A study published by the American Academy of Pediatrics found that more than 90 percent of sack lunches were kept at unsafe temperatures, exposing children to foodborne illnesses. Even lunches that included ice packs reached unsafe temperatures if too few were included or if too much time passed before lunchtime and the ice pack melted, the report found. In the study, published in Pediatrics , sack lunches of more than 700 preschoolers were examined. Although about 45 percent of lunches had at least one ice pack, only 1.6 percent of lunches with perishable items were found to be cool enough to be safe. Of the 1,631 perishable food items in the lunches that were studied, only 22 items were found to be in an acceptable temperature range. More were at dangerously warm temperatures. For parents, this study should serve as a wake-up call. Children are at particular risk for foodborne illnesses. Studies conducted by the Centers for Disease Control and Prevention confirm that children younger than four years old have four and a half times the number of bacterial infection incidents transmitted through food compared with adults. Symptoms of foodborne illness are unpleasant and debilitating. Severe cases, especially in young children whose immune systems are not fully developed, can lead to serious medical issues such as kidney problems, malnutrition, and even death, the study noted. Keeping food cool is an important way to prevent bacteria from growing and making kids sick. Some tips for parents: • Start with an insulated lunch bag or box. Soft, insulated lunch bags or boxes are the best choice. Avoid paper lunch bags. • Include small, frozen gel packs. Have extras in the freezer in case you forgot to put yesterday’s in the icebox to refreeze. • Consider freezing a juice box or water bottle and including it in the lunch. By lunchtime it will melt, providing a cool refreshing drink. • Pack smart. Be aware that leftovers, cold cuts, tuna salads, chicken salads and egg salads all must be kept cold to avoid the growth of bacteria that can make kids sick. Even store-bought, packaged lunch combos containing lunch meats, crackers and cheese need to be kept cold. • Don’t re-use wrappers. Foil, plastic wrap or Baggies are meant to be tossed, even if it seems environmentally friendly to recycle. After a day in a lunch bag, they have become incubators for bacteria. The safest thing to do is to discard them. • Break out the detergent. If you have reusable containers, be sure to wash them out thoroughly with soap and hot water daily. And wash that lunch sack regularly also!   KiKi Bochi is an award-winning writer and editor who hates packing lunches but wants them to be safe.