Parents and children will be enjoying a break from routine during the long summer break, but now is the time for you to plan ahead for the new school term and the health complaints that brings. Problems they will commonly encounter range from head lice and verrucae, stress and anxiety and coughs and colds to scarlet fever, eyesight complaints and obesity.
There has been a sharp rise in the number of scarlet fever cases over the past three years. More than 17,000 cases were recorded in 2015, the highest level since 1969, compared with around 2,000 cases in previous years.
Scientists are still investigating causes for the rise, but have ruled out new strains of the infection and antibiotic resistance, says Dr Theresa Lamagni, epidemiologist and Public Health England’s head of streptococcal infection surveillance.
“Important early signs to look out for are a sore throat, headache, fever and a pinkish/red sandpapery rash appearing within a day or two, typically on the chest and stomach but then spreading to other parts of the body,” she says. “There can be nausea and vomiting too.”
She explains the importance of quick diagnosis and treatment with antibiotics. “If a case is assessed and treated fast, children usually make a faster recovery with less risk of complications, and are also less likely to spread the infection. The risk of infection drops after 24 hours on antibiotics.”
Complications parents should watch for include throat abscess, ear infections, sinusitis and pneumonia. These can occur after antibiotic treatment. “Pharmacy staff can help by referring anyone with symptoms to their GP quickly and being aware of the possible signs,” says Dr Lamagni.
As well as antibiotics, pharmacy staff can recommend self-help treatments to parents to manage symptoms. “You can give paracetamol to reduce fever, calamine lotion and antihistamines to reduce itching from the rash,” says pharmacist Lila Thakerar at Shaftesbury Pharmacy in Harrow.
The new school year brings excitement for some, but for others it’s a source of stress and anxiety, in particular those who have exams. A survey of members of the Association of Teachers and Lecturers found that of those surveyed, almost half said pupils in their school had self-harmed, with 89 per cent blaming testing as the main source of stress. Staff complained that pressure placed on 10 to 11-year-olds was excessive. Almost three-quarters felt young people were under more pressure now than two years ago and 82 per cent said students were more pressured than a decade ago.
Exam stress and bullying were linked to teen suicides in a study by the University of Manchester. Figures published by the Office for National Statistics show an increase in youth suicides last year, with student suicides at their highest level since 2007.
“Many of the young people Young Minds works with say they feel completely defined by their grades and this is detrimental to their wellbeing and self-esteem,” says Nick Harrop, the charity’s media and campaigns manager. “Young people are growing up in a pressurised, fast-paced world and they need to learn the skills to navigate this new world successfully. Resilience building and life skills are just as important as exam results.”
Some children may become very anxious in the run-up to the new school year, especially if they are starting a new school. Mr Harrop has this advice to pass on to parents:
Young Minds has created a website, Headmeds (headmeds.org.uk), aimed at 13 to 25-year-olds who have been prescribed medication for a mental health problem.
About one-in-three children in the UK is affected by head lice at some point during the year. Parents are increasingly weary of treating infestations in their children and are resorting to unorthodox measures in a bid to get rid of them. Mintel reports that parents are using hair straighteners and home remedies, including vinegar and raw eggs, in desperation.
Joanna Ibarra, head lice expert at Community Hygiene Concern, maker of the Bug Buster kit for head lice, says: “More than 30 million children in the UK have experienced head lice and numbers continue to rise. We know from the feedback we get on our helpline that it continues to worry parents and that the products out there aren’t effectively treating the problem. Parents tend to go from one product to another in a quest for one that’s 100 per cent effective in one go, but this doesn’t exist.”
“Pharmacy staff can recommend the Bug Buster Kit (available from chc.org), to be used alongside other treatments if parents wish, so sales of their products won’t be affected,” says Ms Ibarra. Using the right type of comb is essential for effectively getting rid of lice. “Different combs are needed for louse detection and nit removal because a different width of teeth spacing is needed for each task. Using just one comb for both means lice trapped between teeth can remain unseen and be combed back into the hair.” For a nit comb, the teeth should be 0.09 to 0.19mm apart. For a louse detection comb, the gap can be 0.2 to 0.3mm wide. The louse detection comb should be used first, followed by the nit comb. Recommend a mild shampoo to wash off silicone-based head lice treatments, she suggests.
Teams can promote the Bug Busting days with a campaign in the pharmacy to raise awareness – the next one is on 31 October.
“Our research has revealed abnormal levels of frustration with head lice products relative to other OTC categories,” says Jonathan Hill, TyraTech country manager at Ceuta Healthcare, which markets Vamousse.
“Head lice are notoriously difficult to get rid of, despite the use of expensive treatments, with blame commonly directed at products that fail to deliver against bold performance claims. A little understood fact is the most OTC treatments work on contact (therefore diligent application is key) and many require repeat treatment in order to be effective. Community pharmacists can play a key role helping parents to understand this.”
“Ensure you are aware of the differences between types of product so you can educate customers and enable them to make informed choices on the best solution,” says Mr Hill.
Vamousse is being advertised on TV and in cinemas during the August and September back to school period. The TV advert builds on mums’ sense of resignation at head lice returning, with the 30-second commercial telling the story of a new sheriff (mum) who is confronted by a marauding head lice gang in a classic Western stand-off. However, it’s “high noon” for these head lice as the sheriff has something new to fight them with.
The brand has recently introduced a Vamousse Protective Shampoo for regular use during high-risk periods, such as back to school, or for protection from further outbreaks after treatment. Vamousse is also now included within the Minor Ailments Service in Scotland.
Hedrin brand manager Caroline Wheeler, says: “Our research found a third of parents said they felt stressed when finding head lice in their child’s hair, with 47 per cent fearing they would be judged if they didn’t deal with them quickly. We also found that only 35 per cent of parents felt confident about their ability to deal with head lice, so there’s still some work to be done.”
It’s important that pharmacy teams check that parents understand what to expect from a treatment. “Does it need a second application?” says Ms Wheeler. “If it is a physical killer, which does not work by poisoning, it needs to cover hair completely. Nits left on hair after treatment need to be removed physically – they are not a sign the treatment hasn’t worked. Children may still feel itchy after treatment.”
Community pharmacy teams can expect an increase in detection rates around the back-to-school period. “This is a key time to increase visibility of head lice products and information,” she says. “Some parents can still be embarrassed about asking for products, so dual siting in front of counter as well as behind may help.”
Hedrin’s packaging has been relaunched with colour-coded packs for easier selection and the latest addition to the range is Hedrin Stubborn Egg Loosening Lotion for nit removal. A new TV campaign for the brand runs to September.
A study in Korea has backed up some peoples’ concerns about the effect on children’s eyesight of excessive use of smartphones. The study suggested a link between convergent strabismus (cross-eye) and overuse of mobile phones. The findings highlight the importance of regular sight tests for children. All children should have their eyes examined at least once by the age of three, says the Eyecare Trust. Tests are free for children aged under 19 in full-time education.
According to Mintel, parents of under-15s are more likely to give their children vitamins occasionally (30 per cent) than on a daily basis (22 per cent). Mintel research found that many parents are confused by vitamins and supplements, while 18 per cent of parents believe they are harmful.
Pharmacy staff can help educate customers about which vitamins and supplements children may need. For example, official advice from Public Health England on vitamin D has recently been changed to recommend autumn and winter supplementation for all, while at-risk groups including the elderly, young children, pregnant and lactating women, individuals with darker skins, anyone who is not regularly exposed to summer sunshine or who habitually wears clothing that covers their skin while outdoors, should take vitamin D supplements all year round. Up to half of the population have blood levels below the minimum needed for normal bone health, government data suggests.
“Parents are often in a hurry, so a dedicated back-to-school promotional fixture with promotional offers during August and September is vital,” says Anita Clarke, senior marketing manager at Equazen. “There is growing evidence that having the right diet rich in omega-3s can make a huge difference to a child’s development in terms of learning and behaviour.” Equazen is advertising during the back-to-school period.
The new school year is a good time to remind parents of the importance of caring for children’s teeth and establishing a good oral hygiene routine. “Ensure your customers are aware that you stock children’s oral care products and that they can quickly get an overview of the products and price offerings,” says Alessio Martini, brand manager for Oral B at P&G.
“It’s crucial to allocate the segment space correctly, giving more room to bigger sub-segments. This means toothpaste should take up most shelf space, followed by brushes, mouthwash and interdental products. Stock leading brands that shoppers trust and that will be immediately recognised by customers.”
For many parents, back to school means a return to the dreaded chore of making packed lunches each day. About half of all school children take a packed lunch and in some areas parents have no choice. Recent reports show lunches typically contain too much fat, sugar and salt, and not enough fruit and vegetables. One primary school in Buckinghamshire, recently banned packed lunches for younger children after it found lunch boxes filled with cold McDonald’s meals and whole packets of biscuits.
About 70 per cent of children’s lunch boxes contain crisps, cheese products, chocolate bars and biscuits, while only half contain fruit or vegetables, according to Healthier Lunches for Children (healthylunch.org.uk).
“Lunches should include a starchy wholegrain food, a protein portion (eg hummus, lean meat, fish or eggs), a dairy item, vegetables or salad and fruit,” says Ayela Spiro, nutritionist at the British Nutrition Foundation. “Foods can only be nutritious if eaten, so involving children in planning their lunch box is important.”
She advises against sugary snacks. “Although some parents may think that a sugary snack is a good energy boost, on average children are consuming too much free sugar. Healthier snacks include baked pitta bread chips, plain popcorn, rice cakes, unsalted mixed nuts and seeds, cubes of fruit and slices of fruit loaf.”
Ms Thakerar has this advice on improving your back-to-school health category:
Nemesh Patel, Day Lewis Pharmacy, Chelmsford ‘Typically, the back-to-school pharmacy category covers a wide range of products – including head lice treatments, cold and flu relief medicines and vitamin and nutritional supplements. Being close to a number of schools, we feel it is important to ensure families have a selection of products to choose from. Hedrin and Lyclear are the top purchases for head lice treatment. We dual position these products to capture those parents who are embarrassed about asking for advice. Our team looks to desensitise the issue and provide friendly, clinically accurate advice, including prevention techniques, which I feel encourages repeat business. Parents frequently seek advice on coughs, colds, chickenpox and worming during September and October. We invest time in training our teams to ensure they are in the best position to make the correct product recommendations or referrals. This has helped to significantly enhance the customer loyalty and boosted our standing within the community.”
Rena Dadra, Village Pharmacy, London “This category is very, very important to our pharmacy as we’ve got a lot of schools in the area. We sell quite a few products, including multivitamins for children and young teenagers. In terms of specific queries, people usually come in to ask about minor ailments such as chickenpox. The pharmacist is full of children and young teenagers, so we get a lot of different queries. The most common queries we get now are actually for holiday vaccinations, such as antimalarial jabs. With regard to bestselling brands around back to school season, we seem to do well with multivitamin products such as Wellkid.”
Shaheen Bhatia, P&S Chemist, Ilford “This is quite a large category for us, partly because we have several schools in the area. We obviously get all the mothers coming in who have their concerns as their children start going back to school and mums want to make sure they are prepared. We have a supplements section in store and do notice an increase of queries around the back to school season, for example people asking about ‘mind power’ products such as fish oil supplements. We also start getting queries about flu vaccinations at this time of year. We vaccinate children aged over 11 as part of an NHS programme in London – and this programme has been very successful.”