Restore Your Child’s Microbiome After Antibiotics, with Dr. Elisa Song

Antibiotics really are the single biggest, most significant acute disruptor of the gut microbiome. We can consider psychological stress as the most important chronic disruptor, but when we think about antibiotics, they don't care what they kill, they don't kill selectively.

If you want to live like you matter, ditch the pills, look great and feel Freaking amazing. You're in the right place. I'm Dr. Wendy Trubo.

And I'm Dr. Ed Levitan. Welcome to the Feel Freaking Amazing podcast.

Where we empower you to live a vibrant and healthy life by optimizing your structural, chemical, emotional, social and spiritual lives. Hold on to your hats. Hello and welcome to the Feel Freaking Amazing podcast. I have one of my friends and colleagues here today. She's a friend of mine. She is a Stanford NYU UCSF trained integrative pediatrician, pediatric functional medicine expert, mom to two thriving kids, and she's on a mission to revolutionize the future of children's health. She's the best selling author of the Healthy Kids Happy Kids, an integrated pediatrician's guide to whole child resilience. Dr. Song created healthy Kids, Happy Kids as an online holistic pediatric resource to help practitioners and parents bridge the gap between conventional and integrative pediatrics with an evidence based pediatrician backed, mom approved approach. So, Elisa, welcome. I'm so happy to have you here.

Oh, I'm so excited to be here. I'm sorry to not see Ed, but I love seeing you.

Ditto. I'm sorry he's not here, but so you've seen a lot, right? You've really watched trends come and trends go. So what would you say is the state of children's health today?

Well, we know it's not good and you know, it's not to paint a picture of doom and gloom. And that's never me. Right. I never wanna, you know, just share scary statistics and say, okay, there you have it. You know, we live in a toxic world. There's nothing you can do. I mean, you and I wouldn't be doing this work, right, if there was no hope. But, you know, the LAD statistics from the CDC are that nearly one in two kids has some sort of a chronic health condition. I imagine it's probably more than that simply because how many kids have health concerns that are chronic and persistent but don't have a diagnosis, so they're not captured by insurance with the ICD10 codes? Right. And you know, I just think back to when I was a resident back in the kind of early 90s, right. And this was at UCSF where we saw a wide range of patients. But when I was at ucsf, I remember I was in my developmental pediatrics rotation and we saw a child with autism. And I was told by the developmental pediatrician attending that as we were ready to graduate from residency, it's like, look, if you see a handful of autistic kids in your lifetime, that's going to be a lot. I mean, this was like mid-90s, right? Late-90s. I mean, fast forward. I opened up my practice and I was like, oh my gosh, there's so many families in need. And when I was in training for kids with eczema, we were told never, ever put anything stronger than hydrocortisone 1% on the face. And you never put steroids in the diaper area. And now, I mean, they're getting lathered with stronger and stronger, you know, steroid topicals and being put on, you know, anti kind of immunosuppressants, regularly, antimicrobials, I mean, you name it. And so, and I also tell my families in my practice who really can hardly believe it, there was no such thing as sensory processing disorder back then, meaning, like, we just never saw it and wasn't diagnosed. And there was no such thing as type 2 diabetes. It was called adult onset diabetes because kids didn't get it. So this, that's not, I mean, it's a while ago, but not that long ago and things have changed dramatically.

So I know you're all about the microbiome, Elisa, so talk to me about, in the course of life, infections happen and as a parent, it's always this like, fine line between am I going to give my kid antibiotics anytime they're sick? Or how do we determine that? So when kids get sick, can we talk about what are the things that as parents we should be asking the pediatrician looking for, contemplating, like how do we evaluate this as a parent?

Yeah, it's so important on a number of different levels. So just from a global public health standpoint, we know that antibiotics, many, many antibiotics are inappropriately prescribed either for viral infections that aren't necessary or just a broader spectrum. Meaning they kill more bugs than they need to. Right. So we are now at a place where antibiotic resistance could become a leading cause of death worldwide by 2050. I mean, that's right around the corner.

That's our life.

That is our life. And that's, that's our kids lives, that's our grandchildren's lives. Right. And we're also in a place where we know from many studies that up to 70% of antibiotics prescribed for children are inappropriately prescribed. So this is really important for parents to understand now. Parents, grandparents, anyone listening to this podcast. I know you're not the parent who goes to the ER with the sole goal of walking out with an antibiotic prescription, right? I mean, there are parents like that. I used to work in urgent care in the er. And yeah, it. That is, you can tell that is something that some parents would like. Most parents, like you guys listening, want to use antibiotics if they're absolutely necessary, but also want to be judicious about using them and know that they really are necessary. So there are a couple of things, you know, in the book, I give six questions to ask the prescribing doctor before. Before you. Before you start antibiotics. The number one question, the most important question, and this is even for you as an adult, when you're prescribing an antibiotic, the number one question to ask is, hey, doc, is this really necessary? Because you might think, well, of course they're only going to prescribe it if it's necessary. But here's the thing. Some studies have found that doctors can be twice as likely to prescribe an antibiotic, even if they don't think it's necessary, if they think that the patient wants it. Right? And so simply by asking that question, you're opening the door to letting this doctor know, you know what? I'm not one of the parents that came in here just for the prescription. I just really want to know, is it necessary? And if it's necessary, I'll do it, but I want to know for sure. And then ideally, which is unfortunately not going to often be the case, but ideally, they would also be able to tell you if it's not immediately necessary. Are there some other options from maybe an integrative or a natural standpoint? What would happen if I waited on this antibiotic to start? Are there any tests to confirm that it is bacterial and that it needs to be, you know, an antibiotic is needed. Right, that last question, any test especially important when it comes to strep, because I strep throat, because I have had kids go to the air over the weekend, really sore throat, pus on the tonsils, looks terrible. And the doctor says, I can tell just by looking at strep. So here's the antibiotic prescription. I can guarantee that there's not a single practitioner out there who can diagnose strep simply by looking or saying that it smells like strep. I've heard that too. Right. You need to have a culture at the, at the. I would say a rapid strep and a culture because I've. The worst sore throats I've seen are actually viral. I mean, Epstein Barr mono can, can cause if the same or even worse. And laryngitis and Covid is nasty.

Sore throats.

Yeah.

Okay. Okay, so. Okay, so let's fast forward. It's necessary. There's no other treatment. It's gonna get worse if we don't treat. We give their kid or ourselves the antibiotic. How do we restore the disrupted. Because antibiotic is not selective. So we're now essentially scorching the earth and killing all that hard work and getting rid of the good bacteria. So how do we rebuild that, that disrupted microbiome?

Yeah, so that's really important because antibiotics really are the single biggest, most significant acute disruptor of the gut microbiome. We can consider psychological stress as the most important chronic disruptor. But when we think about antibiotics, like you said, they, they immediately, I mean, they don't care what they kill. They don't kill selectively. Although what's, what's also insidious, similar to glyphosate. Some of these antibiotics will preserve the pathogenic flora, which is why we see C. Diff infections after antibiotics. Right. Sometimes Clostridia, klebsiella, they're protected. And those are the kind of bacteria that we don't want to stick around. So ideally, in the ideal world, what would happen is when you're taking the antibiotic, your child's taking the antibiotic, we would use and give a clinically backed probiotic that is known to restore your gut microbiome after disruption by antibiotics. Right. And there are, you know, in the book, I list specific strains, but, you know, there are, there are some broad spectrum probiotics that do have these, these strains in them. I also add a beneficial yeast probiotic called Saccharomyces boulardii, because that in children has been found to reduce the, the antibiotic induced diarrhea. But it's not enough to just sprinkle back in the probiotics because they need a place to call home. They need a place to stay. They need to want to stay. And so we need to create that environment and make sure we're nurturing your child's microbiome with the food that these, that these beneficial flora need to grow and thrive. And that might mean during your, the antibiotic course, you're giving them a prebiotic supplement. But we also want to make sure that there is a good foundation there. And that's all about really getting in your fiber, your phytonutrients, your fermented foods. In fact, one study out of Stanford found that fermented foods was better at improving microbiome diversity than fiber. It didn't mean fiber wasn't important, but. But in terms of that one particular marker. And then antibiotics can also some of them trigger leaky gut. So we're giving gut supporting nutrients like your omega 3s, zinc is, can be really important. Quercetin, glutamine. So whatever regimen you have, I have a gut reset plan that I work through patients with. But then you also. We need to remember, for parents, it's not just one and done right. When we think about giving the. Giving the probiotics, Sure. I mean, you can give them while you're taking the antibiotic course away from the antibiotics. I would continue on for maybe a month or two. But your gut wants to return to the state it was in before antibiotics were given. It likes to bounce back. And so we wanna make sure that even as we're moving forward or back or starting before antibiotics, that we lay the foundations for an optimal microbiome for your kids and teaching them how to do that for themselves. And that's why I have in the book the five things that create microbiome magic that you can do every single day. You know, five things every day. I'm not adding on another thing, but five things that we can think about that are going to enable and establish an optimal microbiome to begin with so that whatever disruption occurs, it can bounce back to that state. Because things like environmental toxicants, I mean, we're never gonna get rid of them completely. Doesn't matter how clean you're living. I mean, we are gonna have forever chemicals in us. I mean, microplastics are gonna be in us. We can't completely avoid them. So the key is laying down those foundations every single day.

And I wanna remind, I think this is a good point to remind the listeners that don't forget your gut runs your body. So if your gut is dysfunctional, that essentially serves as the domino effect for all of these chronic autoimmune cancer, degenerative diseases all. So this is really important. And what I'm hearing, you focus on kids, but it sounds like people can do this for themselves. Healthy kids, happy kids. Get the book, read it, but apply it to yourself too. Right? Like, don't just map it for your children, map it for yourself, because why do it just for them? And not you.

I mean, it should be for the whole family. And I've had, you know, grandparents read the book. I've had parents read the book and say, oh my gosh, I did my own sugar inventory. Now I know how to, you know, where I can swap things to really move the needle on that front. Or wow, I didn't realize these were some of the things to look out for on a food label. Or I didn't realize how important, you know, vagus nerve work was for optimizing the gut microbiome. It is especially important for children, but. Well, I don't want to say especially, it's important for all of us, you know, all of these things, right? Because just as, you know, for, for infants in particular, if we have this opportunity to lay that foundation before babies are born, and in that first, really key zero to three, three months of life, that's ideal. I would love that. Because some of the research now shows that any disruption to your baby's microbiome in the 0 to 6 months of age. So for instance, babies who received antibiotics or antacid medications in the first six months of age have an increased risk of virtually every single allergic disease like hay fever, eczema, asthma, even anaphylactic food allergies by the time they're four. And another really large study looked at mother infant pairs and looked at antibiotic exposure in the first two years of life. They even included antibiotics that were given in utero to mom for, let's say, a sinus infection or uti, and found that those infants who were exposed to antibiotics in the early days of life were significantly increased risk for developing mental health concerns by the time they were older or teenagers. So things like adhd, anxiety, depression, sleep disorders, and the more rounds of antibiotics, the higher the risk. And again, the risk was highest for the 0 to 6 month of age. So if your kids are older right now and they've had antibiotics from their babies, I know it can be stressful to think about, but this is why we just have this information, right? We sit with it. I let people know. My own two kids had antibiotics, both of them, when they were under five weeks of age. We just, we can only move forward. And now you have the knowledge because no matter how old you are or how disrupted your gut microbiome is, we can still restore your microbiome. It's just that it might take a little longer, right? But the first step is in the knowing, right?

And more than that, you want to also be pragmatic, right? So when I was six months old, I had pneumonia. And so they gave me antibiotics for that. But what are the options, right? You know, the alternatives are really worse. So always. And I actually ended up taking antibiotics for a really nasty infection about four months ago. And I'm still rebuilding my gut, like focused on rebuilding my gut. And I'm like just sort of taking on these things that you're seeing and going, okay, I can rebuild. It's slow and steady and hopefully I won't have antibiotics for a while. So. Again, so. So I think, I mean, this has been amazing information. I think the question people are left with other than where do they buy the book?

Right.

I have the book. I'm gonna. I don't lend it out though, because then I never get it back. So where can people buy the book and where can people find you?

Yeah, so my book is. Is available pretty much anywhere books are sold. So of course, Amazon, something like 80, I think 75, 80% of all books are bought on Amazon.

And.

And if you would like to support someone other than Amazon, you can find it at Barnes and Noble, your local indie bookstores. In fact, there's the indie bookstore.com where you should be able to find if there's someone close to you. But you know, Walmart, Target, Barnes and Noble, of course. And then to learn, to stay in touch, keep learning from me. You can, you can sign up on my newsletter, that's healthykidshappykids.com. if you check out the website, I have articles and lots of information there. And I'm most active on Instagram, which is where I share my more frequent updates. So that's HealthyKidsHappyKids.

Awesome. We'll put it all in the show notes so people can reach you. So for the listeners, thank you for joining us for another episode of the Feel Freaking Amazing podcast. And I hope you enjoyed this episode. Dr. Lisa Song, thank you for being here. This was awesome and it's such a pleasure to have you on the podcast.

Well, thanks for having me. And I get to see you in not too long, so.

Exactly. All right, y' all have a good day. Stay well. Inspire and empower someone else by leaving a five star review so they can transform their lives too.