Watch a toddler pick something off the floor and you will see the child squat and then stand, straightening the knees, holding the object close to the body. Somewhere between the instinctive behaviour of early childhood and adult life, bad habits creep in which can cause bad backs.
According to the charity BackCare, back pain costs the country almost Pounds 6bn a year in time off work, and this year 24 million adults will have a bad back.
Early years practitioners are particularly at risk, but problems can be avoided if they lift properly, maintain a good posture, use equipment set at the right height and stay active.
Childcare employers have a double duty to develop best-practice advice: to maintain a healthy staff team and to avoid them setting a bad example.
BackCare's leaflet Vertebral Reality: healthy backs for children and young people says, 'When young children watch adults lifting objects from the floor by bending in the middle, they may assume that is the grown-up way of doing things.'
Early years settings, such as Pocklington Montessori School in Yorkshire, are developing lifting policies to protect staff (see box). 'We had a session on Alexander technique as part of our training and became aware that so much of what we do rests on our physical well being,' says principal Rosie Pressland. 'It made us think about what we do when we lift children or when we simply cuddle them.
'We encourage staff to have a good work-life balance, which includes going to the gym, becoming involved in sports, and swimming. We run classes here after 4pm in aerobics, yoga or dance.'
She adds that as standard Montessori practice, the staff make direct eye contact with the children when engaging with them. This means kneeling alongside the child or sitting down on a child-size chair.
The health and safety officers at Cygnets Education and Childcare in Stratford upon Avon have developed best-practice advice on lifting which is given to new staff during their induction and shared in ongoing training.
Proprietor Linda Findon says that it covers not just lifting children, but what to do when moving equipment or furniture. 'It involves sizing up things to see if it is appropriate to lift on your own or whether you need a colleague to assist you.'
Ms Findon says she discourages staff from picking up children to give them a cuddle. Instead, she encourages them to get down alongside the child, where they can give the same amount of comfort while not straining their backs.
This is also better for the child, she argues. 'I think that in a group setting, if you pick the child up, you remove it from the situation. You can comfort that child while his feet are still on the ground and he is connected physically with the setting.'
But what to do if someone does succumb to back pain? Rosie Pressland says her staff will share duties to ease the burden on someone with a bad back.
If need be the school pays for them to have acupuncture.
In most cases the pain will lessen in a few days, says Nia Taylor, chief executiveof BackCare, but in certain circumstances people are advised to see their GP (see box).
'If someone has a bad back the advice is really to try to keep up with normal activity. The old idea of bed rest has been shown not to be good for you and can be positively detrimental.
'Nursery work involves more than just normal activities. Lifting children when your back is painful may not be a good idea. You should probably go back to work as quickly as possible, but there might need to be some adjustments by your employer to make that possible, maybe in the hours you work and your duties.' NW
Further information
Health and Safety Executive Manual Handling Operations Regulations are being updated and will be published shortly. A free leaflet called Back In Work, advising employers on developing arrangements to deal with back pain in the workplace, is available at: www.hse.gov.uk
BackCare has advice on its website www.backcare.org.uk or ring its helpline 0870 950 0275. It publishes Vertebral Reality: healthy backs for children and young people and Back care, pregnancy and children, priced 2 each.
