kids start school, they develop avoidance behaviors to pooping because the bathrooms at school are scary and gross. Every October, just about 4-8 weeks after school begins, I have a rush of families presenting to discuss their child’s abdominal pain. Even after I perform a careful history and exam, many families still have doubts that constipation is the cause of the pain. In these situations, I will perform an x-ray of a child’s abdomen and it will confirm that the colon is full of poop which has built up over the preceding months.

Myth #2: Constipation is defined by infrequent pooping

REALITY: The main two signs of constipation are extra-large man-sized poops and poops shaped like pebbles or logs. Many people consider this type of poop normal. If a child is pooping regularly, their poop should have more in common with soft-serve ice cream or pudding. While infrequent pooping happens with constipation, many chronically clogged children poop daily, even twice a day, because they are never fully empty. So, frequency is only half the equation in deciding if a child is constipated.

Myth #3: Constipation is no big deal

REALITY: Frequently, children who are constipated become adults who deal with constipation. While occasional constipation occurs to everyone, chronic constipation leads to a whole range of issues. The rectum, the final portion of the large intestines, was never designed to hold large amounts of stool for extended periods of time. Once the rectum becomes overly extended, a person may lose the sensation that poop is even present. This can lead to ‘encopresis’, a condition where a person has the inability to sense or even stop the leakage of stool. In addition, when the poop piles up a large, hard mass forms, leading to both discomfort and issues with the bladder as this mass of poop sits on top of it. A child may need to pee frequently and urgently or may even have spontaneous emptying of the bladder. In some cases, bed wetting can be caused by this buildup of poop flattening the bladder, making it impossible for the child to hold pee overnight. It is also well established that constipation is a risk factor for recurrent urinary tract infections.

Myth #:4 Prune juice, fiber and a dash of probiotics will fix constipation.

REALITY: While a good diet can go a long way to help prevent constipation, once constipation has set in it will likely take a little bit more to fix the problem. This is because once the large intestine becomes overly burdened with stool it stretches beyond its normal diameter. Once the intestines become overly dilated, the stretch receptors that sense when poop is present no longer function correctly and the muscles struggle to move the poop along. The purpose of using stool softeners such as MiraLAX and the occasional enema is not simply to clear out the poop that has built up but also to help retrain the bowel to what normal stool sensations feel like. Since constipation didn’t happen overnight, it often takes at least 3 months of daily poops that have the consistency of soft serve ice cream before the rectum and colon return to their normal size and starts to function normally.

Ultimately, having the child buy into the mantra of letting the poop go as soon as they feel it is what brings long term success in dealing with constipation.

Myth #5: Becoming constipated is a moral failing.

REALITY: In my experience, there is a huge stigma associated with constipation and often parents or children feel like they have failed when constipation is recognized. I want to make it clear that when a child becomes constipated it is not because of bad parenting or because a child has failed, it is most often because environmental factors beyond their control trained them that holding onto poop was better than just letting it go. When a child becomes constipated, assigning blame never helps the situation, but creating a positive team effort that removes barriers to using the toilet is essential to success.

I hope this journey into the world of constipation has been helpful in understanding not only how common this problem is, but also how fixable this issue is as well. If your attempts to fix your child’s constipation have not been successful, please make an appointment with one of the Pediatricians at Canyon View Pediatrics to discuss your child’s specific needs.

Get Moving!

You walk into the house after a long day at work. Johnny is sitting in the family room playing video games and Jennie is lying on her bed texting friends and watching TV. You know your family needs to be more active. You know too much screen time is harmful to theirhealth. You know that you must set a good example for a healthy lifestyle.  But how can you do that when all you want to do is sit down and join them?  Well, it’s time to tackle the impossible and get everyone up off the couch.

The US Department of Health and Human Services recommends 60 minutes or more of physical activity every day for children 6 to 17 years old. They recommend a minimum of 30 minutes, 5 days a week for adults. An active lifestyle has many benefits for the entire family. It improves cardiovascular fitness, builds strong bones and muscles, and helps to control weight. It helps with mental and emotional well-being and reduces symptoms of anxiety and depression. Physically active kids have better grades and better classroom behavior. Structured group activities help build self-confidence and provide social interaction.

It is important to make the activity a fundamental part of your life. Here are a few ways you can help your family move more each day and have some fun while you are doing it:

Get everyone involved 

Hold a family brainstorming session and come up with a list of fun physical activities.

Spend family time being active

  • Play at the park.
  • Take a walk after dinner.
  • Go for a family bike ride (wear helmets).
  • Play a sport together (basketball, soccer, softball).
  • Take an active vacation (hiking, skiing).

Add physical activity to your daily routine

  • Walk or bicycle to school instead of riding in a car.
  • Take the dog for a walk.
  • Take the stairs instead of the elevator.
  • Park farther away from the store.

Learn a variety of skills to find what you love

  • Teach your kids how to ride a bike or ice skate.
  • Enroll in a class to learn to swim, dance, or ski.
  • Look into organized sports or clubs that suit your child’s interests.

Limit Screen Time

  • Limit screen time to one or two hours a day.
  • Don’t put screens in bedrooms (TV, phones, computer, video games, etc.) Kids will spend more time away from the rest of the family if there is a screen in their room.
  • Turn the TV off during meals. Family meals are a good time to talk to each other.

Active parents tend to have active children. It is up to you to be a good role model, encourage family and individual physical activity, and enforce the rules.


“Physical Activity Guidelines for Americans”,

“Overcoming Barriers to Physical Activity”,

Haley Pledger, PA
Women’s Care
Matthew Walton, DO
Austin Bills, DO
Family Medicine
Aaron Fausett, PA
Family Medicine
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