Back-to-School Wellness

Saying goodbye to summer and hello to back-to-school can be a tough transition. Make your school year routine simple and healthy. Here are some wholesome tips and ideas for those hectic schedules getting back to full swing.

#1. Sleep – Let’s start from the beginning. A good day begins with a good night’s sleep. Getting enough sleep is critically important for kids, especially as they head back to school. After a summer of late nights, it is critical to get your kids back on a schedule so they can learn and thrive at school.

The American Academy of Pediatrics recommends that children 6 to 12 years of age sleep nine to 12 hours a night and teenagers 13 to 18 sleep eight to 10 hours. Getting enough sleep, it advises, leads to “improved attention, behavior, learning, memory, emotional regulation, quality of life, and mental and physical health.” Sleep experts recommend not allowing kids to be on device screens beginning an hour before bedtime, and perhaps storing devices in another room.

Be sure to incorporate an extra 20-30 minutes for getting ready for bed so they have time to brush their teeth, pick out their clothes for the next day, and read an age appropriate book or portion of a book. Many parents like to incorporate a simple bedtime prayer as well. If you are interested in starting that tradition and don’t know where to begin, there are some good recommendations here. Praying before bed can teach gratitude, reduce stress, bring parents and children closer, teach forgiveness and the right moral values, as well as creating positivity so your child will sleep with a calm and positive mind.

Successful sleep habits happen best when you follow a consistent bedtime routine. Make the bedroom quiet and dark, with no tv or computer in the room. Turn all electronics off an hour before bedtime. Make sure kids are not hungry when going to bed, but also that they didn’t have a huge meal right before laying down. Rigorous exercise is best avoided 2 hours before sleep.

If you incorporate healthy sleep habits but your child occasionally has trouble sleeping, Genexa Kid’s sleepology is a gentle formula for children ages 3-11. They also have a formula Sleepology that is good for older kids and adults as well. This is especially helpful if your child is restless, nervous, anxious or has been irritable and excitable that day.

#2. Exercise – Deep, restful sleep comes when your day has included activity and movement. This is true for adults as well! Your kids have probably been active all summer, and it’s important to keep moving. Kids typically sit most of their school day, so incorporating sports and exercise into their daily routine will keep them focused, improve behavior and boost positive attitude. And while younger kids have recess, older children especially might be missing out on the health benefits of physical activity. Difficulty sitting still or having trouble staying on task can oftentimes be attributed to lack of exercise and movement!

If possible, enroll your kids in after-school activities or get them outside for free play. Enjoy a family walk or bike ride and encourage them to keep moving. If you engage in physical activity, they will follow along. Sports or other unstructured activity after school is a great way to burn off some extra energy, sleep better that night, and be more focused the next day.

Exercise also benefits the immune system by increasing the production of different types of white blood cells.[1] If you are active outside, you also get your Vitamin D from the sunshine![2]

Children need to move so get them outside to play!

The start of school is a great time to begin good habits to keep your kids healthy and strong all year long.

#3. Diet – I think we all know that when we eat poorly we feel poorly. Feed yourself and your family a clean, whole foods diet.[3] [4] Occasional treats are fun to enjoy but maximize the high nutrient foods for most of your family’s meals and snacks. It is important to avoid simple sugars and processed/junk food. Did you know that within 30 minutes of eating simple sugars (like glucose, refined sugar, and fructose), the ability of your white blood cells (called macrophages) to “eat up” viruses and bacteria DECREASES by 50%! And that effect lasts for at least 5 hours! [5a] Keeping blood sugar levels healthy has been shown to improve immune system activity as well. Clean Eating for Busy Families by Michelle Dudash is a great starting point. Or check any “clean eating” books at your local library or amazon. There’s some great clean eating books for cheap at thriftbooks.com!

#4. Brain Health – Numerous studies show that kids who eat breakfast consistently perform better in school than children who don’t eat breakfast. Learning requires a lot of brainpower, and your child’s energy-hungry brain needs plenty of calories to perform its best. In addition, a systematic review shows that eating breakfast has positive effects on academic performance, cognitive function, quality of life, and wellbeing.[5] Yes, breakfast is that important. Stay away from the high sugar cereals, kids will get a rush of energy and then crash with an inability to focus coupled with fatigue and irritability. I believe a lot of blood sugar symptoms are either misdiagnosed as attention deficit or behavior issues, or they exacerbate the manifestations of these disorders.

Check out the breakfast ideas HERE by Natalie Monson, a registered dietician and mom of 4.

Does my child need a multivitamin? Look at an average daily menu that your kids are consuming. Are they getting enough fruits and veggies? How about calcium and vitamin D? This is an individual parent decision. My guess is that most kids could benefit from a multivitamin. As long as your child is getting iron from his diet, the “iron fortified” is probably not necessary. You can discuss with your pediatrician. Iron containing foods include meats, poultry, fortified cereals and dark leafy greens.

Taking a multivitamin supplement daily can improve cognitive performance in both children and adults.[6]

Choose vitamins that are specifically made for kids and ensure they don’t contain megadoses that exceed the daily nutrient needs for children.

Have you heard of DHA? Docosahexaenoic acid (DHA) is an omega-3 fatty acid used to improve brain and eye health in children. DHA is the predominant structural fatty acid in the central nervous system and retina and its availability is crucial for brain development. Found naturally in oily fish and some seaweed, DHA is also available in supplement form. Many organic dairy companies now add it to their milk. DHA deficiency may be common among children with focusing and concentration issues such as ADHD, according to a report published in the American Journal of Clinical Nutrition in 2000.

A review of seven clinical trials including more than 500 children concluded that children taking a combined EPA and DHA supplement showed improvements in cognitive performance, focus and attention.[7]

There have been mixed reviews on the effectiveness of supplementation with DHA, however most are very encouraging. Keep in mind taking DHA in the form of fish oil may cause certain side effects, such as bad breath, heartburn, and nausea. Many companies formulate their products specifically to avoid these issues. Independent researched evaluation of the best products is explained HERE. Before considering supplementing, of course try food first! Increase your child’s natural intake of omega-3’s with fatty fish such as salmon, DHA enhanced milk or a small handful of walnuts. Flaxseed or flaxseed oil can be blended into a smoothie.

#5. Immune Health – Kids are back to in-person attendance at school. Now more than ever parents are concerned for the health and well-being of their children. So what are the basics of keeping your little ones with a robust immune system? Building on the stated basic health principles listed above, remember: food really is medicine, optimize that great diet with good sleep and exercise. Use targeted nutritional supplements. Keep in mind, you can not out-supplement a poor diet and unhealthy daily habits. Keep the basics strong and you are already sensibly prepared to stay well. Now is the time to establish healthy habits for a lifetime of wellness. If you feel the need to bolster your child’s immunity, check out the following ideas. I have not included links due to the differences in recommended dosing for various age groups. Search for the dosage you need and find the best quality product.

Zinc – Zinc deficiency is known to increase susceptibility to many infections.[7] Zinc and zinc-ionophores (compounds that increase zinc uptake into cells) have been found to inhibit SARS-CoV replication in vitro – that means that it has the potential to prevent the virus from multiplying and wreaking havoc in our bodies.[8] The current circulating SARS-CoV-2 virus looks very similar to SARS-CoV, so optimizing our zinc levels may theoretically have the potential to slow down SARS-CoV-2 replication as well. Given that zinc deficiency is one of the most common nutrient deficiencies in children and adults, ensuring optimal zinc levels is an important part of any immune support protocol. Pumpkin seeds are super high in zinc, an awesome way to boost zinc levels through food. Otherwise, check for the amount in your multivitamin or make sure your child is getting enough through an additional supplement. These doses are based on the tolerable upper intake levels from the NIH. The most common side effects are nausea and vomiting. High doses of zinc for prolonged periods is not recommended.

0-1 year: 4-5 mg daily

1-3 years: 5-10 mg daily

4-12 years 10-25 mg daily

13-18 years: 25-35 mg daily

19+ years 25-40 mg daily

Vitamin C -Vitamin C is one of our most important antioxidants to clean up those free radicals when we’re sick. Vitamin C has very low toxicity and even at high doses is very unlikely to be harmful, with the most common side effects being diarrhea, nausea and abdominal cramps. The following suggested dosages do not exceed the the Tolerable Upper Intake Levels reported by the NIH. Vitamin C can significantly reduce the incidence and severity of pneumonia, (which is one of the major complications of COVID-19).[9]

1-5 years: 125-250 mg daily
6-12 years: 250-500 mg daily
13-18 years: 500-1000 mg daily
19+ years: 500-1000+ mg daily

Glutathione – Glutathione is our “master antioxidant,” found in sulfur-rich, cruciferous vegetables and also produced by the liver. It increases natural killer cell activity (our first line of defense against viral or bacterial infections)[10] and also supports our immune response to viruses, bacteria and parasites.[11] Depletion of glutathione (such as using acetaminophen to reduce fevers) has been found to prolong the duration of viral infections, worsen severity of symptoms, and increase viral shedding from the nasopharynx. Oral glutathione has generally not been found to be well-absorbed, so liposomal glutathione is best. Increased blood glutathione levels and reduced oxidative stress can appear within 1 week. Increased Natural Killer cell activity by up to 400% within 2 weeks![12] There are no clear guidelines for appropriate glutathione dosage for immune support. These dosages are based on what most integrative physicians recommend. People with chronic illness such as asthma or autoimmunity may benefit with higher dosing. Read your labels and adjust label recommended dosages for children.

1-5 years: 50 mg daily
6-12 years: 100 mg daily
13-18 years: 200 mg daily
19+ years: 250-500 mg daily

Vitamin D – Vitamin D is the single MOST important vitamin that you can give your children (and yourselves) this winter.

Sunlight is the best way to obtain optimal vitamin D levels, but optimal skin conversion will only occur during the summer months in the Northern Hemisphere. Vitamin D is found naturally in only a few foods, so supplementation is often needed, but absolutely load up on the all the vitamin-D rich foods you can! Vitamin D status can be assessed through blood 25-hydroxy-Vitamin D levels, 25(OH)D. Unfortunately, there’s no other way to accurately know your Vitamin D status.

Many parents are surprised at how low their children’s Vitamin D levels are, even in the middle of the summer when their children have been running around outdoors in the sunshine all day long. I have seen this as a pediatric nurse many, many times. It can be even more surprising how much Vitamin D supplementation is needed to actually achieve optimal levels.

Vitamin D deficiency may increase the risk of contracting COVID-19. [13],[14] But Vitamin D is not just for Covid-19. Vitamin D can protect against influenza and other winter respiratory illnesses and reduce wheezing in children.[15],[16],[17]

So who is at risk for Vitamin D deficiency? Practically everyone. These factors may be a hint that levels are not up to par: maternal vitamin D deficiency during pregnancy, being exclusively breastfed (The American Academy of Pediatrics recommends that all breastfed babies receive 400IU of Vitamin D3 daily. I believe that this risk factor comes out of the fact that many pregnant and nursing women are deficient or insufficient in Vitamin D. If nursing mothers had optimal Vitamin D levels, it is presumable that their breast milk should have adequate Vitamin D to nourish their babies without supplementation. Nursing mamas, be sure to optimize your vitamin D levels for yourself and your baby!) Other tip offs of possible low vitamin D include: limited sun exposure on the skin, cavities, frequent illnesses, easy or frequent fractures, steroids of any kind whether it is topical, nasal or inhaled.

Food is medicine, so your first line of nutrition for your child should be foods high in Vitamin D. However, the sad truth is that even with the most varied diet, most of us do not meet our optimal nutritional needs with food alone. According to pediatrician Dr. Elisa Song, MD, a daily dosage of Vitamin D3 to MAINTAIN current 25(OH)D levels is generally 1000IU per 25 pounds of body weight, up to 5000IU daily. Higher initial doses may be needed to get to optimal levels in the first place, but this should only take place with blood 25(OH)D monitoring by your physician.

Dr. Song states that when you do not have access to 25(OH)D testing for you or your child, the following are likely safe dosages by age:

0-1 year: 400-600 IU daily
1-6 years: 1,000 IU daily
7-12 years: 2,000-3,000 IU daily
13-18 years: 3,000-4,000 IU daily
19+ years: 4000-5,000 IU daily

Do You Need Vitamin K with Vitamin D?
While Vitamin D enhances absorption of calcium into your bloodstream, Vitamin K is needed to efficiently move that calcium into your bones and teeth to maintain healthy blood calcium levels without causing calcium buildup in your blood vessels, which can lead to potentially harmful atherosclerosis and increased risk for coronary artery disease. While this is typically not a concern for children, it is important to supplement with Vitamin K while supplementing with Vitamin D to synergistically optimize both bone and heart health.[18]

The UK is giving all vulnerable citizens a bottle of Vitamin D this winter.[a] An international group of health, science and medical experts have signed an open letter to world governments that Vitamin D should be prioritized for ALL healthy adults – and let’s please not forget children!

ONE simple intervention – optimizing Vitamin D levels – could have a profound and lasting impact on our children’s overall health & well-being.

If your physician or practitioner has not yet signed the #VitaminDforAll Letter, ask them to review and sign now. Let’s get this in the hands of our elected officials, public health officers, physicians and healthcare workers everywhere.

Vitamin D for All could be one of the most important public health priorities of our time.

So there it is. These are the basics for good health all year long. Read below for additional add-on support.

Probiotics, the “good” bugs in our gut have been found to help us maintain a healthy immune response; support our brain for optimal mood, focus and attention by producing over 90% of our neurotransmitters, serotonin and dopamine. Find them in fermented foods like yogurt, saurkraut, kombucha, kimchi, kefir. Or search for a high quality supplement.

Quercetin is a polyphenol that may have the potential to slow down SARS-CoV-2 replication similar to zinc. Both Quercetin and EGCG (found in green tea) were found to inhibit a specific enzyme that is critical for SARS-CoV replication.[19] Quercetin may also prevent SARS-COV from entering cells in the first place.[20] In addition, Quercetin was found to protect against sepsis and improve survival by inhibiting the NF-kB pathway.[21] Get it from berries, broccoli, tomatoes. Quercetin as a supplement is generally well-tolerated, and side effects are uncommon at doses of 500-1000mg/day. For parents who think their child may have an inadequate intake of quercetin, general recommendations from integrative doctors:

2-4 years: 50 mg daily
4-8 years: 50-100 mg daily
8-12 years: 100-200 mg daily
12-18 years: 200-400 mg daily
19+ years:400-1000 mg daily

Vitamin A – Vitamin A is one of our most important antioxidants along with vitamin C and glutathione. It will mop up free radicals when we’re sick and help us to recover more quickly. As far back as 1928, vitamin A was known as the “anti-infective” vitamin. In fact, in regions where vitamin A deficiency may be present, the World Health Organization (WHO) recommends a 2-day high-dose vitamin A protocol to treat measles.[22] Vitamin A deficiency has been associated with increased risk for infections including influenza.[23] Get this vitamin from carrots, sweet potatoes, broccoli, eggs, cantaloupe and tuna.

If you choose to supplement, the following dosages are based on the Recommended Daily Allowances and Upper Tolerable Intake level of vitamin A per the Food and Nutrition Board of the US Institute of Medicine:

0-3 years: 1,000-2,000 IU/day (300-60 0mcg RAE/day)
4-8 years: 1,500-3,000 IU/day (450-900 mcg RAE/day)
9-13 years: 3,000-5,000 IU/day (1,000-1,500 mcg RAE/day)
14+ years: 5,000-10,000 IU/day (1,500-3,000 mcg/RAE/day)

Omega-3 Essential Fatty Acids – Like vitamin D, the immune benefits of omega-3 essential fatty acids (aka fish oil) are too numerous to list. Omega-3 essential fatty acids reduce inflammation, support healthy immune response, optimize brain and cognitive function, support positive mood, benefit attention and focus, and even gives us healthy skin and hair.[24] Get your omegas from fatty fish such as salmon, sardines and anchovies. It’s also abundant in seaweed, flaxseeds and walnuts. Avoid fish high in MERCURY.

The Institute of Medicine (IOM) has not established specific intake recommendations for EPA and DHA. Instead, they recommend daily requirements for total omega-3s according to a child’s age:

0.5 grams (g) total omega 3s from birth to 12 months
0.7 g ALA for 1-3 years
0.9 g ALA for 4-8 years
1.2 g ALA for males and 1g for females for 9-13 years
1.6 g ALA for males and 1.1 g for females for 14-18 years

Keep in Mind – Immune Resilience is not about never getting sick. It’s about bouncing back quickly and completely, and being even stronger for the next hit.

Early exposure and your immune system
It might be a bit late for this if you’re an adult, but if you expose your children to certain levels of bacteria and viruses as they grow up, the more resilient their immune systems will become later in life. It means they might be less likely to succumb to certain allergies as well.

This is called the ‘hygiene hypothesis’, and is backed up by research suggesting that widespread use of disinfectant/antibacterial products and avoidance of dirt could stop children from developing healthy gut bacteria.

Obviously don’t encourage your children to eat rotten food or skip bath time completely, but do make sure they spend time playing outdoors and don’t worry too much if they come back covered in mud![25] Don’t forget to take off their shoes as long as the environment is safe for walking![26]