We’d all nod in agreement if asked, “…does nutrition matter for babies and kids? Is it important that they have enough to eat? Does it make any difference what they eat?” I bet any pediatrician would too. So why don’t we tap that when it comes to helping special needs kids thrive to their potential? After all, these kids are at higher risk for nutrition problems than typical peers – problems that often go unnoticed, and have the power to impede progress.
We can, and this is what I have done in my pediatric nutrition practice for over ten years, working with kids who have asthma, severe food allergy, autism, Down’s syndrome, arthritis, growth failure, feeding problems, ADD or ADHD, clinical depression, and more. On top of that work, I’ve written Special Needs Kids Go Pharm-Free – because even after a decade working with kids, I am surprised that parents still have so little reliable information on how to leverage nutrition-focused tools for a child with a chronic condition or disability. Just as they can for any child, nutrition tweaks can make or break the difference between staying well or getting sick a lot, succeeding versus struggling at school, growing as expected or being stunted, and relying on symptoms-only drug treatments versus ditching the drugs altogether to feel and function even better.
Pharmaceuticals are not a bad thing. But our health care system may be stacked to make these too much of a good thing for our children. For example, prescriptions to young children for stimulants (like Ritalin) and proton pump inhibitors (reflux medications) – just two types of drugs – have skyrocketed in recent years. Children are now more medicated and more immunized than ever before – but are more chronically sick and disabled too. Between 1980 and 2000, a 57% increase occurred in the rate of children with disabilities served by government programs. In our public education system nationwide, about one fourth of learners are served under the Individuals with Disabilities Education Act (IDEA) – and the increase in number of children served under IDEA has grown at twice the rate of the general pediatric population. In the same time frame that Americans have used more medications than ever, our overall health related quality of life has declined.
What this means is that our children have become more sick and disabled in the last thirty years, not healthier, and that prescribing more medications may not be helping. Physicians aren’t trained in non-pharmaceutical strategies for disease management in the US, as they are in several other developed countries. Controversy continues regarding the influence the pharmaceutical industry may wield here on medical training, clinical trials, even medical journal publications – making good information on strategies like nutrition almost invisible.
Special Needs Kids Go Pharm-Free to the rescue. Affected children are often assumed to be presenting in a certain way because of the condition or disability itself, rather than because of a fixable, nutrition-related impairment. Here are just a few examples of how nutrition can impact a child with a learning difference, developmental disability, or chronic condition. More examples with strategies to address them are found in Special Needs Kids Go Pharm-Free. These spotlight nutrition problems that have been linked in myriad clinical trials and public health data to learning deficits, growth or developmental impairments, insomnia, psychiatric disorders, or behavior problems in children; others abound in my case files:
- Children with Down’s syndrome may have gluten sensitivity or celiac disease more often than typical peers. Even in the absence of celiac disease, untreated gluten sensitivity in itself may impede growth, stooling, and functional abilities for a child with Down’s syndrome. A gluten free diet may help a Down’s child make unexpected leaps.
- Over a third of boys with Asperger’s syndrome tend to be clinically underweight – that is, their body mass index (BMI) is <10th percentile. This is a growth pattern deficit that may impair infection fighting, sleep, continence, and cognition. The only correction: More food! Healthy fats, easy to absorb proteins that are not inflammatory, good carbs – and plenty of them all. In some cases, specialized formulas or custom made smoothies can help too.
- In puberty, low BMI in boys is linked to low total cholesterol. This is inversely related to testosterone level, meaning that testosterone will rise when cholesterol is too low. Low total cholesterol has been linked to psychiatric disorders, suicidality, and aggression. Excess testosterone has been noted in about a third of boys and girls with autism; aggressive or obsessive compulsive behaviors showed improvement, in early work treating high testosterone with medication in these children. Keeping a child’s BMI above 20th percentile, plus allowing ample daily healthy organic fats and oils, are nutrition measures that may help.
- Any child with a self-limited diet (eats just a few foods) or mechanical problems with feeding (tube feeding, swallowing disorders, oral tactile defensiveness) can quickly become depleted for minerals like zinc, which allows normal appetite, growth, and immune function; magnesium, which helps nerve cell function; chromium, which helps control blood sugar; and selenium, a key antioxidant. Children with Down’s syndrome in particular should be screened for zinc status. While a high potency supplement can help, so can slow cooked stews and broths, chock full of vegetables and gluten free carbohydrates like quinoa (a grain that is also high in protein), black rice (higher in iron than regular rice), lima or kidney beans (to add zinc, protein, fiber) or breadfruit and potato (great for potassium). Adding grass fed beef or free range poultry – organic if you can afford it – will further up the mineral, protein, fat, and calorie content of a crock pot meal.
- Any child with a self limited diet or chronic inflammatory condition like cystic fibrosis, rheumatoid arthritis, Crohn’s disease, food allergies, or asthma may have sub-optimal iron status – which will make them more susceptible to infections, more cranky, hyper or irritable, less able to focus at school, and less likely to sleep well. Entrenched iron deficiency (anemia) can leave your child tired, averse to exertion or typical play activities, showing shiners at eyes, and prone to eating non-food items. Have your pediatrician screen serum iron, ferritin, transferrin, hemoglobin, and hematocrit. If a supplement is needed, use one that is gentle and well absorbed, like ferrous bis glycinate instead of ferrous sulfate – but only with supervision, as iron quickly becomes toxic to children.
- Copper is a metal we need in extremely small amounts, and a potent neurotoxin, if too much circulates in a free, unbound form. High serum copper level has been linked to several psychiatric diagnoses. Some children with autism may need treatment to reverse copper toxicity and should avoid copper in daily multivitamins; special formulations are available for this purpose.
- Several studies have documented the presence of opiate-like polypeptides from poorly digested food proteins in autism; these have neurotransmitter effects that can impede language, pain tolerance, stooling, cognition, sleep, and behavior. Special diets or digestive enzymes that target these proteins have shown promise.
- Children with autism were found to have four or more GI issues, including histological changes, diarrhea, reflux, constipation, and abnormal endoscopies, about 40% of the time, compared to 5% of the time for their neurotypical siblings, in a study published in Pediatric Gastroenterology. While some studies countered this finding, debate centers on methodology weaknesses in those studies that “bury” evidence of gastrointestinal problems in these children. In clinically standard nutrition screening in my own practice, I routinely find these problems in children with autism. If your child has a picky, weak, or rigid appetite, vomits undigested food, is dependent on medications for constipation or reflux, has undigested food in stool, can’t move bowels at least three times a week, has more than three loose or foul stools/day, or often presses his stomach on pillows, knees, or furniture for comfort – these signal atypical digestion and absorption that may mean lessened health or functional ability for your child. Several nutrition interventions may eradicate these uncomfortable symptoms and improve the flow of crucial nutrients to your child’s brain, muscles, bone, and organs.
- Food allergies and sensitivities may go undetected in kids with Crohn’s disease, rheumatoid arthritis, autism, asthma, or other conditions. Help can be had with correct screening for these, plus plug-ins of hypoallergenic formulas, special diets, or supplements to diminish inflammation.
- Children with seizure disorders may improve with dietary measures beyond the traditional ketogenic diet. Lessening inflammatory foods, avoiding neurotoxic trigger ingredients like glutamate, glutamine, phenols, or colorings, or treating undectected bowel infections for Candida or Clostridia are measures that have helped children in my practice with seizures.
Changing how your child eats, using a special diet, or adding targeted nutraceuticals may be a long term commitment for a person with a chronic condition or disability. But it is a critically worthy one, if it means a child can improve beyond expectations, attend a regular school with no aide, avoid residential care or placement as an adult, have independence or have a job, and contribute to society in what ever way their unique talents and gifts allow. I have witnessed all of these outcomes in persons with disabilities because of nutrition interventions. This is not new, not novel, not even alternative – it’s simply engaging what we already know to be evidence-based in child nutrition. Any parent can start tapping these tools anytime, with Special Needs Kids Go Pharm-Free.