Healthy Kids, Happy Moms
Page 15
Once most of your child’s symptoms have been fully resolved or under control for three to six months, then you can begin reintroducing the foods you removed (such as dairy and gluten), but ideally, we won’t reintroduce the processed foods and high-sugar foods you removed during the mini cleanse. When you add back the dairy and gluten, you do it one food at a time, for one week at a time. If symptoms return, you may need to remove that food and keep it out of their diet as a new lifestyle (or only have it on special occasions). I explain this further in the Food Roadmap in Step 7.
what to do if your child is currently on a medication
Be sure to continue any medication your child is on. I never stop medications until we’re well into the process and have seen significant improvements in the child’s symptoms. Once you see improvements, discuss the changes with your child’s doctor, so she can help you decide how to potentially wean your child or stop the medication. If your child has asthma, I recommend getting a pulmonary function test with the doctor before beginning to reduce the inhaled steroid.
If you, the parent, are on medication and are making nutritional changes with your child—and I highly recommend you do—please follow the same recommendations with your medications, especially if you’re on medications for high blood pressure or diabetes. If you get to the point where you begin to remove dairy and then gluten from your diet, your carbohydrate intake will decrease significantly, and you will need to monitor your blood sugar more often.
Before starting the Mini Cleanse, fill out this symptom tracker as a baseline. By filling it out weekly, you will be able to track your child’s progress. Don’t count on your memory—leave a paper trail.
You can also find a blank copy of the HKHM - SYMPTOM TRACKER in the appendix or on my website sheilakilbane.com/book.
SETTING THE FOUNDATION/MINI CLEANSE FOR KIDS
We begin by decreasing or removing certain foods while adding others in. Take one to two weeks (or longer if needed) to complete the Mini Cleanse for Kids and set your family’s healthy foundation with nutrition that is ideal for the long term. Remember to fill out the HKHM - SYMPTOM TRACKER before you begin!
Note: For children who are picky eaters and/or those with a diet of highly processed foods, it is especially important to take your time and only go through the Mini Cleanse for Kids until your family adjusts to these new eating habits. Stress is a trigger of inflammation and if making food changes are going to add stress to your household, that defeats the purpose of this program. Start slowly, maybe take a month to complete each step of the Mini Cleanse. I would like this to be a fun, engaging activity you and your family do together. I have more tips for picky eaters later.
MINI CLEANSE FOR KIDS
MINI CLEANSE FOR KIDS
MEAL SUGGESTIONS
AFTER YOU COMPLETE THE MINI CLEANSE FOR KIDS
Congratulations, you completed the mini cleanse. Before moving on, complete the HKHM - SYMPTOM TRACKER. Compare the total score to the score from before the mini cleanse.
By incorporating more plant-based, nutrient-rich foods, you have created the foundational nutrition for your long-term eating plan. Now it’s time to begin removing dairy while adding supplements.
Supplements
I recommend all kids start the supplements and take them for at least three to six months. Follow the Supplement Start Guide carefully (see details in step 6).
Eliminating Dairy
If the Mini Cleanse has not resolved all of your child’s symptoms of inflammation, proceed with removing dairy. During this three-week trial, it is important to avoid certain components of dairy—the proteins (casein and whey)—while still getting enough nutrients such as fat, calcium, and vitamin D from other foods to maintain healthy bones, muscles, and nerves. Remember that lactose in dairy is a sugar. It contributes to gassiness and bloating, but when it comes to eczema, constipation, and systemic inflammation, casein is the main component of milk that can drive these issues. Lactose-free milk is not a good substitute because it still contains the protein casein.
Begin by removing dairy gradually over a three-week period of time. Please follow the instructions in the table below as closely as possible. (The first week remove dairy from breakfast, the second week remove it from lunch, and the third week remove it from dinner and snacks.)
Do not remove dairy all at once or your child may feel irritable and have trouble sleeping, especially if he is drinking two to four cups of milk per day along with eating cheese, yogurt, ice cream, and pizza.
We don’t want to swap out three cups of cow’s milk for three cups of another type of milk. I’d prefer your child switch to water, and if needed, he or she can drink eight to ten ounces of a different type of milk (plant- or nut-based, but limit soy products). A high percentage of people who are sensitive to dairy are also sensitive to soy. No need to cut it out completely, just don’t switch from sixteen ounces of cow’s milk to sixteen ounces of soy milk daily. Also avoid other animal milks (such as sheep and goat) until we see how your child does off cow’s milk. The goal is for your child to eat their calories from food instead of drinking them (smoothies are okay because they are blended whole foods, and fresh vegetable juices are okay as well).
If your child is generally healthy and does not suffer from the signs of inflammation we have been discussing, you don’t necessarily need to remove dairy, but be sure to continue the healthy habits you implemented during the Mini Cleanse. And now you can add in the foundational supplements.
I do recommend you consider a three-week dairy-free trial at some point in time for your whole family to see if anyone feels better. But if that feels overwhelming right now, just add in the supplements! Be sure to fill out the HKHM - SYMPTOM TRACKER each week while you are adding in supplements and removing dairy.
REMOVING DAIRY
REMOVING DAIRY
WHAT YOUR CHILD NEEDS FOR HEALTHY BONES
Research out of Harvard suggests the following:
THE FOUR MAIN CONTRIBUTORS TO BONE HEALTH
Weight-bearing activity
Maintaining adequate levels of vitamin D
Eating foods rich in calcium and other minerals such as magnesium
Eating adequate amounts of vitamin K
removing dairy with a picky eater
Decrease the amount of cow’s milk consumed by 2 ounces each week. There is no rush. Many children I see in my practice are consuming upwards of 32 ounces daily and it may take up to four months to fully wean them off of the dairy. The very gradual weaning allows us time to adjust and start to replace the calories from milk with more nutrient-dense foods. The goal is not just to switch them from 24 ounces of cow’s milk to 24 ounces of non-dairy milk but rather to switch them to drinking water and eating real food. I want kids to eat their calories, not drink them (unless of course, it is a blended smoothie).
If at any moment you feel your child is not getting enough calories or you are not able to get adequate calcium into his diet, take a pause. Add more dairy back into the diet, and don’t move on until his palate expands, and he will eat more foods. We are making some pretty big lifestyle changes and the goal is to set your family and child up for good habits well into the future. Take it slow and steady. Remember, stress triggers inflammation. If removing dairy is going to increase the stress in your home, hold off for now, and consider doing it at a later time.
For some children, there may be other factors to consider beyond your child just being a picky eater. If you suspect something more serious, talk to your pediatrician and consider seeing an occupational therapist or a speech therapist who specializes in picky eating. Please see my website for resources.
zinc and picky eaters
A zinc deficiency can impact taste buds. Consider starting a zinc supplement for two months to see if that helps in addition to the foundational supplements (see supplement section).
AFTER REMOVING DAIRY
Great job! What is your child’s total score on the HKHM - SYMPTOM TRACKER
now compared to before you removed dairy?
If your child has marked improvement off dairy, keep dairy foods out of the diet for three to six months (and possibly even make it a new lifestyle).
If your child is still symptomatic, remain off dairy and consider removing gluten, gradually, following the same steps we used to remove dairy. The first week, remove gluten from breakfast, the second week from lunch, and the third week from dinner and snacks. Remain fully off of both gluten and dairy for at least three weeks.
Fill out the HKHM - SYMPTOM TRACKER after three full weeks of being off gluten and dairy.
If you are seeing improvements, keep your child off gluten and dairy for three to six months. If there is no change at all, you may add each food back, one at a time for one week at a time. If symptoms return, remove whichever food triggered them and keep that food out of the diet for an additional three to six months.
REMOVING GLUTEN
REMOVING GLUTEN
STEP 6
5 Rs OF GUT HEALING USING SUPPLEMENTS
I treat supplements the same way I treat medications, because kids can have reactions good and bad to them. Therefore, I ask you to start supplements one at a time for seven days before starting the next one. Please start them in the order they are listed.
The goal is to change only one variable at a time. Pay close attention and don’t make a new food change on the same day that you are adding a new supplement.
FOUNDATIONAL FIVE SUPPLEMENTS TWO IMPORTANT ADDITIONAL NUTRIENTS FOR RESTORING GI FUNCTION AND OVERALL HEALTH
1. Probiotic 1. Magnesium
2. Digestive enzyme (plant-based) 2. Zinc
3. Omega-3 fat
4. Vitamin D
5. Multivitamin mineral (preferably one that is whole food based) or a whole food supplement (WFS)
Starting Supplements
Refer to the supplement section of the appendix for supplement dosing, and refer to my website sheilakilbane.com/book for a comprehensive and up-to-date list of the specific supplements, including dosing by age, that I use for the patients in my practice. I wanted to make it easier for you to use the exact same supplements for your child that I use for my own patients and family if you would like. They are bundled and available in our online store.
Please pay close attention to how I recommend you begin supplements, especially the timing with meals.
Probiotics and digestive enzymes should be taken at the start of breakfast and dinner because these decrease inflammation and help fully break down the food so it can be absorbed effectively and efficiently.
Omega-3 fats should be given once a day with a meal and with the digestive enzymes. The lipase in the enzymes help break down the omega-3 fats to ensure they get absorbed.
Start magnesium if your child has constipation, asthma, sleep issues, or ADHD or is a picky eater who does not eat foods rich in magnesium (see appendix).
Start zinc if your child is a picky eater, has skin issues, has loose stools, or gets sick often. Only take zinc for two months, unless it is under the supervision of a healthcare provider. Zinc over time can impact copper levels.
SUPPLEMENT START GUIDE
Take the foundational supplements consistently for at least 3 to 6 months, possibly longer for more severe or chronic issues.
Then see the SUPPLEMENT ROADMAP for long-term recommendations.
WEEK 1
Start Probiotic
Probiotics are live microorganisms that, when ingested, improve our health. We have hundreds of different bacteria species along our GI tracts. The research on the microbiome (the bacteria in the gut) continues to rapidly expand. What I share with you in this book may be out of date in a year from now, or even a month from now, so please keep that in mind. Our recommendations are based on current research, in addition to years of clinical experience.
The probiotic has to survive the high stomach acid to make it to the small intestine and the rest of the GI tract. The dose varies based upon the child’s age, weight, and health status. We have given a dosing example for one particular probiotic supplement we have used for years in our practice. Different strains have different dosage.
We start kids off on this particular probiotic species, Lactobacillus plantarum, because it is gentle, is soil-based, and has many health benefits that support immune function and help us restore good GI function. It also does not contain a prebiotic such as fructooligosaccharide (FOS, a carbohydrate) or inulin (a fiber). Prebiotics are the food for the bacteria while it’s in supplement form. For some people, the inulin or FOS can contribute to bloating and gassiness when beginning the supplement, which is why we start with the Plantadophilus. We find it to be well tolerated even for those with sensitive stomachs.
BENEFITS OF PROBIOTICS (PLANTADOPHILUS)
Lactobacillus plantarum strain
WEEK 2
Start Digestive Enzyme
Digestive enzymes play a critical role in helping restore the GI function. They are most often a critical component in restoring a child back to good health. If you are reading this book, chances are your child has some degree of impaired digestion.
FACTORS THAT CAN IMPAIR DIGESTION
We recommend plant-based enzymes that are GMO free. They are stable even in strong stomach acid and are blended to ensure digestive support throughout the entire digestive system, even in those who have compromised digestion.2 The timing and combination will help the body assimilate the food your child is eating, while supporting the microbiome and immune system, decreasing gut inflammation, and promoting gut health. For those with sensitive stomachs, we dose the enzymes mid-meal for a few weeks to avoid any stomach irritation and slowly progress to dosing them at the beginning of the meal.
Do not give your child enzymes if he has untreated eosinophilic esophagitis or an ulcer. It will irritate the damaged tissue along the esophagus and can cause pain. Also, those on prescription blood thinners should not use enzymes unless discussing this with a doctor.
Enzymes should be taken at the start of meals, along with the probiotic.
BENEFITS OF DIGESTIVE ENZYMES
WEEK 3
Start an Omega-3 Fat
Omega-3 fats impact almost every system of our body because they make up part of our cell walls and are critical for overall health, mood, and immune system. Harvard University researchers looked at omega-3 fats and health outcomes and found that up to 96,000 deaths per year are due to omega-3 deficiency.3
Signs of omega-3 fat deficiency in children are increased thirst, dry hair, dry skin, keratosis pilaris (bumps on the back of the arms, cheeks, or thighs), or brittle nails. Kids with ADHD, in particular boys, have been found to be deficient in omega-3 fats.4
BENEFITS OF OMEGA-3 FATS
WEEK 4
Start vitamin D (Wintertime Only)
We have a vitamin D receptor on almost every cell of our body. It is essential to our overall health and immune system, yet one billion people worldwide suffer from a deficiency.8 In the US, almost 50 percent of the population is vitamin D deficient.9
BENEFITS OF VITAMIN D
WEEK 5
Start a Whole Food Supplement or Multivitamin Mineral
The vast majority of children in the US don’t eat adequate amounts of fruits and vegetables. Most likely, your child falls short somewhere as well and would benefit from a whole food supplement or multivitamin mineral.
BENEFITS OF A WHOLE FOOD SUPPLEMENT
WEEK 6
Start Magnesium If Needed
Half of the US population does not get adequate amounts of magnesium. It is one of the most abundant minerals in our bodies and is extremely important to many different systems.10 I suspect most of your children would benefit from a magnesium supplement. Most of the patients in my practice are on magnesium.
Signs of depletion include loss of appetite, nausea, fatigue, constipation, asthma, trouble sleeping, headaches, muscle cramps, fatigue, high blood pressure, heart palpitations (only if working with a cardiologist), AD
HD, and anxiety. More severe signs can be numbness and tingling in the limbs, seizures, and more serious heart issues.
The magnesium that you might purchase in a drug store or grocery store is not what I would recommend, unless you just need it to get your bowels moving over the course of a few days to a couple of weeks. Typically, drug store supplements are in the form of magnesium citrate or magnesium oxide (think milk of magnesia). They remain in the GI tract and will help with constipation, but they don’t get absorbed into the bloodstream. They may irritate the GI tract lining if taken over a longer period of time.
The magnesium I use in my practice is gentle and well absorbed (it has some magnesium citrate in addition to magnesium glycinate). Therefore, it helps with constipation and supports our many bodily processes that require magnesium. Some other gentle forms of magnesium include magnesium malate and magnesium L-Threonate. Refer to my website sheilakilbane.com/book for specific brands.
Constipation (Magnesium + Fiber)