12. Healthy Kids, Happy Kids (with Elisa Song, MD)

So the five things from microbiomegic. Again, these are the five things that your kids are already doing every day. But now in the book you and they can learn how to do them like a gut hero. So we just want to make it super fun for kids. So I have a wheel of whole child resilience. And in that wheel are the five things. The first thing is nourish. How are we thinking about what we're getting in or what we're keeping out to nourish our gut microbiome? The second thing is breathe the way we breathe. This is really a reminder how. How are we engaging our vagus nerve every single day throughout the day to support our microbiome? How are we moving, exercising? How are we sleeping? Because sleep, it just takes just two days of sleep deprivation to disrupt your microbiome and seven days to repair it. So how do we optimize sleep knowing that most of us, including me, I'm gonna admit we're not getting the optimal sleep that we should, even our children. And five is hydration. Good water, good water drinkers, people who are hydrated actually have been found to be more likely to eat more fruits and vegetables and their microbiomes are different and so a healthier microbiome. So Those are the five things.

Dr. Elisa Song founded Whole Child Wellness in 2005, which has since become Whole Family Wellness in 2013. She is on a mission to create a nurturing environment that integrates allopathic and natural medicine customized to each unique child in order to help children thrive to their fullest potentials. Dr. Song has a special interest in providing integrative care for children with complex medical issues. She graduated with distinction in political science from Stanford University. She attended NYU School of Medicine and trained in pediatrics at UCSF Medical center. That's the University of San Francisco or University of California at San Francisco. She earned a Master's degree in public policy from UC Berkeley. And Dr. Song has additional training in functional medicine in holistic nutrition, homeopathy, homeopathic detoxification, acupuncture, herbal medicine and flower essence. She's board certified in pediatrics and holistic medicine and is a fellow of the American Academy of Pediatrics. I'm so excited to welcome Dr. Song. I am so excited to welcome a Dear old friend, Dr. Elisa Song.

I'm so excited to be on right now.

Awesome. Well, yes, we are going to be talking about your brand new book, your first real published book. I know you have a lot of ebooks and a lot of stuff on your website, but this is really great because there are not enough of you in the world. Right. Like, we have so many functional medicine doctors that are working with adults, but we just don't have as many that are working with children. So your new book, healthy Kids, Happy Kids, which we all want, being a mother of a seven year old.

Yeah.

We want them to always be healthy and always be happy. If that was. If we could have that a hundred percent of the time. Well, before we dive into the book and what you've been up to, do you want to kind of just tell our listeners your background, how you got into functional medicine, how you got into pediatrics and working with children? Yeah.

So I've been doing this since I started my practice 20 years ago. It was as an integrative functional medicine pediatric practice in 2004. And I always knew I wanted to work with kids from the moment I was. Well, I was a kid. I mean, growing up. I mean, I love babysitting, I love all the kids stuff. And so I. But I didn't know what that meant because my mom was an obgyn, and I just saw her up, like, out of the house almost every night delivering her own babies. And I'm like, I don't know that I want that life. So I actually was gonna be a teacher. I thought, maybe I'll be a lawyer and do. And I actually did public policy as a major undergrad because I was gonna be on Capitol Hill advocating for children. And so when I realized, you know what, these. The. The lawyer route is not gonna really get me to working with children, then I switched gears. And it was actually after I ran into a flyer back in the late 1980s of this American Holistic Medical Association. I'm like, what is holist? I had no idea. And so as an undergrad, I got myself over to the Santa Clara Convention center and heard these amazing people that were just getting known In, I think, 89, if I remember the year people like Andrew Weil or Deepak Chopra and Joan Borisenko, and I was like, I want to do that. So as I started my medical school training and residency, it was always with this idea that I got. I want to do something broader. I want to know the conventional pediatrics, but I also want to understand all of the other ways we can really help our kids thrive.

We have a similar background that I too, went into medical school with the same idea. I read books by Andrew Weil, and he was kind of my. My hero early on and then going through a very. I don't know about your Medical school. But my medical school was extremely conventional. In fact, I helped them start some integrative training and I was president of the complimentary and Alternative Medicine Interest Club and things like that. But it was really as. I mean, again, I don't know your training, but mine was extremely conventional. And so how was that for you? Sort of knowing, which is how I had done it, knowing I was going to do this very holistic integrative practice. But I was in this very traditional medical school and then residency training.

I love being on. On podcasts where, you know, I love, love, love the hosts and know a lot about them. And yet I'm like, oh, I learned something new and such similar paths because even in med school. So I went to NYU New York University, and I was there in the mid. Early to mid-90s. And I mean, it was so conventional and so traditional. There was only one dean of medical students. I think there was not a single female surgeon on staff. I mean, it was quite a thing. And definitely not. I was definitely not encouraged to do alternative medicine. But even then, I mean, same thing, I headed the sub chapter of the Complementary and Alternative Medicine Interest Group and it was called Alternative. Right, Alternative. And it's not alternative. It has to be now more integrative. And I actually requested to do an elective with this, this Dr. Pally Delevitt in. I think she was at University of North Carolina, who was doing medical student electives in holistic medicine. And of course, and I was declined. I mean, I couldn't go. So I mean, it was just. I know it was so interesting. But then when I was at ucsf, I mean, of course San Francisco, there's much more exposure, even if there's not necessarily support in the, in the academic center. But I was able to. My second year when I did my rheumatology, I had an elective. So I choose rheumatology, immunology. And I asked if I could. If I can create my own elective. And so I did. I actually did a. Created a complimentary alternative elective and wrote a primer on holistic, not alternatives, but holistic therapeutics for juvenile arthritis. And I presented it to the students and the attendings and I. And they let me. It was actually one of my most fun times because they let me go to all the, like, acupuncture offices, osteopaths, chiropractors, you name it, in San Francisco and just kind of hypnotherapist watch what they were doing and take notes and I mean, really just opened my eyes to all the different things that I didn't realize were available as alternative therapies either.

So when you then set up your, you finished residency and you went and set up your practice, did you do that on your own? Did you have a standalone practice? Did you join another practice? And then were you sort of recommending these more holistic treatments or were you practicing in a holistic way?

Yeah, so I opened up my practice in 2004 as whole child wellness and it was a functional integrated medicine practice. I had already taken acupuncture certifications, homeopathy, I had learned about essential oils. Still a lot more to learn. And of course I took the ifm. Back then there was no certification, it was just one course. It was the Applying Functional Medicine and Clinical Practice. So I kind of, I spent a year just kind of absorbing all of this amazing information, which of course back then was really only adult centered. And so I had to extrapolate really, how am I going to apply this to kids? But I just jumped right in. I started my own practice solo. And I mean it was crazy how quickly it just grew and grew and grew without really doing much of anything because I mean, showing just what a need there was.

Are you back then and now insurance based or cash based? How do you practice?

So we, we are cash based. We have I, our visits, I mean my first intake as yours are an hour and a half at a minimum. Because we just want to, I mean I want to dive in and hear your story, tell your story, your child's in this case, review anything that's been done in the past and really get a much deeper look at some of the potential root causes of what's going on. And so, so yeah, we are cash based right now. Unfortunately, my practice has been closed for years and I haven't been able to take new patients. And so I mean that's one of the reasons, I mean twofold, that's one reason why I wrote the book is so that, I mean it's like all of my 20 years of clinical experience and research in one book and then two. I'm now head of a 4M, which is for listeners. It's similar to ifm. It's a really one of the largest functional medicine practitioner education organizations. And so I'm now chair of Pediatric Education and we're doing.

Oh, congratulations.

Yeah, thank you. Annual pediatric functional medicine education for practitioners which has been lacking. And it's just another way that we get build up an army of pediatric practitioners who really understand the need to practice in a broader More integrative way.

Well, that's great because I mean, I don't think IFM has any sort of pediatric track or anything.

They've had kind of, they've had a.

Couple of talks, but nothing. I mean, I know when Elle was born and I was, you know, curious about various things. I would like get on your website and see like what is Elisa doing and what, what, what is she writing about? Because there just wasn't as much information readily available. Well, so you talked about kind of one of the reasons you wrote a book. And it, it is really great to be able to distill all that information. So one of the concepts that you talk about, which I really love in the book, is about hold child resilience. Can we talk about what that, what that means?

My practice is called Whole Family. It used to be called Whole Child Wellness. And as I really thought about what the title of the book should be or actually the subtitle of the book, An Integrated Pediatrician's Guide to Whole Child Resilience, it's really the idea that wellness is such a nebulous term. What we really want is not just a static picture of wellness. What we want is to build that resilience so that we trust that no matter what our kids face in the future, whether it's really high levels of psychological stress when they're in high school, or if it's all of these microbiome disrupting endocrine disruptors that we are bombarded with every day, or that blue frosted unicorn cupcake at a birthday party, they can bounce back their immune system, their microbiome, their brain, their whatever it is. Sure, they may take a little bit of a hit and take a little bit of time to recover, but, but they have the foundations and that's what I want. I mean, that was key. Through the pandemic. It's not about shielding your kids from every single little stressor or infection because that's just not possible. We can minimize what we can, but the key is how do you build that resilience? So you, your kids are the ones who bounce back and recover completely and quickly.

What are your sort of principles to building that foundation?

In the book and in everything I teach, it's really. And for listeners who know your work, of course, I mean, it comes back down to all disease starts in the gut, but also all health starts in the gut. So the book takes a really kind of gut first microbiome centric approach to children's resilience and really ties in. What do I Want parents and practitioners to know about a child's developing gut immune system connection and developing gut brain connection, gut hormone connection. How do we intervene? Well, how do we first prevent that disruption, gut dysbiosis, leaky gut from happening in the first place, and then if that does occur, which of course in our modern world is very, very likely to happen if we're not aware. Right. Unfortunately, how do we recover? How do we do that for a child? Take the knowledge we know on how to restore a leaky gut or heal a gut disruption and get kids to recover and fully thrive.

And so for the people, you know, obviously we'll have people listening at various levels, people who maybe have a grandchild or someone's listening and it's their first child and it's very early on versus somebody who maybe has a child who's seven like mine. To people who have teenagers now. I mean, where. How can you advise our listeners from, okay, you have basically a clean slate to maybe you have some years of wear and tear, to, yeah, you have teenagers now. I mean, of course, I imagine you're not telling people, oh, they're teenagers, don't worry about it. So we still want people to feel that you can still intervene. So can you just kind of talk to us about those different stages?

And here's the thing. No matter how old your kids are, whether they're like infants and toddlers or, I right now have tweens and teens at home with me. The key for us as parents and practitioners is to really educate and empower our kids, no matter how old they are. But do it in their language and do it in a way that makes it fun, not just like, oh, let's talk about these studies, about the microbiome. Because I could spat out studies and it can be fascinating for some teenagers, but not for others, right? And then really make it relevant for them. Because guaranteed, no matter what concern or thing that a child would like to improve, we can absolutely tie back to, hey, here is how those trillions of tiny little friends in your tummy affect that and why it's so important that we are really great hosts to our little ecosystem, our huge ecosystem that lives inside us. And here are the steps to take. So whether it's for a teenager, their acne or their, their PMS and horrible period cramps, right? Whether it's middle schooler who just wants to be the fastest on the soccer field and have an accurate soccer goal, or a toddler who just wants to be able to not have such huge worries and fall asleep Easier, we can always tie that back to their gut microbiome. And when I also inform and educate parents and kids in an age appropriate way about the impact of that disruption. So some of the studies can be quite alarming. There's one huge study, it's nearly 800,000 children, it was military study, where they looked at children, infants who received antibiotics or antacid medications in the first six months of which because they're major microbiome disruptors, and found that those children by the time they were four, had a significantly increased risk of virtually every single allergic disease. I mean, this is hay fever, anaphylactic food allergies, eczema, asthma. We know those are skyrocketing kids. We also know we have a mental health emergency crisis really at all ages, but especially our teenage girls. And in the literature we see in Denmark, another large study looked at infants, young children who received antibiotics, even counting in utero exposure, meaning mamas who got antibiotics while they were pregnant, and found that those infants and children who received antibiotics were at an increased risk, sometimes up to 50% higher risk of virtually every mental health concern by the time they were older kids and teenagers. And the more rounds of antibiotics, the higher the risk. We know this for adults too. We know this occurs. The more antibiotics in an adult, the higher the risk that you will develop anxiety or depression. So we need to shout this out and say, look, the microbiome is so important. So maybe these medications are necessary. In many cases they're not, but sometimes they are. So how do we then take advantage of the benefits of many of these microbiome disrupting medications, but then really mitigate the unintended effects? And so the first key is really building that foundation as we were talking about. And in the book, I go through the five things, I call them five things from Microbiome Magic. And they're five things that you do every single day, your kids do every single day. And we just teach kids, empower them to do them in a way that helps their microbiome, helps them be great stewards for their microbiota. And I go through really, how do we think about what we want to get in, in a really fun way, what we want to keep out of their diet, how do we live and breathe and move in a way sleep in a way that supports our microbiome. And the two most important things that I think as parents we can do to set up our kids for success for the future is helping them learn how to suss out these microbiome disrupting ingredients in Ultra processed foods, because at some point they're going to be on their own and choosing their own foods. So how do we be either savvy shoppers ourselves or. Or help our kids learn how to read food labels like a gut hero? And I have a whole chapter on that. And the second thing is, how do we help our kids learn how to regulate their nervous systems? Because the vagus nerve is really one of the keys to building that microbiome and whole child resilience.

Someone sent me a book for Elle many years ago now about the bad buggies. And I apologize to whoever wrote it. She loves the book, but I don't remember the author, but so she really re. It's a children's book, but, you know, she reads it about the bad buggies and the little girl craving the certain foods for the buggies. And so we've been very fortunate that Elle's only had to go on antibiotics one time. And that was after. That was a year and a half ago. After Covid, we all looked like we were turning into a pneumonia. So she got antibiotics. And so recently I just did a stool test on her, and she has some candida overgrowth, which she has been prone to. And so I'm just able to go back to and say these bad buggies and just like you swim team, and she wants to be the fastest or she might have some outburst. And so who knows what it. What it is. And yesterday she was saying, you know, can I have some ice cream or something? And I was like, no. Or popsicle. I said, no, we are not going to have that. She said, why not? I said, well, that's what those bad buggies are wanting you to have. We need to go home, do all our stuff. So I have. It's hard doing these things in children, trying to mask the flavors of various supplements and the supplements and all the things that, you know, opening up my probiotics and putting them in a zevia.

And all kinds of stuff, and your gut repair formula, your leaky gut revive, all of that. So important. I mean, absolutely. Yeah. And what I love that you're saying is that I want readers to. I mean, not readers, listeners to understand is if. If you hear these statistics on the state of chronic health in our children and you hear how much the. The microbiome plays a role in antibiotic use, and you're thinking, oh my gosh, my kids had so many antibiotics when they were babies, and now they're eight or now they're teenagers. We can always, always restore a disrupted gut Microbiome, it's. The longer away from that initial disruption is. It might take a little longer. But that's why, I mean, you wouldn't be doing the work you're doing, I wouldn't be doing the work I'm doing if it weren't possible. And so, I mean, that's like at any age, if you think, oh my gosh, my kid is one of those kids who really does have the disruption where a stool test would be worthwhile, some, some. A leaky gut protocol would be worthwhile, then absolutely. It's amazing also how, how much more quickly kids respond than adults.

And if only we could get it to where this was just common practice with every pediatrician or. I mean, now some of these lab companies are coming to where you can just go order the lab yourself. I mean, even these functional medicine companies, which you used to previously have to get through a doctor, go to a specific website. I've seen some of them converting to having a, a separate sort of interface for direct to consumer. So you may need a consult with a physician like yourself or someone to help interpret it. But they're, they're pretty easy. And even a lot of them will say, which I like about them because of course, I always want to go to herbal or natural before any other type of antibiotic or, or antimicrobial or something. A lot of them give you the sensitivities at the bottom of, yes, silver will work, or caprylic acid will work, or grapefruit seed extract will work, or it won't.

So yeah, I love that and I love, I. To your point, it is getting more accessible and some, some people don't have a practitioner to work with near them. But that's where I mean, your programs are. So, I mean, you've been doing this for, for decades now, right? I mean, your, your programs are, are so great and that, that's really why I want to have this book in people's hands. And with the stool testing, it's the kind of thing I mean, I talk about and I teach people the clinical clues to suspect that your kiddo might have candida overgrowth. Like the craving, the sugar. I love that you said that. You told Elle. You know what? It's actually those bad buggies that are telling your brain that you want sugar. I mean, so perfect. And then how do you suspect parasites or bacteria? But the truth is we don't really exactly know what's in there unless we do a stool test. I mean, that's one of the best ways to kind of get a starting point and really get a great plan in place.

So you talked about antibiotics, of course, being a major microbiome disruptor. But what are some others? You mean obviously some food and readings from food labels. But what are others? Or can you go more into detail about some of those ingredients in packaged foods that can really disrupt the microbiome?

There are food things in our foods that are microbiome disruptors, which of course are really significant because we're putting those in our mouth and they're directly going to our microbiome and disrupting. And then there are so many non food microbiome disruptors. So we want to live in this world and not be afraid of every single thing around us. But we need to be aware so that we can minimize those exposures when we can. And so in the foods, it's particularly in packaged foods, we have to be aware of these many FDA approved food additives, many of them that have been shown in the literature to disrupt the microbiome, preferentially killing off some of our really good probiotic bacteria like Lactobacillus and Bifidobacteria species and preferentially maintaining some of the bacteria that we don't want, like Clostridia, these, these bad, really bad buggies that we don't want in our bug. One of those is glyphosate. Glyphosate. Or in Roundup, that is if you eat foods that are not organic. And unfortunately even some organic foods are going to have glyphosate, which is Roundup, which was originally patented by Monsanto as an antibiotic. And so at the very least, eating those foods on the environmental working groups lists, Dirty Dozen lists, having those be organic and kale and strawberries are always on that list. I mean, I don't think I've seen a year where they're not.

And I think spinach and celery as well.

That's right. Yeah. So.

Right.

So I'm.

And then apples. Right? And then you, Right. And then you go to the juice place thinking, oh, I'm doing so healthy for myself. And unless it's organic, it's always an apple spinach. It's like a drink of all the celery, spinach, apple. It's like, oh my God, if that's not organic, you've just bombarded your system with pesticides.

So just being aware of that. Right, because if we don't know that, if we don't know that those are the most heavily sprayed, we are inadvertently thinking, oh, I'm actually doing a good thing. And even for the other thing that I really am so focused on prioritizing, educating and empowering kids on and parents is really looking at the added sugars that are in packaged foods. It adds up. Kids should have no more than about maybe 6 teaspoons or 25 grams of added sugar in a day. And that sugar sneaks in. And I talk about doing a sugar inventory where you just take a normal old day where you just look at what you're eating and then you just write down how many grams of sugar at each meal or snack that your kids are having. And I give an example in the book about me doing this before I started reading every single food package and this was even I was already a holistic pediatrician. So me doing this for my kids kids and realizing, oh my.

Right. You go having like the organic granola bar, right? Whatever made and whatever at Target, and you're thinking, oh, this is healthier because it has organic oats or nuts or whatever. And then you look at the back of these things and.

And it's crazy. Yeah, it's crazy. Yeah. I mean, I. I realized I. That I was buying. I thought, oh, I'm doing such a great thing. I'm getting protein and probiotics in a breakfast. I'm doing the vanilla Greek yogurt. When I finally looked and I realized, oh my gosh, in one serving that I was giving my kids and at that point they were probably having a serving and a half. But in one serving, there was something like 30 grams of added sugar. It was actually, there was less added sugar in the strawberry pureed Greek yogurt that I'd been avoiding because I thought, oh, that's gonna have too much sugar in it. It still has too much sugar, by the way. I mean, it still has like 21 grams, right?

As a baby, loved this brand. Col was like just plain, really high fat coconut with I mean, very like your typical yogurt that like, I grew up on homemade yogurt. And now she eats a. A different brand. But she only. I'm lucky. She does not like any of the yogurts with the sugar. But, you know, give her a. A certain bar or something like that. But luckily her go to generally is beef stick. I mean, we keep beef stick, which is great Epic bars in. And last night she was hungry before bed and it's like, can I have a beef stick? It's like, sure, yeah. All day long.

And this is where just being savvy and teaching our kids because now I Have my kids, they're going downtown with their friends. So it gets a little bit more nerve wracking as a parent when your kids are old enough that they're like, I'm buying my own food. And so they may go to Starbucks and get that mocha chip frappuccino that their friends are having. And you look, I'm like, there is 52 grams of added sugar in there, right?

Oh, my God.

And so we talk about, we talk about the added sugars and how we want to balance it. Go ahead, go to Boba, guys, with your friends, please look at the nutrition facts so you make an informed decision. And then if it's more than really what is healthy for your brain, your immune system, your microbiome, then let's really surround that with a bubble of nourishing food so that we can bounce right back. But these added sugars are ubiquitous. You mentioned the bars, but even beef sticks are one thing. But then you look at the jerkies. Some of the jerkies are loaded. Like the teriyaki jerkies are loaded with sugar or. Yes. The protein bars are a source that a lot of parents don't think to look at. So it's not. We want to think beyond the sweet, what we consider sweet treats even. I remember looking at this one bread that was like 21 seed multigrain, organic. And I'm like, wow, one slice of bread had 4 grams of sugar in it. I mean, that's a teaspoon of sugar. You don't. You could have a teaspoon of sugar for the yeast in your bread for the entire loaf. I mean, you don't need that much. And so being really, it's really hard.

Right? I mean, when you take in. In our family, we're gluten free, dairy free, then you take in. We really only eat organic. Of course, if you go out to eat to a restaurant, that's our time that obviously, unless you're going to particular restaurants, which here in Santa Fe is very difficult, that everything's organic. I think options are getting better in bigger cities. And then you're taking into there these dehydrated strawberries that Elle, a friend, had so now she loves, but it's like I can't find them organic. And we just discussed strawberries are always high on the list.

Yeah.

So I really try to limit what I give her. But when I buy fresh strawberries there, I will not buy them unless they're organic. So it's just, it's really hard. And I think it goes back to eating Real whole foods. Right? I mean, you just.

Sure.

And, but, you know, we're working moms. It's, it's difficult. My mother made bread when we were little. She made homemade yogurt.

Yeah.

I hope one day I have the time to do all of those things.

I know. And the reality is, even if we're not eating the ultra processed foods, the packaged foods, we just have to be savvy about and so, and teach our kids too. Because like I said, I mean, for me, when I was younger, I was like, my kids are eating so clean, and I can control everything they're eating as soon as they hit. Even elementary school.

That's what I was gonna say. School for Elle. I mean, it was meat, maybe a little rice and vegetables every meal. That's what it was. And I cannot get a vegetable in her now. I mean, not even occasionally a cucumber and a carrot. But I mean, it used to be broccoli, spinach. I mean, all of these really intense, healthy, very nutrient dense vegetables. And I mean, we, yeah.

And we go through stages. And I, and I trust, because I've seen this now over the decades, kids kind of going like this with their, their intake and, and just, just know for the listeners, if you're in the same boat. I mean, if, if you model that this is how our family eats and your family time and you, you talk about food. Right. When I go grocery shopping with the kids, we look at labels together and we just discuss like, they wanted ice cream. Right. I'm not churning my own ice cream. I, I, we did one summer. So fun. I mean.

Yeah.

To take the rock salt, too, in plastic baggie, if you've ever done that, and shake it. It's so fun. But, you know, for the most part, we're buying ice cream. So I gave them a task. I said, look, you are now old enough, you can read the labels. Let's go find something that doesn't have emulsifiers, does not have the mono and diglycerides, and it can be hard. But now they knew. They picked out Strauss's organic vanilla ice cream. That was cream if you're not paleo. It had cream, sugar, and vinolife extract. That's it. Right. Or all organic. But you can also find coconut ice cream that has the emulsifiers or that don't. Now, emulsifiers are another sneaky, sneaky ingredient that has been shown to also directly disrupt the microbiome and even trigger leaky gut. So I, and it's not going to say emulsifiers on the package, it's going to say carrageenan monodiglycerides, carbox gum, polysorbate 80. So we have to know. But once, like now, once my kids know, oh, I just look for the mono something, something, something, then they know. Yeah, put that back. I'm gonna find something else.

Right? It is difficult out there to kind of not to say that you can do it perfectly. But yes, if we all. I just planted my garden, so I will say the summertime, we go out there almost every night and pick a head of lettuce and add all different kinds of ingredients. And she does love a good salad, but.

Oh, I love that. Well, that's.

And.

And as we're talking about the glyphosate, right? I mean, that's an environmental toxin that we. So many of our soil is so contaminated that we are being exposed to, I mean, even these forever chemicals, right? These pfas that are just everywhere. And one of the things that, for instance, for forever chemicals, what was shocking to me was we know that endocrine disruptors, phthalates, parabens, bpa, bpf, all of these forever chemicals, pfas. I combed the literature, and in children, they have been found to disrupt the microbiome. I'm sure the same thing is happening in adults. And these forever chemicals, I mean, they're called everywhere chemicals because they really are everywhere. And in soil that's contaminated with forever chemicals and foods don't have to test for this. The scary thing that I saw was we're always thinking cruciferous vegetables, broccoli, cauliflower, brussels sprouts. We want to up our glutathione levels and help with detoxification. Well, it's these floret vegetables that absorb the most PFAS from the soil. So does that mean you should never have them? No, but it means that we just have to be aware. And yes, choose organic, please, because that's going to reduce the total burden of the toxic exposures. And in the small studies that have where we look at how do we reduce glyphosate levels with food, how do we reduce forever chemical levels with food? It goes back down to the microbiome, like forever, like glyphosate, for instance, eating fruits and vegetables and fermented foods, or specific probiotic species that can reduce your glyphosate load. Forever chemicals. The one thing that's been found to help reduce forever chemical levels in our body because, I mean, it's really tough, they last forever in our system is actually Fiber. So getting in as much fiber as you can. And fiber is one of our biggest microbiome champions that I talk about in the book. So it really still comes down to your microbes in your gut have their own detoxification systems. We support them. Anything that's ingested through our mouth and gets to them before they get inside us, our healthy microbes are going to help us clear them out faster.

Mm. It can get a little overwhelming even for those of us in the know. Well, you briefly mentioned earlier about the vagus nerve and just the importance of, of utilizing and resetting the vagus nerve and its role in our microbiome. So can you, can you talk to us about that in general and then also what you do for your children?

My two favorite topics to talk about with kids and around kids is the microbiome and the vagus nerve. Because if we can figure out, teach our kids how to optimize both, it sets a foundation for optimal health for the rest of their lives. And they can always go back to it. If they go off to college and they're eating the cafeteria food and staying out all night and getting the pizza. And then I've heard from kids coming back from college that their diet, like there was not a single palatable vegetable in the cafeteria, I'm like, okay, let's think about how we can support. But you know, one thing that's fascinating about the vagus nerve. So just as a background for listeners who aren't as familiar with the vagus nerve. The vagus nerve is the two way information superhighway between your brain and your gut. About 80 to 90% of that communication actually occurs from your gut to your brain. And. But it all is intertwined. A healthy gut microbiome will support healthy brain functioning, healthy neurotransmitter functioning, because our microbiome is responsible for the production of the majority of quote brain chemicals like serotonin that help us feel calm and relaxed. But managing our brain and really that communication that way also helps support a healthy microbiome. And one of the ways that we can assess your vagus nerve health is through something called heart rate variability, which a lot of people have. Oura rings or their apple watch can assess heart rate variability because heart rate variability has been found to be one of the best predictors of current and future health. So when I have kids in the office or when I have parents in the office, I'll say, let's just find your heart rate on your neck. And this is what we want. So as you Take a slow breath in. Well, first they find their heart rate. As they take a slow breath in, their heart rate should increase. And as they exhale slowly, heart rate should slow down again. The variability of your heart rate when you breathe in and breathe out, that's normal and very, very healthy. When we're in a fight or flight stress state, it's just boom, boom, boom, boom, boom, fast and steady. Now the things that we can do to engage our vagus nerve and improve heart rate variability have been found to improve your microbiome, improve children's microbiomes independent of diet. So even if they're not eating the most fiber filled phytonutrient rich, they're not eating a lot of fermented foods. Diet, that's okay. You can work on their vagus nerve and it's going to make a huge difference for them. Which is why, I mean, I actually devote an entire chapter in the book to the vagus nerve. Because we want parents. As you said, sometimes when looking at food, it can feel a little overwhelming. Well, there are five things you can work on with your kids and they can choose. Do they want to work on their vagus nerve right now? Do they want to, do they love to move? Do we want to have more mindful movement throughout the day? Is sleep something that they want to really try to optimize or even hydration? I mean, there's so many things that we can do. So picking the lowest hanging fruit, as you said, as busy moms, we want those quick wins and we want our kids to feel quick wins. So there's all these different points of intervention that we can actually take a look at.

Have you seen or tried an oura ring on your children? Well, your children are older than mine, so it may be. I've been kind of curious. I have some older ring. I don't have my ring on right now, but I moved it to my middle finger where I used to wear it on my ring finger. And so that one was smaller. So I thought, I wonder if it would fit Elle. And if I could just be checking like I do for myself with these things. But I don't know how accurate an OURA ring is or. I mean, honestly, I'm kind of surprised nobody has done anything and geared to any of this stuff towards children. Right. Like, why is nobody.

Yeah, I know one of the things that you know because I've, I've contacted Aura and said, hey, look, I mean I have a huge population of parents who, who would be so interested in learning about and Tracking their kids heart rate variabilities to improve their health.

Right.

And they've said that they just don't have appropriate standards for kids. That's what I'm wondering. I mean, but here's the thing. Children should have higher heart rate variability than adults, right? Yes. And so, so I think if. And I have put it on my kids just to see. And so. And they do have higher heart rate variability than me. But if you notice a trend, and it's really about the trend, because I've been asked, well, what's a good heart rate variability? It's not good or bad, it's what's right for you. So that's why with the aura, it just gets your baseline at first and then sees how much you're varying from your baseline. And so for kids, I think it could be appropriate to get that baseline. It's just that aura can't guarantee that it's going to be accurate for your kids. Same thing with all of these. Now, in the book I talk about all these free ways you can engage your vagus nerve, which are an absolute must, including things like learning how to breathe with your diaphragm, belly breathing throughout the day, there's walking in nature, there's certain gratitude exercises that have been shown in the literature to improve heart rate variability. But then there are also these devices too that are on the market.

Yeah, I was going to ask you about that. Have you tried. I mean, I've tried them. Somebody sent me one, but I haven't tried it with Elle to see.

I've tried several. And when you speak with, I mean, like me as a pediatrician, I've spoken with almost all of them and just asked, hey, can I use this for kids? And their kind of bottom line, which is basically covering themselves. Right. Is that we haven't tested this in kids. We can't recommend it for kids. It's only through doctor's guidance, which doesn't help the mamas who are listening, who are not in my practice because where are they going to get the guidance from? But I have used ear vagus nerve stimulators for my kids who to help them recover from illnesses or chronic health concerns. You need the vagus nerve just for the listeners to be engaged and in really good function to recover from any chronic health concern and chronic disease. So we're finding in long Covid, in fact, there is a vagus nerve stimulating device that is approved by Health Canada for the treatment of long Covid. It's that important with all of the kind of Vagus nerve dysregulation and some of the blood pressure, something called pots that we're seeing in long Covid. Now. The only. The only device that. That really currently right now will. Will say that you can use it in kids. And I do recommend it for kids. I'm wearing it right now is my Apollo.

Okay. I actually have one of those. I have one of the. Like, the version one.

That's right. You know, the first one.

Yeah, the first one.

This is my first one. It actually used to be all black and it's worn out, so it's just. It's. It's silver now. But I, you know, they do have some. Some small studies using this in children with improvement in calm attention and focus, heart rate variability, and of course, they have many more adult studies. But this, because it is not. It's not specifically a vagus nerve stimulator. I mean, really and truly, if you want a vagus nerve stimulator, they're the ones that go on the neck and you stimulate or the ones in the ear, because you have a little branch of your vagus nerve that goes through your ear. This one is on your arm and uses these vibroacoustic different settings to help with calm and focus or sleep or anxiety. And I will tell you, I. I do see some really good results in my patients.

Awesome. I'm gonna see if she likes it. Yeah, I mean, I actually got this.

For me, and I thought, well, I'll share it with the family. And they don't get much chance to use it.

Right. I need to just charge mine and pull it out. But I remember when they first came out, I got one. I used it up frequently, and then just things got busy. But with. With. With more, as you mentioned, anxiety in children, more adhd, more chronic illness happening at a younger age. It's just, why are we, as I'm saying this to all these tech companies out there, I mean, why are we waiting for the adult where we're trying to slow down progression of things or undo things? I mean, why are we not getting these markers in children and starting. Intervening and starting children? I mean, Elle was sick recently, and she said, I'm just gonna tell my body that I'm not sick anymore. I'm gonna wake up tomorrow. Well, and then last night we were.

Just going, breathe in, breathe out, because.

She was just all worked up last night. And in a good way, like, happy, like, just in a really good mood. We're adopting this cat. She couldn't sleep, so but it was like, good Energy. But still it's like, okay, good, we gotta try to settle down. So. And I remember my mom doing things like that with me when I was little. And so, of course, I grew up to be as I am. But. But anyway, it's just a shame that we're not really starting this stuff earlier in children.

Oh, 100%. I mean, that's. It's like you said, our kids are heading that way. Why are we waiting? What are we waiting for? We're waiting for a diagnosis to actually occur rather than looking at these little red flags. And that's, I think, one of the hardest things for many people to kind of wrap their heads around. How do we really, truly practice prevention? But we can. We know that the microbiome, if you optimize at young ages, even in your teenage years, it can change how your genes are being turned on or off. Right? It can change your epigenetics. So just because diabetes, type 2 diabetes runs in the family, or everyone has anxiety in my family. All right, well, that doesn't have to be you. It means you have a higher risk. There's tons of autoimmunity in the family. Yes, you do have a higher risk, yet you can also control a lot of those risk factors, which is so much of the work in your books and your teachings. But if we could really practice this when we're younger, we would have a different healthcare system, we would have a different future for our kids. And I mean, it's so important. And I always want parents to know that this is achievable. We just have to know how. And even with my kids, if I can, and my kids young, even young kids and teenagers, I always like to get baseline lab work. I'm lucky as a pediatrician in my office, I can do that for my kids. And it's astonishing how many kids, Amy, have positive ANA levels, which is for the listeners. That's an autoimmune marker, a general autoimmune marker. The rates of ANA positivity are rising the most rapidly in our 12 to 18 year olds. And it's amazing how many have insulin levels. Fasting insulin levels, showing a pre diabetes state that are butting up against the too high in the normal range or high. But when I get these, and they're abnormal, or they have. They already have Hashimoto's thyroid antibodies. What I tell parents and kids is, you know what? This is actually so good that we are finding this before you get diagnosed with an autoimmune condition, before you get diagnosed with diabetes like this is. This is so great that we have this opportunity now to really reverse things.

Elves only had blood work one time, but, I mean, I put the Emla cream on her, and she was just, like, watching a show and had no idea. I'm only saying it because I know so many people. We had it in my clinic because I would see pediatric patients and we just, the second they walked in the door, put it on both arms. And it's the difference of not feeling anything to just a nightmare, to setting your child up for having a nightmare every time they're trying to get blood work. And it's a very easy thing that your doctor can prescribe and you can show up to the place. You just put it on there. I mean, most labs do not have this.

They don't. They don't.

I mean, my. My sister, half sister, her child was at a young age, I don't know, maybe four, in the hospital, and just. They couldn't get the stick. And her husband's an anesthesiologist, and I'm like, no one recomm. Emily cream.

Poor thing.

I mean, just like, literally, trauma for life. I mean, those kinds of experiences are trauma for life. Kind of.

It's hard. I mean, I'm so glad you mentioned that. I do mention some tips for making blood draws easier, because that's the one thing. If you recommend a blood jar, and then parents or kids are like, because of their past experiences, or it may be that the kids have never had a blood draw, but parents are thinking, how am I going to do that? This numbing cream, which is a lidocaine cream, Emla, you can get a prescription for. You can fill it at any pharmacy. You can even. I had a patient tell me that they actually got a numbing cream, a lidocaine cream on Amazon that's used for waxing. Right. But it's the same. It's very similar. And she said it worked great. Although another patient ordered on Amazon, and I'm guessing it was an old batch because it didn't work that well. But if you set your kiddo up for success for that first blood draw like Amy said, they. They will not associate that needle blood draw with it, with anything negative. And it's so much easier because, I mean, we have blood work done as we get older, and so we want that first experience to be really smooth. So I appreciate you mentioning that.

And the tube will last you and your whole family. If you're like me. I get blood draws without it, but I do ask for the pediatric needle I have to get. I mean, with. I'm constantly checking things on myself, so I'm like. Feel like I'm always getting blood, but if I do IVs, because I don't like the feeling of the catheter going in, I put Emla cream on myself. So Elle was gonna get her ears pair. She ended up chickening out. But for she and her friend, I put Emma on their ears. So it's. If you get one tube, it's like a miracle.

It does last you a long time.

A long time. Like over many blood draws. So.

Yeah.

Yeah. My guess is probably the prescription has a higher level of. Of lidocaine in it than whatever you're getting on on Amazon, but yes. Okay. Well, so you have briefly sort of mentioned these five things to create a magic, a microbiome magic. But can you sort of spell them out here? Cause we've kind of talked about them peripherally, I think.

Yeah, yeah. So the five things from Microbiome Magic. Again, these are the. The five things that your kids are already doing every day, but now in the book, you and they can learn how to do them like a gut hero. So we just want to make it super fun for kids. And so I have a wheel of whole child resilience. And in that wheel are the five things. The first thing is nourish. How are we thinking about what we're getting in or what we're keeping out to nourish our gut microbiome? The second thing is breathe the way we breathe. This is really a reminder. How are we engaging our vagus nerve every single day, throughout the day to support our microbiome? How are we moving, exercising? How are we sleeping? Because sleep. It just takes just two days of sleep deprivation to disrupt your microbiome and seven days to repair it. So how do we optimize sleep knowing that most of us, including me, I'm going to admit we're not getting the optimal sleep that we should, even our children. And five is hydration. Good water drinkers, people who are hydrated actually have been found to be more likely to eat more fruits and vegetables. And their microbiomes are different. And so a healthier microbiome. So those are the five things.

Awesome. And so is there any type of movement that's important or just moving your body?

It's moving your body. So it's right now. I mean, especially through the pandemic, with many places on Zoom school, for way too long, kids were not moving. And so the sedentary. And there are some kids who are very active. But I would say many, many kids out there are too sedentary, many adults, too. So kids should really be moving every day at least one hour. And this is like huffing and puffing, hard to have a conversation. And it doesn't have to be an hour consecutive. It could be your brisk walk to school together in the morning. It could be jumping on the trampoline after school. It can include soccer practice. So all of that adds up. But we just want to make sure that we keep moving. And the number one thing that keeps people from moving or kids from moving is screens. So we just have to think, how do we, when we're on our screens, what are we not doing? Let's get our kids moving because it's so important for their, their microbiome, for their brains. In fact, exercising, especially exercising in nature, has been found to be just as effective as an antidepressant for, like, anxiety. Right. And so again, with our, with our mental health, in a lot of kids, what's going to move the needle? It's supporting their microbiome and really thinking about all these other things that we can incorporate. Even if they're on medications, what can we incorporate that is going to help to support them to be as healthy and vibrant as we'd like them to be, as they'd like to be.

I always love doing these interviews and learning new things. And for me, what was so incredible is hearing that some of these other things, such as the movement, such as the vagus nerve stimulation, the breathing, can have just as much of an effect as the diet and so on those times. Something I'm going to take away from this talk is when I'm traveling and where the sleep is disrupted or we're not able to eat organic. Incorporating some of these or making sure that I incorporate some of these other things to just keep my microbiome healthy while I'm doing them.

Yeah, that's. Yeah, it is true, because they, they all. And even as you said, exercise has been found to improve the microbiome, regardless of diet. And, and again, if you, if you're thinking now, okay, my kids have a disrupted gut microbiome. What do I do? You still have to get back to these five things. It's kind of like if we're trying to, I tell kids your microbiome, it's not like Jack's magic beans. You can't just throw probiotic supplements in there without the foundations of these five things and expect your microbiome to grow and flourish into this thriving ecosystem. We need these foundations. And then sometimes we need to do additional work, like you're doing with Elle now with the stool analysis and doing some of the gut dysbiosis treatments and healing the leaky gut. But the foundation remains the same. And if you're wondering, how do I do that? That's all. In chapter 11 is my whole gut reset program that's really geared towards how do we do this for kids? How do we apply what Dr. Amy is teaching you guys for adults? How do we really make it specific and doable for children?

Yeah. And you have a lot of really great recipes in here. Do you have a favorite or do your kids have a favorite? Maybe I should ask you that.

I don't know. I mean, they love them all. I mean, our chili and our Thai chicken curry they all love. But I would say my favorite one in there is one that a lot of parents don't think about in terms of how to support their microbiome is it's a fermented food recipe, but it's fermented BlackBerry lemonade. Oh, it is so good. And it's because a lot of people, when we think about fermented foods, like, I don't know if I'm gonna get my kids to eat kimchi or sauerkraut.

Or Elle loves sauerkra.

I love that.

And she likes kombucha now. But there's so much sugar in kombucha there.

For sure can be. So we have to watch that. Right. Because we're kind of countering the effects if we have too much sugar in the kombucha. But, yeah, there's so many different ones. But the fermented lemonade is super fun because your kids can squeeze the lemonade and muddle the blackberries and just have fun with it. You can make different flavors you can make into popsicles over the summer so that when they're splashing around outside getting really hot, then you can say, hey, or have some. Have some popsicles. BlackBerry lemonade popsicles. But guess what? They also have probiotics and postbiotics and all the benefits of fermented foods, too.

And throw in a little bit of my leaky gut revive.

Yes. Oh, my gosh, absolutely.

I have a strawberry lemonade flavor, and we've made popsicles out of that. Nel loves them.

I would say your strawberry lemonade leaky gut revive, and your collagen powder. I mean, just make it this amazing, amazing popsicle. Why not?

Before we part, I'm sure a lot of parents are thinking, well, I Mean, we're moving into summer, so some of these viral illnesses and, and illnesses that we're used to in the winter are hopefully coming to a close. But if a parent is being faced with an illness and going to the doctor and they're recommending antibiotics, I mean, are there questions they should ask? How do they know for sure they need the antibiotics versus, like, most ear infections are actually viral? I mean, how can we sort of help guide parents to just not. Thank you. Take the script, take it. I mean, what should they be thinking about?

This is such an important issue that it actually is an entire chapter. I mean, chapter 10 is all on. It's actually literally titled what Every Parent and Practitioner Should Know About Antibiotics. Because there's so many misperceptions out there. But the one thing that we do have to recognize is antibiotics. I mean, whether they're absolutely needed or not, they're still going to disrupt your microbiome acutely. I mean, instantly. And so we need to understand how to be judicious in our antibiotic use. We are headed to a place where by 2050, there are some predictions that antibiotic resistance is going to become a leading cause of death worldwide. So we need to stop and think, okay, how do we be good antibiotic stewards? So we're not the ones who are using antibiotics, prescribing us practitioners, or requesting and using antibiotics as parents inappropriately. Now, as you said, I mean, isn't.

Most of that coming from the meat industry? Meat, chicken, pork industry, a lot of that?

Right. I mean, so they're conventional, you know, in the food we're eating. Right, so absolutely. So one of the things that we want to think about when we're going to the doctor, we know that in some studies, about 70% of antibiotics are inappropriately prescribed for kids. Like you said, for viral infections. Right. Or maybe a little broader spectrum than they need to be. And so I give a list of six questions to ask. But the number one question to ask your doctor, the prescribing doctor, is just to stop and ask them, hey, doc, is this antibiotic really necessary? Now, that does a couple of things. They might still say yes. Right. But at least we know that from studies, some doctors can be up to twice as likely to prescribe an antibiotic, even if they don't think it's necessary, if they believe that you want one. And you've been in the er. I've been in urgent care where there are some parents, not parents listening now, but there are some parents who come in and with the sole Goal of walking out with a prescription. And in that moment where you have 10 minutes for the visit, I mean, you can see how easy that would be to happen. But if you stop and ask and say, hey, my daughter has an ear infection, is this really necessary? That makes the doctor pause and at least recognize that you're not one of the parents who are there just for a prescription. And it also can help them then sit back and explain to you. Yeah, Actually, the American Academy of Pediatrics, their policy statement on ear infections for most kids is to wait and watch for 72 hours and see if it will get better on its own. So you can start having that conversation now. Ideally, you would then be able to ask, well, hey, what are the alternatives? And they may not have any.

Right.

But that's why in the book I give you, for the top 25 acute conditions which most kids get in the middle of the night, like earaches or sore throats or colds and fevers and flus, you can flip through and find what recommendations I have for using homeopathy or essential oils or acupressure. So that while you're waiting and watching and your kid still has ear pain. Right. What can you do? What things like garlic, ear drops or homeopathic. Right. Yeah.

All Elle has ever had garlic ear drops. And then, I mean, I remember these. She had bilateral ear infections. They were like, bulging, and I have a hot onion, and, you know, I love it.

And.

And garlic drops. It's like, if I can just get through, like, the first four years with no antibiotics. Yes. It's like, all. I would still pick up the prescription because inevitably these things happen on Friday, and then your 72 hours is happening on Sunday, and the doctor's office is closed. So I'm so famous for, like, picking up the. Taking the script, getting the antibiotic, and then ultimately throwing it away because we managed to get through it.

Yeah, absolutely.

But that's. As a parent, if.

When you're starting, especially when you're starting to use natural remedies that you haven't before, having that peace of mind that, yes, you could always use the antibiotics if they're needed. And I also give indications, just so you know, when I. When I think into antibiotics are. Are more indicated when you should feel confident that, okay, this is probably time to use antibiotics. But absolutely. I mean, having that script on hand and then you're waiting, and then if that 72 hours falls on Sunday or your kid gets worse on Saturday, yeah, of course you start it. You finish the whole course. Right. Don't just stop after two days if your kid's feeling better, because that's also another way we can get antibiotic resistance. And then you do the mop up and you restore their microbiome with all the, all the things that I think it's really in chapter 11 that I talk about how to restore your microbiome after antibiotics, even if it was years in the past.

Well, this was excellent. Thank you so much. Before we wrap up, I'd like to ask our guest three things that they recommend that our listeners could do today to take back their health.

The first thing is drink your water. Right. Calculate how much. Right. Ooh, I just spilled on myself. My, I would say our goal, we really want to try again. For most of us, I mean, minimum 60, go for 80 or more ounces of water. But if you can do that, I promise your skin will feel better, your hair will be more shiny, your eyes brighter. So I'd say try drinking at least 60 ounces of water today if you're not already. The next thing I would say, even if it's not sunny by you, just go outside, get barefoot, find a patch of grass or dirt or whatever and just stand there and close your eyes and just be there for five or 10 minutes. Like, that's it, your lunch break. Just do that. And the third thing, I actually, I start every morning with a five minute breathing meditation. And it's on, it's a free, it's a free meditation on insight timer. If you just search five minute breathing meditation. It's by Megan Winkler. I have no affiliation with her, but it's, it's, I start my, it's my ritual to start the day. Five minutes. If you just do that, you can even do it while you're grounding.

Well, I was just gonna say I'm the multitasker. I'm the multitasker. Can I be out grounding, doing that.

At the same time? Yeah. Yeah, do. Absolutely. Let's, let's multitask. So I would say those would be three things that I'm looking forward to doing today and hope that you guys can too.

Well, your new book, Healthy Kids, Happy Kids, by the time this, this comes out, will be officially on sale. So people can get this, I assume, wherever books are sold.

Wherever books are sold. Yep, yep.

And then how can people find you?

So the best place to find me is on my, on my website, which is HealthyKidsHappyKids.com and also on Instagram, which is HealthyKids/Happy Kids.

Well, thank you so much for being with us today. This was a great talk. I love to connect and I think this is going to be really helpful for a lot of people out there. So thanks for all that you do.

Oh, thanks for having me on, and hopefully I get to see you and Elle before too long.

I want to thank this week's guests for sharing their time and knowledge, and thank you for listening. To Read the full show notes for each episode, which include a summary, timestamp, quotes, and any resources mentioned, please visit amymyersmd.com podcasts lastly, if you've enjoyed this episode, I'd love if you would leave a rating and a review on Apple or Spotify, and we'll select a few to read out loud in a future episode. Tune in next week to hear from another inspiring guest as we help you take back your health.