Thoughts on Infant and Childhood Constipation

Early childhood constipation is reaching epidemic proportions. So many children are taking Miralax on a daily basis over the course of weeks, months, or even years. This is following advice given by their pediatricians and GI specialists. So what causes constipation? More importantly, how can we address and resolve it in a more natural way?

What is normal?

Constipation is delayed or painful bowel movements. A person, regardless of the age, should  have at least one bowel movement per day. Infants tend to have movements more often.

You may have cause for concern if your child is producing hard, pellet-like movements, or bowel movements with a consistency similar to clay balls. You will want to investigate further if your child arches their back or cries while having a bowel movement.

What causes constipation?

Infant constipation is often related to a food intolerance, often dairy. This can affect the baby either through the mother’s milk or through formula. Removing 100% of the dairy from the mother’s diet for two to three weeks will often resolve the issue. You can work with a nutrition professional to help remove dairy safely, to ensure your child still gets adequate calcium, protein, fat, and vitamin D, and to learn where dairy is hidden in foods.

If, at the end of a trial dairy elimination, the constipation is not resolved, you may consider working with a nutrition professional to help identify the cause.

Constipation in a toddler can be caused by a number of factors: food sensitivity, low fiber diet, poor hydration, or a diet high in binding foods such as bananas, rice (rice cereal), applesauce, bread, and pasta.

Constipation often occurs during the initial introduction to solid foods. Solid food introduction should happen slowly, allowing for the child’s system to acclimate to the new foods. It is not necessary to begin with rice cereal, as that is a low-fiber food and can be binding. Many prefer to start food introduction with fruits and vegetables rather than the traditional baby cereals. For more information on my preferred method of food introduction, baby-led weaning, check out this video.

Not sure how much fiber your child should be getting? Take their age and add 5; a 2 year old child should get 7 grams of fiber per day. A serving of fruit and multiple servings of vegetables each day can help ensure adequate fiber in the diet.

I’m not a fan of “hiding” vegetables in foods, but incorporating them in unexpected places is a little different. What’s the difference? Getting your kids in the kitchen is a great way to get them involved, and interested, in preparing and eating new foods. If you make these chocolate zucchini muffins while involving your kids, by mixing, adding ingredients, and spooning the batter into the muffin cups, you can incorporate a vegetable without “hiding” it.

As an added bonus, your children are more likely to be interested in eating these delicious baked parmesan zucchini after meeting our oblong green friend while making the muffins. For more information on healthy ways to improve your child’s selective disposition (fancy way of saying picky eating), check out this article.

Need a couple of other delicious, nutritious, and high fiber snack ideas? Try crunchy roasted chickpeas! Do your kids like chips? How about crunchy veggie chips? Or coconut chia seed pudding. Roasted vegetables take on a sweet taste as their natural sugars caramelize. Try these delicious roasted beets- just have a few wipes handy! Have a pumpkin craving? Try this pumpkin pie oatmeal. And my personal favorite, which has been flying off the baking pan in my house, peanut butter cookies (made from garbanzo beans- seriously, trust me). For a few more ideas, here is an article on newborn care- good information for anyone trying to find a few easy ways to improve their diet.

The concern for Miralax

Miralax, or the generic polyethylene glycol 3350 (PEG 3350) laxative, is being prescribed for children at an amazing rate. Toddlers are being prescribed daily doses for months, or even years, at a time. This is really astounding since the directions on the bottle say that the product is intended for adults 17 years and older, and not for more than 7 days.

Late last year (September, 2015), a grant of $325,000 was awarded to The Children’s Hospital of Philadelphia to study absorption of PEG 3350 in the very young and whether use of the laxatives might be linked to development of psychiatric problems. (See this NY Times article for more information.)

There has been concern among some parents that PEG 3350 might be addictive. The drug itself is not physically addictive, meaning that when use of the drug is discontinued the body can resume it’s normal behavior without withdrawal symptoms. But when you have a small child, possibly close to potty training age, there could be a mental association that will be difficult to break. If you’re considering discontinuing use of a laxative with your child, I strongly recommend doing so before attempting potty training so that the child knows how to listen to his or her body cues and react appropriately.

Some more natural solutions

Increase fiber in the diet by increasing the amount of plants on the plate.  You can also include ½ tsp of unprocessed bran each day by mixing it into oatmeal or baked products, such as these delicious carrot muffins.

Smoothies are a great way to incorporate fruits and vegetables into the diet. Try adding a tablespoon of flax oil in your child’s daily smoothie to help get things moving.

Help your child drink more water by keeping a full water cup on hand at all times (and a backup or three). If your child isn’t interested in plain water, they may be into water with ice cubes. Or water with whole strawberries or lemon slices. I’m not a fan of fruit juice in the diet in general, but using 2-4 oz of apple, pear, or prune juice to help ease constipation may be appropriate for your child.

If I were a cheerleader, it wouldn’t be for a football team, it would be for probiotics. Adding a probiotic to your regimen is appropriate if you are and infant or if you are a senior citizen, and all ages in between. It’s appropriate if you have had any tummy upset, a cold, or a papercut (ok, a little dramatic there… maybe). My favorite probiotic for kids is Klaire Labs Infant Formula. You can read more about probiotics and probiotic foods here.

Babywearing can help ease constipation by putting the child in an advantageous position for cueing the body. “Squatting is the preferred position for having a bowel movement and proper babywearing mimics this with upright spread squat positioning [similar to the position encouraged by use of the ground-level toilet training seats.” LaKeta Kemp of Tandem Trouble. You can also find many tutorials on safe babywearing on TandemTrouble.com.

“Massage can help with many tummy issues, including constipation. Massaging the tummy area relaxes the abdominal muscles, often easing the strain that is caused by constipation. Additionally, massage can stimulate peristalsis, or the contractions of the digestive tract, to help get a blockage moving again and provide relief. It is important for massage techniques that target the colon to move in a clockwise direction to coincide with the natural direction of the waste in the colon.” Michelle Cordero of East Valley Infant Massage

When to be concerned

Constipation can be caused by some minor, and easy to fix problems. But it could also be a sign of something a little more serious. If constipation is accompanied by vomiting, bleeding, abdominal pain, or bloating, please contact your doctor.

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Pumpkin Pie Oatmeal!

'Tis the time of year when everything has pumpkin. Well at Baby Bloom Nutrition, it's no different. Pumpkin is delicious and reminds us of warm holidays in front of a fireplace- or in sunny Arizona, maybe warm holidays in front of an electrical fireplace with that fake fire video going. Anyway, there is more to pumpkin than the delicious taste and warm-fuzzies.

Pumpkin, actually a fruit, is very high in beta carotene and vitamin and C. Beta carotene is the precursor to Vitamin A, which is key in vision, immune function, reproduction and fetal development, bone and skin health, and is also an antioxidant. 

We are all pretty familiar with the role of vitamin C in immunity. Vitamin C is also a powerful antioxidant, helping to prevent cancer, stroke, and other neurodegenerative diseases.

Research shows that young kids don't know what they want to eat until it's right in front of them and sometimes not even then, but my 2 year old twins wake up demanding pumpkin oatmeal. And the way they scarf it, they obviously know what they want.

Here is a nice picture of my Pumpkin Pie Oatmeal. OK, this is the bowl 10 minutes after announcing that breakfast is ready. It had been a double portion. I didn't get one bite.

I'm all for giving credit where credit is due. I made some changes to this recipe, but not enough changes to claim it as my own. Here is the original recipe.

This recipe feeds one adult. Or in my house, one toddler.

1/4 cup pumpkin puree
1 cup milk (or milk alternative)
1 cup quick cooking oats
1 Tbsp brown sugar
1 Tbsp flax meal 
1/2 tsp pumpkin pie spice

Combine all ingredients and cook over medium heat for 5-6 minutes.

Happy breakfasting! And remember to create a healthy relationship with food.

The Insanity of Nap Time

It's Nap Time! 

Finally, after a morning of cooking, cleaning, diaper-changing, feeding the birds, fixing the toy truck, fixing the toy truck again, fixing the toy truck AGAIN... it's time to relax.


Here is what relaxing looks like:
- Clean up lunch
- Empty the dishwasher
- Try to eat something myself (click here for ideas)
- Put away the laundry
- Journal / feel guilty about not having journaled for months
- Take a shower
- Check email
- Blog (hey! I'm actually doing that!)
- Make menu for the week
- Make shopping list for the week
- Relax- take some time to myself
-Make muffins/pizza rolls/zucchini sticks for the boys
- Pack lunches for tomorrow so we can to the museum when it opens

And of course... Nap. Because you should always "sleep when baby sleeps".

But really, I wouldn't trade it for the world.
But really, I really need a shower.

Probiotics: the Good, the Bad, and the Buggy

What the heck are probiotics?

The word "probiotic" comes from the Latin, meaning "for life". But does anyone actually know what probiotics are and specifically how they can benefit you? It seems like "probiotic" is the new "electrolyte"- it's a buzzword that gets thrown around haphazardly without much explanation. Well here is the information you need to know.

Probiotics are beneficial bacteria that are colonized in your intestines and help manufacture certain nutrients- B12 and vitamin K, to name a couple. The human intestine actually contains TEN TIMES more bacterial cells than all the other cells that make up a person's body! There are about 500 different strains of bacteria colonized in your intestines, helping your gut to be responsible for 70-80% of your immunity. The entirety of the bacteria and fungal species in an intestine is called the "microbiome".

But how do they work? Think of your intestines as a parking lot. When you take your probiotic supplement all of the spaces are full of pretty, well-maintained cars.



However, you can also use food to increase your beneficial bacteria: fermented foods (sauerkraut, kim chi, dill pickles, yoghurt, miso soup), foods with prebiotics, substances that feed good bacteria (asparagus, leeks, garlic, onions, banana, chicory root) and fiber rich foods, that break down to short chain fatty acids which also support intestinal and beneficial bacterial cells.  Combining a probiotic supplement with beneficial bacteria- promoting food is a great idea!  

But when you don't maintain your gut health, parking spaces get empty, and then filled with old, broken-down cars- whose owners don't care if they knock into everyone else when they swing open their doors. These cars represent harmful (pathogenic) bacteria, which cause intestinal discomfort, increased risk of food poisoning, and increase inflammation- the cause of much dis-ease in the gut and in the systemic body. It may even cause you to be more stressed, as recent research has shown that adequate intake of probiotics may alter how your brain reacts to stressful situations. There is ongoing research examining links between probiotic supplementation and such diseases as eczema, allergies, cold prevention, and oral health.

So how do you know if a probiotic is right for you? Most likely, it is. If you have a compromised intestinal tract, you'll want to discuss with your doctor before starting probiotics, or any supplement. Different types of probiotic supplements may be more appropriate for different people, depending on specific physiology and medical history. Many people are familiar with the idea of taking a probiotic when they are prescribed an antibiotic. This is because the antibiotic kills off the offending bacteria in one's body, but before being absorbed can wipe out much of the beneficial gut in the intestine. Thus it is a smart idea to protect one’s microbiome when on antibiotics and even for a few weeks after the antibiotic prescription is over by putting back into the gut even a few of the most beneficial bacteria.

So what else aside from an antibiotic prescription can compromise your parking lot? Antibiotics consumed in the foods, (meat and poultry), environmental pollutants, too much alcohol, coffee, junk food, refined sugars, over the counter medications (particularly NSAIDS), other prescription drugs like proton pump inhibitors;  the list is getting longer as more research comes out. What are the signs that your gut might be compromised? Recurrent gastroenteritis infections, chronic diarrhea or constipation,  gas/bloating, indigestion or maldigestion, flatulence, anxiety or depression, fatigue, vaginal or anal itching, or even bad breath.

How do you find the right probiotic? You'll want to look for a product that has more than one strain of probiotic. Lactobacillus acidophilus is a very popular strain as it's been linked reducing symptoms of IBS, and may actually have cancer-preventing properties. But it's best to balance it with other types; get a good mix of make and model in your parking lot. Bifidobacterium helps with a variety of functions, from vitamin production to killing pathogens, and it is the key probiotic for children under two years old. One of my favorite supplements for young children is Klaire Labs Infant Formula.

This product provides 10 different strains of probiotic in a ¼ tsp dose! This is one benefit of supplement over food (when usually we focus on diet first and supplements second).  You can see on the label to the left that one 1/4 teaspoon dose of the probiotic supplement provides 10+ billion CFUs (colony forming units; the term for individual cells). A serving of yogurt, 6-8oz, would provide a wide range of probiotics, anywhere from 90 to 500 billion CFUs, depending on the processing.  So, day to day food is excellent but when one is taking an antibiotic of have problematic dietary or lifestyle habits that negatively affect one’s microbiome, a supplement is really needed.

A probiotic can be added to milk (breast milk, formula, or milk alternative). If you want to get creative, add it to lukewarm oatmeal, peanut butter (or other nut butter), cream cheese, yogurt... the list goes on and on (please add your own ideas for delivering probiotics in the comments below)!  Do not add probiotics to hot fluids or foods, as they are living cells, and heat will kill them.  Probiotics will survive for up to 6 months outside the fridge if the temperature is <85F.  They will survive two years in the fridge and 20 years in the freezer.

Many times when I have suggested the addition of a probiotic to an infant's nutrition, the mother seems ill at ease. Dr. Mona Morstein of Arizona Integrative Medical Solutions explains, "Probiotics are indeed in breast milk, but only the ones your white blood cells grab from the lining of [the mother's] intestine.  If you have had any antibiotics, or have any gastrointestinal or digestion upset, or any health problem at all, there is a risk your microbiome may not be 100% healthy.  That is why probiotics should be considered in newborns.  Although breast milk is excellent food, the most perfect food of all for babies, there are many studies showing adding a probiotic to a baby’s nutrition prevents episodes of diarrhea.  Other nutrients shown to help a baby reduce auto-immune diseases and allergic developments are fish oils and Vitamin D3.  A mother can either take those products herself to go through the breast milk, or dose them to her breast-feeding baby. A probiotic for a newborn should contain Bifidobacterium as the main, or at least half the species of bacteria in the product."

Moral of the story: is a probiotic supplement right for you? Most likely. Is it right for you infant, child, and spouse? Probably. Try it out and see how much better you feel.

To find out more, like Baby Bloom Nutrition on Facebook, sign up for the newsletter, and join the Baby Bloom Nutrition Forum. And, as always, create a healthy relationship with food.

For the New Parent- Because your child needs a sane parent!

It can be so difficult...

When you're home with a newborn, whether she is your first or your ninth, to take care of yourself.

People come over to offer their help and you just dot know what to ask for. You would love to ask for sleep, but that means asking your guest to change diapers, vacuum the floor, do the dishes- it all seems like such an imposition. But what if you could just ask them to chop a few carrots? Boil some pasta? Easy enough. Here are a few ideas of things you can keep on hand, food that you can just grab out of your handy IKEA food storage containers and eat while you have a calm moment (or maybe a less chaotic moment).

Of course the first thing that should be at the top of any blog about health is water. Make sure to stay hydrated. Get a big water bottle and keep it filled. Keep it on the counter. Keep it with you. And drink it. Of course I should mention for the new parents out there that it should be filled with water- rather than chocolate milk. Or rum.

Fruit- I won't list the many types of fruit that are just ready to go. Grab an apple, or buy some of those pre-sliced baggies. Eat it whole, or dip it in peanut butter. Or Nutella. I'm not judging. Mmm... Nutella. Actually I prefer Justin's Nut Butter Natural Chocolate Hazelnut. Or you could even buy it in these convenient chocolatey packets. But I digress...

Proteins:

• Cottage cheese- add some berries or sliced fruit
• Hard boiled eggs
• Grilled chicken- I love my George Forman Grill. It's so quick, it's an easy clean-up, and you can use chicken strips over salads, on it's own in the middle of the night, or just when you're on your way from cleaning up one mess to cleaning up another!
• Ground meat- see comments on my George Forman Grill above! I love to add zucchini to my meatballs, burgers, and meatloaf. It boosts the nutrition, lightens the texture, and helps maintain moisture.
• Hummus! If you're feeling adventurous, here is a great guide to making your own hummus! If you realize that motherhood in and of itself is enough adventure for now, I highly recommend the Sabra brand hummus, readily available in many markets. Trader Joe's brand hummus is also very tasty- all flavors. Either way, have a tub in your fridge. It's a great source of fiber, folate, and protein. Dip carrots, cucumber, peppers, or fingers!
• Nuts. In a container. On the counter. High in fiber, protein, and beneficial fats. I love buying the Kirkland Signature Extra Fancy Unsalted Nuts at Costco. Easy to grab, no prep. You can throw them on salad, or just eat a handful at a time.
• Peanut butter. My favorite is Trader Joe's Crunchy Salted Peanut Butter with Flax and Chia Seeds. It has an amazing texture and depth of flavor. Pair it with honey, whole wheat bread, or fingers. Or a spoon if you're trying to avoid a mess. I guess.
• Soup- just in general. You could make this delicious crock pot chicken noodle soup, making sure to use crock pot liners- because who wants to clean up a crock pot? Or you could have premade soup boxes on hand (if you add a pinch of garlic, you can call it homemade). I love the Trader Joe's brand soups. In fact, I just stumbled upon this website, which reviews various TJ's products.
• Tofu is a great stand-by, but you have watch the expiration dates on those packages. They mean business. You can grill it, sauté it, or throw it at the wall in a fit of anger (it makes a satisfying squishy sounds before it breaks everywhere- but then you have to clean it).
• Canned tuna or wild salmon. You want to watch the mercury level in the tuna- stick with canned light tuna. You can read more about mercury levels in this EPA report. You can also read about how canned light tuna is actually skipjack- a biblical cousin of tuna, lower in mercury and less of a sustainability issue in this Nat Geo article.
• Yogurt is quick, ready, nutritious- high in protein and deliciousness. It's creamy and satisfying. Greek yogurt is the highest in protein and calcium because of the straining process. I would recommend Nancy's Organic Whole Milk Yogurt. It's the perfect amount of tangy and creamy. You could add sliced bananas and berries, or you could make lassi, an Indian yogurt drink. You ca have it sweet, or have it magnified. Or you could go totally crazy- check out 12 Creamy and Delicious Lassi Recipes, including savory masala spiced lassi with roasted beets... and vegan mango lassi. Whoa. But I digress again. My favorite sweet treat is the Chobani Flip- specifically the salted caramel crunch (it's very sweet- read: it's full of sugar, a special occasion treat).
• Healthy sliced meats- just grab and go. If it can be difficult to find nitrate-free meats, you could opt to make your own! I know this is supposed to be a list to make your life easier, but this is actually super-easy. You can make a ton at once and freeze it. Or have a friend make a ton at once for you! Just look how easy this recipe is!
• Beans. So much to say here. Check out this crazy Pinterest list of bean salads! Wow! Beans are full of protein, fiber, potassium, iron, B-6, and magnesium! One cup of black beans provides 13% of your calcium for the day. My favorite is chickpeas, also known as garbanzo beans- very high in folate. These recipes for roasted chickpeas are amazing. They are crunchy and so satisfying. You can make a ton and have it on the countertop. One can of chickpeas provides 21 grams of fiber (85% DV), and 21 grams of protein. Think you can't eat a whole can of chickpeas? Try crunchy roasted chickpeas. You can and will.

Vegetables:

• Avocado- slice in half and fill with tuna salad. Or ask your mother in law to make you the smoked salmon egg stuffed avocado. Eat slices on top of sandwiches, eggs, chili. Avocado is high in anti-inflammatory fats, which is so important to you right now. Or always. It's also a great source of fiber, vitamin C, and B-6- which has been proven to help with nervousness, irritability, and depression- but us new moms wouldn't know anything about that!
• Beets- steam, slice, and enjoy! Some enjoy juicing beets- just don't spill! Oh man, this recipe for roasted beets with a citrus dressing looks good too, but it doesn't need to be that fancy. You can pair it with chunks of goat cheese, or just have it as a side dish. Beets are also very high in folate.
• Just sliced: carrots, celery, bell peppers, cucumbers
• Frozen peas- when I'm short on time, I just throw them on my George Forman Grill along with the main dish. You could also do that with sliced yams.
• Green beans- raw in a salad, or steamed, roasted with garlic and slivered almonds. Many vegetables can be roasted- just drizzle with olive oil, salt, and garlic (more spices and herbs if you wish), bake for 12-14 minutes at 400*. It's easy, delicious, and you get to feel the accomplishment of having done something other than changing 25 diapers.
• Mushrooms- slice and include in pasta, eggs, soups or stews.
• Potatoes- bake them whole and stick them in the fridge. Slice and reheat as needed on the George Forman Grill. Potatoes get a bad rap, especially white potatoes. But truth be told, they are a good source of fiber (especially if you eat the skin), potassium, vitamin C, and B-6.
• Squash can be intimidating. It comes in crazy colors and shapes. But generally, slice, dust with olive oil, and bake. The baking time depends on the size, but many squad come with a little recipe sticker attached. Here is a delicious recipe for cinnamon roasted butternut squash. You can buy the pre-cubed squash at Trader Joe's. You can probably halve or completely eliminate the sugar from the recipe too.

Grains:

• Couscous is a fantastic grain from the middle east- it's actually a pasta. My boys call it "baby pasta" and I make it in the rice cooker. I love the Israeli couches because the pieces are larger ad make slightly less mess. You can make it with broth or with water. You can serve it with stew, or you can make a salad out of it by adding carry tomatoes, cucumber, and feta like in this recipe. Couscous and quinoa are actually pretty interchangeable as far as recipes go, but quinoa is technically a seed and has a totally different nutrition profile.
• Instant oatmeal. You can follow the directions, or get fancy by adding almond milk, coconut oil, ground flax meal, and chia seeds. It's easy to store, grab, and prepare. It sticks to your ribs- it will keep you full for a while, so you can worry about chasing around those kids or scrubbing that crayon off the wall (seriously, how many times can you ask your husband to quit that???).
• Pasta is great to keep at the ready. Boil it, mix it up with some olive oil, and keep it in the fridge for a few days. You can heat it up with marinara and add some Trader Joe's soy sausage. You can add some cherry tomatoes, avocado, cucumber, and an olive oil dressing and make it a pasta salad. You can add sliced cheese, eat it in the middle of the night, and pretend it never happened...
• Rice is great as a side dish. You can make brown rice, wild rice (which isn't actually rice), or black rice pudding. It's easy to have on hand. You could also make fried rice with all the veggies your friends chopped up for you- or you could sub the rice for quinoa and make friend quinoa.
• Healthy muffins are a staple in my house. I regularly develop new recipes to incorporate (not hide) vegetables. Muffins can be made in large batches and frozen. So can waffles and pancakes for that matter. You can find some of my muffin recipes on Tandem Trouble (you can also find amazing videos on baby wearing there)!
• You can find a great video recipe for homemade oatmeal bars here. There are so many variations available, but having them on hand and easy to grab might save your sanity. And I'm always in favor of adding in some flax meal!
• Whole wheat bread. I don't think I have much to explain with this one.

A recipe I love for new moms, especially those having trouble keeping up their calorie intake during breastfeeding, is chia seed pudding. Chia seeds are high in fiber, calcium, and zinc- you can read more about the amazing health benefits here. To make chia seed pudding, combine one can of coconut milk (not the "coconut milk drink" commonly found in cartons) with 1/3 cup chia seeds, and a tablespoon of honey or maple syrup. Stir and refrigerate at least 4 hours. It's delicious, fast, easy, makes limited mess, and is a great calorie booster for the breastfeeding mom or for the toddler! You can get really fancy with it too- check out these crazy Pinterest recipes!

Please leave your additions to my list as comments below! This is by no means an exhaustive list, but it's a great place to start!

My Child Wouldn't Eat THAT!

Have you ever said, "My child wouldn't eat THAT"?
What was the "THAT"? Sushi? Spinach salad? Freeze dried beets?
Those examples sounds crazy, but those are actually taken from real life. Mine, in fact.
Chances are, if you're making a statement about what your child would or wouldn't eat, it's more of a statement about what you yourself would or wouldn't eat. We all have likes and dislikes. I don't hide the fact that I can't stand mushrooms and olives- I know! And yes, I have tried black olives and green olives.
Actually, I do hide it- from my children. It's all too easy to pass our likes and dislikes to our kids. But it's a better idea to expose them to a variety of foods and let them decide for themselves which flavors they prefer (and I'm not talking about raising picky eaters- that's a whole other topic). I make sure to give my kids mushrooms and olives when I have the opportunity- they can try them and decide for themselves. But in the meantime, I don't make a big deal of it. I don't watch to make sure they try it. I don't try to analyze their facial expressions for hints of a future full of drama and broken relationships as they try to avoid any establishment offering said offending food item. No one food is that big a deal.
Let your children surprise you. They will have likes and dislikes, much like you do. Their likes and dislikes will likely be different than your's. Think twice before you assume your child wouldn't eat THAT. Because maybe they will, and maybe they will ask for more.

It might be hot, but it's Cold Season!

It's back to school time- that means increased exposure to cold, no matter who you are. If you have kids in school, they will be coming home with homework, drama, and all the little bugs they picked up along the way. If you don't have children in school, you will also be exposed- at the mall, at the supermarket, you name it.

What can you do about it? Proper diet and exercise is proven to help with immunity, but there are some supplements you might also want to consider:

Vitamin D- There have been many studies recently touting the many benefits of supplementation with vitamin D. Taking 500-1,000 IU per day can help boost your immunity. You can get Vitamin D from sun exposure, but many people are deficient- residents of Arizona have among the lowest levels of Vitamin D. Why? The sun is out there and blazing, but people are staying inside, or are covering up with sunscreen and layers of clothing due to risk of skin cancer.

Probiotics- 80% of your immunity comes from a healthy intestinal tract. Taking a daily probiotic can help maintain that gut health by lining the intestines with beneficial bacteria- and by not leaving any space for bacteria which might bring illness or damage. Yogurt and kombucha are great sources of probiotics, but not in the amount you'll get from a probiotic supplement. You'll want to find a supplement with multiple strains for the best protection.

Fish oil- It's been known for a while that fish oil is anti-inflammatory, but more recent studies have shown that oil high in EPA and DHA enhance which blood cell activity, boosting the immune system. As a bonus, the oils help with brain developement in young children.

Multivitamin- In a perfect world, we would get all of our nutrients from food. These days, fruits and vegetables are picked before they are ripe, endure long travel, and therefore have somewhat reduced benefits. Supporting your local farm economy by participating in a CSA (Community Supported Agriculture) can help maximize the nutrients on your plate. Taking a multivitamin is like insurance for your diet- it just helps cover your bases.

Enjoy the weather while you can- and eat your veggies!