As we all know, we face many challenges as parents and guardians of children growing up in modern society. However, at a biological level, our children face the continuous and constant challenge of nurturing an immature immune system; a complex system which is constantly developing and adapting to the outside world in order to equip them with a fully functioning immune army in adulthood.
A healthy diet is paramount to provide all the nutrients they need to ensure a strong and robust immune system. If you’re not sure which nutrients are important, or what to do when your children get poorly, we’ve gathered our top nutritional and lifestyle tips all in one place.
KEY NUTRIENTS FOR IMMUNE SUPPORT
Vitamin D deficiency is common and has been linked to tonsillitis in children,[i],[ii] so ensuring adequate supply could be useful in preventing infection. The Department of Health recommends a daily supplement of 10mcg (400iu) for children from 6 months to 5 years of age. Higher levels (1200iu) in school children can reduce the incidence of flu by 40%.[iii] At times of need, you can increase the level for a short period of time (1-2 weeks).
Vitamin D upper limits for short-term in children:
Vitamin A improves immunity through maintenance of barrier membranes, development of lymphatic tissues[iv] and amplification of the immune response.[v] In children, it has been found effective in managing measles infection.[vi]
Vitamin A rich foods: meat, oily fish, eggs, butter. Fruit and vegetables; carrots, sweet potato, spinach, kale, Swiss chard, cantaloupe melon, and peppers, contain carotenoids which can be converted to vitamin A in the body.
If your child is following a vegan or vegetarian diet, it is important to supplement with vitamin A to ensure adequate intake.
The germ-fighting immune cells need vitamin C to perform their task, and they accumulate it for times of viral and bacterial invasion. In children, vitamin C decreases the duration and symptoms of respiratory tract infections,[vii],[viii]including pneumonia.[ix]
Vitamin C rich foods include peppers, broccoli, spinach, strawberries, pineapple, oranges, kiwi fruit, cantaloupe, and cauliflower, and should be consumed raw or only lightly steamed to conserve their vitamin C content. Easy ways to do this include smoothies, fruit salads, or even fruit ‘kebabs’. Vegetables can often be trickier to increase, so finely chopping or grating them, making them into crudités, and adding to soups or sauces can often help.
A good daily dose of vitamin C for children from one year is 250mg, which can often be found in a multivitamin. This can however be increased to 400mg (ages 1-3years), 650mg (ages 4-8yrs), and 1200mg (9-13years) for a short period (1-2 weeks) whilst fighting infections. If using vitamin C in a powder form, it is really easy to add to a water bottle or beaker that the child can sip on throughout the day.
Zinc has a pivotal role in a healthy functioning immune system and also maintains strong barrier membranes in the skin and respiratory tract to prevent microbial entry.[x] Zinc-deficient individuals experience increased susceptibility to a variety of pathogens.[xi]
Zinc rich foods include seafood, beef and lamb, spinach, pumpkin seeds, cocoa, chicken, beans, mushrooms.
A good quality multinutrient will provide enough zinc for a daily dose, however for additional short-term immune support, children aged 1-3years can take a total of 7mg, 4-8years - 12mg and 9-13years a maximum of 23mg.
Elderberry extract has been researched to provide support to immune function by enabling the immune cells to recognise and stop viral invaders, and it comes with a long history of safe and effective use. Research shows that elderberry has the potential to ‘blunt’ the spikes on the outside of certain viruses and stop them from entering the cells where they would otherwise replicate.[xii] Elderberry is therefore often best taken at first signs of infection to stop the virus entering the cells and multiplying, alongside other nutrients which both strengthen and balance the immune system.
Our gut bacteria stimulate, support and enhance the maturation of the immune system. Live bacteria (probiotics) taken as a supplement have been shown to significantly reduce the occurrence and symptoms of coughs and colds, and reduce the need to use antibiotics.[xiii],[xiv]
Probiotic foods include full fat yoghurt, kefir, sauerkraut, miso, tempeh and sourdough bread. A great dessert or snack option could be natural yoghurt with a homemade fruit compote (berries for extra vitamin C or stewed apples for fibre). Kefir can be added to a simple smoothie - strawberry, banana, and kefir. Miso paste can be added to soups, spread onto salmon or chicken before baking, or mixed with some oil and apple cider vinegar and drizzled onto salad or roasted veggies.
A great strategy for supporting immunity in children would be a children’s multinutrient formula which includes a range of immune-supporting nutrients such as vitamin A and zinc, alongsideprobiotics, and perhaps extra vitamin C and elderberry, when needing additional support.
If your children do pick up an infection, here’s what you can do to help:
Remember a fever is the body’s natural process of dealing with an infection. The raised body temperature can kill off bacteria and viruses that are sensitive to temperature changes. A low-grade fever is a body temperature of over 38oC (100.4oF), and above 39oC (102.2oF) is a high grade fever.
Natural ways to support a fever include ensuring they are well hydrated (water, coconut water, homemade ice lollies with water and some fruit), get plenty of rest, give them a bath with lukewarm water, and open a window in the bedroom to keep air circulating.
A traditional remedy used to ‘draw out’ a fever is a washcloth soaked in diluted apple cider vinegar (1 part vinegar to 2 parts water) then placed on a forehead or the abdomen.
If you feel the need to use medication, speak to a doctor or pharmacist about any medication you or your child might need.
For older children with a sore throat, they can also gargle with salt water, or use manuka honey with lemon to relieve irritation.
Prioritise sleep with restricted access to electronic devices. Children may try to persuade you to let them stay up late if they don’t have school in the morning. However, it is important to try to stick to regular sleep routines and practice good sleep hygiene. Try to limit screen time 2-3 hours before bedtime as electromagnetic radiation and bright screens can contribute to environmental stress and inhibit immune function. Turn off the Wi-Fi and listen to the birds outside or read favourite books together.
Avoid refined foods including wheat products, dairy and sugars as they can reduce immune function. Focus on nutrient dense food to ensure they are getting enough immune supporting micronutrients and antioxidants – eat the rainbow!
Don’t be afraid to take the children outside – this is really important for mental wellbeing (as long as you follow government guidelines and are maintaining social distancing at this time).
If you need nutrition and supplement advice, please contact our Nutrition Team or seek the advice of a Registered Nutritional Therapist or other healthcare practitioner for more tailored advice.
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[i] Yildiz et al. The role of vitamin D in children with recurrent Tonsillopharyngitis.Ital J Pediatr. 2012; 38: 25.
[ii] Reid et al. Vitamin D and tonsil disease--preliminary observations.Int J Pediatr Otorhinolaryngol. 2011; 75 (2): 261-4.
[iii] Urashima M et al. Randomized trial of vitamin D supplementation to prevent seasonal influenza A in schoolchildren. Am J Clin Nutr. 2010;14(5):1255–1260.
[iv] S. van de Pavert et al., “Maternal retinoids control type 3 innate lymphoid cells and set the offspring immunity,” Nature, doi:10.1038/nature13158, 2014
[v] Hall et al The role of retinoic acid in tolerance and immunity. Immunity 35 (1), 13-22
[vi] Yang HM, Mao M, Wan C. Vitamin A for treating measles in childrenexternal link icon. Cochrane Database Syst Rev 2011;2005.
[vii] Vorilhon P et al.Efficacy of vitamin C for the prevention and treatment of upper respiratory tract
infection. A meta-analysis in children. Eur J Clin Pharmacol. 2019;75(3):303-311.
[viii] Hemilä H, Chalker E. Vitamin C for preventing and treating the common cold. Cochrane Database Syst Rev. 2013;(1):CD000980.
[ix] Khan IM et al. Efficacy of vitamin C in reducing duration of severe pneumonia in children. J Rawalpindi Med Col. 2014; 18(1):55-57.
[x] Cunningham-Rundles et al. Mechanisms of nutrient modulation of the immune response. Allergy Clin Immunol. 2005; 115 (6): 1119-28.
[xi] Gammoh NZ, Rink L. Zinc in Infection and Inflammation. Nutrients. 2017;9(6):624.
[xii] Weng JR et al. Antiviral activity of Sambucus Formosana Nakai ethanol extract and related phenolic acid constituents against human coronavirus NL63. Virus Res. 2019; 273: 197767
[xiii] Garaiova I et al. Probiotics and vitamin C for the prevention of respiratory tract infections in children attending preschool: a randomized controlled pilot study. Eur J Clin Nutr. 2015; 69(3): 373-9
[xiv] Hojsak L et al. Lactobacillus GG in the prevention of gastrointestinal and respiratory tract infections in children who attend day care centres: A randomized, double blind, placebo controlled trial. Clin Nutr. 2010; 29(3): 312-6
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