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Is FPIES FODMAPs Intolerance In Disguise?

Is FPIES FODMAPs Intolerance In Disguise?

FPIES – food protein induced enterocolities syndrome – is becoming a frequent presence in my pediatric nutrition practice. There are no prevalence studies for it yet, and it has only recently been recognized with a diagnosis code. FPIES is a debilitating and frightening condition that affects young infants. When the baby eats, there is sudden vomiting and even loss of consciousness, along with watery or mucousy stools, more than the usual crying and discomfort, and poor weight gain. Blood may be seen in stool. The sudden movement of water into the gut, along with complex immune reactions, may cause a hypovolemia (low blood volume) to trigger shock symptoms. Toddlers can be affected too.

My breast-fed son exhibited these very symptoms as a newborn, just days old, in 1996. We were terrified and scrambled for answers. He would take a feeding, then just explode – with all of it coming out of his mouth and nostrils forcefully – and then he would collapse into fleeting unconsciousness. This happened three or four times in his first two weeks. We were offered zero treatment, and zero advice. We were told it was colic and that we were just nervous new parents who were probably exaggerating.

Finally my son ended up in the ER where the only offering was a work up (that failed miserably) for spinal meningitis. No one had a clue, and we were not treated well by the doctors. In fact, this was such a wreckage of a moment for us as new, trusting, and hopeful young parents that it is what galvanized me to redirect my focus as a nutritionist and help others in this frightful dilemma. I knew then this was not ordinary colic; I knew there had to be an inflammatory component, based on my training in infant nutrition (which I later learned few doctors ever get). It horrified me that any other parents or babies would be left to struggle this way. It was isolating for us, as we knew no one experiencing this (no internet!), not to mention painful to navigate the indifference of the medical community.

I breast fed on an extensive elimination diet, and my baby improved – but I was depleted, and didn’t have the skill set I have now to really do this right. Once he was transitioned to a homemade goat milk formula, he did even better, and chubbed up nicely. He began to do more of what babies do: He smiled, gurgled, cooed, chattered, giggled, slept, pooped (more normally), and generally was happier to be here.

Now I hear from parents almost every week who have little ones struggling with this same scenario. They have been given the FPIES diagnosis, but that’s about it. There may have been a few tests done, but little else to help the baby be able to eat normally and grow well. Hypoallergenic formulas, then elemental formulas, are tried. If breast fed, the babies do better when mom is on an elimination diet. But like I was, many of these families have become emotionally and physically depleted. Breastfeeding on a deeply restricted diet is hard, and introducing “safe” foods for the baby is a roller coaster. No one wants to see the baby struggle with FPIES symptoms. If all else fails, it’s on to tube feeding.

There is a huge missing piece here. What the GI community is overlooking so far, when it comes to FPIES, is the baby’s gut biome. Some screening is usually done to make sure there is no outright deadly gut pathogen in there, but that’s all. There is so much to learn about how our gut bacteria support us from birth, but we already know enough to start working with it – there is no need to wait. We know that the immune system is “tutored” by the bacteria that populate the baby’s gut. Babies who lose normal, healthy gut flora (bacteria), for whatever reason, go on to have more inflammatory conditions later in life. And in FPIES, there are clear shifts in the body’s immune cells that show a lot of inflammation is going on in the gut. Tests for kids with FPIES tend to show more eosinophils (white blood cells that are common with allergy or inflammation), more immature white blood cells (this is the body’s attempt to fight fight fight), as well as obvious changes in gut tissue that show inflammation.

What is causing it? Is it food protein? The answer is not clear. Kids with FPIES often have negative food allergy (IgE) test findings. I have found this to be true in my caseload too. When I have looked further for food sensitivity reactions (IgG) in toddlers with FPIES (babies are too young to reliably test for IgG reactions), those are often negative too. While some kids with FPIES show reactivity to dairy or soy protein, they don’t appear to do so more than the general population. And curiously, two of the most common trigger foods in FPIES are not high protein foods at all. They’re starchy foods – rice and oat – foods that are often among the first introduced to babies. So perhaps FPIES isn’t about food proteins after all. 

It’s The Biome, Baby! FPIES babies in my practice have shown improvement with efforts to restore expected, healthy gut flora. While GI doctors will conventionally only rule out life threatening gut infections, I use stool microbiology tests to see if the baby has the healthy bacteria needed to develop normal digestion and immune responses in the gut. This testing also screens for fungal species (yeast), because too much yeast in the gut (aka Candida) will disrupt digestion also. And it looks for “commensal” microbes that are not necessarily pathogenic or life threatening, but potentially inflammatory, if there are much more of them than the healthy bacteria babies need.

So far, just as the literature is reporting, I also notice negative food protein reactions in lab testing for FPIES kids. But -and this is where the literature is pretty mum – in my own practice, stool testing for FPIES babies often reveals inadequate helpful flora. Candida species are not a consistent player here so far, but off beat fungal microbes pop up: Saccharomyces cerevisaie (a component of newborn hepatitis B vaccines) or Rhodotorula muculaginosa for example. But the bigger story is that these stool tests do show more of the “commensal” bacteria than expected, at least in FPIES kids I have worked with. Species like Citrobacter, Klebsiella, Hemolytic E. coli, non-difficile Clostridia, or Alpha hemolytic Strep show up, in spades. It appears that there may be more of these commensal strains populating the gut, than the healthy strains.

Is this the problem? Research needs to be done here for sure. When I work with parents to correct these findings, these kids start to improve. I help parents use probiotics, caprylic acid (from coconut oil) and gentle antimicrobial herb tinctures to balance the baby’s gut biome out. Healthy gut bacteria help digest food, and mitigate inflammation. Your doctor may think a prescription medicine could be useful here too, to aggressively clear the commensal bacteria.

Source: IBSGroup.org

Source: IBSGroup.org

Of course, the other major tool at your disposal is food. Gut bacteria eat what we eat, and they eat first. This is where FODMAPs come in. FODMAPs stands for “fermentable oligo-, di- and monosaccarides and polyols”. A mouthful! FODMAPs are carbohydrates that we don’t completely digest. They are fermented (digested) by bacteria in our intestines. Bacteria aren’t supposed to dominate the stomach and upper small intestine (they help finish the job further along in the GI tract, after our own enzymes and digestive juices have worked on our food), but infections may situate there in the small intestine, up high so to speak, when our own digestion is weak, if immunosuppressive effects are in play, or if a recent infection or vaccination was not tolerated well.

Infections that situate in the small intestine are called are called SIBO (small intestine bacterial overgrowth). These are tricky to culture with a stool test because by the time a meal is digested and passed all the way down to the colon, the microbes that may have been busy with that meal at the start of your GI tract may not be detectable anymore – but they can wreak havoc anyway, especially when we eat foods high in those FODMAPs. Breath tests can detect these, but getting that sample from an infant can be tricky. Invasive procedures to dip-stick a baby’s stomach juices have been done, but it’s far easier to just trial some nutrition and food strategies.

Low FODMAPs foods seem to be helping babies and toddlers in my practice with FPIES. They are turning the corner with some weight gain, improving stools, and no more terrifying FPIES reactions. I shorten this list even further, by removing any foods that don’t meet criteria for Elaine Gottshall’s Specific Carbohydrate Diet (SCD). Many foods allowed on SCD are high in FODMAPs. But by limiting foods to those that meet both low FODMAPs and SCD-legal criteria, I have a short list of foods that are most likely to be easily digestible and least likely to be interesting to the commensal microbial overgrowth in a baby’s gut.

Elaine Gottschall, SCD founder

Elaine Gottschall, SCD founder

Some components of GAPS diet can work as well, but I have not seen GAPS alone to work as well as creating individual care plans that draw from low FODMAPs, SCD-legal, and direct interventions to help the baby’s gut biome with probiotics or herbs. It’s trial and error, but the parents working with me on this are the true champions who make it all possible.

Interestingly, grains like rice and oat – two of the most common triggers for FPIES reactions – are first to go when following low FODMAPs and SCD-legal food lists. Soy and dairy products are not allowed either, with an exception in some circumstances for yogurt made from raw goat milk with certain bacterial cultures.

I see rays of hope for FPIES kids, with room to leverage what we already know about irritable bowel disease, inflammatory bowel disease, the role of gut bacteria for good health, and how to use anti-inflammatory foods or anti-microbial herbs or food components. When parents are ready to roll up their sleeves and work with me, it’s a delight when things turn around. For more on FODMAPs, check out Chris Kresser’s post too. And thanks for reading this far!

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

Natural Helps Through Seasonal Allergies: Herbs, Homeopathics, Supplements

Natural Helps Through Seasonal Allergies: Herbs, Homeopathics, Supplements

Have allergies hit your neighborhood yet? Snow is receding for many of us and that means… pollen – and a tough time for many kids. Fall or spring, when allergies hit, several natural tools work well. Put these naturopathic supports in your toolbox to alleviate allergy symptoms. These can work gently and quickly to ease sneezing, runny nose, weeping stinging eyes, or congestion, without some of the side effects some children have from drugs like Benadryl or Claritin. Somnolence (too sleepy), hyperactivity, or insomnia are common unwanted effects from these drugs. The right prescription drug can literally be a life saver too, especially for asthmatic kids during this challenging time of year. Be sure to follow your physician’s instructions, and don’t mix herbs or supplements with medicines unless your pharmacist or physician says it’s okay.

Non- inflammatory diet – Avoid trigger foods that exacerbate inflammatory reactions. If your child has rashes or eczema that come and go, hives, wheezing, or asthma, test for food reactions, not just inhaled allergens. Test both allergy (IgE) and sensitivity (IgG). Avoiding trigger foods can markedly improve respiratory and skin symptoms. This testing is a routine part of my pediatric nutrition practice. Sugary processed foods and processed fats also worsen inflammation in the body, so minimize those by replacing them with whole foods and healthy fat sources (fish oils, avocado, organic eggs or meats, organic nuts and seeds, flax meal, olive oil).

Quercetin – This is one of many flavonoids, which are phenolic compounds found in many plants, including herbs, teas, fruits, vegetables, roots, and wine. Quercetin has broad anti-inflammatory and antioxidant effects. It is not an anti-histamine, but it does inhibit enzymes that start inflammatory cascades in cells. You’ll find lots of quercetin in onions, raw apples, berries, and broccoli. It is widely available as a supplement in capsules or in chewable blends for kids. Quercetin can protect against damage caused in tissues and cells by swelling and inflammation. It can also chelate iron. If your child has low iron or anemia, use this with professional supervision. If your child has iron overload, quercetin may help. Otherwise, usual doses are 250-500 mg daily for school aged kids.

Fenugreek – Like quercetin, fenugreek has strong anti-oxidant and free-radical-scavenging power, meaning it will help cells avoid damage from reactive oxygen species that wreak havoc in the body when inflammation from allergies is high. It has a long history in traditional medicine across many cultures, and has been used in breastfeeding to increase milk supply. For seasonal allergies, its astringent properties may help drain inflammation in sinuses and lungs, and break apart mucus trapped in those spaces. Available in tinctures or capsules; my preferred encapsulated brand is from Medi-Herb. Antronex from Standard Process is another favorite of mine for easing sinus drainage and phlegm; it contains fenugreek, comes as a small, slippery, easy to swallow tablet, and can be safely dosed up to several daily as needed til symptoms improve.

ButterburButterbur – This herb showed itself to be as effective as Allegra in a clinical trial for hay fever. The same outcome occurred in another trial that compared butterbur to Zyrtec. And again when butterbur was tested against placebo. No side effects were noted in these trials. So, it works – but can your child use it? It hasn’t been tested in children for allergies as far as I could find, but it has been tested in children for migraines, with no toxicity or ill effects observed. This makes it a possible winner for kids who need allergy relief but get too drowsy or activated with the usual over the counter drugs. Dosage tested in children was 50-150 mg daily for four months.

Probiotics – The good news on probiotics just won’t quit. Taking probiotics helps reduce upper respiratory infections and inflammation, and can reduce seasonal allergy symptoms like rhinitis (runny nose!). Make them a routine part of your child’s daily food and supplement plan. Lactobacillus strains that have been proven effective at reducing allergic symptoms in sinuses are L. paracasei, L. acidophilus, and L. salivarius. Bifido species were helpful too. These strains can be found at relevant potencies in better probiotics, such as from Klaire, VSL, Custom Probiotics, or Kirkman Labs. Don’t expect them to be cheap, and keep them refrigerated. Chewable probiotics sitting on your supermarket shelves are of virtually no value – the potency is dubious, and too low in any case; and, there are unnecessary fillers that may have more allergens. Buy the good stuff. My clients can do that here at 10% off – let me help you pick one. Ask for regular (not chilled pack) shipping to save a bundle and immediately store in refrigerator on arrival.

nettle11Nettles – Nettle is another somewhat miraculous herb. It has anti-histamine power, and inhibits mast cells, which are another key component of allergic reactions. Like quercetin, it also interrupts enzymes in cells that trip inflammatory cascades. It seems to most relieve itching and sneezing. It’s available as dried leaves which can be steeped as tea, which many kids will be agreeable to sip if they aren’t feeling well. It’s also widely available in capsules, chewables, or tinctures. 100-300 mg daily for children is a usual dose.

Vitamin C – Years ago, researchers found that a 2 gram (2000 milligram) dose of Vitamin C lowered histamine in test subjects by nearly 40%. It actually interrupts histamine formation in the first place. Two grams is an ordinary dose that you may have used before during colds or flu. Vitamin C is a natural laxative too. For some kids, this dose may loosen bowels (perhaps a desired effect, if your child has constipation). Start at about 100 mg and work up slowly, to make sure you don’t trigger diarrhea. Taking this with bioflavonoids makes C even more effective.

Curcumin / Turmeric – Check my blog post on how to easily eat more of this potent anti-inflammatory herb. Though results on how well it works for asthma have been mixed, researchers have found that it inhibits mast cell response, which means it may have anti-allergy effects.

Measles Infection – Has your child had measles infection? There is an up side: Getting actual measles has shown a lifelong protective effect against allergic diseases (and certain cancers!). If your child contracts measles, be sure to support them nutritionally, as this can give them an easier, uncomplicated course of infection. Check my post on how to do that here.

Homeopathics – A number of homeopathic remedies in 12c or 30c potencies (available at many health food stores) can quickly alleviate allergy symptoms. These are used by placing 3-5 pellets under the tongue in an empty mouth, away from foods or fluids. Let them dissolve. If no change in symptoms, the dose can be repeated in 30 to 40 minutes for 12c potency pellets; or 45 minutes to every two hours for 30 c potency pellets. When the correct remedy is used, a clear response occurs. When it does, stop – more is not better. If a partial improvement occurs with a relapse into worsening symptoms, then you’re likely on the right track and another dose is indicated. If no improvement occurs, you’ve chosen the wrong remedy. Euphrasia, Sabadilla, and Allium Cepa are common choices for allergy season. A helpful blog on this can be found here.

There are so many options to help your kids feel better during allergy season, and they don’t all have to be pharmaceutical ones. If your child does well with those – celebrate! If they struggle with side effects or only partial improvement, natural supports may work better. This is a short list. There are many more options that skilled providers have at their fingertips. If you aren’t sure where to start, consider a product for children like D-Hist Junior chewables (10% off to my clients and followers). It has a blend of some of the items mentioned here, and may be a helpful add on to medications if your doctor gives it a thumbs up.

Should You Try A Special Diet For Your Child?

Should You Try A Special Diet For Your Child?

Reasons not to do a special diet for your kids’ autism / ADHD / anxiety / OCD / Tourette’s / speech delay / diabetes / seizure disorder / ODD / depression / aggressive behavior / fill-in-the-blank? I’ve heard them all.

We moms often forget our own power, for finding wellness for our kids. You don’t have to know how to do it (that’s my job, and there are loads of helps out there besides me). You do get to decide if you do it. And you are pretty much the one who is going to make it happen – not your doctor, your kid’s teacher, your spouse or partner, and certainly not your kid. Not “the science”, not the New England Journal of Medicine, not the IEP team, not the local children’s hospital expert team of gastroenterologists, not your allergist, not your neurologist, and not your ABA therapist.

The fact is that food and nutrition really, really matter, for all children, especially for children born nowadays. They are struggling against an unprecedented current of toxicity, inflammation, underweight, missing nutrients, or any of the other things that real food can fix. While you were pregnant, you were too – but being roughly twenty times bigger than your baby is at full term, these may not have had noticeable impacts on you.

These conditions all boil down to toxicity and inflammation, beyond levels that your child’s brain, gut or body may be able to handle. You can leverage food and nutrition to lessen those, and let your child move more swiftly to his or her potential. Or, not: You can stick with the cheap, easy, processed food routine and shorten your child’s life and prospects.

Children with conditions like ADHD, asthma, FPIES, food allergy, autism, global developmental delay, etc etc – can be very difficult to manage. Their futures may feel uncertain, grim even. I have many hundreds of stories from practice (and my own from parenting) of how these children can disrupt a whole family, every day, demanding all parents have to give for energy. Who would choose to live like this, right? If there was an answer, you’d engage it. This is so difficult, and it’s not your fault. And besides…

SKeptical Mom

  • You tried a special diet before and it didn’t work. You tried so hard.
  • You really don’t wan’t to know if this will work, because if it does, then you’ll be one of those annoying foodie gluten free moms who buys organic food. Ugh.
  • You really don’t want this to work, because if it does, you’ll be crushed by the guilt of not having done it sooner, or maybe having done it “wrong” before.
  • It’s easier to do ABA, OT, feeding clinic, a surgically inserted feeding tube, Risperdal, Abilify, brain scans, or anything else that your insurance covers. You’re checking that all out first. (These things may help, but they work better or can be totally eliminated, with the food part really dialed in.)
  • If this stuff worked, they would’ve proved it by now. It’d be on the news. It’s not on the news.
  • Your GI doctor/neurologist/psychiatrist/psychologist/pediatrician said it’s a waste of time.
  • Your school kept sandbagging you by giving your kid the wrong food. Nothing you could do.
  • Your husband doesn’t “believe in it”.
  • Your ex/in-laws/nanny/sister/auntie-who-baby-sits sandbagged you by giving the wrong food.
  • You don’t like Jenny McCarthy.
  • Your kid hated the food. Wouldn’t eat it.
  • The food is too expensive. It’s elitist food. That’s not you. You’re a Dunkin Donuts/Starbucks and Pizza Hut/Olive Garden family!
  • You felt sorry for your child when she couldn’t eat the cupcakes/pie/ice cream/candy at the birthday/holiday/Halloween/Valentine’s Day class party.
  • You just don’t like to cook. Your family is too busy. You eat out a lot.
  • You have other kids. It caused too much fighting to change the food for one kid.
  • Your kid broke through locked doors/cabinets/underground tunnels, found the food he wasn’t supposed to have, and ate it anyway. Nothing you could do.
  • Your kid screamed for hours/broke windows/became violent, when he didn’t get his milk/bread/cookie/ice cream/pizza/favorite pasta or noodles.

No, none of this is your fault. Unfortunately though, it is your problem. It’s your kid. And, no judgment. Many out there know, my family has been through pretty much all of the above.

And yet, there are few things on this planet more determined than a mama bear with a mission. Once you tap into that gut sense of what might be best for your child, any obstacle can be overcome. If your hunch is that food matters, call me.

If you’re blocked by guilt, fear, or judgment for whatever reason, those are potent – they will keep you from moving forward. Get clear first on how you feel about this, before you begin. Start with kindness and forgiveness for whatever you might think you did wrong (you don’t do anything wrong; you do your best). Finding out what foods would work best and changing those routines is a lot of work – it takes total commitment.

It’s my pleasure to guide mama bears through this part of the long and incredible journey of raising children with challenges. If this doesn’t yield results you hoped for, and it was truly followed to the last detail at the right pace, there are deeper biomedical options yet to explore. See the possibility of your child, grown up, independent, and content. Now that always brings tears to my eyes!

Heal Your Child’s Eczema Naturally

Heal Your Child’s Eczema Naturally

Eczema even as painful as this child has can be healed naturally. Finding the right foods to emphasize, foods to withdraw or only use sometimes, and restoring gut health are key to naturally healing eczema. While you use soothing with skin treatments (which can help a lot by easing pain and itching), heal the underlying causes.

Eczema can hurt more than your child’s skin. Eczema can mean that inflammation is active systemically – that is, all over the body, inside and out. These widespread reactions can mean your child has more anxiety, more behavior problems, a pickier appetite, or more frequent infections. Where to start?

1) Plan on 3-4 months to see full improvement. Repair takes time. Painful eczema may mean the immune system is reacting to something deeper than skin, from the inside out. Identify the suspects, and you can repair and heal the skin. This takes good, non-inflammatory, nutritious food. Antibodies to trigger foods stay in the blood for at least three to six months after you stop eating that food. Every time your child eats even “a little” trigger food, the immune reaction is amplified. For best results, avoid the worst offender trigger foods completely. Remember, kids need food to replace what is withdrawn, and it must be of equal or greater nutritional value. Just withdrawing foods only to eat lesser ones will weaken your child and delay repair of healthy skin.

2) Get proper testing. Elimination diets won’t help after a certain point. If you’ve already tried months of withdrawing this or that, and your child still has eczema, it’s time to get properly tested. Allergy tests may not show the type of reaction that is active when a child has eczema. So if you’ve been to your allergist, and the tests looked normal, you may need a different test. I often start with these tests in my own practice, when the trigger foods remain a mystery:

Wheat/Gluten Reactivity and Autoimmunity Panel (click “Array 3” here) – Gluten (wheat protein) is so often a culprit, and so often incorrectly assessed – even by specialists in pediatric allergy and gastroenterology – that this is the panel I go to if I need an emphatic, clear, and detailed picture of exactly how a child’s body responds to eating gluten.

ELISA IgG Food Antibody Profile – Several specialty labs offer this test. I like using these labs best because they have developed a way to sample dozens (93 to be exact) of foods with a very small amount of blood, which is good for kids (who we all know hate to go for blood draws). There is even a method that uses just a few drops of blood from a fingerstick – so you can collect the sample at home and mail it in (nice option for teens or older kids).

There are many other tests out there. I review these options with my patients. Bottom line: Get tested if your child still struggles with eczema and you’ve done everything else you can.

3) Look at the gut. Emerging evidence supports the scenario that eczema starts inside, in the gut, and not outside, on the skin. Your allergist probably told you to get rid of carpet, launder sheets twice a week with hypoallergenic laundry soap, use natural fabrics only, or consider returning your dog or cat to the SPCA. Again, if the eczema is still there, or your child’s skin remains tender and highly reactive to even a puppy’s cuddle, it’s time to go deeper for answers. Humans evolved with microbes and the latest news is that these microbes are expert traffic directors for our immune systems. They may actually teach our immune systems what to react to and what to ignore, especially at the level of the gut wall. They exchange genes with us – potentially helping us write the software for our immune systems. The possibility is that this relationship with microbes gives kids an opportunity to reboot the  software.

Here’s what to do: Clear any constipation, diarrhea, or bowel infections with high dose probiotics, a better diet without sugary and processed foods, and with herbs or even prescription medications to clear and balance microbes in the gut. Elimination diets can fail if this step is skipped, so don’t overlook that gut health piece. Need help? Work with me to do this safely and effectively.

4) Build with the right protein for the job. If you take out a protein source, put back a different one of equal or better value. Make sure it isn’t inflammatory – this is where testing is useful. For example, don’t replace cow’s milk with rice or almond milk. They both lack protein. Use those subs with a protein powder blended into a shake, or add a protein food, like egg, meat, nuts or nut butters if allowed, quinoa with legumes, and so on. Kids need this protein to build and repair! Another example: Don’t switch soy milk, tofu, and soy yogurt in for milk either. Both have protein, but soy is often as triggering as cow’s milk. You may even get better results with elemental (amino acid based) protein products; many are available, but knowing how and when to use them is the key.

5) Add natural anti-inflammatories. Herbs and supplements, topically and orally, can be great adjuncts or even  good primary strategies. Skin salves can be great soothers, and herbs abound for this purpose. A favorite resource of mine for this is Rebecca’s Apothecary in Boulder. They can ship, and answer questions for you. For oral use, some of my favorites turmeric, curcumin, fish oils, nettles, quercetin, vitamin C in higher doses (to bowel tolerance), calendula, calcium lactate, and lots of healthy fats from coconut, organic eggs and grass fed meats, and tolerated nuts or seeds.

Long short, eczema can be healed naturally. Your child doesn’t have to suffer. Some kids have so many food reactions that they can’t possibly remove all of them from their diets and they need special supplementation until they get well enough to safely eat those foods again. I routinely navigate these options for my clients, so contact me if you need help!

Hearty, Healthy Starters For Kids: Breakfast Ideas Without Processed Junk Food

Hearty, Healthy Starters For Kids: Breakfast Ideas Without Processed Junk Food

It can be easier than you think to give your kids a hearty, healthy breakfast starter without opening a box of processed cereal… which isn’t really food. Who knew? I grew up reading the backs of breakfast cereal boxes every morning, munching on my favorites: Cap’n Crunch or Frosted Flakes. As a teen it was Cracklin’ Bran and Cheerios, which were actually thought of as healthier. In those days, we didn’t yet have high fructose corn syrup (HFCS), the processed sugar noted for its mercury content and penchant for driving obesity in children. There was no such thing as genetically modified ingredients either. In a small way, those cereals were less toxic than the same brands today. Parents believed they were healthful products. But they were still plenty sugary, and full of colors and preservatives.

The addition of HFCS and GMO grains into these products has not improved their image, or made them healthier, to say the least. Click here for why I tell my patients to avoid GMO foods and here for  why to avoid HFCS. Families are wising up. Bloomberg Businessweek recently featured a horrified Tony the Tiger on its cover. He’s wearing a gas mask and recoiling from a glowing green bowl of Frosted Flakes. Bottom line: Sales for Kellogg are off, way off, as parents realize what’s in that stuff – but the weird part is, Kellogg doesn’t seem to be getting the memo, as it promises new products like …peanut butter and jelly pop tarts – ? TonyTiger_Businessweek_Cover

You don’t need that. Neither do your kids. And you don’t need to wait for a Big Food corporation to tell you what to feed your family. Here are a few items that give a stronger start for your child’s brain and body. Some come together quickly in the morning rush, and others can be made ahead so they are ready to pull out of the fridge when your family is leaving for school.

Eggs Any Way, of course. Healthiest if you can get eggs from chickens who are not GMO grain fed, but who can peck and eat their usual fare of bugs or feed that is organic. Scramble, fry, or hard boil some ahead of time and eat them as an instant protein and fats boost in the morning. Here are some grain-free ideas for sides with eggs:

– Chop green pepper, onion, and leftover potato or French fries and toss in a hot skillet with olive oil, coconut oil, salt, pepper, and paprika or red pepper. Cook through and serve with egg on top. You can chop these veggies the night before as part of your dinner prep, and set aside for morning.

– Crack an egg into half an avocado, sprinkle with salt, pepper, and a dash of turmeric. Drizzle with olive oil. Bake at 400 degrees for 5-10 minutes or til yolk is firm to your liking. Eat right out of the avocado rind with a spoon!

– Toss leftover hearty vegetables like roasted Brussed sprouts or cauliflower into a hot skillet with olive oil  or coconut oil. Add pine nuts or pumpkin seeds. Sear til hot, serve with your over-easy egg on top (my favorite). Got leftover pesto sauce? Stir that in as you reheat your vegetables and coat them well.

– Hearty greens seared with a soft boiled, over-easy or gently fried egg are delicious, if not a bit sophisticated for kids palate – but you might be surprised. I often set aside greens washed for dinner to use some the next morning. Kale, chard, baby bok choy, arugula and a few spears of asparagus work well. I quickly sear these in coconut and toasted sesame oils, with fresh minced garlic if I have time, and good quality garlic salt if I don’t. Spinkle in sesame seed or pumpkin seed for protein, fiber, minerals and healthy oils.

egg in avocado

Breakfast Meats – Go with organic, non-GMO fed animals here if you can. Side of fruit chunks or veggie hash, or even reheated quinoa or rice from last night. Breakfast meats go direct from freezer to skillet, with a small amount of olive oil and chicken or beef broth, simmer covered til done.

Grains? Many of us are minimizing or cutting out grains altogether. But if you’re not there, there are a few options for breakfasts. If you need to skip gluten but your kids like toast, gluten free bagels and breads (and waffles and English muffins and so on) are everywhere, and if they aren’t in your neighborhood, you can order them. Warning: These can be as sugary or starchy as any other processed breakfast food, but they can be a bridge piece when kids are leaving behind processed wheat and dairy diets and moving into a broader-palate.

– Gently heat an organic corn tortilla (skillet or microwave if you must) and wrap it around a scrambled egg. Add some salsa, fresh cilantro, and cheese (if allowable) to your child’s liking; add mashed ripe avocado if cheese is a no-go. You might succeed with a cheese substitute based on pea protein called Daiya for kids used to cheese with tortillas.

– Rice is a usual accompaniment to eggs, in Pacific-Asian eating styles. Have some on hand to reheat for morning – brown, black (“royal“) rice, or white if nothing else can satisfy your child for now. Serve with hot sauce or salsa.

– Gluten free pancake mixes can be had from Bob’s Red Mill or Pamela’s, available in most supermarkets. Both take moments to prepare. If you have a little more time, mix these up instead:  Pumpkin Pancakes – a grain free and hearty starter with protein, nice fats, and nutrient-dense, grain-free carbs.

honeydew_chunksLunch Meats with Fruit – If you don’t have time to cook anything, this cold combo works well (for school lunches too): Salami or pepperoni that is gluten free and minimal for additives or even organic is a hearty starter. Side with honeydew melon, water melon, pineapple chunks, raw whole almonds, or goat cheddar, if dairy works for your child. Try a lime aioli with this for dipping the fruit (use honey and no garlic, with lime instead of lemon juice). Assembles quickly with an immersion blender – make ahead and keep in fridge to use for dips or salad dressings.

Hot Porridges: Fast, easy, and grain free: Try Cashew (or Macadamia) Coconut Porridge by blending all these in a pot and heat gently, and enjoy:

2 TBSP almond butter

1/4 cup shredded coconut

1 TBSP ground flax meal

1/4 cup finely chopped raw cashews or macadamia nuts

1/3 cup full fat canned coconut milk

1/2 cup canned pumpkin or sweet potato puree

1/4 teaspoon vanilla extract

1 teaspoon raw honey (or maple syrup)

For grains, you can cook your own oatmeal (gluten free or not) or hot brown rice cereal. Some kids like coarser, crunchier textures in hot cereal; some don’t. For the crunchers, add chopped nuts or sunflower seeds. For the smooth kids, oatmeal can be turned into quick oats either buy buying it already finely ground, or by putting it in a food processor yourself, so it is nearly a powder before cooking. If oats don’t fly, whole grain brown rice cereal may be an option. It’s coarser than the infamous Cream Of Rice cereal, with more fiber. Traditional Chinese medicine practitioners love to recommend congee, which is brown rice cooked slowly for days, with water added often, until it is a soft, broken down, easy to digest porridge. If you have the opportunity to keep a pot of this on your stove, some kids will do better with this option. Add coconut oil and an gentle sweeteners like pear puree, a small amount of maple syrup, coconut sugar, or lucuma powder.


Either way, hot cereals are perfect for enhancing with healthy fats and extra protein. Stir in ground flax meal, ground cashews or almonds, sesame seeds or tahini, ghee, butter, coconut manna, or whole canned coconut milk. Chopped nuts or raisins are obvious add-ons too. Sweeten to taste with a little maple syrup (the real deal, not the processed fake stuff), coconut sugar, raw local honey, or stevia drops or powder for a no-sugar option. Cinnamon rounds out the sweetness while also exerting a beneficial modulating effect on blood sugar.

Hot Drinks: Hot chicken broth, especially if you have roasted a chicken this week and made your own, is a good choice for kids with tender stomachs and low appetites in the morning. Heat and enjoy plain or stir in gentle digestive aids like a fresh ginger root slice, some chopped cilantro leaves, scallion pieces, or baby bok choy leaves. Hydrating and nourishing with minerals for adrenal glands, and soothing fats for the brain.

A heftier option is to make cocoa – here is my recipe for a dairy free version, which uses sugar, or not.

Smoothies: The possibilities here are almost endless. Most kids I work with must avoid certain proteins – dairy, gluten, soy, egg and so on. There are many products that can go into a smoothie to add protein, without using those sources. Check out my smoothie recipe page here. Products I use often to boost protein in these are Apex Glycemovite, Thorne MediBolic, UltraCare For Kids, Systemic Formulas Metabo-Shake, ImmunoPro organic whey powder, or free amino acids. Be creative – anything goes. For example, turmeric powder (a great anti-inflammatory) with unsweetened cocoa (which adds antioxidants and zinc) create a fruity, fragrant flavor that is more than either item alone. Add your own sweetener to taste!

Leftovers: Did your kids love last night’s dinner? Nothing says it can’t be for breakfast. Reheat and enjoy.

There are so many ways to eat differently in the morning besides opening a box of processed, sweetened grains with questionable ingredients. Build a routine that works for your family. It doesn’t have to be hard. Once you’ve got the new routine down, you might be surprised how easy it can be.