Dr. Annie Answers: Kid Vitamin Basics

Mother’s Day is this weekend which has me thinking about all the things moms have to worry about… one of the most common being the nutrition and health of our precious little ones. Almost every day at my clinic, I get some sort of question about vitamins – What’s safe? What’s necessary? Where do I get good ones? The answer, of course, varies by your particular health needs and should be discussed with your own medical provider. A few things are pretty generalizable though and I’ll delve into them here by age. This post is about kiddos – coming up next will be an adult version, so make sure you FOLLOW US to get that update!

Breastfed Babies, Birth through 12 months: 400 units Vitamin DScreen Shot 2018-03-09 at 2.08.17 PM

Vitamin D is needed for all babies who are breastfed half or more of their milk intake. I nearly always recommend Baby Ddrops for those who can afford the $10/month averaged cost. These are concentrated drops so, instead of getting your tiny baby to choke down a whole milliliter of vitamin D like the generic ones at the pharmacy, you only have to put 1 drop on your clean finger and put on baby’s tongue before a feeding. If your baby is formula fed, no vitamins needed, they’re already in there – see below for details.

Breastfed Babies, 4 months through 12 months: Add 6-11mg Iron

Iron is recommended for breast-fed babies after the first 3 months of life. Mom’s iron from the womb keeps them going up until that 4 month mark.

Sidenote…. One of the potential benefits of delayed cord clamping at birth is increasing baby’s iron stores for that first 3-4 month period (great review on this by Dr. Raju et al here.) . This is, of course, an important thing to discuss with your own pregnancy care provider, but worth considering for this and other benefits if there is no reason not to do it.

From ~4 months through the rest of the first year, baby will start eating more and more ‘real’ foods which can supply some iron, but usually not enough. The recommended amount by the American Academy of Pediatrics for babies 7-12 months is 11mg per day. For reference, you’d have to get your baby to eat 2 cups of cooked spinach to get that much – not gonna happen.

Option 1: at this age, stop Vitamin D supplement and change to multivitamin. Poly-vi-sol with iron is the go-to recommendation for most health care providers. However, my daughters both projectile vomited it, so we had to use alternatives. Other options are Zarbees Baby Multivitamin with Iron  and Honest Company makes an easy-to-give vitamin powder: Link herepexels-photo-533360.jpeg

Option 2: continue with Ddrops and give iron-only supplement like this one or give a serving of iron-enriched cereal daily. I personally, along with a growing number of pediatric care providers, recommend the former along with introducing iron-rich foods such as pureed meats, dark leafy vegetables, beets and beans before cereals as part of a healthier early diet. Baby cereals don’t otherwise have much in the way of nutrition or “taste education” for that little one. (References here in AAP News and here from NIH)

Formula-fed Babies up to 1 year

Breast-milk is best for moms and babies that can do it in all aspects except these 2 vitamins. Formula comes conveniently stocked with both Vitamin D and Iron so you don’t have to worry about the supplements. Certainly not a reason to choose it over breastmilk, but a nice side-benefit if it ends up being the right option for you. I usually recommend Baby’s Only Organic Formula or Plum Organics Grow Well Formula. Screen Shot 2018-05-07 at 5.58.09 PMThey are well tolerated (review here), have the right amount of all important nutrients and both come out to roughly $1/ounce (compare to Similac Advance Non-GMO at $1.25/ounce). They are also organic and free of corn syrup solids and chemical additives – which, when you’re talking about the ENTIRE nutrition of your tiny rapidly growing baby is important. AND!! You can get them both on auto-ship from Amazon so no leaving the house – bonus!

After 1 year: Vitamin D 400-1000 Units Daily +/- others…pexels-photo-61129.jpeg

This now depends on how picky of an eater your kid has become. If you have that amazing, adventurous eater who loves a variety of meats, fruits, and vegetables and drinks 2+ cups of milk per day, multivitamins are unnecessary. If your child doesn’t get 400-1000 units Vitamin D from fortified milk and other foods, they will need a vitamin D supplement again. Why? What about kids before the advent of vitamins?? Well, kids were outside ALL DAY without sunscreen back then. We now know better and protect their skin – the downside of which is low vitamin D.

If you do have a picky eater  – even if you’re not sure how picky is picky – a multivitamin can fill in the gaps. Again, the above mentioned Zarbee’s and Honest options are great as is Renzo’s Picky Eater Multi. If they’re getting extra of some of those vitamins, they will pee them out.

Hang on…. I hear a question coming out of the Ether….

“Dr. Annie, are the examples you listed above the only good options?? What about Flintstone’s vitamins or Olli Chewables?” Of course those aren’t the only vitamin brand options. If you want to check out others, just read the fine print on the label on the back and make sure they have the right amounts of the recommended vitamins.

Wait…. another one coming in…. “What about probiotics??” I’m so glad you asked! YES probiotics are so important from infancy through the rest of life – so important I’m going to write a separate post all about it ;^)

94 Dr. Annie is a family physician, wife and mom of 2 picky eaters In the Sacramento Area.

Kristy, Au Naturale: The Dreaded DOMS and why it shouldn’t stop you from getting back to exercise

Have you ever had that feeling like your legs might give out if you bend them as you walk down the stairs, causing you to penguin your way down the stairs in fear that your thighs just might explode. Or crawl from one room to another so you didn’t have to stand up?

Have you ever found yourself staring at the toilet during your morning routine and saying to yourself, “I have to pee so bad……but maybe I’ll just go in the bathtub so I don’t have to try and sit down?”

Had to use the “buddy system” to get off a sports bra, put your hair up, or shampoo your hair after a particularly heinous upper body workout?

But hey, “ Never skip leg day”, right? 

Absolutely right.

Whether you are coming from the couch and starting an exercise routine for the first time, or you’ve been in training for months or years and you’re starting a higher intensity level, the fact remains that there is bound to be some muscle soreness. I know I’ve been there. After a particularly intense crossfit workout (ummmm hello 240 lunges on top of a million reps of other things) I live in fear of what I call, the DOMS.

DOMS aka Delayed Onset Muscle Soreness is that pesky “Everything hurts and I’m dying” feeling that sticks with you a day, or sometimes into the better part of a week after an intense workout.

I follow some hard and fast rules so I can get back to high intensity workouts fast. This is of course on top of the usual hydration, good form, and healthy diet everyone should do anyway… And, obviously, this is what works for me and others I smash WODs with, but won’t work for everyone, every time. 

NUMERO UNO: Preventative Supplementation:  One of the best way to help with DOMS, is NOT to “wait it out”, but to get ahead of it with supplementation. The supplement that my husband and I take has not only changed our performance in the gym, but has helped speed up the protein synthesis and recovery of our muscles, and thus speeding up the DOMS so that is doesn’t last days.

BCAAs, Branch Chain Amino Acids, “consist of three essential amino acids: Leucine, Isoleucine, and Valine; all of which play a critical role in muscle development and recovery. The most important BCAA for muscle growth is Leucine due to its unique ability to act as a catalyst for muscle protein synthesis” In essence, supplementing with this formula daily, preferably pre workout, helps increase the rate of healing of those microfiber tears that your muscles are undergoing when you exercise.

You can find our supplement HERE

TWO: Protein, brah: If you are someone looking to increase muscle mass and lean muscle, you may be interested to add some protein into the mix. While there are loads of brands from which to choose, we have to be careful of what “fillers” are involved. The two typical brands I’ve researched for their purity, concentration, and quality of protein, are SFH (Stronger, Faster, Healthier)available HERE and Native Whey from Ascent, available HERE.

Ascent has a blend you take at night with BCAAs in them. So, FEED THE MACHINE with protein, but be careful not to overdo it! 

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Slow reacting night time solution
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Pre or Post workout Protein option
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Adds coconut oil for more essential fats and more “fuel”

And C: STAY MOVING! Don’t let your muscles stay stiff. Plan and active rest day after an intense workout. Walking, yoga, swimming, MASSAGE(hint hint), or light cardio can help your muscles recover more quickly.

So get to supplementing, and get back to it!

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Look, ma…I’m having fun!