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Kids At Play – Heat and Altitude Nutrition Tips

Kids At Play – Heat and Altitude Nutrition Tips

Summers with intense heat are here to stay. We are in an era of extremes all around, and our climate is no exception. Mix high heat, high humidity, and high altitude and you have a potentially dangerous combination for any age. Besides keeping cool with AC, a pool, a fan, a garden hose, or whatever is at hand, here are some food and nutrition replenishment and preparation steps to help kids play safely.

Pre-Hydrate: Living at mile-high altitude and frequently playing at altitudes of 10-12,000 feet for hiking, biking or skiing, my family knows the drill: Don’t chase dehydration! It’s a losing game, one which we’ve seen end in the ER for visiting friends or family who didn’t want to keep drinking so much water. The dehydrating effect of altitude sets in without notice, and heat can do the same. Don’t let either sneak up on your kids!

  • Don’t wait for the fainting spell, nausea, vomiting, or pounding headaches to set in before taking enough fluids. If your child has reached this point, get to the ER for intravenous fluids and give whatever fluids are at hand on the way there.
  • Other signs of dehydration to watch for are muscle cramping, muscle weakness, confusion, sunken eyes, or irregular heart beat. Stop activity, find shade and cooler space, and take fluids.
  • During warm weather, let your kids have plenty to drink – and not just water. Give electrolytes, juices, and frozen fruit slushies or popsicles.
  • Allow plenty of salty foods, and use Himalayan pink salt if you can. It is less likely to have micro plastic pollution than sea salt, and offers dozens of minerals that the body uses to maintain normal blood pressure, temperature, heart contraction, and muscle function.

What About Electrolyte Drinks? There is a lot of hullaballoo about the good and bad ingredients in sports drinks like Gatorade, or electrolyte drinks like PediaLyte. Though they do have imperfect ingredients, don’t keep this hydration from your child so you can hold out for the homemade organic version you forgot at home! More harm than good will be had from not restoring the few minerals and helpful ingredients in these, than from occasional consumption of the junky sweeteners or artificial colors in them. Use them if you have no alternative.

For a cleaner alternative, I like KinderLyte, which is available ready to drink or powdered so you can pack it easily for travel, hiking, biking or camping, and add water on the spot. It has no artificial colors, sweeteners, flavors or preservatives. It also has no fructose or high fructose corn syrup. The calorie source in it is non-GMO dextrose, which is a naturally occurring molecule of two glucose units hitched together – the same stuff that will be in the IV if you do end up in the ER needing hydration. It works fast. And the electrolyte profile in it is higher than other brands; KinderLyte even offers a “core” version with even more electrolyte replenishment in it.

Homemade drinks may work too. Some recipes call for honey or white grape juice plus salt, which naturally have both fructose and glucose, among other types of natural sugars. This may be fine for upstream day to day hydration, but for carrying critical sodium into the body and into cells quickly, nothing beats glucose. A transport mechanism activates in the gut when the right concentrations of sodium, glucose, and water are present – making all three absorb more quickly. This is why I prefer to leave this to the experts in a commercial preparation like KinderLyte, over my own kitchen tinkering (which I love to do!). When the body needs quick restoration of minerals and hydration, I don’t want to mess around.

The Key Players: Calcium, Potassium, Magnesium, Sodium, Chloride A careful balance of all these minerals keeps everything running smoothly, from how our hearts beat, to controlling water levels and maintaining blood pressure, to how muscles contract and whether we’re thinking straight!

  • Make mineral rich foods routine in your kids’ meals. Vegetables and dark greens, meats, eggs, nuts and seeds and their butters, lentils, Pinto beans, seaweed snacks or nori, juiced celery, arugula, chard, and even cocoa powder deliver minerals across the board. Keep these going every day. Kale chips anyone?
  • If you’ve got a house full of picky white-diet eaters (cheese, milk, yogurt, bread, crackers, pasta, butter, toast, pizza, cookies, chips), you’re gonna need a good multivitamin that includes a complement of minerals too (most kids’ multivitamins have just that – vitamins – but few or no minerals). This Child Life Liquid is a good option while you keep up the good work in getting your kids to eat mineral rich foods – they still need them. If your kids are swallowing capsules, you can also buy a multi-mineral option like this one to complement their food intake. These supplements can give your kids something of a baseline for minerals to help metabolic functions, day to day.

Food, Fuel, Function – Compared to vitamins, we need relatively big amounts of minerals like calcium, magnesium, potassium and sodium to function day to day. Amounts we need vary with age, circumstance, activity – but, picture spoonfuls. So when you see that a product has 100 milligrams (mg) of say, calcium in it, that’s only about 5% of your total daily calcium need. If you lumped all the calcium you need in a day into one bite, it would be about a half teaspoon of pure calcium powder. Your total magnesium need in a day is similar – but many experts contend this is too low, even for ordinary activities day to day. Potassium, same story – somewhere between a half to even a whole teaspoon of it, depending on how much you’re sweating, or losing fluids by vomiting or diarrhea. Sodium? Same!

All of these will be expelled and used at higher rates when we are at altitude and in stressful high heat conditions. We need a lot of them, plus water!

  • Carry high potassium snacks like oranges, bananas, watermelon, potato chips (bonus if they’re super salty), or nuts.
  • Avoid dense sugary snacks like dried fruit. They have high potassium and calories, but low water, and this high sugar to low water imbalance may be nauseating if dehydration is setting in.
  • Calcium rich foods to pack are almonds or baked treats made with almond flour, sesame tahini bars, hummus with almond flour crackers, and of course dairy foods if your kids tolerate them. Many cereals are calcium fortified – build some into a trail mix with raisins, almonds, dark chocolate chips, sunflower seeds or any safe nuts.
  • Snacks for high magnesium are cocoa powder or dark chocolate, pumpkin seeds (this is my fave brand), plantain chips, cashews, kale chips, and edamame.
  • If fast sources of calcium are needed and your child can’t manage to eat food high in calcium, calcium lactate capsules or powder are quickest to absorb. I have been known to chew capsules on the chair lift if feeling a little loopy while riding up to 12,000 feet! Calcium lactate can quickly settle muscle cramps and heart palpitations. Another helper I’ve often used is a product called Cal-Amo, which provides chloride and helps balance pH in the blood.

Kids need a lot of food. They need about three times as much food per pound as adults, because they’re growing, and their metabolisms are running faster than ours all the time. On high activity days, high heat days, or high altitude days, consider doubling calories from there – if they’re craving that burger and fries post game or once you’re down off the trail, go for it. Metabolic rate goes up dramatically and your kids will need to replenish. It’s ok to use really high calorie foods if that’s what they’re after! A shake, some fries, a gooey pizza – Occasional forays into these foods will not hurt, unless you are aware of allergies or other issues for your kids when eating these.

If you would like to join my online dispensary and get access to the products I use in practice, contact me here. Have fun out there!

You Get To Love Your Pediatrician

You Get To Love Your Pediatrician

Do you love your pediatrician?

I did not love mine. In fact, my husband and I so did not love our pediatric group that we fired them when our baby was just six months old.

We pivoted.Our little guy never saw a pediatrician again. We wanted to love the pediatrician, not be furious with him.

We worked with our family practice doc, a naturopathic doc (ND), our MD GI specialist, and whomever else stood among the helpers/supporters. Unfortunately and unexpectedly, our pediatric group was not in that camp.

At six months, our little one had had way more office visits than expected. He’d been rushed to the ER, and he’d been hospitalized too. He rarely felt good or happy, rarely smiled, wasn’t interested in movement or much playfulness, and his gross motor skills were delayed such that he qualified for services. He was not sleeping, not feeding well, had constant rashes, kept getting sick, had seizures, and was slipping down the growth chart.

It was rough from the start. And throughout it all, every measure the pediatric group had given us had hurt, not helped, that baby boy. Every. Single. One. From telling us to “let him cry it out” (huge fail) to “more shots right now or we call child protective services” (I complied, and all that ensued were more seizures, more vomiting, more misery, less growth and gain, rashes, pain) to “this is fine, this is normal” (nope) … nothing offered by this pediatric office did any good.

We were done.

So, one day, during yet another phone call with the pediatrician, I hung up on him.

Years before this happened, I had completed my graduate and undergraduate degrees in nutrition and public health, as well as registration as a dietitian/nutritionist. Licensure followed once it became available for my profession too. My training in pediatric nutrition and maternal and child health had drilled me on the power and necessity of nutrition for a baby’s brain, not only in utero, but through the first three years at least. Nutrition, feeding, and a functional gut are crucial. The brain takes half the fuel the body draws out of food during that moment of explosive growth and development. Nutritional compromise, if severe enough, can injure a baby’s brain for life. At the tender age of a few weeks or months, it doesn’t take much to injure a growing brain – especially if it is not corrected.

Wait, did my pediatrician not receive that training? I later learned, they pretty much didn’t, and still don’t.

Frayed to the bone after just six months of being a new mom, there I was on the phone again with the doctor. At this point, we were failing on all formulas, and on breast milk. We’d cycled through different formula trials, each one with the expectation that I’d stop breastfeeding, pump and save the milk, then resume breastfeeding. Breastfeeding had already exhausted me. My son sipped slowly and took 10 hours out of every 24 just to eat even at six months of age. On top of that, he still hadn’t managed to sleep more than 20 or 40 minutes at a time. We’d all been awake 24/7 for six months, relying on mini cat naps. His stools were explosions of mucousy yellow that reached his neck and soaked his clothes up to 8 times a day – to which the pediatrician had mused, “I think it’s [the mucus] coming from the diaper”.

True story. My pediatrician actually said that.

I had to find a new way to feed this guy. He needed to grow, feel better, and sleep better.

I asked the doc, “what did you guys feed babies back in the day, before all these formulas, and when a mom couldn’t breastfeed?”

“Just keep using soy formula” he said, “Nothing else you can do.”

Ok – context: This was 1997. GMO soy formula was the popular go-to if a baby failed milk protein formula. There were no organic infant formulas, no goat milk formulas, no goat milk formula recipes, no internet to speak of, no European alternative formulas. There was milk protein formula (some with more whey than casein, which also failed), there was soy formula, and there was semi-elemental formula (like Alimentum or Nutramigen). That was it. Elemental formula like Neocate was new to the US at that time – but we had already tried that too.

My reaction was: Wait. What? Just keep doing what hurts this baby? Who hadn’t been able to pass stool for 12 days? Who prior to that, was passing black hard pebbles every few days, maybe, with struggle and duress? Whose appetite vanished because he couldn’t poop at all? Who can’t sleep because he’s hungry or is in pain? Just keep doing this? Because…. just because the doctor I’m speaking to is too poorly trained to help this infant thrive?

I slammed the phone down. Fun! Back when you could slam a receiver down on an actual phone. I hung up on my pediatrician. We never spoke to that group again. That was that.

Best decision I ever made. That’s when I really started to find my feet as a mom. That was my moment of empowerment. I took permission, which I realized was mine to begin with, to go with my instinct, and listen to my true nature as a woman and a mom, to take care of the baby I’d carried into this world.

That was also the moment I knew this would be work I’d do, not just for my child, but someday, when I could, I’d do it for other moms who forgot how to hear their intuition, their own power. Because I couldn’t possibly be the only one, and my baby couldn’t possibly the only one struggling with no effective help from the doctor.

Fast forward 25 years. I’ve been in private practice as a registered licensed dietitian/nutritionist for over two decades, helping babies and kids leverage nutrition and food so they can thrive. I’ve pulled them out of the wreckage that conventional pediatrics has made of them.

Ouch to the docs –  I get it. But – truly, what I have witnessed in these years in practice has been daunting. Discouraging. Shocking. Frustrating. How are you guys not seeing it? Once you do, you can’t un-see it: Pediatrics has gone off the rails.

In my training years, the only mention of pediatric chronic conditions was in a single brief rotation at a Shriner’s hospital for kids with severe birth defects (rare) or severe spinal cord injuries. There was no autism, little to no pediatric Crohns disease (and definitely not in infants and toddlers), no diagnosis codes for pediatric OCD, ODD, or severe anxiety disorders – not to mention more recent diagnoses like FPIES or intestinal failure, for which cries for help hit my in box now on the regular.

In the late 1980s when I completed graduate school, 6% of US kids had a chronic condition, developmental disability, other disability, or obesity. Now, even conservative tallies place this at over half of US kids.

I’ve worked with children as young as 2 years old with confirmed Crohns per biopsy. Children with autism diagnoses have made up the bulk of my practice for many years. It’s as though they have nowhere to go, after being placed in ABA therapy and given drugs to control behavior or seizures. Having been in practice so long, I am now seeing a second generation of children – and they are sicker than the generation before. Despite inventing and prescribing many more drugs and biological products for children than ever, our children have only become more sick, less able.

It seems pediatricians no longer understand what health looks like. Or, they have a new super low bar for it, and think it’s “health” when kids need a lot of drugs and shots:

  • If a child stops growing, they wait until the child drops to failure to thrive status, then refer to GI for a tube feeding – for a surgically inserted tube that will deliver a GMO formula with corn syrup and potentially inflammatory proteins.
  • If a child doesn’t sleep, their behavior becomes untenable, or they have environmental allergies, the doc will prescribe drugs to suppress symptoms, which often escalate to more illness and worsening symptoms later on.
  • If a child gets repeat colds and infections (>2 or 3 per year), they are given antibiotics – over and over, even as these fail – and more shots.

There is no investigation. No inquiry. Pediatricians have become rote drug dealers with little skill beyond their prescription pad, and I hear deep frustration about this from families nationwide every week.

Let’s just say it: American Academy of Pediatrics, you’re fired.

Your family deserves good health and a provider who knows how to help you create it

I encourage parents to find the providers who are helpers. Helpers encourage, problem solve, troubleshoot; they hold you up when you are unsure; they restore health by resolving root cause. Are your doctors doing this for your family?

I’ve noticed this in my private practice tenure: Parents who take charge and who cultivate partnerships with providers who are comfortable with fewer prescription drugs, and who respect parents as equals – these are the families whose children move away from debility and chronic illness, and toward higher well being and happiness. The endless upward cycle of more and more procedures, diagnostics, and drugs is worth questioning: Has it made your child healthier, happier, stronger? If so, keep up the good work. If not, there may be a better way, a hybrid of natural parenting with good medical care when warranted.

If your car broke down and stranded you every time your mechanic worked on it, would you keep this mechanic?

 

A good question for any parent: What is health for your kids?
Is it carrying an inhaler, or an Epi-Pen? A diabetes diagnosis at age 8, or maybe Crohns at 12? Taking Zyrtec and Prilosec every day, for years? Antibiotics 2-3x/year or more? Lots of “well visits” which aren’t for wellness at all, but are just for shots? Miralax for stuck poop, twice a year in the hospital for a clean out? Straterra for anxiety and depression, Abilify for volatile behavior? If so then you will love your pediatrician.
If this is your situation, and your are happy, and your kids are happy, then all good. No foul. The goal is good health.
If this is your situation and your children are not happy, not thriving, can’t eat sleep or poop, not enjoying life; if they aren’t growing and gaining as expected, or lack the energy to play; if they are lonely and anxious and indoors every day; if they need prescription drugs to function even at a marginal level … you have options. There are other providers who can help your children enjoy actual health. When we go back to resolving root cause, children can be healthy without a litany of prescription drugs. Providers and resources to explore beyond your general practice pediatrician:
  • Naturopathic Doctor – Naturopaths are licensed and/or require registration and monitoring in 25 states, with 3 more states pending this legislation in 2022.  In many states they can order labs, imaging, or blood draws, and can be recognized as Primary Care Physicians. Their focus is on natural non-drug solutions and root cause.
  • Family Nurse Practitioner or Pediatric Nurse Practitioner  – either may be a helpful ally. FNPs are licensed, independent practitioners.
  • Family Practice Physicians care for the whole family, all ages. Consider looking for one certified in functional medicine. See my caveat about functional medicine for children here.
  • Classical homeopathy  was a profoundly effective tool for my child’s health from a young age, and my family still relies on it today. I was fortunate as a young mom to have this resource in my community, where one of my providers was a pediatric nurse practitioner who was a trained classical homeopath. If you don’t have a homeopath in your area, pick up a copy of Everybody’s Guide To Homeopathic Medicines. This is an invaluable help for resolving minor bumps, bangs, fevers and routine illnesses of childhood, from teething and broken bones to anxiety, sleeplessness, and digestive upsets. It saved me countless doctors visits.
  • Weston Price Organization – If there was ever an organization fierce on whole family wellness, nourishing real food, nutrition, and natural health, it’s this one. You’ll find a great community (local chapters abound) as well as a deep well of information on all  family and child health topics.
Go for it. Have the audacity to fire your pediatrician if their skills and tools are working against rather than for your child. You get to love your providers, and so do your kids.
Food Allergy and Food Antibody Testing For Kids – What Works?

Food Allergy and Food Antibody Testing For Kids – What Works?

Have you done food allergy tests or food antibody tests for your kids, but aren’t sure what it all meant? Tried elimination diets to remove the reactive foods, but didn’t see results?

Scratch tests, IgE blood draw, IgG food sensitivity, skin prick testing, Mediator Release Testing (MRT), and more – there are many ways to assess food reactions, food allergies, and food sensitivities.

It gets confusing. There are different types of reactions to foods, different ways to assess these, and possibly, different inter-actions between food and gut microbes that aren’t well studied. For example: In some cases, it’s unclear if the food is the issue, or if symptoms are due to an imbalanced gut microbe that eats the food – causing production of toxins from disruptive microbes that lead to symptoms. In many cases, I’ve found that just balancing gut microbiome allows a child to eat a food that was suspect for reaction.

In general, mainstream medicine – that is, your MD allergist – only recognizes one type of food reaction (hives, anaphylaxis), and typically only recognizes drug treatments with avoidance of the extreme triggers. That’s all well and good …if that is what your child needs. But what about all the other symptoms and reactions that don’t need the Epi Pen, Zyrtec, steroids, or other drugs? Symptoms that leave your kids feeling lousy with painful gas, bloating, mixed irritable stools that swing between mucousy loose stuff or hard pebbles, chronic stomach aches, migraines, headaches, joint pain, frequent colds or rhinitis, acne, eczema, asthma, hives or rashes that come and go, trouble with focus and attention… All of these can come from reactions to foods your child eats on the regular. How do you sort it out?

Because an MD allergist will only screen for food allergy (with skin prick testing or blood draw for IgE reactions), many kids go without correct diagnosis and continue to feel lousy, for no reason. Food allergy is only one type of reaction to a food. At the very least, there are three types of food reactions:

1) Food intolerances: Food intolerances may or may not involve the immune system.

  • They occur without immune response when we lack enzymes needed to break down certain foods. An example would be lactose intolerance, where the body can’t break down the milk sugar lactose. The result is gas, bloating, and diarrhea. Rashes are usually absent (except perhaps diaper rash, from the skin-irritating loose stools). Kids who are lactose intolerance can often manage yogurt (because the lactose has been fermented into smaller sugars), Lactaid products (because the lactose has been enzymatically treated in manufacturing), or harder cheeses (which don’t contain as much lactose as softer cheeses) –  but not regular ice cream, fluid milk, frozen custard, or other products with a lot of milk or softer cheese (because these still contain lactose).
  • Another example of food intolerance due to poor enzymatic action on a food component is when opiate like peptides are absorbed from food proteins. If you’ve got a super picky eater, this may be your problem. Learn more here.
  • Food intolerances can also happen with immune involvement when too much histamine is made. In this scenario, IgE or hives to a food can be negative, but tingling, stomach pain, or reflux may ensue. This can be part of mast cell activation syndrome (MCAS). Mast cells are white blood cells that help regulate the immune system and are responsible for histamine release. A human stomach has mast cells scattered throughout its lining, where they play a role in regulating stomach acid secretion (we need strong acid to break down food and prepare it for the small intestine). In fact, mast cells can be found along all of the GI tract. A variety of conditions – including chronic exposure to a triggering food – can disrupt mast cell function so that too much histamine is released.

2) Food allergies: Food allergies do involve the immune system. They occur when the body creates IgE antibodies to a food, which then trigger the release of histamine and other pro-inflammatory mediators from mast cells next time you eat that food. These reactions are typically rapid, occurring within minutes or hours. An example would be a peanut allergy that causes swelling, hives, and difficulty breathing.

3) Food sensitivities: Food sensitivities ALSO involve the immune system, but not IgE antibodies.

  • Food sensitivities may involve IgG antibodies instead, in which an IgG antibody is made to a food. This can create a delayed reaction that might play out several hours or even a day or two after eating the food. The reaction can be dull pain, loosened stool, explosive stool, mild rash, migraine, behavior changes, bloating, gradual build up of eczema, or mild congestion.
  • Food sensitivities can also occur when white blood cells might react to a food protein, additive, or chemical, and release pro-inflammatory chemicals known as “mediators” into the bloodstream, which cause symptoms throughout the body. These reactions are often delayed and dose-dependent.
  • An example of either would be a gluten sensitivity that causes stomach aches, diarrhea, or brain fog the day after eating a moderate amount of wheat; a strong behavioral reaction to food colors or artificial ingredients; or eczema that comes and goes, but improves dramatically once a trigger food is removed.

Any one of, or all of these, can happen at the same time!

How To Tackle It All – Where to start? Here are five steps to get rolling.

  1. Get IgE and skin prick testing done with your MD allergist. Rule out the big offenders this way. If there are multiple positives, start only by removing the most serious offenders that are actually life threatening to eat, or that cause significant discomfort (vomiting, hives, diarrhea, stomach pain). If some of the positives are tolerable to eat, keep them in rotation.
  2. If working with your allergist MD doesn’t give resolution or if symptoms persist and food allergy screening was negative, move on to IgG food antibody testing. As above, work with only the top two or three high offenders on your findings. This testing is my preference – tho white blood cell media release tests (MRT) are also popular among some practitioners, I have found in my practice with children – especially young children – that MRT is an over-sensitive test that doesn’t yield the actionable information I need to organize and build a supportive, growth-worthy food intake for a child.
  3. Remove an offending food completely only if:
    • eating it is life threatening (ER visit, Epi Pen, hives)
    • your child eats it every single day (give the body a break from it for two months to start)
    • your child has significant and noticeable impact from that food. This can mean impact on mood, volatility, and attention and focus as much as stomach pain or stool changes that are untenable.
    • always replace a withdrawn food with another one of equal or better nutritional value. For example if replacing cows milk with almond milk, you must add protein and a fat source because there is little protein or fat in almond milk. Use a clean collagen boost and some coconut milk or MCT oil and blend as a shake, or give extra servings of chicken, eggs, avocado, ghee, grass fed beef, or nut/seed butters if safe. You can also ask your provider about elemental formulas if your child has multiple food allergies.
  4. Work with high potency probiotics, especially histamine degrading strains: Lactobacillus reteuri, Lactobacillus salivarius, Lactobacillus rhamnosus to name a few, plus Bifido strains. Start low, with a 10 billion CFU dose daily and if possible work up to 50 or 100 billion CFU daily. Use probiotics year round.
  5. Keep good anti-inflammatory supplements in rotation. These can be used even if your child uses medications like antihistamines or steroids, always let your doctor know:
    • DHA fish oils to 800-2000 mg/day (many liquids available)
    • curcumin and turmeric 400-1200 mg/day
    • D-Hist Junior chewables, 2-6/day (quercetin, N-Acetyl cysteine, nettles, vitamin C)

If you’re using one, give an elimination trial a go for a solid six months. Food proteins like gluten and casein (milk protein) are especially good at triggering all kinds of reactions at the same time, so elimination trials will only work with those proteins if you do it for 4-6 month duration; have zero known cheats including trace amounts in processed foods; also avoid pea protein concentrates at the same time (think Ripple Milk, Daiya cheese, or most “vegan” protein bars, powders and drinks), which look a lot like gluten and casein to the gut; and eat strong replacements for these foods (plain almond milk and French fries won’t cut it!).

If you’ve achieved that, and it’s smooth sailing, go for the re-introduction trial. See how it goes! If you’ve got leaky gut resolved – this is what got the food reactions going to begin with – you won’t see the reactions return. If you’re part of the way there, you’ll see a slow build up of those old symptoms after your child resumes eating the old offenders. In that case, you can judge if you want to continue elimination diet, rotation diet, and/or how much support with anti-inflammatory tools like probiotics you can use ongoing. Good luck and share your experiences below!

Natural and Nutrition Supports During Fever

Natural and Nutrition Supports During Fever

Fever is a mainstay line of defense for the immune system. But you could say we’ve become afraid of fever, as we are told to make it go away when our kids have one – as though the fever itself is a bad thing.

The truth is, fever is one of the body’s many brilliant means to disable a pathogen. It’s not something to be afraid of. And mounting a vigorous fever is a beneficial component for a child’s adaptive immunity to develop. For example, a 104 F degree fever (~40 degree C) will cause a 200-fold reduction in replication rate of some viruses. Powerful stuff!

So why are we told to use drugs like acetaminophen (Tylenol aka paracemetol) to make it go away, especially in kids? I’m surprised to hear parents in my pediatric nutrition practice report that this is still encouraged, especially with vaccination – where evidence has emerged across many investigations that acetominophen reduces immune response to vaccines – making vaccination among the worst times to use it.

Let’s go there for a moment. There has been quite a fiasco over the use of Tylenol in children, and not without reason. For starters, giving acetominophen with fever is problematic. While the body is endeavoring to raise its temperature as a means of attack against a pathogen, Tylenol will un-do the process by lowering temperature and can thus prolong infection and inflammation.

Second, Tylenol quickly depletes glutathione, a natural peptide made by the body as key detoxifier and free radical scavenger. This means it lowers glutathione right when we may need it most, potentially enhancing the toxicity of whatever the body is grappling with.

Tylenol use – especially in toddlerhood when multiple vaccine visits are compulsory, or during pregnancy – has shown an association with the development of autism later on.

Giving Tylenol, plus eating RoundUp (aka glyphosate – the abundant and ubiquitous agricultural herbicide in our food supply, including infant formulas), plus using antibiotics, can create a perfect storm with the power to alter gene expression such that the end result is predictive for autism. No single “gene for autism” has ever been identified, despite years of hopeful searching and untold sums of money spent in the hunt. We know that autism isn’t solely genetic in origin. Rather, there are groups of genes that will be expressed differently, if environmentally challenged with toxins, antigens, or infections at vulnerable moments (like in utero or infancy or toddlerhood). If the gene expression is altered under the “right” conditions (that is, frequent toxic and immune challenges), autism or other neurodevelopmental can result.

Back to fever. What can you do about it, and when to step in?

  • Stay in touch with your doctor for close monitoring when your child has a fever.
  • A normal fever is between 100-104 degrees. If it climbs higher, be in closer touch with your doctor on next steps.
  • Newborns should never have fevers – if your baby is less than 3 or 4 months old and has a fever over 100 degrees, let your doctor know right away.
  • Some natural tools to manage fever and discomfort are…
    • Curcumin, available in liquids and chewable gummies, can reduce inflammation and soften pain. Nordic Naturals Curcumin Gummies or Apex Turmero Liquid are easy for toddlers and school aged children to use.
    • Magnesium is another useful pain reliever especially for muscle aches and pains. It’s available in topical lotions like Cooks Organics Creme, as Epsom Salts in a tepid bath soak, or can be used orally in liquid suspensions like Blue Bonnet Liquid Cal-Mag.
    • Calcium lactate is a fast absorbed form calcium that can actually reduce fever in a beneficial way. During fever, as muscle tissue warms, calcium is leached from bones in a free unbound form called ionized calcium. This activates white blood cells which in turn mount their attack on invading bacteria or viruses. By giving calcium lactate, you make a quick support for white blood cells at the ready rather than having to leach it out of bone through fever. I have many anecdotes from clients for the success of this practice, which may also reduce the likelihood of febrile seizures. 100-200 mg calcium lactate every hour or two til fever drops is usually effective. Standard Process sells this form of calcium as a powder or in small tablets. (Milk and dairy products do not supply calcium in the right form for this task, and other forms of calcium will not work as well if at all.)
  • Homeopathic remedies can be effective for fever also. Belladonna in 30c pellets is a classic solution for a hot, rapid onset fever with bright red dry hot cheeks and flushing. These pellets are available over the counter, but it’s ideal to work with a knowledgable homeopathic practitioner when using these powerful tools. For more detail on using these in your home, see Everybody’s Guide To Homeopathic Medicine   This book was a mainstay in our home when my son was little and saved us many trips to the doctor.

What about before fever? The most important thing you can do for your child is maintain a healthy, solid growth pattern.

If you’re not sure whether your child’s growth pattern is where it should be, check this blog on underweight in children. Even small shifts away from your child’s expected progress for growth are costly when it comes to infection and illness. Growth is the single most powerful predictor of how often a child gets sick and how sick they may get – that is, severity and frequency of illness both go up when children are lapsing off their patterns for growth.

Kids don’t feel hungry during fever, which is a good thing – the body needs resources for the task of infection fighting, and doesn’t want to steer blood flow and energy toward digesting a meal. But fevers are exceptionally costly in terms of the fuel they consume – literally, heating fuel! It can’t be replenished easily during illness, which is why it is so important to keep children well fed and growing strong between infections and illness. Once illness comes calling, the reserves need to be there already.

Top nutrients for the immune system to do its work during illness, that should be well replenished before illness, are vitamin D, vitamin A, zinc, iron, and total protein. Total protein doesn’t mean your kids need a hundred grams of protein a day in food (that’s too much). It means they have good tissue stores, healthy muscle tissue, and some body fat as reserves.

Iron doesn’t work well to supplement during infection, as it may increase inflammation or help microbes, which also love iron as much as we do. So make sure your child’s iron status is strong day to day (click here to learn more about when kids need iron).

Zinc however can be used during illness and doses of 30-100 mg are what I may suggest depending on a child’s weight. Vitamins A and D are stored in fatty tissue and certain types of lipid (fat) molecules in the blood. Make sure your child has ample sources of these vitamins in their day to day routines, before illness. Cod liver oil, wild caught (not farmed) salmon, organic calves liver are all good sources. Regular fish oil (minus the “liver” part) does not provide vitamins D or A, which are key for lung tissue and many facets of strong immune response to viral infections especially.

There are may herbal tools that your local naturopathic doctor is trained to use to help manage infections and illnesses. Check here to explore finding a naturopathic doctor (ND) near you.

Long short, your kids can have fevers safely and effectively, and there are a several options to support them through it. Instead of reaching for NSAIDs like acetominophen or ibuprofen, you might like trying natural and nutrition tools that work with the body to fight infection and recover handily.

 

Detox Support For Kids

Detox Support For Kids

Kids can need detox help too! Like the rest of us, they encounter toxins from ordinary routines, activities, water, food, poor air quality, and more.

The body has many mechanisms to manage day to day toxic exposures. But unlike adults, kids – and especially babies – are more vulnerable due to their smaller size. Toxins and their effects can build up and make it harder for a child to stay well. Behavior changes or agitation, sensory processing glitches, gut symptoms, rashes, or more serious concerns like cough, unexplained fever, or even seizures can result from slowly built up toxic burdens or from an abrupt large exposure. Some circumstances that burden their bodies and make it harder to detoxify are…
  • Wildfire – including proximity to leftover dust and burnt debris – has especially toxic and lingering effects. Watch this video to learn more.
  • Poor air quality from car exhaust, industrial pollutants, fracking, ozone
  • Regularly eating processed foods with additives, colorings, artificial ingredients, glyphosate and other pesticides (organic foods help minimize this)
  • Well check visits where multiple vaccines are administered at once (check here for more detail on detoxifying vaccines)
  • Shampoos, fabrics, bedding, soaps, toiletries and anything used topically can contain parabens, fragrances, formaldehyde, aluminum, titanium, bisphenol-A (BPA), talc, flame retardants – these and many more toxins are in products our children put on their skin every day.
  • Excessive heavy metals from air, water, medications, food, or even toothpaste – which can give your child too much fluoride if they swallow some every day (avoid that with a fluoride free toothpaste).

And a new twist on toxins for children concerns covid vaccines. Learn more about these concerns here. At Flatiron Functional Medicine, where my office and practice are embedded, Jill Carnahan MD  has suggested supportive supplements to help mitigate possible negative effects of a covid vaccine dose. We recommend doing this for 4-6 weeks following a vaccine dose.

These are items I have safely and effectively used over the years in my pediatric nutrition practice. Children can use these items. Check with your doctor if your child uses medications for other conditions or if you’re not sure whether these options are right for your child. Any of these products can be found in my FullScript platform. Set up your own account from here to view any of these products and choose the format (chewable, liquid, powder, capsule) that best suits your child.

Browse any of these below by setting up your own access to my secure FullScript platform.

Click here to set up your own access to these items below.

Circulation Support – Myocarditis and cardiovascular events including stroke have emerged as a potential negative effect of covid vaccines, especially in teens and children. These functional foods and compounds can reduce inflammation and help prevent clots:

  • High potency DHA and EPA omega 3 fatty acids – at least 500 mg DHA and 500 mg EPA. Use a pure and clean brand that allows independent product testing for heavy metals and toxins. My favorites for kids:
    • Nordic Naturals Pro Omega 2000 Junior 2 softgels daily (chew or swallow)
    • Pharmax Finest Pure Fish Oil 1 teaspoon daily (good option for high potency with low volume of liquid)
    • Barlean’s High Potency Omega 3 Key Lime (pudding like texture)

If your child can swallow capsules:

  • Pycnogenol Douglas Labs 25 mg capsule daily. Pycnogenol has been shown to lower inflammation in children with asthma, to reduce asthma medication needed, and to have beneficial effects on cardiovascular health. If your child uses a medication for behavior or seizures, check with your doctor before using pycnogenol. Pycnogenol may lower blood pressure. 
  • Allergy Research Group Nattokinase 36 mg capsule – Nattokinase is an enzyme with capability to reduce arterial plaques and lower blood lipids.  

Anti-oxidant and Anti-Inflammatory Support –

  • DaVinci Labs CoEnzyme Q10 ChewMelt – 1/2 chewable daily
  • ReadiSorb Glutathione 1/2 to 1 teaspoon daily
  • Empirical Labs Liposomal Curcumin / Reseveratrol 1/2 – 1 teaspoon daily
  • D-Hist Junior chewables – 2 (smaller children) or up to 6 chewables (kids over 50 lbs) daily
  • Seeking Health Optimal Vitamin D drops 2000 IU per drop – get a baseline vitamin D level at your pediatrician to discern if more than 4 drops weekly are needed.

Gut and Overall Immune Support –

  • SBI Protect 1 scoop daily in soft food or liquid
  • Probiotics – Allergy Research Group Lactobacillus or ProFlora 4R Spore Probiotic
  • Animal sources of vitamin A: Cod liver oil 1/2 teaspoon daily for children <50 lbs and 1-2 teaspoons daily for larger children. This gives the form of vitamin A (14 hydroxy retro-retinol) that turns on T cells. Synthetic vitamin A supplements (retinyl palmitate) don’t do this and neither do plant carotenoids (at least not without some metabolic transitions first).  You can also use vitamin A rich foods like grass fed organic full fat dairy foods including butter, pastured egg yolks, and liver.
  • Cats claw – capsules or drops available:
    • QuickSilver Scientific Cats Claw Elite – 1 pump daily
    • Pure Encapsulations Cats Claw capsule 1 daily (children over 70 lbs)
To set up your own account for access to these and other products I recommend and use in practice, contact me here
My Baby Was Treated With Reflux Medicine. Now What?

My Baby Was Treated With Reflux Medicine. Now What?

Did you know that reflux medicines (aka Proton Pump Inhibitors or PPIs) are among the most overused drugs in the world? 

Reflux medicines make the list of top ten most prescribed drugs in the world. If your baby or child is on one, your gastroenterologist (GI doctor) probably prescribed it to lower stomach acid for presumed gastroesophageal reflux disease (GERD).

In your doctor’s eyes, these drugs are considered generally well tolerated and are not considered harmful to adults or even children. The problem is that (some of ) these drugs are only approved for short term use in children – but, it’s common to leave babies, toddlers or older children on them for months or even years at a time. I see this in my pediatric nutrition practice all too often! When these drugs are taken for months at a time, there is potential for serious side effects that can cause lasting digestive and immune system issues.

Another dilemma with getting a PPI for GERD is that the diagnosis is typically based on a brief conversation with mom about spit up, colic, or vomiting. Rarely seen is an actual diagnostic test for whether someone needs this drug – in adults or kids. Measuring stomach acid is the confirming diagnostic for “excess stomach acid”. This requires an invasive endoscopy procedure which must be performed under sedation or anesthesia. Even with endoscopy, if inflammation is seen in the esophagus’ tissue during that procedure, it is assumed that excess stomach acid is the cause. The only way to assure if this is actually true is to add a pH probe to the endoscopy procedure. This probe measures the pH (acid level) in the stomach.

Another way to confirm is to observe stomach acid actually entering the esophagus (that is, stomach contents are going up instead of down) with a barium swallow and observing results, live in real time, on X ray.

If  a pH probe shows that the stomach is indeed too acidic, a PPI may indeed help. If the problem is normal acid levels that gurgle backwards up in to esophagus, a PPI may help, or may not help at all – it may make the problem worse over time. And here’s the other twist: Even weak stomach acid (at a pH of 3 or 4) is still too acid for delicate esophagus tissue. But it’s too weak to do a good job of moving food out of the stomach and into the small intestine. So, this leaves food sitting in the stomach, and gurgling back up in to the esophagus.  A PPI may temper that burning sensation a bit, but it will not solve the problem of getting food moving along in the other direction – in fact, it will make food sit longer in the stomach, giving more opportunity for the food to gurgle backwards into esophagus. This is exactly how many of my young patients end up needing more, more, and more reflux medicine… until it stops working even at the highest dose.

Here’s When To Intervene

Babies normally have some spit up or vomiting. If your baby is clearly in pain, crying hard, unable to eat, and not growing or gaining, then a PPI can offer some temporary relief. Likewise, if your doctor saw highly irritated esophageal tissue on an endoscopy, then a short term use of PPIs may soothe the situation. Babies should not be left to cope with pain when a medication can immediately help. 

Create a strategy up front with your doctor to use those tools temporarily. A switch in feeding can often make a big difference. Changing a breastfeeding mom’s diet can help, by removing foods like dairy, eggs, or high FODMAPs foods like onions, garlic, apples, prunes, or broccoli.

Formula fed babies can improve with a switch to something more digestible: Consider hydrolyzed formulas like Alimentum Ready To Feed, or formulas with a different protein profile like Gerber Soothe (more whey, less casein), or a goat milk formula option. All of these are worthy measures before placing your baby on a reflux medicine.

There are also gentle herbal glycerite tinctures for children that soothe the stomach and gently encourage normal digestive function. One of my favorites is Gaia Herbs Tummy Tonic, which I’ve used with success for many years in my pediatric nutrition practice. This herbal tincture is one of may herbal blends known as digestive bitters. They gently stimulate the stomach to produce its own normal array of acids so digestion can begin. 

Since reflux drugs lower stomach acid, they also lower the protection we get from having that natural acidic barrier between the big bad world and our bodies. This acid barrier is supposed to be very acidic. A gastric juice pH as low as 1.0 is normal. This can prevent harmful bacteria that may be in our mouths from entering the body. But if the stomach pH gets too high – that is, if it becomes less acidic – this matters for 3 key reasons: 

  1. Potentially harmful oral bacteria can work its way into lower parts of the GI tract, a trip that would not be made possible when there is enough stomach acid. Once it makes its way into the GI tract, foreign bacteria can cause such infections as Clostridium difficile, Salmonella, Campylobacter as well as Escherichia coli. 
  2. When harmful bacteria invade the GI tract, they can begin to overgrow and compete with the “good bacteria” that we rely on to help us with digestion and immune system support. Over time this impacts the diversity of our microbiome and can cause dysbiosis, a condition where the good bacteria is reduced and too much bad bacteria is allowed to grow – creating an environment that can also lead to yeast overgrowth, constipation, irritable loose stools, picky eating, food intolerances, food allergies, or pain.
  3. Too much of the wrong kind of bacteria and not enough of the good kind can lead to inflammation in the gut, which then cause the gut wall barrier to be more permissive – that is, the tightly compacted tissue structure inside the gut wall gets a little loose, with microscopic spaces that can allow larger molecules than normal to enter circulation in the body. These can be partly digested food proteins, toxins, or microbial organic acids. This is known as “leaky gut” and people may experience all sorts of discomfort or chronic systemic inflammation as a result.

My child was treated with a PPI. Now what?

Long term PPI use can disrupt healthy gut microbiomes, and favor yeast or fungal species. Over time, these drugs can make weak, picky appetites, weak protein digestion, weak absorption of minerals like iron and zinc, and poor B12 absorption. You can…

  1. Use my Sensory Nutrition Checklist to look for signs that certain nutrients are not being well absorbed. Supplements can help cover the deficits in the short term, as you repair your child’s appetite.
  2. Explore with a stool test that assesses helpful bacteria as well as pathogens, fungal species (yeasts), and disruptive commensal species.Stool study findings can be addressed with non prescription tools in many cases, such as rotations of certain probiotics or herbal compounds that discourage fungal or disruptive bacteria species. Most of these tests include measures for inflammation and digestive function too. This is an easy way to sort out what is going on. Be sure to work alongside an experienced integrative and functional practitioner when ordering your child’s stool test to understand and interpret the results and what the best protocol might be to improve your child’s microbiome health. They are likely to have knowledge and experience with therapeutic herbs and probiotics that can be used to help resolve your child’s GI issues in the most gentle way possible. Clearing gut dysbiosis directly in this way can accelerate restoration of normal digestion.
  3. Join my Nutrition Cafe secure on line group chat, where we tackle topics like this in detail on a regular basis in HIPAA secure live zoom chat with me.
  4. Change up your baby’s feeding routine per suggestions above. Find easy to digest foods; these are usually low FODMAPs fruits, vegetables, and grains, plus gentle protein sources like white fish, chicken, or turkey. Avoid fermented foods or bulky high fiber foods at first; these may become easier to handle later on.
  5. Avoid high potency multi strain probiotics at first. Start with a simple one like Klaire Factor 1 or Klaire ABx Support. More complex products like GutPro may be better tolerated later on.
  6. Gently restore stomach acid with a combination of a digestive bitters tincture like Tummy Tonic, with 1/4 teaspoon Braggs Apple Cider Vinegar, at meals or feedings. This can be mixed with pleasant tasting juice such as a small amount of elderberry juice or pineapple juice (which has some natural enzyme in it too). Other helpful soothers and gentle gastric stimulants are peppermint, ginger root, lemon rinds or lemon juice in water, or chamomile tea. Use these regularly and steadily for a gradual repair of gastric juice.

Give this project some time, especially for kids who have used a PPI for more than 3-4 months. Gradually a healthy appetite without bloating, hiccups, gas, constipation or pain can be restored.

Thanks to Rosanne Walsh, AADP board certified nutrition and health coach and RD intern for building this blog post with Judy!