Maggie McKay (Host): This is Children's Health Checkup, where we answer parents most common questions about raising healthy and happy kids. Today, we'll discuss how to boost your child's immunity with our expert, Piper Merrill, Pediatric Nurse Practitioner at Children's Health. We'll discuss some lifestyle tips that can help build a strong immune system, as well as the role of vaccinations, germs, supplements that can help a child's immune system, and which foods you can incorporate into their diet as well. And we will talk about what weakens their immune system.

I'm your host, Maggie McKay. Welcome Piper. It's so nice to have you here today.

Piper Merrill, PNP: So good to be here. I'm excited.

Host: Me too. I can't wait to hear more about this because I'm a little bit of a germophobe myself. And when my son was growing up, my husband's like, Oh my goodness. Let it go. You're like crazy about this. But seriously, let's just start with what is the immune system and what role does it play in a child's overall health?

Piper Merrill, PNP: Yeah, I think that's such a great place to start. I think most of us know the function of the immune system is to keep us healthy. But how does that work? How does it keep us healthy? So I would just say the role of the immune system is very crucial in the overall health of any human being, right?

Our kids, because what it does, the immune system basically is there to protect our body from outside invaders. An invader would be a virus, bacteria, fungi. And then these bacterias and funguses and viruses, they all produce chemicals. That's what we call toxins and the function of the immune system is to fight off disease in our body and to keep us healthy.

And it develops during childhood through exposure to microbes and it is also, the immune system is supported and we'll go in more detail in this, but proper nutrition, sleep, vaccinations, physical activity. But I thought first I would dive in a little bit to, what is the immune system without too much depth.

But we have two parts of the immune system. It's the innate immune system and then the acquired immune system. And the innate is what we're born with. This is your child's rapid response system. It's the first to respond when it finds an invader. And this is made up of your skin, your eyes, the mucous membranes that line your respiratory tract, your GI tract, your GU tract. So I mean, we just don't think about the immune system is really all over our body. The innate immune system is really inherited. So we're born with that. The acquired immune system is what we develop as our body is exposed to microbes and chemicals that are released from the microbes.

And these two systems work together. The acquired immune system with help from the other immune system, they make antibodies that protect our body against these invaders. And, the antibodies stay in your child's body. It can take several days for the antibodies to form after the first exposure. But what's great about the acquired immune system is that then it recognizes this invader and it has formed antibodies that fight that. So that's why the acquired immune system is something that is so important. And with immunizations, that's what we're training our child's immune system to make these antibodies, to protect them from the harmful diseases instead of having to get the disease, which then produces antibodies.

Host: What factors can weaken a child's immune system? 

Piper Merrill, PNP: It's interesting. What weakens it also is what can strengthen it. Which is good news. So it's actually lifestyle factors. So proper nutrition which I think nutrition sometimes is very hard for parents because we understand vegetables are very important, fruit are very important to eat but to try to convince a three-year-old that that fruit and vegetables are what they need to eat is sometimes challenging.

So I get that parents. And so what I tend to tell my parents and patients is smoothies are a great way to get veggies into kids. If you'll put in a blender, don't do a juicer cause you want the fiber from the skin of the vegetable or the fruits, but putting in some kale, some spinach, and then put in bananas and strawberries.

They will not taste the veggies, but it is important. Proper nutrition. We know this. Fruits and vegetables, the Mediterranean diet is known to be, I think the most well rounded diet and that would consist of vegetables and fruit and then you want to stay away from the candy, the sodas, the sugary cereals, the ice cream. I know parents. They're pretty convincing with their cute faces.

They want all that stuff. But that actually weakens the immune system. That's kind of crazy to think how powerful that is. But proper nutrition, you want things that sustain your blood sugars. You don't want the spikes in your blood sugar, which that's what these simple carbohydrates do. They give spikes in your blood sugars, that's why then they crave more sweets. And then it causes inflammation in your gastrointestinal tract is your largest immune organ. 

And if you're eating a lot of sugar, we're causing inflammation, which there's good inflammation from the immune system, which that's when you get stung by a bee or an insect and your hand gets red, it gets a little swollen. That's a good part. That means your immune system is responding to this invader and it's fighting it off. So that's good inflammation, but chronic inflammation from poor nutrition is not the kind of inflammation that we want.

Other thing that affects our immune system in a good way can strengthen it or it can weaken it, is exercise. I know we all have such a aversion to that sometimes. But we don't have to do, you don't have to run a marathon, but get your kids out walking. Walking enough to where you're getting your heart rate up.

So moderate exercise. Get them outside. Get them playing. Moms, dads, get them off the electronics. Get them off their phones. They don't understand how good nature is for them. Be outside. Get in the sun. Play. This is great for their mental and emotional health as well, which that leads into the next thing that strengthens our immune system, is managing our stress.

So with kids, just being at school, we don't think about they may have a new teacher or they might have the style of the teaching that the teacher does, might not fit with their personality or they might have a child in the class that's bullying them or not even bullying, but just picking on them.

But those can be traumatic stressors for kids. So we need to think about when they come home from school, how can we decrease their stress? Teaching kids yoga. It's a big deal. It's great. Learn to stretch. The other thing is deep breathing, which I think that's kind of funny in the midst of, I know if I'm throwing an adult temper tantrum, the last thing I want someone to tell me is to take a deep breath. 

But if we'll teach kids how to breathe deep when they're stressed, what that actually does is lower the heart rate. It tells your brain it's not a bear. I'm not really under threat. That's what stress is. The brain feels like you're under threat. So it increases your heart rate, it increases all your anxiety levels.

So you take in a deep breath and teaching kids parents, it's kind of the whole thing on the airplane. Put the oxygen on you first and then on the child. So we have to learn to calm ourselves so that we can then help the kids calm themselves. So that's managing stress. These are things that can either strengthen or weaken and, basically what that means is if we are managing our stress, we are strengthening our immune system. Chronic stress will lead to inflammation in our body, which is unhealthy.

Host: So we've learned things that can weaken a child's immune system, a poor diet, a lot of sugar, and some everyday habits or lifestyle factors that can naturally boost their immune system is exercising, get out in the sun, put down the screens. But when it comes to kids, are there specific nutrients, Piper, supplements or foods essential for building a strong immune system? And if so, what are they? 

Piper Merrill, PNP: Really if you're eating a well balanced meal, if you're eating good nutrition, you shouldn't have to use a lot of supplements. And there again, supplements are not in replace of a good diet. So it is, that's what's important because, and I say that because, supplements is a huge marketing industry.

And we have to be so careful with supplements because they're not, and I want parents to understand they're not regulated by the FDA, which is the Food and Drug Administration. How our prescription drugs are monitored for safety and effectiveness of the drug itself. Like it monitors, does this drug really do what it says it's going to do?

Well, for supplements, there's no government agency that really regulates those. So what is in that pill is not regulated by anybody. So I say that though, that you will know to talk to your providers, talk to nutritionists. I think we underuse registered dietitians. Especially if you have a chronic illness, if you have asthma, if you have irritable bowel syndrome, if you have other illnesses or you just feel like, I really want to know good nutrition for my child.

A nutritionist is a great place to go, but some of the nutrients that I think have shown to help our immune system would be like vitamin D and that's the D3 is that particular type, zinc, vitamin C and then omega 3 fatty acids. Those would be some supplements that I would hone in on.

Host: And that's okay for kids?

Piper Merrill, PNP: Yes, those are all okay. Now that's, there again, how much of each one of those. So that's when I say consult your provider to ask them or you can always a great resource as well is a pharmacist. 

One more thing on supplements, there is a little bit of regulation on some of the supplements and there are some things you can look for and it's called a USP certified or NSF certified. Look for a little symbol that says that. And those have been more, just looked into on how they're made, basically. But that just gives you a little tip. Read the labels, know what you're taking, monitor teenagers, parents, you know, they like these, creatinine drinks, energy drinks, but you want to make sure that you just know what's in them before they're putting that in their body and how they're going to respond to it.

Host: I used to take a screenshot of all the nutritional information on things and send it to the pediatrician and say, is this okay for my son?

Piper Merrill, PNP: That's exactly right.

Host: I thought it might have been overkill, but, okay, Piper, let's talk about vaccinations. So what role do vaccinations play in strengthening a child's overall immune health? 

Piper Merrill, PNP: Yes, it is very interesting and it is a sensitive subject and I'm very sensitive to that for parents but, vaccines help the body learn. We talked about the acquired immune system.

Once it's been exposed to an antigen, which is a substance, once it's been exposed to that, it recognizes that. And so it doesn't have the same reaction the second time. So vaccines help the body learn how to defend itself from disease without the dangers of the full-blown infection. The immune response to a vaccine might cause, you might get tired, you might not be comfortable for a couple days, the resulting protection can be for a lifetime. So infections are unpredictable and can have long term consequences. Even the mild or quote symptomless infections can have serious consequences. Vaccines work by imitating an infection, the presence of the disease causing organism in the body to engage the body's natural defenses. So the ingredient in vaccines, I think that's what freaks people out. Sometimes this is just an antigen. That's the invader. And in vaccines, you get a weakened or a killed bacteria or virus that makes the immune system think that you've had the full blown disease. So it produces antibodies. That then you don't get sick. The child doesn't get sick with the full disease. There's also bits of the exterior surface of the antigen.

And that's like the flu vaccine. People always say, oh no, I don't want the flu vaccine because I feel like I get the flu. Well, actually you can't get the flu from the flu vaccine because you're not getting the flu virus. That's not what they're giving you when you get that vaccine. You're just getting bits of that genetic material to make your immune system think you've had the flu.

But what you're feeling is your immune response. That's a healthy response. That's what you want is you want your immune system to respond. So yes, you might get a little headache, you might feel a little tired, but you don't have the flu. You are then not going to get the full blown flu. So the disease itself, right?

So that's the great thing about vaccines is the role in the overall health is that they just strengthen the immune system and they strengthen the child. So you're not always sick.

Host: Do you recommend them to parents when they ask you? What should they do?

Piper Merrill, PNP: I do recommend the vaccines. Yes.

Host: Okay. Good to know. Well, we know exposure to germs is also necessary for building a strong immune system, but like I said in the beginning, I'm a germophobe, admittedly. Can you explain how that works and how parents can find the right balance between keeping their kids safe from illness while also letting their natural immune system develop through exposure because it's true. You want them to get sick now and again, but you don't want to overdo it so they're never exposed.

Piper Merrill, PNP: That's so true. I think too, through COVID, I think this is when we also became germphobics.

Host: Yeah.

Piper Merrill, PNP: I don't think we all used hand sanitizer and all that as frequently as we do now. So, I think that's always a hard question to find the balance, but I'd say during flu season, during RSV and the winter seasons when more viruses are out there, it's good to teach the kids, good hand hygiene, right?

Washing their hands, using a tissue to wipe their nose instead of using their hands or their shirt. Rubbing our face a lot. Like we said, the immune system is in our eyes as well. So any mucous membrane that can take something is teaching kids, right? Hand hygiene. When you go to school and you go to the bathroom, wash your hands. When you, even in the classroom, wash your hands, right?

So it's there again. It's teaching the kids we want you to stay healthy and these viruses are on doorknobs. They're on the desk. They're on. It's always a balance of not making them paranoid where we turn them into washing their hands so much that they're raw but yet acknowledging that there are viruses out there and we don't want them to get sick. 

Maggie McKay (Host): Piper, do you have any other advice in a nutshell for parents who are hoping to boost their child's immune health to fight allergies and illness? What's like the two most important things you can leave them with? 

Piper Merrill, PNP: Yeah, so allergies are very different than illnesses. Allergies are actually when the immune system malfunctions. I'll tell you a little bit what allergies are. So you have seasonal allergies, which would be like hay fever, from pollen, ragweed, those things and the symptoms they cause, I think this is helpful for parents to understand. 

It's hard sometimes to distinguish a cold from allergies. Allergies are going to start out with clear mucus, itchy eyes, itchy nose, and you're going to get a sore throat with that. But, you can say well a cold is kind of that way too. The difference in a virus and allergies would be your nasal drainage with a cold is going to turn yellow. It's going to have yellow and green. Yellow and green doesn't mean bacterial, just means infection, viral versus allergies are just going to say clear drainage. You're going to have more of the watery eyes, itchy eyes, itchy nose, and then just knowing how to treat those. So really nasal congestion can come with a cold or with allergies.

But allergies you want to treat more with like Flonase or antihistamines. That's what's going to help that. You can't really prevent allergies. What you mostly want to do with allergies is identify the triggers. 

If you have mild symptoms, runny nose, congestion, and you're able to kind of treat that, it's just seasonally a couple times during the year, then you just treat it with medications. When an allergy starts becoming chronic, I'm not sleeping because I'm so congested, allergies can be miserable if they're really serious.

You can get miserable. You can feel drained because you're not sleeping good. So if that's the case, then you do need to see an allergist. Talk to your providers. Go to an allergist so you can identify the allergens and knowing what's going to trigger your allergies because it's usually a predisposition genetically when you have allergies.

It is familial, runs in the family. So those are just things that can probably help with allergies. It's just recognize the difference between a cold and allergens. 

Host: Piper, thank you so much for sharing your expertise and your time. This has been so helpful and educational. We really appreciate it. 

Piper Merrill, PNP: Thank you so much for having me. I've enjoyed it. I am passionate about helping parents, with their kid's health, it's so important, and I know it's important to parents. You're doing a great job, parents. . 

Host: Again, that's Piper Merrill. For more tips on how to keep your child healthy and happy, visit childrens.com/health-wellness. Thank you for listening to Children's Health Checkup. If you found this podcast helpful, please rate and review or share the episode and please follow Children's Health on your social channels.