Healthy Kids, Happy Moms

by Sheila Kilbane, MD

  research: high dairy and calcium intake doesn’t necessarily lead to healthier bones in children

  Calcium intake was not correlated with bone mineral density among children aged four to eight years, but magnesium was. Magnesium intake and absorption may be an important and relatively unrecognized factor in bone health in the US.20 For this age group, the UK recommends 450 to 550 mg per day of calcium vs. the 1,000 mg recommended by the US.

  Supplementation of calcium or dairy intake in children showed no increase or only a small increase in bone mineral density. But once supplementation was stopped, the increase did not persist.21,22,23,24,25,26 These study results do not support the use of calcium supplementation in healthy children as a public health intervention, but cannot be extrapolated to children with medical conditions affecting bone metabolism.27

  Girls and boys in early puberty who were not getting adequate calcium were given three additional servings of dairy per day. There was no effect on bone mineralization. This suggests a lower threshold for calcium intake, and amounts above that may have little additional effect on bone mineralization.

  For teen girls, some suggest the body adapts to a lower intake of calcium (400 mg per day) by increasing the absorption. However, if intake levels fall too low, this can impact overall calcium retention and possibly bone health.28

  Greater milk consumption during teenage years was not associated with a lower risk of hip fracture in older adults. In fact, among men, every additional glass of milk consumed per day during adolescence was associated with a 9 percent greater risk of hip fracture later in life.29

  As you can see, the research falls short of the dairy advertisers’ claims that milk alone makes healthy bones. Since decreasing or stopping dairy for many of your children is one of our big tools for decreasing inflammation and restoring balance, we must pay close attention to all factors and all nutrients that impact bone health.

  Perhaps the most complicated part of bone health is getting our kids outside away from their screens and eating more greens!

  WHAT IS THE RIGHT THING FOR YOUR CHILD’S BONE HEALTH?

  I lean toward Dr. Willett’s review of the research regarding the high amount of calcium recommended daily. I think it may be somewhat higher than what our kids actually need. The systems of our bodies that require calcium for proper function include, our beating heart muscle, skeletal muscle (responsible for all of our movement), and the firing of our nerves. They each use calcium in concert with a host of other minerals. Why would one system (our skeletal system) be so much more dependent upon a high amount of one single mineral than all the other systems?

  Then, take a look at some of our furry friends who clearly have strong and healthy bones without the obligatory two cups of milk per day (I have yet to see a racehorse or lion with a milk mustache). It seems to me, the recommendation of physical activity being the most important factor for bone health holds a lot of weight.30

  However, we must take into consideration the limitations of each child. Some kids may be less mobile than others, some kids may be in a time of their life such as high school where they have to sit and study for longer periods of time and are not able to be as active, and some kids may live in an area where it is not safe to be outside playing. In those situations, a higher amount of calcium may be warranted.

  All of this being said, I do think it is prudent to follow the recommendations for calcium intake as closely as possible while paying attention to the many other nutrients needed. This basically means eating a wide variety of fruits, vegetables, nuts, seeds, beans, proteins, and fats . . . you know the list by now! Five different studies consistently found some type of benefit to bone with increased or high intake of fruits and vegetables.31

  In order to make implementing the calcium recommendations a little bit easier, I have created a long list of whole foods, along with their calcium content, which you can find in the appendix.

  WHERE DOES THIS LEAVE US WITH THE RESEARCH ON COMMON CHILDHOOD ILLNESSES AND DAIRY?

  A brilliant mind in the field of pediatrics shed some light on this topic of dairy and common childhood illnesses for me. Dr. Frank Oski in 1983 wrote a book called Don’t Drink Your Milk. Here’s what he had to say about dairy and illness:

  At least 50% of all children in the United States are allergic to cow’s milk, many undiagnosed. Dairy products are the leading cause of food allergy, often revealed by diarrhea, constipation, and fatigue. Many cases of asthma and sinus infections are reported to be relieved and even eliminated by cutting out dairy.32

  Hmm . . . this follows more along the lines of what I was seeing in clinic. Eliminating dairy for a period of time, or even making it a new lifestyle change for kids with the common inflammatory illnesses, was a game changer. It often completely altered the course of the child’s health and they were able to avoid further rounds of antibiotics, steroids and, more importantly, doctor visits.

  I could write an entire book on dairy, and the first draft of this book had three chapters on the subject. It included all the juicy details of the following studies, which I find fascinating. However, my editor assured me the details were quite boring, and if anyone wanted to read them, they could look the studies up. So following is what used to be pages worth of information that is now simply a lovely and easy-to-view table.

  I have listed the illnesses along the left-hand column and then the percentage of kids whose issue improved when dairy was removed. In the fourth column I listed some of the other potential triggers for that illness, and the fifth column contains a few of the important aspects of the study I thought would help you better understand the information. This table is by no means an exhaustive list, but it is very compelling.

  Dairy’s Role in Triggering Inflammation in the Following Common Childhood Illnesses

  TRIGGERS DAIRY = COW MILK PROTEIN PERCENTAGE OF CHILDREN IN THE STUDY WHO WERE ALLERGIC OR SENSITIvE TO DAIRY OTHER POSSIBLE INFLAMMATORY TRIGGERS NOTED IN THE STUDIES FURTHER DETAILS ABOUT THE RESEARCH STUDY

  Eczema33,34 Dairy 30% Egg, Tomato, Artificial Colors, Preservatives, Gluten35, Staph bacteria on the skin36

  Chronic ear infections37 Dairy 38% Wheat 33%, Egg 39%, Peanut 25%, Soy 20%, Corn 17%; Other foods that were of much lower significance: Orange, Tomato, Chicken, Apple 78% of the kids were allergic to more than 1 food on skin prick test

  16-week elimination diet of the foods the children tested positive for decreased the middle ear fluid in 86% of the kids.

  When the food was reintroduced over 16 weeks, 94% ended up with another ear infection.

  Constipation38 (bowel movements were 1 every 3 to 15 days—YIKES!) Dairy 68% Within 1 week of removing cow’s milk, 68% of the kids experienced a soft, non-painful bowel movement (some within 2 days). Some of the kids remained off dairy for 8 to 12 months and upon reintroduction, they all became constipated again.

  Asthma39 Dairy 15% Eggs40 and environmental allergies—60% of kids with asthma also have environmental allergies41 The authors of this study concluded, “It is worth considering possible milk allergy in children with asthma, particularly when poorly controlled in spite of proper routine management.”42

  Babies: Reflux (GERD)43,44 Dairy Up to 30% Dairy allergy can mimic reflux symptoms in up to 30% of kids with reflux.

  Breastfed babies and colic45 Dairy in mom’s diet 50% of breastfed babies experienced an improvement when mom eliminated cow’s milk from her diet.

  iron-deficient anemia46 Excess cow’s milk intake (more than 24 ounces per day) is a major cause of iron-deficient anemia in kids younger than 6 years of age.

  TAKEAWAYS

  It’s time to reexamine the importance of dairy products for children’s health in light of science. Calcium and magnesium work as a team for strong bones. The four main contributors to bone health are: Weight-bearing activity

  Maintaining adequate levels of vitamin D

  Eating adequate amounts of calcium-rich foods

  Eating adequate amounts of vitamin K

>   Dairy has been linked to many common childhood illnesses.

  CHAPTER 8

  strategic supplements to support digestion

  The goal of taking supplements is to help restore proper Gi function, so we can optimize our body’s ability to break down and absorb the nutrients from our food.

  —DEB ALLEN, RPh, integrative pharmacist

  THE SUPPLEMENT PORTION OF this program was created with significant contributions from the kind, gracious, and brilliant integrative pharmacist who works with me, Deborah Allen.

  Deb was managing the pharmacy at a large chain store when her triplets were born. I love her story because it’s not only about the triplets but also about a mother who was determined to get to the root cause of her children’s ailments. I suspect that many of you will identify with her tenacity.

  “I remember watching these tiny beings holding onto life in the NICU. My babies each weighed less than three pounds and could barely maintain their own body temperature, let alone digest and absorb nutrients,” Deb says.

  Sixteen years later, as she sits in our office over a cup of tea, I watch Deb’s passion ignite when she recalls the early days of motherhood. “I could see their little nervous systems being taxed just trying to exist. They had dips in their heart and respiratory rates from being held outside of their incubators. All those biochemical pathways I had memorized in pharmacy school were playing out before me in real time.”

  As the triplets transitioned home and away from the monitors, Deb closely observed how they responded to things like guests, baths, eating, and sleeping. It’s easy to detect stress when hooked up to a monitor and a buzzer goes off. But once the triplets were home, the signs of stress became more and more subtle (which is the case for most kids—and adults for that matter). Luckily, Deb and her husband had become keenly aware of what to look for and how to minimize external stressors. It was important that all of the babies’ energy would go toward eating, digesting breast milk, and growth, instead of toward recovering from small stressors all day long. Digestion and the function of our digestive enzymes are significantly impaired by stress or the “fight-or-flight mode” of our nervous system.

  Sadly, the babies were not tolerating her breast milk, which Deb had been assiduously pumping while they were in the hospital. “I was pumping enough for a small village while trying to recuperate from the C-section and lack of sleep. The huge blow came when the doctor told me I needed to stop giving them the breast milk. He said they needed to go on something that would help them gain weight and lessen their symptoms.”

  “The babies were colicky, fussy, and not gaining weight at the rate they needed to. I was desperate to be part of the solution. I cried as I dumped all my frozen milk and the babies were switched to a soy preemie formula. Looking back, I sometimes get so angry that the doctors didn’t tell me to remove any foods from my own diet first to help them tolerate the breast milk.”

  Now, as the mother of teenagers, Deb has come to peace with what was done in the past while acknowledging that if she’d known then what she knows now, she would have done things differently.

  Recall what you learned in chapter 1 regarding the role between genetics and our environment. Despite having nearly identical DNA and being born at the same time, the excess inflammation and prematurity in Deb’s triplets manifested differently. I talked in that chapter about the variety of ways inflammation can present in children. It may be eczema or recurrent ear infections in one child and wheezing and constipation in another.

  One of the kids was a restless sleeper. She was all over the bed at night and could not stop moving her legs. She also had chronic croup that required frequent steroids.

  Another one suffered with eczema, recurrent ear infections, and chronic constipation. Deb followed the GI doctor’s advice. “We put her on MiraLAX and gave her glycerin suppositories at one year of age. Often, we had to physically aid her to poop.”

  The third one also had recurrent ear infections, but her other challenges were more nervous system and development related. “She had trouble with speech articulation and fine motor skills as well as some sensory integration issues. This meant she was easily overwhelmed by loud noises or busy environments. She needed a lot of external physical pressure to calm down like big bear hugs (as many kids do). Spinning also seemed to be calming.” As Deb looks back, “Understanding the significant role digestion, proper nutrient absorption, inflammation, and the nervous system play in a child’s overall health was a world I didn’t know existed.”

  Over the next three years, Deb dug into medical research. “I said to myself, ‘I’m going to seek out as much as I can learn about those biochemical pathways that are not allowing them to thrive.’” She knew there had to be a food connection, so Deb went to great lengths to prepare beautiful organic meals for the children.

  Stressed by her own health, and by taking care of three chronically sick children, Deb turned to acupuncture for herself. She started feeling so much better that she began bringing the kids for sessions. The acupuncturist told her about digestive enzymes and probiotics designed to aid the children’s ability to decrease inflammation and to break down and absorb the fats, proteins, vitamins, and minerals from the food they were eating. This made sense to Deb, since digestion is the key to giving our bodies the nutrients they need.

  Deb took an incremental approach to elimination of some key inflammatory foods. First, she started the supplements one at a time, the probiotic, Plantadophilus (Lactobacillus plantarum), and then the digestive enzymes. Next she removed dairy and then gluten. Once she felt the kids’ digestion had improved (more normal bowel movements, better sleep, smoother skin), she added in fish oil. She knew enough not to add in this extra fat until their bodies were digesting foods better. Otherwise, the fish oil would go right through them, and she would have three sets of diapers containing expensive supplements that did not get absorbed by their bodies!

  The kids’ health didn’t completely normalize overnight, but she saw big gains. She knew that if she could just remove the obstacles, the triplets’ bodies would rebalance and heal. And heal, they did. She continued to focus on keeping the major inflammatory foods out of their diets (artificial dyes; refined sugar; packaged, processed foods; dairy; and gluten) and to focus on digestion with key foundational supplements.

  The kids continued to do better and better. When they were four years old, she went back to work. Armed with a new understanding of nutrition, inflammation, and illness, she experienced her work in the pharmacy through a much different lens. She recalls, “I saw things that I had learned with the kids translate in the pharmacy. Patients of all ages were being ping-ponged from specialist to specialist. It became clear to me that the medical field was not looking at the bigger picture. People were being given medications that were hindering their ability to break down and absorb the nutrients from their foods.”

  Deb started seeing a pattern when it came to acid reflux. “The patient would get an acid blocker they were supposed to stay on for the rest of their lives. Since the body needs strong stomach acid to activate pancreatic enzymes that digest and absorb nutrients such as protein and fat, these patients don’t have the natural resources to make adequate amounts of neurotransmitters or hormones and end up relying on medications to sustain them. These patients would be back to the pharmacy in six months with another prescription for depression, anxiety, sleep problems, or focus issues.”

  THE PHARMACEUTICAL MARCH

  (Concept created by Deborah Allen, RPh)

  I first met Deb when she came into my office to tell me about the probiotics and enzymes she had begun selling instead of managing the retail pharmacy. It wasn’t long after that initial meeting that we began working together. When we began incorporating the method of supplementation to support digestion that Deb used with her children, I started to understand digestion in a whole new way.

  Identifying the root of your child’s inflammation and restoring their digestion are two key factor
s of the HKHM program. As Deb often says, “Syndromes are just a bunch of symptoms put together, but it doesn’t give you the underlying reason why. All the things ending in ‘itis’ (colitis, arthritis) are really telling us that the patient has inflammation.”

  MY SUPPLEMENT MISTAKE EARLY ON

  When I first started practicing integrative medicine, I did with supplements what I was trained to do with prescription medications: I used them to deal with symptoms, because I still was not always figuring out why the child wasn’t absorbing iron in the first place. I was just happy to have more high-quality supplement recommendations at my fingertips. For example, if a child had iron-deficient anemia, I wasn’t necessarily always advising parents to truly look at the child’s diet to see if their gut was inflamed, but instead I was just prescribing a better-quality iron supplement than the one they had bought from their local pharmacy that was giving them constipation and making the child’s stomach hurt.