While the folders and backpacks are purchased, and new clothes ready to be worn, one of the last things parents might be thinking about is a string of headaches their children might get after returning to school.
Though there are many causes of headaches, Barbara Piehowicz, director of nursing for the Washington County Health Department, said there could be a few more specific to the area.
"For one thing, if they have a daily headache, it may be due to an infection," she said. "Living in this area, the Ohio Valley Crud, as many call it, leads to a lot of sinus infections...Ear infections (are also) frequent causes of headaches in children."
Piehowicz said eye strain is also a common headache trigger.
"A lot of times when children complain of headaches, they need to have their eyes checked," she said. "They may be straining their eyes. (During the school year) nurses (should) do routine eye exams. If (a child is) having problems reading the chart, (nurses) send a note home to the parent to make sure they go see an optometrist."
When it comes to headaches, typically the summer is easier for children, said Dr. Jack Gladstein, professor of pediatrics and neurology at the University of Maryland School of Medicine and director of the pediatric headache program and member of the National Headache Foundation.
At a glance
Headaches in children
Causes can include: eye strain, low electrolytes, dehydration, lack of sleep, certain foods, some infections like sinus and ear and stress/anxiety.
Prevention: Plenty of fluids, lots of rest.
Treatment: Over-the-counter medicines, but prevention works best.
For information on headaches, visit the National Headache Foundation at headaches.org.
"Kids with headaches often get better during the summer," he said. "There's less stress, they eat better and get lots of sleep."
Gladstein said that changes once school starts up, when children are getting less sleep and are affected by more stressors.
"You need to make sure they eat before they go out," he said. "Getting kids to finish their homework and get to bed earlier (is also important). Middle school is the worst time: there's a lot of social pressure, kids are meaner. Kids are going through stress getting through school."
Gladstein said it's important to make sure that parents address stressors before they get out of hand.
"Find out why they're stressed," he said. "Deal with that if at all possible."
Some children do get migraines, which Piehowicz said many don't realize can happen.
"Sometimes if a family has a history of migraines, a child can have it too," she said. "I think a lot of people think you have to be an adult, but you don't."
Gladstein said if a child does have migraines and is on medication, it's important they take it right after a migraine starts.
"The longer you wait, the harder it is to treat the headache," he said. "(It's important that parents) work with teachers and nurses...and make sure everyone understands getting the migraine medicine (is important)."
Piehowicz said a few other triggers can include food and drinks.
"Certain foods can cause (headaches), those rich in nitrates like bacon and hot dogs," she said. "Or drinks with a lot of caffeine...Sometimes kids get dehydrated and their electrolyte level might get low. They can also become hypoglycemic (low blood sugar) if they don't eat or drink enough."
She said hypoglycemia can occur even if a child is not a diabetic.
"A lot of times too, (headaches are even caused by) emotional factors," Piehowicz said. "They can get stress and anxiety from peers and teachers."
She added that over-the-counter drugs can be used to treat headaches if necessary.
Gladstein said there are a few ways to prevent headaches in children, including making sure they stick to a sleep regimen, get exercise and have plenty of fluids.
"Changing the sleep pattern can be a migraine (or headache) generator," Gladstein said. "When you get the kids up for school early, (don't allow them to) sleep in on the weekend. Sleepovers (wind down) at midnight and then they're up at 8 or 9 (a.m.)"
He added that one thing parents should be concerned about is a pattern change in the headache itself.
"If somebody had headaches twice a week last year and it's every day (this year), they need to make sure everything's OK," said Gladstein. "It may trigger more evaluation (on a child's condition)."