Episode 78- Healthy Kids Happy Kids with Dr. Elisa Song

Hi everyone. Welcome to Baby Steps Nutrition, a podcast that focuses on nutrition, health and wellness for families of children of all ages and stages. I'm your host, Argavan Nealforush, a pediatric dietitian and mom of two young children. My goal is to bring you impactful information that you can apply every day in a simplified, practical form to make life easier. Now let's get into today's conversation.

Trying to access trusted kids health advice can seem daunting and overall defeating. We parents have the best intentions for our children, yet we are bombarded with fear based messaging that cause unnecessary stress rather than feelings of empowerment and optimism. Dr. Elisa Song is a Stanford, NYU and UCSF trained holistic pediatrician who founded Whole Family Wellness in California, one of the first and most highly regarded holistic pediatric practices in the country, as well as Healthy Kids, Happy Kids, an online resource for trusted holistic pediatric advice. Dr. Song incorporates conventional pediatrics with functional medicine, holistic nutrition, homeopathy, acupuncture and much more. Dr. Song, you need no introduction at all. A warmest welcome to you.

Oh, thank you so much. I'm honored to be here.

I cannot tell you how excited I am that you're here. So many questions to discuss. I'm excited to dive right in. I want to go back to your background, your journey to becoming a pediatrician and when you pivoted from an allopathic focused philosophy of care to where you are now, a more holistic, integrative one.

Yeah, you know, it's interesting because as you said, my mother was an OB GYN and I grew up in a very conventional household. We didn't use a lot of medicines. We were, knock on wood, healthy kids growing up. And I actually did, did not even think I was going to follow in her footsteps and become a physician. I just, you know, she was an OB GYN delivering babies at all hours of the night. That's when I saw her busy practice. And I thought, I don't know if that's for me. But I always knew that I wanted to work with children. So my intention was to be a teacher or, you know, really advocacy. And, you know, children's rights have been a passion of mine. So then I switched gears in college and I was on the path to become a lawyer and a public policy advocate and civil rights advocate and work in Washington D.C. and somewhere along the way, you know, I was here at Stanford and I saw flyer my junior year and it was this conference for the American Holistic Medical Association. I'm going to date myself. This is back in the late 80s. And this is where when.

Integrative gurus today, like Deepak Chopra and, you know, Andrew Weil, they were just getting known. I had no idea who they were. And something drew me to that. So I went and my mind was blown. I mean, here I was, this like, you know, 20 year old, 19 year old kid, and I'm thinking, oh my gosh, this is kind of what I want to do. I went back to my mom and I said, hey mom, you know, I actually think I might want to become a naturopathic doctor. And my mom and my family were like, what is that?

So I mean, they didn't say no. I mean, they were very supportive of what I wanted to do, but they just, they were hesitant, you know, they wanted to make sure I was making the right decision. So I ended up instead, you know, cramming in two years of pre med requirements into my last two years of college and off to medical school I went. And I thought, okay, at least, you know, let me, let me dive in. And so I started medical school with an eye towards what, how can we be more holistic, you know, with our kids? I always knew if I went into medicine, it was going to be as a pediatrician. So, you know, med school was so frustrating. This is in the late 90s. I mean, I was at a very male dominated school, nyu and was not encouraged to pursue integrative medicine. It was called, quote alternative medicine at that point. And I'm so glad we moved to integrative medicine. But my path was forged. And so medical school, residency, this was really my focus and my passion. And again, serendipity, as I was graduating residency and I thought, I don't know what kind of a doctor I want to be. I'm a pediatrician, but I don't, I mean, I don't want to work in the hospital. You know, the grind of private practice, which really is just about, you know, band aid medicine, giving medicines to put out fires, it's just not for me. And so I thought, maybe I'll go back to my policy roots. But I saw this flyer again on the wall for this Food as Medicine conference, and this is at Berkeley. And I thought, why not go? And then, I mean, again, mind blown, I heard Mark Hyman speak and I just thought, what is functional medicine? So again, you know, this, this journey, I just thought, okay, this is what I want to do. And so I just, I think, you know, for me it wasn't a journey because I was sick with a chronic illness or my, my child was, or a family member was, which is how a lot of functional medicine integrative practitioners come to this work. I mean, knock on wood, thankfully. But you know, being open to the messages that are being sent to you. And I thought, okay, this is truly where I'm meant to be and where I'm meant to serve. So it's been a great journey.

And what's amazing is all of those passions that you started with, you found a way to integrate all of those into your current role today. Like, I feel like you're doing all those things, the advocacy, you know, you know, there could be politics involved and all of the other things. Like you always thought you'd get into even being a lawyer, right. Representing, advocating. So that's pretty neat that you found a way to do all of that.

I mean, that is actually as we think, as I think about, you know, the future of, you know, where this journey will lead, it really does need to be policy on a larger level. Whether it's my own community and my kids, school and the school district and the larger community. I mean, food policies, healthcare policies, they need to change. And you know, it's an uphill battle, but there are more, more and more folks in the trenches doing this work and the message needs to get out. We cannot allow our kids to live in the world we're living in anymore without facing up to the fact that, you know, this world is not serving our kids in the best way that it really needs to.

Agreed. And even someone like myself started in traditional schooling, you know, worked at pediatric hospitals and so more of that acute care treatment. But to see where things are going with the holistic integrative. Now, we don't want to just be managing disease, but we want to be preventing it, given the alarming rates, and we're going to be talking about that too, that are happening in our children. Like we really need to start as young as possible and really get to the root cause of what's going on.

Absolutely.

Which brings us to integrative medicine. So meaning we are looking at the whole child and we know that's a gold standard of care. But why are we still seeing in 2022 a lot of practitioners, a lot of people with the mindset of that acute care treatment.

So it's interesting, I think part of it is the knowledge, I really have to believe that as physicians, if there were more awareness and open mindedness about.

Just the fact that yes, these interventions that we have in conventional medicine can be life saving. They are meant to put out fires. I Mean, steroids, they're magic if you have inflammation, right? But we need to step back and think, well, what are we doing? Why is that inflammation? Why is a fire raging in this child's body in the first place? And really get more of the studies out to the general practicing clinician, because the studies are there. It's not like this is not fringe medicine. This is truly evidence based medicine. But conventional medicine parses out the body and the brain into different parts. So neurologists look at neurology journals, gastroenterologists look at gastroenterology journals. You know, rheumatologists look at, you know, allergy immunology journals. And so we know our body is not, you know, these individual systems that live in isolation. Our cells need to live in community. And there's so much kind of intertwining of how each of our organ systems work, especially our gut, which we're going to get to. And so, you know, if you're a gastroenterologist, you need to also be looking at the neurology journals to look at that gut brain connection. If you're an immunologist, you need to be looking at the gastroenterologist. I mean, it just goes around. And of course, the nutrition journals, right? You know, we know how little nutrition most physicians get in their medical school careers. And so I think part of it's the knowledge.

And, you know, keeping this learner's mindset. If one thing, you know, that has become so clear during the pandemic is we don't know a lot. You know, we know a lot, but then we don't. And what we know can shift in a moment's notice. I mean, what we knew about the pandemic back in, I mean, let's say summer of 2020, right? You know, maybe a few months into the pandemic is very different than what we know now about the pandemic. And so we have to be ready to pivot. So that's one thing. And then the other thing is that, you know, I think just a society as a whole, we have become.

You know, I don't want to point fingers at anybody, but, but in, on a certain level, we have lost the trust in our bodies and our brains to recover and heal and be well. I mean, we have lost the ability to understand what it means to thrive and be resilient. And so we are relying on, you know, band aids to help make everything right. In the short term. It's the same way that we can think about, you know, there's this concept now, as opposed to helicopter parenting, there's this bubble wrap parenting. We just want everything to be perfect for our kids. No ouchies, no bumps and bruises, you know, psychologically or physically or immunologically. But that doesn't really help serve our children. And in the same way with medicine, of course, there is a time and a place for everything. You know, when it comes to conventional medicine, you know, like I said, antibiotics can be life savings. There is a time to reduce a fever, you know, with antipyretics, but not as often as we think. And so, you know, we just want to now step back and say, how do we integrate what we know from natural medicine, functional medicine, conventional medicine, and really get the best care for our kids?

And you brought up a great point about this band aid solution. And I think that goes hand in hand with the daily grind of society. Like when something happens and it slows us down, we're easily frustrated and we want a quick fix. And that goes with when our children are sick, like when they have a fever or, you know, those things like recurring ear infection that's become really common, but it's not normal or chronic constipation. And so it's like you go to the pediatrician, you want some quick prescription so your child can feel better, but we're not really getting at the root cause of what's going on.

Yeah, absolutely. And I think, you know, when parents understand, and here's where I struggle as a, you know, I don't know about struggle. It's a balance. Right. As a pediatrician, but then as a mom, and we all know as moms, we have way too many things we feel guilty about. Right.

You know, all the time. Yes.

I mean, every little thing. I mean, I still think about that, you know, that tuna fish sandwich that I had to eat when I was pregnant with Kenzie.

Right, right.

Like, you know, what did that do? I mean, you know, so we all, like, we always want have this tendency to try to find blame somewhere, and it's usually with ourselves as moms. Right. So. So it's a fine balance. You know, I want to educate parents and practitioners, but not have that fuel further, you know, mom self blame. Really use that as a jumping point to say, hey, look, you know, what's done is done in the past. Now we know that perhaps there were some downstream effects from, you know, the medications that my child got or, you know, the things that I did, you know, you know, for my family, you know, as in terms of their diet. Let's understand those downstream Effects get the benefits where we can and remove the unwanted adverse effects. I mean, let's talk about, you know, let's think about fever. We were just talking about. I mean, we all want our kids to, you know, basically not be miserable. Right. But, you know, there is a time and a place for the fever. We have to understand fever is your body's natural way of helping us slow down the germs, mount an immune response. Right. Those inflammatory cytokines that cause a fever, they're doing their job of trying to contain the infection and help your immune system respond. So when we bring down fever artificially with things like Tylenol or Motrin, we are, yes, your child may be bouncing around, happy as can be, and feeling like they can, you know, run around the yard again, but we're not helping their body fight the infection. And it's been shown that reducing fevers artificially can actually prolong, you know, the infection for your child and actually make them more infectious, have them shed more virus, you know, from their nose. So these are things that we want to think about. This is where with. From an integrated approach. No, we don't want our kids to be miserable. We can actually use things like homeopathy and essential oils to help your child's body recover and bring their fever down naturally while not suppressing their immune response. And we use ibuprofen judiciously. Right. We use ibuprofen when our kids are so miserable from the fever that they're not drinking well and at risk for dehydration or they're not sleeping. Sleeping well, because sleep is one of the most restorative things when our kids are sick. So, I mean, we want, you know, when kids are sick and parents call me and say, well, they're just not acting like themselves. They want to lay on the couch all day. I say, that is awesome. You don't want your child's body, you know, running itself ragged, using all of its energy to run around and not fight the infection. So let your kids be couch potatoes. Embrace that and understand that when your kids get sick, sick and recover, their immune system builds, builds those muscles, that immune memory that gets them stronger and stronger for the next virus or the next infection that they're going to be exposed to.

Yeah. And this goes back to listening to your body. What is it telling you? It's telling you it needs to rest. We know rest is best, but sometimes we don't prioritize that enough. So it's all of those things like your body is telling you what it needs.

Yeah, absolutely.

Let's talk about the pandemic. A lot of aha, light bulb moments for everyone. But in your case, as a mom and a pediatric health expert, what did you learn? What did you see there?

You know, I would say my biggest kind of aha and you know, kind of solid solidifying of, you know, what I've been, you know, working towards, educating myself and educating families and parents is the idea of, you know, what does it really mean to thrive and what does it really mean to be resilient? And it's really, you know, moved me away from, I don't want to say, just a prevention mindset because prevention is key. I mean, of course we want to prevent crisis, chronic illnesses, but shifting that language and saying, you know what? Life is not just about preventing chronic illness and waiting for the next shoe to drop, Right? It's really, let's shift that to a thriving mindset and understand that in helping our kids thrive and be resilient, no matter what psychological, immune, infectious or toxic stressor comes your way, they can bounce right back, you know, quickly and completely and remember how to do it better the next time. Because when we're trying to prevent, I mean, even with the pandemic, when we're trying just to prevent our kids from getting sick, prevent exposures, prevent X, Y and Z living in a bubble, we're still living, as you said, in this kind of fear based model where we are afraid that the world is out to get us and our kids and our kids cannot survive that the pandemic has shown. I mean, and there was plenty of fear in the beginning of the pandemic. There still is a lot of fear going around. But if we put ourselves. And I was right there, right. Put yourselves back in February of 2020. Okay. Right after school started, right back after the holidays, and we're hearing about this virus that was coming out of Wuhan and we're just watching the news in just fear, horror. Like, what is going on? How much do I have to be worried about for my kids?

And then in March, what happened, most of us, right. Spring break happened and our kids never went back. Yes, right. Yeah. And it was, you know, the, the media, what was going on, what we were seeing in our communities, if, especially if you lived in New York, New Jersey, you know, it was just devastating and so paralyzing, you know, for the most part. And I, you know, we were right there. I mean, you know, if you go way back, I mean, this is before we even really knew how kids were doing with COVID before I even was able to get any swabs from the lab because they were so backordered. You know, Kenzie started to have a little fever. Bodie started to have a little fever. And we're like, what is going on? Could not test whether to see whether it was Covid or not until the very end when Kenzie was, you know, pretty much recovered and I was able to get a swab and she was positive. Right? And then Bode developed all of these symptoms that, looking back, were really signs that he could have been heading towards MIS C or multisystem inflammatory syndrome in children. He had the red eyes, prolonged fever, the hive like rashes. He was hallucinating, you know, seeing really scary visions and hearing really scary voices. His oxygen kept dropping, dropping, dropping. He had really severe stomach ache, really, really severe headache. I mean, if I, you know, knowing that what mis c was back then, because we didn't know what mis c was until the spring, summer of 2020, it was probably good that I didn't know, right? But all I knew was, oh my God, what is going on? And that fear that, that gripped me as I was saying goodbye to Kenzie and Peter at the emergency room door, right? Stepping in, I wasn't sure if I was going to be allowed to stay with him because at that point they were separating. You know, making. Making people with COVID stay in a separate place. I wasn't sure if they're going to let me be with him. And I wasn't sure what was going to happen. I wasn't sure. I mean, to be totally honest, and I hate to say this out loud, but at that point I wasn't even sure, like, who was going to come out the door at the end, right? And I mean, I just never, ever want another parent to have that fear when they go into the emergency room. And we know so much more now. We don't have to have that fear. And so learning through that, and that's what really made me take that deep dive into, you know, what is a functional medicine approach to what little we know about SARS CoV2. You know, what lessons can we learn from SARS CoV1 and from MERS, the prior SARS type outbreaks? How can we help our immune systems become so resilient that we can get through the initial infection and reduce our risks for having post Covid complications like MIS C, myocarditis, long Covid And I do believe that we have those tools now. I can never claim that these are going to be absolutely Effective and that it can treat these conditions, but certainly it can help your child and your immune systems be so resilient that we reduce those risks. And that's what I want parents to understand. You know, resilience, it's not about never, ever getting sick. Right. Resilience is about trusting and knowing that when we do get sick, our immune system and our brains and our bodies know how to handle it. And we can, like I said, recover quickly and completely bounce right back and then move ahead and be ready for whatever comes next.

And so you did mention with headlines. And we know we're constantly bombarded, right? Even well meaning family members, friends, society, things that we see on social media, in the news. A lot of it is scary, anxiety provoking. And some people feel just doom and gloom. They're completely overwhelmed. And as human beings, we know we're naturally inclined towards more negativity bias.

Yes.

Why is that happening? Actually? First question, and then the second question being if we want to access credible, helpful information. Right, because that's the message that we want to get out there. There's a lot of stuff out there. But where can parents go to know that they're getting trusted advice? That's evidence based, that's going to be helpful.

I mean, such a good question. I mean, this is. The media is. I mean, that's what the media is supposed to do, is to sensationalize, get us to read their headlines, you know, get us to read their, their articles. And you know, crises are just perfect fuel for that. I mean, we saw that back in with 9 11. There was so much, you know, secondary trauma that children had from, you know, I mean, us as parents just glued to the TV and the radio and kids kind of secondarily hearing that. I think, you know, with COVID initially there was some of that. And you know, I have some, some kids who.

Are still living in fear because that's. There was so much of that in their families. I have other kids who were shielded largely from that. And, you know, parents just had discussions about the virus and how they can get their immune system strong. And now they are able to expand their lives bit by bit to a comfortable place. But honestly, I would say, you know, keeping the TV and the radio off is a good idea. I mean, I don't watch the news at night. It's way too. I mean, I get a knot in my stomach whenever Peter has the news on at night and I just leave because there's nothing. I'm not gonna say nothing. There are, is. There are rarely news Stories that leave you feeling better after you've listened to them.

Agreed.

I mean, it's the same thing with social media, right. There are rarely times that, and this is especially true for children, that you get on social media and you feel much better at the end of your session. Right. And so, so I just, you know, turn off the news, turn off the radio. There's no need to listen to that. Choose a time of day, not first thing in the morning, where you go through maybe your, you know, your news feed online and just, you know, pick and choose which articles you're going to read and always take headlines with a grain of salt and read the article. You know, you know, most articles, when you get past the headlines, you know, they, they do try, I mean like the, you know, the well world from New York Times and they do try to have articles cited. I always want articles cited. You know, I always want numbers and I always want to keep the conclusion, not necessarily take the conclusion that the reporter has made as my own. Right. I'd like to, you know, read the articles, read the journal article first. Right? Because I mean, not the journal, the media article first. Because that's what's easily accessible if you do have more of a.

And a lot of parents nowadays have a little bit more of that scientific background just because we've been reading papers, even if you're not in the health profession, but read the papers and see what you can glean and then come up with your own conclusions that are relevant for you. Right. I mean, not, not every article is going to be relevant for your child, for your family. Family. And we always have to take things in the context of, you know, how, how is this serving my child? What can I do from this? You know, what is the actionable item that, that I can take from this? I mean, I'm very careful not to just post information that has zero action and just doom and gloom like you said. Right. Because I mean, what, what does that do for us? It really doesn't do anything for us except create more anxiety which then further causes more psychological and immune stress. So I think stepping back, making your own conclusions, understanding the foundations of true health and resilience and trusting that your body and your child's body.

Has the foundations to stay well and get well and that, you know, and your kids and you may not be there quite yet in terms of the diet and lifestyle that fosters resilience. But the mindset is, I would say, the most important. If we have that trusting, health based mindset and that resilient mindset, that's more than half the battle. Right. Even if your kids have a pack of takis with their kids, with their friends one day, that's not gonna be the ultimate hit. Right. Our mindset and how we move forward is gonna be what keeps us.

Well, totally. And I think going back to what you were saying and something that I always advise to pick a few select credible, helpful sources and just follow those because if you're trying to navigate the online world, a, it's almost impossible to keep track of what's air quote true and what's false. And then just it's, you know, a lot of it is opinion based too. So it depends on where the person's coming from, what their intentions are. And so that can add even more confusion or fear and anxiety if you already sort of suffer from that as a baseline. So nothing good comes out of that.

Nothing. Nothing Good. That's true.

Dr. Song, I really want to get into your passion, which is pediatric autoimmunity chronic health illnesses. We know the rates are skyrocketing. I mean, it is absolutely insane. Why should we not accept this as a new normal? What is happening in our children?

So, oh boy. I mean, this is, you know, it's a passion of mine because this is something that we really do need to understand as parents and practitioners. That, you know, one of the, one of the articles that I point back to this was back in 2005, so 17 years ago, 2005, there was an article in the New England Journal of Medicine that that estimated, looking at the statistics and the trajectory for our children, estimated that.

This was the first generation of children where they are expected to have a shorter lifespan than their parents. With all of our medical advancements, right, our kids are expected to die at a younger age than we are. And that is simply unacceptable. And it was mostly due to lifestyle related diseases. These non communicable diseases or NCDs, like obesity, diabetes, heart disease, you know, cancers. And so, you know, many of these are lifestyle mediated. Diet and lifestyle mediated fast forward. And the pandemic has also shined a glaring light on, you know, the fact that these diet and lifestyle related diseases, these NCDs non communicable diseases, as you know, as defined by the World Health Organization, remain, apart from elderly age, remain the biggest risk factor in children and adults for serious Covid disease, mortality and disability. You know, even for long Covid.

And this is not to blame anyone who has diabetes or heart disease. You know, we are living in this world that is not helping us stay well, right? Our ultra processed, ultra fast, you know, ultra stressed life. And it's, I mean, through no fault of our own, you know, we've, we've come to believe over the decades that, you know, as I'm researching for the book I'm writing, there's a date in 1930, I think it was 1972, where the first Swanson TV dinner was, was invented. Actually, this was in the 50s, right? The first Swanson TV dinner. That, that Swanson TV dinner tray is in, it's in the, it's the, the Smithsonian Institute as one of the pivotal moments in the food industry in the United States. I mean, oh my gosh.

And, and that was touted, it was marketed to the busy working mom, right? Moms had to start working back then. So busy working moms who couldn't get homemade dinners on the table, this was just as good as homemade. I mean, way to pull at a mom's heartstrings, right? You're like, first I'm working, I'm away from my kids, I can't get a home cooked meal on the table. But oh my gosh, I have Swansons to save me.

Yes. And it's a TV dinner. So in front of the tv. So not mindful eating whatsoever.

No, that's right. And so this was where, you know, the advent of, you know, the, the food additive industry just exploded. The food additive industry is one of the, the most rapidly growing industries in the world. I mean, it's a billions and billions dollar industry. And why food additives make our food taste sweeter, taste better, last longer on the shelf, look prettier. Right? And so we've, we've become brainwashed over the years that this is what food should taste like and this food is actually good for us. And so now there's a lot of, there's decades of undoing that has to happen, you know, for ourselves and for our children. And we're getting there, right? There's more of an awareness of, you know, what is going on. But these food additives and, you know, the artificial colors, the food emulsifiers that keep our food together in a package without a becoming a goopy mess. Glyphosate, which is Roundup, you know, that was patented initially as an antibiotic. Psychological stress, the overuse and misuse of antibiotics, you know, in treating things like viral infections, those are all contributing to this epidemic of pediatric autoimmunity and chronic disease. And why is that? Because they all lead directly to the road of having gut dysbiosis, leaky gut disruption, to our gut microbiome. And so I know we're going to dive into that, but that is one of the underlying factors for why we as a society, why our children are not staying well, because everything that we are exposed to in our modern world is disrupting their gut microbiome. And so now we need to say, let's find, flip it, and understand what are the things we can do to support our kids. Healthy gut microbiomes so that they are less at risk for chronic health, illness, for chronic, you know, for pediatric autoimmunity, and can really thrive in the way that they were meant to.

Yes. And you had shared that 60% of all kids now have some, I hate to use the word diagnosis, but sometimes that helps in terms of figuring out what's going on with a child. But add, constipation, anxiety, depression, and I think you had mentioned that it's going to be higher, like closer to 8 out of 10.

Well, so let's think about that. Right. Currently, about 55 to 60% of all children in the United States has some sort of a chronic health concern. One in five kids has eczema. One in ten kids has ADD. By the time kids are teenagers, about 50% are going to be diagnosed with any mental health disorder. One in three teenage girls has been diagnosed with an anxiety disorder. I mean, this is, you know, you look around, it might be your child, your neighbors, your friends. I mean, your neighbor or your friend's kids, your kids, classmates. You will know somebody, some child, or many children around you. And you may not even know that they have, you know, reflux or chronic constipation and have been on Miralax for years or that they're struggling with, you know.

Separation anxiety or an autoimmune illness or depression. But it's there more than half of our kids nowadays, and that number is increasing steadily. I mean, one statistic showed that by, in the mid, I mean, really by 2025, right. Just around the corner, we might be in a position where 8 in 10 children has some sort of a chronic condition. Right. Chronic diagnosis. By chronic, I mean, it's just, it's not going away, right? I mean, your kids shouldn't be chronically constipated. I mean, sure, everyone gets constipated every once in a while, especially if you're traveling over the holidays and get a little dehydrated. But it should not be a daily, weekly common thing for your child to be constipated and need help with pooping. Right. Even with antibiotics. And we are at the place where by 2050, there was a recent report showing that by 2050, antibiotic resistance, these superbugs could be a leading cause of death worldwide. That is frightening and astounding. I mean, it could be something, as you mentioned, ear infections before, it could be that an ear infection is something that now is so treatable, especially with, you know, integrative medicine tools, becomes something that we have to worry about for our children. And that is unacceptable. You know, one round of antibiotics they've shown can potentially increase your child's risk of anxiety later on, you know, as teenagers and adults, by maybe 20 to 50%. So this is not to say that we throw all antibiotics out, right? Like I said, antibiotics can be life saving, but we know they are often inappropriately used. Let's take ear infections for instance. About half of ear infections are viral. They will not respond to antibiotics. About, you know, maybe another 30, 40% are bacterial. But even of those, many will resolve without antibiotics. And then some are mixed and some can be caused by funguses. Well, there are evidence based tools like a garlic herbal tincture for as ear drops that can work possibly even better than antibiotics at killing the organisms and also reducing pain and don't have those potential downstream effects on your child's gut microbiome. And just, you know, for parents who are listening, who, you know, may not understand that connection between antibiotics and the disruption to the gut microbiome. Antibiotics kill bacteria. I mean, great, right? But not all bacteria are bad. When we think about the microbiome, the bacteria, the organisms, not just bacteria, the bacteria, fungus, viruses, even parasites that live in our gut. And in fact, all of our organs have their own microbiome. Our skin has its own microbiome. Our breasts, milk, ducks have their own microbiome to give our babies probiotics with breast milk. Our heart has its own microbiome.

These hopefully are beneficial organisms, bacteria that support us, right, that live in harmony with us. But antibiotics will kill. They don't discriminate. They could kill bad bugs, but they can just as easily kill good bugs. And so then in disrupting, killing the beneficial bacteria, those probiotics that are in our gut, microbiome that leads away for abnormal bugs taking hold, that leads away for yeast parasites, bad bugs to get in, which then underlies the increased risk for virtually every chronic illness that we're talking about, even if it has nothing to do with gut symptoms. Because of the way our gut, our children's gut has an intimate connection with their developing brain and their developing immune system, even their developing hormones.

And I think now it's known that the use of antibiotics, especially in our parents, generation, grandparents, it was just an overuse. So now that people are paying attention, like, you don't just give antibiotics for everything.

Yeah.

Because it's done so much harm.

Yeah, absolutely. And this is, you know, even for, I mean, I have some friends who, you know, they have a cold and, you know, they call, hey, can you prescribe me some antibiotics? I'm like, no, because first of all, that's not good antibiotic stewardship. Right. We need to be very aware of this impending problem of antibiotic resistance and also the fact that it's been shown. There's an article that just came out in Children. They looked at all of these medical records for various clinics and picked out children who first, they found that many, many kids were inappropriately prescribed antibiotics, whether it's for viral infections or for symptoms that are stuffy nose for two weeks and parents are at their wit's end and the doctor says, oh, maybe it's a sinus infection, let's try the antibiotics. Right. Even if it's not necessarily warranted. But, you know, so many kids were inappropriately prescribed antibiotics. And those children who were inappropriately prescribed antibiotics had a much higher rate of side effects and complications from using those antibiotics, like C. Diff infections in the intestine, which we know are becoming increasingly problematic too.

I want to actually talk about the child's gut microbiome, and we know it starts way, way back, even at contraception. Can you give us a little bit of a crash course of the importance of the gut microbiome when it starts to form and then things that affect it as the person comes into the world?

Yeah, absolutely. So your baby's gut microbiome starts with your gut microbiome, which started with your mother's gut microbiome, and on and on. But the most relevant in the moment is even before you start getting pregnant or thinking about getting pregnant. The ideal situation would be to do some cleanup, take a few months, three to six months, to step back and say, how do I optimize my gut and my vaginal microbiomes on my entire microbiomes so that when I am pregnant, first of all, I have the best chance of getting pregnant with a healthy baby and having a healthy pregnancy and then delivering a baby who has the stage set for a healthy gut microbiome? And we know many of us growing up, we were exposed to a lot of antibiotics or a lot of medications or a lot of stress or maybe had frequent infections ourselves. So even just one round of antibiotics can shift your gut microbiome to an unhealthy one. It's just stepping back and saying, okay, I've had antibiotics in the past. What can I do to reset my gut microbiome? Why is that so important for the moms to have a healthy gut microbiome? Because the bugs in your gut, the healthy bacteria that ferment foods to create short chain fatty acids like butyrate, can then take that butyrate and really have amazing downstream, you know, even acetate, all those good short chain fatty acids are used to.

Improve epigenetic potentials. Right? They can help to shift how your and your baby's genes start to express themselves in a healthy way or a not such healthy way. So start with mama's gut microbiome for moms. Many moms, during pregnancy, I do recommend taking a probiotic supplement, but always start with food as medicine. Make sure you're getting in tons of good fiber, that rainbow fruits and vegetables, you know, legumes, whole grains, you know, and keeping out.

The things in our diet that directly disrupt our gut microbiome, like food additives, you know, eating as clean as possible, those added sugars, keeping those to a minimum, and eating organically because. Because glyphosate was initially patented as an antibiotic. Now, this doesn't mean never eating out of a package, but it means being a smart label reader and choosing those foods that have cleaner ingredients, as few as possible, without those chemical additives that are going to cause gut dysbiosis. Gut dysbiosis is a term for an abnormal balance of bugs in your gut. So that's when mamas put pregnant. There is some controversy as to whether or not some of mom's gut bugs actually get transferred through the placenta.

And, you know, that controversy will probably remain, but there is also some of those mom's gut microbiome metabolites definitely get through to the baby through cord blood and through the placenta. So it still is very important for moms to have a healthy gut microbiome. And then at birth, if your babies are birthed vaginally, they're going to be exposed to your gut and your vaginal microbiome as you're getting delivered through the birth canal. And so then their first exposure is going to be to your bugs. And that's why we want to make them healthy, because then those bugs start to get colonized in your baby's gut microbiome. And babies who are born vaginally have been shown to have Very different gut microbiomes, which, with more beneficial bacteria than babies who are born by C section, whose gut microbiome tends to look more like skin bacteria. Now, if your babies are born by C section or if you've required antibiotics during your pregnancy, I mean during, well during pregnancy, but also during your delivery, let's say for group B, strep, then it's not an, you know, it's not a done deal. We can make sure your baby's gut microbiome gets healthy. We just want to make sure then that you start supplementing your baby with probiotics in your breast milk. Or if you are choosing to formula feed or need to formula feed, then we can put that into formula as well. And then after birth, through about two to three years of age is this really key window, this beautiful window that we have to help shape our baby's gut microbiome. After about two to three years of age, your baby's gut microbiome looks much more like an adult microbiome and doesn't it takes a lot more to shift the balance. It's also the reason why, you know, for my patients, once babies are two or three years of age, the whole family can get the same probiotic, right? So babies, typically they'll get a baby probiotic for the first couple years of life. Now I mentioned briefly that the gut brain, gut immune, gut hormone connection, your baby's brain immune system, hormones, they are, it's like this amazing potential to thrive and be healthy. And they're developing rapidly after birth. Your baby's brain is exploding with new synaptic connections, new neurons, new brain cells. And what's fascinating is that this explosion in brain synapses mirrors the explosion in your baby's gut microbiome composition, right? The same explosion of the brain neurons and synapses and shift in the gut microbiome also happens during your child's teenage years. And then we have another remodeling that occurs when we're, when we're, you know, during senescence, when we're elderly. So it's fascinating and you might think, well, what's influencing what, you know, maybe it's the brain that's causing all these changes. It's a two way street. There's a two way communication, a highway of communication between your gut and your brain called the vagus nerve, which many you listening have heard of. But here's the most fascinating thing, is that 80 to 90% of the communication occurs from the gut to your brain via the vagus nerve. So which comes first? Right. I mean, we really want to make sure that our child's gut microbiome is as healthy as possible. So it is sending the best signals to your child's brain, the gut, the immune system. About 70% of our immune system resides in our gut. And the way that our gut microbes communicate with everything, all the food, the toxins, and the infections that are going through our gut, traveling through our gut, it lays a foundation for how our gut microbes communicate with our immune system and lets us know, hey, this is friend or foe. Do I need to attack it or do I need to stay chill and accept it? And so we can see how important it is during those early years when we want our child's brain to be shaped as ideally as possible, when we want their immune system to learn how to respond as healthily and normally as possible. We have to start with their gut microbiome.

And given this intricate connection between the gut and the brain. So if there is, and a lot of people have now heard of the term leaky gut, and then inflammation, which is the root cause of a lot of these conditions that we're hearing about. So what's happening there with the leaky gut? What are some of the things that are, you know, air quote hits to the leaky gut?

Yep, absolutely. So gut dysbiosis, abnormal bacteria and composition in the gut and leaky gut go hand in hand. So. And gut dysbiosis can be a trigger of leaky gut. And leaky gut is one of the underlying factors in virtually all chronic conditions.

So what we want to think about is the fact that our small intestinal lining is one microscopic cell layer thick.

At the interface between the inside of our gut and our bloodstream. I mean, think about that one microscopic cell layer. So you can imagine, you know, how easy it would be to disrupt a single microscopic cell layer. Now that that cell lining is beautiful, right? The small intestinal lining, it has all of these finger like projections that stick out into the gut to increase the surface area to absorb nutrients that are meant to get in and also block out, keep out things larger, you know, inflammatory food particles, infections, toxins, keep them out of our bloodstream and just have them pass through in our poop. What happens when we are eating the wrong foods, exposed too much on a daily basis to psychological stress or physical and immune toxins, Is that our small intestinal cell lining, that microscopic cell layer, that single cell layer becomes disrupted. The spaces in between the small intestinal cells that have this, it's called a tight junction that keeps out all the unwanted things starts to get less tight, starts to get more leaky, right? So now all of a sudden, larger inflammatory food particles, viruses, pathogens, environmental toxins, all are allowed to slip through into our bloodstream. And those beautiful finger like villi start to get a little frayed, and they can't absorb nutrients as optimally. So what happens is this sort of double hit with not absorbing nutrients, needed nutrients as efficiently and allowing unwanted things into our bloodstream. And eventually, if this continues to happen, our immune system starts to react, create inflammation, create antibodies against certain foods or environmental toxins, start to say, I don't like this. I'm going to create inflammation. Now, inflammation is not a bad word per se. Acute inflammation is what helps our immune system deal with whatever toxic threat is there. We have an infection, inflammation occurs. We get a fever and we take care of the job. We get a cut on our skin, inflammation occurs. The skin gets a little red, right? Getting all of those white blood cells to the area, and then it heals. Inflammation is problematic when it becomes chronic. It doesn't go away. The fire is constantly simmering, or if inflammation is directed at the wrong part of our body. And so during this inflammatory attack, if our immune system starts attacking your child's thyroid or their intestinal cells or their joints, that's when they can develop things like autoimmune, you know, Hashimoto's or rheumatoid arthritis, or, you know, Crohn's disease. So this leaky gut, you know, underlies, you know, much of what's going on, you know, for our kids with chronic illnesses. And the great thing, though, is that with functional medicine tools, we can heal leaky gut. We can heal gut dysbiosis, right? So if you're listening as a mom, you're thinking, oh, my gosh, my child has eczema, or, oh, my gosh, my child has, you know, anxiety, or my child already has an autoimmune illness. Is it done now? Right. Is it too late? It's never too late, right? The earlier you start, the easier, I'm not gonna lie. Right. So, you know, the longer it goes along, there's more to undo. But it absolutely can be undone. It's just a matter of fact, first knowing that this is what's going on and then taking that first step in that healing journey.

Yes, And I want to get into the healing journey in just one second. In terms of nutritional factors, we hear about gluten, dairy, and soy, and some people will use the term allergy sensitivity interchangeably. But we know that they're not the same. How do those things impact the gut and how much should we be paying attention to those things?

Yes. So we know that, you know, there is this huge upsurge in children with anaphylactic life threatening allergies to peanuts, to shellfish, to eggs. I mean, you name it, you know, much more than when I was a child right now, you know, in my child's, in my kids school, during field trips. I mean it's, I mean on a certain level it's disheartening but also, you know, sometimes a little bit unbelievable how many kids need to carry with them an EpiPen or an asthma inhaler or you know, whatever medications. So you know, these quote, true allergies, they are mediated by a type of antibody called an IgE antibody. Those are typically very obvious, right? Your child eats an avocado and immediately they're throwing up and can't stop or they get hives or swollen tongue or lips or they start wheezing. And those, you know, those type of immediate allergies, they're called immediate because they usually occur within seconds, sometimes you know, minutes to an hour later. They're, you know, those, they're often the ones that, that your children are born with. Now I mean, why are more children, you know, being born or developing these, these life threatening allergies? I mean a lot of different conjecture. One is potentially that, you know, they found that, you know, using a barrier, a moisturizer on your kid's skin to prevent their skin from absorbing these food allergens through their skin could be helpful. I mean, but you know, let's look at the disruption to our children's skin microbiome too. When we're talking about leaky gut and gut dysbiosis, we're not really talking about those, those immediate allergies. So while, while there are more, more and more centers, allergists around who are able to do desensitization for kids with, you know, life threatening anaphylactic allergies. That's not what we are trying to reverse and heal when we're working with leaky gut. What we're trying to do with leaky gut is, you know, when it, remember I said that all with the leaky gut you're allowing these larger, well digested pieces of food to enter your bloodstream. Eventually your food says whoa. Especially if your kids are eating them every day. Let's say, you know, let's say, I mean, I'm going to say something healthy like, like Kale, let's say you're like, oh, we are going to do kale chips breakfast, lunch and dinner. Right? And they're getting the same thing over and over and over again. And in a leaky gut situation, those kale antigens are entering your child's bloodstream and eventually your immune system's like, you know, this is a little too much. I'm going to make an antibody. And typically it's an IGG antibody. It might be other immune factors and develops what's called a food sensitivity or a delayed reaction. These reactions sometimes don't show up for three, four, or five days after eating a food. Which is why if your kids are eating, let's say, kale chips every single day, it can be really hard to correlate their eczema with the kale they're eating because they're eating it every day. Right. There's no change in it. Those food sensitivities we can heal and reverse when we heal the leaky gut and give your immune system a break. So that's what we're talking about when we're talking about resolving gut inflammation.

And let's talk about the 5R healing program. How do we heal the gut?

Yes. So I love talking about the five Rs. The five Rs are basically the plan to heal leaky gut and reverse what's going on in your child's gut. So the first R is remove. So we're removing anything that's inflammatory, irritating to the gut and the immune system. So most importantly, it's going to be abnormal gut bugs. So I do recommend, if you're suspicious that your child has leaky gut or gut dysbiosis, that you work with a functional medicine practitioner who can order some testing, some stool testing, especially because, you know, frankly, with, with poop, especially since a lot of kids with gut dysbiosis, they don't have any gut symptoms. I can't tell what's in your child's poop unless I look. So doing a comprehensive stool analysis, seeing, are there any bad bugs in there that we need to remove? Also, what foods, you know, are my child sensitive to right now that I need to remove temporarily while we're trying to heal the gut and some of these foods, I mean, that you can consider doing a, doing a food sensitivity blood test initially, I would say just get rid of the big hitters. Right. The most common food sensitivities are going to be gluten, dairy and soy, maybe eggs. Right. Those are the most common. Now you might Be saying, oh, my gosh, but gluten and dairy, all my kids eat. What are they going to eat? So the part of the remove and this elimination diet is not to instead, still further anxiety. Right? But it's working with an amazing nutritionist or health coach who can flip that and say, all right, we're going to take these foods out of your child's diet first. We're going to add in a lot of different alternatives that are healthy and delicious and get to the point where we can remove these foods so that they're not. It doesn't feel like deprivation. So it's not a race. You don't have to remove it the next day. Some parents, they can. They're like, okay, out of the pantry. Next day, we're on it. Other parents, it's going to take months, right? If your kids are more selective and that is okay, right? They didn't get to where they are overnight. They're not going to get back to being totally well overnight again. This is a journey, and we want to make it positive. We never want kids to feel deprived. And another key piece of that is shifting our own mindset to, wow, isn't this amazing? Now that I know what foods are triggering my child's symptoms, isn't it amazing that if I can remove these at least temporarily, their symptoms can resolve and perhaps they'll be able to go back to eating some of these in the future.

So that's a remove piece. We want to.

Replace whatever's missing. And so this can be digestive enzymes to help your child digest foods a little bit more easily. We want to re inoculate or recolonize your gut with all the healthy gut bugs. So this is making sure that your gut bugs that you want to foster are getting the right foods. That's your fiber, right? Your fruits, vegetables, you know, beans, whole grains, fermented foods. Fermented foods. And take your pick. You can try, hopefully, you know, just keep trying. Trying. Trying can be sauerkraut, kombucha, miso, g, kefir, but we're getting in all the good gut bugs. And oftentimes a probiotic supplement is going to be needed during this stage. We also want to make sure that we repair your gut lining. Remember that leaky gut, the small intestinal cells. We need to make sure those villi get nice and strong again, that the tight junctions become tight again. And we have healthy small intestinal cells. So these are going to be things like glutamine and amino acid. Zinc is really important for Repairing the lining of your gut, omega 3 essential fatty acids, you know, antioxidants. So just repairing. And then the fifth R, which is I believe, the most important R. When I was training in functional medicine way back in the early 2000s, it was only the four Rs and the four Rs that I just mentioned. Now there's a fifth R, which is called, which is rebalance, which I believe is the most important if we're going to not just get our kids well, but keep them well. Rebalancing means restoring the gut brain, the mind, body, spirit connection, re engaging the vagus nerve. Remember, going back to the vagus nerve, our vagus nerve is so important for the health of our gut microbiome and our gut brain connection. And so, you know, these are when I talk about, you know, practicing mindfulness with your kids every day, practicing gratitude, you know, having joy and love, you know, being out in nature, you know, practicing breathing techniques, diaphragmatic belly breathing, all of these things that on a daily basis just give our vagus nerve more exercise, gives it more muscle memory, is going to, to help get your kid's gut healthy, but also keep them there so that the next time they have.

A bag of Skittles or a round of antibiotics, they're not going to flip immediately back to having, oh my gosh, now their eczema is back again. Their gut must be disrupted again. It's not about having fear of what's going on. It's about resilience in the gut microbiome too. And that's the rebalance piece.

I love it. And if people want to start anywhere, that fifth ring is a great place to start and continue 100%.

I mean, it's that the fifth R, it's free, it makes the whole family feel good. Right. And it has trickle down effects. Not just to feel good and calm. I mean, who doesn't want that? But it helps balance your immune system, it helps support a healthy gut microbiome, it helps restore sleep. I mean, so many benefits, you can't even, you know, count the benefits. And so I agree. I'm glad you said that. I mean, just starting right there would be the best thing for the whole family.

Yes. And all of the amazing resources and the tips that you suggested. I would love to include a link for our listeners in the show notes to make them easily accessible. Dr. Song, you are a wealth of knowledge, but in addition to your private practice, you have this amazing online community which I've. That's where I found you first and you're there to commit, sharing your knowledge and expertise. Why is this important to you to do both?

You know, it's so important because my, my practice, my private practice in the San Francisco Bay area, it's been closed to new patients for, I mean, I want to say almost a decade now. I mean I am, I do take siblings and you know, see new patients here and there, but it's just, you know, it's me, right? You'll always get me, but, you know, it's me alone. And guys, you guys know as moms, you know, as partners, you know, in a marriage or, you know, trying to maintain friendships and family relationships and you know, have your own busy practice in business. It's a little crazy making sometimes. And so it just got to a point where I was getting started so.

Just heavy hearted that I had to turn away so many parents who were calling to say, can you see my kid? Can I make an appointment? And so, I mean that's really what propelled me into starting my online educational platform, Healthy Kids, Happy Kids and start, you know, gosh, I mean this was back in 2016 was when I started Healthy Kids, Happy Kids. So it's been, you know, six, six or so years now. And you know, back then I didn't even know what Facebook was. I mean I had all my friends who were on Facebook and I was like, I don't need to do that. I don't know what that is. Right. And, and, and, and Instagram, forget it. I mean that was a whole, whole new thing.

Yes.

But now, you know, new is always a little daunting. But now, you know, I'm, I'm on Facebook and Instagram under Healthy Kids Happy because I don't post very often. But what I do post because you know, when I'm on social media, I do it for a reason. Whether it's to maybe get a few laughs. Right. Or maybe maybe learn something. And I don't want a lot of just extra fluff. And I appreciate and value, you know, all of the mamas, papas, you know, grandparents and practitioners who follow me on Instagram and Facebook. And I never want to waste your time with fluff. I mean I always want it to be chock full of information, whether it's to bring joy or to bring health information.

Yes, I am right there with you, Dr. Song. I want to ask about you, your non negotiables when it comes to your own self care.

So I will say it's this, the mindfulness piece that is one of my non negotiables and what does that mean? It has to be concrete. So one of my non negotiables is that I need and I treasure my quiet mindful time in the morning. So I wake up before the rest of my family and it's one of my morning rituals where.

You know, I do, I get, I get my cup of coffee, my cinnamon coffee and I sit and I, and I do a five minute meditation because you know, like most moms, if you're especially now back to school, you get up, you have to pack, make the breakfast, pack the lunches and it's like go, go, go. So before I get into the go, go, go, I spend five minutes. I have my Insight meditation timer app. I have my favorite five minute meditation app. It's called, it's by Megan Winkler. W I N K L E R I love this, this meditation. It's a breathing meditation, a mindfulness meditation. And I sit there, I wear my Apollo neuro vagus nerve stimulator on my wrist and I just settle into the day. And if I start my day with that, the morning is more smooth. I'm not frantic, you know, rushing around, you know, yelling at the kids. Right. I'm a mom like any other. I mean, I'm not above yelling every once in a while. Right. But you know, there are mornings, I mean, I'm just thinking about my kids started back at school last week and there was one morning where I was tired and I decided I was going to lounge around in bed for a little bit. But that meant I didn't have time for those five minutes to myself, which really is more like 15 minutes. So I didn't have that time to reset my brain for the day. And that morning there was definitely more raised voices and rushing and not as happy a morning as it could be. So very important to start the day. I learned this from one of my friends too. I mean she never, she starts today first thing looking at her phone, email or social media feeds. And why is that? You know what, I can't remember who I heard this from. But when you start the day by checking your email or social media, you are allowing someone else to set the tone for your day.

There's plenty of time for that all day long. Set the tone for yourself and then you can let the other things happen.

That's a great point. And I was looking at some studies a little while ago where for many people the cortisol level spikes in the morning. So if you get up and you're doing those things and your cortisol level is high. That's when you feel rushed and frantic and your anxiety levels through the roof and you're yelling. So you almost have to work against that. All the more reason to do it. Dr. Song, where can our listeners find out more about you? You mentioned a little bit before, but if we were to summarize all the ways.

Yeah, well, it's probably the best way to find me is so my online blog education site, that's www.healthykidshappykids.com and then Instagram is ealthykidshappykids and then Facebook, you can just Google healthy kids, happy kids and I'll come right up. But those are the three best places to keep in touch and also keep updated with the health information education that I share.

Wonderful. And I will include all of those. Dr. Song, as a parent, a healthcare professional, I want to really thank you so much for your dedication to children and their families to thrive as naturally as possible with a peace of mind. It doesn't get better than that.

Thank you so much. It's my honor and my pleasure to.

Be on here and I feel like we can all play a part in positive, proactive change. So thank you for inspiring and encouraging all of us to do that.

You're welcome. Thank you.

And to the listeners, thank you as always for tuning in. Until next time.

Thank you for listening to the Baby Steps Nutrition podcast with your host, Argavanu Forouche. We hope you enjoyed our deep dive into all the tips and tricks you and your family can use to make daily life a little easier. If you enjoyed this episode and you'd like to support the podcast, please leave a rating and review, share with others and follow us on social media, Instagram, Facebook and Twitter abystepsnutritionpodcast. As always, you can head over to babystepsnutrition.com to sign up for our email list as well as check out all the links and resources in the show notes. See you next time. Tune in, feel great.