The American Academy of Pediatrics made the following recommendations about backpack safety in 2014.
Backpacks are great for kids to carry items back and forth from school to home, but backpacks that weigh more than 15 percent of your child’s body weight may cause health problems for your child. Neck, shoulder and back pain may develop from carrying a heavy backpack everyday.

The spine is made of 33 bones (called vertebrae) that have disks in between them that act as natural shock absorbers. A child carrying an unusually heavy backpack leans their head and chest forward to compensate for the weight of the pack, which puts stress on the back and neck. If your child uses only one strap to carry their backpack, the spine’s natural shock absorption ability is reduced because only one side is carrying the weight and your child will end up leaning to one side to make up for the extra weight in the pack.

When choosing a backpack check to make sure that it has two wide, padded straps that fit over your child’s shoulders, a padded waist or chest belt that will distribute weight more evenly across the body, multiple compartments to distribute weight, and does not have a width greater than the child’s chest.

Backpacks that have metal frames, such as those used by hikers, are better for your child’s back, but may not fit into lockers at school. Backpacks on wheels are also better for your child’s back, but many schools do not allow them, as other children may trip over them in hallways. Check with your child’s school to see what their policy is for these types of packs.

Parents can help prevent backpack-related injuries by:

• Making sure that the backpack is the right size.

• Teaching your child to pick up and put on the backpack correctly. Your child should face the backpack, bend at the knees, grab the pack with both hands to lift it, and put one strap on at a time.

• When wearing a backpack bend both knees when you bend down. Do not bend over at the waist when wearing or lifting a heavy backpack.

• Encouraging your child to use his or her locker frequently during the day instead of carrying all of his or her books at once.

• Telling your child to avoid carrying unnecessary items in his or her backpack. If your child does need to carry heavy items, such as sporting equipment, the heavier items should be placed in the back of the pack, closer to the body.
If your child experiences back, shoulder or neck pain, struggles to get his or her backpack on or off, leans forward when carrying his or her pack, or has numbness or weakness in his or her arms or legs, contact your pediatrician.
Sally Robinson is a clinical professor of pediatrics at UTMB Children’s Hospital. This column isn’t intended to replace the advice of your child’s physician.