Have you done food allergy tests or food antibody tests for your kids, but aren’t sure what it all meant? Tried elimination diets to remove the reactive foods, but didn’t see results?
Scratch tests, IgE blood draw, IgG food sensitivity, skin prick testing, Mediator Release Testing (MRT), and more – there are many ways to assess food reactions, food allergies, and food sensitivities.
It gets confusing. There are different types of reactions to foods, different ways to assess these, and possibly, different inter-actions between food and gut microbes that aren’t well studied. For example: In some cases, it’s unclear if the food is the issue, or if symptoms are due to an imbalanced gut microbe that eats the food – causing production of toxins from disruptive microbes that lead to symptoms. In many cases, I’ve found that just balancing gut microbiome allows a child to eat a food that was suspect for reaction.
In general, mainstream medicine – that is, your MD allergist – only recognizes one type of food reaction (hives, anaphylaxis), and typically only recognizes drug treatments with avoidance of the extreme triggers. That’s all well and good …if that is what your child needs. But what about all the other symptoms and reactions that don’t need the Epi Pen, Zyrtec, steroids, or other drugs? Symptoms that leave your kids feeling lousy with painful gas, bloating, mixed irritable stools that swing between mucousy loose stuff or hard pebbles, chronic stomach aches, migraines, headaches, joint pain, frequent colds or rhinitis, acne, eczema, asthma, hives or rashes that come and go, trouble with focus and attention… All of these can come from reactions to foods your child eats on the regular. How do you sort it out?
Because an MD allergist will only screen for food allergy (with skin prick testing or blood draw for IgE reactions), many kids go without correct diagnosis and continue to feel lousy, for no reason. Food allergy is only one type of reaction to a food. At the very least, there are three types of food reactions:
1) Food intolerances:
may or may not involve the immune system.
- They occur without immune response when we lack enzymes needed to break down certain foods. An example would be lactose intolerance, where the body can’t break down the milk sugar lactose. The result is gas, bloating, and diarrhea. Rashes are usually absent (except perhaps diaper rash, from the skin-irritating loose stools). Kids who are lactose intolerance can often manage yogurt (because the lactose has been fermented into smaller sugars), Lactaid products (because the lactose has been enzymatically treated in manufacturing), or harder cheeses (which don’t contain as much lactose as softer cheeses) – but not regular ice cream, fluid milk, frozen custard, or other products with a lot of milk or softer cheese (because these still contain lactose).
- Another example of food intolerance due to poor enzymatic action on a food component is when opiate like peptides are absorbed from food proteins. If you’ve got a super picky eater, this may be your problem. Learn more here.
- Food intolerances can also happen with immune involvement when too much histamine is made. In this scenario, IgE or hives to a food can be negative, but tingling, stomach pain, or reflux may ensue. This can be part of mast cell activation syndrome (MCAS). Mast cells are white blood cells that help regulate the immune system and are responsible for histamine release. A human stomach has mast cells scattered throughout its lining, where they play a role in regulating stomach acid secretion (we need strong acid to break down food and prepare it for the small intestine). In fact, mast cells can be found along all of the GI tract. A variety of conditions – including chronic exposure to a triggering food – can disrupt mast cell function so that too much histamine is released.
2) Food allergies: Food allergies do involve the immune system. They occur when the body creates IgE antibodies to a food, which then trigger the release of histamine and other pro-inflammatory mediators from mast cells next time you eat that food. These reactions are typically rapid, occurring within minutes or hours. An example would be a peanut allergy that causes swelling, hives, and difficulty breathing.
3) Food sensitivities: Food sensitivities ALSO involve the immune system, but not IgE antibodies.
- Food sensitivities may involve IgG antibodies instead, in which an IgG antibody is made to a food. This can create a delayed reaction that might play out several hours or even a day or two after eating the food. The reaction can be dull pain, loosened stool, explosive stool, mild rash, migraine, behavior changes, bloating, gradual build up of eczema, or mild congestion.
- Food sensitivities can also occur when white blood cells might react to a food protein, additive, or chemical, and release pro-inflammatory chemicals known as “mediators” into the bloodstream, which cause symptoms throughout the body. These reactions are often delayed and dose-dependent.
- An example of either would be a gluten sensitivity that causes stomach aches, diarrhea, or brain fog the day after eating a moderate amount of wheat; a strong behavioral reaction to food colors or artificial ingredients; or eczema that comes and goes, but improves dramatically once a trigger food is removed.
Any one of, or all of these, can happen at the same time!
How To Tackle It All – Where to start? Here are five steps to get rolling.
- Get IgE and skin prick testing done with your MD allergist. Rule out the big offenders this way. If there are multiple positives, start only by removing the most serious offenders that are actually life threatening to eat, or that cause significant discomfort (vomiting, hives, diarrhea, stomach pain). If some of the positives are tolerable to eat, keep them in rotation.
- If working with your allergist MD doesn’t give resolution or if symptoms persist and food allergy screening was negative, move on to IgG food antibody testing. As above, work with only the top two or three high offenders on your findings. This testing is my preference – tho white blood cell media release tests (MRT) are also popular among some practitioners, I have found in my practice with children – especially young children – that MRT is an over-sensitive test that doesn’t yield the actionable information I need to organize and build a supportive, growth-worthy food intake for a child.
- Remove an offending food completely only if:
- eating it is life threatening (ER visit, Epi Pen, hives)
- your child eats it every single day (give the body a break from it for two months to start)
- your child has significant and noticeable impact from that food. This can mean impact on mood, volatility, and attention and focus as much as stomach pain or stool changes that are untenable.
- always replace a withdrawn food with another one of equal or better nutritional value. For example if replacing cows milk with almond milk, you must add protein and a fat source because there is little protein or fat in almond milk. Use a clean collagen boost and some coconut milk or MCT oil and blend as a shake, or give extra servings of chicken, eggs, avocado, ghee, grass fed beef, or nut/seed butters if safe. You can also ask your provider about elemental formulas if your child has multiple food allergies.
- Work with high potency probiotics, especially histamine degrading strains: Lactobacillus reteuri, Lactobacillus salivarius, Lactobacillus rhamnosus to name a few, plus Bifido strains. Start low, with a 10 billion CFU dose daily and if possible work up to 50 or 100 billion CFU daily. Use probiotics year round.
- Keep good anti-inflammatory supplements in rotation. These can be used even if your child uses medications like antihistamines or steroids, always let your doctor know:
- DHA fish oils to 800-2000 mg/day (many liquids available)
- curcumin and turmeric 400-1200 mg/day
- D-Hist Junior chewables, 2-6/day (quercetin, N-Acetyl cysteine, nettles, vitamin C)
If you’re using one, give an elimination trial a go for a solid six months. Food proteins like gluten and casein (milk protein) are especially good at triggering all kinds of reactions at the same time, so elimination trials will only work with those proteins if you do it for 4-6 month duration; have zero known cheats including trace amounts in processed foods; also avoid pea protein concentrates at the same time (think Ripple Milk, Daiya cheese, or most “vegan” protein bars, powders and drinks), which look a lot like gluten and casein to the gut; and eat strong replacements for these foods (plain almond milk and French fries won’t cut it!).
If you’ve achieved that, and it’s smooth sailing, go for the re-introduction trial. See how it goes! If you’ve got leaky gut resolved – this is what got the food reactions going to begin with – you won’t see the reactions return. If you’re part of the way there, you’ll see a slow build up of those old symptoms after your child resumes eating the old offenders. In that case, you can judge if you want to continue elimination diet, rotation diet, and/or how much support with anti-inflammatory tools like probiotics you can use ongoing. Good luck and share your experiences below!
Fever is a mainstay line of defense for the immune system. But you could say we’ve become afraid of fever, as we are told to make it go away when our kids have one – as though the fever itself is a bad thing.
The truth is, fever is one of the body’s many brilliant means to disable a pathogen. It’s not something to be afraid of. And mounting a vigorous fever is a beneficial component for a child’s adaptive immunity to develop. For example, a 104 F degree fever (~40 degree C) will cause a 200-fold reduction in replication rate of some viruses. Powerful stuff!
So why are we told to use drugs like acetaminophen (Tylenol aka paracemetol) to make it go away, especially in kids? I’m surprised to hear parents in my pediatric nutrition practice report that this is still encouraged, especially with vaccination – where evidence has emerged across many investigations that acetominophen reduces immune response to vaccines – making vaccination among the worst times to use it.
Let’s go there for a moment. There has been quite a fiasco over the use of Tylenol in children, and not without reason. For starters, giving acetominophen with fever is problematic. While the body is endeavoring to raise its temperature as a means of attack against a pathogen, Tylenol will un-do the process by lowering temperature and can thus prolong infection and inflammation.
Second, Tylenol quickly depletes glutathione, a natural peptide made by the body as key detoxifier and free radical scavenger. This means it lowers glutathione right when we may need it most, potentially enhancing the toxicity of whatever the body is grappling with.
Tylenol use – especially in toddlerhood when multiple vaccine visits are compulsory, or during pregnancy – has shown an association with the development of autism later on.
Giving Tylenol, plus eating RoundUp (aka glyphosate – the abundant and ubiquitous agricultural herbicide in our food supply, including infant formulas), plus using antibiotics, can create a perfect storm with the power to alter gene expression such that the end result is predictive for autism. No single “gene for autism” has ever been identified, despite years of hopeful searching and untold sums of money spent in the hunt. We know that autism isn’t solely genetic in origin. Rather, there are groups of genes that will be expressed differently, if environmentally challenged with toxins, antigens, or infections at vulnerable moments (like in utero or infancy or toddlerhood). If the gene expression is altered under the “right” conditions (that is, frequent toxic and immune challenges), autism or other neurodevelopmental can result.
Back to fever. What can you do about it, and when to step in?
- Stay in touch with your doctor for close monitoring when your child has a fever.
- A normal fever is between 100-104 degrees. If it climbs higher, be in closer touch with your doctor on next steps.
- Newborns should never have fevers – if your baby is less than 3 or 4 months old and has a fever over 100 degrees, let your doctor know right away.
- Some natural tools to manage fever and discomfort are…
- Curcumin, available in liquids and chewable gummies, can reduce inflammation and soften pain. Nordic Naturals Curcumin Gummies or Apex Turmero Liquid are easy for toddlers and school aged children to use.
- Magnesium is another useful pain reliever especially for muscle aches and pains. It’s available in topical lotions like Cooks Organics Creme, as Epsom Salts in a tepid bath soak, or can be used orally in liquid suspensions like Blue Bonnet Liquid Cal-Mag.
- Calcium lactate is a fast absorbed form calcium that can actually reduce fever in a beneficial way. During fever, as muscle tissue warms, calcium is leached from bones in a free unbound form called ionized calcium. This activates white blood cells which in turn mount their attack on invading bacteria or viruses. By giving calcium lactate, you make a quick support for white blood cells at the ready rather than having to leach it out of bone through fever. I have many anecdotes from clients for the success of this practice, which may also reduce the likelihood of febrile seizures. 100-200 mg calcium lactate every hour or two til fever drops is usually effective. Standard Process sells this form of calcium as a powder or in small tablets. (Milk and dairy products do not supply calcium in the right form for this task, and other forms of calcium will not work as well if at all.)
- Homeopathic remedies can be effective for fever also. Belladonna in 30c pellets is a classic solution for a hot, rapid onset fever with bright red dry hot cheeks and flushing. These pellets are available over the counter, but it’s ideal to work with a knowledgable homeopathic practitioner when using these powerful tools. For more detail on using these in your home, see Everybody’s Guide To Homeopathic Medicine This book was a mainstay in our home when my son was little and saved us many trips to the doctor.
What about before fever? The most important thing you can do for your child is maintain a healthy, solid growth pattern.
If you’re not sure whether your child’s growth pattern is where it should be, check this blog on underweight in children. Even small shifts away from your child’s expected progress for growth are costly when it comes to infection and illness. Growth is the single most powerful predictor of how often a child gets sick and how sick they may get – that is, severity and frequency of illness both go up when children are lapsing off their patterns for growth.
Kids don’t feel hungry during fever, which is a good thing – the body needs resources for the task of infection fighting, and doesn’t want to steer blood flow and energy toward digesting a meal. But fevers are exceptionally costly in terms of the fuel they consume – literally, heating fuel! It can’t be replenished easily during illness, which is why it is so important to keep children well fed and growing strong between infections and illness. Once illness comes calling, the reserves need to be there already.
Top nutrients for the immune system to do its work during illness, that should be well replenished before illness, are vitamin D, vitamin A, zinc, iron, and total protein. Total protein doesn’t mean your kids need a hundred grams of protein a day in food (that’s too much). It means they have good tissue stores, healthy muscle tissue, and some body fat as reserves.
Iron doesn’t work well to supplement during infection, as it may increase inflammation or help microbes, which also love iron as much as we do. So make sure your child’s iron status is strong day to day (click here to learn more about when kids need iron).
Zinc however can be used during illness and doses of 30-100 mg are what I may suggest depending on a child’s weight. Vitamins A and D are stored in fatty tissue and certain types of lipid (fat) molecules in the blood. Make sure your child has ample sources of these vitamins in their day to day routines, before illness. Cod liver oil, wild caught (not farmed) salmon, organic calves liver are all good sources. Regular fish oil (minus the “liver” part) does not provide vitamins D or A, which are key for lung tissue and many facets of strong immune response to viral infections especially.
There are may herbal tools that your local naturopathic doctor is trained to use to help manage infections and illnesses. Check here to explore finding a naturopathic doctor (ND) near you.
Long short, your kids can have fevers safely and effectively, and there are a several options to support them through it. Instead of reaching for NSAIDs like acetominophen or ibuprofen, you might like trying natural and nutrition tools that work with the body to fight infection and recover handily.
More than ever, my clients are asking me what to do about covid shots for their kids.
This is a challenging topic. It’s polarized to the extreme, fraught with fear and grief (we’ve all lost loved ones and friends to covid), and rife with misinformation on all sides. Do you give your kids a covid shot? How many? Which one? Do they work?
Listen to my video cast on this topic if you prefer that over reading – advance to minute 16:00 for this topic.
As a health professional with a graduate degree in public health indoctrinated into why we use vaccines, population study design, and how population health data is collected and validated, and as a clinician with training, a license, and degrees to practice, I am puzzled by the events of the last two years. Little has occurred that reflects sound tenets, science, standards, or practice in public health, let alone clinical practice, where treatment for covid sufferers has been all but absent per mainstream medicine. And here we are, two years later, still suffering, still masked, getting shots, and getting sick.
The truth is we could have done a better job, and still can going forward. We have tackled devastating diseases before.
An interesting example is HIV/AIDS. Having lost a sibling to AIDS in 1993, I followed the evolution of this tragic pandemic as it unfolded in the 1980s and 90s. Globally, AIDS is the world’s second most fatal infectious disease, after tuberculosis. Both kill far fewer people than chronic conditions like heart diseases and strokes. While Sub-Saharan Africa remains heavily burdened with AIDS cases and fatalities, the US has seen vast improvement in both case and fatality rates: In 1994, our death rate for AIDS peaked at nearly 15 per 100,000 population, when it became the leading cause of death for all persons aged 25-44 in the US. My brother was one of those people. He died at age 37.
There were no vaccines, no masking, no restrictions on individual movements, no lockdowns, no banning family members for visitation in care settings (I stood by my brother’s ICU bedside unmasked as he died), no divisive mandates barring persons with AIDS from their jobs, or from society. Instead, thanks to focus on treatments and prudent measures for safe sex and needle use, the US lowered its AIDS death rate to 1.77 per 100,000 population.
Though AIDS is transmitted through bodily fluids rather than air droplets, many people were terrified to be in the same room as a person with AIDS back in the 1980s and 90s. AIDS is far more lethal than covid. Since the beginning of both pandemics, AIDS has infected roughly 80 million people in the world and killed nearly half of them (37 million), while covid has infected roughly 200 million people worldwide and killed less than 2% of them (about 4 million covid deaths worldwide) (here’s my source for that comparison). In 2020, Americans were more likely to die of heart disease or cancer than they were to die of covid.
Currently in the US, the covid case fatality rate is about 1%. It appears to be becoming slowly endemic and less virulent. We see that, overwhelmingly, most who contract covid survive it.
Elderly persons bear the brunt of mortality from covid, comprising about 80% of those who die from it. For children, a covid death is incredibly rare, while infection is typically mild. In 2020, when the case fatality rate for covid in the US was slightly higher (the virus was newer, with more virulence, and we were not immune), the likelihood of needing hospitalization for covid for persons under the age of 40 was less than half of one percent, while as high as 9% for persons over 60.
We are fed a lot of rhetoric through media. Much of this is inaccurate or omits critical facts that don’t fit the pharmaceutical industry narrative.
As a dietitian/nutritionist, I am required per my license to tell you to ask your doctor what to do about vaccines. As you open those discussions with your doctor about vaccinating your children against covid, I hope you will include these resources in the conversation. We are fed a lot of rhetoric through media. Much of this is inaccurate or omits critical facts that don’t fit the pharmaceutical industry narrative. Here are some facts you may not have heard, given the high level of fear circulating in our media:
- The more a population is vaccinated against covid, the more covid infection has spread. This finding was published here in the European Journal of Epidemiology in September 2021. The data reviewed vaccine uptake across 68 countries and nearly 3,000 US counties. Populations with a higher percentage fully vaccinated had higher COVID-19 cases per 1 million people. In other words, not only did vaccination fail to prevent spread, it may have worsened it. The authors state that “sole reliance on vaccination” has failed and that we must engage other strategies.
- The World Health Organization does not recommend booster doses for anyone – not in July 2021, and not now.
- The World Health Organization does not recommend covid vaccines for children.
- Read an interview here with a pediatrician who, like the World Health Organization, advises against covid shots for children.
- As of January 7 2022, over a million adverse events to covid vaccines and nearly 22,000 deaths from covid vaccines had been reported to the US Department of Health and Human Service’s Vaccine Adverse Event Reporting System (VAERS). Some have called for full stop on covid vaccines due to deaths from covid shots.
- This number of events is unprecedented. It exceeds total reports of events to all vaccines since the program began. VAERS was enacted in the 1980s as part of legislation that shields vaccine manufacturers from liability. This legislation also created the Vaccine Injury Compenastion Program, a government fund for those injured or bereaved by vaccine deaths. This fund, paid for by a tax on vaccine sales, is the only path to restitution for a vaccine injury or death. Since October 1988, no-one can sue a vaccine manufacturer, physician, or institution for death or injury caused by a vaccine. This is why you – and your pediatrician – never hear of vaccine injuries. These cases, if reported at all, skirt juried trial for medical malpractice or product defect. They enter the closed and separate government claim system known as Vaccine Court.
- VAERS is a voluntary, passive reporting system that captures as few as 12% of vaccine adverse events that actually occur and possibly as few as 1% (one percent) of events. Millions of injuries and deaths from covid vaccines may be unknown and unreported.
- Myocarditis tops the list of covid vaccine injuries among 12-17 year olds. As of 1/7/22, VAERS records 38 children under the age of 17 as dying from covid shots (view data here and here). These lost lives are not necessary or reasonable collateral damage. This is especially poignant since elderly persons and those with comorbidities – not children – represent the greatest burden of covid infection and death. In other words, these children died not because covid presented much risk to them, but because of thin rhetoric that asserts they might have threatened others.
- Data published in January 2021 – a year before high vaccine uptake worldwide – described how covid vaccines had potential to cause “adverse pathological events” in heart or lung tissue. The authors called for long term safety studies but the FDA’s Emergency Authorization has pre-empted these.
- Fully vaccinated persons with “breakthrough” (vaccine failure) cases have peak viral load similar to unvaccinated persons and can efficiently transmit infection, including to vaccinated contacts. In other words, vaccinated persons can spread infection and are a larger threat than an unvaccinated, asymptomatic well child or adult.
- Pregnancy is no time to take an experimental pharmaceutical. Due to their Emergency Use Authorization, covid shots bypassed usual FDA requirements for studies on safety and long term effects, making them essentially experimental. Booster vaccine products are regarded as similar enough to the original shots and thus also bypass usual FDA safety testing standards.
- Only one retrospective assessment of outcomes for babies born to women given covid shots in pregnancy has been published, by the CDC in January 2022. This in itself is disturbing because no safety data existed in 2021, when women were given these by the tens of thousands anyway. Predictably, the CDC’s own analysis touts the safety of covid vaccines in pregnancy. But the analysis had many flaws that biased it toward a favorable picture for covid vaccination in pregnancy:
- The unvaccinated group had triple the number of African American mothers in it, biasing toward more pre-term birth in this group compared to the unvaccinated group. In other words, the CDC “cherry picked” a cohort of women known to have more premie babies in general, thus hiding an increase in premature births that the vaccines may have caused in the vaccinated group. The CDC acknowledges that African American race is a risk factor for premature birth, perhaps as much as 50% higher than white women.
- Obesity, another risk factor for pre-term birth, was over-represented in the unvaccinated group as well. This defect also makes increased premature births in the vaccinated group “disappear” in the analysis.
- Women who had a covid vaccine in their first trimester were excluded from the analysis. The first trimester is when risk is highest for injury to the baby from toxins or infections. This flaw in the data analysis allowed the CDC to hide miscarriages, birth defects, or premature births more handily because they only analyzed data for women who got covid shots later in pregnancy – after the crucial window when embryonic structures are developing.
- What we are seeing with the emergence of variants is a phenomenon that may be accelerated by vaccination itself. According to this piece in The Lancet, “these findings suggest that variants of SARS-CoV-2 could evolve with resistance to immunity induced by recombinant spike protein vaccines” – that is, vaccines appear to be driving variant evolution, according to the authors.
- Like flu viruses, which are adept at genetic mutations that make them ever more evasive to our immune system’s defenses, corona viruses can do the same. This is why new flu shots are recommended every year. You can now expect to be pressed to take boosters for covid as we fruitlessly chase these mutations. Vaccination won’t eradicate covid anymore than it has eradicated influenza; what’s worse, it may promote viral evolution toward more infectious variants.
“Look at the science” is a popular refrain nowadays. But the closer you look, the worse covid shots look. Scrutinizing study design reveals the bedeviling details
Many of you know that my child was injured by his infant vaccines. His case took nine years to reach the Vaccine Court docket – to say there is a back log of death and injury cases is a gross understatement – and this was years before covid. This is what propelled me into the niche of practice I chose. After experiencing the shock, horror, trauma and loss of watching a measure assumed to be safe and necessary nearly kill my child and then trigger ongoing health challenges, my family also experienced the brutal tone-deaf posture of our health care system with acknowledging and treating these injuries. This continues today, with more intensity, malignancy, and vitriol than ever. It’s intense out there right now!
I encourage you to explore and learn about vaccine failures, injuries, ingredients, efficacy (study these per vaccine), policy, and industry. Make informed choices. Change providers if you must; find those who allow inquiry, and who engage integrative and functional medicine tools. Protect your family’s health with good food and nutrition, lower stress, joy, and strong community connection. If you suspect your child – or anyone you know – had a vaccine injury, do your part and report it here. This may help save others’ lives, and may help hold manufacturers to account for safer vaccines.
Infectious disease has always been and will continue to be strongly correlated with environmental and host factors, including nutrition and nutrigenomics. Food and nutrition status are fundamental drivers of immune response and power, especially in young children. Vaccination is not the sole savior – we have ample scientific precedent for this fact – and a one-size-fits-all vaccine policy or mandate ignores science and clinical precedent for host variation and virus behavior in populations. It is a societal failure that I hope to see pass out of fashion in my lifetime.
“Look at the science” is a popular refrain nowadays. But the closer you look, the worse covid shots look. Scrutinizing study design reveals the bedeviling details, and this is what I was trained to do in my graduate studies. These flaws and inconsistencies throughout the pandemic have played well for the pharmaceutical industry, but not so well for families or children, who have suffered egregiously – physically, psychologically, and financially.
I hope this answers your questions about my thoughts on covid shots for children. For tips to leverage nutrition to defend against respiratory illness and support the immune system during illness, click here. For helpful nutrition supports following a covid shot, click here.
Did you know that reflux medicines (aka Proton Pump Inhibitors or PPIs) are among the most overused drugs in the world?
Reflux medicines make the list of top ten most prescribed drugs in the world. If your baby or child is on one, your gastroenterologist (GI doctor) probably prescribed it to lower stomach acid for presumed gastroesophageal reflux disease (GERD).
In your doctor’s eyes, these drugs are considered generally well tolerated and are not considered harmful to adults or even children. The problem is that (some of ) these drugs are only approved for short term use in children – but, it’s common to leave babies, toddlers or older children on them for months or even years at a time. I see this in my pediatric nutrition practice all too often! When these drugs are taken for months at a time, there is potential for serious side effects that can cause lasting digestive and immune system issues.
Another dilemma with getting a PPI for GERD is that the diagnosis is typically based on a brief conversation with mom about spit up, colic, or vomiting. Rarely seen is an actual diagnostic test for whether someone needs this drug – in adults or kids. Measuring stomach acid is the confirming diagnostic for “excess stomach acid”. This requires an invasive endoscopy procedure which must be performed under sedation or anesthesia. Even with endoscopy, if inflammation is seen in the esophagus’ tissue during that procedure, it is assumed that excess stomach acid is the cause. The only way to assure if this is actually true is to add a pH probe to the endoscopy procedure. This probe measures the pH (acid level) in the stomach.
Another way to confirm is to observe stomach acid actually entering the esophagus (that is, stomach contents are going up instead of down) with a barium swallow and observing results, live in real time, on X ray.
If a pH probe shows that the stomach is indeed too acidic, a PPI may indeed help. If the problem is normal acid levels that gurgle backwards up in to esophagus, a PPI may help, or may not help at all – it may make the problem worse over time. And here’s the other twist: Even weak stomach acid (at a pH of 3 or 4) is still too acid for delicate esophagus tissue. But it’s too weak to do a good job of moving food out of the stomach and into the small intestine. So, this leaves food sitting in the stomach, and gurgling back up in to the esophagus. A PPI may temper that burning sensation a bit, but it will not solve the problem of getting food moving along in the other direction – in fact, it will make food sit longer in the stomach, giving more opportunity for the food to gurgle backwards into esophagus. This is exactly how many of my young patients end up needing more, more, and more reflux medicine… until it stops working even at the highest dose.
Here’s When To Intervene
Babies normally have some spit up or vomiting. If your baby is clearly in pain, crying hard, unable to eat, and not growing or gaining, then a PPI can offer some temporary relief. Likewise, if your doctor saw highly irritated esophageal tissue on an endoscopy, then a short term use of PPIs may soothe the situation. Babies should not be left to cope with pain when a medication can immediately help.
Create a strategy up front with your doctor to use those tools temporarily. A switch in feeding can often make a big difference. Changing a breastfeeding mom’s diet can help, by removing foods like dairy, eggs, or high FODMAPs foods like onions, garlic, apples, prunes, or broccoli.
Formula fed babies can improve with a switch to something more digestible: Consider hydrolyzed formulas like Alimentum Ready To Feed, or formulas with a different protein profile like Gerber Soothe (more whey, less casein), or a goat milk formula option. All of these are worthy measures before placing your baby on a reflux medicine.
There are also gentle herbal glycerite tinctures for children that soothe the stomach and gently encourage normal digestive function. One of my favorites is Gaia Herbs Tummy Tonic, which I’ve used with success for many years in my pediatric nutrition practice. This herbal tincture is one of may herbal blends known as digestive bitters. They gently stimulate the stomach to produce its own normal array of acids so digestion can begin.
Since reflux drugs lower stomach acid, they also lower the protection we get from having that natural acidic barrier between the big bad world and our bodies. This acid barrier is supposed to be very acidic. A gastric juice pH as low as 1.0 is normal. This can prevent harmful bacteria that may be in our mouths from entering the body. But if the stomach pH gets too high – that is, if it becomes less acidic – this matters for 3 key reasons:
- Potentially harmful oral bacteria can work its way into lower parts of the GI tract, a trip that would not be made possible when there is enough stomach acid. Once it makes its way into the GI tract, foreign bacteria can cause such infections as Clostridium difficile, Salmonella, Campylobacter as well as Escherichia coli.
- When harmful bacteria invade the GI tract, they can begin to overgrow and compete with the “good bacteria” that we rely on to help us with digestion and immune system support. Over time this impacts the diversity of our microbiome and can cause dysbiosis, a condition where the good bacteria is reduced and too much bad bacteria is allowed to grow – creating an environment that can also lead to yeast overgrowth, constipation, irritable loose stools, picky eating, food intolerances, food allergies, or pain.
- Too much of the wrong kind of bacteria and not enough of the good kind can lead to inflammation in the gut, which then cause the gut wall barrier to be more permissive – that is, the tightly compacted tissue structure inside the gut wall gets a little loose, with microscopic spaces that can allow larger molecules than normal to enter circulation in the body. These can be partly digested food proteins, toxins, or microbial organic acids. This is known as “leaky gut” and people may experience all sorts of discomfort or chronic systemic inflammation as a result.
My child was treated with a PPI. Now what?
Long term PPI use can disrupt healthy gut microbiomes, and favor yeast or fungal species. Over time, these drugs can make weak, picky appetites, weak protein digestion, weak absorption of minerals like iron and zinc, and poor B12 absorption. You can…
- Use my Sensory Nutrition Checklist to look for signs that certain nutrients are not being well absorbed. Supplements can help cover the deficits in the short term, as you repair your child’s appetite.
- Explore with a stool test that assesses helpful bacteria as well as pathogens, fungal species (yeasts), and disruptive commensal species.Stool study findings can be addressed with non prescription tools in many cases, such as rotations of certain probiotics or herbal compounds that discourage fungal or disruptive bacteria species. Most of these tests include measures for inflammation and digestive function too. This is an easy way to sort out what is going on. Be sure to work alongside an experienced integrative and functional practitioner when ordering your child’s stool test to understand and interpret the results and what the best protocol might be to improve your child’s microbiome health. They are likely to have knowledge and experience with therapeutic herbs and probiotics that can be used to help resolve your child’s GI issues in the most gentle way possible. Clearing gut dysbiosis directly in this way can accelerate restoration of normal digestion.
- Join my Nutrition Cafe secure on line group chat, where we tackle topics like this in detail on a regular basis in HIPAA secure live zoom chat with me.
- Change up your baby’s feeding routine per suggestions above. Find easy to digest foods; these are usually low FODMAPs fruits, vegetables, and grains, plus gentle protein sources like white fish, chicken, or turkey. Avoid fermented foods or bulky high fiber foods at first; these may become easier to handle later on.
- Avoid high potency multi strain probiotics at first. Start with a simple one like Klaire Factor 1 or Klaire ABx Support. More complex products like GutPro may be better tolerated later on.
- Gently restore stomach acid with a combination of a digestive bitters tincture like Tummy Tonic, with 1/4 teaspoon Braggs Apple Cider Vinegar, at meals or feedings. This can be mixed with pleasant tasting juice such as a small amount of elderberry juice or pineapple juice (which has some natural enzyme in it too). Other helpful soothers and gentle gastric stimulants are peppermint, ginger root, lemon rinds or lemon juice in water, or chamomile tea. Use these regularly and steadily for a gradual repair of gastric juice.
Give this project some time, especially for kids who have used a PPI for more than 3-4 months. Gradually a healthy appetite without bloating, hiccups, gas, constipation or pain can be restored.
Thanks to Rosanne Walsh, AADP board certified nutrition and health coach and RD intern for building this blog post with Judy!