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Safety & Prevention

Backpack Safety

By: Saji Azerf, MD, FAAP

Being loaded down with textbooks, gym equipment and school supplies can make backpacks heavy and hard to wear. If they're not worn properly, backpacks may cause back, neck and shoulder pain in children and teens. While backpacks have not been shown to cause scoliosis or long-term problems, it's never too early to start good habits that can decrease back strain and pain.

Use the tips below to choose the best school backpack for your child.

How to choose the right backpack for school

Here's what to look for in the perfect backpack:

  • Correct size—Bigger is not necessarily better. The more room there is in a backpack, the more your child will carry-and the heavier the backpack will become. Make sure to choose the right backpack that fits your child and their needs the best. The bag you choose should be proportional to your child's height.

  • Has two broad, padded shoulder straps—Having adjustable straps that are broad and distribute weight evenly between both shoulders is important. More padding does not translate to less pain. Both straps should stay even in length. Non padded straps can be uncomfortable and dig into your child's shoulders.

  • Has a padded back—This can provide increased comfort when the backpack is appropriately fitted and close to their back. It also protects them from being poked by sharp objects or edges (pencils, rulers, notebooks, etc.) inside the pack.

  • Includes a waist belt or chest strap—Belts and straps help redistribute the weight of the backpack more evenly across the body.

  • Look for backpacks with compartments: These can help evenly distribute the weight of contents throughout the backpack.

Tip: Include your child in the decision-making process and help them make a smart purchase. This will allow them to tote their packs comfortably all year long and you won't have to go searching for a replacement.

How to safely pack a school backpack

  • Pack the backpack so that most of its weight rests in the curve of your child's lower back. Pack the heaviest items like textbooks and computers closest to the body and place other items equally on the right and left sides.

  • Pack items in the different compartments. This helps distribute heavy loads evenly.

How to know if your child's backpack is too heavy

  • Backpacks shouldn't weigh more than 15% of your child's body weight. This means a child who weighs 100 pounds shouldn't have a backpack that weighs more than 15 pounds.

  • If your child needs to lean forward to support the backpack's weight, then it's too heavy. Consider using a backpack with handles or a rolling backpack if your school allows it.

To help keep lighten the load, encourage your child to:

  • Clean the backpack weekly and take out unneeded items.

  • Store items in a locker when possible.

  • Take only what's needed to school.

Teach your child how to pick up & wear a backpack the right way

When picking up their backpack, your child should bend their knees to avoid back strain. Then, the key is wearing the backpack so that it puts weight on the strongest muscles in the body: the back and abdominal muscles.

  • Use both shoulder straps. Slinging a backpack over one shoulder can strain muscles.

    • Adjust the shoulder straps so the backpack rests in the middle of your child's back.

    • The backpack should fit close to your child's body.

    • Secure the waist or chest strap. This helps keep the backpack close to your child's body and distribute the weight more evenly.

  • Make sure the bottom of the backpack rests in the curve of the lower back. The backpack should go from waist level up to about 1-2 inches below the shoulders. A backpack should never sit more than 4 inches below the waistline (bellybutton).

When not to wear a backpack

There may be times where your child or teen shouldn't wear a backpack, such as after surgery or an injury. Consider requesting a second set of books to have at home, if possible, and time to go back and forth to a locker so only items for one class at a time need to be carried.

Talk with your pediatrician

Reinforcing healthy back habits for your child can help reduce the risk of back pain. Do not ignore back pain in a child or teenager that occurs at times other than wearing a backpack. Ask your pediatrician for advice.

More information

About Dr. Azerf

Saji Azerf, MD, FAAP is a member of the AAP Section of Orthopedics. He practices as non operative pediatric orthopedist in suburban Atlanta, GA.

Last Updated
American Academy of Pediatrics Section on Orthopaedics and Pediatric Orthopaedic Society of North America (Copyright © 2022)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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