Gut Health for Kids

July 31, 2012 in Categories: , , , by

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(Created as a guest post for The Paleo Parents)

Gut health is essential for overall health.  A healthy digestive tract is efficient at absorbing nutrients from your food, protecting the body from foreign invaders including mounting appropriate immune responses when required, and at regulating a wide variety of hormones.  A growing number of health conditions are being linked to poor intestinal health.  As you already know, the foods you eat can have a powerful influence on your gut health (for more information on how grains, legumes and dairy contribute to a ‘leaky gut’, read this post, this post, and this post).  So, what about kids?  A paleo diet is a fantastically healthy diet for kids, as we consume only the most nutritionally-dense foods (I am very fond of the nutritional analysis presented in The Paleo Diet).  It is also a great starting place if your child requires a focus on healing the gut. 

Many of the recommendations for optimizing adult gut health (as outlined in here and here) are appropriate for babies and younger children.  However, getting a child to eat what you know is good for them can be a challenge!  Also, many of the supplements recommended to promote healthy digestion are inappropriate for children (such as digestive enzyme, hydrochloric acid, and apple cider vinegar supplementation; other supplements such as L-glutamine and quercitin should only be given to your child under the supervision of a medical professional).  So what can you do to help them?  Whether you are looking for strategies to heal your child’s confirmed or suspected leaky gut or are looking for ways to protect your healthy child from developing a leaky gut, here are some ideas for promoting a healthy gut for your child (including some practical tips for pulling it off!).

1. Start Them Off Right:  Breastfeeding your baby is the best way to ensure that their digestive tracts develop a healthy diversity of beneficial bacteria.  However, if you face insurmountable obstacles to breastfeeding or have gut dysbiosis yourself (or if your child requires antibiotic treatment), you may want to supplement with a source probiotics to help their digestive tracts establish this essential probiotic diversity.  I chose to supplement with a small amount of acidophilus for a couple of months before starting my youngest on solid foods (I didn’t know any better for my oldest and I still regret it).  I bought acidophilus/bifidus supplements in capsule form, broke open the capsules and put a tiny pinch of the powder in her mouth before nursing a couple of times a day, starting at about 3 months old.  I bought the highest diversity/quality probiotic supplement I could find and changed brands every time I bought a new bottle (I was taking it for myself at the time, so I went through a small bottle fairly frequently).  Other people achieve the same using fermented foods (for a baby or toddler who can’t chew raw sauerkraut, a little of the “juice” around the sauerkraut can be given on a spoon or mixed in with other foods).  It also helps not to start solid foods too early (typically, the digestive tract isn’t really ready for solids until about 6 months old).  I am a big fan of “baby-led weaning” which essentially means that you don’t start your baby on solids until they are ready to self-feed.  For both of my girls, that was around 7 months old (they could pick up small pieces of cooked vegetable or soft fruit, put it in their own mouths, chew and swallow), but many babies aren’t ready until older than this, and that’s okay!  If you are wondering what foods to introduce first, check out my post on paleo baby foods (this post is written for traditional introduction of solid foods, but the information is also relevant to baby-led weaning).  Don’t worry if your child is older and you missed your chance, because you can still…

2. Sneak Some Probiotics Into Their Diet:  Even after your child is eating solids, a continuous supply of good bacteria and yeast in their diet is good for them, especially if you are trying to restore gut microflora diversity after illness.  You can introduce these in the form of kombucha, yogurt and kefir (I’m a big fan of homemade coconut milk yogurt and kefir), fermented vegetables like raw sauerkraut and homemade pickles, and/or acidophilus supplements (you can continue to break open acidophilus capsules or switch to chewable tablets once your child is old enough).  Frequent small doses are more effective than one large dose, so 1 Tbsp of homemade kombucha or coconut milk kefir mixed in with your child’s food or beverage daily is a great way to go (do keep in mind that regular kombucha does have a small amount caffeine).  This is especially important after any infection requiring antibiotics or steroids and after stomach bugs.  Is this important to do if your child is healthy and you are just looking to prevent problems?  The answer is yes and no.  If your child is healthy now, they almost certainly have a healthy diversity of bacteria growing inside them now.  There is no added benefit to including a probiotic supplement in their diet.  Fermented foods however, are still beneficial as these help feed the good bacteria growing in their guts in addition to adding a much greater variety of beneficial bacteria than typically found in supplements.

3. Include some healing foods in their dietHomemade bone broth is rich in glycine, which is very important for healing the lining of the gut and reducing inflammation (for more information, see this post).  My 2.5-year old loves to drink plain bone broth, but it can also be added to mashed vegetables, smoothies and even homemade popsicles! Organ meats like liver (especially if grass-fed) contain Vitamin D, tons of vitamin and minerals, and more glycine than muscle meat.  Just because you don’t love liver, doesn’t mean your child won’t.  It’s a soft meat and many young kids find the texture more enjoyable than muscle meats.  If your child isn’t a big fan, check out my recipes for hidden-liver meatloaf and hidden-liver Turkish meatballs.  Oily cold-water fish is not only rich in omega-3 fatty acids (the highest omega-3 fish are salmon, mackerel, sardines, herring, kipper, anchovies, trout, fresh tuna, and carp) which helps resolve inflammation, but is also high in vitamin D and selenium.  My 2.5-year old loves brisling sardines and both my kids love poached or baked salmon.  There are dozens of neat seafood recipes out there, from salmon cakes to fish sticks (which could be made with haddock, cod, hake, halibut, sole, flounder, bass or perch which are all moderately high in omega-3), which may entice your child to eat them.  The medium chain triglycerides (MCTs) in coconut oil are known to have anti-microbial and anti-inflammatory properties.  Extra virgin coconut oil also contains a large amount of Vitamin E and other anti-oxidants and is wonderful for cooking just about anything, from paleo baking to scrambled eggs (or even just eating off a spoon!).  Coconut butter can be eaten by the spoonful or added to soups and curry dishes.  Full-fat coconut milk (which can be easily made at home) can be added to smoothies or used to make homemade kefir or yogurtGrass-fed meat (and butter and ghee from grass-fed diary) is rich in conjugated linoleic acid (CLA), a fat known to promote healing, as well as providing plenty of vitamins, minerals and having a balanced omega-3 to omega-6 ratio.  My kids love anything made with ground beef, from Swedish meatballs to tacos!

4. Avoid gut irritating foods, including foods you child has a sensitivity to:  Avoiding grains, legumes, dairy, processed foods and refined sugar will go a long way to improving your child’s gut health.  However, if your child is facing an uphill battle with health, there are some other culprit foods worth eliminating as well.  If your child has signs of Small Intestinal Bacterial Overgrowth (SIBO), you’ll want to limit starchy vegetables (see this post for a guide on which vegetables are okay for SIBO and which are better to avoid).  Another class of vegetables that can cause issues for some people are those high in types of sugar that qualify as FODMAPs (Fermentable, Oligo-, Di-, Mono-saccharides and Polyols).  Continued digestive symptoms after following a paleo diet may indicate SIBO or FODMAP-sensitivity (also known as fructose malabsorption).  There is a high degree of overlap between vegetables that are avoided to address SIBO and those that contain FODMAPs.  If you aren’t sure, try an elimination diet approach where you avoid all vegetables which may be problematic for 3-4 weeks and then slowly try reintroducing them one at a time to see if they cause digestive symptoms.  In addition to these vegetables, other foods may be problematic due to development of food sensitivities (this is common in children and adults with severely leaky guts).  You can evaluate whether or not these foods are problematic for your child using an elimination diet approach (where you leave the suspected foods out of your child’s diet for 3-4 weeks and then add them back in one at a time).  Sensitivities to eggs, nuts, seeds, and vegetables from the nightshade family (tomatoes, eggplants and peppers) are common.  Alternatively, you can find a naturopathic physician or chiropractor who can order a food sensitivity blood test (IgG and IgA).  Any foods that your child tests positive for in a food sensitivity test should be avoided completely for at least 6 months, after which you can reintroduce small amounts to see if the sensitivity persists (many sensitivities will disappear after the gut has fully healed).

5. Play and Have Fun:  Kids need both structured and unstructured play time, both active play and quite, focused play time, and both independent and social play time (with other kids and/or with adults).  Having this mix of different types of play is important for the developing brain, but also helps regulate hormones (like stress hormones, which are particularly important to gut health) and helps tire kids out for a good nap and a good night’s sleep (also critical for healing and staying healthy).  And making sure to take time to have fun with your kids is good for your stress levels too! 

6. Get them outside:  If you read my post on the importance of sunlight, you’ll remember just how important it is to be outside for a good amount of time every day.  For kids, it also provides space to run around and a stimulating environment for their developing brains to explore (you get to play and get sun exposure! Yay for efficiency!).  I aim to have my kids outside for at least 1-3 hours every day, weather permitting (I am a big supporter of playing outside in just about any weather as long as you’re dressed for it!).  Beyond the benefits of fresh air and exercise, sun exposure on their skin is essential for the formation of Vitamin D (you don’t want to let them get sunburned, of course).  Vitamin D is very important for healing and reducing inflammation.  If getting outside is not possible for you and/or your child or if you feel that your child may deficient in Vitamin D, it is worth talking to your doctor about a Vitamin D3 supplement.

7. Provide an environment conducive to sleep:  Sleep can be more or less of a challenge depending on your child.  One book that I really like for gentle sleep strategies for babies is The No-Cry Sleep Solution (also available in a toddler through preschooler edition).  The tips that have been most helpful for me and both of my non-sleepers are:  have a rock-solid routine (not just at bedtime but consistent structure throughout the day), put your kids to bed earlier rather than later (they will often sleep longer if they go to bed earlier), and have kids sleep in a cool, very dark room.  A white noise machine may also be helpful. 

8. Don’t make food a battle:  However you chose to introduce food to your child, whether or not you chose to give your child options or only give them what everyone else is eating, don’t make meals a battle.  This means having a realistic expectation of what and how much your child might eat, of how long they might sit up at the table, and of age-appropriate table manners.  Even if you are taking a firm stance, don’t argue or raise your voice.  Stress and food just don’t mix.  And stress can hinder healing.  Keep in mind that, when given a variety of healthy foods, the vast majority of children will naturally eat what their bodies need.  The two most important things that you can do to help your child learn how to eat healthily is do so yourself and present them only with healthy options. 

As a final thought, I believe you are already doing the most important thing you can to help your child get/stay healthy by learning about how food affects the human body.  If you are unsure how to apply any of these recommendations or whether they are appropriate for your child, please discuss them with your child’s doctor or alternative healthcare provider.


Wow your a busy blogger. It’s hard to keep up!.

My son had an ear infection that left him with a cough only at night for a good 2 months. The Dr. said it was ear that was draining causing the cough.
I suggested to my wife that we attempt to make Kombucha, so we picked up a few bottles from from the health food store. We where gonna use this as our seed to get started, ended up just giving it to both my kids, a shot glass full 3 times the first day. My sons cough disappeared for the first time in 2 months the first day and has not returned. Coincidence?

What do you do if your child (7 yrs old) just refuses to eat? And yes, he has held out a couple of days at a time before. 🙁 We were only introduced to the Paleo lifestyle a month ago. For the rest of the family, it’s going great. For my 7 yr old, not so much. I have tried a variety of clever ways to “hide” the veggies in the meat, etc…but he still refuses to eat. How do I get him healthy without starving him??

Gosh, I’m not sure I have the best answers here. I also didn’t use “let them starve until they eat what’s in front of them” strategy for my kids (very contrary to my other priorities as a parent plus my 5.5-year old would literally starve to death) although I did find that being a little firmer with my 5.5 year old was required–about 6 months ago we changed to the “rule” that she has to eat what is on her plate (and I always make sure to include at least a couple of things I know she likes). With her, the challenge is meat. We still struggle most evenings, but it’s getting easier. I use a combination of reasoning with her “you have to eat protein to grow and be healthy”, thinly veiled threats “if you don’t finish your meat quickly, you don’t have time to play before bedtime”, and bribery “once you’re done your meat you can have a green popsicle”. We tried giving her her leftover supper for breakfast once, and that didn’t work very well. Finding more meat options that she likes has been tremendously helpful, but she is also slowly developing a taste for these new foods (I think getting her 6-year molars is helping her chew them). I guess I use a combination of patience, trying to find foods she likes, and rules/discipline (framed as positively and unconfrontationally as possible). I’m not sure that helps, except maybe to day that it’s a process. We’ve been working on this for 6 months are are seeing slow, gradual improvement.

My family is mostly paleo at this point. We are very new to this and none of us have any noticeable food allergies. I do allow an exception though…dairy. My kids are 2 and 4 years old. My 2-year old still insists on drinking milk every morning. My 4-year old sees her brother drinking milk and so she wants it too. I also allow them to have plain greek yogurt, cottage cheese and string cheese (all from organic/grass fed sources). Because they are young, I am afraid to phase out dairy for the uses of calcium, and nothing more. I know there are other sources of calcium but my son is picky so I’m worried that he will be calcium deficient. Any thoughts on this? Thank you.

I have to admit that I am really on the fence about dairy. I don’t tolerate it myself and I am currently trying my kids without it (but may reintroduce it in the future, I’m still trying to figure that out). I think that if your kids are healthy, and especially if you are finding organic, grass-fed sources, that it should be fine for them to consume dairy (the discussion is different if they are having any health or behavioral issues).

A great summary of the pros and cons of dairy is this post by Chris Kresser: Also, if you have a look at or, there are some great pro raw grass-fed dairy arguments (which can be contrasted with Prof. Cordain’s arugments against in The Paleo Answer).

Thank you so much for your reply and for sharing the post. I will definitely read it and consider my options. My kids have absolutely no food allergies (nor has anyone else in my or my husband’s family). I removed grains/refined sugars from their diet because I they add no value, but dairy has some value that I feel like is especially important at their age.

If at any time they start to show health or behavioral issues, I will definitely remove it and see how they do.

Thanks again!

I just found your website and I am blown away by the quality and quantity of information here. I will stick around here for a while, to read all your posts.

Your article mentioned about adding probiotics, and I am aware that they are good for you. However, my kids seem to be intolerant to probiotics even the most common strains. I had tried giving them many tries but they seemed to react to it every time. The most common reaction is highly emotional, depressed, and moody. Both my son and my daughter reacted similarly. I want good bacteria in their bodies but I don’t know why their bodies seem to react adversely. What can I give in lieu of probiotics supplement? I tried natural probiotcs such as fermented veggies, kefir, yogurt but similar issues arouse, but lesser in severity. Please advice.

Good job noticing those reactions! Most people wouldn’t draw the link. It might be a yeast sensitivity or maybe something like a histamine sensitivity. I would just suggest focusing on prebiotic foods (whole fruits and vegetables), and other nutrient dense foods (fish, organ meat). If you can get organic local and fresh produce, a great source of probiotics is eating it without washing first. Playing outside and in the dirt is another great way to get exposed to beneficial organisms. I love the soil based probiotic Prescript Assist for adults, but it hasn’t been tested in kids, so I’m very hesitant to recommend it. Another great option would be to look at probiotic moisturizers, soaps and cleaning products (we use Chrysal in our home, not cheap but awesome). It basically loads your environment with beneficial bacteria, which helps control the growth of pathogenic bacteria and increases casual exposure instead of having to take a supplement.

So glad to see this as it has been on my mind lately. I have lost weight going Paleo (2.5 years now) and yet I do not want my kids to lose any weight at all. In fact, I am trying to get them to gain a little because they are so petite (but very active and healthy). Do I keep grains in their diet to keep them from losing pounds or stick to paleo for them and hope that they will not drop in their weight?

Hi My 8 year old son was diagnosed with Celiac disease , IBS & leaky gut last June.Its not just gluten he reacts to, its also fish, eggs, soya, nuts , grains, legumes, vegetable oils and dairy. Fruit and Vegetables also have to be kept to a minimum as he has bowl and nerve damage & fibre causes incontinence. Due to these challenges he eats a lot of red meat, duck , pork and chicken. How healthy could this be?

It’s too bad about the fruit and vegetables. Does he tolerate them better cooked? or in smoothies? If not, I think this is a time where vegetable juices can make a big difference in terms of nutrition. I would also encourage you to add some organ meats for the different amino acids, vitamins, and minerals they have compared to muscle meat.

Thanks Tamar for the response. Yes, healthy fats are the main food group in our house and yet I still have lost weight without the carbs, which is what I want to avoid with my kids. But the article you linked to is very helpful. Thanks again!

My daughter is 15 (just turned in May). Over a year ago, she was experiencing severe dizzy spells and was extremely exhausted. We went to several doctors and none could really give her good direction on what was going on. She started the paleo diet a year ago and it really helped her symptoms. She only gets dizzy spells once in a while. But, she still have aches and pains in her joints, a lot more than a 15 year old should, and she is also quite fatigued and has irregular periods. We can’t afford a naturopath because the only ones in our area are at health spas and they cost thousands of dollars for an initial consult. So, we’ve been playing with her diet and with supplements. About a week and a half ago, she started the autoimmune protocol with me (I have autoimmune issues too, and I haven’t been able to lose weight even though I’ve been paleo for a year). She says she feels really healthy and I actually saw her dancing around the house yesterday (yay!). I lost 5 pounds in the last week (yay again). The question I have is: is the AIP too low carb for a teen girl? She eats bananas and sweet potatoes and fruits like apples and peaches, but I worry that she won’t get what her body needs as a developing girl. This has never been something I’ve forced on her, but she’s very determined to get control of her health. Thanks in advance for your reply.

The AIP is fine for all ages. You can play with your carb intake by eating more or less fruit/starches, but Sarah doesn’t recommend more than 20g of fructose per day. – Christina, Sarah’s assistant

– I forgot to ask: I plan on doing reintroduction of foods after 8 weeks. How long should I keep my daughter on the AIP before I reintroduce foods?

Hi – my 7 year old daughter has been constipated on the AIP regime. Today the stool was very dark. It reminded me of when I was taking iron tablets. Could eating so much iron-rich meat and offal cause constipation? I’d like to think not! She also eats fish and seafood, broth, a little daily kefir and some fermented veg a few times a week.

She is very happy with the food, eats a ton of veg and greens. It is never a struggle to get her to eat what you recommend. We have been eating this way for two or three months now. I am still very constipated and have just cut out FODMAP and starch foods to see if that helps. Should I try that with my daughter?

Thank you in advance

Also, regarding my daughter above. She hasn’t been constipated the whole time just now and then. This week has been the worst week. The other thing I have noticed is that her mood has changed. She has become challenging this week, argumentative, surly, aggressive. I would previously associate this behaviour with a food reaction such as food colouring. I have been assuming that it must be something else causing her to behave like this, but it occurred to me today that I have been letting her try tomato this week. One cherry tomato every other day and two today. Have you ever heard of tomato affecting a child’s mood/behaviour/constipation? It’s so extreme. And hard to figure out all the possibilities. Could be a coincidence each time I think she might be reacting to something..

Sure, it could be the tomato. Any food at all can cause a reaction if your child is sensitive to it, and it’s really something you don’t know until you eliminate the food and then reintroduce it. – Christina, Sarah’s assistant

I’m curious about using l-glutamine as part of our protocol to heal our daughter’s gut. Is there a brand you recommend?

Thanks for this post!
My 2 year old started developing gradual eczema behind her knees at 20 months. 6 weeks ago, something drastically changed (she was with her grandparents for 2 weeks while we were on our honeymoon). We came back to full on eczema behind her knees, and a belly/back rash.
I immediately put her on gluten free diet; and dairy free for 2 weeks now.
We did food sensitivity testing and genetic testing. Sure enough, sensitive to grains and goat milk (but not cow milk interestingly enough). Prior to this, she’s been raised via the Weston price suggestions, and we really didn’t introduce grains until about 16 months. She’s also hetero for MTHFR if you’re familiar with that. Her dads side of the family has lots of seasonal allergies and asthma, tho no eczema. My side is clean 😉
My question is, how long will it take for me to start seeing some progress? I think we’re heading in the right direction (the stomach/back rash is mostly gone and knees are not as red and angry). I know we’re working on healing her gut, but is this a year long process? What’s your experience with healing kiddos?
It’s also more challenging b/c she can’t really tell me what’s going on, or if she’s feeling different. I have to just go on my observations. I have noticed that when we started her on kombucha (that she loves), she gets wet burps sometimes followed by hiccups. Should I be doing some digestive enzymes? Is there a food source for that? She’s never had constipation problems. We’re staying away from sugary foods, citrus and eggs as well.
She does drink bone broth, takes Probiotics, borage oil, anti-histamine support and methylated supplement. We’ve always been an organic family, eating a wide variety of foods. Which makes this even more frustrating!



When my daughter was a toddler, we worked with a holistic nutritionist to heal her gut. Some of the supplements she said to give her were L-glutamine (1750 mg 2xday) and more recently, some papaya digestive enzymes. You mention these may not be safe for kids. Can you tell me more about this?

I’m just starting to explore your blog, and really love it. We healed my daughter’s gut problems, now I”m getting ready to work on my own so this has been really helpful.

Sarah, I have read your blog for years and own your books, the information provided has always been encouraging and evidence based on my healing journey from Celiac. Thank you. PLEASE HELP ME WITH MY 7 YEAR OLD SON! He has a severe salicylate sensitivity, that despite avoidance of salicylates and supplementation with fish oil (helpful) and enzymes, continues to get worse. We have been at this for 4 years. He eats 100% gluten free (but not grain free!) and 90% home cooked real foods and rarely any dyes and preservatives. He reacts with extreme inattentiveness, behavior swings, night waking, and irritability from eating nutrient dense vegetables and fruits like tomato, apples, peppers, broccoli, spinach, berries, and even foods like coconut oil and olive oil. His list of NO foods is so long. I give him bone broth, probiotics, and high quality liquid vitamins and minerals for years to try and heal his gut and increase his tolerance to these foods. No go. What do I try next? I have a feeling the grains need to come out (Paleo or GAPS) for some time, but is there anything else I can do? There is SO LITTLE information on the internet about this, and I trust your research and insights. If you can post more (beyond what you have already written about) on any research into salicylates, histamines (my issue!), oxalates, and other food chemical sensitivities, I think you would reach thousands of us who feel lost in this maze. Thank you so much!!

I have a type one diabetic daughter (recently diagnosed). We enjoyed eating paleo(ish) but now her endocrinologist team is encouraging me to give her a much larger amount of carbs than we are used to eating. I am having trouble making 40 percent of her diet carbohydrates. Any thoughts?

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