FLCCC I-Care for Kids: Prevention and Treatment Protocol in Children and Adolescents (2023)

Most children with COVID-19 handle the virus well and recover fully. Despite a lot of fear-mongering, COVID is not a deadly disease for most children. In fact, data show that the death rate is extremely low in patients under 17 years old. This guide aims to help you understand the real risks and know how to respond. The best thing you can do is focus on making sure your child is healthy overall and that their immune system is strong and robust.

Recommended Therapies

Here's the summary (details and dosing below):

  • Vitamin D: Adequate Vitamin D levels help our bodies fight inflammation and boosts immunity.
  • Vitamin C: An excellent antiviral that protects against a wide variety of viruses including COVID-19.
  • Vitamin A: Found in red, yellow, and orange vegetables and a main component in cod liver oil.
  • Zinc: Strengthens innate and adaptive immunity and inhibits the virus from entering cells.
  • Ibuprofen: Reduces fever, treats aches, and fights inflammation. Do not use for low-grade fever.
  • Quercetin: Kills the virus, and is a potent antioxidant and anti-inflammatory.
  • Probiotics: Helps train the immune system to attack pathogens (rather than itself).
  • Ivermectin: Clinical experience shows ivermectin to be safe and effective in children.
  • Melatonin: A potent antioxidant with important anti-inflammatory effects.
  • Essential oils: Do not ingest; diffuse in the room or apply topically to the skin.

Vitamin D

The American Academy of Pediatrics recommends 400 IU of Vitamin D per day for infants younger than 12 months and 600 IU per day for children/adolescents. Breastfeeding infants should be given daily Vitamin D supplementation until they are fully weaned and drinking fortified milk.

Many functional and integrative clinicians think these guidelines are too low to address issues of mood, prevention of other diseases, and optimal immune function. Ideally, we recommend supplementation to achieve blood levels of 50-80 ng/dl. Since blood levels are dependent on sun exposure, diet, latitude, skin color, obesity, socioeconomic status, and individual genomics, it is difficult to recommend doses that will be optimal for every child. However, as a general rule, this is a good place to start: 

  • 0-12 months: 800 IU per day 
  • 1-5 years: 1500 IU per day.
  • 5-12 years: 2000 IU per day 
  • 12-17 years: 3000 IU per day (or 4000 IU per day once adult size is reached)

Vitamin C

Vitamin C is an excellent antiviral and protects against a wide variety of viruses including COVID-19. It is also a spectacular antioxidant, combatting the oxidative stress that happens when children are sick, hurt, or stressed. Vitamin C is found in red, orange, and yellow fruits and vegetables, so a healthy diet is crucial to providing Vitamin C sources.

Dosing recommendations vary, and many official recommendationsx xi are lower than what some functional and integrative doctors would use in their clinical practice. FLCCC recommendations for daily intake are as follows: 
  • 0 to 6 months 40 mg 
  • 7 to 12 months 50 mg 
  • 1 to 3 years 15 mg 
  • 4 to 8 years 25 mg 
  • 9 to 13 years 45 mg 
  • 14 to 18 years 75 mg 
When children are sick, they may benefit from higher doses. We often recommend 500- 2000 mg/day when children are sick because they benefit from the antioxidant effects. Vitamin C is a water-soluble vitamin, so any excess will be excreted in the urine. Note that when Vitamin C is given as an oral supplement, some children may develop diarrhea if too much is given at one time. 

Vitamin A

Vitamin A is an excellent antiviral that has been used to successfully treat measles, and it is found in red, yellow, and orange vegetables. It is also one of the main components in cod liver oil (in addition to Vitamin D and Omega-3 fatty acids). Our recommended dosages are as follows: 
  • 0 to 6 months: 400 mcg/1300 IU 
  • 7 to 12 months: 500 mcg/1600 IU 
  • 1 to 3 years: 300 mcg/1000 IU 
  • 4 to 8 years: 400 mcg/1300 IU 
  • 9 to 13 years: 600 mcg/2000 IU 
  • 14 to 18 years (boy): 900 mcg/3000 IU 
  • 14 to 18 years (girl): 700 mcg/2300 IU 

Zinc

Many children are deficient in zinc, which strengthens innate and adaptive immunityxii and inhibits viral entry.

Food sources of zinc include oysters, clams, nuts, and seeds — foods that most self-respecting toddlers and children do not eat often. Zinc has an impact on appetite and is often lacking in the diet of picky eaters. Correcting via food intake alone may be challenging, so zinc supplements may be a good option. Zinc supplements should be given with food since children sometimes feel nauseous if it is given on an empty stomach. Zinc and copper maintain a see-saw relationship. 

When zinc is low, copper tends to be high. When children are deficient in zinc, supplements do not typically bother them. But after their zinc stores are replenished, they may start to be disturbed by a metallic taste. If this happens, decrease or stop giving zinc supplements. 

Dosing guidelines: Give one dose close to bedtime, since it is valuable for the detoxification processes that happen during sleep. 
  • Under 5 years old: work up to 5- 10 mg twice a day, given with food 
  • 5-12 years old: most children can tolerate 10-15 mg twice a day, given with food 
  • 12-18 years old: doses of 20-25 mg twice a day with food is usually well tolerated. 

Quercetin

Quercetin, a mast cell stabilizer that prevents the release of inflammatory cells and histamine, has direct virus-killing properties against the virus that causes COVID.xiv It is a potent antioxidant and anti-inflammatory agentxv that is usually well tolerated in children. A flavonoid, quercetin is found in many fruits, vegetables, seeds, and nuts. Rich sources include berries, onions, shallots, tomatoes, and Brassica vegetables like broccoli and Brussels sprouts. Supplements should not serve as a substitute for a nutrient-dense diet. Due to a possible interaction between quercetin and ivermectin, if you are giving your child ivermectin we suggest staggering the doses so one is given in the morning and one at night. Reasonable starting doses for pediatric patients follow, but doses can be doubled in consultation with your pediatrician and based on your child’s circumstances. 
  • 2-4 years: 50 mg daily
  • 4-8 years: 50-100 mg daily 
  • 8-12 years: 100-200 mg daily 
  • 12-18 years: 200-400 mg daily

Probiotics


The gut is the seat of the immune system in children; the microbiome they develop in the first 1,000 days of life can have major implications for their health as adults.

Probiotics help train the immune system to attack pathogens (rather than itself) and inhibit the growth of microbial pathogens. The composition of gut flora evolves as the child grows. Therefore, for infants, we recommend probiotics that correspond to the composition of gut flora in breast milk (which provides abundant lactobacillus and bifidobacterial). Probiotics come in powders for infants, which can be sucked off a finger or mixed in soft foods. 

Toddlers can use powders or chewable tablets, which tend to be tart. Older children can swallow capsules. As always, supplements should not substitute for a diverse, nutrient-dense diet. 

Good sources of probiotics and prebiotics include Kefir, low-sugar yogurts, and fermented foods like pickles and sauerkraut. Children who are exposed to tart and savory foods in infancy are more likely to enjoy those foods later, compared to babies who are mostly offered the sweet foods they innately prefer. 

Note that children with less diverse gut flora or with a history of Caesarean section birth, early antibiotic use, or lack of breastfeeding, are more at risk for chronic illnesses later.


Melatonin


Melatonin is a potent antioxidant with important anti-inflammatory effects. In young children who cannot swallow the extended-release pills, the shortacting forms can be associated with nightmares and rebound night wakening about 4-6 hours after sleep onset. If it is given at night, extended-release formulations are preferred if the child can swallow pills. Multiple studies in adults have shown melatonin beneficial in treating COVID, but pediatric studies are lacking. However, a robust body of literature about the use of melatonin for sleep disorders in children with neurodevelopmental disorders, including ADHD and Autism Spectrum Disorder, shows safety and efficacy. A good starting dose for pediatric patients is 0.5 to 1 mg/kg/dose. 

Dosing should be flexible depending on how the child responds and whether they have side effects. Doses can be increased as follows: for infants (1 mg), older children (2.5–3 mg), adolescents (5 mg), and for children with special needs (0.5–10 mg) irrespective of age.xxiv The most common side effect is morning sleepiness. Other side effects reported in the package insert include headache, dizziness, and diarrhea. 

Melatonin might be particularly indicated for children with autism since they often have disrupted melatonin production and may have lower baseline melatonin levels. Children with autism frequently have ongoing inflammation and high levels of oxidative stress,xxxi so the anti-inflammatory and antioxidant effects of melatonin may be particularly helpful in resolving COVID-19 symptoms. 


Ivermectin


Children in many countries around the world receive ivermectin regularly as a dewormer. Experience suggests that the medication is safer than aspirin. Safety and effectiveness in pediatric patients weighing less than 15 kg (33 pounds) have not been established, according to the package insert, although one published paper suggested it is safe under 15 kg.

This body weight limitation would apply to children on average less than 3 years old, who usually tolerate COVID quite well and may even be asymptomatic. While the FDA has not approved ivermectin to treat COVID-19 in pediatric or adolescent patients, our clinical experience, as well as the analysis of worldwide data of efficacy in multiple populations — coupled with our dissection of the flaws of trials that did not show ivermectin to be effective against COVID-19 — lead us to conclude that ivermectin is safe and effective in the prevention and early treatment of COVID-19 in children. For pediatric dosing guidelines, we extrapolate from dosing recommendations for use against parasites. 

Most studies in pediatric patients use doses of 0.2-0.3 mg/kg/dose for parasite treatment. Ivermectin in pediatric patients has been shown to be safe in doses up to 600 mcg/kg/day. Continuous high-dose ivermectin has been shown to be safe in children with leukemia.xx Case reports of ivermectin toxicity in children show neurologic symptoms with full recovery at a dose of 30mg/kg (100 times the usual dose).

Empirical experience by many integrative and functional medicine practitioners leads us to feel comfortable with dosing ivermectin at 0.4 mg/kg/dose for 5 days as early treatment in at-risk children. The side effect profile is less concerning than most other drugs we prescribe. For prevention, we recommend weekly dosing at 0.4 mg/kg for most vulnerable children. This can be modified based on exposure patterns and caseloads in the child’s community. 

For prevention, FLCCC recommend weekly dosing at 0.4 mg/kg for most vulnerable children. This can be modified based on exposure patterns and caseloads in the child’s community. For post-exposure prevention, give an initial 0.4 mg per kg dose then repeat a second dose in 24 to 72 hours. The package insert recommends taking on an empty stomach with water. However, higher ivermectin levels are obtained when taken with a fatty meal, xxii which is what we recommend for COVID. 

Children who might benefit the most from early treatment with ivermectin include those who have chronic conditions like obesity, diabetes, or chronic lung and heart disease. Note: The American Academy of Pediatrics does not recommend its routine use in children for COVID at this time.

 

For Special Circumstances

  • Hydroxychloroquine: Not needed in most cases; decision to use in selected high-risk individuals would involve informed consent discussions between the clinician and family.
  • Azithromycin: Azithromycin is formally recommended for certain bacterial illnesses and has the advantage of indications down to the age of 1 month. Its value in the treatment of COVID-19 is related to its role as a zinc ionophore, which means it allows zinc to enter cells. In July 2020, there was a call for studies utilizing azithromycin at the first signs of COVID illness, but there is little in the published literature about COVID and azithromycin and children. Most protocols that utilize azithromycin for pediatric patients use the standard dose of 10 mg/kg/day for 1 day, then 5 mg/kg/day for 4 days; maximum dose 1.5 gm total dose.
  • Asthma medications: Children with asthma are at higher risk of complications from COVID infection. When COVID is circulating, it is wise to make sure that your asthmatic child keeps taking any controller medications (such as inhaled steroids) and has refills of any rescue medications (like albuterol).
  • N-acetyl cysteine (NAC): Helps promote detoxification.
  • Omega-3 essential fatty acids: Excellent anti-inflammatories.
  • Mouthwashes and nasal sprays: Have not been studied in children with SARS-CoV2.

Not Routinely Recommended

  • Acetaminophen in repeated doses: this can cause suppression of glutathione, which is important for proper immune balance, good detoxification, regeneration of gut epithelium, mitochondrial function, and as the major intracellular antioxidant. Too much acetaminophen can cause liver damage. Avoid repeated doses over the course of several days
  • Antihistamines
  • Antibiotics early in the illness
  • Decongestants
  • Cough suppressants
  • Aspirin for fever: this is associated with potential Reye’s syndrome, a rare but serious condition that most often affects children aged 6-12 years old with viral infections. Aspirin use has been correlated with swelling of the liver and brain and altered neurologic status that characterizes Reyes, so we do not recommend it for routine fever control. However, in cases of blood clotting and hyperinflammation after the initial viral load phase, baby aspirin once or twice a day can be very helpful.

What to do when your child has COVID

Lifestyle measures like excellent nutrition, good sleep, and being exposed to pets and good old-fashioned dirt will help modulate a child’s immune system so they can appropriately respond to viruses and infectious agents.

We also recommend:

  • Regular handwashing with soap and water: Upper respiratory viruses are often spread when a child touches infectious material and then touches their nose or eyes, inoculating themselves with the virus. Frequent handwashing can interrupt this cycle.
  • Playing outside in nature: The chance of catching a virus when playing outside is negligible. Spending time in nature is crucial to a child’s health, development, and mental well-being.

What NOT to do when your child has COVID

  • Don’t panic! Most children usually experience COVID as a mild upper respiratory infection. Many will have no symptoms.
  • Don’t isolate except when acutely ill.
  • Don’t mask your child, as masks are not effective in limiting cases of COVID and can have negative effects.

Hydroxychloroquine in Children 

In a Brazilian study (published on MedRxiv 2021) as a pre-print, children with moderate symptoms were given hydroxychloroquine sulfate 6.5 mg/kg/dose every 12 hours in the first day and 3.25 mg/kg/dose every 12 hours from day 2 to 5.

It was possible to observe in patients treated their symptoms of COVID-19 (group 3) with hydroxychloroquine and azithromycin for five days, presented statistically better improvement of the symptoms when compared to those that did not follow the protocol (p = 0.039). Three patients were hospitalized and discharged after recovery.


Note: Dosage varies based on size and age of child; see I-CARE For Kids protocol for full details (February 2023 version):

Key Takeaway

Talk to your pediatrician before giving any supplement to your child. Most milk formulas for kids are already fortified with multivitamins. Taking too much multivitamins might be harmful to your kids.

DISCLAIMER

The I-CARE: For Kids protocol is meant solely for educational purposes regarding potentially beneficial treatment approaches for COVID-19 in children. Never disregard professional medical advice because of something you have read on our website and releases. This is not intended to be a substitute for professional medical advice, diagnosis, or treatment regarding any patient. Treatment for an individual patient is determined by many factors and thus should rely on the judgment of your pediatrician or qualified healthcare provider. Always seek their advice with any questions you may have regarding your medical condition or health.

Please note FLCCC's full disclaimer at: www.flccc.net/disclaimer

Reposted and adapted from: https://covid19criticalcare.com/protocol/i-care-for-kids/

An alternative approach to treating acute and chronic pediatric conditions - with a focus on post COVID infection and post COVID vaccine symptoms, or “long vax”, in children. Dr. Paul Marik and Dr. Pierre Kory was joined by special guest, naturopathic pediatrician Dr. Lawrence Palevsky (video below):

 

Related: 



Kids Z-Stack

Z-Stack is a multivitamin developed by Dr. Vladimir Zelenko, MD — a physician known for developing the "Zelenko Protocol" for treating and preventing COVID-19. The protocol has as its centerpiece, but not exclusive piece, the combined use of Hydroxychloroquine (HCQ) and Zinc as a means by which a person can both help to prevent or mitigate the contraction of COVID-19, or can actually treat the disease once it has been diagnosed.  

Kids Z-Stack
Z-Stack for Kids

He has since evolved his protocols to include a quercetin, zinc, vitamin D and C protocol for low-risk patients as well as guidelines for COVID-19 prevention.

In an effort to make it easier for patients, Dr Zelenko has developed an oral supplement that contains all four key ingredients: vitamin C, quercetin, vitamin D3 and zinc together. It’s referred to as 'Z-Stack Supplement'. 

Z-Stack Vitamin cocktail provides key ingredients needed in order to help your body fight off this deadly invader. 

The cost of the Z-STACK vitamin cocktail is $55 per bottle for a one month supply. 

Dr. Zelenko has launched the Z-Stack vitamin for kids in the form of gummies, which could very well prove to be effective in the prevention and treatment of the COVID-19 in kids. The cost for Kids Z-Stack is $55 per bottle (90 gummies) as well.

Where to Buy Kids Z-Stack?

Kids Z-stack is available on Dr Zelenko's website. Here is the link: Z Stack for Kids Supplement 

Note: To get 5% OFF, please use this coupon code: DRFRANCIS

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