Category Archives: Healthful approach

Insect repellent guidelines

Insect repellent guidelines and recommendations

I had published an article evaluating insect repellents about 5 years ago . The main ingredient I have consistently recommended to prevent insect bites has been Picaridin. It is still difficult to find in stores and for the most part has to be ordered online.

In addition since most people travel in the summer months and many to areas now considered high risk for lime ticks it is essential to know which products cover these as well. The high picaridin concentration products also are effective against ticks as well. Permethrin is considered the most effective ingredient for tick avoidance. However, Permethrin is not as safe to place directly on the entire body and should be applied to clothing only.

Tips to avoid mosquitos 

Place a large fan by each doorway, Mosquitoes cannot fly past a strong wind force.

Spray all your plants and areas that are breeding grounds . there are many natural products that several companies are using to spray in our yard.

Empty all containers outside that contain water to avoid the mosquito breeding

Mosquito lights ( zappers) and fans to attract them work in a restricted area . Several brands are popular including dynatrap which I have found to be effective.

My recommendations for products you can easily purchase

Sawyer 20% Picaridin spray or lotion

Repel -15% Picaridin – ( Has a red Label and says Tick defense but is the same for Mosquitoes  ) Available in Target and Walmart.

Natrapel – 20 % Picaridin

Wipes – Natrapel 20% Picaridin

Fan- place a large fan at your entrances angled to keep the mosquitoes from flying into the house. Or around the area where you plan on sitting in the yard.

Lime tick preventionSawyer permethrin

Top products recommended by Consumer Reports

Sawyer Fisherman’s Formula – 20% Picaridin

Natrapel 8 hour- 20 % Picaridin

Off Deepwoods V111- DEET 25 %

Repel Lemon Eucalyptus  Oil of Eucalyptus 30 %

2019 update to insect repellent for mosquito protection. As before, I used Consumer Reports ratings and suggestions as my starting point for recommendations. This time there is added emphasis on the most successful protection with less concern regarding  type of spray- organic or not . Similar to last review “ Picaridin “ ingredient comes in first across the board for both effectiveness and least toxic to you and your children weighed against this effectiveness. Over the years I have tested most products since I am a personal mosquito feast. The organic and natural products do not work for me and their smell was so noxious that family and friends and my dog stayed away from me but the mosquitoes  were hardly deterred .In addition many of these “ natural and organic” products have not been tested by the FDA and really can not be verified for safety, quality, ingredients,  or effectiveness. With the Zika virus making the stakes higher than ever to prevent mosquito bites all individuals involved with caring for children and preventing disease are more strongly than ever recommend products that work effectively rather than are most natural. Fortunately , in this case the one I have found to be most tolerable across the board Picaridin is the most effective and least irritating.

In addition with consideration to the environment Picaridin also rates highly. Many of the organic and natural products would have contaminating effect on the environment in the concentrations necessary to garner any substantial repellent activity. But in this instance they do not offer enough protection against the Zika virus mosquito to warrant serious consideration. DEET has been found in streams and rivers and shown to have some impact on wildlife. Taking effectiveness , toxicity to children, and least possible environmental impact I recommend “ Picaridin” as my first choice in insect repellent.  The only difference , the products that have been previously recommended do not have a high enough percentage of Picardin in their solution. 20 % seems to be the concentration that works the best in the Consumer Reports testing and ratings . The brands which were the most effective were Sawyer Fisherman formula Picaridin, Naturapel; 8 hour with Picaridin, . Deepwoods off with 25 % DEET was as effective against mosquitoes but not ticks, but I do not recommend that strong of a percentage of deet for children. Repel lemon eucalyptus 30% was the only non Picaridin based repellent rating as high but the smell is difficult to tolerate and it’s irritating to the skin and eyes to the point that it is not recommended for anyone under 2.  

Insect protection and repellent guidelines.

  1. The ingredients proven the most effective and with the longest history of safety is Deet. Picaridin has been studied for 15 years and has proven to be safe and is less irritating especially to children with sensitive skin. Oil of Eucalyptus has proven to be moderately effective as well.
  2. Children under 2 months of age should not receive any topical insect repellent. [ Use mosquito netting to prevent any access to babies ]
  3. Oil of Eucalyptus should not be used on any children under 2 years of age due to the concerns regarding possible eye irritation.
  4. Apply it to your hands and then rub them on your child. Do not spray it anywhere near a child to avoid inhalation of fumes. In the case of Permethrin for lime tick prevention do not put it directly on your hands before spraying it on your child’s clothes and shoes.
  5. Do not apply it to a child’s hand, they may put them in their mouth.
  6. Adults should do the applying for young children.
  7. Apply to clothing first and foremost to avoid unnecessary skin irritation. Do not apply it under clothing.
  8. Apply sunscreen first before adding insect repellant.
  9. Sunscreen and insect repellent mixture is absorbed in a higher degree and not recommended.
  10. Be careful applying to cuts wounds, and after shaving. It can be absorbed more readily.
  11. The percentage of each ingredient correlates to the time spent outdoors. 10 % is usually sufficient. However, now we recommend Picaridin 20 %.
  12. There has been no reported serious illness regarding the use of these ingredients in children.
  13. The recommended ingredients are safe for pregnant women, breastfeeding moms, the elderly, and babies older than 2 months of age.
  14. Natural products that have proven moderately successful include Avon “Skin so Soft”, California Baby, and Burt Bees. And some essential oils tend to be helpful including cinnamon oil, eucalyptus oil, citronella oil, peppermint oil,  lemongrass and rosemary. However, in the recent Consumer Reports review none of these natural style products were effective against the Zika carrying mosquitoes .
  15. Remember to reapply according to the instructions on the package .
  16. Pay attention to any skin irritation in areas where you apply the repellant.
  17. Should wear long sleeves and long pants this year. Collared shirts give more protection.
  18. Shoes – be very cautious with open toed sandals and crocs.
  19. Hat- hats offer protection not only from the sun but also keeping mosquitoes off your face and scalp. Can spray the hat before putting it on to offer even more protection.
  20. Try to avoid early morning and dusk through the night time without complete protection described above.
  21. Don’t spray near food and wash your hands before eating.
  22. Do not go to sleep or get in your bed before washing off the insect repellent.

Make your own natural insect repellent ( have not been proven to be as effective as the recommended picaridin products.

Base: Calendula cream – 4 0z -has repellent qualities as well

Cinnamon leaf oil -about 20 drops or 3 ml

Peppermint oil – 20 drops

Rosemary oil 10 drops

Lemongrass oil  20 drops

lavender oil – 20 drops

( I avoid citronella and eucalyptus even though they are he most effective ingredients because of their strong odor and irritating quality on the skin.

Deet  products are the highest rated-for most effective by consumer reports for all concentrations .  I tend to add  smell and feel to the list of important criteria in selecting an insect repellant.

Consumer reports ranked Deep woods Off, Cutter Backwoods, and Off family care the most effective at 98% with Cutter Backwoods unscented and Off Family care smooth and dry much more tolerable for feel and smell to me. They all last up to 8 hours and keep mosquitoes away well. However, due to the higher percentage requirement for DEET for the Zika carrying mosquito , I prefer we avoid DEET at those levels.

Picaridin– the product I use the most has a similar effectiveness. Previously I have recommended the the lower percentage of products by Off and Cutter advanced which contain 5-7 % Picaridin. These two products have worked well for me in Florida as well as while hiking in Mosquito infested areas. Consumer reports ranked Natrapel which has 20% Picaridin very highly at 97 %. And now with the concern with a more vigorous mosquito carrying the Zika virus , based on Consumer Reports findings , the higher percentage is now recommended.

Permethrin – used in treating lice on the hair and body is a good tick repellent. It should be handled carefully and applied to clothing and shoes when going out in areas known for deer ticks.

Avon skin so soft has a smell and feel that I have never been happy with. It is ranked as more effective than organic products at 73% by consumer reports.

Lemon Eucalyptus– ( for instance Repel ) works well but the smell is generally intolerable to others. In my experiment I had to walk and jog by myself by at least 10 feet due to the annoying smell to other people in my party. My dog would not go near me or any room that had the clothes sprayed with Eucalyptus. This is not recommended for children under 2.

Organic products- based on plant oils generally are considerably less effective as a group .Bite Blocker  had a 56 % rating and Burt’s Bees had a 24 % rating compared to the recommended products effectiveness by Consumer reports.

Off ” clip on repellent”– the off “fan” that clips on and distributes a fine mist of repellent by fan is moderately effective if you are still for long periods of time. It is not nearly as effective if you are moving or walking. There is a warning on it to not breathe in the fumes, which is not really possible especially for children. In addition to these findings by Consumer Reports it tends to not last nearly as long as it states on the package. I have used it for sitting in the backyard and it helps keep the mosquitoes away, but I would not recommend it for small children.

Stickers and bracelets – have been successful for many parents. I have tried them on my collar ( one on each side to avoid putting on repellent and they have moderate success in avoiding mosquito bites.

Warren Krantz MD

Approach to allergies

Allergy management

Medical care– seek medical care for any of the below symptoms particularly if it is of acute and problematic nature. Allergy symptoms have many similarities to other medical conditions.Before attempting any self treatment or holistic methods below please discuss your or your children’s symptoms with your Physician for a consult and physical exam.Things are not always what they seem and a trained physician is the best place to start when diagnosing and managing allergies.

Description of allergies

General explanation for allergies is your body’s immune overreaction to things in the environment and your diet.

Common allergic symptoms include runny nose, sneezing watery itchy irritated eyes, nasal congestion,sinus problems, skin rashes, hives and itchy skin rashes. Severe reactions could include swelling in the throat, eyes, lips, coughing with trouble breathing.

( For any symptoms call your Medical doctor, and any doubt as to the severity of your or your child’s symptoms go to the emergency room or call 911)

An example of a mild allergic reaction is when you are sensitive to someone’s perfume and start to sneeze, develop a runny nose and itchy eyes.

The sources of these irritants are many and can be from food which can also cause stomach pain, gas,bloating and diarrhea; or allergens that range from pets to the environment which tends to cause runny nose, coughing, and respiratory issues. . Allergic and commonly called atopic symptoms range from merely a little sneezing to sensitive eczema skin and asthma with wheezing.Many allergies run in families .

Managing allergies:


  • Elimination of the sources of your allergy in the home, outdoors, diet , and personal care products
  • Medical treatment from over the counter to emergency medical care always consult your physician first
  • Foods, herbs, teas, that help with allergic symptoms
  • Supplements that may improve allergy symptoms
  • Lifestyle change- exercise, meditation , stress reduction can moderate some of the allergy triggers



Best method in managing allergic symptoms is to avoid the causes in the first place. Below are things to consider eliminating to lower your exposure to allergens that cause your allergic reactions.

Environmental and Household allergy management and control

Pets bring us unconditional love and joy but allergies to these pets can be problematic . Your friendly family pet can help enhance a child’s immune system by exposing them to healthy bacteria and at the same time help the whole family de-stress, but many people are allergic to dogs and more so cats,( there is really no such thing as a non allergic dog, only some dogs shed less.) All dogs potentially cause allergies in the house and particularly in the child’s room. Also something to consider even if you and your children are not allergic to your dog or cat is that your pet is the perfect vector for bringing all sorts of outdoor irritants and allergens into the house including pollen, ragweed, grass, dirt, mold etc.



Mattress- buy a hypoallergenic mattress ,place a plastic cover on mattress, no curtains,no frilly blankets. No carpet. No stuffed animals or toys in the room, keep them away from contact in glass or storage containers. Keep pets out of the babies room until you know the child is not allergic to this pet. Take your shoes off when you come into the house. Any clothing with lotions , plant residue or spray remove and leave in the washroom, by the front door or the bathroom.

Dust and mite collectors-  try to eliminate clutter, curtains,  carpet , stuffed toys, mattresses, and furniture that collects dust,

Cleaning products– detergents, carpet cleaners, floor products including bleach, ammonia, and anything with a scent  are all irritants.

Exterminator and bug spray – have non toxic brands. Stay out of the house for at least 3 hours after you spray for insects or the exterminator does. Keep your child out of the room where you spray for at least an hour when you do it yourself.

Indoor plants– pay attention to any indoor plants that may have mold,bugs, seed, flowers or pollen.

Air conditioning – use an electrostatic filter to lower the dust and allergens in the air, clean vents with non toxic chemicals. Have the whole unit checked for mold and germs in the motor, pipes and fans. Set up an ultraviolet light to keep the filter clean and free of mold.

Mold is a particularly problematic in humid climates such as South Florida. It can get in the air conditioning vents, walls, floorboards, and any closet, bathroom, or moist area inside the house or outside. Be vigilant to keep the house mold free it can be one of the most irritating and toxic sources of allergies and respiratory problems.


including your yard and the neighborhood –

Be aware of the allergy irritation potential of the flowers, plants, trees with pollen surrounding your house or apartment.

Insects are also a common source of allergic reaction ranging from simple itchy mosquito bites to severe redness swelling and respiratory issues with bee,wasp,and red ants. If you find you or your child has a severe reaction to one of these insects you should see an allergist and make sure you have diphenhydramine and an injectable with you whenever you are outdoors or in school.

Seasonal allergies particularly mold during rainy season,pollen during the windy season, and decaying leaves on the ground during fall are things to consider.

Chemicals sprayed on the grass in your yard, the neighborhood or the park travel back in the house on your shoes with allergens from outside are additionally something to be aware of.

Pools and lakes can be a source of problems- pool chlorine tends to bother many children. Lakes can have algae and other plants that are irritants.


Hygiene – is a new area of discussion. We of course want to be clean but not too clean. Appropriate hygiene is the catchphrase- try to avoid putting allergens on your body and face by touching your face and nose with contaminated hands from touching plants, dust ,and pollen by washing regularly after coming in from the outdoors or when you know you have a substance on your hands. This can initiate an allergic reaction without even realizing you have done it yourself.

But there is much discussion regarding being too sterile with wipes, hand sanitizer, constant washing and cleaning. This leads to eliminating good bacteria from the skin as well as causing children to be more susceptible to allergens from food and the environment since they were not exposed and allowed to develop a tolerance while they were young. They subsequently do not develop a proper proportional response to allergens and overreact to anything new causing worse reactions. So use wipes and hand washing when you know there is particularly dirty little hands or your child touched something obviously irritating. But it is not necessary to constantly clean them for any reason.

Personal and household supplies that you should consider eliminating or changing.

Beauty supplies-perfume,cologne, make up, shaving cream,deodorant, body lotions, soaps. Can all be irritants and should be evaluated for possible allergic reactions. Hair supplies- shampoo and conditioner, straighteners, creams, spray, gels can also cause allergies and rashes around the hairline and neck.

Additional Things you put on your skin, moisturizer, sunscreen, insect repellent are all known to be very irritating to the skin and respiratory system.

Cleaning goods including clothes detergent, household cleaners like floor cleansers, furniture polish, dust sprays .

Other possible sources for allergies in the house. Smoke , candles. Incense, fragrance .

Food elimination when trying to uncover allergies

Keep a food diary or log to try to see if their are any foods which might be responsible for allergic symptoms. Generally food allergies are manifested more internally such as stomach upset, gas, loose stools. But often they can also be part of a wider allergic profile such as congestion, coughing, eczema and atopic skin and rashes.

First monitor your most commonly ingested foods , diary is one of the most common. Then look carefully at the known allergic food group including berries, corn, nuts, tomatoes, citrus, and eggs. Then move on to evaluating you or your child’s diet for additional foods consumed and those you may need to eliminate. Next see if eliminating them makes an improvement in your symptoms.  It can take up to a week or longer to notice improvement but often the difference can be seen in a few day’s.

If elimination and management particularly once you have consulted your physician or child a Pediatrician does not help then it may be time to  take your child to an allergist

[ Early introduction of common healthy allergic foods such as peanuts and fruits such as berries is now recommended to prevent development of these allergens in children  ]

Medical management :Always seek medical advice from your medical doctor and child’s Pediatrician before beginning any medication including over the counter meds. Even the smallest of signs of allergies can turn into big problems quickly so consult your physician for advice and a plan in the event of worsening of your symptoms.

Medications to have in your cabinet and with you when you travel if you have known allergy symptoms in the family

Benadryl or generic name diphenylhydramine, claritin, allegra, and more emergency treatment as prescribed by your physician for known serious allergies. epi-pen, and auviQ

Nasal- washes with sterile saline is often helpful in keeping your nasal passages open and clear of allergens. Cortisone sprays are now available over the counter but should be recommended by your physician prior to beginning any therapy

Non medical options to reduce allergic symptoms to try  

Foods to include  that have been known to help with allergies

Quercetin containing foods – quercetin is a  component of foods that it is known to be anti inflammatory and antioxidant particularly for the over response of our immune system to things that cause allergies

Foods high in quercetin include red apple skin, red onions, capers used in flavoring  ( try to find low salt), lovage leaves, berries including blueberries and elderberries , black plums,and red grapes.

Nettle Leaf is another anti inflammatory plant that has been commonly used to help with allergic symptoms.


Quercetin and nettle leaf supplements are also available – please check with your physician before starting as any antioxidant may interfere with other meditation


Green tea has catechins which helps reduce histamine ( the source of allergic reaction ) production by your body in response to allergens.

Ginger tea is a good  anti inflammatory and helps calm allergies

Rooibos tea helps reduce the histamine response as well

Peppermint tea is known to help with the congestion and allergy symptoms

Nettle, yerba mate, and lemon balm tea can all also help with allergic symptoms.

Spices and herbs

Cinnamon in general helps with it’s anti inflammatory and blood stabilizing properties. Cassia cinnamon in particular helps moderate allergic symptoms with about a teaspoon a day being the recommended amount.  Cassia cinnamon mixed with spanish needles makes a reasonable anti allergy mixture that has been researched to have benefits.

Turmeric once again helps with allergy symptoms with it’s anti inflammatory benefits

Elderberry syrup has been used for centuries to help with allergy symptoms such as congestion and runny nose.

Ginger itself is useful for allergy symptoms by lowering your reaction and helping with cough.

Black pepper also has been shown to be useful to help lower allergy and other atopic symptoms including skin issues.

Probiotics- help your intestinal flora keep your immune system functioning at peak and generally maintain the appropriate response to stimulants in food.

Stress reduction is immune building and allergy reducing

Exercise always helps calm your nerves which contribute to allergies. Blood flow enhances clearance of sinuses and thinning of the mucus

Meditation and mindfulness at the very least helps with the anxiety and frustration associated with chronic allergy sufferers. But in addition there much research regarding the nature of stress and its effect on your immune system even your overreaction to allergens in the environment and the development of allergies particularly eczema .

As with all recommendations please check with your physician before beginning any regimen .

Allergies present a particular dilemma for anyone trying to avoid medications and live healthy .

Allergic symptoms can be miserable and often worth using medications to be comfortable. But if you do your homework with the help of this guide  you can reduce your dependence on some medications and use them more wisely

Warren Krantz MD

The HealthfulMD

Author of “ Start Healthy, Stay Healthy”.

The too active child and natural ways to maintain focus and calm

The active child – natural ways to help maintain focus and calm

Every parent, at some point, thinks  their child is overactive and concerned that they might have ADHD . And who hasn’t blamed sugar or chocolate or sweets for kids acting out of control ? Most parents blame misbehavior on their child being either overtired, hungry, or getting sick . The next question invariably is “what can I to do to prevent my child from being hyper?”

From a medical and psychological professional’s perspective ADHD needs to be treated properly and is considered a true disease with multiple treatment modalities not just magic pills. These methods include psychological family counselling, behavior modification, parenting education, medical and psychological evaluation, and comprehensive testing. The whole family has to participate to change the household dynamics and ingrained patterns of reactive behaviors when interacting with the active child as part of the comprehensive psychological work. Being the Pediatrician, I am fortunate enough to develop a good relationship with my families and have gained unique insight into the personality of each child and the parents sincere efforts to use whatever of the available non medical modalities they could to manage their often disruptive child. When all these efforts have not been successful in improving behavior, self-esteem, or their ability to succeed then the parents and I feel that medication is  the correct treatment option.

It is always recommended to have a Medical exam before beginning any therapy to rule out any treatable sources for changes in behavior like poor sleeping, sleep apnea, allergies, stomach upset , and pain . It is also recommended to include a blood exam for thyroid , anemia, proper organ functioning, and other medical and physical causes .

[Please consult your physician before trying any remedies to alternative therapies for any behavior issues.]

ADD and ADHD evaluation and treatment is well described by many other resources. That is not my goal here. My purpose here is to offer guidance to some of the remedies promoted by many non medicine proponents.

While changing the diet of your child is not the end all for diagnosed ADHD children it can be part of a comprehensive and constructive plan to effectively treat a child with many of the characteristics of an overactive child.

Food and behavior There are many things you can do to modify your child’s diet that might help them not be as reactive. Managing their diet  is something simple that might have an impact on their behavior..

Elimination diet

There are no comprehensive double blind studies to show that particular foods tend to overstimulate children who have a tendency to be overactive or have ADHD, but it has become an accepted anecdotal notion by most Pediatricians and parents that many foods hype their children up. It is worth keeping a log of foods your child eats and correlating their behavior to these foods.

The foods listed below are commonly accepted as foods that make even the average child excitable and should be the first foods you eliminate in their diet management plan.

Chocolate – particularly brands with more processed sugar. Dark chocolate with high percentage of cocoa over 85% and less cocoa butter and sugar is much less likely to cause over activity.

Processed sugar in store bought products and packaged foods is also considered overstimulating in many forms for children.

Candy not just chocolate has a lot of processed sugar and fillers.

          Baked goods like cakes with frosting, cupcakes especially with icing and sprinkles .                  Drinks – soda, juice with sweeteners, fruit drinks, sports drinks.

          Cereals- most of the store bought children’s cereals are packed with artificial                               sweeteners and sugar even the ones deceivingly marketed as healthy.

Food coloring particularly red dyes in candy, drinks, colorful cereals, snow cones, slurpees, colorful icing, colored sprinkles.

Fatty fried and sugary food – fat seems to make the effect of the meal even worse for hyperactivity. Donuts are a perfect example of fried with sugary coating.

Big carb meals generally makes everyone tired but also causes a “hyper” child to have less control over impulsivity and lose their focus.

Foods and natural means to improve behavior

Foods, supplements, and natural products that are popularly accepted to help with focus and calm excitable behavior

Low glycemic foods particularly high fiber healthy whole foods maintain an even sugar level without the resultant highs and lows of high glycemic low quality foods. Keeping their sugar and insulin level stable tends to also maintain an even behavioral response to diet. You don’t get the initial jump in energy from sugar and avoid the follow up drop in energy from the precipitous drop in blood sugar.

High fiber food assist in stabilizing blood sugar in addition to keeping constipation another distracting problem from exacerbating the unwanted behavior.

Zinc has been shown in some studies to help improve attentiveness and calm children with hyperactive behavior

    Zinc rich foods -seeds include pumpkin seeds, watermelon seeds, squash seeds,and sesame seeds. Also dark chocolate, garlic wheat germ chickpeas or hummus have good amounts of zinc.

Magnesium is considered a good mineral for calming nerves and some studies have shown it to be particularly low in ADHD children.

Magnesium rich foods include dark chocolate , seeds particularly pumpkin seeds, nuts especially almonds and cashews, bananas , avocados, deep sea fish, legumes-beans,lentils, chickpeas, peas,  tofu, whole grains – barley, wheat, oats, and of course lots of healthy greens.

Choline is considered important to nerve development and function. Good healthy diet with plants as a main food offers more than enough choline .

    Choline rich foods – Soy products including soy milk and tofu,  quinoa, broccoli, cabbage, kale. Animal products having higher levels of choline include yogurt, fish, liver, and eggs. Egg as a source is controversial for it’s true value versus negative health impact. And liver comes with it’s own heart health cost.

Omega 3 rich foods have been shown to help with attention in children – including fish oil, ground flax seed, deep sea fish – salmon ( limit the amount due to mercury contamination)

Teas- green tea has been shown to help with focus, other teas that might help include white and black teas, all purported to help with focus

Herbs have historically been used to bring calm -lavender , velerian,ginseng and green oats, and lemon balm are the most widely used herbs with some success in calming and helping focus. Also ginkgo biloba, licorice root, brahmi, gotu kola, and pine bark have been used for centuries by many eastern cultures. [AvoId kava due to liver toxicity and other side effects ]

(Once again consult your physician before trying any remedy )

calming teas and other herb teas are more for sleep and slowing down at bedtime, they really are not useful for waking hours, chamamille, passiont flower, lemon balm

Essential oils- lavender, rosemary are most commonly used to help active children with focus. Others include peppermint oil, Ylang ylang, Frankincense, which have been reported to calm, and may help with focus.

[Essential oils are not for oral ingestion and are only to rub on the skin. Be careful with redness, rashes, and allergies. Some anecdotal discussion also include the value of scents of these same oils for calming effect.]

Supplements – zinc, magnesium, green tea supplements are purported to help quiet an overactive child. I am generally not a big believer in supplements instead of the natural plant source for benefit. It can be worth a try with problematic children particularly if they will not eat many of the healthy sources for these supplements.

Activities and other tools to help your child develop a sense of control over their own behavior

Sports– exercise has many benefits for a very active child. It has been proven to have positive effects on self esteem, overall health, learning ,and improves nerve function and helps release their pent up energy. Team sports in particular teaches a sense of camaraderie and teamwork often lacking in a very active child’s life. Teamwork also helps with their self-esteem by working with others to a common goal and form friendships outside of the classroom.

Channeling energy – creative stimuli and focus adaptation on tasks such as – artwork- painting, pottery and sculpture; music- playing an instrument ; puzzles and constructing- building blocks and legos; projects- science, design, and gardening.

Games – board games can help the active child learn to take turns and focus on the tasks without the stress of school work.  Family game time with a set of rules should be fun and an opportunity to learn the structure of cooperating with positive reinforcement of acceptable behavior working with others.

Limit screen time and video games- both these modern day habits have led to what has been called the ” dis-tractable generation” possibly contributing to the rise in ADHD diagnosis.

Shorten Work and activities which require a lot of focus and concentration.They are much more successful with intense brief focused tasks and homework, rather than sitting for hours and not getting anything done while fidgeting and their mind wandering.

Movement – whenever your child takes a break from work try to find ways for them to move. Any form of movement activity helps calm the nervous system and the endorphins that are generated have additional calming benefit. It helps them re-focus their energy .

Meditation and mindfulness – teaching your children the art of breathing to refocus their energy and calm both their active mind and body is a vital part of non medical means to helping then develop staying power and a better focus.

Music particularly classical music calms the brain and can be helpful in bringing focus to a task. I tell parents of newborns to play classical music for a sense of peacefulness for newborns and the family household and they will respond to it for the rest of their lives.

Pets are beloved family members and elicit a lot oxytocin production just by interacting with them. This can makes you happy and also has a calming effect. A sweet dog can be an important asset to manage erratic emotional behavior for any family member but in particular for an energetic  over active child. In addition the bond and satisfaction in caring for a pet is a bonus for self-esteem and character building

A good caring non judgmental family is the best resource for any child. Particularly those children dealing with the difficulties and frustrations of ADHD and Hyperactivity.

Health is lifelong- chapter 2 from “Start Healthy, Stay healthy”

                   Health is lifelong- chapter  2

I decided on the specialty of pediatrics because it is a happy field. Kids get better! Most of the time. You get to know families . Watch children grow and develop into good people. Pediatricians primarily focus on a child’s health while they are under our care.  Our goal is to get them through childhood healthy . We specialize in preventive guidance including vaccines, acute and chronic childhood illness, childhood behavior, and childhood safety.

To us childhood health outcomes refer to diseases that we document which begin in childhood.

The diseases which occur after they grow up are a whole other story in a much larger internal medicine textbook . Which generally speaking is not on a pediatrician’s bookshelf. The saying “little kids little problems big kids big problems”, assumes the big problems of heart disease, diabetes, cancer, by in large are part of adult medicine and not the venue of pediatricians.

We pay very little attention to a long term healthy lifestyle approach that focuses primarily on life long nutritional excellence. Nutritional health has a very narrow perspective in Pediatrics. We help introduce food, guide parents to the best nutrients for their children to help grow healthy, and avoid obesity. But very few physician’s have the type of concentrated lifestyle training in nutritional medicine to have a significant impact on a child’s lifelong health .

Like many other pediatricians, over the years of practicing I had noticed a tremendous increase in the number of overweight children even before childhood obesity and diabetes became a recognized concern. With these observations was a realization that the parenting focus had not been keeping up with the changes in family dynamics namely poor diet, video games, screen time, and parental busy-ness.  I have tried to change this by working with families to make substantial improvements in weight and exercise of overweight children for years. I’ve instituted many programs and consultations in order to help parents change their children’s eating and exercise habits and lower their weight. I even began a sports and Nutrition Center with a dietitian as well as a psychologist in my office.

But successful nutrition and exercise modification resulting in lower weight and improved fitness parameters were few and far between. Without meaningful and long term family adoption of change there is little hope to improve the child’s weight and health.

      I have had difficulty in getting parents with overweight children to improve their lifestyle and consistently participate in nutrition counseling. It is very challenging to change an unhealthy pattern that has already been established even as young as 2 years of age. Family food habits and cultural tendencies are ingrained early. But as hard as it is for an adult facing health issues to change their habits it is even more complex to change a child’s eating and exercise behavior. Try pleading your case and rationalizing with a five year old who has already developed a taste for sweets, fried foods,  fatty meats, and salty foods. Not to mention eating processed snacks at every chance.

The conclusion that is obvious if you have been a pediatrician for any length of time is that if we don’t start early with a health and nutrition conscious approach the chances of creating the template for a healthy lifestyle later is difficult .It’s important to start from the beginning by developing your child’s taste for nutritious food. Food and health values related to diet and exercise have to become a priority just like vaccines, illness prevention, car seats, seat belts, smoking, and home safety. This is not luck of the genetic lottery but a given. If you and your family do not eat healthy and make good nutrition a priority and move regularly ; illness will be part of your child’s life sooner rather than later. Poor nutrition choices will accelerate disease resulting from childhood obesity and poor lifestyle including diabetes, heart disease , hypertension,and cancer.

It’s never too early to start eating healthy . The markers of disease are forming right below the surface attacking your children from an early age.If you start early there is a better chance to prevent poor health and chronic disease before the damage is done. Raising your children healthy is the mindset I try to  promote . Starting early from the beginning by developing tastes for good food is the surest way to help your child lead a healthy life .

Setting the tone for good nutrition early is as important as anything else you’re going to do for your child. Most of the parents of my patients worry about all sorts of diseases from autism to cancer  . Everyone is very much on alert for anything wrong with their children especially fever , cough, and developmental problems but a healthy diet is the one thing you can control. It is a gift you can give your child for a good life.

Warren Krantz MD


Author of “Start healthy, stay healthy”

Vitamin C

Vitamin C without supplements

The best source for vitamins is whole natural food and not supplements.

[Please consult your physician before self treating a medical condition with any supplements or alternative therapy including holistic remedies.]

Why is Vitamin C good for you?

The main benefit of vitamin C is it’s an antioxidant and anti inflammatory properties . Whole natural plant foods have both the most vitamin C and the best form to benefit from . These properties of vitamin C rich foods help protect the body from oxidative stress and fight free radicals that cause cell damage which can lead to disease. The value of this is in its disease fighting properties such as helping lessen skin damage from the sun, fighting colds, preventing and improving chronic diseases..

Colds and viruses- these properties of vitamin C in plant form help you protect against the symptoms associated with the cold namely all the inflammatory responses ,congestion, pain, and fever. These are often lessened with an anti inflammatory diet including foods sources containing high levels of vitamin C.. Vitamin C from plant sources can work in conjunction with your body’s immunity to reduce the length of illness of colds and viruses.

Cancer – there is no real proof that vitamin c helps or cures cancer. However, eating foods with high vitamin c content helps with inflammation and antioxidative stress that studies have shown can lead to cancer. Foods high in vitamin C and the vitamin C itself may help prevent and repair the cell damage that can lead to cancer.

Heart disease- higher levels of vitamin C have been linked with lower heart disease, better blood flow to the heart arteries, and better blood pressure.

Skin-vitamin C is involved in protein production and formation of healthy skin and healing such as collagen production, maintenance, and strength.. It helps prevent free radical damage and cancer development on the skin from sun exposure.

Natural whole food is the best way to get the most bioavailable vitamin C. All plant foods contain vitamin C. Below are the top 5 vitamin C rich foods for fruits and vegetables.

You get the most vitamin C by eating the fruits and vegetables raw.

The top 5 fruits for vitamin C content.






The top 5 vegetables for level of vitamin C

1.Bell peppers

2.Broccoli/broccoli sprouts

3.Brussel sprouts



It is always better to cut out the middle man when striving for better health- go straight to the food source for the vitamins and nutrients you require . The less processing and the closer you are to the natural unadulterated form of a food the better for your health and well being. The less chemicals and additives that change a food the better for your body and the environment.

Warren Krantz MD, FAAP

Diarrhea dilemma

Diarrhea the natural treatment

Ask any vegan  how they treat diarrhea and they will offer a difficult response. When your whole life is high fiber plant based diet treating diarrhea and stomach issues is always a dilemma .

Traditionally we have and continue to treat diarrhea as naturally as possible but with low fiber starchy foods and electrolytes. Pediatricians refrain from using any medications particularly those over the counter medications which treat the symptoms and not the condition. Diarrhea is one of the few maladies where we are more patient than not and for the most part let your body heal itself. The symptom of  diarrhea generally speaking is a natural tool to rid the body of toxins from pathogens such as viruses and even bacterial intestinal infections . We try to accomplish this while insuring that the child and adult do not become dehydrated or toxically ill from the infection .Our major emphasis is on fluid replacement with high electrolyte solutions and low sugar foods including a bland carbohydrate diet while eliminating foods that irritate the bowel.

Below is the basic natural approach:

                                         Medical supervision

Medical supervision to insure the diarrhea source is not infectious, doesn’t need a culture, you do not have parasites , or require any medical treatment – always consult your physician before beginning any self treatment of diarrhea.


Adequate hydration is the key to making sure you or your child do not get dehydrated and require iv fluids

Electrolyte solutions are our main source of hydration for diarrhea by containing the electrolytes you are losing in watery stool – pedialyte, coconut water, watered down and low sugar gatorade/powerade are the mainstays of re-hydration therapy and should replace other fluids.

                                          Elimination diet

Elimination of foods and drinks that increase intestinal movement . Eliminate fibrous fruits and  vegetables, oily fried foods, dairy ( including formula and milk but do not stop breast feeding), and spices should all be eliminated in the effort to control the diarrhea.


Healing Tea for diarrhea- in a cup of peppermint tea mix a teaspoon of ginger and turmeric to help settle bowel inflammation

                                            Binding foods

Foods for control of diarrhea and resting your intestinal system particularly carbs. Binding foods should be low in oil . Breads crackers, low in fiber and low in whole grains. Particularly saltines and cuban crackers, with minimal ingredients, including bagels, plain rice, plain pasta, ( all the low fiber foods not recommended on a regular diet). Applesauce, bananas, mashed carrots. Try adding tumeric or ginger to your bland food to reduce inflammation.

                                            Healthy healing

Healthy healing foods-pumpkin meat, coconut, carob powder, teaspoon of apple cider vinegar 2 -3 x a day.

Nutritional yeast and brewer’s yeast ( live yeast should not be used in crohn’s or patients with immune problems ). These have essential amino acids and protein, especially important for vegans who generally get their protein from high fiber sources like beans.

Probiotics for diarrhea symptoms: below are the most common bacteria reviewed to help restore bowel flora from diarrhea. No one recommended probiotic has everything. May use more than one. For instance start with culturelle, and can add florastar and another type listed below to come close to the full panel of helpful bacteria needed to replace the flora lost during bouts of diarrhea.

Certain bacteria you want for illness associated diarrhea include Lactobacillus GG, L. Acidophilus, bifid lactis, L. reuteri, and saccharomyces boulardii

Children- florastar for antibiotic associated problems, culturelle for general gastro problems,trunature, and natures way are all recommended . Can combine 2 of these once consulting with your physician. culturelle was not reviewed by consumerlab; one of my sources for

Adults- culturelle, nature’s way, align has one strain good for IBS, phillips, garden of life has many of the bacteria you would want.

Yogurt with pre and probiotics can be helpful such as Activa, but always be cautious with the dairy and not for vegans.

Medication for diarrhea should be very limited, and rarely for children. It can cause more problems than you started with. Natural food modified treatment is recommended more than any other condition . We do not use medicine in children it can cause bloating, abdominal pain, and blockage of the intestine. Check with your physician before using any meditation for diarrhea.     

Warren Krantz MD, FAAP

Getting to sleep


Simple and natural methods for getting to sleep.

Symptom: not being able to fall asleep or getting back to sleep if you wake up in the middle of the night.

This section is not considered part of sleep training for infants and toddlers – that is covered under behavioral issues.

[As with any guidance please consult your physician or child’s Pediatrician before beginning any treatments whether it be natural, holistic, homeopathic, or supplements.]

Natural treatments and lifestyle changes that can help you fall asleep and stay asleep longer are divided into behavioral or habits, food and meals, exercise, stress reduction, natural remedies.

Basic sleep schedule – consistency of bedtime. Make a bedtime routine for any age. give yourself time to wind down. Warm bath.  Quiet time. No distractions . Peaceful fun and games.  Reading. And any brain activity that is distracting and calming but not over stimulating to the body or mind.

One of errors people make when they do not get enough sleep at night whether it be by choice staying up late or a sleepless night is to sleep in,  later. While it may seem like a good idea to help you catch up with your sleep, the overall effect is to change your natural circadian rhythm. This would have a negative overall impact on sleep and restfulness. If nothing else staying up late and sleeping in just reinforces the poor sleep pattern rather than your natural sleep cycle.

Rather than staying up late and waking up late, turn it around. Start waking up with the sunrise and stay awake until you create a new reasonable bedtime in order to get 7- 8 hours before the next day’s sunrise. This will tune your body and mind into daylight and reset your circadian rhythm. This process actually  keeps you healthy , your immune system functioning at it’s peak, your brain focused and you feel less stress.

Psychological and stress reduction .

Calming yoga and meditation including visualization, corpse pose, mindfulness meditation

Reading, writing, art, music- listening to classical music has been shown to calm your brain waves. Activities with a lot of repetition will have a calming effect on your brain( like knitting).

Food that help calm and elicit melatonin

Dark cherries, tart cherry juice.

Good hard fermented cheese  ( for those non vegan)

Foods with tryptophan- nuts(walnuts), bananas

Magnesium from nuts and seeds

B6 foods aide in melatonin production Pistachio nuts and garlic , banana are B6 rich

Potassium rich foods also help in muscle relaxation. Citrus,dates and figs,tomatoes.


Lettuce leaf – eat a bunch shredded in salad sandwich wheat multigrain seed rich bread.

Easiest and best choice-lettuce tea. Use  romaine ,  2 – 4 large leaves to 6-8 ounces of water steep in boiled water for 15-20 minutes . drink cup of that. For infants a teaspoon or 2

Herbs and essential oils:

lemon balm. Lavender oil, candles, incense, put oil on your pillow.

Saffron oil or in food. . Valerian calming for stress- coming in tea, supplements.

Can put a few drops on your pillow. Light a candle or use essential oils in your bath .


Lettuce tea- see above

Chamomile tea – decaf

Lavender tea

Passionfruit tea


Lemon balm with lemon grass

Exercise regularly – aerobic and especially anaerobic like weight lifting should be earlier in the day. . Yoga is a good winding down exercise as is a slow swim.


White noise

Noise machine, soft music, waves.

Rotating fan

Staying fit and healthy with good air circulation is very crucial to getting a good night’s sleep.

Please as with all information check with your physician to assure your poor sleep is not medically related.

Warren Krantz MD


The truth about protein

The truth about protein

[ As with all posts the below is for informational purposes only. It is not to be considered as medical advice. Before making any changes in diet or health please check with your Pediatrician or Physician first]

This is one of the most perplexing issues confronting those of us who counsel patients to eat healthier. In our culture we have been programmed to believe the word “protein” is synonymous with animal protein. If we are weak, need to  build muscle, lose weight, gain weight, have a celebration  “ Beef. It”s what’s for dinner”. It’s the food source most people associate with vigorous health. You must need protein ( meat, chicken, turkey)  if you are sick or weak. “Make sure to get your protein”is the first remark regarding nutrition when growing up and old. Even for most people who understand there are other sources of protein from plants still believe that meat protein is a better more substantial form of protein . It’s as though everyone pictures a muscle man eating a steak and sickly little guy eating beans and kale. Real men eat meat. Popular concept, but not based on any facts or science. Plant protein calorie per calorie is a healthier form to receive your protein. It does not come with the baggage of meat protein as recent studies linking meat sources of protein with cancer and heart disease have demonstrated  .

The most common question I get when anyone hears I am Vegan is where do you get your protein?

My goal in this post is not to advocate for vegan eating or against eating animal sources of protein but to get the facts regarding food sources of protein and their relationship to good health. Many people want to know what are the portions of meat that are necessary to get your needed quantity of protein and how to replace the amount of animal protein in order to eat healthier especially if they want their child to attain a healthier weight . The overall amount of meat we eat in order to get protein in in the US is well over the maximum protein amount we need for good health. In fact, many sources believe the excess protein we ingest from animal protein is part of the problem regarding our poor health as a nation. 

Quick takes:

  • Can you get enough protein from plant based foods? Yes
  • Plant based foods source of protein is healthier than animal protein. Plants have no fat, no cholesterol, have phenols, anti-inflammatory, and  high fiber.
  • Nuts , seeds, beans, all have plenty of protein. nuts 18 gm , seeds 30 gm, beans 15 gm-

Compared to a hamburger 16 gm, 3 oz steak 25 gm, 3 oz chicken 15.8 gm.

  • Nut butters, hummus, tofu and tempeh are all high protein high nutrient easy to eat foods that are vegan and add to your health.
  • Bean dishes of all sorts have high protein, high fiber and add to your health. Improving colon health, heart health, lowering cholesterol and maintaining a healthy weight.
  • Grains also have good protein. Even brown rice, whole wheat pasta, quinoa all are healthy source of protein.
  • Do greens have protein? Yes. Broccoli for instance has 16.7 gm per bunch
  • Even some berries have protein . Goji berries have 4.7 gm of protein

In the US the recommended amount of daily protein is 56 grams for men and 46 grams for women.

At one year of age approximately 12 grams of protein a day is what is recommended- (see chart below for more details on protein amount and requirements).

Your source of protein is the key to good health – whatever the number or percentage of calories you follow , the majority of the calories from protein should not be animal protein because of the dangerous fat and harmful elements for health. Animal protein should be at most a supplementary source of calories to maximize health. Too much protein is harmful to your liver and kidney and over indulging in animal protein causes damage in all organs.

What is your main source of protein? Is it a healthy source?

You will find that there are more sources of protein than you knew. A good varied diet with an abundance of plant protein sources is easy and healthful.

Scroll down for the answer and to try to match vegetable protein to the below examples of meat protein.

Red meat- hamburger single patty 15.7 gram protein ; 25 % of calories from protein.

                      -3 oz steak  25 gram of protein;   36% of calories from protein

Chicken breast tenders 3 oz   15.8 grams protein ;   22% of calories from protein

Turkey breast    22.2 gram of protein; 74 % of calories from protein

Below is a table comparing average protein content of food groups.


                                                                             Protein avg cup                               % Adult American RDA

Beef   80 grams / 3oz=31 gm 120%/ 60%
Chicken   55 grams / 3 oz = 22 gms 100%/ 45%
Fish   62 grams /. 3oz= 22 gms 100%/ 45%
Dairy/ cheese/milk   9 grams slice/ 8gms cup 16%
Eggs   17 grams 30%
vegetables/greens   4- 5 gram 10%
Nuts  18-20 grams 40%
Seeds   30     grams 55%
Grains    6 – 8 grams 15%
Beans    15    grams 28%

These percentages are based on the American version of the daily protein requirements. But the WHO organization and most healthful guidelines prefer a much lower number of required protein for maximum health especially for kidney and other organ maximum function.

Below is a table of age and protein requirements

Age                                             Female protein req per day               Male Protein req per day

Newborn 10 – 12 grams same
1 -3 yo 13-20 grams same
4-8 yo 19- 25 grams same
9-13 yo 34 gams same
14-18 yo 46 grams 56 grams
Adult 46 grams 56 grams

Protein minimum requirements per age. Generally based on weight and US standards

Sample of “ Healthful foods” and their protein content.


Broccoli – 1 bunch cooked 16.7 gram 47% calories from protein/ 100gm 3.8 gram protein

Spinach cooked 5.3 grams of protein cup cooked , 41% of calories from protein

Kale 100 gram 1.9 gram protein / cup chopped 2.5 gram of protein 23% of calories from protein

Sweet potato 1 medium 2.3 gram of protein 9 % of calories from protein

White potato baked 4.3 gram for medium potato, 10 % of calories from protein

Peas- 5.4 grams of protein /100 gm 7.9 gm cup

Mushrooms 5.6 grams per cup,

Corn 4.7 grams per cup

Brussel sprouts 2 grams per 1/2 cup of protein

Squash 5.1 grams per cup of protein

Cauliflower 2.1 grams per cup of protein


Rye 17.5 grams cup uncooked

Brown rice 5 grams protein cooked per cup

Wild rice 6.5 grams protein cooked per cup

Barley 3.5 grams protein per cooked cup

Couscous 6 of grams of protein per cooked cup

Quinoa 8.1 grams of protein cooked per cup

Oatmeal 5.9 grams of protein cooked per cup

Amaranth 9.3 grams of cooked protein per cup

Whole wheat pasta 7.5 grams of protein cooked per cup


Soybeans roasted 36.8 grams protein per cup

Lentils cooked 18 grams protein per cup

Kidney beans cooked 15.5  grams protein per cup

Baked beans 14 grams protein per cup

Black beans cooked 15.5 grams protein per cup

Split peas cooked 16.3 grams of protein per cup

Pinto beans cooked 15.4 grams of protein per cup

Chickpeas cooked 14.5 grams of protein per cup

Nuts and Seeds

Almonds       6 grams per ounce        20 grams per cup

Cashews      5 grams per oz              21 grams per cup

Walnuts        4.3 grams per oz           18 grams per cup

Macadamia  2.2 grams per oz           11 grams per cup

Pistachio       6 grams per oz             25 grams per cup

Pecans         2.6 grams per oz           13 grams per cup

Chia seeds   4.7 grams per oz           33 grams per cup

Flax seeds    1 tablespoon 1.3 gm     31 grams per cup

Sunflower seeds                                29 grams per cup

Pumpkin seeds                                  12 grams per cup

Sesame seeds                                   26 grams per cup

By looking at the above list you get the idea that if you eat a bountiful meal of grains, vegetables, nuts and seeds you get more than enough protein. This should be motivation along with being healthful to lower the quantity of meat sources of protein without fear of wasting away from protein malnutrition. Look at the amount of  food you could eat to be completely full for about the same calories and same protein. You would get away with less harmful fat by varying your protein sources. In addition, vegetable protein comes with heart protecting  anti inflammatory properties.

Which do you think is a more healthful way to get the same protein?  One burger or a cup of good grains with vegetables, beans and seeds? Which has more fiber? Is filled with more good vitamins? Has a more anti inflammatory effect? Which plate of food will harm your heart and blood vessels less? Help your digestive system more and help prevent colon cancer ? All this and still get enough muscle building protein?

If you know the answer to all these questions you are a step closer to being Healthful

“Vegetables, grains, beans, nuts, and seeds is what’s for dinner!”

Warren Krantz MD, FAAP

Future blogs will detail healthy protein rich meals and servings of healthy protein filled foods.

Antibiotic overuse and health

A recent article evaluating antibiotic use and correlated weight gain was recently published by Brian Schwartz of Johns Hopkins, in “The journal of Obesity”. This gives me a starting point for a discussion of antibiotic overuse and the harmful effects they have both immediately and long term. Even when judiciously used by many physicians there are issues with intestinal bacteria changes.But these changes are especially common place with  the rampant over prescribing because of fear, lack of understanding, and due to time constraints. There is still a prevalent  ignorance regarding disease and the use of medications and their complications. Everything you put in you mouth has good or bad health effects both immediate and long term. Antibiotics more so than the majority of things you put in your body has an immediate negative impact, but more and more we are learning about the long term impact. This article studies the relationship of antibiotics to weight gain for children with increasing proportion with rising number of antibiotics used. This goes on to relate it to the loss of good bacteria in your gut that can process food and help break down good nutrition. This is a new idea regarding weight gain but not new knowledge that the loss of normal bacteria flora in your intestine causes all sorts of problems. These range from digestive issues to many other systemic diseases. By changing your intestinal system you lose a lot of natural ability to build immunity through the gut, a main source of fighting illness, and have poor absorption of nutrients, causing stomach, issues, gas, bloating, inflammatory bowel disease and all sorts of chronic diseases. Antibiotics alone are not the only cause of this. A poor western diet with processed foods, fats, sugars, salts ,toxins including those from animal protein ,  junk food, and diary. These have direct and lifelong negative impact. We now know intuitively that when you are on antibiotics you should take a probiotic ( which add good bacteria) especially if the use is prolonged.  Antibiotics kill all bacteria randomly including the good bacteria in your gut making the way for stronger more dangerous bacteria to flourish. And now for the really bad news: This antibiotic misuse  is not just personal where it wipes out our useful bacteria and can make you personally resistant to that particular antibiotic by helping the strongest of the bacteria mutate: antibiotic overuse is causing a worldwide plague of resistant bugs that are not treatable with the antibiotics we currently have. This may be a boon to the drug companies who want to come up with a super expensive super bacteria killing antibiotic, but even they are running out of the options to do this. They are going back to nature to find natural plant antibiotics in tropical forests remote environments to find remedies to fight these super bugs. The pharmaceutical companies are finding the origin of strong antibiotics, manipulate and synthesize them to fight the resistant bugs they have created while wreaking havoc on your intestinal and immune system. I personally prescribe antibiotics when necessary and will not sacrifice anyone’s health for the sake of a philosophy or politics or to be strictly“ natural organic”, but necessary means well documented and proven , or there is no other choice when the danger of watching and patiently waiting for a disease to resolve would far outweigh the use and dangers associated with the medication prescribed.

The theory of the study is that antibiotics change a child’s intestinal flora by changing the way one digests food and therefore absorb nutrients differently, possibly absorbing more calories and fat. In turn gaining weight faster than other children.

The average additional weight gain by the time they were teenagers in this study was 3 lbs. Early in childhood children would gain weight after the antibiotic use but would lose it, but by the time they became 15 the weight gain was permanent.

Researchers, in preliminary studies believe the weight will keep going up as the patient’s age.

Other variables that could contribute to weight gain do not seem to be accounted for in this study including family lifestyle and health perspective including the following factors:

Food quality- fatty food, meat, dairy, processed food, sugar,  fried foods. all lead to               weight gain and changes in intestinal flora as well. Antibiotic use in animals is a main source of this growing worldwide resistance.

Activity level– less activity and exercise is a well known factor in obesity and weight gain.

Illness – chronic illness, multiple antibiotic use could be correlated with sickly less active children.

Overuse of physician’s care– have a tendency to seek medical care for small viral illness and prefer antibiotic use to natural means and patiently waiting for viruses to resolve.

The broader point is that maintaining good natural bacterial flora in your intestine is one of the key components to good health, whether it be maintaining a healthy weight as pointed out in this study or by eating healthy and supporting good bowel function. Your intestinal system health is linked to overall health more intricately them we previously understood.

by Warren Krantz MD, FAAP

Boosting the immune system to fight colds and illness.

How do we build up our children’s immune system during cold and flu season

       One of the most common questions I get each year particularly with young children entering school is “How do we keep my child from getting sick all the time and build up their immune system?”. Generally my answer is “every child gets sick almost constantly at a rate of about every other week when starting school” . You have to catch the germs in order to build up an immunity and be able to fight it next time. But it does not stop the parents frustration and their constant quest for that magic remedy to build up their immune system so they do not get sick or at least fight the viruses better. There is no shortage of supplement companies, snake oil salesman, and wannabe physicians promoting their short cut to immune stardom. Basically my advice is old fashioned grandma like advice which always included fresh air, go to the ocean ( living in South Florida is easy), exercise, eat your vegetables, chicken soup, don’t eat so much candy, and get plenty of sleep. Well, things have not changed that much with all our searches, supplements, and advances in medical science. I believe premier nutrition and healthy lifestyle is your best means to a good immune system and ability to stave off disease and fight the common childhood ailments. Junk foods, fried foods, processed sweets and snacks at the very least do not help your immune system and conservatively speaking cause more inflammation and irritation when you need to be fighting viruses. 

     Eating well is the cornerstone of good health and immunity. This is easier said than done for children. For those patients and families familiar with my feeding guidelines you have a head start. But eating well is none the less the best way to begin to build a strong immune system. Prevention starts with good food including – lots of greens , sweet potatoes,  fruits , apples with red skin, red onions, and purple and red fruits for example.  Lots of fiber.  Making sure your are hydrated with lots of water.

Organic food itself is the best way to get the vitamins and phytonutrients to boost immunity and keep it at peak in cold and flu season in order to be ready for the influx of germs.
    Dark fruits have the best and most bio-available vitamin c, and phytonutrients. ( vitamin        supplements do not)

Eat them– eating the fruits is the best source of these immune building nutrients –                    blueberries, pomegranate,  cherries, raspberries,  dark grapes, etc.

Juice them– dark juice as a second choice if they won’t eat the fruit. Blueberry juice , pomegranate , dark grape,  or tomato juice.

Blend them and hide them- Super power HealthfulMD immune smoothie – base of almond, hemp, or soy milk; walnuts, avocado , super greens ( if they don’t like green vegetables- you can buy in health food stores ), spinach hides the best, and also kale. Blueberries, strawberries , bananas, peach , pineapple, or cocoa powder for sweetener. Flax seeds  for fiber and  omega 3, mushroom, ginger , cinnamon help boost the immunity.

Super power soup before or during illness. Vegetable soup or chicken soup base : add mushrooms , garlic , turmeric as tolerated, oregano in good amount, greens if liked by child – kale,  spinach, broccoli,  broccoli sprouts, sweet potatoes,  spices as tolerated -chili peppers,  cumin, and ginger.

Probiotics may help. If you or your child is a healthy eater particularly vegetarian style or for a healthy vegan probiotics may not be necessary or beneficial . The type of probiotics depends on the system you want to enhance . Gastrointestinal symptoms would be one type  and  upper respiratory ( colds) would be another form to use . Types of probiotics include lactobacillus acidophillis, and bifid bacterium. Look for recommendations in future blog posts.  Ask your physician for safety of any supplement and probiotics and their recommendations.

Sleep is essential to maintaining health- children 8-9 hours  
Manage stress – lavender,  chamomile. Exercise, yoga, meditate.

Tea– as calming and immune boosting
    Hibiscus – mix with ginger.
    Other red rooibos teas are sweet and may be more palatable for children.
    Green tea – honey , lemon and add ginger and cinnamon
    Chamomile tea has both calming and immune enhancement
Nutritional yeast – tablespoon a day increase immunity

Supplements: not medically researched or approved but have anecdotal improvement in immunity.

Immunoberry supplement

Eldeberry. Astralagus, Grape seed extract,  Oil of oregano all are purported to have immune enhancing properties to fight and ward off colds.