Lifting is an inevitable part of a typical day in the childcare setting. Lifting children, picking up toys, and carrying trash bags are just a few parts of the day that require a childcare staff person's back to be in good shape.

The most common cause of low back problems comes from stretching muscles, tendons and ligaments leading to inflammation, swelling and pain. The key to minimizing back pain is prevention. By bending correctly, back strain can be prevented. Because half of the body's weight is lifted with incorrect lifting, the result is severe and unnecessary strain on the back.

Here are suggestions to prevent back injury:

• Bend from the knees-not the waist-and keep the back straight.
• When picking up a child (or a heavy object), keep the child as close to you as possible and avoid twisting when lifting. Lower crib sides before lifting a child from the bed and keep the child in front of you, pick him or her up, then carry to another location (without twisting) before placing down.
• Get a firm footing before lifting and keeping feet parted with one alongside the child and the other slightly behind.
• Adult furniture is sometimes hard to find in a childcare setting. Staff should not use child-size chairs or tables all of the time. While it is important to maintain eye level contact with young children, remember to take care of the back by using adult-size furniture for quiet times or breaks.
• When holding or rocking children, use comfortable chairs or furniture with good back support.
• Use changing tables that are at a comfortable height for standing.
• Use ramps or small steps to allow children (with supervision and hand support) to climb up to changing tables or other places where they might normally need to be lifted.
• For trips to the park or playground, use multi-seat carts or wagons to transport children.

Outside the childcare setting, there are other prevention techniques that can help avoid back strain. When driving, keep the seat forward and position the knees so that they are higher than the hips. Sleep, exercise and weight control can also strengthen the back. You may want to consult a specialist for guidance in these areas.

If back strain or injury occurs, and if the injury is not easily treated with rest and over-the-counter anti-inflammatory medication, seek medical assistance. Stretching exercises can help treat back injuries but seek a medical opinion before trying these exercises. Back braces are relatively inexpensive and can help support the back and "force" proper lifting by not allowing incorrect bending.

Childcare program directors can help reduce the possibility of back injuries (or sick days due to back problems) by educating and working with staff on prevention. Many hospitals and wellness clinics offer programs that focus on back injury prevention. Consider inviting a health professional to talk to staff about back injury prevention.

With proper techniques and focus on prevention, back injuries can be minimized.

RESOURCES

For more information on back care, refer to:

Healthy Young Children, published by the National Association for the Education of Young Children (NAEYC), 800-424-2460, www.naeyc.org.

The ABCs of Safe and Healthy Child Care, published by the Centers of Disease Control, 800-CDC-1824, www.cdc.gov.