Before answering this question, it’s important to note that I’m a huge proponent of food as medicine. At CentreSpringMD + Peds, we have a holistic approach to pediatric care, and dietary recommendations often are the bulk of our integrative treatment plan for our pediatric patients. That said, as a mom I totally understand that making sure your kids get all of their nutrients from food can be a difficult endeavor. Whether they are picky eaters or not, there are certain nutrients that need to be supplemented to be at their optimal levels.
Getting enough DHA and EPA in even a healthy adult’s diet can be a challenge. I’m sure there are some kids who love eating wild-caught salmon 3 times a week and grub on flaxseed meal and walnuts every day, but for the rest of the kids out there, some supplementation is needed. DHA and EPA are crucial for optimal brain development and overall health, and they have anti-inflammatory properties as well. We love Nordic Naturals brand as a clean source of fish oil-based DHA/EPA for all ages. It is wonderful for infants through age 3, after which kids can transition to this one. Once they’re able to swallow pills, the ProOmega Junior is the go-to option (these actually have a strawberry flavor and can be chewed as well as swallowed whole). With very few exceptions, all my pediatric patients walk away with a recommendation to start a clean Omega-3 supplement.
Important for so many body functions, including strong bones, a thriving immune system and healthy mood support, Vitamin D is often found to be low when we test even the most sun-loving kids. Children of all ages need or could benefit from Vitamin D3 supplementation. The recommendation for breastfeeding infants is 400 IU daily (we use this one). Around 12 months, I recommend closer to 1000 IU daily (this is a tasty choice), and as kids get older (and depending on their lab levels), we increase to 2000 – 5000 IU daily (these are great once they’re able to swallow pills.)
Just about every child can benefit from probiotic supplementation. The microbiome is such an important “organ” in our bodies. So many medical issues and illnesses can come about or be exacerbated by gut flora being out of balance. Babies develop their microbiomes upon birth through the vaginal canal. Cesarian birth and antibiotics during labor (both potentially life-saving interventions) can affect an infant’s microbiome from day one. Any antibiotic courses that follow will also change the microbiome. Other factors like sleep habits, non-antibiotic medications, and foods alter the bacterial environment in our guts.
At the Center, we generally start babies on a low-dose probiotic like this one around 6 weeks old (and will start before 6 weeks if birth was cesarean or baby/mom received antibiotics). After 12 months, we transition to 2.5-5 billion CFU daily as a powder and this once they can do a chewable tablet. As kids get older, and depending on their situation, we can go up to 5-10 billion CFU daily. In certain situations, (like SIBO – Small Intestinal Bacterial Overgrowth), probiotics can worsen symptoms so we always take each child’s individual health and symptoms into consideration when deciding on probiotic doses.
Most kids don’t need a multivitamin if they eat a whole-foods varied diet. We prefer to personalize vitamin supplementation in kids depending on their individual needs. I absolutely LOVE our Nutreval test as a way to pinpoint a child’s specific vitamin deficiencies – this makes fine-tuning their dietary and supplement regimen a breeze!
However, most kids do need some extra B vitamins, and we prefer to make sure they’re getting the active – or methylated – forms of B12 and Folate. This can be achieved through a specialized B-complex vitamin from a compounding pharmacy, or through a cream like, which provides methylated B12 and methylfolate, absorbed directly through the skin. Sometimes, when more than just the B vitamins are deficient, I may offer a multivitamin to give kids more of what they’re needing. Chewable vitamins that contain methylated B’s, and actually taste good enough for most kids to take, are hard to come by, but we carry and recommend these with good success.
Beyond these basics, we often find that kids need additional specific vitamins or supplements to help them thrive. A thorough evaluation will help us determine what each child needs, so be sure to bring them in to see us!
|Dr. Jamilet Alegria, M.D., joined the CentreSpring MD team of providers in the fall of 2016 after spending years as a Pediatric Hospitalist at both CHOC Children’s in Orange County and at the Pomona Valley Hospital Medical Center Inpatient Pediatrics Unit in Southern California.|
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