A Dietitian's 10 Tips for Keeping Kids Healthy

I am blessed with healthy kids who are rarely sick (knock on wood), but I know that's not the case for all parents out there. Some kiddos I know seem to be sick quite often. Here are some tips I use as a dietitian and mama to support and maintain my kids' immune system.

#1: Wash Those Hands

This is something you and your children already know, but here's a reminder about washing hands, and often, with plain 'ol soap and water. It's just as good at killing the influenza A virus as an alcohol-based hand sanitizer. Try to do a thorough job by rubbing the hands well, scrubbing under the fingernails and between fingers. Encourage your child to keep their hands out of their nose and mouth as much as possible. 

#2: Breastfeed As Long As Possible

I breastfed my oldest son until he was 11 months old and the youngest until he was 14 months old. Breastfeeding has many major immune system benefits. Mom’s milk is full antibodies, white blood cells, immune factors, and enzymes, which protect your baby against a wide variety of diseases and infections not only while s/he is breastfeeding but, in some cases, long after he has weaned.

#3: Vitamin D and Immunity

Vitamin D3 is a top immune-supporting vitamin! There’s a link between low vitamin D levels and the risk of getting a respiratory infection, which includes the common cold, the flu, sinus infections, bronchitis, and pneumonia. People with low vitamin D levels tend to have a higher chance of developing a respiratory infection. Vitamin D is also being studied for its association with type 1 diabetes in children, autism, asthma, and many other autoimmune diseases. During the winter months, with minimal sunlight, people’s vitamin D levels are certainly lower. Not only is the amount of time you’re exposed to the sun much less, but if you are exposed, the sun’s rays are also weaker. Here's more info about that, but in a nutshell, don't be deficient in vitamin D.

I’ve given both boys a liquid vitamin D supplement since birth. Breastmilk typically doesn’t contain enough vitamin D, so the American Academy of Pediatrics recommends supplementing 400 IU every day from birth. There also aren't a lot of food sources of vitamin D, but here are the main food sources: cod liver oil, sardines, salmon, fatty fish, cow’s milk and dairy products (but avoid when sick), eggs, caviar and mushroom grown outside.

I prefer giving my kids a liquid vitamin D because it's easy and one of my boys doesn't swallow pills or capsules yet. When buying vitamin D, examine the dose to see how much vitamin D there is per drop. I've seen doses ranging from 100 IU to 10,000 IU per DROP! All the liquid vitamin D supplements I've used are tasteless and odorless, and my kids literally tip their head back and open their mouth. You can also drop it into water. Super easy! If you're pregnant or breastfeeding, Vitamin D is a must and all your questions are answered here!

The Vitamin D council recommends a maintenane dosage of approximately 1,000 IU per 25 lbs. This is the level of vitamin D3 necessary to keep your levels the same, but if your child's levels are suboptimal, she will need more. An optimal vitamin D level is 60-80.

#4: Probiotics and Immunity

Probiotics are another top immune-supporting supplement! Probiotics are living microorganisms and when consumed in adequate amounts, they offer a health benefit within the digestive tract. This is important because nearly 75% of the immune system is located throughout the stomach and digestive tract, so without enough healthy bacteria, your health may suffer as a result.

By keeping your child's gut healthy, you are also supporting the brain, immune system, digestive tract, and detoxification pathways. Both my boys take a probiotic supplement as often as I can remember! I offer it after dinner and love this one: Seeking Health Probiota 12, which comes in both powder and capsule form. I took a probiotic while breastfeeding, and once they turned six months old, I started offering a powdered infant probiotic on occasion. Here are some tips for picking a quality probiotic supplement. 

By age 3, the gut microbiome is about the same as an adult, so if your kiddo is

#5: Fish Oil (Omega-3 Fatty Acids) and Immunity

Fish oil or cod liver oil are two of the best ways to get enough omega-3 fats into your kids' system. These particular fats have a lot of benefits, but in regard to the immune system, they support healthy inflammatory levels, which is important when the body is trying to fight off bacteria and viruses. Omega-3 fats also support a healthy, normal immune response.

When buying fish oil, check for impurities because fish oil can contain contaminants like heavy metals. Only choose reputable brands. The ones I choose and am confident in recommending is: Nordic Naturals, Lysi, Metagenics, Designs for Health, Uckele and Seeking Health. Ideally, find a brand that's willing to share their material safety data sheet so you can know whether they’re testing for impurities and whether the product contains impurities or not.

typical dose depends…usually higher than what’s on the bottle, but that’s a safe start. The average does of cod liver oil is ½ tsp per 25 lbs. body weight.  

#6: Offer a Fruit and/or Vegetable at Every Meal and Snack

The amount of vitamins, minerals, antioxidants, and phytonutrients in these colorful foods are undeniable. When the body fights infection, it makes free radicals in the process. Antioxidants help mop up those free radicals, which protect cells from damage and promote a healthy immune system. In particular, vitamins A, C and E are both vitamins and antioxidants especially great for supporting the immune system, but overall, eating a variety of fruits and veggies is the key. 

Another immune benefit from eating fruits and vegetables are the prebiotics they provide, which is what the healthy bacteria (probiotics) in the gut require to feed on and thrive. The most potent prebiotic foods are onions, garlic, Jerusalem artichokes, leeks, chicory root, bananas and local honey.

Over the years, I’ve found a few tricks to maximize my boys’ fruit and veggie intake each day. First, when I pack my out-of-the-house snacks, I include a lot of carrots, snap peas, celery, apples and oranges. My young boys seem to always be hungry, and if fruits and veggies are their only option, they’ll eat it. If they complain about it, they eventually come around because they're hungry enough.

Second, if they’re hungry while waiting for breakfast.lunch or dinner, I often offer an “appetizer.” It’s usually whatever vegetable I have in the refrigerator, such as sliced bell peppers, sliced cucumbers, or a full carrot or celery stick. If it’s pre-dinner, I usually offer some kind of dip, such as a homemade salad dressing, sour cream-based dip (sour cream, dill, smoked salt  = yum!), or cashew-based veggie dip. This will be enough to hold them off until the meal, and if it quenches their appetite, at least it's nutritious foods they've filled up on.

Third, don’t underestimate a smoothie! They’re so easy to pack full of fruits and vegetables, and on a busy morning they’re the most convenient and filling breakfast. My kids drink a smoothie with breakfast or as an after school snack quite often. They also love green drinks, and this Dr. Oz green drink is their favorite.

Fourth, try different cooking methods since they effect vegetable flavors differently (steaming, baking, boiling, stir-frying), and don't forget to add seasoning and spices for more flavor. 

#7: When it comes to Veggies, Try and Try Again. Don’t Give Up!

It can take15+ exposures to the same food before a kid will try it or like it. Or, your kiddo may gobble up a food one day and refuse it the next. Don't take that to mean they'll never eat it again.

My youngest kiddo, in particular, will turn his nose at broccoli one meal and the next time it's we serve it, it’s his favorite thing on the plate. I never know so I always offer! My point being, just because your child says they don’t like something, please don’t stop offering it, and never remind them: “You don’t like that” or make any comments that bring negativity toward the food.

#8: More Water, Less Sweetened Beverages

Stay hydrated! The vast majority of kids and adults are chronically dehydrated and staying hydrated is one of the most important things we can do to support the immune system. 

Both my kids have their own stainless steel kanteen and it goes everywhere with them. They learned to love water at a young age because it was all I served. My kids are 6 and 8 y.o. now, and I don't think they were exposed to juice until they were 3 or 4 years old, and it was offered at a birthday party. I don't buy juice to drink, soda, capri sun, gatorade or other types of sweetened beverage. When I buy juice, it's either for my margaritas or homemade popsicles.   

I worked in a WIC clinic (Nutrition program for Women, Infants, and Children), and I witnessed first hand the negative effects drinking juice everyday can have on a child's health (teeth, appetite, weight, energy). I guess you could say I learned to despise juice! I prefer to serve my kids water and real fruit instead.

How do you know how much water they need? An easy tool is half their body weight, so if you have a 50 lb. kiddo, 25 ounces of water per day is the recommendation. If they're sweating (ie: a fever), they need even more fluid. When sick, coconut water and bone broth are great hydrating fluids that support the immune system. I also think assessing urine color is an easy way to see whether you child is hydrated or not. 

#9: Sugar and The Immune System 

Within 30 minutes of eating simple sugars (like glucose, refined sugar, and fructose), there’s a 50% reduction in your white blood cells’ abilities to kill germs. This effect is most noticeable 2 hours after ingestion but still present 5 hours later!!! Wow, that’s some power sugar has over immunity.

Keeping blood sugar levels balanced has been shown to improve immune system activity. Takeaway: keep those sugars down. Year round, but especially as we head into the cold and flu season.

#10: Lots of Sleep!

When it comes to health, sleep plays an important role. While more sleep won’t necessarily prevent you from getting sick, skimping on it could adversely affect your immune system, leaving you susceptible to a bad cold or case of the flu. Without enough sleep, the body makes fewer cytokines, a type of protein that targets infection and inflammation, effectively creating an immune response. Cytokines are both produced and released during sleep, causing a double whammy if you skimp on shut-eye.

Each kiddo's sleep needs are different. I've learned my older son needs more sleep, so I aim for the higher end of the range for his age -- he's 8 y.o., so 11 or 12 hours is ideal for him. 

The American Academy of Pediatrics sleep recommendations by age per 24 hours.

Infants: 4 to 12 months 12 to 16 hours (including naps)
Toddlers: 1 to 2 years 11 to 14 hours (including naps)
Preschoolers: 3 to 5 years 10 to 13 hours (including naps)
Grade-schoolers: 6 to 12 years 9 to 12 hours
Teens: 13 to 18 years 8 to 10 hours

Take into account what time your child typically wake up, roll the clock backwards the recommended number of hours and then 30 minutes before that. Remember, this is hours actually asleep, so you have to allow time for the bedtime routine, which can be lengthy at our house. 

It isn't easy changing old habits and starting new ones, but you don't have anything to lose and a lot to gain! Not only will your children's health improve, but you might save yourself a lot of money by staying out of the Peds office and Urgent Care! Not to mention less lost school and work days tending to a sick child. Cheers to a healthy 2020!

In Health and Happiness,

Kelly Harrington, MS, RDN

Registered Dietitian Nutritionist for Healthy Goods

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