ADHD and Growth Concerns
Written by Kaitlin Cushman, Healthy Height's In-House Nutritionist
In the most current survey conducted by the CDC and The National Survey of Children’s Health, 5.1 million children in the United States have Attention Deficit Hyperactivity Disorder (ADHD). For those children ages 4-10 years old, 1 in 15 children have been diagnosed with ADHD (1). Of these children, 3.5 million children are prescribed medication to treat their ADHD symptoms.
The types of medicines used to treat ADHD are amphetamine or methylphenidate based, low dose stimulants. ADHD medications can benefit these children by calming their hyperactivity and decreasing impulsivity. With the benefits of the medications, there are also some hefty side effects, such as sleep problems, decreased appetite, headaches, stomach aches, moodiness, and irritability (2). But here is the tricky part: children are growing and they need adequate nutrition in order to support regular growth. The most detrimental side effect caused by side effects like lack of appetite, sleep problems, and stomach aches is delayed growth. Add on top of that, if a child is a picky eater and is being treated for ADHD with medication, then ensuring the child’s nutritional intake is adequate can be a real challenge.
Let’s dive deeper into why the side effects of ADHD medications are a concern for childhood growth!
ADHD Medication and Lack of Appetite
There are many factors that contribute to a child’s growth. Of course genetics have the largest influence over a child’s height, but making sure your child is eating a diet rich in high quality protein, whole grains, fruits, and vegetables is the best way to help them reach their full growth potential.
If your child is on a low dose stimulant for ADHD and is suffering from lack of appetite, the following are some helpful ways to ensure your child is eating enough:
- Feed your child before giving them their medicine- making sure they eat first will also help prevent stomach aches related to the medication
- Make sure your child always has a high protein breakfast- protein supplies the building blocks for growth
- Avoid unhealthy and sugary snacks- don’t waste their appetite on nutritionally empty foods
- Nutrient-dense protein shakes, like Healthy Height, can replace the lunch that was unwanted
ADHD Medication and Sleep Issues
Some children have issues with falling and staying asleep when taking ADHD medication. However, there are some children who have sleep issues because of their ADHD, and medication can actually help with sleep. Regardless of which is causing the sleeplessness, adequate sleep is crucial to their growing bodies.
When your child is sleeping, growth hormone is hard at work helping them grow tall. At the beginning of the deep sleep cycle, growth hormone is working at its most intense levels. This is why getting your child to sleep and staying asleep is key (3). It is recommended that children ages 3-5 years receive 10-13 hours and children ages 6-13 receive 9-11 hours of sleep each night to promote healthy growth. Additionally, if your child is already struggling with growth, interrupted sleep can compound the issue (4).
If your child has ADHD and is suffering from sleep issues, here are some tips to help:
- A consistent routine and bedtime- this can help put their busy mind at ease
- Keep your child’s room dark, quiet, and distraction free
- Avoid too much screen time right before bed
- Keep activities before bedtime calm to reduce stress- bedtime can be stressful for a child that has problems falling asleep
ADHD and Your Child’s Diet
While there is no dietary treatment or ADHD diet, it is important manage the challenges that come with ADHD to prevent any nutritional deficiencies. You may have heard that there are particular foods to avoid, such as all sugar and food additives. You may also be concerned about specific vitamin and mineral deficiencies. While research has yet to demonstrate that there are specific foods to completely avoid, ensuring your child is not vitamin and mineral deficient is ideal for optimal growth.
Dietarily speaking, there are some good rules of thumb specific to children with ADHD. As discussed earlier, it can be a challenge just to get a child with ADHD interested in eating. But what should your child be eating when you have triumphed over their lack of appetite?
The following are some guidelines for your child’s diet if they have ADHD:
- Avoid sugar spikes: Blood sugar spikes can cause a child with ADHD to become irritable, moody, and stressed. By eating meals that contain protein and fibrous whole grains, rather than sugary foods, your child’s blood sugar levels will be better managed and consequently they will be able to manage their behavior better (5).
- Treating Iron Deficiency: Some research suggests that there may be an association between iron deficiency and children with ADHD. A 2014 study investigating this relationship found that low serum iron, ferritin levels were more prevalent in those children with ADHD. Additionally, iron supplementation has shown to help improve cognitive ability and contribute small improvements to growth. You should speak with your child’s pediatrician before giving your child iron supplements (6,7,8).
- Supplement with Omega-3: A randomized, 3-month, omega 3/6 placebo-controlled showed that some children when treated with omega-3 supplements saw improvement of their ADHD symptoms after 6 months of treatment. While this may not work for every child, there are many other great benefits of omega-3 supplementation (9).
Helping a child with ADHD grow and develop can be very challenging. Utilizing these strategies to help your child grow and acknowledging progress, big or small, can help your child reach their full potential.
1. U.S. Centers for Disease Control and Prevention. Key Findings: Trends in the Parent-Report of Health Care Provider-Diagnosis and Medication Treatment for ADHD: United States, 2003–2011. 2014.
2. Boorady R. Side Effects of ADHD Medication: What to look for, and how to handle them. Child Mind Institute.
3. Norton A. ADHD Medications Linked to Sleep Problems in Kids: Review of studies finds drugs like Ritalin, Adderall may create sleep woes for some. Health Day. 2015.
4. National Sleep Foundation. National Sleep Foundation Recommends New Sleep Times.Nationalsleepfoundation.org. 2015.
5. Newmark S. The ADHD Food Fix. ADDitude: Inside the ADHD Mind. 2011.
6. Bener A, Kamal M, Bener H, Bhugra D. Higher Prevalence of Iron Deficiency as Strong Predictor of Attention Deficit Hyperactivity Disorder in Children. Annals of Medical and Health Sciences Research. 2014;4(Suppl 3):S291-S297. doi:10.4103/2141-9248.141974.
7. Low M, Farrell A, Biggs BA, Pasricha SR. Effects of daily iron supplementation in primary-school-aged children: systematic review and meta-analysis of randomized controlled trials. CMAJ 2013; 185:E791 – E802.
8. Baumgartner J, Barth-Jaeggi T. Iron interventions in children from low-income & and middle-income populations: benefits and risks. Curr Opin Clin Nutr MetabCare 2015; 18:289 – 294.
9. Johnson, M., S. Ostlund, G. Fransson, B. Kadesjo, and C. Gillberg. “Omega-3/Omega-6 Fatty Acids for Attention Deficit Hyperactivity Disorder: A Randomized Placebo-Controlled Trial in Children and Adolescents.” Journal of Attention Disorders, vol. 12, no. 5, 2009, pp. 394-401.