Keeping your family well over winter
By Dr Marissa Kelaher
If you've got young kids, you'll know just how frustrating it can be when they catch cold after cold… seemingly just recovering from one bug, when the next one comes along!!
While a certain number of infections are normal in the first few years of life (and part of ‘training’ our immune system), fortunately there are also lots of evidence based ways to help their little bodies stay healthy and well.
In this blog post we'll run through what REALLY helps - and give you some tips to get through winter in one piece!!
THE BASICS
The main proven ways to prevent bugs are the obvious ones most people will know about :
Breastfeeding until at least 6 months if possible (the WHO recommends until age 2 if you are able to)
Trying to avoid ALL cigarette smoke exposure, including second or third hand smoke (this is strongly linked to respiratory illnesses in children such as ear infections, asthma, and bronchiolitis)
Having a warm dry mould free home as much as you are able - airing out the house during the day, and using a dry form of heat, as well as potentially a dehumidifier if your house is damp can all help (as well as insulation and heating where possible).
The aim is to avoid cold damp (which is often shown by black mold growing on windows etc), as well as very cold temperatures. Try keep bedrooms above 18 degrees, and living areas around 20 degrees - not always easy in drafty NZ homes, although hopefully new rental laws help!
Following standard health advice such as handwashing, vaccinations, and teaching your kids to cough or sneeze into their elbow, and wash hands before eating /after toileting /when they get home
But there are also many other lesser known yet simple strategies that can help once you've covered the basics ❤️
NUTRITION
Getting adequate micronutrients in food is a biggie - in particular vit A, zinc, selenium, vit E, vit C, vit D and iron - as these are all needed for our immune system to function well. Having a healthy gut microbiome is also key, see our gut health blog post for more details.
In young children these nutrients are particularly important, as their immune systems are developing, and they also come into contact with far more bugs than adults (schools and day cares in particular!)
Even though it can be tricky with fussy eaters, it's always FAR better to get nutrients from food than a supplement if possible. Check out our blog post on tips to get kids to eat more veges!
Whole foods contain a huge variety of nutrients ‘packaged ‘together, whereas supplements often only have one or two in isolation, and lack the other health benefits of whole foods (such antioxidants and polyphenols, which are highly beneficial for immune function).
We cover whole food antioxidant rich nutrition and polyphenols in our transform your nutrition focus course and Reboot course
Foods are also FAR safer to use, as its very difficult to overdose on vitamins from food sources with a balanced diet - whereas some nutrients are toxic in high amounts (in particular iron, vit a, zinc, selenium, and vit d).
Some research shows that certain high dose supplements may even cause harm.
Fortunately its not as hard as you think to get enough of all of these with some simple tips and habits 😉
Here are some of the top sources of these nutrients in foods, try include as many as you can on a regular basis (and remember diversity is key!)
Vitamin C: red and yellow peppers, dark leafy greens, kiwifruit, broccoli, berries, and citrus fruits
Vitamin E: almonds, roasted sunflower seeds, avocados, and nuts
Zinc: cashews, chickpeas, seeds, eggs, and chicken
Vitamin D: salmon, tuna, tofu, eggs, cheese, and mushrooms. Often a supplement is needed in winter months in colder areas as we get most of our vitamin D from sunlight. Children with darker skin, who are indoors most of the day, or who cover up their skin for cultural or health reasons are at higher risk of deficiency. If in doubt, its safer to supplement (at recommended doses - Vitamin D is toxic in high doses)
Selenium: brazil nuts, certain types of mushrooms, fish, poultry and eggs. NZ soils are low in selenium so brazil nuts (grown overseas) are one of the best sources, and can be eaten whole, or ground (for young children)
Beta Carotene (vit A precursor): carrots, sweet potatoes, winter squash, spinach, kale, cantaloupe, and apricots
Iron: dark green veges, beans /legumes, eggs, red meat (its good to include plant sources as these are absorbed differently to meat sources, and affect the gut microbiome differently)
For kids, aim for 1/3 of each meal to be fruit/veges, and ideally at least 1 serving of dark green veges/day.
1/3 of each meal should be healthy protein (ideally mostly plant protein) and 1/3 complex (non processed) healthy carbs.
These proportions are different to most adults due to the higher energy needs of kids for growth.
We get it’s hard at times to get your kids to eat well! Some of our top tips for getting little people to eat a balanced diet include:
Normalise eating fruit and veges, and get them involved in helping with food prep/cooking - kids love to help! They will mimic what you do, so modelling healthy eating is more effective than just talking about it ❤️
Offer fresh or dried fruit, raw veges, and nuts as snacks, rather than high calorie processed foods or foods with added sugar. Serving chopped raw veges as a pre dinner snack or after school snack is a great idea, as they're often very hungry by then and be more likely to eat them😏
Try incorporate fruit and veges into healthy baking - zucchini, carrot, banana, berries, beetroot, feijoas, and apples/pears are all great for this. You can also often add lots of different ground nuts and seeds into baking without changing the taste significantly (ie linseed/ground almond/ground Sunflower seeds)! We have lots of these recipes in our transform your nutrition and Reboot courses.
Even legumes can be used as a quick healthy base for baking - checkout our black bean brownie recipe in the ‘free stuff’ section!!
Add grated or shredded veges to their favourite meals ie pasta sauce, nacho beans, soups, lasagne etc. Green leafy veges are very easy to add if chopped up small (you can even puree veges to add into meals if texture is an issue). Legume based burger patties are also great and super cheap and nutritious, such as the black bean burgers in our nutrition course.
Replace sweet deserts/snacks with raw fruit and nuts. It may take some getting used to, but it's a great habit to start. Very sweet food can ‘condition ‘ tastebuds so that less sweet foods (such as veges) taste unpalatable, and often cutting back on added sugar and ultra-processed foods is one of the key steps to getting kids to eat their veges - as this helps their tastes (and gut bacteria) adjust.
Lots of added sugar in our diet is also not great for our mouth or gut microbiome, and can negatively impact immune function. You don’t have to avoid it completely, but Western diets are FAR higher in sugar than what is recommended, so try to check the nutrition labels on foods (most added sugar comes from processed foods), and limit sweet snacks. Ideally also avoid sweetened drinks (those with added sugar), and limit fruit juices (as these are also very high in sugar)
Some treats are fine in a balanced diet - if in doubt remember the 80/20 rule (aim for 80% whole mostly plant foods, and the 20% you can relax a bit on)
If all else fails, smoothies are a lifesaver! We make easy peasy breakfast smoothies (with banana, frozen berries, edamame beans for protein, and unsweetened yoghurt or coconut yoghurt) and green smoothies (ie frozen spinach, banana, frozen mango, edamame beans, and water) most days, and the kids love them ❤️
Use nut butters, avocado, or hummus as a topping for wholegrain toast or pita breads
And remember - kids naturally graze - it's what they eat over a week than matters rather than getting it perfect every day don't stress about getting it right 100% of the time, even small changes help!
We have LOADS of yummy, family friendly plant based recipes in our Nutrition focus course that include all of these tips to make it easier. And they’re tried, tested, and approved by our own little people!!
A FEW OTHER TOP TIPS:
Exercise helps immunity in kids just as much as it does for adults, and can significantly reduce the risk of catching colds. Get them outside in fresh air as often as you can, you'll all feel better! Learn more about how exercise boosts our health in our activity module
Playing in nature improves immunity - it lowers stress hormones, and improves our gut biome, as well as helping our immune system to work more effectively. Many plants put substances (including organic compounds called phytoncides) into the air that seem to boost immune function.
Sunlight also stimulates specialised immune cells called T cells, that help fight infection, and produces vitamin D when it hits our skin, so getting safe sun exposure is an added bonus (it also makes us feel happy!)
Stress and lack of sleep affects kids just as much as adults. For practical tips on reducing stress (for the whole family!) checkout our Take control of your stress mini course or Reboot course
Aim for both a regular bedtime and adequate hours of sleep - some kids need more sleep than others, and if in doubt aim for more! We cover sleep in depth as well as tips for healthier sleep in our restorative sleep course.
Free play is hugely important for kids - it's how they destress, process things, and learn. It also gives them exercise and helps sleep. Try to ensure lots of free time daily away from screens (outdoors if possible) to just let them play and be kids. You don't need to organise anything, just step back, take a deep breath, relax, and let them play!
Vitamin D supplements (check recommended dose for age) can be a good idea over winter unless your kids are out in the sun a lot, see previous section on this
Vitamin C is commonly advertised for colds, yet the evidence to support taking a supplement is actually very limited! Some studies show a small benefit, others do not. If taken within 24hours of a cold starting it MAY slightly shorten the duration (how long a cold lasts), but doesn't seem to reduce severity.
Similarly taking regular vit C supplements doesn't reduce how often colds occur, but MAY shorten them slightly.
As vitamin C is high in brightly coloured fruits and veges, you're far better to eat these on a regular basis to get enough, as these also contain loads of other immune healthy compounds and nutrients
There is some limited evidence that probiotics can reduce the number of colds and tummy bugs in preschoolers, so they can be worth a try if the above measures don’t work, or if your child has had a lot of antibiotics. Lactobacillus rhamnosus GG is the strain studied most for this.
Some kids with recurrent unexplained ear and sinus infections MAY also have a dairy intolerance (which is very common in some populations, especially Asian, Maori, and Pacific Island people) - it can be worth talking to your doctor or dietician about a trial off dairy if this is the case, and ask about healthy safe dairy alternatives to ensure nutrient needs are met.
Omega 3 intake is just as important for kids immune health as adults - ideally through foods, although a supplement can be helpful at times if you are struggling to get enough in. Great sources are walnuts, ground linseed, chia seeds and oily fish.
If your child still gets sick all the time, and you think they may be at risk of a vitamin deficiency, please talk to your doctor about whether testing for vit d/iron/zinc is indicated. Another option is to try an immune specific kids vitamin with these in it, again check with your doctor first if safe to do so, and don't exceed recommended doses for age (these are all toxic in high doses). They can be helpful especially if you have a young child who is a very picky eater!
In general routine blood tests are best avoided in young children unless essential (for obvious reasons, as they don’t like them!) but can be helpful in selected cases, if their diet is very restricted, or if they have tummy issues which could affect levels.
Vitamin D and zinc levels often have a cost as well (they are only funded in specific situations)
Focus on gut health as always - include lots of prebiotic and probiotic foods (high fibre and fermented foods) , and try to avoid high sugar foods /refined carbohydrates/highly processed foods which can negatively affect the gut microbiome. Checkout our gut health blog to find out how to optimise those gut bugs!
Antibiotics in early life can significantly alter the gut biome, and are strongly linked with allergies in later years. Only use them if essential to do so, and if advised to by your doctor.
While antibiotics are essential (and lifesaving) in some situations, many common childhood illnesses are viral and do not need antibiotics.
Even many ear infections in children over 2 will clear without antibiotics (but again please seek medical advice on this).
However we ALWAYS advise you talk to your doctor, and do not with-hold antibiotics if they are necessary
Try to avoid antibacterial soaps/cleaners if possible, simple soap and water is better, as anti-bacterials can kill our natural beneficial skin and mouth bacteria. . Hand sanitisers are sometimes needed ie if you cannot access soap and water, but if you are able to physically wash hands this is usually preferable
Simple remedies such as a warm drink with fresh lemon, grated ginger, and raw honey are great for colds, as honey soothes the throat, and the lemon and ginger are packed full of antioxidants and vit c. Do not use honey in children under 1 year old.
A spoonful of honey and cinnamon also works well for coughs - and is shown to even work better than commercial cough medicine (which have very little evidence in kids)!
Natural chest rubs like tui cough balm can be great so long as you follow instructions on the packet.
If you're struggling with getting enough nutrients in (ie in toddlers or very picky eaters), or your child is still getting colds despite trying all the measures above, then a trial of an immune specific multivitamin can sometimes be useful.
Aim for one with good levels of zinc and vit d, and be careful not to exceed recommended limits for these as they can be toxic.
Pharmacies often carry these and can give you great advice on dosing etc
And above all, remember they are only small for a short time, and even the healthiest kids still get sick sometimes!!
You don't have to be perfect, just try aim for a diet rich in diversity and whole plant foods, get as much time outside as you can, give your kids lots of time to play, ensure you're all getting enough sleep, and enjoy those precious years - they go past quickly ❤️