Heavy backpacks can cause long-term harm to children's shoulders and spines. Studies show that 10-30% of children experience back pain by their teenage years, which may be linked to carrying heavy backpacks daily. One study found that the average backpack load was 22% of a child's body weight, and over 30% of children carried loads over 30% of their body weight at least once a week. Carrying heavy backpacks can cause children to adopt a forward head posture. Reducing backpack loads to 10% of a child's body weight or less can help maintain normal posture and lung function.

1. THE EFFECT OF HEAVY BACKPACKS ON CHILDREN
The modern schoolchild is required to carry a variety of heavy objects to school. Large
textbooks, stationary, sports kits and even laptop computers. Many children carry all these
things in a school bag, usually a backpack. However, research shows that having this weight on
their backs could cause longstanding harm to the shoulders and spine.
Back pain in children appears to be more common than was previously thought. Studies
have indicated that 10%–30% of healthy children experience back pain by their teenage years.
Recently, attention for the many possible reasons for back pain in children has focused on the
daily load of the backpack. In a recent survey of 237 Italian children in their sixth year of school
and with an average age of 11.7 years, 94% of them carried a backpack to school and 37%
carried it for more than 15 minutes each school day. The average load was 22% of individual
body weight, and one-third of the children carried loads of more than 30% of their body weight
at least once a week. About 65% children reported that carrying a backpack made them tired
and 46% felt that it caused them back pain.
Other studies of children's posture and contour of the spine have shown a clear
association between backpack load and postural response. Children assume a compensatory
forward head posture under backpack loads greater than 10%–15% of their body weight.
POINTS TO CONSIDER WHEN BUYING A SCHOOLBAG
• Purchase bags with wide, padded and adjustable shoulder straps. Padded straps help
absorb the load while narrow straps can dig painfully into shoulders.
• Buy a backpack with a moulded frame and adjustable hip strap waistband to transfer
some of the load from the spine to the pelvis. This will mean that the weight of the full
backpack will rest on the child’s pelvis rather than their shoulders or spine.
• Be sure the backpack is the right size. The bag should not be wider or longer than the
child’s torso.
• Choose a lighter material. Consider the weight of the backpack when it is empty.
• Don’t try to save money by buying the biggest pack to "last through college." Buy one
that is appropriate to the child’s size and one that they approve of.
HOW TO PROTECT A CHILD’S SPINE FROM EXCESSIVE BAG WEIGHT

2. • Pack items carefully. Place heavy items so they are closest to the child’s back and make
sure they can’t move around. It is important to be balanced in the natural centre of
gravity.
• Educate the child on how to carry a bag properly and safely.
• Children should use lockers to store unneeded books and sports equipment in the
school.
• Adding the morning stretching exercises, with deep breathing as part of the morning
regimen, to help the students in reaching the maximum respiratory vital capacity.
• Packaging a year's curriculum into separate modules instead of a single text, may also
help reduce the backpack load.
PREVENTION
The evidence suggests that reducing the load to 10% of body weight maintains normal
posture and lung function in children. Ways to reduce the load include using a properly sized
backpack that is snug to the middle of the back and has padded, broad straps and a waistband
to transfer some of the load from the spine to the pelvis and reducing the carrying time.
Carrying a bag is an unavoidable part of school life. With the large amount of
extracurricular activities and classes which children now participate in, backpacks can become
extremely heavy and cause discomfort and pain. However, with these practical tips and
education, parents can find a suitable solution and ensure that their children remain
comfortable, healthy and happy throughout each school day.
Dr. Ravi Malik
M.B.B.S., M.D. (Paed)
Sr. Child Specialist
Convener Medical Education, IMA-National
Asstt Secretery General, IMA-National