The Rise in Kids Illnesses

As COVID safety guidelines loosen, common colds and infections are back. Here’s what to look out for and how to boost kids’ immunity.

BY GINA LAMB-AMATO, M.D.

Since the COVID-19 pandemic lockdown, common childhood viral infections were, until recently, seen at a much lower rate in the pediatric population. COVID-19 preventive measures like lockdowns, mask-wearing, social distancing, staying inside, and cleaning surfaces at an increased frequency, prevented common respiratory and gastrointestinal viral infections from spreading in children.

Now that children, for the most part, are not in lockdown and the above COVID-19 preventive protocols have become more universally relaxed in the U.S., pediatricians are seeing an uptick in respiratory and gastrointestinal diseases.

WHAT’S GOING AROUND?

RSV infections, which cause respiratory and pneumonia illnesses in babies younger than 1, started being diagnosed this spring and summer and continue to be a threat. Before the pandemic, RSV was mainly seen in the winter months. During the pandemic lockdown, RSV and other viruses including influenza A, influenza B, norovirus (aka the stomach bug), and parainfluenza (a virus that causes colds, bronchitis, and other illnesses) were at much lower levels than pre-pandemic lockdown.

DECREASED IMMUNITY

Children’s social and school life were extremely restricted when schools, preschools, nursery schools, and day care programs were shut down. Normally, babies and children develop their immune system by being exposed to viruses, bacteria, funguses, and other microbes. When babies and young children play in the dirt with other kids, they are exposed to microbes, which helps them develop and regulate their immune systems. They further develop immunities to different childhood diseases when they enter school or a day care setting.

The lockdown’s strict hygiene protocols, along with being kept at home, prevented children from exposure to microbes and the opportunity to develop their immune systems. Since very young children have not been exposed to non-COVID-19 infectious diseases like colds and the flu, they have not developed and increased antibodies to these illnesses. Therefore, children do not have the strong immune system that they would have normally developed. Now that kids are returning to school, they are at risk for having decreased immunity to pediatric infectious diseases.

Another reason for decreased immunity is that many kids did not get the immunizations they needed during the pandemic lockdown.

IMMUNITY BOOSTERS

There are many ways to boost your child’s immune system, from diet choices to encouraging a healthy lifestyle.

Breast is Best: For newborns, breast-feed if you’re able. There is colostrum in breast milk, which helps build your baby’s immunity.

Wash Your Hands: Have your child wash their hands frequently, especially when they come inside your home and before meals. Have them sing “Happy Birthday,” which is about 30 seconds long and an essential duration to kill viruses, bacteria, and fungi. There are other hand-washing songs and games, such as “Baby Shark,” which is available on YouTube.

Stay on Track: Make sure to keep your child up to date with all their vaccines. When children do not get their immunizations according to schedule, they are at risk for childhood diseases.

Follow Doctor’s Orders: Please don’t insist on antibiotics if your pediatrician recommends otherwise. Unnecessary, chronic overuse of antibiotics causes antibiotic resistance and weakens the immune system’s response to infections. Then, when antibiotics really are needed, they don’t work as well.

Be Good to Your Gut: Excellent nutrition boosts immunity. Probiotics and prebiotics are great for your child’s gut health. » Kefir, sauerkraut, yogurt, and pickles are good sources of probiotics. » Prebiotics, which are plant-based, help stimulate good bacteria to grow in the gut. Plantains, yams, and asparagus provide prebiotics.

Snack Well: Make sure your kids have a varied diet to get all the nutrients they need. » Nuts, seeds, and beans are good snacks to promote immunity. They contain zinc, which is one of the most important minerals that boost kids’ immune systems, as well as vitamin E and healthy fats. They support the immune system to function optimally because they have antioxidant properties. » If your child eats meat or animal-based foods, they are good sources of zinc. » Oranges and grapefruits are an excellent source of vitamin C. Vitamin C prevents cell damage, promotes collagen production, and lowers cortisol, which is the hormone that can cause stress. » Blueberries have natural antihistamines, which help reduce inflammation. They have many antioxidants, including flavonoids, which can minimize symptoms of stomach virus and colds. » Apple skins contain quercetin, a flavonoid that decreases inflammation. Encourage your child to eat the whole apple, including the peel. » Pears also contain vitamin C and anti-inflammatory flavonoids in their peels.

Get Cooking: Cook with vegetables and spices, like broccoli, dark leafy greens, garlic, turmeric, ginger, and bell peppers. Leafy green vegetables have vitamins A, B6, C, D (helps with blood clotting), and K; magnesium; and calcium, which help your child’s immune system fight infection. The antioxidants help to detoxify a child’s system from pollution, chemicals, infectious diseases, and high levels of sugar.

Supplement if Needed: It is better for kids to boost their immunity through eating the right foods rather than taking supplements. However, some children are picky eaters and the only way to get vitamins and probiotics into them is with supplements. » Keep in mind that supplements are not regulated by the government the way medications are regulated. When you buy vitamins or minerals, these products have not been evaluated for FDA approval. Some supplements contain ingredients and quantities of ingredients that aren’t mentioned. With more and more fortified foods like breakfast cereals, granola bars, orange juice, and even fortified water, your child’s vitamin intake might be excessive with supplements, and can interfere with the absorption of other nutrients. If your child is taking medication for an illness, supplements can interact and have an adverse effect on their immune system. » Supplements will never replace proper nutrition from food. Get creative! If kids don’t consume leafy greens, for example, make zucchini muffins or smoothies! » One supplement to give kids is vitamin D since kids cannot get enough of it from food. The natural way to get vitamin D is through sun exposure, but that is difficult because children often use sunscreen when outdoors.

Rest: Sleep is when a child’s body rests, regenerates, and heals. Sleep deprivation is associated with decreased immunity.

Move: Exercise builds resilience in children, thereby making them able to fight infectious diseases. Get outside with your kids!

Keep Calm: Finally, it is important to reduce stress and anxiety in children to boost their immunity. This can be done through mindfulness activities, yoga, meditation, and deep breathing. Helping children decrease stress is one of the best immune boosters.

Gina Lamb-Amato, M.D., is a pediatrician who has worked in conjunction with Mount Sinai’s pediatric team. She has a master’s degree in child development and child psychology and helps perform consultations and evaluations for children ages newborn to 12. She also runs parent-child playgroups, where play, art, baby massage, and other techniques are used to help children develop optimally. She has training and expertise in COVID-19 and offers consultations for parents to help their children cope with the stress of the pandemic.