46: Elisa Song : Modern Pediatric Gut Health

Welcome to YOUR Health reset, where we address the real root causes behind health issues today to get you rapid results on your health journey so you can be who you came here to be, mind, body and spirit. I'm your host, Sinclair Keneally, survivor of complex chronic illness, expert on resolving root causes, and co founder of Detox, Rejuvenation and meditationrx. Let's get started.

Welcome back. We are continuing our conversation on root causes and the rapid results that become possible once you assess and understand and address those root causes. Today we are joined by my amazing friend and colleague, Dr. Elisa Song, who is a tireless advocate for the children of today. And she is so well known for her balanced viewpoint of what is needed for families and for children to actually thrive in today's complex modern age. So today we are doing a deep dive into the gut brain axis of little kiddos and what affects their health at early stages of life and what you can do at home about it. This is such an amazing, detailed masterclass. It's truly just so packed with gems. I hope that people watch it even if you don't have kiddos in your life because it will shed so much light into what has gone on to lead you to where you are today and also what you have control over in getting back your health and hopefully the health of all the little ones in your life as well. So enjoy. Today I am joined by my wonderful friend, Dr. Elisa Song, pediatric specialist and luminary in the functional medicine space. Thank you so much for joining us today, Elisa.

Oh, thanks, Sinclair. I'm really excited to bring this information to everyone listening.

We are so thrilled to have you. Do you want to just dive and share your slides with us?

Let's do it.

Wonderful.

So when we were talking this morning or previously about what we wanted to cover together, I let Elisa know about how advanced our audience is and that we really wanted to dive into the nitty gritty together. So I can't wait.

Yeah, we're gonna dive in and then go into some of the science. But I always, I'm a pediatrician and a mom, so I always wanna make sure it's practical. We have to walk away with actionable items and also not fearful. Right. Because as a mom, there's so much we have to feel guilty about. So this is not if you're a mama or grandma, this is not to go back and have any guilt around whatever I'm going to discuss today, but to move on with some knowledge, additional knowledge and know that we can always. Everything is modifiable Wonderful.

Thank you so much.

All right, so we're going to talk about the child's gut brain connection today and what the implications are for our kids developing brains in utero and beyond. This is who I am. These are my kids, and this is what I do every day. They're my inspiration. And we are always talking about gut health and poop and what we eat. So it's about laying down healthy foundations. This is just some more background about who I am and what I do. As Sinclair said, I am an integrated pediatrician and pediatric functional medicine expert, and I would not practice any other way. So why do we want to understand the gut brain connection in kids? And I know you guys are all savvy and you know about the gut brain conn, but in kids, it is so especially important to understand how and when the gut brain connection really starts to develop. We all know there's an epidemic of childhood neurodevelopmental disorders. Rates are skyrocketing for autism. In 2021, the CDC reported that approximately 1 in 44 kids in the US is diagnosed with autism spectrum disorder. And this is based on 2018 data. If we go along this trajectory, we can see by 2033, which, I mean, is really just right around the corner, one in four kids may have a diagnosis of autism spectrum disorder. So we need to understand what is going on. And for kids on the spectrum, kids with any neurodevelopmental or psychiatric condition, we have to look in the gut. We know ADHD is skyrocketing. The average age right now, kids being diagnosed with ADHD is 6.2 years. And if they're diagnosed at 6.2 years and placed on an ADHD medicine when they're 6, what is the end? Where is the end? And we know that kids with ADHD have comorbid anxiety and depression and addiction disorders. So we need to address this now, really, from a preventive lens, which is why I'm so glad Tickler is doing the summit. Anxiety disorders are skyrocketing. One in four teenagers has an anxiety disorder. And by the time they're 18, okay, almost one in two is going to have some sort of a mental disorder, right? Some sort of a psychiatric diagnosis. And of course, now living in the midst of the pandemic, over two years into this, the American Academy of Pediatrics has called mental health in the United States for children an emergency. We are in a state of emergency for our kids, and it's time to wake up. So what if we could unravel some of this and Go back to the infant's gut microbiome and think about how can we shape our kids future neurodevelopmental and neuropsychiatric outcomes by looking at their guts.

So just that. Yeah. Just some fun brain facts. I love talking about the brain. The average weight of a newborn brain is a little under a pound, right? That's 13 ounces. The adult brain weighs about three pounds. So babies come out with their brains amount of third of the weight of an adult brain. What's fascinating, new babies in that first year of life, almost every day it seems like something's changed and they're bigger. And the newborn brain triples in size during the first year. And by the time they're six, a child's brain reaches about 90 to 95% of an adult size. Really? If you look at babies, their heads, by the time they're three, pretty much an adult size head and then their bodies have to catch up. As a pediatrician we really, we stop measuring head circumference around three years of age. What is fascinating is that neurons are brain cells. So the adult brain has about 86 to 100 billion neurons. And those neurons have to be connected by synapses. Those are the connections between the brain cells. And the adult brain has billions of synapses. But what's fascinating is that toddlers have almost twice the number of synapses per neuron as adults. Now we don't keep all of those synapses, right? And we don't keep all of those neurons. So what happens in that process of growing and developing as a toddler and as a teenager, which is the second most rapid time of brain development and neuron formation and synapse formation, they get pruned like cutting a rose bush. So we want to make sure. Let's please build the right connections, right? Have that rose bush grow optimally and then prune only the things we want to leave and keep the connections that we want to keep. So we always have to be thinking about that. 60% of our brain is fat. So get in your healthy fats, not your trans fats, but cholesterol, right. 25% of your body's cholesterol is in the brain. Cholesterol is not a bad word, especially when it comes to kids brains. So get in your egg yolks. Sure. Lots of good sources of healthy cholesterol. And this all starts in utero. Maybe I really should back up into even before moms get pregnant. Right. It really starts with that epigenetic priming of mom and dad and what their gut microbiome looks like. We. We don't forget about dad. So it. But for all intents and purposes, we're going to say it really for the baby, it starts at least in utero from the moment that conception happens. And so the prenatal and the peripartum, so around the time babies are born, Right. During labor and delivery. And that first year of life really set that stage, the foundation for colonization of the baby's gut microbiome. Now, it's not entirely true, probably, that babies are born with a, quote, sterile gut. That's what we used to think, that sterile, as babies come out through the vaginal canal, then they pick up some of mama's vaginal microbiome and her gut microbiome, and that sets the stage for colonization. But. Yes, and maybe a little. Not. But the. But by the. For the most part, the adult type gut microbiome is really established by the time kids are about two or three years of age. It's really hard to shift that. Not impossible. Right. But if there are forces like antibiotics or antacid medications will disrupt the baby's gut microbiome when they're infants under about two or three years of age. And that sets the stage for something called dysbiosis. Abnormal bacteria, yeast parasites, viruses in the gut, it's harder to shift that balance. So we have this golden opportunity when our babies are young. And that first year of life is the most rapid and dynamic phase of postnatal brain development that corresponds with gut microbiome development. It's all in parallel.

I'm so glad to hear you highlighting this today, Elisa, because so many of our people that come to us as adults with chronic, complex digestive issues, they're surprised to see on our intake forms, we ask about antibiotics at every developmental stage.

Yeah.

I can't tell you how many times it turns out. Oh, yeah, I had a lot of earaches as a kid, a lot of ear infections. So, yeah, I did. But that was back when I was a toddler. I can't tell you how many times I had em. I got ear tubes in all that.

Absolutely.

Okay, so we know it started back.

Yeah. And we have to even go, go back into. Did mama get antibiotics for UTI while she was pregnant? Or maybe mama had tons and tons of antibiotics as a kid herself for ear infections and sinus infections and starts off the pregnancy with a disrupted gut microbiome. So we have to really think. And during labor and delivery, we screen for something called group B strep and if mothers have group B strep in their vaginal canals, and then mom is given IV antibiotics around the time of delivery, which has been really key in preventing group B strep sepsis in newborns. Which we absolutely don't want, right? We don't want our babies to be septic and have pneumonia. But then we have to think about, there's a time and a place for everything, including antibiotics. But how do we think about the unintended consequences that can set the stage for later health concerns and really undo that? And we have the tools, right? We have the five Rs, we have probiotics, so we have those tools. There was a huge study, a landmark study of over almost 800,000 children. This was a military study. So they had access to all those records. And what they found was that babies who were given either antibiotic medications or antacid medications in the first six months of life had a significantly increased risk of every single allergic disease by the time they were four. So asthma, allergies, hay fever, anaphylactic food allergies, hives, you name it. And the authors speculate that this is very conventional. It was a jama, conventional journal, but they speculated because it was a shift in the early baby's gut microbiome that then informed the gut immune system connection when we were focusing on the gut brain connection. But the gut is connected to only all of our organ systems and our developing hormones, immune systems, brain, you name it.

So are we going to cover a little bit about how parents can maybe right the ship a bit if they're listening to this and stressing out about what's already happened with.

Totally. Absolutely. That's wonderful. That's why I always say, move. We don't look back. The only reason we look back is to look how far we've come. And we only know. We only knew what we knew at the time. And now you're going to know more. And I know, mom, listen, you're going to say, oh, my gosh, was it the antibiotic? My kids got antibiotics. I will say it crushed me, but they got antibiotics. My son, when he was 4 or 5 weeks old, he had strep infection in his throat and his ears, which is unheard of for that age. My daughter had a UTI when she was at three weeks old and had jaundice. And did I wish I didn't need to give antibiotics? Yes. But am I going to mess with that when they're that little? No. So I gave them the antibiotics and I knew. Give the probiotics give the glutamine and whatever else that we did to really try to restore their gut. Developing gut microbiome. But if you didn't do that right now and your kids have asthma or eczema or adhd, don't worry. We should start now. We know look in the gut, right? If we don't look, we don't. But now we're going to move forward one step at a time. When we look at the gut brain axis and how the microbiome really affects wellness or unwellness, right? Disease or being healthy and optimally healthy, we see that the guts and the brain communicate in a bi directional manner. Okay. So when we're healthy, a healthy gut will send signals to the brain to be healthy and happy. And the healthy, happy brain sends signals to the gut and the immune system and the rest of our body to also be healthy and happy. And our gut lining, our beautiful epithelial lining in our gut has these amazing little villi that absorb the right things like our nutrients, but keep out all the bad things like these bugs and toxins. And we have these tight junctions and our gut is intact. It is not leaky. When we get dysbiosis, whether it's through antibiotics or stress, stress free inflammation, which can also trigger changes in our gut microbiome, we can get a leaky gut and these little pathogens are allowed to enter. Or imagine these are big food particles, like huge pieces of gluten allowed to enter and our immune system starts to react, create inflammation. This inflammation then goes to the brain and says, hey, I'm stressed, you know, I'm going to, I'm going to have these signs of dis ease and send that back down and create more dysbiosis. And it becomes this kind of perpetual vicious cycle. So we just need to understand the cycle so we know where can we intervene to break the cycle. And it's a bidirectional flow. And guess what? The communication between the gut and the brain is through the vagus nerve, which we guys I know have all heard about, but I love talking about the vagus nerve. It's a two way street. Our gut microbiome actually influences how we feel, how we think, our behaviors, and vice versa. How we feel, how we think, how we behave affects our gut microbiome. But what's fascinating is that the vast majority, 80 to 90% of the miscommunication happens from the gut to the brain, right? The gut sends way more signals to the brain than vice versa. So then we have to Think with the trillions of bacteria in our microbiome, with more microbial cells on and in us than human cells, who's really in charge here, right? Is it our brain or is it our gut? So something to think about, right? We cannot look at the bugs in our gut as separate from us. They're our friends. We are living together. We need to be friendly hosts for each other. So this is just a diagram that I think is fascinating to look at, to see. You know, we know that by the time, by two or three years of age, there are about 50% more synapses in the toddler brain than the adult brain. And this huge explosion of synaptic growth parallels this huge explosion in the change in the development of their microbiome. So these critical windows of neurodevelopment in infancy, right here, down here, parallel the rapid changes in the gut microbiome. What's fascinating is in adolescence we have that same amazing explosion of synaptic growth. And same thing. There are shifts in the adolescent microbiome that also occur and they correspond with, if there are disruptions during these critical periods of gut microbiome and brain development, this can profoundly affect the bidirectional communication, vagus nerve to gut. And then we see this increased risk of neurodevelopmental disorders, right? Autism, adhd, anxiety, mood disorders, impulse control disorders. So we really want to make sure that we are mindful of.

Protecting our children's gut microbiome so that they can have the healthiest brain possible. And many of you know that the vast majority, 80 to 90% of our neurotransmitters, are made by our gut bacteria. But look at these, right? Serotonin. It's our feel. Good. Keep us relaxed, calm, help us sleep. Neurotransmitter imbalances are going to result in anxiety, depression, ocd, but also gut symptoms. Irritable bowel syndrome. There's a reason why, quote, antidepressant medicine can often work and help people with ibs. It's not because their depressant is in their head. It's because they need more serotonin to optimize their gut function and their brain function, right? So we don't want to classify these medicines as, oh, you're just on an antidepressant, that's just in your head. We want to think about what is the pathophysiology, what's going on, and how do we address that. Dopamine, right? We need for attention and focus and motivation. Acetylcholine is responsible for nerve cell to nerve cell communication. Really important for kids with. For neurodegenerative diseases like Alzheimer's. GABA helps us respond to stress in a healthy way and relax. Norepinephrine is a catecholamine that's responsible for fight or flight. And histamine. So many people don't think of histamine as a neurotransmitter, but histamine is a neurotransmitter along with what we think about with allergies and, and reflux. So we have lots of different kinds of histamine receptors on every single cell in our body. H1 receptors cause hives, classic allergy symptoms. H2 receptors in our gut release stomach acid and can be implicated in reflux disease. But we have H3 and H4 receptors on our brain cells and our immune cells. So we need to be mindful. That's why so many people with chronic illnesses, kids and adults, have histamine concerns, Whether it's outright mast cell activation syndrome or they just, they have mast cell issues.

So can we unpack that for a second? Because I know that the families that come to us with a whole household of histamine issues, they've taught themselves to think of histamine as the bad guy. So can we reclaim that relationship just for a second?

Yeah. Histamine is the bad guy at the end of a long chain of events that have happened, right? So you can throw your H1 blocker, your H2 blocker at it, your DAO enzymes, your quercetin, your luteolin. That is going to help you feel better, right? I also use homeopathy. I love homeopathic APIs, mellificon and histamitum. But that's, that's still band aid medicine, right? We need kids to feel better and adults to feel better. We need you to tolerate food without having a huge histamine rush. But we need to then think about what is going on. Why is this activation happening? It's not a hundred percent the gut, but it's a lot the gut. So going back to the gut and really addressing the gut microbiome and the dysbiosis, I. When we talk about the 5R healing plan, there's one piece that gets not missed by a lot of practitioners, but not the importance that it should. So we're going to talk about that because the healing will not occur without this.

Distinction.

So when we talk about, like you mentioned, right, families who just have an antibiotic after antibiotic, sinus, infectious ear infections, UTIs, pneumonias, whatever it is, what we, what I want parents to understand is not that you say no to every single antibiotic, but we need to use antibiotics judiciously, right? We need to know when it's the right time. That's why as an integrated pediatrician, I feel really blessed to have other tools, right. I have my homeopathy, I have my herbs, I have my acupuncture, I have all of these two diet and lifestyle tools to manage acute illnesses to try to prevent the unnecessary use of antibiotics. And I will tell you, since practicing this, right, the number one reason for antibiotic prescription and a visit to the doctors are ear aids.

Right?

Ear infections. We know that at least half of ear infections are viral and are going to resolve on their own, and a good number that are bacteria are going to resolve on their own and use. And I used to write I don't even know how many prescriptions every day for ear infection when I was in a conventional practice. But since I've been practicing on my own as an interviewed pediatrician, I, I could probably count on maybe the fingers of both hands that I've had to prescribe antibiotics for ear infection in the last, since I started my practice in 2004.

Wow.

Yeah. As I'm dating myself, but you know, but now we, but sometimes antibiotics are needed. So what we want to understand though, even just one course of antibiotics can greatly increase your risk for depression, anxiety. Just one course, right? And the more antibiotic exposures you have, the increased risk. This may be because of gut dysbiosis, especially with gram negative bacteria that release something called lipopolysaccharides or LPS and cause endotoxemia. Endotoxemia is also something that is not widely recognized. Really important to know also when we're thinking about the 5R healing step, and this is not if your child has anxiety or depression and they've had antibiotics in the past, you know that last exposure may have just been the straw that broke the camel's back, right? There's never just one thing. You can't ever just go back and say it was that antibiotic when they were two months old. You can't do that. Right? We just know it's setting the stage. So now we know. How do we, how do we move forward and optimize our gut microbiome for our kids so they can move out of this vicious cycle that's occurred? There are lots of different endotoxin producing group negative gram negative bacteria. And when I check a comprehensive stool analysis, I'll look for these. In particular, I'M very concerned. If not very concerned, I should not say that I pay more attention if there's Klebsiella or Citrobacter in the gut in the background of an autoimmune family history, because these can make you more susceptible to autoimmunity. I do look at that. And I put Strep and Candida because these are not gram negative bacteria. Strep is gram positive. And Candida of course is a yeast. But they can produce endotoxin like substances, these LPs like substances that can have similar actions to the endotoxemia caused by these bacteria. Um, this is from Kieran Christian, who's awesome, right? He's a microbiologist. And there are many different ways that lps, lipopolysaccharide and endotoxemia can cause different chronic health concerns. That can be endocrine, hormonal health concerns, they can be GI health concerns, they can be autoimmunity, but for sure they can also be neuropsychiatric.

And what's really interesting, I just put this here as a rat study. Rats are very similar to humans, the rat frame. But in this particular study, they purposefully cause endotoxemia in these rats. Right. By giving them lps, exposing to lps, what was really fascinating is if they gave them probiotics first that prevented the long term LPS induced anxiety and depression that remained in the rats who didn't get probiotics into adulthood. Okay, so the interesting. Yeah, so the conclusion was probiotics during puberty could mitigate the inflammation and also decrease stress induced vulnerabilities to emotional behaviors later in life. So this is just to say, make sure that your kids guts remain as healthy as possible. Talk to your kids about it. Right? Kids don't like feeling crummy. Now in high school, it's this expectation from so many of my high school patients that yeah, I have, all of my friends are on Prozac, so I'm sure eventually I'm going to be on it. We want to shift that expectations and from wherever you're at, whatever age you're at. But ideally, when they're young, even as toddlers, we talk about the buddies in our gut and how we want to protect them and why they help us feel better and help us stay calm or help us sleep and really talk about gut health in a kid friendly, age appropriate way so that kids know. All right. I know if I go out with my friends and have a bag of fiery hot Cheetos or Takis and a gallon of Soda.

That's gonna not be good for my gut. And I know I already have trouble with staying focused and being still in class. And I really don't like getting yelled at the teacher. So I'm gonna decide whether or not I'm gonna have this. And if they decide that, they're gonna have it anyway, you know, yell. We don't. We don't punish in that way. We just say, look, let's pay attention. Now, you made that choice, right? We want it to be an informed choice. Pay attention to how your body, your brain are feeling today, tomorrow, so that you know how this affects you. And then you can make a choice next time based on that information. Because we're not always going to have our kids living with us. We not. We want them to understand how to make us connections and informed decisions. Yeah. Get it early.

The most heartbreaking thing is for parents to come to us and say, okay, my child is in college.

Yeah.

And they're having serious digestive disorders. It's progressed to the point that we're at X, Y, Z stage. It's okay. This is a lot harder to deal with now that they're outside of the home.

Yeah, a lot harder to deal with. And also, especially for the young man, that of nails, brain development really doesn't complete until they're about 28 years of age. Adolescent girls, it's a little sooner. It's never complete. Our brain is always plastic and we can always build new synapses, but there's less possibility. Right. But until that point, that. That prefrontal cortex is not working as well to make all those good decisions or optimal decisions for themselves. So there's not. We want to make sure that kids understand what those good decisions are before they get into that stage of adolescence. And then in adolescence, we need to learn how to let go as parents. But keep, just keep reinforcing. Let's see what these good decisions are so that when they're on their own, they can continue to at least think about them. So when we think about establishing gut. Healthy gut microbiome, we'd love to do it from the moment kids are born. Right. That would be the ideal. Mamas just know this is not to make you feel guilty if your kids are already born. If you're thinking about getting pregnant and you haven't had kids yet, it's a perfect time to think about how do I make sure that my baby is born with the healthiest gut microbiome possible. Knowing the implications for an optimal immune system, hormone system, neurologic system. So just a reminder, infant intestinal colonization really is established by about one to three years of age. It's harder to change the composition later in life. Not impossible. But ideally, we would start preconception while pregnant and in the immediate postnatal period to try to optimize the circumstances for a healthy gut microbiome. No mama guilt here, right? You have too many things to feel guilty about. And just remember, knowledge is power. We're going to just look forward. But what are some of these factors, these prenatal and postnatal factors? Mama's gut microbiome is really key.

So.

So working on your gut, if you have the opportunity, work on optimizing your gut before you get pregnant. Right. Because the gut microbiome is so key. Your gut microbiome is so key to your baby's gut microbiome. And there is. This has been a bit controversial, but it is possible that there is some microbiota that is transferred through the placenta. We want to make sure that your gut microbiome is healthy and ready for a delivery as well, ideally vaginal. Now, maternal antibiotic use, whether it's during pregnancy or around the time of labor and delivery, of course, will shift the gut microbiome. And that's why I see a lot of babies and moms now with nipple thrush, a thrush in the mouth, and really yeasty diaper rashes. I can't say it's solely because of that. Ever since we really started this group B strep prophylaxis, definitely a lot more people, a lot more babies with, you know, with resistant yeast issues. So we want to be mindful of that. Maternal prenatal probiotic supplementation has been found to be so beneficial for babies, especially if you have a family history of asthma and allergies. And that can mitigate the. Any antibiotic use. Right. It can help support your gut microbiome to support your baby's gut microbiome if you need antibiotics. Of course, we don't ever advocate smoking ever. But especially when you're pregnant. Right. Maternal stress. Who's not stressed now, thinks. Right, but. Right. But I want to put stress up there as possibly the most inflammatory factor or at least one of the most inflammatory factors in our health. In our bodies and our mind, our brain and our immune systems don't distinguish between psychological stress or physical or immune or infectious stress. They create the same amount of inflammatory cytokines. We get the same HPA cortisol stress response. So it's very important to look at stress as A toxin. Right. And think about how do we help our moms manage their stress. Whether it's financial, psychological relationship stress, whatever it is. We need to make sure that we are supporting moms mode of. Yeah. Mode of delivery. We know cesarean babies typically within that first day, first couple of days, first week of life will tend to have gut microbiome that resemble more skin bacteria on. On mom's skin and surgeon's skin as opposed to babies who are born vaginally. They get all in this awesome vaginal bacteria from mom and also some gut bacteria. And the other fascinating thing with maternal stress is we. They found that psychological stress amongst can actually change your vaginal microbiome. It's just, it's amazing the connectedness. That's why we can't separate mind, body.

So fascinating.

Yeah. So now there are times where C sections are necessary life saving for both mom and baby. But we just know, okay, if you're born cesarean, let's make sure, let's just turn the baby on probiotics right away if we can. Let's make sure mama is getting probiotics and eating fermented foods and getting drinking her bone broth and then how babies are fed. Breast milk has. Is rich in probiotics. Moms breast, breast milk ducks. Right. Her mammary glands have their own microbiome and the babies would get lots of probiotics and prebiotics. The human milk oligosaccharides are the amazing food for this probiotics to grow. And formula does not compare. However, more and more formula manufacturers are really trying to replicate the health benefits of breast milk putting, adding in prebiotics, human milk oligosaccharide analogs like 2 ficosal lactose or 2 FL, adding in ARA and DHA, the omega 3 fatty acids. Excuse me. That are so important for brain and eyesight development. So there are definitely better formulas out there. A lot of these formulas though are from Europe. You're gonna be looking at the European formulas because they just have unfortunately better standards like cleaner products across the board, not just formula, but skincare products and the household cleaners than we do here in the States. Very sadly.

Yeah. With consumer demand will drive it. Right. So the more we educate each other, the more people.

Yes.

If money is driving the bus, let's tell them where the money is. That's right.

That's right. You have to vote with your dollars. Right. And we show manufacturers what we demand. I remember this is, I think it was actually over 10 years ago when Nestle announced that they were going to remove the artificial dyes from their candies because in Europe, foods, food products with artificial dyes or preservatives have to have a warning label that this food may cause behavioral problems in your kid. We don't have that same warning here in the United States. But Nestle decided that they were going to take and some of the other candy manufacturers decided they were going to take out some of those, some of those artificial dyes. And they said they clearly see it in the press release. It wasn't because there are any health concerns. Of course there are, but it's not because it's a health concern. It's because there both seem to prefer it. Right. But hey, we can't get everyone to admit that there are some health concerns with artificial fake kind of freaking food. But at least if manufacturers are listening and say, hey, look, this is what the public wants, this is what consumers want to buy, then great, we should have that change slowly.

Yeah. Never doubt that an army of mom bloggers can change the world.

Yep, Yep. And this is just showing just the various factors, the prenatal factors that I just went through, mom's diet, stress, gestational infection mode delivery, baby feeding, and how that really remember this bidirectional gut brain connection between the baby's developing gut microbiome and the baby's developing brain really can impact later neurodevelopmental and neuropsychiatric outcomes. So we want to be thinking about that. So, but what happens if your kid does develop gut dysbiosis and leaky gut? It happens, right? It happens to the vast majority of us. So that's why don't feel guilty, right. We have life forces. We cannot live in a bubble. We cannot live sheltered away from every single stressor on our body and our brain, because that would be stressful right there. Right. But we try to minimize the stressors that we can understand the impacts of certain medications or things that are unavoidable and then we correct those. Right. We learn how to heal and reverse some of those unintended consequences. So first thing, of course, we're going to try to prevent if possible. So this is for mamas, or hopeful mamas who are trying to thinking about getting pregnant at some point. Start preconception, right? Make sure your gut is healthy. Eat that rainbow of fruits and vegetables. It's so cliche. You got to go back to what's real, right? What's basic. And some of the most profound effective answers in life for health are the most simple, right? We don't need to look for fancy answers. So eat that rainbow. Get in your fiber, right, which you can get with fruits and vegetables because those are the prebiotics that feed your gut microbiomes. Make sure that if you need antibiotics, you take probiotics. Use mindfulness techniques to reduce your stress. I'm going to go over some of those. Oh, I wrote probiotics. If you are obese or smoke, work, work with your practitioner to reduce those comorbidities. If your baby is born by C section, there's something called vaginal seating that I would talk with your OB about, talk with your midwife about. That's where basically cotton swab is. Put it into your vagina. And after the baby's born by C section, the baby is feeded with that in the mouth, in the nose, around the anus. So we're just trying to see can we get some of the benefits of vaginal birth, Even if your baby was born by C section, of course we want to not try to not use antibiotics unless necessary during pregnancy. If you can breastfeed, even just a little bit, every drop does count. But choose your formula wisely and then supplement for the babies, whether they're breastfed or not. Most babies will benefit from a probiotic supplement or later in Life, an Omega 3 supplement if it's not in their formula or if moms are not taking Omega 3s themselves while they're pregnant or nursing. They should when your child's older. Same principles for how to nourish your gut microbiome. Let them play in the dirt. There's so much to being out in the soil and also informing our gut microbiome, reducing our toxic stressors. Look, stress is right up there. And sleep actually really supports a healthy gut microbiome, too. In this day and age where children and adults are vastly sleep deprived, we want to make sure that we're underscoring the importance of quality restorative sleep. So if there is gut dysbiosis, though, and you have a leaky gut called increased intestinal permeability, and we're looking at how to optimize the gut brain connection, I do recommend if you, if your child already has a neuropsychiatric condition, or maybe, maybe they don't have an actual diagnosis, but they have sensory issues, they're not comfortable in their skin, they're acting out in class, they're wiggling, they, they're on the floor, they can't sit still and concentrate. Look at the gut, Right. Even if they don't have diarrhea or constipation or tummy aches. Because gut dysbiosis doesn't always cause any GI symptoms. Right. And it can solely manifest as brain conditions. So I do recommend working with functional medicine practitioner who can take a look in. In your kid's poop and do a comprehensive stool analysis. Because I can't look at a kid and say, oh, they have klebsiel, they have strep, they have yeast. I can't do. I can have suspicions, I can have some clinical suspicions, but I want to know what's in there and assess for dysbiotic organisms especially. Remember that endotoxin producing gram negative bacteria. I wanna know if that's it too. I consider food sensitivity and allergy testing. Now, the positives are that, is that what foods you. You might be sensitive to. The downsides to that is, well, first some of those sensitivities that light up. Sometimes you get a test and you're like, oh my gosh, I'm allergic to everything. What can I eat? And then. And some of those may just be kind of collateral damage. And they're just bigger ones. Right. That we need to remove first, like maybe gluten and dairy or eggs or corn. Right. The biggies that then those other ones would just fall away. And I don't want kids and adults who feel more stressed about what they can't eat, because that causes inflammation too. Right. There's something called orthorexia where you have this fear of eating or not eating certain things. We always want to focus on what you can eat, not what you can't eat.

Okay, thank you so much for saying that. Because we get people coming to us and they've been down to a handful of foods for, for sometimes decades.

Okay.

So just because you had a food sensitivity test that said X, Y, Z, it's not a life sentence. And it's an expression of what's happening right now. And if you look upstream, there's a lot of potential to shift that.

Absolutely, absolutely. And then the other thing too is when I think about gluten, if the test is negative for gluten, but I have this child with a lot of inflammation and neurologic symptoms and behavioral symptoms or gut symptoms. Am I gonna say they can keep eating all the gluten they want? I'll probably still recommend a trial off of gluten. So for some, it. It can be helpful to see it on paper. Oh my gosh, you have three stars of gluten. Okay, we're gonna just get outta the household. But Then on the flip side, if you have no, no red flags for gluten, it can be really challenging, especially if maybe one of the parents has. It is not quite on board to try to go off anyway. Just think about what and why you're testing. And also know there's no test for sensitivities to sugar, artificial dyes, flavors, or preservatives or histamine reactions. We just can't test for that. We have to just see clinically, your child is your best test. You are your best test, right? If you eat a food and you react all right, if it's. Even if the test is negative, I know that food is not right for me right now, and we can do some healing so that eventually we maybe that food will be okay. So what's the plan? We need to get rid of those dysbiotic organisms if they're there. We mop up the endotoxins, we optimize our microbiota, which we call psychobiotics, and we heal the gut with the five Rs. So. And I know you guys have gone through all this. A lot of you are very familiar with this. So I'm just gonna try to pepper in some things that are a little bit newer, maybe a little bit different. But removing includes stress. That is something we have to remove for our gut and all these toxins and food allergies and fake foods. But endotoxins are really important. There's something called serum derived bovine immunoglobulin S B I that specifically removes endotoxins from the gut before they can be absorbed into your bloodstream and cause endotoxidemia. This is really important for autoimmune illnesses like rheumatoid arthritis, rheumatism, Crohn's disease, really lupus, it's really important for any mental health concern. Psychiatric disorder, anxiety, ocd, depression, of course we're going to replace what's missing for kids. I don't really do hydrochloric acid, but digestive enzymes and chew big capital. We have to slow down and chew our food because your digestion starts in your mouth, in your teeth that mechanically break down the food. And the salivary amylase, it starts to break down the stomach surges, and then that signals to your pancreas to release digestive enzymes into your stomach to digest the rest of your food. So we have to chew, not gobble, food down on the go. Okay. Reinoculate with the good bugs. If your kids have any neuropsychiatric symptoms and we want to use what are called psychobiotics, which I'll talk about a little bit. Prebiotics. Fermented foods start your kids younger. I have some kids who they started young and this one little six year old girl, her favorite food in the world is sauerkraut. I love it.

But sometimes you have to be careful if histamine is an issue, but it's usually not. I usually find even for kids who have histamine issues, it's not that all fermented foods are off the table. It's about the load, right? And making sure that you're really moderating and paying attention, preparing the gut lining with the nutrients in these. Everyone really thinks about glutamine, but we have to think about zinc. Zinc is really important for skin lining healing, whether it's eczema on the skin or whether it's your gut lining. And of course, omega threes and quercetin is a really great healing nutrient for your gut too. Now this rebalance, why did I put this in orange? Because this is the one. When I first trained in functional medicine back in the early 2000s, it was called the 4R program. There was no 5R, it was 4R's. There was no rebalance. And so you would go through the whole 4R program, kids would get better. You heal the gut, 75% of your patients are going to feel so much better, right? But they didn't stay there, they kept going back, right? If you're a practitioner, you're like, I'm doing everything. Or a parent or a patient. And you're like, I'm doing everything that's right. I feel better. Sometimes I might even go into court remission. But then I always seem to flare again, like, why can't I stay? And I really think that this rebalancing, restoring that gut, mind, body, spirit connection is the key. And it's the piece that we as, as individuals and as practitioners, we don't have as many tools at our fingertips. And, but not only that, we haven't put it in the top of our mind. As important as the yeast cleanse, as important as probiotics, right? As important as X, Y and Z. It is as important, maybe more important. So literally, if you're a practitioner, get out your prescription pad or your treatment plan and you put it there as part of the treatment, that is really a priority, right? We have to shift what we think of as priorities because the mind can't take second place. It's, it really is going to, going to make the difference. Not I Should say the vagus nerve. Right? It's really all about strengthening the vagus nerve. Here's the five R's. I just. I print this out for patients just to have it. A natural. A reminder. What are those five Rs? And so that's here for you guys to download for free, just as a reminder. If many of you are already familiar with the five Rs, but these are psychobiotics or particular probiotic strength that have been shown specifically to improve optimal neurotransmitter levels and help with depression, anxiety, and manage stress and reduce cortisol. So we definitely want to get in our psychobiotics, and we're having these concerns while we're fixing the rest of the gut. Fermented foods have been found to reduce social anxiety. This is kimchi. I love kimchi. Not just because I'm Korean, but because there's so many studies around kimchi. Actually, kimchi supports the immune system and was found back in the H1N1 scare, the flu scare. It was found to kill H1N1 influenza in vitro. Right. So many benefits. But fermented foods also, in this one particular study, reduce social anxiety. Right.

So parents who have a child with social anxiety, I know that you're leaning in right now because it affects everything.

Yes, absolutely. And so if it was. If it could be as simple as getting in some fermented foods and shifting your trans gut microbiome, then would you do that? But too many practitioners don't know conventional practitioners. So this is where, from an integrative standpoint, right now we know, and now we're gonna work on your gut. You guys wouldn't be here listening to the summit if you didn't know. But this is just more. Okay, let's really go for it.

I think this is so important because for those of us who have come to this for our life's work, we didn't come to it easily. And everybody listening to the Summit, you know that the modern lifestyle is not this. We're considering it the default, but it's not actually conducive to health. So it actually does take work to reclaim what we have lost.

Absolutely, Absolutely. My. My mission is really to help parents understand, practitioners understand that this, quote, new normal of chronic disease in kids, it's not something we should accept as normal. We need to redefine what's normal for our kids. Our kids should be thriving. They shouldn't have a bag full of medicines every time they go on a field trip. Right. They should be comfortable in their bodies. They should be joyful, they should be healthy. Anyhow, this is. Yes, we do need to be reclaim what actually is reclaimed. Right. So this is just I mentioned the serum dry bovine immunoglobulin. It's one of my favorite supplements I just wanted to show. Here, this is your. Oops, my cursor. This serum dry bovine immunoglobulin that, that can bind to this lipopolysaccharide, this, the endotoxins produced by these gram negative bacteria before they have a chance to get into your bloodstream. Okay. So that's our goal here. Okay, so let's talk about this fifth arc, which really I think is the most important arc. This is all about optimizing the vagus nerve. Remember the bidirectional communication between the gut and the brain? Right. Mostly from the gut to the brain and that's through the vagus nerve. So when we optimize vagus nerve functioning that the signs of vagus nerve function, not dysfunction, point to optimal health. And what's one of the ways we can measure vagus nerve functioning is through something called heart rate variability, which many of you guys may be familiar with. I wear my aura ray to track my heart rate variability every night. And heart rate variability is a manifestation. We can, it's an outward sign that we can tell that our vagus nerve and our parasympathetic rest, digest and heal part of our nervous sympathetic nervous system, autonomic nervous system, is in balance with our sympathetic fight or flight freeze sympathetic nervous system. Right. And it's a balance. We don't want the sympathetic to be nothing. We need that, right? We need that to manage everyday stressors or study for an exam or fight infections. But we don't need that to be here. Right? We need a balance. So when we optimize heart rate variability, which you know now. So a wealth of information pointing to how optimizing heart rate variability can lead to optimal physiologic, immune, psychological health. And what we're really looking for when I. One of the things I do when I listen to a kid's heart rate and their lungs is I look for the heart rate variability. And how do I do that? It's. We can proxy that with something called respiratory sinus arrhythmia. Now when you're in a state of calm and you feel your pulse here and you take a big breath in.

And then you exhale.

Your heart rate when you inhale grows faster. And your heart, when you exhale slows down. And for some and kids always have, should have really wide respiratory sinus arrhythmia. Sometimes it's really dramatic, right? That arrhythmia, that rhythm change when you're breathing in and when you're breathing out. But as we get stressed when we're in fight or flight, it's all, it's the same.

It'S just the same. We're in that we're. Our heart's racing, it's saying it's not varying, right. So we want to optimize this. So how do we optimize heart rate variability? It's really with through those quote mind body techniques that a lot of people put to the I'll do it when I have time right List. But we need to elevate that to. You have to make the time for this if you want to get well. And, and it's. Unfortunately the things that we have to do on our own are the hardest things. Exercising or practicing mindfulness. A lot of people still in this day and age, it's so much easier to pop a pill and say can even like a supplement and wait for change. Right. Which can happen. But like I said, we want to keep you there. So how. What are some concrete tools? There's CBT, cognitive behavioral therapy, there's mindfulness meditation. HeartMath is another app that you can use to give that instant biofeedback with through an ear clip that senses your heart rate. And as you're inhaling and exhaling, look at a rainbow flower diagram. It will see do you have this optimal heart rate variability? Do you have coherence? Which if, if you've ever been in the zone, like oh, I'm in this productive flow state as an athlete, you just, you visualize and you get in that zone and that's coherence, right? That's the state of optimal heart rate variability. Belly breathing is really important to learn how to do well because by the time we're an adult, we breathe through our shoulders and not through a diaphragm. Right. Practicing gratitude and loving kindness, laughter, eft tapping, emotional freedom technique, acupuncture. And if you can stimulate your vagus nerve through acupuncture or these little vagus nerve stimulus, these are all different tools that we have. Sometimes just doing these passive things like tapping or acupuncture or vagus nerve stimulation is the best way to start for kids because not all kids want to sit there and do a heart math session or learn how to meditate. Tell you, meditation can be really easy for kids out. But cognitive behavioral Therapy finding a therapist who can teach you some CBT tools, especially for teenagers. It's a gold standard for anxiety in teenagers and it's been shown to improve heart rate variability. Now these are a series of self help books from my friend who's an amazing child psychologist, Don Huebner. And she's, she teaches kids how to use cognitive behavioral tools in these little workbooks for anxiety, for ocd, for negativity, for anger. And this is a book for older kids and teenagers outsmarting worry set. I mean amazing tools soon. There's also one called what to do when you dread your bed. She's amazing. But this is teaching CBT tools to kids through workbooks. There are apps I love my insight timer app. It's a free app with meditation experts from around the world. And this when kids come into the office, teenagers, if they have phones, parents who have phones, I say download the insight timer app and bookmark this five minute breathing meditation by Megan Winkler. It's how I start every morning and the mornings when I feel like I'm too rushed, I don't have time, it sets a different tone for the rest of the day. Okay. And it's five minutes literally. So I tell kids, I tell parents, if you don't have five minutes to do this breathing meditation, it's because you don't want to. Right. Everyone has five minutes.

Yeah.

So if it is important, you'll make time.

If it's not, you'll make an excuse.

There are other apps that are great. Stop, rethink, headspace. Tom, The Oak app is something that a 12 year old patient of mine turned me on to. And then this is the heart math, Right. This is another great way heart math has been shown to help people and kids with ad addiction, writer's block, sports performance, connection and gratitude. There's something called a loving kindness meditation and this was shown in college students when they practiced this loving kindness meditation for six weeks. It improve their heart rate variability and sustain that improvement. And they had a greater sense of connectedness to others, positive emotions. And this is so simple. Four sentences, that's it. Okay, so the first, really I think one of the most important things we should do with this exercise is first you sit and you give yourself gratitude. You right. Because some of the most unkind words we hear about ourselves are from our own brain. Right? So first, give yourself gratitude, give yourself forgiveness, give yourself love. And you tell yourself, may I feel safe, may I feel happy, may I feel healthy, may I live with ease. And then we stop and we can think about our sister, our brother, our partners, our family members, our friends, our community, our neighbors, people in the world. We could send that out to folks suffering in the Ukraine, right? Whoever we want to, we just extend that loving kindness, right? During COVID when things were really rough, I would tell people who felt helpless, just send that loving kindness out to frontline workers, right? Just send it out, right? To community members who are in need. And you just sit there, you send them loving kindness and gratitude for what they do. And you say, may you feel safe, may you feel happy, may you feel healthy, may you live with ease. And I promise you, you cannot do this without having a sense of calm and feeling just so much better about what's going on in your life. Easy, simple, four sentences. Belly breathing. Breathing with your belly, right? Using your diaphragm to really pooch out that belly like a balloon, right? We all suck in our bellies, but we just want to pooch out our belly like a balloon. Fill our lungs full with air, hold it at the bottom, and then exhale slowly, hold it at the top. There's something called square breathing or box breathing, which my son actually used when he would. He had Covid back in March of 2020 and was hospitalized. And when. When he was having some. Any trouble breathing, we would sit, we would shout our healing mantras, right? My body is healthy. My lungs are healthy. I'm getting stronger and stronger. And we would do our square breathing, and his oxygen levels would pop back up so much higher. And square breathing, right? You just take a big breath in.

Hold it at the top, exhale, and hold it at the bottom, and you just keep going around. They teach Navy Seals box breathing for calm and focus, right? But that's another simple way to just get your. Get yourself to slow down, breathe with your belly, hold it at the top and at the bottom. And that lowers cortisol or stress hormone, increases heart rate variability, and of course, improves our mood and energy. So there's a really cute Elmo video on YouTube and the link here with rapper Common and singer Colby Kelly that talks and that goes through all the monsters. Belly breathing is super fun, okay? But kids, Kids actually typically know how to belly breathe. Babies belly breathe just naturally, right? And somewhere along the way, as kids, as teenagers, as adults, we stop doing that. And I've had parents come in, I'm teaching kids how to belly breathe. You can also lay on your back, put a light book on your belly, and really. And say, when we breathe, we're going to watch it go up and down, right? That book should move. And so many parents are like, I can't do it. They're like, try not to breathe with their shoulders. Right? So practice that. Right. EFT emotional freedom technique is tapping, uses acupressure points, acupuncture points to really stimulate those acupuncture meridians while you're repeating certain affirmations. And so many clinical studies around improving heart rate variability, improving happiness, reducing cortisol, reducing cravings, improving ADHD symptoms, and actually improving antibody levels in your mouth for lots of benefits. But there's a tapping solution app that if you guys. I have not tried tapping. This is another thing that kids can do, right? Because they don't have to sit there. It's just, okay, let's just tap. I know it seems silly, but let's go ahead, say, even though I feel really stressed right now, I still love and appreciate myself. Right? And you just. And then you can't go through a tapping session without feeling, I'm a little less stressed. Okay? And then remember, joy, love, and laughter really are things that you want to make priorities in life. Sometimes in life, it can feel like there's nothing to be joyful about, Right? But we always want to remember that it's a perception of stress that can make that stress worse, harmful for you or positive for you. And it's not that you want to be flippant about tragedies, but you always want to make sure what is. How is my perception of what's going on affecting my health and what actually is happening around me? Mindset really and truly is everything.

So I will leave you guys and Sinclair with gratitude for having me on this summit and being allowed to share this information with you and Sinclair and everyone listening. May you feel safe, may you feel happy, may you feel healthy, may you live with ease.

Thank you so much, Dr. Elisa. And I think I'm speaking for everybody in the audience when I say how healing it is at a very deep core level to hear such an accomplished doctor spend so much time talking about how we can reclaim our own health and return to the best of who we really are, both individually and in our families. So thank you so much for spending so much time with us today and for sharing all of your wisdom. And we're just cheering you on as you spread your message in the world. So thanks for being here.

All right. Thanks, Sinclair. Thanks, everyone for listening.

Thanks for listening. Go to detoxrejuvenation.com to find the links in the show notes to everything we covered in this episode. Please subscribe, review and share with other humans who need this precious information. Let's help each other. Until next time. Love, Sinclair.