_{by Geri Brewster, RD, MPH, CDN}

Well, frost is on the pumpkins and the chill is in the air. The news is filled with articles of the anticipated flu season. Children are washing their hands at school before lunch, using their hand sanitizers between classes, coughing into their sleeves, covering their noses and mouths when they sneeze, and not sharing water bottles – all good and necessary.

Parents are emphasizing enough sleep (the recommended amount of sleep for children younger than age 5 is 11 hours or more per day, for children 5-10: 10 or more hours per day, and for children 11 and over: 9 hours or more). They should also be emphasizing a minimum of 5 servings of fruits and vegetables daily.

Let's start with the ones you might find most familiar.

Vitamin C may not prevent a cold from occurring, but studies show it will shorten the number of sick days.

Probiotics: Thanks to yogurt commercials, many people now know what nutritionists have been saying for years: 70% of your immune system is in your gut. In the field, this is known as GALT: gut-association lymphoid tissue. Studies show that probiotics stimulate GALT and enhance immunity. If your child takes an antibiotic, talk to your healthcare provider about recolonizing their gut flora with probiotics. I recommend that probiotics and antibiotics be separated by 3-4 hours. Researchers have concluded that gastrointestinal flora is essential in the development of healthy immunological systems in children.

Garlic: Research has demonstrated garlic's broad antimicrobial effects. Compounds in garlic can help fight against bacteria, viruses, and yeast. While aged raw garlic may be best, benefits can be gained by roasting and adding to soups. Like:

Chicken Soup is a great way to get many of the 5 servings of vegetables and fruits recommended daily. It's rich in antioxidants, vitamins and minerals, and garlic! Researchers have found that chicken soup's mix of ingredients reduces inflammation, calming all the irritation that accompanies a cold or flu.

Multivitamins and Minerals: Vitamins and minerals work in metabolic pathways that help our immune systems fight infection and disease as well as detoxify harmful compounds and remove them from our bodies. Because stress, both physical and emotional, can increase our need for nutrients as our bodies fight and detoxify, it is important to optimize our intake with a daily multivitamin. With all the over-scheduling that goes on in our busy lives, we are often adding poor intake, fast or processed and refined foods, along with simple, sugary carbohydrates to the mix of emotional and physical stress. This combination takes its toll on our immune systems making us more vulnerable to disease.

A multivitamin won't fix everything, but vitamins such as our B's, C and minerals like magnesium, help our adrenals manage the amount of stress hormones they produce.

Vitamins A, E, and minerals like zinc and iron help optimize our immune systems.

Vitamin D has many functions, including immune system support, antibacterial and antiviral properties, and reducing inflammation. Many adults and children are vitamin D deficient or insufficient. This can be determined by a simple blood test which may indicate the need for higher doses for a short period of time. After that, what is found in a multivitamin may be enough to support sufficient levels.

Fish oils are often a good source of Vitamin D, as well as Vitamin A, along with Omega 3 fatty acids that can reduce inflammation as well. Grandma's cod liver oil and chicken soup ring tried and true! If taking a fish oil, make sure the label indicates that it has been molecularly distilled and is free of contaminants.

I also recommend a "clean" multivitamin and mineral. By that I mean one without artificial colors, flavors, sweeteners, or chemical preservatives. A November 2007 article in the medical journal LANCET revealed that artificial colors and benzoate preservatives (found in many candies) increase impulsivity and reduce attention in children found to be sensitive. My feeling is: when it comes to vitamins and minerals, why add ingredients that are working against balancing our children's bodies?

On that note, if your child is getting run down and sniffling, do not load him up on sugar!  Sugar can feed some of the microbes that you are hoping that your child will be able to fight, while it also weakens some of the good bacteria that is working as GALT. Sometimes colds and flu happen after a party, not only from the germ exchange, but also from the sugar consumption. When your child has had too much of the sweet stuff, help to alkalize their body and provide balance with a bowl of vegetable soup, a vegetable/apple smoothie, a green drink or salad, or raw vegetables and hummus dip.

Echinacea has a good safety profile with uncommon adverse events. Due to cross-sensitivity, individuals with allergy to ragweed, chrysanthemum, marigold and daisy may be at increased risk for allergic reaction. A 2004 study found a combination of echinecea, propolis, and Vitamin C to be effective in preventing respiratory tract infections in children. I recommend that echinacea not be used regularly throughout the season, but intermittently and as needed. Propolis is a natural resin created by bees.

Coconut oil has broad spectrum antimicrobial properties and is delicious to include in recipes throughout the winter.

Doses of any of the supplements noted above will vary based on a child's age and size. So, discuss what is advised for your child with your healthcare provider and have a wonderful and healthful winter season!

References:
American Academy of Pediatrics: Healthy Children 2008
Guandalini S. Probiotics in children: Use in diarrhea. J of Clin Gasto. 40 (3):244-8,2006
Kligler B, et al. Probiotics in children. Ped Clinics of North America. 54 (6):949-67,2007.
University of Nebraska Medical Center. Stephen Rennard MD. The benefits of chicken soup. Published Oct 17, 2000. CHEST.
http://www.vitaminDcouncil.org.
Cohen, H A, et al. Effectiveness of an herbal preparation containing Echinacea, Propolis and Vitamin C in preventing respiratory tract infections in children: a randomized, double blind, placebo controlled, multicenter study. Arch Ped, Adolesc Med. 158:217-21, 2004.