CHAPTER ONE


Children and Natural Supplements
It's automatic: You're a parent, you have a child, you worry. Even before he or she emerged from the womb, you were concerned about your child's health, and that concern is ongoing. Perhaps you have decided to introduce your child to natural supplements as a way to protect his or her health. Right now, only one-third of children ages two through 17 take nutritional supplements, according to a recent report, but many, many more could benefit from them. And your child can be one of them!
Parents everywhere know—or they find out very quickly—that keeping kids healthy can be a challenge. Kids often are picky eaters, they fall and get bruises and broken bones, they are exposed to germs, and they contract childhood illnesses. As a parent you face many challenges, but there are also many steps you can take to help ensure the health and well-being of your children.
Part of that effort, and one that is growing in popularity, is to give children natural supplements—vitamins, minerals, and other nutrients, as well as herbal remedies—for a wide variety of reasons, ranging from boosting the immune system to fighting an episode of common cold or flu or earache, to making sure they get all the nutrients they need while they go through a picky-eater stage. More and more parents are turning away from antibiotics and other prescription and over-the-counter medications and supporting the health of their children with natural supplements.
This chapter explores why infants, young children, and adolescents need supplements, how to get children to take them, how to choose supplements for children, and which additives to avoid. It also discusses different herbal remedies that are safe for children and how they can be used to prevent and treat certain illnesses and diseases, as well as promote overall health and well-being. Once you gain a better understanding of how your child can benefit from natural supplements, you will be better able to make an informed decision about which supplements to choose when you turn to Parts 2 and 3 for details on natural supplements and the conditions they can treat.

DO YOUR CHILDREN NEED NUTRITIONAL SUPPLEMENTS?

Will all the parents whose children eat the daily recommended number of fruits and vegetables, who get no more than 20 percent of their calories from fat, who get enough calcium for strong bones, and who eat only a limited amount of sugary foods and beverages and other junk foods please stand up and take a bow. Did anyone stand up? If so, you are in the minority.
As a parent, you are also in the minority if you provide nutritional supplements for your children. The latest figures published in the February 2009 issue of the Archives of Pediatrics and Adolescent Medicine reported that 34 percent of children and adolescents ages two to 17 use vitamin and mineral supplements, which means 66 percent of them do not. You may be among the majority of parents who do not give your children supplements but you are thinking about it. You may be asking yourself: Do my children need nutritional supplements?
In a perfect world, children might not need to take any nutritional supplements. But in our stressful, fast-paced, fast-food world, they are an asset. Pediatricians often recommend a daily multivitamin or mineral supplement, or even additional individual nutritional supplements, for:
• Picky eaters who do not eat enough food
• Kids who do not eat regular, well-balanced meals consisting mainly of fresh, whole foods
• Kids who have chronic health conditions such as digestive problems or asthma, especially if they are taking medications. (Do not give your child any supplements if he or she is taking medications until you talk to your doctor.)
• Active kids, especially those who are heavily involved with sports
• Kids who eat a lot of fast foods and/or processed foods
• Kids who are on a limited diet such as dairy-free (may need calcium supplements), vegetarian (may need iron), or other restrictions
• Kids who drink a lot of carbonated sodas, which can leach essential nutrients from their bodies
When you look at this list, it seems that it covers just about child you know. And that's okay, because taking supplements is an easy yet effective way to protect your child's health.

Supplements Can Be Good Medicine

The number one reason by a landslide (75 percent) why parents give supplements to their children is to promote overall health and wellness, followed by supplementing their nutrition (22 percent) and to treat colds (5 percent). Interviews with 8,000 consumers show that of parents who buy nutritional products for children younger than 12 years of age, 43 percent buy multiple vitamins and 38 percent buy vitamins that are specifically labeled for use by children. Parents who buy minerals are looking for calcium (45 percent), zinc (22 percent), and fluoride (15 percent). We discuss all of these and many other supplements in this book.
We know that it's difficult to make sure your children eat nutritious food all the time. For some parents, getting their child to eat a vegetable—any vegetable—is a major challenge, and a fight they feel they have lost. The term "picky eater" seems to apply to more and more children. Many children will latch onto a few specific foods and refuse to eat anything else. One mother says her five-year-old will not eat anything except macaroni and cheese, peanut butter and jelly, and grapes, no matter how creative she tries to be. Another says her six-year-old daughter will not eat anything that is green, "squishy," or has leaves. Does this sound familiar?
Even if your child does eat some fruits and vegetables and stays away from most sugary and junk foods, other factors can deplete nutrient levels, just like they can in adults: stress, environmental pollutants, lack of sufficient sleep, and use of medications (including antibiotics). Add to this the fact that children are growing and so need optimal nutrition, essential ingredients they will not get if they eat lots of processed and/or fast food, which offer empty calories and poor nutritional value.
Another important reason children can benefit from supplements is to boost their immune system. Did you know that a child's immune system is not fully developed until he or she is 14 years old? Yet that doesn't stop the bacteria, viruses, fungi, parasites, and other disease-causing organisms from attacking. In fact, they have a much better chance of taking hold and causing symptoms or disease because the child's immune system is not up to speed. That's why eating a healthful diet and taking supplements to boost the immune system can be your child's best defense against illness.

Food Versus Supplements

It is important to remember that supplements are exactly that: they are meant to supplement the diet, not replace it. Whole, natural foods are still the best way for your children (and you) to get the nutrients that are essential for health. To help you along, the U.S. Department of Agriculture (USDA) and the Institute of Medicine created a food pyramid just for kids, but many experts believe the USDA should have been stricter when it comes to some of its guidelines for grains (should insist on whole grains), dairy (should insist on low- and non-fat), and sweets (should eliminate them). In the book Real Food for Healthy Kids, authors Tracey Seaman and Tanya Wenman Steel have taken the USDA guidelines and expounded on them, providing parents with a solid foundation from which to select foods for their children. Here are some guidelines by age and an explanation of the categories.
Vegetables: Best choices are dark, bright veggies, such as spinach, carrots, sweet potatoes, bell peppers, and tomatoes. Starchy veggies such as corn and baking potatoes are less nutritious.

Fruits: Choose those richest in vitamins, such as strawberries, blueberries, peaches, mangoes, and apples. Limit fruit juices—they are high in sugar and lack fiber—and select 100 percent real fruit juice without added sugar when you do buy juices.

Grains: Select whole or multigrain flours and products; also brown rice, oatmeal, and whole-wheat pasta. Strive to eliminate white bread, white rice, and white pasta from your house.

Meats and Beans (protein): Meats and poultry should be lean with fat and skin removed; fish, eggs, beans, tofu, and other soy foods should be baked, steamed, grilled, or stir-fried, not fried.

Dairy: Low-fat products are preferred, but check with your doctor about serving your child either no-fat or whole-fat products.

Oils: Olive oil is preferred, but safflower and vegetable oils are alternatives.

Fats and Sweets: Limit your child's intake of sugary foods, soda, fried and fast foods.
So, have we answered the question to your satisfaction? Although well-nourished children may not need a multi-mineral/vitamin dietary supplement, it is likely the most inexpensive, simple, and effective way to help ensure they are getting the nutrients they need and to support their still-developing immune systems. Overall, most children can benefit from a multimineral/vitamin dietary supplement designed for young bodies, plus an omega-3 essential fatty acid.
If your child has health problems, he or she may need additional or different supplementation, or a therapeutic dose for a limited amount of time to support the immune system and to enhance the natural healing process. You are encouraged to discuss the use of additional vitamin and mineral use beyond a multi-mineral/vitamin with your physician or nutritionist.

Does Your Child Need Individual Supplements?

Individual nutritional supplements are typically given for one of two reasons: a deficiency needs to be corrected, or symptoms or an ailment need to be treated. In either case, you may want to check with your doctor before giving your child an individual supplement, especially if he or she has a medical condition and/or is taking any type of medication or other supplements.
Several nutrients top the list of those that parents worry that their child is not getting in adequate amounts. Here is a brief look at those nutrients.
• Iron: A deficiency of this mineral is not as common as it used to be in children and teens, mostly because breakfast cereals and breads are fortified with iron. However, if you have any reason to believe your child may need iron, consult your physician. Children who are very picky eaters or who eat nutritionally inadequate diets may be at risk of iron deficiency, which can cause anemia and impact brain function. Adolescent girls who have begun menstruation may be at increased risk for iron deficiency. Before you give your child iron supplements, however, you should have his or her iron levels checked by a physician. Taking too much iron and/or taking iron supplements when there is no deficiency can be harmful to your child's health.
• Fluoride: The American Academy of Pediatrics and other organizations recommend that children use fluoridated toothpaste, even if they live in an area that provides fluoridated drinking water (unless the water contains more than 1.2 milligrams [mg] per liter). Too much fluoride can discolor the teeth and be toxic. The benefit of adequate fluoride is that it is proven to reduce the incidence of cavities. So before you consider giving your child sodium fluoride supplements, make sure you know how much fluoride is in your drinking water. Your local water company should provide that information to you, or you can buy a water testing kit. If your water is not fluoridated, talk to your doctor about how much fluoride your child may need to take.
• Calcium: This mineral is the number one additional nutritional supplement that parents buy for their children. A sufficient intake of calcium is critical during childhood up through early adulthood because this is when bones reach their peak mass. If peak bone mass is not reached during these developing years, the risk for osteoporosis is greatly increased later in life. Many vitamin and multivitamin/mineral supplements contain calcium, but it may not be enough. Children ages one through 10 need 800 mg daily, and those 11 through 18 need 1,200 mg. Children rarely reach these goals through diet alone.
• Vitamin D: The need for vitamin D goes hand-in-hand with the calcium requirement, because without sufficient vitamin D, calcium will not be absorbed and utilized properly to build bone. Children older than six months need 400 International Units (IU) of vitamin D daily. Because vitamin D is produced in the skin after exposure to sunlight, children who get exposure to the sun regularly may not need a supplement. Most children's vitamins provide enough vitamin D, but check the label.
• Omega-3 fatty acids: Fish oil supplements provide omega-3 fatty acids, which are needed for proper development of the nervous system, brain, heart, and skin. Children who eat fish and nuts regularly are likely to get enough of this critical nutrient, but those who do not could benefit from a high-quality fish oil supplement. One concern about fish oil supplements is contamination with mercury and other toxins, so look for products from companies with high purity standards.
• Other supplements: Additional vitamins, minerals, and other nutrients may be helpful to treat specific symptoms and ailments, as we discuss in Part 2.

GIVING YOUR CHILD NUTRITIONAL SUPPLEMENTS

Convincing an older child to take supplements is usually not a problem, but young children may view a supplement as they would a lima bean: yuk! Fortunately, some children's vitamin and mineral supplements are available in fruit-flavored chewables, which are fine for children who are old enough and who agree to chew them. Children younger than four or five years will need to get their supplements in more creative ways. The following tips are for younger children or for older ones who may resist chewing or swallowing a supplement, who have difficulty swallowing tablets or capsules, or who have learning or cognitive disabilities and can benefit from an easier approach to taking supplements.
• Crush tablets and pour out the contents of capsules so the supplement can be mixed into a child's favorite beverage or some food. This may require some experimenting until you get the right balance of supplement with food or beverage so your child does not taste the supplement, which may be bitter or have some other disagreeable taste. Do not use hot foods or beverages to hide the supplement. Some suggestions are applesauce, pineapple or apple juice, jam, or mashed banana.
• Put the supplement into a small portion of food or beverage, and as soon as the child consumes it, "chase" it with something that tastes good. Fresh fruit (pureed or chunks) or fruit juice usually work well. Do not "contaminate" the child's entire portion of food or beverage with the supplement. If you do and the child refuses to or does not finish the portion, he or she will not get the supplement.
• Consider liquid supplements. However, because the liquid preparations tend to lose their potency rather quickly once they have been opened, store them in the refrigerator and make sure the caps are on tight.
• When choosing a chewable vitamin C tablet, get the nonacidic ascorbate form. This is easier on tooth enamel than the common ascorbic acid form of the vitamin. As a precaution, have your child rinse his or her mouth with water after chewing either form (nonacidic or acidic). In fact, it is a good habit for your child to rinse after chewing any supplement to remove any residual materials that could harm the teeth.
The one thing you do not want to do is lead children to think of nutritional supplements as "candy," even though the supplement you give them may look and taste like it. If your child asks questions about the supplement and seems to need some kind of reassurance or explanation before he or she will take it, you might tell them that the supplement is a very special treat that is good for their body but that it should only be taken once a day. In all cases, supplements should be treated as medicine and so kept out of reach of children.
DOSING OF NUTRITIONAL SUPPLEMENTS FOR CHILDREN


• When giving your child nutritional supplements, whether it is a multi-supplement or a single nutrient product, buy supplements that are made specifically for children.
• If you cannot find children's supplements, talk to your pediatrician or other knowledgeable professional about the proper dose for your child.
• As a general rule, dosing of nutritional supplements for children for therapeutic purposes is one-quarter to one-half the stated adult dose, depending on the age and weight of the child.
• Because each child is unique (a 10-year-old child may weigh as much as a 13-year-old child, and vice versa), you should always consult your child's pediatrician before giving him or her nutritional supplements, either as a daily supplement or to prevent or treat a specific condition.

HOW TO CHOOSE NUTRITIONAL SUPPLEMENTS

You are standing in front of shelves or sitting in front of your computer looking at webpages of supplements, and you are feeling overwhelmed and confused. Dozens of manufacturers produce scores of supplements aimed at children, and all of them claim to have a wonderful product. Regardless of whether you are looking for a general multi-mineral/vitamin supplement or specific individual nutrients, you want to look for reputable manufacturers who make high-quality products. These are more often found in nutrition or health food stores. You can consult with your child's physician about which brands are the best to buy, do research on your own, and visit ConsumerLab.com, a website that evaluates and reports on supplements. Once you have one or more brands in mind, you can shop around for the best prices.

Buying Supplements

First and foremost, children are not little adults; therefore they should not take a multi-mineral/vitamin designed for adults. You should not cut an adult dose in half when it comes to a multi-supplement, because a child's requirement for each individual nutrient is not half of an adult's. (See the table of Recommended Daily Allowances for children and adults in Chapter 3.) You can, however, divide an adult dose of a supplement that contains a single nutrient if dividing it will give you the child's appropriate dose. To make dosing easier for you, we have included both a child's and an adult's dose (when appropriate) for the natural supplements discussed in Parts 2 and 3 on common ailments and natural supplements to treat them.
Children's dietary supplements can be purchased as capsules, tablets, liquids, and chewables, which are especially popular with younger children. A high-quality supplement will provide the Recommended Dietary Allowance (RDA) of the most essential vitamins and minerals and not exceed the tolerable upper limit on any nutrient in the supplement.
According to a report from Consumer Labs, their evaluation of children's multivitamins found that only one brand tested (Flintstones Gummies) did not exceed the tolerable upper levels (UL) for vitamin A as retinol. Taking too much vitamin A as retinol may cause bone problems. That is not to say that there are not other brands of children's multivitamins on the market that are provide all of the nutrients within safe guidelines. The take-home message is to know the tolerable upper limit for each nutrient when you are shopping for vitamins and minerals for your child. When you look at the chart, you will notice that tolerable upper limits have not been identified for all vitamins and minerals at this time.
Another consideration is lead. In 2008, the Food and Drug Administration (FDA) tested 324 multivitamins designed for children and women and found that nearly all the products contained small traces of lead. The good news is that none of the products tested had more than the safe/tolerable levels for lead, which for children younger than six years is 6 micrograms (mcg) daily. Four of the tested products had no traces of lead. Parents are encouraged to consult the FDA list, Consumer Labs, and other resources for information about lead and other concerns regarding nutritional supplements before making a purchase. (Also see Chapter 3 and the section on lead.)
Shop for supplements that do not have additives such as artificial flavorings, colorings, and sweeteners. Also check the labels for anything to which your child may be allergic, such as milk, wheat, eggs, fish, nuts, soy, or other additives. In short, you want supplements that are free of additives, period.

SHOULD YOU GIVE HERBAL REMEDIES TO YOUR CHILDREN?

A growing number of parents are giving herbal remedies to their children for some of the same reasons they are buying vitamins and other nutritional supplements for them. In the case of herbs, however, more often they are taken to help prevent or treat a specific symptom or ailment.
And why not? Plants have been used for millennia to treat a wide range of symptoms and health problems, and today many of our over-the-counter and prescription medications are based on plants. In fact, about one-quarter of the prescription drugs in the United States contain active ingredients that come from plants. Some medications contain active components that have been synthesized from chemicals that are similar to those found naturally in plants.
Most of the drugs in the United States, however, are composed of patented, synthetic ingredients that can bring in big profits if they are successful in the marketplace. The unfortunate reality is that because Nature's products cannot be patented, they are not profitable the way pharmaceuticals are. But that does not mean herbal remedies cannot be effective. Just like medications, sometimes they work, and sometimes they don't. And in most cases, the herbal products are less expensive and cause fewer side effects than conventional medications. Some people like to say that herbs are Mother Nature's way to be gentler to her children.
That said, we must also discuss the fact that herbal products (and nutritional supplements) are not subject to the same scrutiny by the FDA that over-the-counter and prescription medications are, which means consumers must be vigilant when shopping for and using these products. You should always tell your child's physician that you are planning to give your child an herbal supplement. If your doctor does not agree and you want a second opinion, seek out a healthcare provider who is knowledgeable in the area of herbs and nutrition. This will often be a naturopath who can guide your choice of herbs for your child and your family.

HOW TO CHOOSE HERBAL REMEDIES FOR CHILDREN

First and foremost, consult a knowledgeable healthcare provider before you give herbal remedies to children. Also, do your homework: find out all you can about the herbal remedies you are considering for your child. While many herbal remedies are safe and effective for children when given in child-sized doses, others should be avoided in young people. When in doubt, consult an expert.
For example, earlier in this chapter we mentioned that glucosamine makes up 3 percent of the total amount of herbal supplements that parents buy for their children. Our research shows that experts do not recommend giving glucosamine to children because no studies have been done on the impact it may have on growing bones and joints. Therefore the use of glucosamine and its related supplement, chondroitin sulfate, in young people is not recommended.
The majority of common childhood illnesses, for example, colds, flu, ear aches, and diarrhea, originate from viral infections. Although single herbal remedies can be effective in treating these conditions, you will likely also see combination remedies when you are shopping. There are many good antiviral herbal blends on the market that combine, for example, echinacea, goldenseal, ginger, and other herbs, which we discuss in Part 3. Administer these compound remedies as you would a single one: according to body weight.
Finally, if you are the parent of a young child, it may seem like he or she has one cold after another. In fact, children younger than six or so may have eight or more colds per year until their immune system reaches a higher level of maturity. If you can introduce young children to immune-system-boosting herbal teas (see "Herbal Pops") at an early age, you may not only help significantly reduce the number or severity of colds they develop, but you may also help establish an appreciation for herbal remedies and a habit that they can have the rest of their lives—a habit of preventive care.
HERBAL POPS


• Make a strong infusion using herbs of your choice.
• Mix with an equal amount of 100 percent fruit juice. Apple and grape juice work best.
• Pour into ice pop trays and freeze.
These pops are too cold for children who have an earache, but they can be a great way to introduce your child to herbs and provide immune boosters at the same time in a tasty treat!

HOW TO GIVE HERBAL REMEDIES TO CHILDREN

According to the FDA, if a medication is to be given only for children, then it must be studied in the pediatric population. Around the turn of the millennium, only 25 percent of the prescription drugs marketed in the United States had specific, researched information about how to administer the drug to children. By 2008, the FDA reported that an estimated 50 to 60 percent of prescription drugs used to treat children had been studied at least in some part of the pediatric population. Chances that a medication has been studied in children less than one month old are close to zero.
Most medicines that are given to children—both prescription and over-the-counter—have been developed for adults and then given to children even though they have not been studied in children. The situation for herbal remedies is similar. In the case of herbal supplements, the generally accepted dosing guideline for children is calculated in proportion to the adult dose, which is based on a 150-pound adult. Therefore, a 50-pound child may be given one-third the adult dose and a 100-pound child may be given two-thirds the adult dose. This is only a guideline, and parents are encouraged to speak with a knowledgeable healthcare provider before giving any herbal supplements to their children, especially those younger than 12 and/or those who may have a chronic medical condition, such as asthma, type-1 diabetes, or juvenile arthritis.
If you are feeling especially adventurous, you may want to prepare your own herbal tinctures. It isn't hard to do, and because you can make them with glycerin (available in pharmacies) instead of alcohol, they are a better choice for children.

HOMEMADE HERBAL TINCTURES

Tinctures can be made with 100-proof alcohol (vodka is a good choice) or with glycerin or cider vinegar. Although the latter two will not be as strong as an alcohol-based tincture, they are still effective and are good options for children's remedies. If you use vinegar, warm it up (not hot) before pouring it.
• Choose your fresh herbs and coarsely chop stems, leaves, and/or roots. Flowers can remain whole.
• Place the herbs in a clean, dry glass jar and fill it to the top with the liquid of your choice. The herbs must be completely immersed in liquid.
• Place an airtight lid on the jar, label the jar with the name of the herb and the date, and store it in a dark place for six to eight weeks.
• Strain out the herbs and pour the tincture into clean, dry bottles. Label with the date and ingredients, and you're done!

BOTTOM LINE

Nutritional supplements and herbal remedies for children can help boost their immune system, supplement a less-than-ideal diet, promote growth, help treat common ailments, and contribute to their overall health and well-being.



Copyright © 2011 by Macmillan