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If you’re a parent facing a new autism diagnosis for a child in your family, your head might be spinning about now. Where do you start? Medication? Behavior therapy? Speech therapy? Occupational therapy? Different classroom? Social skills group? What to eat or nutrition is probably the last thing you want to think about… not to mention the fact that your newly diagnosed child is probably an epically picky eater. While you know they should eat better, they just…. don’t. Ok so… Feeding therapy?

Nutrition Must Come First With New Autism Diagnosis Because…. Nutrition must come first with a new autism diagnosis, because autism is a chronic condition with unique medical and nutrition features. Kids with autism have higher rates of ear infections, respiratory infections, food allergies, asthma, gastrointestinal problems, sleep disorders, seizures, and nutrient deficits. Nutrition deficits worsen all the problems on that list. The right nutrition support can repair them too.

No matter what level of severity your child’s presentation is for autism, nutrition is an essential tool to tap. In my pediatric clinical nutrition practice, I have observed time and again that the right nutrition support makes other interventions work faster and better.

Nutrition is so pivotal, so central to your child’s brain and development. It is shocking that, still, in the 21st century, children with autism are rarely offered any nutrition screening or intervention. This has nothing to do with “the science”, and everything to do with profits: Providing nutrition services takes more time, has no patented medications, devices, or procedures to sell you, and is delivered by families themselves, once they are up to speed on what to do. But you may not hear much about it from your care team, even if your team includes a gastroenterologist. Don’t be fooled into believing that it doesn’t matter or can’t change your child’s developmental progress.

Brains Are Only There Because Of Food… Your child’s brain happened because you ate while pregnant. Severe malnutrition while pregnant can make us spontaneously lose the baby. For pregnancies that are carried through less severe malnutrition, this will make the baby’s brain weight lower than normal, with fewer neurons and glial cells – a permanent change. Brains can only grow from whatever is eaten. For kids with developmental deficits, leveraging this to support can make or break their long term outcome. Even being marginal or deficient for just one nutrient while pregnant – like iron – can permanently alter a baby’s brain structure and function, and cause low birth weight.

Nutrition continues to be crucial to the brain even after your baby is born. If nutrition is weak in the first years, your baby’s brain will have fewer glial cells, reduced myelination, and less synaptogenesis. In fact, there are five major processes that allow a human brain to grow and develop. While many processes unfurl to sprout a brain in a cranium, all of them are vulnerable to nutrition deficits. None of them happen to potential, without adequate food and nutrition. Impeding any one of these processes can lead to developmental features that can affect people with autism.

This all starts when you’re pregnant and depends entirely on what you eat. It doesn’t stop until the end of adolescence, and in that window, brains still depend on whatever is eaten, to build and run themselves. Kids’ brains need almost twice the energy of an adult’s, just for starters! The academic evidence base is rich, deep, and decades-long, when it comes to describing how nutrients and energy from food let the brain do its job.

Given access to the many and varied nutrients and fuel that brains need to build themselves, and barring exposure to neuron-wilting toxins (like mercury, aluminum, head injuries, solvents or industrial chemicals), brains can acquire skill. They sort, process, remember, learn, regulate, manage sensory inputs, and control motor functions. They run basal metabolic functions for us, like breathing, sleeping, filtering our blood and lymph, and digesting. The bottom line is that a child with a developmental diagnosis owes his or her brain every possible leg up – especially during critical growth spurts of ages 0-3 and early teen years.

What’s the deal with autism and nutrition? What could nutrition have to do with your child and a new autism diagnosis? Big topic.

Your Care Team May Not Know What To Do About Nutrition… I’ve worked with children on the spectrum since 1999, providing nutrition assessment, support, and intervention. I’ve authored books on it, trained other professionals in autism and nutrition, blogged on it, and lectured on it. I’ve completed hundreds of nutrition assessments and care plans for kids with autism, from all over the US and in other countries. And guess what:  I have never met a child on the spectrum free of a nutrition concern. In most cases, nobody on the child’s care team had ever looked for these problems. But when we found them, and fixed them, these children’s lives began to improve dramatically.

This happens all the time. Why? Because your neurologist, speech therapist, pediatrician, occupational therapist, and neuropsychologist aren’t nutritionists. It’s not their job to do this assessment, and they aren’t trained or expected to do it. But it’s well known that autism and nutrition is a thing. It’s just not their thing.

In most cases, nobody on the child’s care team looks for nutrition problems

Common nutrition problems for children with autism go beyond low status for zinc or iron, eating narrow diets, missing out on varied proteins, lacking brain-critical fats or oils, or having tantrums that exhaust you at mealtimes. Kids on the spectrum do often have those problems, and solving them will improve behavior and functioning.

The Autism-Nutrition Puzzle Is Deep And Varied, And You Deserve Professional Guidance… There’s much more to the nutrition puzzle, and new research on this is emerging all the time. More often than typically developing kids, kids with autism also have problems with digestion, constipation, diarrhea, stomach pain, gas, or just plain eating. Besides eating poor diets more often that can leave them malnourished, they may lose a lot of nutrition because of diarrhea, chronic loose stools, or gut microbes that steal nutrients before they are absorbed. Gut microbes can even alter the pH of your child’s digestive tract enough to make absorbing certain nutrients difficult – further impeding how nutrients like iron or zinc get to the brain. Both are critical for attention and focus!

Solutions for these problems depend on thorough nutrition assessment. This defines the baseline, and makes plain what food or nutrition piece to tackle first. Professional nutrition assessment has many pieces, including lab work, nutrition focused physical exam, food diaries, and history. Lab tests alone are not enough for pediatric nutrition assessment.

Pivotal for a child with autism is assessing and correcting the gut biome. This is doable, and results can be remarkable – for behavior, appetite, picky eating resolution, and fixing constipation once and for all. The gut biome plays a role in brain development according to several studies (here’s just one), and gut bacteria contributes directly to autism-like behaviors, according to mounting research. Optimize this piece of your child’s autism puzzle, and you are likely to see remarkable changes. Get guidance – just tinkering with probiotics is not likely to have a therapeutic benefit.

In my practice, I assess gut biome with stool culture that includes fungal species, beneficial flora, disruptive opportunistic bacteria, and pathogen bacteria. I also use PCR DNA stool studies – a more sensitive method than culture – to find parasites, protozoans, viruses, and more. Learn more here about why basic pathogen stool culture or antigen studies may not do enough to solve this piece of the puzzle for your child with autism.

Special Diets Are Not Unsafe… What about special diets for autism? I never recommend any diet without a rationale made clear to me from labs, symptoms, history, and clinical signs. Whatever diet your child eats, it should be tailored to your child, through individualized assessment and care. Your child is worth it. Don’t jump on a dogma bandwagon – get clinical facts that describe your child’s situation. I have witnessed tremendous turn-arounds in children with autism whom I placed on restricted diets. Monitoring is the key, as is replacing what you remove with equal or even better food.

Contrary to the story you may have heard that elimination diets are risky, I have never found this to be true. I instead see that these children become healthier, happier, and end up with a broader palate overall, thus getting more nutrition and food, and growing better, sleeping better, learning better, and settling down into their true selves. What is risky is leaving a child in picky eater mode, unable to eat more than a few foods, or waiting years until all other interventions fail before providing good nutrition care. You will have missed opportunities for brain development that only happen in time sensitive windows at younger ages.

I have also not found that children suffer socially when using dietary restrictions typical with an autism diagnosis. Instead I routinely witness that because behavior and social skills rapidly improve with the right nutrition support, children with autism become more socially engaged, make more friends, and get more access to social landscapes as a result. Kids tend to choose to be with their new best friends, rather than their old favorite food.

New autism diagnosis? Put nutrition first. It’s just the tippy top of the iceberg of potential! All those other services you’re looking at right now, and wondering how to pay for, work far better when paired with the right nutrition platform. Your child will get more mileage out of each intervention, whichever one you choose. In fact, you may even find you need fewer services or less intensive services, once nutrition support is engaged. I have witnessed many instances of children graduating sooner that expected out of Applied Behavior Analysis, feeding clinics, or social skill groups because of a nutrition piece.

Get Autism Nutrition Help Now! Not sure where to start? Here are two books on autism and nutrition that I’ve written for parents to start with, here and here. Send me your questions or comments below – I look forward to hearing from you!

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