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What REALLY Heals Leaky Gut in Kids

What REALLY Heals Leaky Gut in Kids

Healing leaky gut is one of the most requested tasks in my pediatric nutrition practice. Many parents are surprised to hear me say that it is possible to repair leaky gut in children of all ages.

But what really works? There is a lot of buzz about dietary approaches, probiotics, and supplements, and less good research on leaky gut than we’d like, especially when it comes to infants, toddlers, kids, or teens. However, after twenty years in my clinical pediatric nutrition practice, I can tell you what nutrition supports I’ve seen consistently work, and what strategies often fail.

First, let’s get on the same page about what leaky gut is, and isn’t. It doesn’t mean there are actual ulcers or holes in your child’s intestine that are “leaking”. But it can mean that the intestinal wall has lost some integrity – and has become too permissive about the size of molecules that it lets pass into your bloodstream.

Another way you might hear leaky gut described is “intestinal permeability” or “hyper-permeability” – again, expressing a condition in which the intestine’s normally very selective, tight process for digesting and absorbing food has become, well, loose and sketchy!

Practitioners – myself included – might scrutinize zonulin, stool microbe studies (microbiology culture or PCR DNA methods), inflammatory markers like calprotectin, or immune markers like immunoglobulin A in a stool sample to gauge gut environment. Some doctors may order a lactulose-mannose test in which patients drink a concentrated solution made of those sugars. How these two sugars, which are different sizes, are excreted in urine can give a measure of how permeable the gut is. For more on intestinal permeability tests and their pros and cons, click here. Food allergy and non-IgE food reactions may also be measured, which requires a blood test.

Key To Restoring Leaky Gut Is….

Key to restoring a healthy gut is repairing “tight junctions” – these are the microscopic, traffic-cop structures of your gut. They form a tight seal between cells in the intestinal wall. When these junctions are injured, they break down – and larger-than-ideal molecules cross from the intestine into the bloodstream, triggering all sorts of reactions to stuff that your bloodstream and distant tissues were never meant to see in the first place. These might be anything from polypeptides (over-size fragments of food protein molecules that can masquerade as false hormones, false neurotransmitters, or invading antigens) to toxins, getting access your body from your gut, when they’re not supposed to. This permeability scenario is a catch-22, in that it can easily perpetuate itself, as more injury persists in the gut.

The intestine is our largest immune system interface with the world outside the body – so leaky gut can also wreak immune havoc, from autoimmune problems to frequent infections and illnesses.

What injures the gut? Lotsa stuff – and, making this harder is that leaky gut symptoms are often diffuse and insidious. They can evolve gradually, or with an abrupt onset that never quite resolves. Leaky gut can trigger symptoms in the GI tract of course, but also far from the gut, like headaches or joint aches, stiffness, pain, fatigue, or frequent colds and infections.

image courtesy Jill Carnahan MD

Here Are Usual Suspects for Triggering Leaky Gut

  • antibiotic use
  • intestinal Candida or other fungal species infections
  • undiagnosed food allergy or food sensitivity
  • intestinal flu or virus
  • food poisoning
  • non celiac gluten sensitivity
  • poorly tolerated routine vaccinations
  • chronic stress
  • traumatic brain injury or concussion
  • C section birth (baby misses exposure to helpful vaginal flora)
  • mom treated with antibiotics in pregnancy or at delivery for any reason
  • mastitis (mom needs antibiotics while breastfeeding)
  • radiation therapy
  • being underweight especially if you’re a baby, child, or teen

Most kids have had at least one of the items on this list. But that last one is key. In itself, underweight can cause intestinal permeability especially in children. You can address all the other triggers, but if your child is underweight – that is, more than fifteen percentile points off his or her expected pattern – your child’s gut can remain “leaky”. There simply isn’t enough raw material and energy on board for that tissue to repair itself, while your child is also trying to grow.

Here’s the rub: Generally, nobody scrutinizes your child’s growth pattern that closely (I will be honest and tell you that I even see gastroenterology work ups overlook this level of detail – and I routinely read my patients’ reports from their GI specialists nationwide). Without defining your child’s actual expected growth pattern – that is, where your child should be today given parental stature, pregnancy history, birth/delivery history, and growth history since birth – then you don’t know if your child is underweight or undernourished. You can learn more about that here.

I meet many children who are underweight. Sometimes it’s caused by families placing kids on diets that are too restrictive. Or some families have become so traumatized by frightening reactions to foods that they just don’t know how or what to feed their children – so, they don’t. Sometimes it’s caused by a well meaning practitioner who didn’t monitor growth and food intake, because they’re focused on lab tests and supplements instead, gave no guidance on what to actually eat, and encouraged a restrictive diet without effective replacements for foods taken out. I have also seen underweight caused by reflux medicines, which can diminish appetite and digestion when used for more than a few weeks or months. When it comes to picky eating, this too will drive growth status down in kids, injuring the gut too via underweight and poor diet.

The flip side of this coin is assessing what your child eats – how much and what – and the only way to discover if your child eats enough non-triggering, nourishing food is to assess a food diary  (part of every new patient intake I do), and then align it with the growth assessment. The food your child eats is the lumber that will be used to do the gut repair – so it has to be the right stuff, in the right amount. Supplements (including glutamine, which is a helpful amino acid but not an energy source), herbs, and probiotics don’t provide this raw building material. I meet a lot of kids who have been given a lot of supplements, lab tests, antifungals, special diets, and measures to repair leaky gut. But they’re still struggling – because this essential growth and feeding part gets lost in the shuffle. But put the right feeding plan with the right supplemental supports, and boom – now you’re talking!

Here’s What Works to Repair Leaky Gut In Kids

  • Balance gut microbe environment with herbal or prescription agents to directly address fungal burden, Clostridia burden (even commensal strains can be problematic if they far outnumber other helpful strains), Strep or Klebsiella, parasites, protozoans, and whatever comes up on testing. Combine this with probiotic supplementation that matches your child’s stool studies. My preferred tools for assessing this are GI MAP and Doctors Data Stool Microbiology.
  • Customize the special diet to your child. Skip dogmatic, one-size-fits-all approaches.
  • Give enough protein! Kids may need anywhere from 1 to 2 grams of protein per kilogram bodyweight per day depending on degree of growth impairment.
  • Give the right protein; assess first which proteins are triggering with lab studies. Replace trigger proteins with equal or better value non-trigger protein sources, and keep them varied.
  • Use free amino acids. Supplementing with amino acid mixes that give all 8 essential amino acids (and not just glutamine) has been a big bonus in my practice for kids who need deep gut repair. Formulas and powders are available. These give the gut direct access to building blocks for new tissue growth and repair. I use anywhere from 5 to 15 or even 30 grams daily of this protein source, depending on a child’s needs or status. Caveat: These won’t work well without an adequate total diet around them to support energy needs.
  • Give enough total food including “clean” (non sugary) carbohydrates, which are crucial for growth in children (carbs preserve protein for structure and function, and keep it from being burned for energy) and ample healthy fats and oils. Kids can need 4-6x more calories per pound than adults, depending on age and growth status. Don’t feed them like little adults – give energy-dense, nutrient-rich food.
  • Mastic gum, licorice root, zinc carnosine, glutathione, mineral-rich foods or products like Restore are just a tiny sliver of the thousands of products that can aid gut tissue repair. Work with a knowledgeable provider who has used these in children before. Using these tools is a routine part of my practice.
  • Correct sleep pattern so your child can sleep deeply and wake rested. Sleep is when our organs are busy with repair and clean up. Hint: Children who are underfed tend to sleep poorly and wake more often.
  • Minimize stress in your child’s world. Don’t discuss “leaky gut” with younger kids and don’t frame food or their bodies as problematic. Use positive language and emphasize the power to heal, which we all have.
  • Give it time (like, months), be chill, and remember that your child’s body is a miraculous thing with its own innate drive to grow, repair, and heal.

And Now For The Leaky Gut Fails…

  • Using rigid diet strategies for growing kids can be too restricting to support growth, gain, and gut repair. Yeast free diet, GAPS, ketogenic diet, AIP, SCD, Paleo, or Body Ecology all have merits (and devotees!), and I use components of all of them in my practice. But in themselves, none of these were created for use in children (except ketogenic diets for seizure control) and can fail when children are already struggling to gain or grow. If you’re not seeing good growth, gain, and progress in behavior or food reactions with one of these strategies within 2- 4 weeks, or if initial improvements lapse quickly, then it probably isn’t right for your child. Customize to your kid instead!
  • Needing your child to like any of this, including taking supplements, having blood draws, or accepting different foods. You’re the adult. They’re not going to make it easy for you – that’s a given. Hint: Picky appetites can improve with addressing these three steps – don’t assume your child “won’t eat that”.
  • Staying on reflux medicines for months at a time. These will work against your gut healing efforts by keeping pH in the stomach too weak to initiate good protein digestion. They will also cause your child to feel less hungry over time, to eat less, and to become more picky – thus leaving your child underfed and unreplenished for the task of gut repair. Learn more about the downside of reflux medicines here.
  • Using glutamine, vitamins, minerals, or lots of supplements before you situate the right feeding strategy for your child. Feeding strategy means knowing what foods to use, how much and which sources of protein, fats, and carbs, and for how long, to support your child’s expected weight and height.
  • Being aggressive with fermented foods, probiotics, or too much Saccharomyces boulardii. These can backfire if used for too long or at too high a dosage, and may even start to create their own dysbiosis or discomfort.
  • Leaving fungal, parasite, SIBO or SIFO, or other dysbiosis untreated or under-treated. This can interrupt appetite, digestion, and stooling and keep tight junctions from sealing up.
  • Giving up after 2-4 weeks. This is a restore and repair effort that may take months, depending on how long your child’s gut has been in the weeds.

Want help? This is a lot! Let me sort the best options for your child. Contact me today to set up a time to work with me remotely or in person. Or, peruse my options for books and on-line-course support.

 

 

 

 

 

When Flu Shots Fail, Nutrition To The Rescue

When Flu Shots Fail, Nutrition To The Rescue

You’ve probably noticed the uptick in terrifying news stories about flu in the last month or so. That’s no mistake – the CDC, FDA, and pharmaceutical trade would like you to be afraid, very afraid, of flu, in hopes that you’ll go get a flu shot.

Too bad the shot is such a fail this year.

This happens. Every year, best guesses are made about which flu strains to include in a vaccine, many months ahead of flu season. The soothsayers don’t always guess right.

And too bad even in good years, flu shots are no slam dunk. Their efficacy is, well, meh. In the 2014-2015 flu season, they were almost 100% ineffective, offering protection only 6% of the time. Over the years, they barely reach a 50% efficacy rate at preventing flu –  a coin toss or worse for odds. Some data show they don’t work at all, especially in the elderly,and they may even spread more infection.

Besides not having a stellar performance record, there are problems with this product: It contains mercury or aluminum (which is almost as neurotoxic as mercury, and suspect as an Alzheimer’s trigger), contaminant or rogue viral material, formaldehyde, and so on (why do parents wring hands about which organic Paleo snack is best, then don’t blink about injecting this stuff into their toddlers?). This is all heavy baggage for a product that the government would really, really like you to use, and that is why supermarkets, schools, drug stores, and even McDonalds are trying to give you a flu shot. My neighborhood supermarket plays flu shot shill on its pharmacy phone line, offers a feel-good incentive of a free meal to the homeless if you get one, and hangs placards everywhere about how easy it is to just walk in and get one.

But alas. People still recoil. Still, all is not lost. There are many strategies to build your immune strength so that you either don’t get flu, or if you do, it is a milder bout with shorter course.

Your body uses a tool kit to fight and manage infection. The tools it uses are manufactured by you, from food you eat. Vaccines don’t deliver any of those tools. All they do is deliver a ghost version of the infection, with some irritants to stimulate your immune system. It’s your job as a host-body to respond with protective strategies – things like immunoglobulins, white blood cells, and so on. Those are what protect you, not the vaccine itself. You have to make that stuff.

So prep yourself and your kids with the right stuff. There will be flu. There will be snot. There will be fever. But maybe your kids avoid it, or maybe you don’t get so bad a bout. Here’s how immune systems work best:

  • Make sure your child is not underweight. Don’t think s/he is? Read this. Your child should be north of the 10th percentile for body mass index (BMI), or for weight to height ratio. This is when kids’ bodies have robust resources to draw on to fight and manage infection, a task that consumes protein, calories (energy) and the nutrients below, to name a few. Underweight kids get sick more often, stay sick longer, and are at higher risk for complications from infection, due to a well understood phenomenon called cycle of malnutrition and infection. This kicks in even when kids are just a little bit underweight.
  • Maintain strong status for vitamin D, heading into winter and all throughout. Though lab ranges generally cut off at 30 ng/mL as too low, in our office we prefer to see patients in the 40-60 ng/mL range.
  • Maintain strong status for vitamin A rich foods. Cod liver oil is a good source, but don’t use more than a teaspoon daily for kids under 40 or 50 pounds. Too much vitamin A is not a good thing and will trigger low appetite, bone pains usually in long bones, dry peeling skin, demineralization of bones, or vomiting. If your doctor tests your child, levels should be at least 20 mcg/dL for health; below that warrants supplementation, according to the World Health Organization.
  • Eat zinc rich foods or supplement zinc. Zinc is another critical nutrient for immune function and building white blood cells. It has helps prevent viruses from replicating and attaching to your nasal membranes. Since it’s in foods many kids can’t eat (allergy) or don’t like, it’s common to have marginal zinc status. You can safely supplement 15-30 mg/day in children with lozenges, liquids, or pills; more may be needed acutely. As much as 75-150 mg zinc has been clinically trialed in children, safely. Pumpkin seeds, most nuts, lamb, pork, eggs, spinach, flax meal or flax seed, shrimp, chick peas, mushrooms, and cocoa are zinc rich foods. Caveat: Chocolate with cane sugar won’t go far since sugar will drop white blood cell count and drop your body’s defenses. Which leads me to my next recommendation…
  • Don’t eat sugar during flu season. See previous bullet. This means eat more vegetables than fruits; skip juices or soda for water, tea, or broth; pass on baked treats, muffins, candy, granola, sugary power bars, starchy pasta with sugary tomato sauce; check your kids’ favorite condiments for sugar (ketchup, dressings, canned or frozen snacks).
  • Check your kids’ iron status early in the fall. This is best done with a full iron study, which includes:
    • Ferritin
    • Serum iron
    • TIBC (iron binding capacity)
    • Transferrin
    • Hemoglobin (HgB) and hematocrit (Hct)
    • Complete blood count (CBC)

This is more blood work than your pediatrician usually would order to check iron. I like that data because it fully describes where and how your child is using iron, a critical immune nutrient, and thus tells me what to do about it all, for nutrition support. It will also yield details about your kids’ red and white blood cells, and where nutrition deficits may be emerging. Since we store iron and since it is a toxin as well as a necessary mineral, the body has eloquent strategies to absorb it from food, store it, use it, or excrete it. Looking at just ferritin, which is what your doctor and your insurance plan may prefer, won’t tell the whole story. If iron status is marginal, shore it up with good diet: Eggs, red meats, dark greens, beans, ample protein, and a supplement if necessary. Don’t supplement iron without supervision – it can be toxic or deadly if misused. Weak iron status can take weeks or months to replenish, so start early in the fall.

  • Good old vitamin C: When the government set up minimum daily requirements for nutrients decades ago, we didn’t know much then about nutrition in healthy people, much less in sick people. Eating 60-100 mg of vitamin C daily might keep your gums from bleeding or getting scurvy, but it won’t go far to tool up your immune system. This is a safe nutrient to eat a lot of, barring known concerns for kidney stones; infusions of C of 50,000 mg (fifty grams) are not unusual in functional medicine practice. Vitamin C stimulates production of neutrophils, lymphocytes, and phagocytes – all powerful defenders for you. Eat a lot of it. Too much will cause watery stools, so that is your barometer for how much you can tolerate. Supplementing 500-1000 mg/day and more during illness may do the trick.
  • Play outside, and get exercise. Tell your kids to go build a snow man. Do yoga, get upside down, go sledding, take a walk. Sunlight, fresh air and movement will move lymph, which carries much of your seek-and-destroy fighter pilot white blood cells. Lymph’s only pump is your muscle action, and gravity. Blood is pumped by the heart but lymph depends on moving and breathing vigorously to flush itself around, and help you release debris and toxins from infection-fighting.
  • Don’t stress. Seriously. Stress is a swift and powerful buzz kill for your immune system. It actually suppresses it. Do what you can to counter it, if you can’t avoid it: Watch funny movies, break some plates, watch kitty videos, say oooommmm three times.

You just may be able to beat colds and flu even when flu shots fail. Tool up your body’s fighters so they have the armour they need to do their job. Food is the building material for all these tasks. Vaccines can influence the assembly line, but you still need the raw lumber to build stuff like immunoglobulin, neutrophils, lymphocytes, phagocytes, T cells, and much more; that stuff is made of protein, fats, good carbs, vitamins and minerals, which you gotta eat. Vaccines aren’t the lumber. They’re just the fire drill. Getting a flu shot without good nutrition already on deck is like throwing the fire alarm without having the fire truck, fire fighters, or hoses ready. Flu is no joke for vulnerable people, and it isn’t always obvious who might be vulnerable – but you can keep your fire crew at the ready at all times with good nutrition.

 

 

 

 

Surprise! Your Child Is Underweight

Surprise! Your Child Is Underweight

 

Is your child underweight? Your doctor would have told you, right?

Maybe not. In fact, I am often the first person to capture this finding in a toddler, child or teen who has seen multiple providers, from the pediatrician to gastroenterologist to allergist and so on. But this is really important for kids. Why? Because once kids slide into growth impairments, it throws a lot of other stuff off kilter for them. One, their immune systems don’t work as well. They can get sick more often, stay sick longer, and have more complications from infections than kids in healthy status. Two, they struggle more to behave, learn, focus, or sleep, and will often experience more anxiety, less self regulation, and more mood swings. This can happen even with mild or moderate growth impairments. In other words, kids don’t have to be severely underweight for this stuff to go wrong. When kids finally hit bottom with that failure to thrive (FTT) status, this will create a leaky gut – something many parents ask me about – because there aren’t enough nutrients and energy from food for the child’s gut wall to maintain its integrity. And, the younger a child is, the more vulnerable they are, when dropping off channel.

Pediatric providers generally won’t intervene on or even mention a lagging growth pattern unless your child is really, really underweight, as in – heading for the very bottom of the growth chart. Why not? There are several reasons why this can be true:

  • Your insurance may not pay your doctor to intervene on any growth impairment other than failure to thrive (FTT),  a severe and entrenched problem in which a child has fallen to below the fifth percentile for weight for age.
  • Your doctor may not know that dropping just fifteen percentile points off expected growth pattern, for either weight or stature, actually means your child is underweight or undernourished.
  • Your pediatrician may not know how to calculate your child’s ideal body weight, expected weight, or expected height, or doesn’t have time to do it.
  • Your doctor doesn’t have time to scrutinize, integrate and explain all the growth data in that brief fifteen minute visit, including all the things that impact growth, from your kids’ food intakes to energy level to genetics.
  • Your doctor isn’t sure how to help you fix the problem, or why it’s happening in the first place, if they notice it.

Because I work with kids with problems like allergy, autism, FPIES, inflammatory bowel conditions including Crohn’s disease, or all sorts of circumstances in which they can’t eat regular diets, it’s common for me to find that a child is indeed underweight. Many parents who contact me have placed their kids on special diets on their own, and don’t realize their kids are underfed and malnourished, even with all the best efforts at feeding well. But it can be a relief to know exactly what and how much food your child needs to grow, feel, and function better.

Usually, parents are downright surprised at what a difference something as simple as the right food intake makes for their kids.

This quote is straight out of clinic today from a mom regarding her fifth grader. Before nutrition intervention, he had severe attention and focus issues for which he’d been unsuccessfully medicated. He had accidents at school (smearing, pooping in his pants). He got sick often with colds. He was unhappy or frustrated often. After nutrition care, mom said this:

“Looks super healthy, I’ve never seen him this healthy. He seems more like a regular kid. He is thriving. He is growing like a weed. He is happy.”

This boy is off stimulant medication, using the bathroom independently and not having accidents, and has not had any infections for months, for the first time in his life.

What would your pediatrician do for these problems?

He would do what had been done for this child, and failed: Give methylphenidate (stimulants like Focalin, Ritalin, etc) for inattention and hyperactivity; Miralax for the constipation; antibiotics for the infections; and a “he seems fine” shrug for the moderate drop off of expected weight for age.

Nutrition care is not a replacement for medical care – and vice versa: Medical care is not nutrition care. They do different things, and require different skill sets. Strong nutrition in kids makes them healthy; prescription drugs mostly avert acute problems. Neither replaces the other, both are important for kids – but, unfortunately for kids all across the US, nutrition is not a big player in pediatrics nowadays.

Is your child underweight? Is it impacting their health? It’s easy to find out. There are well established criteria for determining things like expected growth pattern for a child, and how to restore it if lost. There are many tools at my disposal too, to sort out what foods would best serve your child, what foods you might really need to avoid, and what foods you really may not have to worry about. If you’re not sure, schedule an appointment and we can just find out!

Can Camel Milk Help FPIES, Allergy, Autism, and More?

Can Camel Milk Help FPIES, Allergy, Autism, and More?

There has been buzz for years now about camel milk, and its purported benefits for autism, Crohn’s disease, allergies, feeding problems and more.

I’ve been slow to embrace this possibility, because all mammalian milk (including human breast milk) contains milk protein – that is, casein – and casein can become problematic for many reasons. Casein structure varies a bit from species to species or even across breeds of animals in the same species (as described in the A1 versus A2 milk conversation).  This is what can make goat milk or sheep’s cheese more tolerable than cow’s milk for some kids. But all these milks – including human breast milk – can make a neuroactive protein fragment called casomorphin.

I’ve needed a good explanation for why this is not a problem with camel milk, and I found it.I’ve changed my mind, and now recommend it in certain circumstances. If you’d like to try it, you can purchase it here.

Here’s what I found out when I investigated camel milk:

Camel milk truly is different from milks that we make, or cow, goat, or sheep milk too. Here is a detailed comparison of what’s in camel milk versus human breast milk. But one thing all mammalian milks have in them is a protein called casein, which is often allergenic. Even as casein varies across species and can be easier to tolerate depending on the animal it comes from, generally, all casein can turn into a littler protein chunk called casomorphin. This can be a big trouble maker.

Casomorphin is great for babies in their first year. It is correlated with optimal psychomotor skills and muscle tone. But it can wear out its welcome, when a child’s intestine doesn’t acquire the skill to digest it thoroughly, past the age of 12-14 months. I routinely see this in my practice, in milk-addicted kids: Constipation, delayed language or aphasia (non-verbal), extreme picky eating, tantrums, ADD/ADHD, disrupted sleep, and behavior problems can come from a diet that uses mostly casein as a protein source. When those signs are active, kids are usually turning that casein into casomorphin, which is potently addicting, making for an extremely picky appetite, causing constipation and terrible behavior. If this is your kid, buy this e book. You’re welcome. It will save you a lot of time, pain and agony in feeding clinics, GI doctor’s offices, or in surgery avoided for a G-tube.

Casomorphin is easy to measure in urine. I have found it in the urine of older toddlers still breastfeeding, who strictly avoid dairy foods in their diets otherwise, and whose mothers strictly avoid dairy too – proving that the casomorphin indeed can come from weak digestion of the protein in breast milk. In these cases, weaning to non-dairy proteins in food did the trick.

Casomorphin is a “powerful opioid, more powerful than morphine itself“. It blunts sensation, and can delay potty training; it also prevents a process called synaptic or neural pruning, in which the brain adjusts its growth to accommodate new developmental phases. Without pruning, kids’ heads grow disproportionately large, and development – especially for language and social reciprocity – can stall. It’s common for me to see this phenomenon in children with autism who have had diets liberally inclusive of dairy protein, whether it’s from milk, cheese, yogurt, ice cream or whatever – all these dairy products contain casein. Gluten and soy proteins can form morphine-like neuroactive peptides too, in the context of weak digestion. These have been linked to autism features, for many years now. This is why kids with autism may begin to speak, function, behave and sleep better by removing wheat, dairy and soy foods entirely – stop eating opiate like neuropeptides, and their brains begin to work again.

What about camel milk? It turns out that the casein in camel milk is different enough in its structure to not create casomorphin, the opiate-like neuropeptide I’m talking about – while at the same time, its other components are also unusual – making for some extra healing benefits. It doesn’t have the same casein structure that cow’s milk has, and thus can’t create casomorphins that have brain-damaging potential, as is seen in autism. Camel milk lacks the beta-lactoglobulin found in cow milk; that, plus its different casein structure, means that the two most allergenic proteins in cow milk are absent from camel milk. The whey proteins of camel milk are different too, making them less allergenic. And camel milk has higher amounts of the immune protecting proteins lactoferrin and immunoglobulin than cow milk – though some dispute that the difference is enough to explain the medicinal benefits. But because camel immunoglobulin molecules are tinier than those in cow or human milk, and because they appear to be more potent in completely neutralizing an infectious agent, they can more easily target and disable viruses or bacteria in the gut. Traditionally, one of its many uses was for clearing rotavirus – something your child was probably vaccinated for, as rotavirus vaccines have been included in the CDC schedule since 2008 (look for RotaTeq on your child’s vaccine record). Who knew all they may have needed was camel milk?

Little data exist for its healing properties, but the little that is out there is compelling. A controlled clinical trial in fourteen children with autism who drank pasteurized camel milk instead of cow’s milk for eight weeks “revealed a decreased hyperactivity, increased alertness, grasping power and curiosity, better social interaction and many parents commented on the newly expressed effort of their children to listen and obey instructions.” The children also had daily bowel movements instead of being constipated, and got sick less often. Urine samples showed no elevation of beta casomorphin-7, the trouble-maker molecule in question for milk drinkers. In a larger, double blind, randomized trial of 65 kids with autism, profound improvements were once again noted, from just two weeks of camel milk consumption. And yet another blinded and randomized trial in 60 children with autism found that camel milk significantly reduced oxidative stress (a well documented feature of autism that underlies behavior problems, GI symptoms and more) while it gave a boost to the kids’ glutathione levels, which is a healthy body’s top protector against toxins. Glutathione is legendary for being depleted in kids with autism, and has been the target of much investigation, since correcting it may diminish features of autism. Glutathione is also a key to reducing symptoms of Crohns disease; a healthy gut wall is rich in this antioxidant, while a sick one is depleted of it.

Another obscure report lauds camel milk as a wound healer in diabetes; other findings suggest that camel milk has enough insulin-like peptides in it to effectively lower blood sugar. Meanwhile, here’s that nasty casomophin from cow milk again, possibly triggering diabetes. I found no trials specific to food protein induced enterocolitis syndrome (FPIES), but did find one that plainly showed that most kids with milk protein intolerance handle camel milk just fine, and that skin prick testing worked to screen for this option.

While controlled trials are few, anecdotes are plentiful on the web, describing remarkable improvements in children with autism who switched to camel milk. Here is a collection of some research on camel milk nutrition and how it can work for kids with other-milk allergy.

This all sounded good enough for me to spring for $275 worth of frozen camel milk (it doesn’t come cheap). I’m going to try this out. My son has a long history of inflammatory bowel symptoms and struggles to gain weight; I have a long history of autoimmune problems and am dependent on infused human immunoglobulin therapy to, well, pretty much stay alive. If anyone had good reason to give camel milk a try, I do. And there are a few hundred kids in my case load who might benefit. I like to have first hand experience with whatever I recommend to my families.

The only dromedary dairy in my region was cryptic and unfriendly when I reached out; they wouldn’t let me visit or purchase in person, so I passed. Besides, knowing that the entire Front Range of Colorado is under siege from cancer causing fracking contaminants in air and water, I felt it would be better to buy a product from somewhere else. Camel milk isn’t sold in stores near me as far as I could find, so I went with the one outfit that seemed well equipped to produce, sell, and ship milk reliably: Desert Farms. I’ve ordered and tried this milk myself, and was so pleased that I have become an affiliate for this product. As a recipient of immunoglobulin therapy, I am monitored closely every few weeks for my immune status, and I’ve continued to steadily improve. Let me know how camel milk worked for you!

Wanna try it? Purchase Desert Farms here.

 

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.