Dr Leila Masson on Children’s Health A to Z, Asthma, Eczema, ADD, Fussy Eating and more

Dr Leila Masson, an integrative pediatrician, joins me to chat about the world in which we live and its impacts on our children's health environmentally, nutritionally, emotionally and on so many different levels. We chat about Dr Leila Masson's book "Children's Health A to Z, Asthma, Eczema, ADD, Fussy Eating and so much more.

Dr Leila Masson on Children’s Health A to Z, Asthma, Eczema, ADD, Fussy Eating and more Introduction

Today we are revisiting one of Australia’s, in fact, I would say one of the world’s leading pediatricians, Dr. Leila Masson. And Leila is an integrative pediatrician.

And you know what I’m often asked, what is a holistic dentist and a holistic dentist is aware that there is a body attached to the mouth we are working on and the pediatrician whose integrative recognizes that the world in which we live impacts on our child’s health environmentally, nutritionally, emotionally, on so many different levels.

So this is an opportunity, we cover so many different issues here that are relevant, whether you have a child or not, are relevant to us all. And if you have a child, if you have a family, this is a great opportunity to update your knowledge and get advice from really one of the best. I love talking to her. I hope you enjoyed this conversation I had with Dr. Leila Masson.

Podcast Transcript

Dr Ron Ehrlich [00:00:07] Hello and welcome to Unstress. My name is Dr Ron Ehrlich. Before we start, I’d like to acknowledge the traditional owners of the land on which I am recording this podcast. The Gadigal people of the Eora Nation and recognize their continuing connection to land waters and culture. I pay my respects to their elders of the past, present and emerging.

Well, today we are revisiting one of Australia’s, in fact, I would say one of the world’s leading pediatricians, Dr. Leila Masson. And Leila is an integrative pediatrician.

And you know what I’m often asked, what is a holistic dentist and a holistic dentist is aware that there is a body attached to the mouth we are working on and the pediatrician whose integrative recognizes that the world in which we live impacts on our child’s health environmentally, nutritionally, emotionally, on so many different levels.

So this is an opportunity, we cover so many different issues here that are relevant, whether you have a child or not, are relevant to us all. And if you have a child, if you have a family, this is a great opportunity to update your knowledge and get advice from really one of the best. I love talking to her. I hope you enjoyed this conversation I had with Dr. Leila Masson. Welcome back to the show Leila.

Dr Leila Masson [00:01:36] It’s such a pleasure to be talking to you again. Ron.

Dr Ron Ehrlich [00:01:39] Listen. Well, it’s always a pleasure and we’ve had such great feedback. And of course, just some months ago, I spoke to Jeffrey Mason, your husband, and this could almost become the Jeffrey and Leila show. But anyway, it was great to speak to him.

And it’s great having you back, Leila, as a pediatrician now, well, let me take a step back from that. We’re told so often that when there’s an epidemic of chronic degenerative diseases like heart disease, cancer, autoimmune diabetes, and it’s often dismissed as well. We’re getting old. You know, what do we expect? The population is aging. So I thought this was a great opportunity to touch base with you as a pediatrician and say, well, how are kids doing?

Dr Ron Ehrlich [00:02:25] What’s your response to that? What are you seeing on a daily basis?

Children’s Health

Dr Leila Masson [00:02:30] Well, that’s a really interesting question. It brings up two points. First of all, that all of those diseases of old age actually start early on. And whatever a child experiences in terms of nutrition and environment and stress in early life has an effect on their lifelong health.

So if a child is born malnourished because of intrauterine growth retardation, where they don’t get enough nutrition in utero, that will affect them and increase their risk of having high blood pressure and heart disease later in life. So for me, as a pediatrician, I always think my main of course, my job is to help children who are sick. But I think my main job is actually to educate families on how to keep their children healthy so that they will be healthy, lifelong.

Dr Ron Ehrlich [00:03:21] Well, that is one of my questions right at the end, how to keep our kids healthy. And it’s so interesting to say that because we do hear the statement show me a child at seven and I will show you the adult. And it’s often thought of in terms of the mental attitude and health that this he was saying. It’s it goes right across the board fundamentally.

Dr Leila Masson [00:03:45] Yeah. I mean, I think in terms of physical health, that’s definitely, you know, clearly shown, I think in mental health. I mean, obviously, there are some predispositions, but I see so many difficult children and they don’t turn into difficult adults necessarily.

I think a child still goes through so much brain development and, you know, certain parts of the brain not immature and therefore impulsive and selfish and all of the things that does not mean they’re going to be like that as adults. I always tell the parents because sometimes they think, oh, my God, what is my child going to turn into? And they’re often they’re not very nice, but not to the other point of your question is that we have a real epidemic of childhood illness as well.

In particular, we have more allergies, more asthma, more ADHD, more autism, more autoimmune disease, all of those are going up and even overweight and obesity is now becoming a huge issue and, of course, affects the lifelong health.

You know, if you are going to have already metabolic syndrome at 12, it’s really, really hard to make sure that you’re going to be healthy for the rest of your life. So it’s there are clear underlying causes that have to do with lifestyle and always sound so simplistic. And I think sometimes people discount it because it is too simple.

You know, if you eat a healthy diet, if you sleep enough, if you keep away from environmental toxins and a lot of them, you actually have control over people who say, oh, my God, the world is so toxic there’s nothing we can do about it. It’s not true. The main toxins you have control over. And if you lead a healthy lifestyle of exercising enough, you know, and not just enough, maybe a bit more than enough and stay away from screens have not fallen into that trap of the sedentary lifestyle that so many kids are getting into now.

Kids now spend half the amount of time outdoors playing compared to their parents. And already their parents were more sedentary than the grandparents. So it is simple and basic, but it really is what we were evolved to live like.

Dr Leila Masson [00:06:02] We were evolved to live like hunter-gatherers, and we are living a completely different lifestyle now. So clearly that’s going to have an effect on our health. But in addition to that, it gets a little bit more complicated and maybe a bit more sexy if you want, and then just that.

But for example, I mean, one, if any interesting recent study that I read was about the interaction of BPA, the CNRA, which is a plasticizer, and autism and there have been studies now for twenty-five years showing that environmental exposures increase the risk of a child developing autism. And that’s been kind of two camps. The camp that said, no, it’s all genetic, but they haven’t actually found a gene.

They found different combinations of genes, maybe, but there was not one gene that really apply to many people. It’s obvious just to a few families. And then they were the people say it’s really the genes, maybe load the trigger, but it’s the environment that shoots the gun. So, and this study showed how they actually combine how they work together.

So it showed that people may have genes that when the child is exposed to BPA in utero, those genes get turned on and then cause autism later. So they make that toxin and actually affects the way the brain develops, and I find that fascinating because that’s really the research we need.

I mean, it’s not a matter of turning off those genes. I mean, maybe one day we will we’ll be able to do it. But we don’t also know what else happens if you turn off a down genes. But the message is we need to really take those environmental toxins seriously. And BPA has been banned from many things, like from baby bottles, because we know it’s not good for babies’ brains.

Maybe we didn’t quite understand how it worked and it can affect the thyroid as well, which is incredibly important for brain development. But we know it’s toxic and there are many, many studies. The interesting thing about BPA studies, actually, I find that fascinating, is that of all the studies you look at, all the studies that have been done, many show it’s not toxic.

Dr Leila Masson [00:08:23] But if you look at the studies that are not done by the plastics industry or anyone involved in making money out of BPA, all of them show that it’s toxic. So all of the studies done by universities or independent environmental agencies, I think I’d let show BPA is toxic to children’s brain development.

So we need to avoid environmental toxins. And it’s. Many, many families are aware of that, but too many are not. And I think that’s one message that really needs to go out there, that we can do a lot by avoiding plastic and fly sprays, pesticides, all of those toxins that affect the brain.

Alcohol, of course, there is no safe level of alcohol in pregnancy, actually, not in the rest of your life either. But at least let’s take that very seriously for pregnancy and smoking. So, and internal fire in the house, fireplaces, are very toxic for children’s lungs. Its small particles go into the lungs and the brain is not a good thing. And those things we have total control over.

Dr Ron Ehrlich [00:09:31] Yes, cause you’ve raised some issues there. I mean, the issue of this confusing public health messages where some experts tell us that something is safe and other experts tell us they’re not. And this is a story that is very easy to miss. But once you hear it difficult to ignore, and that is the role that industry plays in reassuring us that their products are safe and yet independent products to independent research shows.

Otherwise, tell us let’s just take a step back on the autism as an example because the trends in autism over the last twenty-five or thirty years have been quite shocking. Can you just share with us what has been going on there?


Dr Leila Masson [00:10:18] Yeah, it is a really shocking story. So when I did my pediatric training 30 years ago in San Francisco in four years, I saw one child with autism it was not a thing then. But soon after, about twenty-five years ago, twenty-four years ago, the epidemic really started. And people we still don’t know exactly why, but clearly it has to have an environmental major component because our genes haven’t changed in the last 30 years and someone in two thousand five hundred, which was a very generous estimate then.

Some people say one in ten thousand, but let’s say one and two thousand five hundred at the time. It’s now one and fifty-four children. And the numbers are going up. Every time there’s another study done, it goes up a little bit. So it’s very scary.

So that means like almost two percent of children these days have a diagnosis of autism and autism, you know, I mean, I’m all for the idea of neurodiversity, but I see the children as really severe autism. And it is hard if a child is unable to communicate and screams of pain and doesn’t sleep all night. And it’s not a fun thing to do.

So I think whatever we can do to reduce the risk of children developing autism is a good thing because it’s a whole body. It’s not just a slightly different brain you can have. Yeah.

Dr Ron Ehrlich [00:11:54] What do you say to people that say, that’s a shocking statistic? Is it because our definition of autism has expanded and now it’s including a lot more children that otherwise would previously not have come under that. What do you say to that criticism or that statement?

Dr Leila Masson [00:12:15] That was investigated. Because people, of course, at first said, oh, it’s all over-diagnosis, early diagnosis. And yes, there is more diagnosis. Yes, there is earlier diagnosis.

But there is also a real increase, definitely that those studies have been done and shown. And if you, I mean, just one simple thing. If you look at 40-year-olds, you don’t see a lot of people. You don’t see two percent of people who cannot communicate and are basically in care because they cannot function and can’t do anything for themselves.

So, and maybe not all children with autism are at that level. But if you would know if there was such a huge, huge population of adults severely affected and we don’t have that. So I think it is a true increase.

There is a broader definition. But on the other hand, I mean, we used to have that diagnosis of Asperger’s, which was a diagnosis of autism, and that’s that name has been taken out partly because it’s turned out to was the Nazi so not sexy anymore and so good we don’t have that anymore and we have now high functioning autism instead. And those children that function OK, a lot of them do quite well.

A lot of them have very strong interests and very technical interests and maybe. Become a professor of engineering or something like that, but, you know, it is having a strong interest is not as much as having high functioning autism. People joke about that all the time. Oh, yeah, the father’s an engineer and he doesn’t make eye contact, but that’s not autism. So we have a lot more cases affected, more children and families affected these days in the system.

Dr Ron Ehrlich [00:14:12] Now, you mentioned metabolic syndrome because I know part of that is that the blood, the white blood sugar is in diabetes type two used to be referred to as late-onset diabetes. That term is no longer appropriate. I mean, what are we seeing in children? Are we seeing this in children?

Diabetes for kids

Dr Leila Masson [00:14:32] Yeah. I mean, 30 percent of children in the United States are now overweight or obese. And Australia is following closely behind. I mean, in terms of adult obesity, we are just as bad as the United States here. So imagine children are too. And I mean, it’s clearly what we were doing to ourselves.

It’s the food we eat and it’s the lack of exercise. And yes, the environmental toxins will also have an impact. But if you eat, you know, we fix for breakfast and pancakes and then a chicken sandwich for lunch and a pizza for dinner you are going to get and well because these are not foods that actually give us nutrients, they give us calories, far too many calories. And they actually have additives added to them that make you more hungry. So you want to eat more and more.

Whereas if you ate at least five servings of vegetables, I would say serving us food fits in your child’s palm on your palm. And only five percent of Australian eats five servings of vegetables. So if we are eating junk and the government is not helping, I have to say, you know, they have nice projects and programs for losing weight and educating people.

But on the other hand, on a policy level, they are allowing companies to sell this junk food. And my 19-year-old son was super smart. We just dropped them off at Melbourne University in second year. And he said to me, you know what, the government spends money to fight this preventable Covid.  It’s well spent.

Absolutely, but there are other preventable diseases that they’re not spending any money on, they could just say, you know, you cannot eat this food or subsidize vegetables and give money so that families can actually eat healthy food instead of the cheap junk that everybody eats.

Dr Ron Ehrlich [00:16:35] Yes. Well, we did a program at the end of last year with the Australian of the Year, Dr. James Muecke, and James was championing diabetes, type two diabetes and had a revelation that perhaps the Australian healthy eating guidelines, as they are referred to, they used to be the food pyramid and then the food plate, but are not perhaps as good as they could be.

Dr Leila Masson [00:17:03] I think the healthy eating guidelines and most countries I mean, Americans are always the main ones, but everybody looks at them kind of the second version of that. It is many, many different lobbyists getting together, trying to get their share of that plate or the pyramid. And it’s the dairy lobby. It’s a meat lobby. It’s a grain lobby. It’s a nut lobby.

I mean, a few years ago, I went to a conference where someone was giving a lecture on how healthy nuts are, in particular walnuts. And it was the first time that nut and seed had been actually included in the pyramid. And someone said, do you know why? It’s because the nut lobby was included for the first time in the negotiations. And I mean, I like nuts and they’re healthy, but it’s, based on science saying these are the things we should really eat that are healthy for us.

It is people really fighting over giving more money to be included. And, you know, the pyramids and the recommendations have changed over the years. And they are a little bit better. But they’re still not great, are they? I mean, we know that we could do better.

Dr Ron Ehrlich [00:18:15] Yes. Well, that’s interesting because, as you say, we know because we are involved in nutritional and environmental medicine. But for the well-meaning practitioner who hasn’t got time, doesn’t make time to explore these, they look to the government for advice and that’s where it starts to go wrong. Tell me, ADHD is another one that we see quite a lot of. How is that diagnosis made? I just. Yeah. How is the diagnosis made?

Attention Deficit Hyperactivity Disorder (ADHD)

Dr Leila Masson [00:18:45] I mean, it’s considered kind of the bread and butter of a pediatrician these days because 10 percent of children get a diagnosis of ADHD. And so the diagnosis is made on behavior so that checklists and the teachers fill out and parents fill out. Both checklists agree that the child is either hyperactive, impulsive, not paying attention, not getting work done. All of those things, that’s, you know, long list then the child gets a diagnosis and then the next step is if you have the diagnosis and you get a drug.

Dr Ron Ehrlich [00:19:20] Right.

Dr Leila Masson [00:19:21] And I see a lot of families to say that’s not the approach we want. We want to actually look at underlying causes. We want to see why is our child like that? Is there anything we can do? And I would say ninety-nine percent of the time there is something you can do to them. And many, many children have nutritional deficiencies.

So for example, iron deficiency, if you are iron deficient, your brain will not function as well as it would if you had good iron levels. And iron deficiency is common amongst children because hardly they eat junk and the junk interferes with the absorption of iron. So even if they eat a high iron diet, they’re not absorbing it.

Then there are other things like zinc deficiency, soils in Australia are quite low in zinc. So even if you eat a healthy diet, you may not get enough zinc during periods of fast growth. So many child is growing fast, which they do throughout the childhood, and they need maybe more zinc than they can get from their diet. And I always look for children’s white spots on their fingernails.

That’s the kind of indicator that they may be low in zinc and it does affect brain processing, the speed. So the children who are actually quite smart, but they’re just not processing and therefore lose focus and attention often the ones and those are also the kids who are irritable and easily frustrated, then there is a lot of research on just food additives and the effect on ADHD type behaviors.

So children who eat like the orange coloring 102 or the preservatives like 202 or I mean, there’s a long, long list. I have those lists on my website for people interested and that they interfere the focus, attention, behavior, even the fine motor skills and then there’s beautiful studies done where they film two groups of children having a birthday party and one group gets an orange drink that contains 102 and 202, so the orange coloring and the preservatives. And the other group gets a drink that looks the same, taste the same but doesn’t have those additives.

The group that has the additives within half an hour they are at each other’s throats. They are fighting, they’re uncoordinated, they are irritable. When they give them drawing exercises, they can’t draw they can’t even do a Roly-Poly anymore. And the other group that got a healthy drink is playing nicely during all the party games. And they will coordinate and they are happy. And I bet you, most parents have had their children returned from birthday parties said oh, my God, I’m not going to send my child to another birthday party that climbing the walls afterwards. And it’s the food that they get them.

So that’s really, really interesting and then, of course, our sedentary lifestyle and lack of exposure to nature. There’s a whole new area of research called nature medicine where exposure to natural settings, the effect of that on the brain is studied. And I love Richard Louv, he wrote a book called The Last Child in the Woods, and he coined the term nature-deficit disorder, NDD instead of ADD. And now we have beautiful research showing that if a child goes for a walk in the woods or in a park or even by the beach for half an hour, it increases their focus, increases their attention, calms them down, increases their ability for creative problem-solving.

So it’s all-around positive for them. There’s nothing negative. And some of them more progresses schools actually taking that into account and with their students, they send them out if they have a field. I mean, let’s be in Australia, New Zealand. We have schools that have lots of green around them. It’s not the same where I’m from, I’m from Berlin. And a lot of schools are just concrete blocks with a little concrete courtyard.

But, you know, if you can send the kids out into nature, it will help their overall mood behavior focus attention. And we should have at least an hour a day of that. And who gets it? You know, I mean, a lot of parents tell me we just don’t have the time. And I said, you know, your life will be so much easier if you just take the time. Let’s say, even if you don’t have an hour, half an hour after school, instead of coming home, take your children to the park and let them run around.

Dr Ron Ehrlich [00:23:55] One of the things talking environmentally, you know, we both, we bump into each other at the beach. Let’s say we know this. I often see parents approach the beach from very different perspectives. They’ve got those kids that are playing in the sun, in the sand, and all this. And I’ve got other kids that are covered from head-to-toe rash tops, hats, plastered on with sunscreen. What do we say to that?

Dr Leila Masson [00:24:25] Well, we do have to be careful on the southern hemisphere, especially Australia and New Zealand with sun damage. So I do agree that we have to protect our children’s skin because you see the people who grew up with that sun. I mean, nobody has grown up with the amount of sun UV that we have now.

It’s getting worse over time. But even people who grew up in Australia are now in their 60s and 70s. They get melanoma at the highest rate in the world because they had too much sun exposure when they were young and they got sunburn.

So we have to avoid sunburns at all cost. On the other hand, we do need some sun exposure because you need vitamin D when the sun hits your skin, your skin produces vitamin D and vitamin D is very important for your immune system, you get less infections, your allergy symptoms go down. So the kids with the lowest levels of vitamin D have the highest rates of asthma exacerbations and the worst eczema. So just making sure the vitamin D is optimal helps with those kind of allergic diseases.

It’s also important for the brain, for your mood, for your behavior. So children with low vitamin D or even adults get that seasonal affective disorder where they get irritable in the winter. We don’t have a terrible winter in Australia. But I do check a lot of children’s vitamin D levels. And in the winter, the only children who have sufficient vitamin D are the ones who take supplements. And sufficient is a little bit different from deficient. So the labs say below 50 is deficient, below 80 is insufficient. So you really want it above 80. And that’s not easy in the winter because in the winter the sun is at an angle where it doesn’t produce enough vitamin D in the skin, so unless you’re out a lot and of course we talked about that, nobody’s out a lot.

So the kids who are out a lot in the summer have really good levels in the summer they go to 150, 200 just on being at the beach and running around and then that slowly goes down through the winter. But I really see kids who have such high levels in the summer.

I mean even in the summer, I mean it may be the kids that I see because obviously, I see kids with issues, but I rarely see a child with such great levels in the summer. So they start out at 80 in the summer and then in the winter it goes down and then it will be very quickly in the deficient range.

So, yeah, I think my recommendation is always to get the app called the D Minder and that app knows where you are. So it knows how strong the sun is, it tells you the UV score and then it tells you how long you should be in the sun safely to get the amount of vitamin D that you need and that takes into account, your age and everything so you can put everything in it, it’s fantastic. And before nine a.m., after five p.m. in general, the UV is at a safe level. So even if you just let your kids run around, make it at those times and then slip, slap, slap them the rest of the time.

Dr Ron Ehrlich [00:27:35] Yeah, yeah. Another one is gut microbiome and its effect. And we did a show about a year or a little bit more than ago about PANDAS. Just give us a quick 101 and refresher on PANDAS and about the importance of it and gut microbiome.

Pediatric Autoimmune Neuropsychiatric Disease Associated with Strep (PANDAS)

Dr Leila Masson [00:28:00] Yeah, two huge topics, two of my favorite. So PANDAS is Pediatric Autoimmune Neuropsychiatric Disease Associated with Strep. Now there is a new term called PANS, Pediatric Acute Neuropsychiatric Syndrome. And that newer term takes into account that it’s not just associated with streptococci and that it may not be an autoimmune reaction, but just a misguided immune reaction.

But the research shows that it may be kind of broader than just autoimmune. But what it is, is children who were perfectly fine had then maybe a sore throat or a chest cold or some other kind of infection, and sometimes it’s a toxic exposure rather than an infection have an acute onset of OCD behaviors, so washing their hands 100 hundred times, being completely compulsive about cleanliness or obsessed with a person anxiety and also separation anxiety.

So they often develop a phobia of school because they just don’t want to separate from their parents and other symptoms. So that can be tics, so like eye blinking or funny movements, it can be a stutter, it can be a new onset of bedwetting or accidents during the day when they had been dry before,  a change in handwriting is very typical. So kids who have normal handwriting and withdrawing beautifully suddenly can’t do it anymore. And this comes from inflammation in the brain and the basal ganglia.

So whatever the immune system is doing to fighting the infection causes inflammation in the brain and these kids are very severely affected often and very suddenly so that sudden onset is a clue. And the treatment is to reduce inflammation, so the first thing is to give three days of Nurofen actually just plain Nurufen for three days, three times a day, you don’t want to give it long term because it can affect the stomach, but for three days it’s safe. And you want to see whether just by reducing inflammation, the child’s less anxious, less OCD, less tics. And that is kind of like a test and now there are more of a kind of stronger version would be to give some steroids like maybe something like that, what kids get when they have bronchiolitis, for example, or asthma.

But we start with the Nurofen. And then trying to figure out what was the cause and treating it. And often it is strep and giving an antibiotic actually cures those children. Now, I have seen, I don’t love antibiotics, I have to say, I try to avoid them because we are overprescribing antibiotics and it affects our microbiome but we’ll get into that in a minute.

But in this case, I have seen children who had been admitted to psychiatric closed units for months and treated for mental illness, also another very typical symptom is anorexia. So these children don’t eat, they lose their appetite and they get treated for anorexia nervosa, but in fact, they have PANS. And when you give them a course of antibiotics, they lose all the symptoms they’re fine again. So in this case, I think the antibiotics are much, much safer than having a child taken away from their parents and put into a closed unit, I mean, can you imagine the trauma of that in itself?

Dr Ron Ehrlich [00:31:37] Shocking.

Dr Leila Masson [00:31:38] So I think we need more awareness of PANDAS so that general practitioners and even psychiatrists who see children like that realize that maybe it’s not a mental illness, but an immune disorder. So that’s my short 101 on PANS.

Dr Ron Ehrlich [00:31:58] That’s good.

Dr Leila Masson [00:31:59] And there is a good Facebook group on PANS and I’ll give you those to the study notes. And then microbiome, which kind of has something to do with PANS but is also much, much broader. So just like with everything, when you think about how we evolved, we evolved to eat probably a hundred different types of fibers a week and probably at least 10 to 20 servings of fibers a week, of vegetables and roots and mushrooms and nuts and seeds and fruits and all of those things, and now five percent of the population get their five servings.

So it’s really, really we’re not eating what we need to feed our microbiome because fiber is something we as humans cannot digest, we lack the enzymes for that but the gut flora digests the fiber and thrives on that. So if you eat fiber, you’re growing a microbiome that’s healthy, that likes fiber, where if you eat sugar and white flour, then you’re growing a gut flora that loves sugar and white flour and actually sends messages to your brain to eat more of that. And those bacteria that love sugar and white flour are things like yeast and Australia and bad cops that we don’t want a lot of. And it also doesn’t create a diverse microbiome.

One of the biggest markers of a healthy microbiome is how much diversity you have, we want at least 500 different kinds of bacteria and we are losing diversity with every generation because our diets are becoming more and more narrow. So if you have a healthy microbiome, it’s a very good predictor for long-term health. You will have less inflammation, which of course, in the end, is the basis of every illness.

If you have inflammation in your brain or in your joints, or in your heart or wherever it is in your arteries, that’s what causes the illness, in the end, no matter what is causing it and having a great microbiome reduces that inflammation, so you are going to be healthier. And the foods that create a good microbiome, so let’s say nuts and seeds, they also give you other nutrients that are really important and that we’re lacking as a society.

So magnesium, magnesium is one of my favorite minerals because it is calming, and I just, you know, just giving kids magnesium ideally in the foods, the nuts and seeds, and vegetables, but, you know, if that’s hard, then you can put a magnesium salt in the bath and gets absorbed to the skin and they sleep better, they’re calmer, they’re happier, they’re not longer get the sore legs, you know, I have so many kids who come in and their parents say, my child has growing pains.

And I say that growing doesn’t really hurt, it’s not the growing, it’s your child has actually magnesium deficiency and has slight muscle spasms all the time that hurts, it’s really bad pain. But if you have enough magnesium in it, then you don’t get that. So just doing that one thing, getting kids to eat their handful of nuts and seeds every day can make such a big difference.

Dr Ron Ehrlich [00:35:27] Well, I mean, you know, gosh, we’ve got vitamin D, we’ve got iron, we’ve got zinc, we’ve got magnesium. You know, we haven’t even talked about selenium is part of the deficient soil as well, I’m sure it plays a very important role somewhere. It’s so interesting, isn’t it? Because we hear so much about mental health, child mental health, and we’ve touched on ADHD and autism.

But of course, there’s depression and anxiety and people are just not associating what’s going on in their gut and in their environment with mental health. Is that a fair statement to make?

Dr Leila Masson [00:36:03] Yeah, yeah. I think it’s, I mean, the research is really accumulating now to show that gut flora has an effect on the brain, which is something that even 10 years ago, people would roll their eyes.

It is said that you know, I mean, I’ve been doing this kind of work now for almost 20 years. And when I said that children on the spectrum have an abnormal gut flora, my pediatrician colleagues would laugh, but now we have all, I mean, we already had studies then they just hadn’t read them.

But now we have so many studies that prove that kids on the spectrum have different gut flora from neurotypical children and that is inflammatory and can cause pain and diarrhea and malabsorption and all of those things actually cause some of the symptoms we see as autism, the self-harm, and the screaming is often a sign of pain because children can’t communicate that they’re in pain, and once you address their gut, their gut flora, and the either diarrhea, constipation or the combination, they calm down and they don’t scream anymore and they don’t hurt themselves anymore.

So the gut flora has a lot to do with the severe end of mental health but as you say, also with anxiety, also with depression. And the research is just really coming out now, I mean, there are even probiotics now marketed for those kind of issues.

But what I want to say is it’s, I think it’s also another big thing we forget, and that’s the way we raise children, you know, I mean, we used to have a whole village, of course, you know, it’s a cliche, but it’s true, you know, I lived in Pakistan for two years, I set up a clinic there as a volunteer after medical school. And the kids grew up, you know, with hundreds of kids and aunties and uncles.

Dr Leila Masson [00:37:55] And they were all ages together. It wasn’t like just the two-year-olds together and then just the five-year-old together or two kids in a family or even one kid who rarely saw kids of different ages. And there was just so much social interaction, so much kind of social grooming going on all the time.

It’s completely different from our insular, you know, cellular families where we just have four people, maybe three people, maybe five people and a dog. But I know so many families who have no support, the moms are really, really struggling because their parents on a different country, on a different state and feel very isolated and haven’t really seen other children being raised.

They haven’t seen children being even breastfed or even haven’t even held a baby before they have their own baby. And then, you know, that causes a lot of stress. And then when the parents are stressed, I think you get into kind of a negative cycle of stress parenting and you’re the expert on the life, less stressed.

Dr Ron Ehrlich [00:39:05] Aspirational Leila, aspirational.

Dr Leila Masson [00:39:09] I always recommend looking into a kind of positive parenting programs because, you know, the research is so clear that if you get into that positive cycle of positive parenting, positive attention to positive behavior rather than always in negative behavior you have, a healthier, happier child who will also behave better and you’ll have a happier family.

So I think that is another big part of this, not just in the physical environment and the toxins and the lack of nutrients, we need to look at everything.

I mean, I think one of the things that this pandemic that we’re living in has taught us because we have moved so much to our online life, you know, we could have tens, hundreds, thousands of friends or followers.

Dr Ron Ehrlich [00:39:59] But of course, what we’re learning in this pandemic is how critically important this face-to-face community or village is. And I hope that’s a positive that comes out of this, that we appreciate that even more. What about fascinating? I mean, I’ve got a few grandchildren now and I’ve got lots of children who are patients. And what do we say to parents saying, oh, he just won’t eat it, he just won’t eat it, they won’t eat it, what do I do? What do you say to that? You talk about nutrients, but child won’t put it in their mouth.

Dr Leila Masson [00:40:35] You know, I mean, one thing ideally prevented by breastfeeding, because when a baby is breastfed, the taste of the milk changes with every single meal.

So a child who has been breastfed for the first six months exclusively has already had thousands of different taste bud experiences, whereas a baby who is formula fed had one experience, the same one every single day. But you know what, if you see the toddler, it’s too late, but you can’t say go back and do that. But for the next baby, you know, it’s a good idea.

Dr Ron Ehrlich [00:41:09] Before we leave that one, I’m guessing that the more varied the mother’s diet is during that period, would also introduce the child to more tastes. I had never even thought of the taste.

Dr Leila Masson [00:41:23] Absolutely. And even in pregnancy. You know, the babies drink the liquor inside and that liquor has a taste of what the mother does eat. So the more variety the mother eats, the better. That’s one thing. The toddler, so one thing is zinc deficiency, if you’re zinc deficient, your taste buds don’t work well. So if you have a toddler who gets lots of infections, lots of colds and is quite irritable, and has white spots on their fingernails, maybe think of zinc.

But it’s also, of course, are a little bit difficult. All of that. I know lots of toddlers who are not difficult, I have to say as well, but being patient is one big thing and just really exposing them, setting a good example, so I think the most important thing is for the parents and the child to eat together and for the parents to eat a healthy diet with enthusiasm and not saying, oh, this is healthy and that’s why you have to eat it but just saying, oh, I love this broccoli, it’s so delicious.

And, you know, if you do that, you’re just setting that example, the child will follow it eventually, maybe not the first week, maybe not the second week, but eventually, a child will eat the broccoli if you keep offering it, if you give up and just say,

OK, I’m just going to give him his white bread with cheese five times a day, then you’re not going to get them. You have to, if your child only will eat two foods, at least offer the other foods, have your child play with the food, have them lick it, have them help you chop it, you know, whatever you can, you know, age-appropriate, of course, but have them help you with gardening, maybe grow a few vegetables or some greens and then show them how they grow and how they can pick them up and take them to the farmer’s markets so that they can see real fruits and vegetables and prepare them together and just keep offering. For older children, always explain to them that their taste buds, in order to enjoy and your food may need up to twenty-eight exposures.

Dr Leila Masson [00:43:25] So they may have to try the food twenty-eight times before they like it. And you know, you can keep a little checklist, kids like that. And sometimes after the 15th time they say, oh no, I like it. So just being persistent and not giving up, you know, I think that’s a real mistake and I made that mistake with my oldest son, he went through a phase of it, all he wanted was spaghetti and cheese, and now looking back, I think, oh, my God, why did I allow him to have that?

Every day it’s spaghetti with cheese and he’s completely gluten-intolerant now at twenty-four. And he must have been then already maybe, I don’t know, but you know, it was almost like an addiction and I wish if I could turn time back I would say no, you know, and if you have to go through withdrawal, you have to go through withdrawal for four weeks. But you will eat your broccoli eventually. So you have to do it with kindness. You know, you can’t. But yeah, I think it’s.

Dr Ron Ehrlich [00:44:23] Persistence with kindness.

Dr Leila Masson [00:44:25] Exactly.

Dr Ron Ehrlich [00:44:26] Well, because, I mean, I can understand why. I gave them this. They spat it out, they threw it down on the floor, they hated Vegemite sandwich. That was good.

Dr Leila Masson [00:44:37] Yeah. We’re so worried about our children not eating enough.

Dr Ron Ehrlich [00:44:41] Yeah.

Dr Leila Masson [00:44:42] And I think we have to give up on that worry. You know, nobody in Australia has calorie deficits, nobody. But what we do have this nutritional deficit. So, you know, if you give in and give your child the Vegemite sandwich or the spaghetti with cheese, they will get a deficit and their nutrients because they’re filling up on things that have only calories but empty calories. They don’t give them any nutrients. No phytonutrients, no antioxidants, and minerals, no vitamins.

Dr Ron Ehrlich [00:45:12] Mm hmm. OK, well, you know, I mean, I think that business about the breast, the variety of the mother’s diet, you know, when the child is in utero and breastfeeding, giving different tastes, that’s a whole other aspect to breastfeeding that I had not considered. What about kids that are difficult sleepers? I mean, sleep is perhaps one of the biggest challenges to a newborn, you know, to a new family, but sleep problems persist and you must see a lot of them. What are some of the things you’re saying? I mean, some of them you have already mentioned. But when someone comes with sleep issues, what do you say to people?

Sleep Issues

Dr Leila Masson [00:45:53] You know, I would say that overall sleep problems affect most of my patients that if I had to rate the issues, that would be the number one because whether it’s ADHD or autism or allergies or, you know, just being irritable, sleep is a number one, and not sleeping enough and not having enough quality sleep will affect your mood and behavior and focus attention the next day.

They even did the study where they woke up children, they did an IQ test on them, and then they woke them up half an hour earlier, a couple of weeks later, half an hour earlier than they would usually wake up, and did another IQ test, and their IQ dropped several points.

So that doesn’t show that the kids were not as intelligent that day, but it just shows you how important sleep is for your brain to function well. So sleep is incredibly important and also for the parents, you know if a child doesn’t sleep, the parent don’t sleep then sleep deprivation is like a torture myth that everybody is just miserable.

So for sleep, I would say a very, very straightforward lifestyle interventions, you have to have your daytime exposure to daylight at least an hour outside because that daylight actually triggers later when it gets dark, your melatonin release and melatonin is a hormone in your brain that makes us sleepy.

And then you have to have no light exposure for about an hour or two before you settled a bit, so no blue screen. So the blue color in screen, from computers and TVs and so on and iPad, stops your brain from producing melatonin. So people now use orange glasses, they use blacks, that changes the color of the screen. But of course, for children, the best thing is not to be on screen for two hours before they go to bed because it also cuts down on their overall time, they shouldn’t spend as much time on screens.

Everybody spends too much time. So whatever excuse you have to stop them, it’s a good excuse. So that’s very important then your magnesium, we talked about that already, very, very important.

If you’re low in magnesium, you’re irritable, you have may have the restless legs that can also be caused by low iron. So iron and B12, the things I check on every child who has sleep problems, they usually look quite pale if they’re low those, but it’s very common and that interferes with sleep. So you want to really just check the basic things that you need for having a calm brain and no muscle aches and that you can relax.

Then you need to have a healthy sleep environment. So no lights in the room, you know, nontoxic. If your child has an allergy to dust mites, which is very common, you know, reduce the dust mite exposure, those simple things like that. No mold, mold is so common in Australia and definitely affects your health and your sleep. But I also think that we are seeing sleep as like everything is in a modern way and our genes haven’t changed, we are still like hunter-gatherers and children want to sleep with somebody.

Dr Leila Masson [00:49:13] They don’t want to be in their separate cave, they want to be in the cave where everyone else sleeps. And we always had the family bed in our family and it worked really well and eventually, the kids moved out when they were no longer interested and then moved in with the dog instead, in their bed.

But I do see so many kids so anxious around bedtime and the parents, both of these programs where they sit by the bed and then they will sit by the door and Tanah that I mean sleep training. I think it’s just overrated.

I think if your child needs someone to lie down with them, lie down with them and until they’re asleep and they will sleep better and then be calmer, there’s nothing wrong with it, you know, I mean, it’s your extra time to cuddle with them, to give them some skin to skin, which reduces their stress hormones, calms down their heart rate, the breathing and, you know, with babies the first few months, there is a risk of increased risk of SIDS, but from three months on, which is actually considered safe to sleep with your baby, you have to have certain conditions, you know, you can’t smoke, you can’t drink, you can’t be on drugs, you can’t have a soft mattress, you can’t have bedding that could cover the baby.

So there’s lots and lots of things you have to make sure of, but it’s not difficult to do that. And then the baby sleeps so much better in their parents arms. or on their chest.

Dr Leila Masson [00:50:34] Or in a little, even in a little things that you put in the bed where the baby’s inside safe, but within an arm’s length of you, you know, so they’re safe, but you can still have skin to skin contact with them. And you’re very aware of, you know, are they calm, are they breathing, do they want to breastfeed, you just roll over, breastfeed them, put them back in that little pod.

So I think a more humane approach to sleeping for children is needed. And then we also need to make sure that we’re not doing things that interfere with sleep, like having them watch screens until they just go to bed and they’re wired and go to sleep and then maybe eat a very sugary meal or meal full of additives just before that also wires them.

I very much like chamomile tea as a simple intervention. A cup of chamomile tea after dinner is very calming and some parents put two or three or four tea bags in, depending on how strong they need it and you sleep better at just calms down your nervous system.

Dr Ron Ehrlich [00:51:47] It’s so interesting to hear you say the family bed, because when my daughters were born, particularly my older daughter, who’s now thirty-four, I read a book called The Continuum Concept and also the family bed. It was a major focus when we were, anyway, that’s a whole other story, we’re not to program on it.

Listen, we’ve covered such territory today and I just wondered if you might take a step back, because we’ve been through a very challenging period over this last 12 months. And I don’t think it’s over yet. Taking a step back as a pediatrician, just as a person engaging in the world, what do you see as the biggest challenge for us now at this time in our modern world? As an individual.

The Biggest Health Challenge

Dr Leila Masson [00:52:31] That’s an interesting question. There are so many challenges, but I mean, I would say the environment is our biggest challenge and I would say that if we don’t take care of our environment and stop destroying it, there won’t be a world for our grandchildren to live in. So I would say that’s the most important. There’s of course, many, many issues.

But if I had to just put one, that would be that, because you know, the deforestation and rising CO2 levels and we’ve had fires and floods which are clearly due to environmental destruction and climate change, I’d say that’s the number one. But community is the next one. And I think that’s the one that became really clear is Covid, because people were very, very isolated for a long time and kids brains were affected by being in lockdown and not being in school. And community is another thing we’re evolved to have, and if we don’t get that greasing, the community greasing of the brain, you are not going to develop those kind of social skills that you need to function well in a society.

So I think I know a lot of people now who are really reaching out and trying to create more community because of Covid. And we’re so lucky in Australia that we are not very affected, I mean, yes, we were locked down and yes, we can’t leave the country easily, and those are things that can be hard but, you know, my family in Europe, they’ve had Covid, they’ve been very sick, people died.

I mean, it’s a totally different story then and they’re still in lockdown, so it’s when I walk through the streets in the evening and see the restaurants, I think, oh, my God, if I took a picture of that and sent that to my family and friends in Europe, they would cry.

But community, you know, we’ve had now, we organized a street party in December just to get to know all the neighbors and it was so nice, you know, everybody now when we walk, we meet people we’ve met and there’s a much tighter feeling of community. And I think that’s what we need more. And people are creating more groups of people, they’re reaching out, there is a Facebook page today, and the name is maybe a bit funny, the Bondi Beach babes, but it’s solely for women to make more connections. And every single day you see a message, I’m twenty four and I’m lonely, I have moved here from so on, so it say, anyone who wants to pour coffee today and immediately there would be ten people say I’ll have a coffee with you, and I love that.

I think that’s what digital media should be, social media should be used for, not for selling you more things and making you feel bad because you don’t look like a star, but for creating more connections, positive connections. So I think environment community would be my top.

Dr Ron Ehrlich [00:55:28] Well, what a great note to finish on. And thank you again so much for joining. And I always love talking to you. And thank you. We’re going to have links, of course, to your web page and your wonderful book that you’ve written as well. Thanks so much.

Dr Leila Masson [00:55:43] Thank you. Ron. It was always a pleasure talking with you.


Dr Ron Ehrlich [00:55:47] I just love talking to Dr. Leila Masson. And what two wonderful notes to finish on, environment and community, and there are two things that we are going to be.

We have been and we will continue to champion, because I think one thing this pandemic has taught us more than anything and it’s taught us a lot, is the importance of community and building our own community physically, those people around us getting to know our neighbors, getting to know our neighborhood as supporting local businesses and just connecting, physically connecting with people.

Look, there was just so much in that I’ve got to go back and listen to it myself. It’s just the breastfeeding story. I mean, we’ve always heard about breastfeeding as being a positive immune function for a child. But how about that, introducing all these different tastes to your child in utero and while you are breastfeeding and that idea of being persistent and kind to fascinators, not just you’ll eat your vegetables or you want to do this or that, you know, I think we just need a little bit of kindness and persistence and again, we come to the gut microbiome and we heard it from Leila, diversity equals resilience and resilience equals health, and I’ve said this many times that whether we’re talking about the gut microbiome, the oral microbiome, the soil microbiome or our world in which we live, the more diverse, the more resilient and the healthier we will be.

Look, we’re going to have links to a lot of this web page, she’s written a terrific book, The A to Z of Children’s Diseases. She’s just a wealth of information, and we could have spent another few hours talking to her.

Don’t forget to look out for our online courses. Don’t forget to download the Unstress with Dr. Ron Ehrlich app. That’s how you have to search it on the App Store Unstress with Dr. Ron Ehrlich, and it will keep you up to date on the latest episodes. We’re doing Healthy Bites now on a regular basis so it’s an opportunity to showcase and issue a podcast or a story and just be positive and uplifting because that’s what I’m hoping this year will be for you and also for me and for our whole world.

Let’s make that happen. So until next time. Oh, and don’t forget to leave a review, of course, I have to put in that plug because if we’re going to play this game of social media and getting this app to as many people as we can, and if that’s our message, help us get that app to as many people as we can send.

Sit down for a moment and put a review on iTunes, because apparently when your reviews go over 100 or 150 or 200 or dare I say, even thousands, you know, it pushes you up in the rankings and makes you more visible, when I think this is a worthwhile message to make visible. I hope you do, too. So until next time, 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.