Holistic paediatrician, Dr. Elisa Song, joins me to chat about leaky gut, fussy eating, screen time and its challenges, sleep, the importance of community for developing brains, the immune system and inflammatory responses, as well as vaccinations. This is jam-packed with information and Dr. Elisa Song then leaves us with some simple steps to help kids thrive holistically; body, mind and spirit.
Selected Links from the Episode
- Dr. Elisa Song website
- Dr. Elisa Song 3 Part Facebook live course on gut health
- Unstress episode with Dr. Jodie Lowinger on mental health
- Unstress episode with Dr. Leila Masson on an integrative approach to a healthy child and you
- Dawn Huebner – What to do when you worry too much
- Breathe for Kids App
Dr. Ron Ehrlich: Hello, and welcome to Unstress, I’m Dr. Ron Ehrlich. Now, today I want you to get ready for a taste of what could be the most thorough visit to a doctor you could hope to have. I’ve mentioned my passion for integrative health practitioners and after today, if you’re not already looking for or seeing an integrative health care professional or looking at that approach to your health this will surely convince you, if you indeed needed convincing. My guest is Dr. Elisa Song who founded the Whole Child Wellness clinic in California, USA in 2005. It’s now the Whole Family Wellness Center.
I actually do think mission statements are important. We’ve had one in our clinic and I recognize it as perhaps the most important document we have ever produced. And Elisa’s mission is, “To create a nurturing environment that integrates allopathic,” now, that’s the best that modern medicine has to offer, “And natural medicine, customized to each unique child and person to help them thrive to fulfill their full potential.” Now, Elisa has a family practice but has a special interest in integrative care for children with complex medical issues. And this includes: autism, ADHD, asthma, autoimmune illnesses, eczema, food allergies and sensitivities, reflux, gastrointestinal disorders, neurological disorders, and environmental illness. It’s a long list but this is precisely what people are facing today with children’s health.
In addition to qualifications in pediatrics, political science and public policy, I actually think that’s a great combination actually, Elisa has trained in functional medicine, holistic nutrition, homeopathy, acupuncture, herbal medicine, and other natural therapies. She is, also, as you will hear, a great communicator. I hope you enjoy this conversation I had with Dr. Elisa Song.
Welcome to the show, Elisa.
Dr. Elisa Song: Thank you, Dr. Ehrlich. I’m so glad to be here today.
Dr. Ron Ehrlich: Oh, Dr. Ron, please, oh, Ron is fine.
Dr. Elisa Song: Okay, Dr. Ron.
Dr. Ron Ehrlich: Let’s not get too formal here. Now listen, the word holistic evokes a lot of things to many people. And you describe yourself as a holistic pediatrician, what does the word holistic mean to you?
Dr. Elisa Song: Holistic can mean so many different things but to me, when I discuss holistic pediatrics, I really think about taking the whole child into context, their body, mind, and spirit and looking at everything that affects a child’s health from within and without. So that includes not just the food they’re eating and the air they’re breathing but it also includes the thoughts that they’re having because we really need to look at these internal and external stressors as impacting their whole health and their whole body, mind, and spirit. And it also includes their relationships outside of their selves with their family and their friends and their teachers and their community. So holistic really means taking that whole child approach and looking at the child in the context of everything that they’re interacting with.
Dr. Ron Ehrlich: That’s fantastic look, we’re going to come back and visit some of those things you just raised with us. But I know you … I’d … It’d be interesting to get a little bit of your own journey here because I know you come from a traditional medical background, I mean, literally.
Dr. Elisa Song: I do, yeah. And my mother, in fact, is a Western-trained OB/GYN, so I grew up in a medical household. And I never ever thought I was going to go into medicine. I knew that I wanted-
Dr. Ron Ehrlich: Well, she was out delivering babies all the time, was she?
Dr. Elisa Song: She was. And I loved working with babies and with kids and I had in my mind, for as long as I can remember, that I wanted to work with children and advocate for their well-being in some way. And as an undergraduate at Stanford, I actually majored in public policy and was going to go into law and be a children’s rights lawyer. But then, somewhere along the road, these things happen that just open up these doors for you. And if you’re open to them, and take those doors and it leads you on this fascinating journey.
And I stumbled upon one the very first meetings of the American Holistic Medical Association which was back now in the early 1990s. In fact, I think it might have been 1990 or ’91. And I had a chance to hear these speakers who were barely known at the time. So they were Andrew Weil, Deepak Chopra, Joan Borysenko. And I was totally hooked. And I knew at that point, that I wanted to do something more with holistic, integrative medicine but I didn’t know what that was. In fact, I looked at a naturopathic school called Bastyr, which is one of the most highly respected naturopathic schools in America.
At that time, nobody knew really what naturopathy was, and my mother had certainly never heard of it. So off I went to medical school, committed to the medical school. And I was completely disillusioned. I did not really like anything I saw in medical school and in residency training. We were just really putting band-aids on symptoms, and we were great at managing acute trauma and putting out fires, but we weren’t being trained to heal kids, right? And understand the whole patient. And back then, and gosh this is now in the late 1990s, we didn’t see much autism, at least not in the university setting. I was at UCSF, which is a tertiary coronary care medical, academic center. I was told in my career if I saw a handful of autistic kids that would be a lot. I saw one a child with autism in my entire three years of pediatrics residency training. Come out into the real world, what do you know?
I mean, there are kids who were sick with chronic illness, simmering chronic low-level illnesses or high-level illnesses but they weren’t getting better. We were putting them on steroids. We were putting band-aids on their symptoms, and they were coming out the other end with more complications often.
And so then, I stumbled upon another kind of serendipitous event I saw this conference called the Food as Medicine Conference. And there, I heard Mark Hyman talking about something called functional medicine. I was totally hooked again. I sort of refound my passion for holistic pediatrics and working with kids. And that’s where I just jumped off and studied functional medicine. I actually also do acupuncture and homeopathy and practice essential oils and herbal medicine in the practice. So, that’s my integrative sort of toolkit. There’s so many other modalities, energy work, Reiki, chiropractic, Ayurvedic, that all have a role in helping to heal our kids because we don’t have all the answers, not one person has all the answers. And that’s where I find a passion in continuing to learn and continuing to collaborate so that we can really get our kids well.
Dr. Ron Ehrlich: Isn’t interesting, I mean, I find it intriguing because I’ve always felt and I always feel that the integrative medical practitioner should actually be sitting at the top of this total health pyramid because they’re so well placed to assess a person’s health. I’m just intrigued why more practitioners don’t have this kind of open, a-ha moment because it’s so exciting. What do you think is holding medical practitioners back from embracing this whole concept?
Dr. Elisa Song: I think it’s twofold. I think the most important factor is just a lack of knowledge and awareness that there is this whole other paradigm of thinking about how to approach our children’s and adult’s healthcare. I think that there’s, of course, a fear of leaving that safe paradigm that we’re taught in medical school but I used to be a bit more cynical that the medical field was not moving in the right direction and we were just getting adults and kids who were sicker and sicker but I do have hope. I work now and I have practitioners, pediatric, medical doctors, naturopathic doctors, chiropractors, therapists who are reaching out and saying, “Hey, I heard this podcast or I read this article and its so fascinating. And I’m hearing that you’re getting these results with kids. I want to learn more.”
And that’s where the BioCeutical Research Symposium that I’m actually here in Australia for is amazing because it’s bringing together practitioners who are really invested in spending additional time, additional resources, additional time away from family to really gain this knowledge for their patients because that’s where we will learn a root cause, integrative approach to healing our kids. And, for me, one of my passions is really looking at pediatric autoimmunity and pediatric chronic health concerns and functional medicine because that’s … excuse me, that’s one area where we just don’t have many answers in conventional medicine.
Dr. Ron Ehrlich: Yes, no, well, I think when people are … The thing that both sets of doctors those that haven’t … aren’t integrative and those that are, the thing they both have in common is I do believe they both want the very best for their patients. It’s just how we approach that. But listen, we often congratulate ourselves on living longer. We hear that a lot. Aren’t we great, isn’t it terrific when our age, we’re … but our kids really … our kids it’s such an interesting, looking at our kid its health, it’s kind of they’re the canaries in the coal mine. And I know you’ve got a young family. And having an integrative practice, I know you see families not just kids although you’re focusing on kids, how are our kids going? How are they doing?
Dr. Elisa Song: Well, I would … I wish I could be the bearer of better news but our kids aren’t doing that great. This was back in 1994, the New England Journal of Medicine wrote an article saying that for the first time in history our kids are expected to have a shorter lifespan than us. Now, that was over 10 years ago, and things have not gotten any better. And in fact, I would say things have gotten worse, our kids nowadays are facing, truly facing an epidemic of chronic illness, whether that is autism or ADHD, anxiety, these allergic illnesses like asthma and eczema and autoimmunity, so this is now what has truly become our new normal. And I would tell parents and practitioners listening, this should not be considered our new normal and it doesn’t have to be.
Dr. Ron Ehrlich: Mm-hmm. Well, I know you’re also in Australia, you’re going to be talking at the Mindd Conference. And that’s how … we’ll, hopefully.
Dr. Elisa Song: Yeah.
Dr. Ron Ehrlich: Yes, which is a fabulous annual event as well.
Dr. Elisa Song: That’s right, that’s right.
Dr. Ron Ehrlich: And I know that Mindd focuses on children’s health and the statistics that come out of that sort of one in three have allergies, one in four have asthma, one in 10 in Australia have ADHD, and in Australia one in 100 have autism. I think it’s even higher in America.
Dr. Elisa Song: Yes.
Dr. Ron Ehrlich: So these are worrying statistics, aren’t they?
Dr. Elisa Song: Well, they are and I don’t think that the statistics in America and Australia are very different. In some places, in America, we do have probably about one in 68 kids diagnosed with autism. In some pockets, actually, in California and in New Jersey those numbers are even higher. And I’ve seen statistics that at our current trajectory. And this is not just a matter of better diagnosis but at our current trajectory by 2033, which is just around the corner, 15 years from now, one in four kids will have autism.
Dr. Ron Ehrlich: Oh, my God. One in four will have autism?
Dr. Elisa Song: One in four. So we will have … There is not going to be a single person who is not touched by a child that they have themselves or a relative or a friend or a student that does not have autism. And this … And it’s not just autism, it’s all chronic illnesses in kids. The statistics now are that at least, a little over one in two kids, of … over 50% of kids have some sort of a chronic condition. Now, chronic conditions can be what we would consider quote “mild” like eczema, although, I’ve seen very severe cases of eczema ranging to anxiety ADHD, autoimmune illnesses, juvenile arthritis, and diabetes … type 1 diabetes are on the rise.
But again, this trajectory is increasing and so this … latest statistics I’ve seen are that by 2025, and this is less than a decade away, that 80% of all kids will have some sort of a chronic diagnosis. So that simply is unacceptable, this is you … In my mommy’s groups, so when I … when my daughter was … I mean, she’s now eight-years-old but when she was an infant and I was in some of mom-baby groups and we’d meet for play dates. I mean, it seemed like almost every child, every infant had reflux and was being put on an antacid medicine or had these rough, really red irritated cheeks and itchy skin.
So starting from birth, we have kids who are having reflux and digestive issues and eczema and cradle cap and then the march just goes on. And so we need to think about what we’re doing, not just when our children are born but also prenatally and think about all the factors that go into that. And that’s exactly what I’ll be speaking it about at Mindd and at BioCeuticals because if we have this knowledge, we can actually use that as power to prevent and heal what’s going on with our kids.
Dr. Ron Ehrlich: Mm-hmm. Well, what is going on? Why are we seeing these problems?
Dr. Elisa Song: Yes, there are so many different factors but I really do believe and many of them are listeners and many people who are familiar with functional medicine have heard the saying, “That all health starts in the gut.” And that truly is the root cause of many, many of the chronic conditions and autoimmune conditions that are affecting our kids. And especially, for our children when they’re developing gut microbiome, from in utero, right? From the time that they’re in mommy’s womb to the time … from the time that they’re born, that very moment of their gut microbiome being established has an intimate relationship with the developing brain and immune system.
So we have this critical period where we can actually impact our kid’s health for a lifetime. So I do think we need to look at the gut and all the factors that are going on with how our children’s gut microbiome and regulation are really being affected and going so wrong that their health is being tipped over into having some sort of chronic illness and not bouncing back into a healthy baseline.
Dr. Ron Ehrlich: Mm-hmm. Look, we hear so much about the gut. I mean, if people are listening to health articles and podcasts, they’re always going to be hearing now about the gut and the microbiome. Can you kind of give us a basic gut immune microbiome basic 101, like a crash course, if you like, a crash five or 10-minute overview, a five-minute overview for our listener. Why that’s so important?
Dr. Elisa Song: Yes, yeah, yeah, it’s … And it’ll would be a crash course. I actually did … Because this was so important for parents to understand, because it’s an essential, critical intervention point and a prevention point, I did on my Facebook page a three part gut health Facebook live course. And each of those videos was an hour to an hour and a half long. And even-
Dr. Ron Ehrlich: And we will have links to those.
Dr. Elisa Song: Okay, and even then, I felt like, “Wow, there’s so much more I want parents to know but the gist of it is that our gut, being the heart of our immune system and our nervous system, right? The gut is called the second brain. When we establish a healthy gut microbiome, this has a trickle-down effect into every single organ system in our children’s bodies. The same thing goes for adults but for children because we’re in this time of rapid development and changing, any changes in the gut, in gut health can have significant impacts long term for their future health outcomes.
So when we think about the gut, and I think about two different factors that are affecting our gut regulation, our gut health. The first is our gut microbiome, what are the bugs that are in our gut? And we have healthy microbes called our probiotics with many different kinds of Lactobacillus species and Bifidobacter species and many more that we’re just elucidating. And then, we have our not so healthy gut microbes which can include admiral bacteria which can cause autoimmunity directly. We have yeast, we have parasites, we even have viruses which are a little bit harder to measure.
But that, when we have an imbalance of our gut microbiome, that’s something called gut dysbiosis. Essentially, an imbalance of good and bad bacteria, yeast, parasites, and other microbes. And we know gut dysbiosis is linked with many different chronic childhood conditions including autism, ADHD, anxiety, eczema, and autoimmune illness.
Now, this gut dysbiosis can occur at any point in time in our children’s lives. It can even occur in utero if mama’s gut is not healthy herself, that can get transferred down into baby’s gut when they’re emerging from the womb, either by a vaginal birth or a C-section birth.
And so, we have these prenatal factors that go into really what our baby’s gut microbiome is starting off in life with. And then, we have various postnatal factors including how our babies are fed from birth, the way they’re birthed, C-section or vaginal, and what medications and other interventions they may be exposed to. Of course, stress too, we know maternal stress, what’s fascinating is maternal stress alone can impact her gut microbiome and her vaginal microbiome which then impacts also what that baby is exposed to as their coming out to the vaginal canal. So that’s gut dysbiosis.
And then, we have something called leaky gut which I’m sure many of your listeners have heard of as well. So leaky gut is a well described phenomena that also is associated with many of the same childhood conditions that gut dysbiosis is associated with. You can have both, gut dysbiosis and a leaky gut and typically, you do. But sometimes you have a leaky gut without necessarily having too much dysbiosis because there are other factors that are causing inflammation to the gut.
But leaky gut, essentially, is a phenomena where the small intestinal lining which should have very tight junctions between their cells and not allow irritating or well-digested food particles to enter the immune system becomes more leaky. The space between the small intestinal cells widens. The small intestinal cells become less efficient at absorbing nutrients. So we get into the cycle of not absorbing nutrients as well as we should from the food we’re eating. And then, also our immune system being bombarded by these irritating inflammatory pieces of food like gluten or dairy or any food that we’re eating all the time, which how many of our kids are essentially eating the same things every day, maybe in different forms but they’re eating a quesadilla or a pizza or a pasta with cheese, that’s all gluten and dairy, right?
And so eventually, our immune system starts to react, create inflammation, and create symptoms. The symptoms that arise are going to depend really on our genetic factors and what else is going on with our immune system in our brain but can include things like itchy eczema skin, sleep problems, reflux, chronic constipation, attention and behavioral issues, so.
Dr. Ron Ehrlich: Mm-hmm, I mean, people … Yeah, people kind of assume that if there’s a gut problem that the first and maybe only symptom is a gut issue but it’s not necessarily the case is it?
Dr. Elisa Song: It is not at all. And this is where I have parents come in and children come in who don’t have any apparent gut issues. They don’t complain of tummy aches. They don’t have reflux or constipation or diarrhea. They’re coming in for their kids sensory issues or attention problems or they’re coming in because their children have asthma or because they have joint pains and have been diagnosed with juvenile arthritis. And I tell them, “Hey, look, well, the first step is going to be to take a look at your gut and actually do a stool test, a poop test, right? I talk to every child about their poop. And they look at me and say, “Well, but there’s nothing wrong with my gut.” And I let them know, “It doesn’t matter if you don’t have any apparent gut symptoms, your health starts in the gut. Your gut informs how your brain or your immune system or your hormones are working. So we need to start with the gut.”
And it is fascinating how many times, in the vast majority of cases, when we actually do dig in and take a look with various testing methods, we see that the gut has significant imbalances in their gut bacteria or parasites or yeast. And children have many, many food sensitivities that they weren’t aware of that are contributing to this inflammation in their systems.
Dr. Ron Ehrlich: Mm-hmm. Well, we hear a lot also about gluten and dairy. This has become a very … Well, I think it’s on the rise, people’s awareness of it but it’s not always as simple as that either is it? Because-
Dr. Elisa Song: It’s not.
Dr. Ron Ehrlich: … often if you are sensitive to one or two, there is this issue of cross reactivity. Could you explain to our listener a bit about that because we’re always looking for simple solutions but it is a bit-
Dr. Elisa Song: That’s right.
Dr. Ron Ehrlich: … a little complicated, isn’t?
Dr. Elisa Song: Absolutely, and this is where functional medicine provides that broader, more holistic paradigm but we can still get pigeonholed into trying to have a more reductionist approach. So we really want to think about what’s going on when children have inflammation and a leaky gut. Essentially, I mentioned that you can develop a food sensitivity to any food that you’re eating too often or too much of. And gluten and dairy are two of the most highly inflammatory foods that we can eat. I do recommend, despite what any testing shows, that all kids who come in with a chronic condition, that they do a trial, a hundred percent off of gluten and dairy for at least two to three weeks, just to see if that’s a factor, but it’s only one piece of the puzzle.
We’re looking to see what else is creating or triggering and perpetuating inflammation in this child’s body. It might not be gluten, it might just be dairy or might not be gluten or dairy, it might be eggs. Or it may be the quinoa that they’re eating too much of because they are gluten free but now they’re eating quinoa pasta every single day. So we want … Or it may be that it’s the moulds in their environment or the emotional stressors at school because they’re being bullied.
We want to take into account all the factors that are filling up this child’s inflammation bucket. And sometimes we get one huge factor, perhaps, gluten that if we can remove, the inflammation bucket is lowered enough that that child feels significantly better and we can then move forward in terms of healing. Or sometimes we have many, many small items that are filling the inflammation bucket and we really need to target multiple inflammatory factors before we make a dent in lowering the bucket if that makes sense.
Dr. Ron Ehrlich: Yeah, very much so. Now, listen, yeah, this is interesting because when kids, what about kids or again, even teenagers and I know some adults who are really fussy eaters and their parents know … we know or their parents know what’s good for the child but can’t get the right food into them, how do we deal with fussy eaters?
Dr. Elisa Song: So this is probably a parent … every single parent’s concern, right? From the moment that our babies are born, we especially as mamas are so I don’t want to stay obsessed but yes, I was obsessed with making sure my child was getting enough food, the right food, the right variety of foods, right? And that’s our job as parents to make sure our children are nourished. For fussy eaters, I do look at a few different factors. Some kids may have sensory issues, oral aversions that are really affecting their ability to tolerate physically and psychologically various food textures or flavors. And so if that’s the case, if your child has any sensory issues or perhaps you’re not even aware they have sensory issues around feeding per se in their mouth or the way that their oral motor function is occurring. I would consider an evaluation with an occupational therapist or a speech therapist who specializes in feeding.
But other … apart from that, I do recommend finding a great nutrition consultant to work with because it’s not just a matter of saying, “Here, try this, try this, try this.” It does take patience and it can take a child and an adult, sometimes 40 or 50 times of tasting a food to actually find that food acceptable. But with that patience, we want to really work with kids and teenagers in a slow and steady and directed fashion.
So if your child likes, for instance, softer foods like applesauce and you want to get them to expand their variety of fruits, we’re not going to then immediately jump into a crunchy apple or a crunchy, what’s another crunchy fruit? I can’t even think of one right now.
Dr. Ron Ehrlich: Oh, okay, look, well, another crunchy fruit.
Dr. Elisa Song: But, yes, so if we’re going to work with softer foods like maybe a banana or a pear puree, right? So we’re going to work with the same texture and then, expand on different flavors or we can work on textures but the same flavor. So if they like applesauce, we might then work on apple slices.
So, we also want to make … get kids involved in the kitchen, helping to cook their own foods, they’re going to be much more likely to eat, try different foods if they are invested in the preparation process and the meal planning process. For younger kids, we can make it a game. There are various games out there to help them eat that rainbow of fruits and vegetables. And I also, think about zinc. So I think about zinc from a functional medicine and a nutritional standpoint because our fussy eaters often aren’t getting enough zinc in their diet. And in fact, many, many kids aren’t getting enough zinc in their diet.
And when our kids are low in zinc that’s going to affect their palate. It’s going to affect their taste buds. It’s going to affect their appetite. So some of our pickiest eaters, if we can get enough zinc into them likely through supplementation, all of a sudden, we see that their appetite improves. And they actually have a taste for more variety of foods. So that’s something that you could work with a practitioner to measure zinc levels and see, “Does my child have adequate zinc?” And if not, let’s go ahead and try some supplementation, see if that helps.
Dr. Ron Ehrlich: I imagine that’s quite a big one really because that is how zinc deficiency is detected, using a taste test, isn’t?
Dr. Elisa Song: It … Yes, you can use a zinc tally test, it’s called and for kids and adults. It’s a little harder on the very young children but if you can’t taste the zinc, that metallic zinc taste, then it means your body is likely very deficient in zinc and you need more. And zinc deficiency has really become so recognized in infants that the American Academy of Pediatrics recommends meat as some of our first infant foods now because that’s going to be one of our richest sources of zinc.
Dr. Ron Ehrlich: Mm-hmm. Now, taking a step back from the nutritional side of things, although maybe not, it’s surprise … We did a program and you mentioned one in two kids have chronic conditions and some horrible statistics around … We’ve spoken about asthma and allergy and ADHD. We had a program a few weeks ago with a clinical psychologist who we were talking about youth mental health, and she gave me a statistic that blew me away, one in four children under the age of 18 have been diagnosed with anxiety. And that’s diagnosed. So God knows how many there are who are undiagnosed. What’s … And that’s of course, now translates into teens and adults also with diagnosis of anxiety and depression. What’s an integrative approach to these kind of problems? What’s your approach?
Dr. Elisa Song: Yes, and this something that is so important for any parent or grandparent or educator to understand is that our children and teenagers are truly facing an epidemic of mental health illness. Anxiety and depression … In the United States, one in two teenage girls has been diagnosed with clinical depression. And this is trickling down to younger and younger ages. We’re having toddlers, preschoolers who are being diagnosed with generalized anxiety disorder and oppositional defiant disorder.
So if you have a diagnosis from early on and you’re placed on a psychiatric medication, that we have no idea of the long-range impact of how that’s affecting our kids neurotransmitters, where is the end road? If you’re placed on a serotonin reuptake inhibitor at eight, do you think that child has a chance of getting off by 18 or 25 or 30 when they might be trying to have their own baby, if we don’t take a root cause approach. And so this is … We’re taking that functional medicine integrative approach can really do such incredible work for our kids to either keep them off of medications or help them wean off of medications, if they’re already on them.
So one of the root causes is gut dysbiosis, our probiotics, so what some listeners may not know is that 80% or more of all the neurotransmitters in our body are made by the probiotics in our gut and that includes serotonin, which is our feel-good, relaxed, help us sleep neurotransmitter and dopamine which is our … the motivation and reward and attention neurotransmitter. So if your child is having anxiety or depression or attention problems, sensory issues, behavioral issues, we need to start looking at the gut and see how do we balance out our gut microbiome so that our … their gut is actually making the neurotransmitters that their brain needs.
We can also have yeast dysbiosis. Now, yeast is a big factor for many kids who have mental health and neuropsychiatric symptoms because yeast can create these alcohol byproducts that literally will make our kids act like they’re drunk. And we want to think about all the different ways that you have seen an adult get tipsy with alcohol, right? They might be incredibly giddy and manic and not focusing very well. They may angry. They may be sad and weepy. There’s … Or they may just have brain fog and not be able to concentrate. So all of these different ways that we see our kids acting sometimes, it could be a sign of having underlying yeast overgrowth.
Dr. Ron Ehrlich: Wow.
And we want to look, right? And we want to look at foods. I always look at foods to see which foods inflaming especially to the brain. And this is where gluten is especially neuro inflammatory. And celiac disease can show up in many neuropsychiatric ways without any gut symptoms. So looking to see what other foods our children may be sensitive to. For any child who’s having emotional symptoms, behavioral symptoms, it is very important to eliminate all the artificial dyes, flavors, or preservatives from their diet.
Now, some kids are going to be exquisitely sensitive to these. And you’ll notice an immediate effect and other kids not as much but we know that these artificial dyes, flavors, and preservatives can cause significant attention and behavioral problems in kids. And in fact, in the European Union, there are warning labels on every single food that contains these ingredients that, that food may cause attention and behavioral problems in the child eating them.
Dr. Ron Ehrlich: Mm-hmm. Yeah, go on, please, this is fantastic.
Dr. Elisa Song: Oh, yeah, and so a couple of other points too, when we’re thinking about nutrition, of course, when our kids are depressed or anxious, they may not be eating as well as we’d like to or they may not have been eating as well as we’d like to from the beginning. But we do want to look for nutritional insufficiencies that may be contributing and the two … especially, the three biggest areas that I look at for this are vitamin D.
Vitamin D is actually a hormone and it has profound impacts on our brain functioning and so important for mood regulation. And also, looking at magnesium, most adults and for sure, most children are deficient in magnesium. And magnesium is such a calming mineral. When your kids are constipated or tummy aches or muscle aches, that’s a sign of magnesium deficiency or insufficiency. But also sleep problems, worries, fears, those are all signs that your child likely needs more magnesium. Then, of course, we get the omega-3 essential fatty acids that we would get from our wild fish like salmon because that DHA and EPA, there are two omega-3 essential fatty acids that are found in fish oils both are so important in protecting the brain and reducing inflammation.
Then, finally, one of the last pieces that I’ll talk about at the BioCeuticals Symposium and Mindd … at the Mindd Conference is looking at chronic infections that may be triggering brain inflammation and other neuropsychiatric and mental health symptoms. And this is an area that is not as well known but there is a condition called the PANDAS, Pediatric Acute-Onset Neuropsychiatric Disorders Associated with Strep or PANS, Pediatric Acute-Onset Neuropsychiatric Syndrome where we know that certain infections can trigger either acutely or a little bit more subtly and chronically. This changes in how the brain is functioning and the immune response in the brain and create anxiety, OCD symptoms, tics, fears in our children, cognitive processing issues. So they’re not able to focus in school and their handwriting really declines other behavioral issues. And that’s an important area that I don’t want to miss.
If none of the other root cause approaches has helped, then I look for infections or I look for infections if parents tell me, “There was a change. My child went … had a flu-like illness and then ever since then they have been anxious or worried or not able to leave their room,” And sometimes it’s a little bit more subtle, we do have these sudden cases where we have these extreme rages and explosions of aggression and OCD. But other times, it’s just this gradual anxiety and cognitive problems, focus that is worsening and parents look back. And as I go through the history and we realize, “Wow, it … things really changed in fourth grade.” And if we can think about some time of fourth grade, it was after the flu in February. This is our winter in America. And then, ever since then, that was their worst school year and it hasn’t gotten better. So then, I’ll look for infections to see if that could be a cause.
Dr. Ron Ehrlich: Yeah, fantastic. Wow, what a great overview that is … but listen, another major challenge is technology. Since, I mean, you’ve got two young children-
Dr. Elisa Song: Oh, yes.
Dr. Ron Ehrlich: How old are your kids?
Dr. Elisa Song: Mm-hmm. My kids are eight and six and a half. So we have some technology but luckily, knock on wood, not too much just yet.
Dr. Ron Ehrlich: Well, we were talking as … Again, to Dr. Jodie Lowinger who runs the Sydney Anxiety Clinic and she was talking about some of the issues that are arising out of technology and the effect that, that is having on kids mental health. What’s your observation of that in a pediatric practice?
Dr. Elisa Song: I think technology is a huge factor. The two things that I really never leave an appointment with a child without talking about our … is screen time and sleep because I think those two factors if we can get a handle on those, in addition to the nutrition, we would get our kids thriving so much more fully. And with technology, there are several, different issues involved there. The fast-paced instant reward that you get playing video games has an impact on our adults and … But especially, children’s developing brain neurotransmitters, our children, and our adolescent brains.
When we look at the brain of the teenager, the teenage brain is going through as rapid a time of brain development, new neural connections and new sort of habits and synapses that are forming as an infant’s brain. It’s fascinating and so we want to look at this time, this preteen teenage time where our kids are getting engrossed in video games and screen time as a critical moment where if they’re focused on this rapid reward stimulation that’s affecting their dopamine response, they truly can become addicted to those screens. And also, set the stage for future addictions that are not screens and may be as harmful or more harmful than the screens that they’re on. So we have that particular issue.
And then, we have the issue that when they’re on their screens, they’re not having this social engagement and community and social media is not the same as engaging one on one or in a group and having that personal interaction and this community is so important. We know from the elderly that community is one of the biggest pieces in preventing Alzheimer’s but … And we haven’t looked at that factor in our teenagers and children as much but that community is so important for our developing brains and for their immune system and for their inflammatory responses.
When they’re on their screens, social media is one of the driving factors in anxiety and depression in kids and teenagers. And so, we really need to be aware what our kids are being exposed to, how they’re posting. And in fact, we are in this huge social experiment, you and I didn’t have the internet growing up. We didn’t have social media growing up, our parents, this generation of parents is so ill-equipped to understand how to help our children navigate this maze because we don’t know how to navigate this maze. In fact, I just had my daughter, eight years old yesterday tell me, “Can you please put down your phone and be with us at dinner.” And I was actually trying to take a picture of them so I can memorialize it on Facebook. Now, how is that, right?
Dr. Ron Ehrlich: Yeah, well even … well, modeling is a very important part of dealing with this issue, isn’t?
Dr. Elisa Song: Very important, very important, right? And then, we have the other … the Wi-Fi issue. And I’m also very concerned about the exposure to electromagnetic frequencies for our children’s brains and for their immune systems and for their cellular health. We know, our cells vibrate at very particular electromagnetic frequencies and when they’re bombarded by these external frequencies from cellphones and from our Wi-Fi systems in our homes, in the office buildings that we can’t escape, it does something to how those cells function. And I think that this EMF, electromagnetic frequencies are one of the biggest drivers for why our children’s immune systems aren’t responding in the way that they should.
We don’t have more strep around, we don’t have more infections around per se but the way our children’s immune systems are responding to those infections are different. And so, we have this concern with the EMF. And then, I also have this major concern with how EMF and the blue light from screens are affecting our children’s sleep. Our teenagers are up all night doing their homework which is another issue that we could go on and on about. But it is impacting … it is shutting down their melatonin, tricking their brains into thinking that it’s daytime and not allowing their brains to get that restorative sleep. And I want all parents and children to understand that it is in sleep that our body and our brain heals. And it’s in sleep that our brain learns and retains memories. It’s in sleep that our children grow and release growth hormone and our bodies detoxify.
So if we don’t prioritize sleep, we’re not getting in probably the vast majority of the healing and restoration, rebalancing that our body needs to stay well.
Dr. Ron Ehrlich: Wow, that is just a brilliant overview, thank you, that’s terrific. Listen, another topic, just very quickly because vaccinations is such a … it’s such … so controversial.
Dr. Elisa Song: It is.
Dr. Ron Ehrlich: People feel so passionate one way or another. When … And you must have this all the time patients coming in saying, “Doctor, what should we be doing?” What do you say the people who are concerned about this issue?
Dr. Elisa Song: It’s so tough because I know in Australia as in the US, parents used to have the right, this is in California where I live to really come up with their physician, their practitioner a vaccination plan that really was individualised. We don’t have that ability anymore unless you have a medical exemption for a vaccine. But I would tell parents, “Don’t … Whatever you do, do not make your decision based on fear.” There are too much fear and anger and emotion on quote “both sides of the issue.” And I say quote “both sides” because there shouldn’t be a side. What I tell parents is that I am neither 100% pro-vaccine or 100% anti-vaccine, what I am 100% is 100% pro-safe vaccine and 100% pro-child.
And what that means is acknowledging that any medical intervention, whether it’s a vaccination or a medication we’re giving to a child that any medication can have side effects and can have serious adverse side effects. And there’s no intervention that is either 100% safe or 100% effective. There is a book by one of my friends and colleagues, Dr. Paul Thomas called The Vaccine-Friendly Plan that I think is a great book to start with. There’s tons of research there to really help parents identify which child might be at risk for having these serious, adverse reactions.
And by that, I don’t necessarily mean a sore arm, I mean the ongoing perhaps neurodevelopmental concerns and autoimmune concerns that we can see in the literature theoretically exist and can exist. And I’ve seen patients who have been harmed but that is not all kids. I do want parents to understand that most kids will get vaccines without any immediate, adverse reactions. And I say immediately because Dr. Yehuda Shoenfeld is a researcher who has identified the syndrome called ASIA, A-S-I-A, autoimmune syndrome induced by adjuvants or autoimmune/autoinflammatory syndrome induced by adjuvants, recognizing that there are some adjuvants like aluminum in vaccines that can trigger autoimmunity in susceptible children.
And here’s the rub, how do we know who’s susceptible, right? This where this whole field of epigenetics and understanding how these very small changes in our DNA can affect how we detoxify various medications and pharmaceuticals and how our immune systems will react to certain stimuli can really help us create this whole new field of pharmacogenetics and vaccinogenetics and really personalized medicine to know, “Well, this child is more risk for having serious harm from this particular intervention but not from this intervention.”
Now, I will say that in working with children who have a chronic illness, the kids that I see who are more at risk, potentially, for vaccine reactions and serious vaccine reactions are those kids who have underlying mitochondrial and methylation issues. And these are children who we may have a family history of chronic autoimmune illness, mental health concerns, cancers, early heart disease, even if they don’t have any of these concerns themselves. And of course, at birth or a two-month-old baby who is facing their first series of vaccines, we don’t have a history on them per se but we do have family history to guide us.
But as kids get older, mitochondrial signs may include having low muscle tone. Perhaps, their suck wasn’t as strong when they were nursing or taking the bottle or when they’re sitting up, their posture as a toddler should be completely perfect. You look at these toddlers with perfect backs but these are toddlers with … who may have hunched back, sitting a little slumped, not able to sit … crisscross applesauce or have a poor pencil grasp or sitting in what we call a W-position where they’re sitting on their bottoms and their legs are splayed out in the W to the sides of them.
And so, if I have any of these warning signs that this child may have underlying mitochondrial or methylation issues, it doesn’t mean that vaccines are completely off the table but it means that I would like to support this child’s body and immune system with things like Methyl B-12 for methylation support, CoQ10 for mitochondrial support and glutathione for detoxification support. And I do use homeopathy so I would also include homeopathic thuja to really help ensure that this child’s body is functioning as well and optimally as possible so that they have the response to the vaccine that we would like them to have and no adverse reactions.
Dr. Ron Ehrlich: Wow, so really, I mean … And preparing our child’s immune system for this vaccination is critical, isn’t it?
Dr. Elisa Song: It is.
Dr. Ron Ehrlich: Or making sure there are in as good a shape as they can be before we give them these vaccinations.
Dr. Elisa Song: That’s right, that’s right.
Dr. Ron Ehrlich: That’s terrific. Listen, we’ve covered so many … so much territory here. What would … If we left out now, our listeners just had this a-ha moment and thought, “This is just so good. There’s so much here.” How do I get started? What are two or three or four tips that you would leave our listener with to … What’s the message that you would our listener with?
Dr. Elisa Song: Yeah, I’m so glad you’re asking this because when you listen to podcasts and sort of go through different articles, it can be very overwhelming to know where do I start? Is … I can’t do it all. And that’s absolutely true, you cannot do it all but you can start step by step and make incredible strides that way. And so for parents who are really wanting to take the step for it and understand how to help their kids thrive holistically: body, mind, and spirit, there are some simple steps that they can start with.
So the first step is really thinking about how am I going to nourish my child’s gut immune system connection? And that’s going to be focusing on a whole foods diet, really trying … not trying to be perfect but trying to reduce the amount of processed, packaged foods, getting out those foods with artificial flavors, dyes and preservatives, trying to get in that rainbow of fruits and vegetables as much as possible and nourishing their gut with those fermented foods.
We haven’t talked really about fermented foods but fermented foods are really the best way to get in the probiotics into your child. And if your child does not yet have a taste for fermented foods, and I say yet, because children can develop a taste for fermented foods, we just keep trying but you can supplement with probiotics but getting in some miso soup or kombucha or kefir, sauerkraut. There’s so many different ways to get in delicious fermented foods to really nourish that gut immune system connection in your child.
And then, the second piece would be thinking about how do I nourish and nurture my child’s gut-brain connection? And this, again, is with those fermented foods and probiotics but it’s also really thinking about slowing down, not over scheduling. This is so important and I need to remind myself this all the time. Many parents look to me and say, “Well, you’re a holistic pediatrician and you’re a holistic mama, how do … what do you do?” And I let them know, it is a daily struggle for me to try to slow it down for myself and for my kids, right? It’s not easy in this day and age but it has to be a priority.
We need to minimize that screen time, at least an hour before bed, shutting down their screen. Or if your children … are days where need to get a project done on their computer for homework, then having an amber, blue light blocking glasses or there are various apps that you can download on to their screen so that the light dims to an amber color, so it doesn’t interfere with their melatonin production, prioritizing sleep, ensuring that kids are getting adequate sleep, which means for most kids … teenagers eight to 12 hours. Some teenagers need more sleep than children. And for younger kids trying to get at least 10 to 11 hours of sleep. Of course, that varies a little bit by age and by individual child but most adults don’t get enough sleep, most children don’t get nearly enough sleep.
Finally, we need to understand ourselves, how to manage our stress and practice mindfulness, so we can teach our kids the same things. This is so important. Our kids are facing stressors every single day, wherever they are. And stress, what I tell parents is that stress is not a negative per se. Life is not life without stress. And we wouldn’t appreciate the beauty and wonder what … of life without having the stress in our life and some of those negative experiences. It’s how we manage those experiences and manage our stress and come out the other end more resilient and more able to handle life in a productive happy, peaceful way that is going to help our children be resilient and thrive.
So, I do give various tools because this is where we need concrete tools. We can’t just tell parents, “Go out and do yoga and meditate,” because that means very little when you don’t know how to in the first place. And so, there are books that I recommend for kids. One of my favorite authors, she’s actually at this point now, a good friend and a colleague but she’s a child psychologist, her name is Dawn Huebner, spelled H-U-E-B-N-E-R. And she has a whole series of what to do books for children, to teach some cognitive behavioral tools to manage their worries or their fears. And one of my favorites is What To Do When You Worry Too Much. She has over … a book for older kids called Overcoming or Outsmarting Worry.
But she also has books called What To Do When You Dread Your Bed or What To Do When Your Temper Flares or What To Do When You Grumble Too Much. So teaching our children how to help themselves. It’s not our jobs to make our children happy all the time. It is our job to help children understand how to create that happiness for themselves. And then, there are a variety of apps too. And one of my favorite right now, at the moment, is called Breathe For Kids. So giving concrete tools but that is probably now as I’ve been a functional medicine practitioner and holistic pediatrician for over 10 years now, this piece of showing our children how to manage their stress and practice mindfulness is going to be the ultimate piece in keeping our kids well and healing them if they do have chronic illness.
Dr. Ron Ehrlich: Elisa, this has been such a treat to talk to you. There have been such … so much information here. We really appreciate the time. I hope you enjoy the rest of your visit to Australia and-
Dr. Elisa Song: Oh, thank you.
Dr. Ron Ehrlich: … I’m sure you’ll come back again and I’m looking forward to catching up with you at the Mindd Conference.
Dr. Elisa Song: Yes, for sure. And thank you so much for having me on your show.
Dr. Ron Ehrlich: See how important the gut is? See how important sleep is? And what about slowing down, going back to that great episode we did with Dr. Jodie Lowinger, episode 25 on mental health. I recall she mentioned two keys to managing mental health issues: managing expectation, expectations, and modeling behavior, particularly, when it comes to technology but also, I guess, in how we sleep, breathe, nourish, move, and think. It’s a message for our kids. It’s a message for ourselves. And so many of my guests have recognized as surely we all do that slowing down is such an important part of managing our lives.
Now, I’m not preaching, believe me, this is aspirational for me. It’s what I love about doing this podcast. I’m learning and reminded of so much that helps me. I hope it’s helping you too. Life is a bit like tapping a hoop along the aim is to keep it balanced, tap too hard and it gets away from you, stop tapping and it falls down, but just getting it right keeps it and our lives balanced, so profound.
We will have links to Elisa’s fabulous Healthy Kids Happy Kids blog. That’s www.healthykidshappykids.com where she shares her expertise with parents everywhere and that includes Australia. And whether you have a kid or not remember, just as kids are the canaries in the coal mine, what’s good for them is invariably good for you.
I hope you enjoyed today’s episode. If you’d like any other topics covered or guest interviewed, send me a note. And while you’re at it, help me spread the word and leave a review on iTunes. So until next week, this is Dr. Ron Ehrlich, be well.
This podcast provides general information and discussion about medicine, health, and related subjects. The content is not intended and should not be construed as medical advice or as a substitute for care by a qualified medical practitioner. If you or any other person has a medical concern he or she should consult with an appropriately qualified medical practitioner. Guests who speak in this podcast express their own opinions experiences and conclusions.