Getting your kids’ annual physicals this month? Take this check list with you to your appointment. There are straight forward, nutrition-focused solutions to all of the problems on this list. No drugs, no therapy, no ongoing visits to behavior clinics. Simple measures may resolve these problems without drawn out drug trials or therapies that leave your family frustrated and exhausted. If your pediatrician is stumped about how to use real food and nutrition tools, let’s talk soon!
1 – Diarrhea is not a developmental phase
How often have I heard, “my doctor said it’s ‘toddler diarrhea'” or “Clostridia difficile is common in kids, it doesn’t need treatment” or “it’s okay because my kid is still growing” or “it’s because he has FPIES“. Yes, infants and toddlers have varying stool patterns, but there is usually a reason for it that can be fixed. And it should be, because chronic diarrhea robs your child’s brain and body of critical nutrition. Teething, fevers, and stomach bugs can disrupt potty pattern for sure, but the operative word here is transient. Funky poop should resolve back to a comfortable pattern within a few days or a two weeks at most. Expect a baseline pattern of formed (not hard, not dry) stools every day that are easy to pass. Ongoing loose, explosive, mucousy, irritable, burning, or foul stool is not healthy, normal, or necessary to put up with. It is a sign that something is awry – food intolerances or allergies, background infections, reflux, or weak nutrition status to name a few. It can also make it harder for kids to potty train, when they never know what’s coming!
The other clear sign for good digestion and nutrient absorption in kids is steady growth pattern, with no flattening trend for weight, height, or body mass index. Daily eliminations that are soft formed (or soft gold mush for breast fed babies) are a sign that your child is digesting and absorbing his food well (in ancient Ayurvedic medical traditions, anything less than a soft formed elimination after each meal is considered constipation!).
Kids who have chronic diarrhea also often exhibit what can be misconstrued (and fruitlessly treated) as behavior or psychiatric problems like anxiety, irritability, low motivation (fatigue), bad sleep patterns, or inattention. What I so often find is that once digestion and stool pattern are supported, these problems fade too, as kids absorb nutrients and energy more reliably. Who wouldn’t feel better?
Long short – if you have a cranky little who can’t sleep well and who has a lot of loose messy stools, investigate. Don’t mask symptoms with long term drug dependence – fix the underlying problem. Your child’s gut health can likely improve with non-drug, nutrition-focused measures… even with conditions like FPIES. And if your school aged child is struggling with chronic loose stools, fatigue, and poor energy, expect it to be better. If your pediatrician can’t help, and a gastroenterology referral was a dead end too, schedule an appointment for integrative nutrition with me today.
2 – The most important thing for fighting infections is strong nutrition
Forget the vaccine debate. Nutrition status is the single most critical factor (of the “greatest public health importance“) to influence whether kids get sick, how often, for how long, and whether or not they have complications with illnesses or infections.When kids do get sick with serious bugs like flu or measles, well nourished kids fare far better, with a less complicated, shorter course of illness and full recovery. For over seventy years, data have piled up to show what a huge impact nutrition has on the immune system, from several angles – from your kids’ tissue stores of vitamin A, to total protein intake, growth status, iron or zinc status, inflammatory chemistry, and more! You can help your kids stay well even as they are surrounded by sniffles and coughs at daycare or school, by setting them up with tip top gut health and food. Judicious use of supplements, probiotics, and herbs can work wonders too – just be sure to tailor these to what your child needs, not a one-size-fits-all approach. Music to my ears: When parents whom I’ve worked with tell me, “We didn’t have any colds this whole winter!” It happens.
So what is nutrition status? It isn’t what supplements you’re eating, whether you’re vegan or Paleo, or even what food you give your kids. It’s a number of things that are classically measured in children to assess how healthy they really are. These are not all included in a standard well check or school physical, but some may be added on if you ask your doctor. Strong nutrition status is evident in:
- Solid growth pattern in your child’s expected channels for weight, height, and body mass index. Your child can be expected to proceed at percentiles achieved at birth, unless s/he had a special circumstance that needed support very early, such as low birth weight or premature birth; even this can be expected to improve some as your child grows. Though pediatricians generally won’t address growth regression until children fall way down the chart, drops of more than fifteen percentile points that persist for more than three months warrant investigation for cause.
- Mid range lab findings for serum iron and ferritin (not at high or low edge of the range); normal blood count; normal chemistry panel with serum protein, albumen and other findings in mid lab range.
- Infrequent illnesses with short duration and full recovery.
- Strong clinical signs for healthy hair, skin, teeth, and nails; no or few cavities in the child’s lifetime.
- Ability to play, sleep, learn, and eliminate comfortably.
3 – Your child may need iron when s/he is not anemic
It’s common at annual physicals to check hemoglobin and hematocrit for kids, which is done with a finger stick blood test. These are two tests to check if your child is anemic. The problem with this is that these are low sensitivity tests that don’t pick up pre-anemia. Pre-anemia is a thing! It is a state in which iron stores are depleted, but hemoglobin and hematocrit are still in the normal range. These kids need iron support, and depending on diet, food intake and other factors, the fix may be just the right food, or may require the right iron supplement (there are several) or even an iron prescription. Kids in pre-anemia will have any or all of these features:
- shiners under eyes, pallor
- more frequent infections and colds; may take longer to recover
- irritable; crabby one minute, happy the next
- hyperactivity with fatigue – “crash and burn” pattern
- math may be most difficult subject (iron is related to math learning!)
- difficult sleep pattern, insomnia, can’t settle to sleep or sleep through
- picky or weak appetite; may want to chew non food items
- in girls in puberty, menstrual flow may be heavy, fatiguing, and/or with clots
Since iron is poisonous as well as essential to our bodies, don’t give iron supplements without guidance. Request thorough testing to find out if your child needs iron, vitamin B12, protein, or just the right food to correct anemia. I can help you with this as well, by finding an easy to tolerate iron supplement or B12 protocol, as well as how to work in replenishing foods.
4 – That allergist referral won’t find all your kids’ food reactions
Allergists check one thing: Allergies. They look for reactions by checking IgE (immunoglobulin E) responses to foods or other substances. They may measure histamine and tryptase levels too, among other things that relate to those swift and dangerous reactions that have you grabbing the Epi Pen. But there are many other types of reactions to foods that disrupt stools, skin, behavior, and functioning. If allergy testing was negative for your child, but there are frequent colds or congestion, asthma, eczema, messy irritable stools, weak picky eating, or other nebulous symptoms, assess more deeply. So far, while insurance coverage for food allergy testing is common, it is not common for testing for food sensitivity reactions, or other immune responses to foods. Identifying these can make life a whole lot better for kids struggling with multiple symptoms – but, be prepared to go out of network and possibly pay out of pocket for these tests. Depending on your insurance and your child’s nutrition diagnosis, it may or may not be covered. I guide parents with this testing, can authorize it if your doctor does not know how, and interpret findings to build a nourishing diet for your kids.
5 – Nutrition CAN reduce ADHD symptoms without medication
Big topic. Pediatricians are trained to offer behavior therapy as a first line of intervention for young children with ADHD; if that doesn’t work, their next recommendation is for medication with behavior therapy. But what they don’t learn is how to help children achieve functional focus with nutrition, gut health, and food. So much can be done! Stimulant medications have many drawbacks and side effects. Search my blog posts on nutrition and ADHD – there is ample to mine there. You can also view this free lecture on nutrition and ADHD.
Children as young as three years old can be given stimulant medication, per FDA guidelines. It may seem like an easy quick fix, but there are other options. This is not without costs to your child’s health and well being; suicidality may increase in older kids given these medications. Help your child eat and absorb the nutrients his brain needs to focus. Take out the toxins, inflammation, and noise in the body. You may be amazed at the difference nutrition care can make.
Why doesn’t my doctor practice nutrition?
Pediatricians don’t have a lot of time when they meet with you for a school physical or well check; insurance companies tightly control what topics can be addressed in those visits, how long the visit can take, and how much a doctor is paid for that service. When your pediatrician wanders from the format, he essentially won’t get paid for his time. And, they need to have a high volume practice to make money – meaning even less time to listen to you, educate you on meals and nutrition, or research new topics on their own. Further discouraging nutrition in pediatrics is that drugs are much more profitable. Drug companies now wield heavy influence over pediatric care, from the time a doctor begins medical training to every week in practice, when drug company sales reps visit with samples, glossy brochures, pens, free lunches, treats, or incentives to write prescriptions. It’s irresistible and easy. There is no such format for nutrition intervention for complex problems. Last but not least, pediatricians are not required to complete much training in nutrition. They simply may not know what to do.
In my nutrition practice, I give clients lengthy appointments to integrate all facets of your child’s care into an individualized nutrition care plan, including lab studies, history, growth status, food intake, and aspects of your lifestyle. I write detailed care plans for each encounter. This takes a lot of time that pediatricians don’t have. If you’re stuck, get started today with an appointment. Or go to my home page (scroll down) to download your free Sensory Nutrition Checklist – begin today with some easy tricks to help your kids function better!
I’m now serving my second generation of clients, working with moms who where were not even born when I finalized my credentials as a dietitian/nutritionist. Recently I did a double take noticing that a young mom I was working with was born on my wedding day – Wow!
It has been quite a journey. I’ve watched earlier clients’ kids, and my own son, grow up to be more functional and able, after rocky and uncertain beginnings. But I have some bad news for you young moms: It is a lot worse out there than it used to be. It’s very different for you than it was for my generation. There’s a whole new normal, and it ain’t pretty.
More than half of US children are now chronically sick or disabled – meaning that it is now more common for kids to have chronic conditions or developmental delays, than it is for them to be healthy, growing strong, and developing or learning normally.
During my graduate years in public health nutrition, this was unthinkable. CDC goals we worked with then have not come close to being met. We’ve not only fallen short, we’ve actually violated the very first goal to “prevent morbidity and disability “- ! Both have increased dramatically for US children in the 21st century.
Type 1 diabetes has quadrupled. Children under age 10 are now getting diagnosed with Type 2 diabetes – actually unheard of when I was trained in the late 1980s; this was only diagnosed in overweight, middle-aged people at that time. At least 80,000 kids in the US are diagnosed with Crohn’s disease, a severe and chronic inflammatory bowel disease, and its incidence in children is increasing. I meet kids each month who have similar symptoms but have never been diagnosed, and I just worked with my first toddler diagnosed with Crohn’s disease this spring. During my training, this wasn’t even mentioned as a condition that a young child could have. Even the phrase “toddler diarrhea” didn’t exist (diarrhea is not a developmental phase!). Babies and toddlers were not diagnosed with, or given medications for, GERD (reflux drugs like Nexium came to be so overprescribed, they were called “purple crack“). Asthma, cancer, allergies, and of course – autism – are all increased far past their 1985 levels, with no signs of slowing down. And are you tired of hearing yet that autism has shot up nearly 150-fold since 1975, and that some estimate that half of US children will have it by 2025? How will this country function, populated by sick and disabled adults? How will we pay for their care?
Those are big questions. But here is the question that has had me scratching my head for the last twenty years: What are our pediatricians doing about it?
Are they even thinking about reversing these trends, in any meaningful way?
If they are as young as you are, it’s doubtful they know how miserably we failed at reaching the CDC’s goals from the late 20th century, for population health. Or that they’ve had much of a deep dive into child nutrition and its role in development, learning, behavior, and immune strength. I also do wonder if they know what it’s like to see kids who never need any prescription drugs, because they’re just …healthy.
Being sick repeatedly throughout the year, needing multiple rounds of antibiotics, being developmentally delayed, having an impacted, inflamed, or ulcerated colon, being unable to eat anything but milk, yogurt, or Pediasure, or having only loose, burning, foul stool or impacted hard stool may be common nowadays, but it isn’t normal.
Your kids should be healthy, comfortable, vibrant, eating, eliminating daily, sleeping well, growing, playing, and thriving! If they can’t because of a chronic condition, then they still deserve to reach their fullest potential, enjoy their highest well being, and feel good as often as possible.
From my perch as a pediatric nutritionist/dietitian, I have watched it get harder and harder to restore kids’ health, away from the chronic gastrointestinal, feeding, growth, developmental, and allergy/immune problems they have. Kids bodies seem more compromised, their immune systems more confused, their intestines less functional. The work is more complex than it was in 1998 or 2000. Diagnoses like FPIES (which my own son had in 1996, before there was a name for it), milk protein intolerance, food allergies, intolerance to breast milk, and EoE are not unusual now, but they earned no mention during my training in infant and child nutrition in the late 1980s.
I often wonder how pediatricians of my generation reconcile this. Do they notice, like me, that children are sicker, as government data show?
Moms under 35 have it rough. You are..
- The first generation to grow up with more antibiotics, vaccine doses, psychiatric medicines, and just plain more prescription drugs than any other.
- The first generation to grow up eating GMO foods.
- In the years you were conceived, patent and marketing laws for drugs changed – and dozens of new drugs flooded the market, whether we needed them or not, and regardless of non-drug options that may have worked as well or better.
- The goal posts have moved for what counts as valid published medical “science” – much of it is now ghost written by the pharmaceutical industry.
- Environmental protection laws are either being stripped or unenforced, allowing more toxins into air, water, and food.
- You are now bearing children with more toxic burden than any parents before you in America’s history.
In short: It’s a lot harder to have healthy kids these days. Your bodies were exposed to more toxins, sooner, than people of my age. And now your children are exposed to all of this even before they’re born, in utero.
So now what? It’s simple: Remember that your kids get to be healthy.
That is their birthright, and their normal. Expect them to be healthy, not chronically sick. But you have to do some serious footwork, even before pregnancy, to help them get there. If your kids are already here on the planet, there is a lot you can do to diminish their odds for chronic disease, developmental injury, and psychiatric conditions. If your kids are already affected by these problems, there is still plenty to do with food, nutrition, and good support for immune function and detoxification – you might be surprised to see how well your kids can be.
Here you go:
- Eat organic whenever you can. It matters. I actually did some work on this during my graduate studies (eons ago) and found that yes, organic foods are more nutritious, and have fewer toxins (though not toxin free, thanks to widespread use of pesticides and GMO crops in the US).
- Don’t eat GMO food, period. Minimize it as much as possible. Here’s why.
- Find out if your kids have food sensitivities or allergies; feed them foods that nourish deeply, not foods that chronically inflame.
- If your kids need antibiotics, restore healthy flora – you will know it worked by appearance of a daily, comfortable elimination (no bloat, hiccups, burps, picky eating, straining, watery stuff, mucus, dry pebbles, or foul odor – just formed easy to pass stool and healthy appetite).
- Drink filtered water, not tap water. Put filters on shower heads. Or, consider a whole house reverse osmosis water filter.
- Don’t use plastic containers for food. Avoid plastics, xenoestrogens, and xenobiotics in lotions, shampoos, soaps, or foods.
- Eat more vegetables, more plant foods, and less meat and sugar than you want.
- Eat loads of ancestral, organic fats and oils.
- Don’t have a C section if you can help it. If you can’t, seed your baby’s gut biome with probiotics or your own flora.
- Don’t get vaccinated while pregnant. It can increase your risk of miscarriage, and it delivers toxins like aluminum, mercury, and rogue viral or human DNA into your body. Effects of vaccinating pregnant women on their unborn children for asthma, allergies, or other immune mediated conditions are unstudied.
- If you need antibiotics during pregnancy, delivery, or breastfeeding, take all precautions to restore your baby’s gut flora with probiotics and a healthy diet.
- Read this 2017 study on the health of vaccinated versus unvaccinated kids. Choose soberly what you want to do.
Those are good starts – a big effort, yes; harder perhaps, but the upstream work is well worth it if there is a chance it can prevent burdensome chronic conditions in your kids. If you need more specific guidance for your own child’s situation, contact me for an appointment and we can get started.
Herbs, vitamins, and minerals can support immune response during and before illness. Anyone can buy them – but are they safe? Do they work? How do you use them?
Like any prescription drug from your pediatrician , if you’re using the wrong dose, in the wrong context, at the wrong time, or with substances that don’t mix safely, immune supports can fail, or can trigger strong reactions that make your child feel worse.
New flash: Pediatricians don’t train in the use of non-prescription supports like herbs, foods, nutrients, or supplements. They do train in how to prescribe drugs and when to make specialist referrals. Odds are, if you ask your doctor how to use, say, olive leaf extract, caprylic acid, or the correct form of garlic for anti-viral support, they won’t know what you’re talking about.
Botanicals, herbal compounds, foods, and supplements have diverse actions on our brilliant and complex immune systems. Herbs and nutrients also have direct antimicrobial effects of their own. This means they can be potent allies in your quest to get your family through winter infection-free, by preventing illness, and by pumping up the body’s fight if colds and flu happen.
Here are my top five go-to’s for natural, non-drug ways to help children divert illnesses and infections:
1 – Eat lots, eat well! Data show that underweight kids (body mass index below 10th percentile) and overweight kids (body mass index over 90th percentile) get sick more often and stay sick longer than normal weight peers. Immune supports can’t work as well when the body is already struggling for energy and resources. Emphasize vegetable carbs over grains: Think pumpkin, parsnip, broccoli, cauliflower, sweet potato, spaghetti squash, butternut, beets, Brussel sprouts, and hearty greens like chard, kale, arugula or spinach. These are mineral-rich, phytonutrient powerhouse foods. For grain source carbs, mix it up. Don’t give the same processed simple starchy grain day in and day out. Vary grains to include quinoa (technically not a grain but more closely related to beets), buckwheat, different types of rice (black, brown, jasmine), or others. if your child can tolerate gluten, choose organic (US wheat is one of the most RoundUp-laden crops we grow, with the average rate of RoundUp applied to it having tripled in recent years). If your child is too picky to vary carbs as suggested here, we need to talk. That picky diet is one reason why your child may get sick more often. Work with me on strategies to change it.
Eat fats and oils, organic as often as affordable, and natural (unprocessed). Fats carry critical immune defense nutrients like vitamins A, D, and E into tissues. Grass fed butter like Kerrygold (available at Costco or most supermarkets), or at least organic butter or ghee, are great options, as is coconut oil, olive oil, avocado, eggs, meats, fish and nuts/seeds and their butters. Think in terms of giving the equivalent of 1 quarter cup daily of fats and oils from all foods (this includes fat in foods like eggs, meat, or fish) – that’s about how much a school aged child needs. Teens will need more.
Protein matters all day long for kids. Breakfast cereals and milk are thumbs down in my book – mostly sugar, little fat and weak protein that only comes from the milk. Not an auspicious start to a demanding school day! Homemade chicken broth, egg drop soup or broth, pumpkin pancakes, smoothies with protein powders – check my recipe archive for ideas and my breakfast post too. Give proteins throughout the day. If your kids are hungry, let them eat.
“But my kid eats like a horse, and still gets sick.” Right? So: Eating plenty can have a curve ball – and that is, in kids with rigid, starchy, addictive eating patterns for sugar, wheat, and dairy food. Not healthy. See Milk Addicted Kids for more info on that. Lastly, avoid offering too many tough-to-digest, raw, bulky, or fermented foods. Relax strict Paleo, Yeast Free, GAPS or other tight routines if your child’s body mass index is too low. Check my recipes for some ideas to gain and grow.
2 – Olive oil and olive leaf extract – These have several anti-microbial, antioxidant, and immune supporting components, including hydroxytyrosol, oleuropein, luteolin, and apigenin. Some have anti-inflammatory effects; oleuropein has gained popularity for its broad activity against viruses, bacteria, and fungal (yeast) microbes. Other bitter compounds in olive leaf, caffeic acid and verbascoside, have direct antimicrobial action too, against several bacteria and fungal species (yeasts). Human studies are few, but in vitro, oleuropein kills many bacteria, including Klebsiella pneumonia, Mycoplasma, Staphylococcus aureus, Pseudomonas aueruginosa, and others (but doesn’t harm beneficial stuff in the gut like Lactobacillus). As for viruses, oleuropein blocks viral protein production and interrupts replication – that is, the virus can’t stay alive and can’t reproduce itself in the presence of oleuropein, meaning it can’t easily survive in you or spread to others, when you’re eating oleuropein from olive leaf extract!
Good news: Olive leaf extract and olive oil are safe, with low toxicity. Side effects may include looser stools (a benefit for some) if eating a lot of oil at once. Oleuropein may also lower blood pressure, so this is a caution for kids with low tone, low blood pressure or fatigue. Animal studies on the extract have shown safety and efficacy at 8 mg/kg per day; this would be roughly 200 mg daily for a 55 pound child. For kids who can swallow capsules, I suggest Gaia brand Olive Leaf or Nature’s Way Standardized Olive Leaf extract because these are standardized to contain a minimum percentage of oleuropein and they are alcohol free (alcohol extractions don’t show the same potency as water extracts or oil infusions of olive leaf). For kids who don’t, Barlean’s Olive Leaf Complex is a good choice, as it also standardizes the amount of oleuropein in each serving and even has flavored options. Meanwhile eat at tablespoon or two of olive oil daily at room temperature or slightly warm; over heating it will reduce the power of its immune boosting components.
3 – Berberine – This herbal extract is found in many plants, including goldenseal, philodendron, and barberry. It has a wide range of antimicrobial activities; one of its skills is to make it harder for bacteria to attach to mucus membranes in lung or other tissue. Whole plant extracts that contain berberine have other components that create a synergistic effect, making them effective even against antibiotic resistant MSRA. Berberine’s ability to arrest Staphylococcus, Streptococcus, and Pseudomonas organisms was demonstrated years ago. Berberine has also been shown to increase immunoglobulin A (IgA) levels; IgA is the first line of defense in tissues that line the ear, nose, throat, lungs and gut. Like most herbs, its benefits go beyond immune support – it has been shown to benefit heart function and regulate menstrual pattern too. Tinctures and capsules are widely available. Cautionary note: Berberines are synergistic with several drugs, including Diflucan and ampicillin, so if your child is needing prescription drugs, talk with your care team before mixing these. A school aged child can typically safely use 200-600 mg berberine daily during acute illness, if not mixed with drugs. As always, if you’re not sure, get help from your licensed health care provider.
4 – Real Deal Chicken Broth – Recently my dad had a lingering cold, something that can be quite dangerous for the frail elderly (which he is). I suggested he sip broth daily – but my dad said he didn’t like it. At their house, I saw that my folks were using store bought broth that was indeed not very tasty. I roasted a chicken, and after we enjoyed the meat and pulled it off the bones, I made broth – which is not at all hard to do. In it went fresh bulbs of garlic, sage, thyme, rosemary, fresh ginger root (peeled and sliced), salt, a dash of dry white wine, and an entire lemon cut into quarters. After simmering for a day it was ready and my dad liked it a lot better than the store bought stuff. Good broth has an array of easy to absorb minerals and amino acids like proline, glycine, and glutamine, which are released from the collagen and ligaments in the chicken as it simmers. Its anti-inflammatory effect has even been verified with careful study. Ginger root adds an expectorant action on lung tissue, while lemon rind and pulp lend immune supportive bioflavonoids, minerals, vitamin C and limonene, which has been shown to boost white blood cells. Real chicken broth is so easy to make. Offer it plain or you can add your kids’ favorite noodles (yes, there are even gluten free Ramen noodles), drop in an egg to poach, or stir in a few raw greens (spinach, scallion, arugula, or basil leaves).
5 – Red Root (Ceanothus) – This is a powerful aid to help lymph nodes drain and clear debris created when we kill infections; all those dead microbes have to get out somehow, and after the immune system is done disabling them, it is our lymph system that is the clean up crew. Actually feeling sick is more about this debris clearing out through lymph, liver, spleen and kidney than the offending microbes themselves. Red root can act broadly on the lymph system to help clear this debris. Red root also has some direct anti fungal and antibacterial actions, antioxidant activity, and some evidence shows it can also boost white blood cells and T cells. Use just a couple of drops of tincture to start for a child; this is a potent tool and best used with oversight from your licensed naturopathic doctor.
This is a very short list, and I’ve skipped many obvious favorites – including nutrients like vitamins A, D, C, iron, or herbs like echinacea or elderberry – already widely known as great helps for colds and flu. There are many hundreds of possibilities to support us naturally, when it comes to colds and infections. Unlike antibiotics, herbs are difficult if not impossible for bacteria to gain resistance to, because rather than being single chemicals with a single action (like antibiotics). they are complex living entities with multiple components in their extracts or whole parts; and, they too can adapt in response to a microbe’s assault.
Prescription drugs for colds and infections have their place. Respect and engage them as needed with your doctor’s guidance. If antibiotics and other drugs fail your family, or if you simply wish to avoid them, natural tools can be important adjuncts. If you are just looking for tools to build your kids’ immune wellness, foods and herbs can go further than drugs – make good eating and natural supports a way of life, and your family will benefit!
When I hear a parent tell me that their kids get ear infections, upper respiratory infections, stomach bugs, and need antibiotics more than once a year, I wonder why. Are your kids passing colds back and forth all winter long? Sniffles and fevers every month, for someone in the house? It can be better.
It didn’t used to be this way. Are kids less healthy?
The answer is yes. More kids than ever before have chronic illness, obesity, and/or disability in the US – in fact, over half of them do. And more US children are in poverty now than in the last fifty years – which means many, many kids are eating poorly and falling into mild to moderate malnutrition.
Kids spend more time indoors and in front of screens, less time moving and playing outside in fresh air, and are swimming in electromagnetic forces (EMFs) from wireless devices, 24/7. They can barely escape the flow of media targeted at them.
Their stress is unprecedented too, as schools dial up testing, homework, and extracurricular activities.
Add to this unprecedented use of prescription drugs for kids – from reflux medicines to more vaccine doses to Tylenol, anti-inflammatories, steroids, psychiatric medicines, and antibiotics – and you’ve got even more toxicity for the body to clear. Flu shots in particular may add to this problem – are they spreading more infection than they prevent? Viruses from vaccines can shed and spread; this is called “secondary transmission“, and flu shots are among the most common culprits for this effect. The data are not very supportive of annual flu shots – read more here.
Lousy food. More stress. Less sleep. More toxicity. It’s a perfect recipe for dropping an immune system!
Luckily, what kids eat makes a huge difference, possibly the most important difference, and you can work with that. There are “extensive, synergistic, antagonistic, and cyclical interactions” between nutrition and infection (source here). Infants and children in strong nutrition status get sick less often and recover faster than kids who are underweight, overweight, or who are marginal for key nutrients. Marginal or low status for even one vitamin, mineral, or macronutrient can lower the immune system’s power! Give your kids the building blocks they need to fight infections.
Think of it this way: When the rains come, you want your roof to be strong and water tight. You don’t start repairing the leaks after it starts raining. Food and nutrition is like that roof. If it’s leaky to begin with, your child will stay sick longer, get sick more often, and may have complications. Sure, you can give your child supplements to support clearing of infection and fighting fever when they are sick. But you can also prevent leaks to assure that the roof weathers the storms.
Get these in, day in and day out, year round:
Enough Food – Simple, right? But if your child is picky with a narrow, weak appetite, this is a problem to fix. Kids who are too thin for their height (weight for length, weight for stature, or body mass index below 10th percentile) will get sick more often and stay sick longer. Appetite can be suppressed by reflux, mineral deficiencies, antibody reactions to foods, or latent gut overgrowth of Candida, yeast, parasites, or unfriendly bacteria like Klebsiella oxytoca and others. Contact me for an appointment if you would like to troubleshoot this and turn your child’s appetite around, so they can eat enough to thrive.
Varied Food – Kids need carbs, protein, fats, oils, plus minerals and vitamins – the works – most every day. Many parents I meet in my practice have become afraid of certain foods. Some over-restrict carbs, others over-restrict fats and oils, while still others give only one or two protein sources (usually, dairy). Using a Flintstone’s chewable won’t go far to overcome a poor diet. Most over the counter kids multivitamins are just that – a few low potency vitamins. No minerals, and if any, they’re at irrelevant dosages. If your child is picky and eats mostly dairy for protein, s/he is probably missing a number of key nutrients that the immune system needs to build its defense mechanisms. Plus, whole fresh foods offer antioxidants and phytochemicals that aren’t classified as “essential” nutrients but are notable for their beneficial immune modulating effects. Variety is so essential to fueling a strong growth pattern and strong foundation for your child’s immune system to run its many moving parts. Even if growth status is good and your child eats enough quantity, if the quality is sub-par, s/he will be more vulnerable to infection.
Protein – Our immune systems are extraordinary intelligence if nothing else. They are comprised of countless molecules that we manufacture and “remember”, moment to moment, in response to our environments. These molecules are almost entirely proteins. They need a lot of building material! So do bones, skin, and every other tissue, as well as hormones and neurotransmitters that help your kid sleep, pay attention at school, or calm down in the evening. Protein demands are high in kids, who are growing, playing, and learning. Being sick increases protein demands. Not only do kids need enough protein, they need enough fats and carbs around that protein in their diets, to protect the protein so that it isn’t just burned up as fuel. Sure signs that too little protein is on board include slowed growth for height, brittle hair, peeling soft nails… and getting sick often. Protein needs to be good quantity and good quality: Use varied sources that don’t trigger inflammatory reactions. If your kids have eczema, stuffy noses, seasonal allergies, or picky bloated bellies, rule out food allergy (IgE reactions) and food sensitivity (IgG reactions). Making antibodies to food is one thing that will drag your kids’ infection fight down for sure. If they’re eating triggering foods all year, expect more colds and flu in the winter season.
Iron – …It’s complicated. We need it. But, iron is toxic if we have too much; in fact, it’s potentially lethal, so don’t give your kids iron supplements without professional guidance. Guess what else needs iron? Bacteria. Viruses may also target iron toting cells in the body for their own needs as well. This is why you don’t supplement iron when a child is sick. It’s like fertilizing the weeds, and your child may get sicker as they bloom in his body! Because of this, humans evolved with a number of tricks to sequester iron away from harmful infectious agents – like hoarding iron away from serum and into storage proteins like ferritin. Clever… but this can create a sort of anemia, or other problems. I help parents get blood work done to identify iron status for kids, and your pediatrician can do this too. If your child is teetering on the edge of anemia, has pre-anemia, or weak iron stores, then the next bug that comes along may have a better shot at your kid. Every time a child gets sick, iron stores are drawn upon to help fight infection. Read my blog on iron and anemia here – and get on iron rich foods like pumpkin seeds, hemp hearts, sesame tahini or seeds, lentils, dark meats, red meats, eggs, and dark greens. Kids with chronic inflammatory conditions or chronic infection especially need attention on this problem, as these circumstances change iron kinetics in the body.
Vitamin A – Before vaccines were available, a lot of effort was made to identify why some kids breezed through infections like measles while others had stark complications, died, or suffered vision loss from it. One of the first things researchers noted, as far back as the 1920s, was that animals with weak vitamin A intakes got sick and died a lot more often. Vitamin A has been studied extensively since. It has multiple immune modulating effects and exerts a protective effect against viral infections. It is specifically protective against measles and has been used as a treatment for measles in high doses by the World Health Organization. It maintains the integrity of tissues lining the gut and throat, so they can keep pathogens out. Kids low in vitamin A have more respiratory and ear infections. Give your kids vitamin A rich foods every day: Sweet potato, carrot, dark greens like chard, spinach, kale, or romaine lettuce; mango, apricot or dried apricot, peaches, cantaloupe, peas, grass fed butter or ghee, butternut squash; a half teaspoon cod liver oil daily is sufficient to keep vitamin A levels up for most kids. More is not better. Too much vitamin A can be hard on liver tissue, so don’t use more than two teaspoons cod liver oil daily for a child for more than one or two weeks. If your child is 0kay with dairy, use full fat organic grass fed milk or yogurt if you can, for best vitamin A value – it is a fat soluble vitamin and resides in the fatty part of the milk.
Sugar – Eating sugary food can suppress white blood cells, one of our most important defenses. Save it for special occasions, not for daily consumption. Lose the hidden sugars: Juice, processed punch drinks, processed snacks (crackers, chips, cereal, cereal bars, energy bars, power bars), fruits every day without vegetables, and a surplus of breads and pasta can translate into too much starchy, sugary food that drags immune defenses down. Any processed food is likely to have excess sugar or simple starches added to it, from ketchup to Pediasure. Use those foods infrequently and replace them with healthier alternatives. Explore healthy Pediasure alternatives here.
Pediatricians today mostly focus on drugs and vaccines, not food and nutrition, when it comes to managing infections and illnesses. But food and nutrients matter for immune defense – especially for kids. From zinc, to vitamins C, D, and E, to omega three fats and everything in between, there is research to back it up. Help your kids defend themselves with whole unprocessed foods, and potent supplements if needed. Want care advice for your child? I can’t give it here – but would be glad to help you in an appointment. I look forward to hearing from you!
How can you tell if your child needs extra iron? How do you supplement? Is it safe? Is it necessary? Can you do it with just food?
I’m asked these questions a lot, and I’m often in the position of suggesting iron screening, for kids who show signs of anemia, pre-anemia, or marginal iron status. Iron repeatedly pops up as problematic for many US children, based on government survey data collection that began in the early 1960s. Anywhere from 5% to 15% of kids in the US are in poor iron status. Being overweight appears to double the risk for kids, of having low iron. There are racial and ethnic disparities too, with non-white children possibly more likely to have low iron status.
How iron works in the body is a complex topic. It has many jobs besides helping blood carry oxygen to tissues. Weak iron status will trigger cognitive and behavior problems in children. It’s one of the first nutrition pieces to screen when kids have hyperactivity and inattention. Low iron can have lasting, possibly irreversible, negative impacts on IQ, if it has been present long enough. Interestingly, iron is especially key for math learning – so if math tasks stand out as problematic for your child, consider iron screening. Iron is critical for normal immune function and neurotransmitter balance too. So if depression, anxiety, or insomnia are in the mix, once again, iron may be part of the problem.
As necessary as iron is, it is also toxic. Our bodies have ingenious ways to shuttle iron around safely, so it doesn’t damage tissues or overload pathways where it isn’t needed. Too much of it can be lethal for anyone – not just children, though children are more vulnerable more quickly, by virtue of their smaller body weight. So, if you are supplementing iron, do it with professional oversight, so you can be sure your child isn’t getting too much. If you are uncertain, ask your pediatrician for screening. This will require a blood test, but it is well worth the trouble, to safely correct iron status if a supplement is needed. Even if you learn that it is not needed, this is good information that can keep you safely replenishing your child with food. Mild to moderate iron deficiency may show no obvious signs or symptoms, and this is where a blood test can be useful. A thorough iron assessment includes these lab tests:
- serum iron
- total iron binding capacity
- percent iron saturation
- total unsaturated iron binding capacity
- complete blood count
Just checking hemoglobin (Hgb) and hematocrit (Hct), which can be checked with a quick finger-prick and single drop of blood, is no longer regarded as sufficient to assess iron status. Once those two tests drop below the reference range, it’s likely that low iron has been a problem already, for a long time. In other words, checking just Hgb and Hct is a case of too little, too late, when it comes to screening iron status. At a minimum, your doctor should include a ferritin level test in any iron screening. Though reference ranges drop as low as 6 or 10 nanograms per milliliter for ferritin, children function better when it is at 30 or 40. In my own practice, any child with a ferritin below 30 will receive nutrition support to improve iron status, if they exhibit any of the signs below. Depending on other findings, this may be from food, from herbs, or from iron pills – but in any case, all is carefully monitored.
Signs of weak iron status include…
- Dark circles under eyes
- Pale countenance
- Broken, restless sleep
- Irritability, mood lability
- Depression, anxiety
- Frequent infections, colds, illnesses
- Inattention, hyperactivity
At this point, your child may have pre-anemia. The body is not yet fully depleted for iron, but ferritin may be dwindling toward the 20s or teens. Ferritin is a storage molecule for iron. Once it is low, there is little cushion for the body to sustain demands for iron – things like infections, colds, busy learning activities, or normal sleep rhythms, not to mention physical exertion. You can consider foods that are iron rich as well as gentle herbal supplements (be sure to ask your doctor for guidance) or iron supplements, in the 5-10 mg range daily.
Once a child is anemic, things change. At this point, the body is truly depleted for iron. Your child may exhibit:
- breathlessness, easily fatigued
- sleepy during the day
- unable to complete tasks
- physical weakness
- cold hands and feet
- irregular heart beat
- anxiety, apprehension
- chest pain
- veins visible through pale skin
- nose bleeds
- heavier, more painful menses
Blood work guides the replenishment strategy. Your child may need high dose iron, at levels in this table below, for some time:
Once the body is anemic, iron can take months to restore. Your doctor may (should) repeat blood work after a few weeks on an iron supplement, to monitor progress. Don’t use doses this high on your own – get guidance.
Typically, pediatricians prescribe a form of iron called ferrous sulfate. Many kids don’t tolerate this well. Ferrous sulfate can cause stomachaches, constipation, headaches, backaches, and poor appetite. Some children also have dramatic spikes in disruptive behaviors when they take the iron they need. Other more tolerable forms are available, such as ferrous bis-glycinate, food based supplements, or iron rich herbal liquids. Liquids, chewables, and tablets are available.
Keep up iron rich foods of course too – eggs, lentils, pumpkin seeds, red meats, dark leafy greens, sesame tahini, chick peas, hummus, Brussels sprouts, raisins, dried peaches, potatoes with skin on, arugula, sunflower seeds or sunflower butter – if your child doesn’t like these foods, you may have some work to do correcting gut microflora. Doing so usually broadens appetite.
If your child reacts badly to an iron supplement, especially with behavior spikes, this is another indication that you may need to balance gut microflora before supplementing. Microbes love iron, and giving it orally in high doses can essentially “fertilize” these microbes in the gut or body. This can manifest behaviorally. Investigate if there are active gut infections for Candida, Klebsiella, or other disruptive species. Clear them out with medications or herbs, and proceed with iron restoration from there. This can work best in some cases.
Another caveat is chronic inflammatory conditions. Inflammation in the body can shift iron findings on lab tests. Kids with asthma, rheumatoid arthritis, cancer, chronic illness, Crohns disease, or allergies may show a shift on blood work that makes iron status look weaker. Serum iron may be low while iron stores (ferritin) are high. If your child has a chronic condition and you are concerned about anemia, ask your doctor to refer you to a specialist who can help, as this may be beyond the scope of practice for your pediatrician.
Iron is a deal breaker nutrient – like any other! Nutrients are nutrients because research has shown them to be essential. Without them or with weakened status for any one of them, we falter – and kids are especially vulnerable. Balancing iron status can change your kid’s life. It may keep them off psychiatric medicine, and will restore their abilities for learning and playing. Check into it!
Lentil soup is a good iron resource.
Does your child get sick every winter? Can you prevent the annual colds, bugs, flu, croup? There are definitely some foods, herbs and supplements that help – a lot! One of the easiest things you can do is add supplements that help the immune system function more robustly. It’s no secret that dozens of nutrients, plant components, single herb extracts, or herbs in combination have potent, positive effects on the many layers of our busy, miraculous immune systems. Ayurvedic medicine, Chinese medicine, and countless other traditional cultures know this better than western physicians, who rely on drugs and surgery.
The right foods make an even bigger difference. When there is a commitment to eating whole “clean” (organic, unprocessed) food as a regular habit, especially less sugar, less processed stuff, and plenty of plant foods that give minerals, enzymes, antioxidants, and other beneficial compounds, it’s easier for your immune system to function. Viruses and microbes love sugar as much as you do. Eating sugar has an immediate suppressive effect on white blood cells’ ability to attack bacteria. And, the stress of constantly clearing toxins like heavy metals, chemicals, pesticides or GMO foods bogs your immune system down.
Popping pills can’t nourish your kids’ immune potential as much as a routine of whole food, less sugar, and less processed starchy food (pasta, bread, bagels, granola bars, crackers, chips). While you’re working on that, rotate these through winter to shore up your family’s immune systems. There are so many to choose from, not to mention items that your Traditional Chinese Medicine practitioner or Naturopath can offer you for acute illnesses, to lessen the duration and severity of symptoms. While prescription drugs generally suppress symptoms, traditional medicine practices do the opposite: They modulate the immune system in its effort to kill pathogens, and to aid organs and lymph in eliminating the consequent toxins.
This list is for good daily maintenance. Use them consistently – the benefits build over time. As always, especially if your child uses medications, check with your doctor about adding supplements:
• N-acetyl cysteine (NAC) is widely available in capsules, but not found in food. We make it ourselves from protein we eat, when well nourished; it’s an amino acid the body uses to make glutathione, a major antioxidant. But extra stresses on the immune system can increase demand, and it’s easy to less than you may need – especially for kids I meet in my practice, who tend to have trouble eating good diets. NAC is especially helpful for lung tissue and has some pedigree for helping asthma, inflammatory conditions, and reducing bouts of flu and respiratory illnesses. 300 to 900 mg daily is a usual dose, depending on body weight. It is used in higher doses for obsessive compulsive symptoms, but lower doses are notable for helping lung tissue.
• Broad spectrum, high potency probiotic: Buy from a reputable brand devoted to high quality. Cheap probiotics aren’t worth it. Unless you’ve been given specific reasons not to from your GI doctor, most kids can use a potency between 25 to 75 billion CFUs daily per dose. Less won’t have much impact. Probiotics are emerging for not only supporting gut health, which many now regard as a cornerstone of immune health, but for aiding lung health too!
• Cod Liver Oil and Vitamin D: Kids can safely use a half teaspoon dose daily up to 100 pounds body weight or so. Heavier kids can use a teaspoon or two. Vitamin D should be checked with your doctor each fall. If it’s below 40, use 2000-5000 IU daily for kids. Debate continues on whether you ought to use fermented cod liver oil. I let parents choose whatever they can comply with daily, since, unless you pick a very poor product, some is better than none. For non-fermented, check Nordic Naturals or Pharmax. These are my preferences in that case. Enjoy free shipping and discounts off your Nordic Naturals purchases by ordering here and entering my practitioner ID 107159.
• Astragalus: This is a time honored herb in many traditions. For western herbalists, it is noted for its ability to boost B cells, T cells, and the body’s ability to identify bacteria and viruses. If your child tends to be sick often or have low energy, after you make sure his or her diet is adequate and fully nourishing, you can add a tool like astragalus to tone immune function. Capsules or tinctures are available. Peruse options here – over thirty of them as capsules or tinctures. For young kids, glycerite tinctures are ideal.
• Andrographis: Check out this list of benefits when andrographis is used for colds, flu, and infections. Shorter duration of illness and reducing severity are documented effects of using this herb. Both anti-inflammatory and immune stimulating, this herb can be a better choice than echinacea for kids who have chronic inflammation from conditions like rheumatoid arthritis, asthma, or allergies. If your child feels worse using this herb, it is possible that it is clearing a latent viral load that needs to go. Kids will feel sicker if this is done too quickly, so back down or withdraw the herb to a level that is tolerable.
• Vitamin C and Zinc: Use vitamin C to bowel tolerance daily, especially if your kids shun vitamin C rich foods daily. Buffered forms of C work may be easier to tolerate for kids who have normal digestion and who are not on reflux medicines; if your child uses reflux medicine, a non-buffered form may be best. If kids are eating a lot of sugary stuff (orange juice, fortified juice, fresh fruit, sweetened yogurt not to mention candy, ketchup, and obvious sources) then you may want to add more. Lozenges, capsules, liquids, powders – every option is out there. With zinc, this will support better white blood cell production for infection fighting. To dose vitamin C, start at 250 mg for young kids under 40 lbs and increase to one, two or three grams (1000-3000 mg). Loose watery stools mean too much C. Constipated kids may get relief by using high doses of buffered C. For zinc, 30-50 mg daily can be safely used in most cases, as long as your child’s iron status is normal. High doses of zinc can worsen iron status, so check with your doctor or contact me for guidance if you’re not sure (your child must become a patient of mine in order for me to give individual care).
• Iron and mineral-rich foods, with strong protein and plenty of healthy fats and oils: Snacks like pumpkin seeds, sunflower seeds, butters from nuts and seeds, any dark leafy greens your child will accept are perfect. Homemade broths are perfect as a start to a cold day or after school snack, because they give all of these good nutrients. See my blog on mineral rich snacks for kids here (these support adrenal glands, which will pump out more cortisol when your child gets sick). If your child struggles to eat protein rich foods, try powders in smoothies, puddings, broths, cocoa, or even tea. Check this blog for protein powders, here for all smoothie blogs, and here for a hot cocoa that avoids common allergens but tastes creamy and delicious. And of course.. if your child has an undiagnosed gluten or dairy sensitivity, infections will be more frequent and take longer to recover if they are eating those foods daily.
Gluten sensitivity can cause all sorts of noise
Be sure to visit my blog on immune boosting foods too. I love it when my clients tell me their kids are not getting sick for the first time in years, once we begin thorough and individualized nutrition support. If that sounds good, let’s talk soon! Contact me here or schedule your time to speak with me by choosing an option here.