The human body is often described as a well-oiled machine, where each part has a specialized function that contributes to the overall function of the machine. But when one part is damaged, the entire machine can stop working – and it’s often the smallest piece that has the biggest impact.

One of those small but mighty pieces is the gut microbiome – an ecosystem of microbes living inside your intestines. These microscopic organisms include a multitude of different bacteria, viruses, fungi and parasites. The gut microbiome dictates how food is digested and absorbed, how the immune system works, as well as how we feel, think and behave. (If you’re looking for an excellent way to explain this to children of all ages, check out A Garden in Your Belly by Masha D’yans – I highly recommend it!)

When these gut microbes are healthy and balanced, we are healthy and balanced and able to function at our best. However, when this balance is off (gut dysbiosis), that well-oiled machine starts to break down and has been linked to just about all childhood conditions from reflux and asthma to behavioral problems and insomnia and everything in between.

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Gut Health Starts at Day 1

The foundation of your child’s gut microbiome is laid from the moment they were conceived until they’re about 2 years old. These critical first 1,000 days shape your child’s microbiome for the rest of their life, as well as their temperament and future immune, physical and psychological health.

Now, if your child is over the age of 2, don’t panic! Yes, the gut microbiome is more stable and more difficult to change after this age, but it is never too late to create a healthy gut – it just might require a little more creativity and persistence.

Building a Healthy Gut

As a dietitian, gut health is at the forefront of my mind, especially when it comes to my children. While I try to lay healthy foundations for them, it’s hard in our modern society full of ultra-processed foods, inactivity and stress.

Earlier this year, I discovered Dr. Elisa Song’s book, Healthy Kids, Happy Kids: An Integrative Pediatrician’s Guide to Whole Child Resilience, and immediately wished this gem was out a decade ago before my first child was born. Dr. Song redefines “normal” for children with a personalized root cause approach to medicine. The book is beautifully laid out, weaving science with practical suggestions that any family could adopt.

These practical suggestions are broken down into 5 simple steps – each of which work together to build a balanced, strong gut microbiome. These do not need to be followed in order. Start with 1 or 2 strategies that are attainable and won’t become a battle with your child. Then build from there as your family is ready.

1. Nourish

Let’s start with food – one of the most direct ways to build up (or break down) your child’s gut microbiome.

Eating a variety of minimally processed, colorful foods, provides the gut with everything it needs to grow and thrive. However, other foods and ingredients can have the opposite, unwanted effect.

What foods should your child eat?

Eating the rainbow and adding more whole grains, fruits and veggies will boost your child’s intake of fiber and phytonutrients. These compounds come from plants and directly support gut health.

Fiber acts as food for the gut microbiome and helps ensure regular bowel movements. Depending on age and gender, children need 25-40g of fiber every day. The more processed a food is, the less fiber it contains. For example, 1 medium apple with skin = 4g fiber; ½ cup applesauce = 1.5g fiber; 4oz apple juice = 0g fiber. Therefore, shifting away from processed foods will naturally increase your child’s fiber intake.
Phytonutrients and polyphenols reduce gut dysbiosis, lower inflammation and help the good microbes thrive while kicking out the bad guys (and doing lots of other amazing stuff). Phytonutrients are what give plants their color so more color = more phytonutrients. Use this rainbow checklist for inspiration on new fruits and veggies to try. Then play a game with your child and count how many colors they eat each day.

And we can’t forget about fermented foods (yogurt, sauerkraut, miso, natto, kimchi, tempeh, etc.) with their famous gut balancing benefits that increase microbiome diversity and enhance immune function. Yes, these may be a harder sell for some kids, so start with a very small amount and keep trying! Exposure, exposure, exposure.

What foods should your child limit or avoid?

If your child isn’t the most adventurous eater or not quite receptive to eating more broccoli and sauerkraut just yet, it may be helpful to focus first on things to limit or remove from their diet.

Some of the worst gut disruptors are sugar, sweeteners, food color, additives and glyphosate.

While it’s nearly impossible to fully avoid all of these ingredients, you can start to chip away at them by:

Eating more whole, minimally processed foods.
Carefully reading labels and ingredients lists.
Choosing organic when able (follow the Environmental Working Group’s guide).

2. Hydrate

Water helps regulate body temperature, transports nutrients, cushions joints and, very importantly, helps you poop! Constipation is never fun, but beyond the physical strain it causes, constipation has also been associated with changes in gut microbiome diversity and function.

How much water does your child need?

As a general guideline, aim for ½ ounce of water for every pound of body weight. For example, if your child weighs 40 pounds, they should be drinking at least 20 ounces of water every day.

Try these tips to ensure your child stays hydrated:

Drink a glass of water first thing in the morning.
Use a cool water bottle.
Refill the water bottle as soon as it’s empty.
Drink with a straw.
Infuse water with lemon, lime, pineapple or other fun produce.

Note: Sugary drinks like fruit juice and soda DO NOT count towards your child’s daily hydration. As mentioned above, sugar and sweeteners negatively impact the gut microbiome and should be consumed in moderation, if at all.

3. Move

Physical activity is good for overall health. It can improve mood, increase brain health and cognition and lower risk for almost all major illnesses. Exercise also helps improve the health of your gut microbiome by creating a better balance of good to bad microbes.

But there’s a kicker – you have to keep moving to sustain the beneficial changes to gut microbiome diversity. Once you stop exercising, the changes appear to start reversing.

How much exercise does your child need?

Recommendations vary slightly by age, but in general, children should participate in moderate-to-vigorous physical activity for at least 60 minutes per day.

Not necessarily 60 consecutive minutes, but 60 minutes collectively throughout the day. This could look like: playing during recess for 20 minutes, jumping on the trampoline for 10 minutes and participating in dance class or soccer practice for 30 minutes.

When it comes to intensity level, your child’s heart should be pumping and breathing a little harder than normal – able to talk but not sing.

4. Sleep

The gut microbiome plays a big role in sleep regulation. It is responsible for producing many neurotransmitters, including serotonin and melatonin, which are essential for good sleep.

Interestingly, our gut microbes also have their own circadian rhythm. When you get enough quality sleep, your gut microbiome’s rhythm is also optimal and it can continue functioning as it needs to. However, when your sleep is off, your gut microbiome’s is too. Even as little as 2 nights of sleep deprivation has been shown to decrease good gut bacteria and increase harmful gut bacteria. And sadly, recovery isn’t that quick, taking up to a week to get back to baseline.

How much sleep does your child need?

Newborn (0-3 months): 14-17 hours
Infant (4-12 months): 12-16 hours (including naps)
Toddler (1-2 years): 11-14 hours (including naps)
Preschool (3-5 years): 10-13 hours (including naps)
School Age (6-12 years): 9-12 hours
Teen (13-17 years): 8-10 hours
Adult (18+): 7+ hours

If sleep is a struggle, try some of these tips to make bedtime more manageable:

Work backwards – figure out what time your child needs to be up in the morning, then move the clock back to get the minimum recommended sleep (see list above) to determine a good bedtime.
Start bedtime routines early, allowing plenty of time for bath, books, snuggles and falling asleep.
Stop screens at least 1 hour before bedtime.
Take a warm bath, adding a little Epsom salt if desired.

5. Breathe

Stress activates the sympathetic nervous system – otherwise known as fight or flight mode. When stress is resolved, the parasympathetic nervous system and vagus nerve kick in, restoring balance. With chronic stress, the sympathetic nervous system dominates, creating an imbalanced system that sets off a cascade of negative health effects. And the gut is not immune to those effects.

In fact, chronic stress is a top gut disruptor. Stress (perceived or real) has a negative impact on the gut microbiome, creating an unfavorable ratio of good to bad bacteria. On the flip side, having a rich diversity of gut microbes optimizes vagus nerve function and heart rate variability. A healthy gut supports a healthy vagus nerve, and a healthy vagus nerve supports a healthy gut. It’s a two-way street!

Now, we can’t (and shouldn’t) completely shield children from stress (no matter how much we wish we could). The absence of stress can cause children to be bored and unmotivated, while too much stress can lead to feelings of overwhelm and anxiety. However, a healthy amount of stress will allow children to develop resilience and perform at their best – aka “be in the zone.”

How can you help your child effectively manage stress?

Breathe! More specifically, pause and slowly breathe while engaging your heart and mind – not just respiration. This mindful breathing has been shown to improve vagus nerve function and heart rate variability, reduce anxiety, depression and anger, increase focus and positivity, and promote better sleep. And optimizing vagus nerve function and heart rate variability can improve your child’s gut microbiome – independent of diet! How powerful is that?

Mindfulness is an active awareness of what’s happening in and around you. It’s being fully present in the moment. While it only takes a minute or two, it does require practice. Try these techniques to cultivate mindful breathing:

Read My Magic Breath with your child and practice in real life.
Do belly breathing (this video sing-a-long was a favorite in my house!).
Gently and slowly blow bubbles.
Try box breathing.

And I can’t talk about building a healthy gut without mentioning antibiotics. While lifesaving, antibiotics are equal opportunity players when it comes to bacteria, wiping out both the good and the bad. Refer to Dr. Song’s book and have a discussion with your child’s pediatrician about appropriate antibiotic use and ways to restore the gut microbiome after taking antibiotics.

"All Disease Begins in the Gut"

...Hippocrates said it best over 2,000 years ago. The gut truly is the foundation for lifelong health. It’s never too late to build a strong foundation, you just have to start somewhere.

What one gut health boosting strategy will you start implementing today?

Peanut Butter Almond Flour Muffins

Makes 10 muffins
PRINT RECIPE

Ingredients
2 ripe bananas
1 egg
1-2 Tbsp maple syrup (optional)
⅔ cup natural peanut butter
¼ tsp vanilla extract
1 cup almond flour
¼ cup unflavored protein powder
½ tsp baking soda
chocolate chips (optional)

Directions

Pre-heat oven to 350ºF.
Mash bananas in a large mixing bowl.
Add egg, maple syrup (if using), peanut butter and vanilla, stirring to combine.
Stir in almond flour, protein powder and baking soda. The batter will be very thick.
Fold in chocolate chips (if using).
Pour batter into silicone muffin pan.
Bake in oven for approximately 20 minutes, or until a toothpick inserted into the middle comes out clean.

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