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Five Things Your Pediatrician Doesn’t Know About Nutrition

Five Things Your Pediatrician Doesn’t Know About Nutrition

Getting your kids’ annual physicals this month? Take this check list with you to your appointment. There are straight forward, nutrition-focused solutions to all of the problems on this list. No drugs, no therapy, no ongoing visits to behavior clinics. Simple measures may resolve these problems without drawn out drug trials or therapies that leave your family frustrated and exhausted. If your pediatrician is stumped about how to use real food and nutrition tools, let’s talk soon!

1 – Diarrhea is not a developmental phase

How often have I heard, “my doctor said it’s ‘toddler diarrhea'” or “Clostridia difficile is common in kids, it doesn’t need treatment” or “it’s okay because my kid is still growing” or “it’s because he has FPIES“. Yes, infants and toddlers have varying stool patterns, but there is usually a reason for it that can be fixed. And it should be, because chronic diarrhea robs your child’s brain and body of critical nutrition. Teething, fevers, and stomach bugs can disrupt potty pattern for sure, but the operative word here is transient. Funky poop should resolve back to a comfortable pattern within a few days or a two weeks at mostExpect a baseline pattern of formed (not hard, not dry) stools every day that are easy to pass. Ongoing loose, explosive, mucousy, irritable, burning, or foul stool is not healthy, normal, or necessary to put up with. It is a sign that something is awry – food intolerances or allergies, background infections, reflux, or weak nutrition status to name a few. It can also make it harder for kids to potty train, when they never know what’s coming!

The other clear sign for good digestion and nutrient absorption in kids is steady growth pattern, with no flattening trend for weight, height, or body mass index. Daily eliminations that are soft formed (or soft gold mush for breast fed babies) are a sign that your child is digesting and absorbing his food well (in ancient Ayurvedic medical traditions, anything less than a soft formed elimination after each meal is considered constipation!).

Kids who have chronic diarrhea also often exhibit what can be misconstrued (and fruitlessly treated) as behavior or psychiatric problems like anxiety, irritability, low motivation (fatigue), bad sleep patterns, or inattention. What I so often find is that once digestion and stool pattern are supported, these problems fade too, as kids absorb nutrients and energy more reliably. Who wouldn’t feel better?

Long short – if you have a cranky little who can’t sleep well and who has a lot of loose messy stools, investigate. Don’t mask symptoms with long term drug dependence – fix the underlying problem. Your child’s gut health can likely improve with non-drug, nutrition-focused measures… even with conditions like FPIES. And if your school aged child is struggling with chronic loose stools, fatigue, and poor energy, expect it to be better. If your pediatrician can’t help, and a gastroenterology referral was a dead end too, schedule an appointment for integrative nutrition with me today.

 

2 – The most important thing for fighting infections is strong nutrition

Forget the vaccine debate. Nutrition status is the single most critical factor (of the “greatest public health importance“) to influence whether kids get sick, how often, for how long, and whether or not they have complications with illnesses or infections.When kids do get sick with serious bugs like flu or measles, well nourished kids fare far better, with a less complicated, shorter course of illness and full recovery. For over seventy years, data have piled up to show what a huge impact nutrition has on the immune system, from several angles – from your kids’ tissue stores of vitamin A, to total protein intake, growth status, iron or zinc status, inflammatory chemistry, and more! You can help your kids stay well even as they are surrounded by sniffles and coughs at daycare or school, by setting them up with tip top gut health and food. Judicious use of supplements, probiotics, and herbs can work wonders too – just be sure to tailor these to what your child needs, not a one-size-fits-all approach. Music to my ears: When parents whom I’ve worked with tell me, “We didn’t have any colds this whole winter!” It happens.

So what is nutrition status? It isn’t what supplements you’re eating, whether you’re vegan or Paleo, or even what food you give your kids. It’s a number of things that are classically measured in children to assess how healthy they really are. These are not all included in a standard well check or school physical, but some may be added on if you ask your doctor. Strong nutrition status is evident in:

  • Solid growth pattern in your child’s expected channels for weight, height, and body mass index. Your child can be expected to proceed at percentiles achieved at birth, unless s/he had a special circumstance that needed support very early, such as low birth weight or premature birth; even this can be expected to improve some as your child grows. Though pediatricians generally won’t address growth regression until children fall way down the chart, drops of more than fifteen percentile points that persist for more than three months warrant investigation for cause.
  • Mid range lab findings for serum iron and ferritin (not at high or low edge of the range); normal blood count; normal chemistry panel with serum protein, albumen and other findings in mid lab range.
  • Infrequent illnesses with short duration and full recovery.
  • Strong clinical signs for healthy hair, skin, teeth, and nails; no or few cavities in the child’s lifetime.
  • Ability to play, sleep, learn, and eliminate comfortably.

 

3 – Your child may need iron when s/he is not anemic

It’s common at annual physicals to check hemoglobin and hematocrit for kids, which is done with a finger stick blood test. These are two tests to check if your child is anemic. The problem with this is that these are low sensitivity tests that don’t pick up pre-anemia. Pre-anemia is a thing! It is a state in which iron stores are depleted, but hemoglobin and hematocrit are still in the normal range. These kids need iron support, and depending on diet, food intake and other factors, the fix may be just the right food, or may require the right iron supplement (there are several) or even an iron prescription. Kids in pre-anemia will have any or all of these features:

  • shiners under eyes, pallor
  • more frequent infections and colds; may take longer to recover
  • irritable; crabby one minute, happy the next
  • hyperactivity with fatigue – “crash and burn” pattern
  • math may be most difficult subject (iron is related to math learning!)
  • difficult sleep pattern, insomnia, can’t settle to sleep or sleep through
  • picky or weak appetite; may want to chew non food items
  • in girls in puberty, menstrual flow may be heavy, fatiguing, and/or with clots

Since iron is poisonous as well as essential to our bodies, don’t give iron supplements without guidance. Request thorough testing to find out if your child needs iron, vitamin B12, protein, or just the right food to correct anemia. I can help you with this as well, by finding an easy to tolerate iron supplement or B12 protocol, as well as how to work in replenishing foods.

 

4 – That allergist referral won’t find all your kids’ food reactions

Allergists check one thing: Allergies. They look for reactions by checking IgE (immunoglobulin E) responses to foods or other substances. They may measure histamine and tryptase levels too, among other things that relate to those swift and dangerous reactions that have you grabbing the Epi Pen. But there are many other types of reactions to foods that disrupt stools, skin, behavior, and functioning. If allergy testing was negative for your child, but there are frequent colds or congestion, asthma, eczema, messy irritable stools, weak picky eating, or other nebulous symptoms, assess more deeply. So far, while insurance coverage for food allergy testing is common, it is not common for testing for food sensitivity reactions, or other immune responses to foods. Identifying these can make life a whole lot better for kids struggling with multiple symptoms – but,  be prepared to go out of network and possibly pay out of pocket for these tests. Depending on your insurance and your child’s nutrition diagnosis, it may or may not be covered. I guide parents with this testing, can authorize it if your doctor does not know how, and interpret findings to build a nourishing diet for your kids.

 

5 – Nutrition CAN reduce ADHD symptoms without medication

Big topic. Pediatricians are trained to offer behavior therapy as a first line of intervention for young children with ADHD; if that doesn’t work, their next recommendation is for medication with behavior therapy. But what they don’t learn is how to help children achieve functional focus with nutrition, gut health, and food. So much can be done! Stimulant medications have many drawbacks and side effects. Search my blog posts on nutrition and ADHD – there is ample to mine there. You can also view this free lecture on nutrition and ADHD.

Children as young as three years old can be given stimulant medication, per FDA guidelines. It may seem like an easy quick fix, but there are other options. This is not without costs to your child’s health and well being; suicidality may increase in older kids given these medications.  Help your child eat and absorb the nutrients his brain needs to focus. Take out the toxins, inflammation, and noise in the body. You may be amazed at the difference nutrition care can make.

 

Why doesn’t my doctor practice nutrition?

Pediatricians don’t have a lot of time when they meet with you for a school physical or well check; insurance companies tightly control what topics can be addressed in those visits, how long the visit can take, and how much a doctor is paid for that service. When your pediatrician wanders from the format, he essentially won’t get paid for his time. And, they need to have a high volume practice to make money – meaning even less time to listen to you, educate you on meals and nutrition, or research new topics on their own. Further discouraging nutrition in pediatrics is that drugs are much more profitable. Drug companies now wield heavy influence over pediatric care, from the time a doctor begins medical training to every week in practice, when drug company sales reps visit with samples, glossy brochures, pens, free lunches, treats, or incentives to write prescriptions. It’s irresistible and easy. There is no such format for nutrition intervention for complex problems. Last but not least, pediatricians are not required to complete much training in nutrition. They simply may not know what to do.

In my nutrition practice, I give clients lengthy appointments to integrate all facets of your child’s care into an individualized nutrition care plan, including lab studies, history, growth status, food intake, and aspects of your lifestyle. I write detailed care plans for each encounter. This takes a lot of time that pediatricians don’t have. If you’re stuck, get started today with an appointment. Or go to my home page (scroll down) to download your free Sensory Nutrition Checklist – begin today with some easy tricks to help your kids function better!

 

 

Your Kids Get To Be Healthy

Your Kids Get To Be Healthy

I’m now serving my second generation of clients, working with moms who where were not even born when I finalized my credentials as a dietitian/nutritionist. Recently I did a double take noticing that a young mom I was working with was born on  my wedding day – Wow!

It has been quite a journey. I’ve watched earlier clients’ kids, and my own son, grow up to be more functional and able, after rocky and uncertain beginnings. But I have some bad news for you young moms: It is a lot worse out there than it used to be.  It’s very different for you than it was for my generation. There’s a whole new normal, and it ain’t pretty.

More than half of US children are now chronically sick or disabled – meaning that it is now more common for kids to have chronic conditions or developmental delays, than it is for them to be healthy, growing strong, and developing or learning normally.

During my graduate years in public health nutrition, this was unthinkable. CDC goals we worked with then have not come close to being met. We’ve not only fallen short, we’ve actually violated the very first goal to “prevent morbidity and disability “- ! Both have increased dramatically for US children in the 21st century.

Type 1 diabetes has quadrupled. Children under age 10 are now getting diagnosed with Type 2 diabetes  – actually unheard of when I was trained in the late 1980s; this was only diagnosed in overweight, middle-aged people at that time. At least 80,000 kids in the US are  diagnosed with Crohn’s disease, a severe and chronic inflammatory bowel disease, and its incidence in children is increasing. I meet kids each month who have similar symptoms but have never been diagnosed, and I just worked with my first toddler diagnosed with Crohn’s disease this spring. During my training, this wasn’t even mentioned as a condition that a young child could have. Even the phrase “toddler diarrhea” didn’t exist (diarrhea is not a developmental phase!). Babies and toddlers were not diagnosed with, or given medications for, GERD (reflux drugs like Nexium came to be so overprescribed, they were called “purple crack“). Asthma, cancer, allergies, and of course – autism – are all increased far past their 1985 levels, with no signs of slowing down. And are you tired of hearing yet that autism has shot up nearly 150-fold since 1975, and that some estimate that half of US children will have it by 2025? How will this country function, populated by sick and disabled adults? How will we pay for their care?

Those are big questions. But here is the question that has had me scratching my head for the last twenty years: What are our pediatricians doing about it?

Are they even thinking about reversing these trends, in any meaningful way?

If they are as young as you are, it’s doubtful they know how miserably we failed at reaching the CDC’s goals from the late 20th century, for population health. Or that they’ve had much of a deep dive into child nutrition and its role in development, learning, behavior, and immune strength. I also do wonder if they know what it’s like to see kids who never need any prescription drugs, because they’re just …healthy.

Being sick repeatedly throughout the year, needing multiple rounds of antibiotics, being developmentally delayed, having an impacted, inflamed, or ulcerated colon, being unable to eat anything but milk, yogurt, or Pediasure, or having only loose, burning, foul stool or impacted hard stool may be common nowadays, but it isn’t normal.

Your kids should be healthy, comfortable, vibrant, eating, eliminating daily, sleeping well, growing, playing, and thriving! If they can’t because of a chronic condition, then they still deserve to reach their fullest potential, enjoy their highest well being, and feel good as often as possible.

From my perch as a pediatric nutritionist/dietitian, I have watched it get harder and harder to restore kids’ health, away from the chronic gastrointestinal, feeding, growth, developmental, and allergy/immune problems they have. Kids bodies seem more compromised, their immune systems more confused, their intestines less functional. The work is more complex than it was in 1998 or 2000. Diagnoses like FPIES (which my own son had in 1996, before there was a name for it), milk protein intolerance, food allergies, intolerance to breast milk, and EoE are not unusual now, but they earned no mention during my training in infant and child nutrition in the late 1980s.

I often wonder how pediatricians of my generation reconcile this. Do they notice, like me, that children are sicker, as government data show?

Moms under 35 have it rough. You are..

  • The first generation to grow up with more antibiotics, vaccine doses, psychiatric medicines, and just plain more prescription drugs than any other.
  • The first generation to grow up eating GMO foods.
  • In the years you were conceived, patent and marketing laws for drugs changed – and dozens of new drugs flooded the market, whether we needed them or not, and regardless of non-drug options that may have worked as well or better.
  • The goal posts have moved for what counts as valid published medical “science” – much of it is now ghost written by the pharmaceutical industry.
  • Environmental protection laws are either being stripped or unenforced, allowing more toxins into air, water, and food.
  • You are now bearing children with more toxic burden than any parents before you in America’s history.

In short: It’s a lot harder to have healthy kids these days. Your bodies were exposed to more toxins, sooner, than people of my age. And now your children are exposed to all of this even before they’re born, in utero.

So now what? It’s simple: Remember that your kids get to be healthy.

That is their birthright, and their normal. Expect them to be healthy, not chronically sick. But you have to do some serious footwork, even before pregnancy, to help them get there. If your kids are already here on the planet, there is a lot you can do to diminish their odds for chronic disease, developmental injury, and psychiatric conditions. If your kids are already affected by these problems, there is still plenty to do with food, nutrition, and good support for immune function and detoxification – you might be surprised to see how well your kids can be.

Here you go:

  • Eat organic whenever you can. It matters. I actually did some work on this during my graduate studies (eons ago) and found that yes, organic foods are more nutritious, and have fewer toxins (though not toxin free, thanks to widespread use of pesticides and GMO crops in the US).
  • Don’t eat GMO food, period. Minimize it as much as possible. Here’s why.
  • Find out if your kids have food sensitivities or allergies; feed them foods that nourish deeply, not foods that chronically inflame.
  • If your kids need antibiotics, restore healthy flora – you will know it worked by appearance of a daily, comfortable elimination (no bloat, hiccups, burps, picky eating, straining, watery stuff, mucus, dry pebbles, or foul odor – just formed easy to pass stool and healthy appetite).
  • Drink filtered water, not tap water. Put filters on shower heads. Or, consider a whole house reverse osmosis water filter.
  • Don’t use plastic containers for food. Avoid plastics, xenoestrogens, and xenobiotics in lotions, shampoos, soaps, or foods.
  • Eat more vegetables, more plant foods, and less meat and sugar than you want.
  • Eat loads of ancestral, organic fats and oils.
  • Don’t have a C section if you can help it. If you can’t, seed your baby’s gut biome with probiotics or your own flora.
  • Don’t get vaccinated while pregnant. It can increase your risk of miscarriage, and it delivers toxins like aluminum, mercury, and rogue viral or human DNA into your body. Effects of vaccinating pregnant women on their unborn children for asthma, allergies, or other immune mediated conditions are unstudied.
  • If you need antibiotics during pregnancy, delivery, or breastfeeding, take all precautions to restore your baby’s gut flora with probiotics and a healthy diet.
  • Read this 2017 study on the health of vaccinated versus unvaccinated kids. Choose soberly what you want to do.

Those are good starts – a big effort, yes; harder perhaps, but the upstream work is well worth it if there is a chance it can prevent burdensome chronic conditions in your kids. If you need more specific guidance for your own child’s situation, contact me for an appointment and we can get started.

How To Get Kids Off Miralax

How To Get Kids Off Miralax

Miralax is one of the most commonly prescribed drugs for infants, toddlers and kids. It isn’t FDA approved for them. It contains ingredients found in anti-freeze. Concerns for its toxicity have mounted (as they should – one child in my practice slipped into a coma during an in-patient, closely monitored procedure to give high doses of the laxative ingredient in Miralax to clear a fecal impaction). The label states it is only to be used by adults for up to seven days – but children have entered my practice who have been on it, with their gastroenterologists’ blessing, for years – which is not unusual. And when I meet these kids, they are still constipated, still unable to move bowels without drugs or suppositories, still picky eaters, and they don’t feel good. Their parents want them off Miralax, and so do I. Having messy, uncomfortable “applesauce” stools every day – or none – is not healthy.

The Truth About Miralax Use

The truth is, besides having potent toxicity for at least some children, this drug does nothing to treat causes of constipation. Like many drugs, it is a bandaid approach. What it does do is turn stool into mush, by pulling more water into the intestine. Children can go from being impacted with hard dry feces (very uncomfortable, and encourages toxins from stool or disruptive microbes to leach back into circulation), to expelling some mushy stool regularly. But, they can still be left with impacted, sticky fecal matter, despite using more, more, and more Miralax.

A common picture that I’ve encountered in my practice for kids on this drug is “overflow diarrhea” – that is, blow outs of loose stool every few days, with or without firm, hard, or dry plugs of stool. This overflow, which seeps around the impacted matter, causes staining in pants that kids (or teens) can’t control. For toddlers, it can explode up the child’s back and and down to ankles. Many moms have described to me the daily chore of stripping kids down, bathing them, and getting fresh clothing because this pattern covers their toddlers or babies in stool.  Older kids experience embarrassing stool accidents with this pattern. Needless to day, this is exasperating and concerning for parents – and miserable for kids. Regardless, it’s common for pediatricians to use Miralax indefinitely anyway: In 2013, Miralax was the fourth most popular drug in the “digestive” category, with nearly $180 million of it sold!

There are many other solutions. They are non-toxic, safe, and more effective. My top three interventions for constipation are…

Mycelial form of Candida

Mycelial form of Candida – Why you don’t want to go there

1 – Assess and clear fungal infections in the gut.

Prevailing thought in gastroenterology today dictates that nobody gets fungal infections, unless they are immune suppressed. It’s rare for GI docs to regard fungal infections in the gut as a problem. Your pediatrician usually won’t either. Their belief is that fungal microbes (aka yeast, Candida, mold) are normal residents in human intestinal micro-biomes. True enough – if there is little to no fungal growth there. A lot of fungal microbial growth is not normal. Without testing stool specifically for fungal culture, there is no way to know what is growing in there, or how much of it. Healthy kids can have fungal infections in the gut. Antibiotics, C-section delivery, prior thrush, using reflux medicine or use of some infant formulas can trigger fungal overgrowth in a baby or child’s gut.

Most GI doctors do not screen for this, but many functional medicine labs offer this test. I use it often in my practice. Why? Because fungal overgrowth in the gut can be quite constipating. A simple treatment with anti-fungal medicine can fix it. Drugs like Diflucan, Nystatin, or Sporanox do this. There are not many anti-fungal drugs out there, which is one reason why doctors are hesitant to use them unless they really have to – they don’t want resistance to develop to these drugs. But if a child is so constipated that they’ve spent years unable to eliminate normally or painlessly, or they can’t eat well, grow, or thrive, then it’s time to pull out those big guns (IMO!).

If your baby has had thrush – that is, a white coated tongue, or a diaper rash with white patches in stool – an anti-fungal medication may be offered, because thrush is a kind of fungal infection. But fungal load can persist deep in the GI tract, which, don’t forget, is several feet long. There is plenty of space between mouth and anus for fungal microbes to thrive. Just because the white coating on the tongue is gone, and the diaper rash too, does not mean the fungal infection is all gone. A lengthier course of medication can clear the problem, if it is lingering in colon or intestine.

Herbs can help keep fungal infections cleared out too. Common tools include tinctures or capsules of oregano, thyme, grapefruit seed extract, goldenseal, berberine, uva ursi, caprylic acid, black walnut, garlic, undecylenic acid, and many others. I often support my patients’ gut micro-biomes with herbal tools, so contact me if you need this help.

This product blends several herbs to help clear fungal infections in gut

This product blends several herbs to help clear fungal infections in gut

For entrenched fungal infections, I have not found probiotics alone to be effective. In fact, a popular probiotic used for intestinal fungal infections called Saccharomyces boulardii (“Sac B” for short) is problematic if used incorrectly and may worsen constipation. A more aggressive, multi-pronged approach is more successful: Direct clearing of the fungal infection with an herbal or prescription agent; different food; and, lastly, the right probiotic.

Strangely, while Miralax is not FDA approved for youngsters, anti-fungal medicines like Diflucan and Nystatin are approved for use in infants. They are safer. They can do a good job of clearing constipation from fungal infections, so explore this with your doctor if your child has been constipated for a long time. Don’t be daunted if you are dismissed. Find an integrative health practitioner who will help, and talk to me about non-prescription supports.

2 – Lose the reflux medicine!

Fungal infections worsen reflux, and reflux medicines worsen fungal infections. Click here for more on why you don’t want to leave your child on reflux medicine for very long. Like Miralax, reflux medicines are widely prescribed for babies and kids – some say over prescribed – but are not approved for use in those age groups. There are no proton pump inhibitors (reflux medicines) approved for use in infants age one year or younger. There is only one approved for use in children under age eleven years. Still, I have encountered countless infants and toddlers given reflux medicines only approved for adults, and left on them, for over a year or even two. This will worsen constipation, since it worsens fungal infections, and lowers digestive function overall. Using reflux medicine long term also diminishes uptake of many nutrients, especially minerals. Two children in my practice who used reflux medicines for over a year suffered fractures later on, and others have experienced stunting and delayed bone age. They were not absorbing minerals normally, and could not mineralize or grow bone as expected.

Talk to your doctor about weaning off reflux medicine if your child has used it for more than two months. There are many ways to improve digestion and diminish reflux without drugs. This is also one of my specialties in practice, so contact me if you need help. Changes in foods and use of herbs can gently enhance your child’s digestion while you wean off a reflux medicine. Correcting the gut micro-biome will help as well. Do this with guidance for better, faster results.

3 – Use Magnesium.

This one is so simple. Magnesium is an easy way to pull water into the gut without toxic effects from peculiar ingredients in products like Miralax (dyes, gluten, polyethylene glycol). Magnesium oxide is a stronger laxative than magnesium citrate; magnesium citrate is stronger than magnesium glycinate. There are other forms of magnesium besides these three, and depending on your child’s presentation, there is probably a magnesium option that can get him or her off Miralax. A very effective product, widely available, called Mag O7 is an ozonated form of magnesium that has worked beautifully for some of the most constipated children in my practice. Use this with guidance; the label instructions are intended for adults, and this dosing is too high for most children.

How much? Magnesium is calming, which is great, but too much is sedating and may slow heart rate. So this must be used with guidance, especially for infants or young toddlers. I choose which product and what dose, based on each child’s case. There are liquids, powders, and capsules of various magnesium products. One of the most popular is Natural Calm, available on many supermarket store shelves. A teaspoon gives 350 milligrams of magnesium citrate. This is a large dose for an infant, but may be perfect for a school age child. More than two teaspoons daily is not likely to be necessary and may be too sedating for your child. If you have any questions about using these products, especially if your child takes other medications, ask your pharmacist or pediatrician.

These three ideas are only the beginning. From foods to herbs to drug-free options, there are many ways to clear constipation that are not only non-toxic, but more effective than Miralax – and they create better overall health by replenishing and balancing the cause of constipation, rather than giving it a toxic bandaid.

Click on the graph below, to see the absolutely mind boggling amounts of money spent on “digestive” drugs. These data are only for the year 2103! Which of these has your child used, and which would you like to replace with non-toxic, healthy options? It’s possible. Need help getting your child off of Miralax for constipation? Contact me and let’s get started!

 

Digestive Drug Sales 2013

Are Thrush and Yeast Infections Pediatrics’ Biggest Fail?

Are Thrush and Yeast Infections Pediatrics’ Biggest Fail?

Can a baby have a fungal infection? Yes – and undiagnosed, untreated fungal (yeast, thrush) infections could be one of one biggest failures of pediatrics today. How could this be?

I have often seen untreated thrush/fungal/yeast infections in babies, toddlers, and kids persist, then shift, into deeper, entrenched problems. Then the prescription drug parade ensues, usually in this order, with only limited or modest success: Prilosec (or other reflux medicine); Pediasure; Miralax; Ritalin, Concerta, or other stimulant, followed by something for anxiety or depression, like Straterra, Zoloft or Seroquel. Is this health care, or drug dependency? And are the kids feeling great, or lousy?

Most children who come to me for nutrition intervention only get to me as a last resort. They’ve been to gastroenterologists, neurologists, psychiatrists, feeding therapists, occupational therapists, behavior therapists, speech therapists. The last thing their parents want to do is change up the food in the house – especially when specialists don’t help them do that, and they tell parents it won’t do any good anyway (as most of them have told my patients). Too much work, right?

But eventually parents are at wits’ end. They have a picky child who eats poorly, grows weakly, or has reflux. Or they have an enthusiastic but still picky eater (read: stuffs food in mouth to choking) who loves starchy, sugary food like bread, chips, cheese crackers, candy, carbs, dairy junk (yogurt tubes or sugary milk substitutes). Their kids have big behavior problems: Tantrums well past toddler years. They can easily melt down, overstimulated, in public places, like restaurants, supermakets, or malls. They struggle at school, for being aggressive, combative, inattentive, or oppositional. All before they are five or six years old…. Uncle! Time to try that crazy nutrition stuff.

You’ve probably heard of Candida, or yeast infections, or thrush. And we’ve all heard a lot about gut biome, and how crucial it is for many aspects of health. This burgeoning area of research may not make the pharmaceutical industry very happy. Turns out that nearly any chronic condition – from Alzheimer’s, asthma, and autism to anxiety, depression, rheumatoid arthritis, and much more – may be treatable through improving the microflora (bacteria) in your gut.

How do you do that?

Easy. You change what you eat. You use the right probiotics, tailored to your stool testing or your history. You clear out nasty gut microbes that don’t help you, and there are many fabulous herbs that can do that. You do this as a lifestyle, not as a ten day course of a drug. And, your body begins to restore itself from the inside out. That is the “crazy nutrition stuff” in a nutshell – and it’s not what your pediatrician is primarily trained to offer.

Recent reports indicate that you can even improve conditions like these through a fecal transplant – using a healthy donor’s poo to reboot your own colon with microbes that know how to run a clean shop in there. Good gut bugs communicate intimately with the immune system, and help it “learn” – learn what is friend, what is foe, what to react to, what to ignore, what to kill and pull apart, what to leave alone.

The pharmaceutical industry only makes hay when they can sell a patented product (as in for example, hundreds of millions of dollars in a single year from just one vaccine). But they can’t get far with … your poo. That stuff is yours. It’s definitely not patentable. Pharma also can’t get far with food, which is not patentable either. If you eat better, they lose money. Food isn’t patentable unless it’s processed beyond recognition or engineered genetically by Monsanto (patenting everything you eat is their business model, which is why they really don’t want you to learn about how bad GMO foods are for your gut, or to even know they’re in your food – hence the labeling battles). Probiotics are naturally occurring organisms. Not patentable, because they simply already exist. But food, probiotics, and even someone else’s poo may be better for kids than many of the drugs they are routinely given.

I digress a little here, but to a point: These addled kids tend to have really disrupted gut biomes. And, they are very often full of yeast. This can be like thrush throughout the GI tract, whether or not it’s visible in the mouth. That means there is too much Candida, Saccharomyces or other fungal strains in charge of the gut biome – and hence, your child’s digestion, absorption, and eliminations.

We find this out with stool testing that looks beyond the basic horrible microbes your insurance company pays a gastroenterologist to check for. We look for beneficial species like Lactobacillus strains, Bifido strains, and others. We also screen for annoying microbes like Klebsiella or Citrobacter species that may well be usual enough to find in a human gut, but not to excess. They shouldn’t be in charge of the conversation in there, so to speak. And if a child is underweight or in weak nutrition status, these microbes can have a pervasive negative impact.

And, we find yeast. Lots of yeast.

This is how fungal infections make you sick

This is how untreated thrush can situate itself and make your child miserable

Now, here’s the thing. Fungal microbes are somewhat usual members of our micro biome. But, they are normally kept in check by a healthy immune system. Mostly, they only raise an eyebrow for your doctor if your child has (a) florid thrush, in which white fluffy fungal stuff is literally coming out both ends – mouth and anus; or, (b) very serious immune deficiency problems, like leukemia or AIDS or neutropenia. If a child has a fungal skin rash, usual practice is to give a topical anti fungal cream. Other than that, pediatricians and gastroenterologists are generally unconcerned about yeast overgrowth in the body, because they are trained to only manage it for immune suppressed people.

But thrush can indicate yeast is a player even after an oral medicine like gentamicin clears it from the mouth. It’s easy to find out. Besides checking stool cultures or stool DNA analysis for yeast, I may also request a urine microbial acid test that looks for the “trash” that yeast cells make. Finding loads of this trash in urine means that yeast is present somewhere in body, possibly to a degree that is disruptive for mood, behavior, stooling, appetite, or more. It may even mean that a child’s repeat urinary tract infections are from yeast, not bacteria – in which case, antibiotics will not only do no good but will actually worsen the infection.

You can look at yeast (or mold for that matter) in many other ways with other lab tests, but the bottom line is this: A lot of children seem to be walking around with a lot more fungal and mold microbes in them than is healthy. What does this do? Typical symptoms are:

– Constipation severe enough for kids to be Miralax or enema-dependent, or to have had hospitalizations to clear fecal impactions

– Bedwetting well into school age years or even later

– Aggressive, rageful, violent, or oppositional behavior severe and frequent enough to impede learning, socializing, or ordinary tasking; abates if favorite foods are given, flares when hungry

– Appetite rigid for sweets, starches, dairy foods, and wheat (pizza, bread, pasta, crackers, mac and cheese, cookies)

– Refusal of protein foods (meats, fish, eggs, legumes, nuts, nut butters)

– Extreme pickiness for textures; easily upset by mixed food textures; refusal of fresh foods especially vegetables

– Dependence on reflux medicines (fungal infections can cause reflux, and reflux medicines cause fungal infections!)

– Allergies or sensitivities to many foods (which may be undiagnosed as well)

– Chronic fatigue, frequent malaise, with intermittent hyperactive bursts

The incredibly simple thing is this: Clear these fungal loads out of a child’s gut or body, and you have a different child. Behavior, appetite, everything starts to improve. The constipation ends. Gradually, given the right food and the right tools, the gut will start to heal up too.

But we haven’t even talked about the real problem here. Candida albicans, one of the most common yeast microbes found in our intestines, can shape shift from its initial “bud” form to a more debilitating “mycelial” form (see the pictures above). In this case, it grows little threads called hyphae that penetrate the gut wall tissue. It uses these to suck in nutrients for itself. It literally sends out little fingers that puncture your gut wall, in order to anchor itself there, eat and grow more, and hide better from your immune system. Watch the video to see what I mean:

Once in this mode, yeast and thrush infections are harder to clear. They create “leaky gut”, which creates more food allergies, more food sensitivities, and more susceptibility to other infections – including yeast infections in other locations. Many children start life susceptible to this scenario from birth. How? By receiving antibiotics directly or indirectly through mom, by getting a hepatitis B shot (made from a yeast strain called Saccharomyces cerevisaie), by arriving via C-section (in which case they miss getting mom’s vaginal flora on the way out), or by getting formula instead of breast milk (which favors undesirable microbes over beneficial ones).

Given that we know all this, we can do better for our kids. Many drugs prescribed for children – from Ritalin to Reglan – may become unnecessary, if underlying Candida infections are cleared, better food is in the mix, and the gut biome gets to work as intended. This can be straightforward to manage with the right non-prescription tools. Click the appointment tab above if you’d like to work with me on strategies to clear problems caused by untreated thrush or yeast infections. I look forward to hearing from you!

 

Why You Should Avoid Reflux Meds For Your Baby – And How To Do It

Why You Should Avoid Reflux Meds For Your Baby – And How To Do It

If your baby or toddler is using reflux medicine, maybe it’s time to quit. Here’s why, and how.

This is one of my least favorite findings in a little one’s history. Why? Because the longer reflux medicines are used, the weaker a child’s digestion becomes. The weaker your baby’s digestion becomes, the harder it is to absorb food and nutrients. This creates a domino effect of trouble! Just click through this FDA powerpoint presentation to the Pediatric Advisory Committee to see what I mean. From fractures to fecal impactions, it’s not pretty.

Most parents report to me that reflux medicine seems to help a little at first, especially for quelling colic and crying. But soon, the benefit fades.

Then the baby becomes more picky, appetite more sluggish, stools more constipated and slow, belly more bloated. Feeding gets harder, not easier – and the reflux medicine dose goes up. After a few months, we have a fussy eater who is having tantrums about feeding, who is dependent on Miralax to have bowel movements, and growth pattern has slowed down. After a few years on reflux medicines, it’s common for me to be looking at a stunted child who is barely getting taller; who is epically picky, cranky, or anxious; who is struggling to learn, behave, or develop normally; and who is so stuck on Miralax even at ever increasing doses, it doesn’t work so well anymore.

The whole point of these medicines is to weaken stomach acid – presumably because too much acid is irritating the esophagus. Reflux medicines (“proton pump inhibitors” or PPIs) are the second most prescribed drug for infants and children, behind antibiotics. Does your baby even need it?

These medicines were created and approved for use in adults who may actually have too much acid gurgling up from the stomach into the esophagus. But this may not be what is happening in a baby or toddler’s digestion. Reflux medicines are not FDA approved for use in infants (kids under a year old) but are routinely prescribed anyway. Even if actual reflux was the issue, the only way to know for sure is to put the baby through an invasive procedure with something called a pH probe. A probe is stuck down the baby’s throat in “dip-stick” fashion so that a reading on the stomach’s acidity can be taken. Infants may need sedation and hospitalization to get through this procedure. Obviously, it’s all too easy for your pediatrician to hand you a prescription instead and say “try this”.

Even the FDA knows this drug can be bad for babies

Before you try that, you should know that there are many drug-free options that work well, and leave your child’s digestion in tact. Try these instead – because reflux medicines have been found to have these negative side effects:

• reduce uptake of iron, zinc, calcium, and magnesium

• increase risk of breaking bones

impede absorption of vitamin B12, and reduce serum levels of B12

• enhance fungal (yeast) infections in the gut or esophagus

• reduce the helpful bacteria in the gut (which makes digesting food even harder) while encouraging pathogenic bacteria

• cause bacterial infections of the small intestine

• cause Clostridia difficile infections, a hard to treat bacteria that causes diarrhea

seizures under certain predisposing conditions

Yuck! Imagine all this going on in a tiny infant’s gut, which is just getting started in learning to digest and absorb food.

Basically, these medicines weaken stomach acid – and thus, make the stomach less capable of digesting anything. The ability to digest and absorb food is gradually weakened. Effects from using these for more than a few weeks? Examples from my own practice include linear growth grinding to a halt (kids can’t grow taller), delayed bone age (kids’ bones are not growing normally), and fractures of hip, wrists, or spine – in kids. Other nutrients become harder to absorb too, especially vitamin B12. Anxiety becomes prominent – and this is not surprising, as we learn more about how gut bacteria are linked to mood and anxiety.

But that’s not all. Changing the acid level of a human digestive tract means you change which microbes can  grow there. The microbes we carry in our intestines do a lot for us. They help us digest food, communicate with our immune systems, and help fight off invading infectious microbes that can make us sick. Using reflux medicines favors microbes that are not ideal – such as Clostridia difficile (linked to seizures and autism like features in tests on rats) and fungal infections (Candida or other yeast species). These definitely do not help your baby or child. A healthy gut has a pH that will favor helpful species, like Lactobacillus strains or Bifido strains.

So what to do? Try these steps – and learn more detail in my book Special Needs Kids Go Pharm Free. The first chapter is all about babies, from feeding to colic to sleep, reflux, and more.

1) If you’re breastfeeding, trial a diet without the usual suspects. Remove dairy, gluten, nuts, eggs, or soy. Some babies fare better when brassicas are removed (cauliflower, broccoli, Brussel sprouts). Don’t remove all these foods at once. Experiment with rotations. Always put back in a strong, nutritious replacement for any food you take out. Use ample organic fats including eggs, ghee, meats and poultry, legumes, and vegetables. You may need to use alternate protein supplements to keep you strong and energized while your own diet is restricted. Need help with this? Contact me.

2) Change up the feeding routine. Milk and soy proteins are not what your baby was built to digest. So, if you’re using milk or soy formula, change it. This alone may ease “reflux” symptoms. Use a partly digested (“hydrolyzed”) formula instead. Some ideas here.

3) If you’re using milk protein formula, don’t switch to soy. It may be just as hard or harder than milk protein to digest. And soy. See step (1).

4) Switch to organic, GMO-free formula. GMO ingredients in conventional formula are potential trouble for your baby’s gut bacteria and gut health. Read here for why I tell my patients to avoid GMO foods. More scientists are expressing concern that GMO foods alone may be triggering autism in our children.

5) Use probiotics, like Klaire Labs Infant Therbiotic. This blends a number of beneficial strains that babies need in their guts for good digestion and to reduce inflammation. Klaire does not sell directly to the public, but you can purchase here  or call them directly at 1-888-488-2488, with my provider authorization code 825.

6) Use an herbal tincture designed for babies and toddlers, in a glycerite base, that supports digestion. My favorite is from Gaia Herbs. Order at 10% off when you use my log in, MyNCFC and 80303 password, or call Emerson Ecologics at 1-800-654-4432. Tell them I’ve referred you and get 10% off.

7) Put Epsom salts in your baby or toddler’s bath at night. This is calming, and delivers both magnesium and sulfur via absorption through skin. Sulfur is a key mineral for many digestive functions. Dissolve one half cup in the bath and soak for twenty minutes.

8) Clear fungal infections. If your baby had thrush, he may need some stronger medicine to clear any lingering fungal load from the digestive tract. Fungal infections alone can alter the acidity of the digestive tract, and keep it sub-optimal – thus causing more reflux!

These are so easy to do. Use these steps to prevent ever getting on a reflux med, and to help your baby or toddler wean off. Let me know how it goes!

Thanks for stopping by! If you don’t see answers here to your baby’s situation and need more help, make an appointment to work with me – you can view options, fees, and access to my calendar here. I can’t answer treatment questions or give individual care advice in this forum, but look forward to working with you one on one.

Gaia Tummy Tonic

7 Things I’ve Learned From Kids With Autism

7 Things I’ve Learned From Kids With Autism

Hard to believe it has been eighteen years since I began my work in pediatric nutrition, starting with the surprise landing of my own beautiful, red head, now-grown-and-handsome-launching-for-college son (surprise because I never thought the red hair in my family would carry through, and because he has always been a surprisingly intense guy).

If you don’t know what dropped me into this niche, read my bio here. Long short, it happened to my family. In 1996, I was on my own as a new mom, scratching my head (clawing at it? until it bled?) trying to figure out what had happened to my amazing baby boy and how to fix it. For all the gory details, epiphanies, and crazy that we went through with doctors, schools, and mean people, read my first book here. I had to write it down – because I knew that I could not possibly be the only mother witnessing such struggle in her baby while all our doctors told us it was normal. How many other babies were going through this “normal” that was not normal? How many would suffer life-long disability because of it? Would my son be one of them? Those were my questions. My son was eighteen months old before a now-renown gastroenterologist named Tim Buie told me that indeed, having explosive foul burning wet stool all of your life, plus multiple sensory and other debilitating problems, was not normal at all.

Since then I’ve had the privilege of helping hundreds of infants, children and teens in the pediatric nutrition practice I formed as a result. Many had autism diagnoses, many had autism features but no label. Among those, some were already worked up by specialists for myriad physical findings. So, I’ve been honored to be entrusted with countless physicians’  notes, reports, lab findings, and chart notes in these children’s files – an education in itself. Some of these kids were simply worked over by costly specialists and had not enjoyed successful treatment at all. Others were treatment naive – they got a label, a brain scan, and some behavior therapy. Here are things I’ve learned, both as a parent and as a clinician. I hope they help you on your journey with your child, whatever their label may or may not be.

1 – Labels do not matter. What matters is how a child presents. Look at the child. Work them up as though there is no label. Disregard the word “autism” and simply investigate physical presentation. Never accept “Head banging, anxiety, teeth clenching, yelling, fecal smearing, chronic constipation, weird eating habits etc etc are because he has autism.” That is a lie. Autism does not cause any of those things.

2 – When a child feels well, they are happier. They can learn. They can thrive.

Feeling better, ready to play!

Feeling better, ready to play!

3 – Many children with autism do not feel well. They can’t tell you because: (a) They are non-verbal. (b) they have always felt this way and don’t know any better. (c) They are awash in a (treatable) opioid brain chemistry that dulls their sense of pain (ever watch your child with autism bonk his head, hard, and just keep going?)

4 – If your doctor tells you there is nothing wrong, but your intuition tells you something is wrong, your intuition wins. True story: So far, I have not met a mom whose intuition was wrong.

5 – I have not yet met a child with autism with an entirely normal physical work up. I don’t mean a normal physical exam, I mean a normal work up for everything: Allergy, autoimmunity, inflammation, gut flora, mineral balance, food intake, toxicity, or gastrointestinal findings.

6 – There are two kinds of normal: One your insurance company will pay for, and one that is your child’s birthright. Guess which one is healthier?

7 – Every child with autism is in there. They are cogent, and desiring connection with others, even if not on a level you may understand. They may not feel well enough to express these things.

Each and every child with autism or autism features deserves to reach for their innate birthright of vibrant health, and connectedness with their fellow humans. Even those seemingly desirous of a lot of isolation, on some level on their own terms, need connection and love. Find the path to your child’s health and connectivity whatever it may be. I can’t wait to see what other amazing things my son will do in this world (he’s already blown our socks off). Had we listened to the naysayers, dark-outlook and criticizing teachers, meanies, and downright misinformed doctors when he was little, I shudder to think where he would now be (extremely disabled, or, six feet under). Thank you to all the providers and friends who joined our journey to hold my son up with us. It takes a village!

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Can nutrition help your child with autism? I don’t know. But I did write this e book to help families approach their health care providers with the right questions to find out. Click here for Five Essential Lab Tests For Kids With Autism