The #1 Root Cause of Sick Kids Today (And Why It's Getting Worse)

It's so great to have you on the Doctor's Pharmacy podcast. We've known each other for 20 years now, maybe pretty much. And uh, we met at a conference years ago on food is medicine. Uh, I was speaking, you were in the audience, and I think it had an impact on you, cuz, uh, look at you now. You just came out with this great new book, "Healthy, Happy Kids: An Integrative Pediatrician's Guide to Whole Child Resilience." And our kids are definitely not resilient today.

Well, I just, you know, I, I really want to thank you because if I, if I hadn't met you back in, you know, was it 2001, whatever it was, um, I probably wouldn't be doing this today. And I say that in all honesty. I mean, you really are one of the pivotal moments in time where, you know, they say when you're ready for the right teacher, the right teacher will come, and that was it. I mean, I was fresh out of residency, kind of thinking, I don't know if I really want to do this, right? I spent all this time. And then hearing you speak and really thinking about the power of food as medicine. No one had, I've never heard that concept before. Never heard of functional medicine. And I thought, that's what I want to do. Yeah, I'm doing it.

You know, it's interesting when I hear this story a lot because, you know, we, we go into medicine wanting to do good, and usually caring about helping people. And, and we learn all the science, we learn all the biology, we learn all the drugs and all the diseases. Yeah, and we think we're equipped to really help people. But when we get out there, we go, it's sort of not like I thought it was. The landscape isn't the same. And we thought that we would be doing things that would actually be making a difference. But often what we're doing was just medicating people. Yeah, and, and naming the diseases and then giving the drug for that particular condition. And it really didn't solve the problem. And, and so, you know, I hear this from a lot of doctors. Like when they hear the paradigm of functional medicine, they go, God, this just makes so much sense. Like, this is actually what I wanted to do. This is actually what medicine should be. And what you've done, and you're a pediatrician, is take this body of knowledge, which hasn't really been well applied to children, and you've really taken that on and been a leader in the field now of functional integrative pediatric care.

That is my mission because, you know, as a pediatrician, you have this, you have such a golden opportunity. I mean, you have this, this kind of unwritten map in front of you, this beautiful child that you want them to have the best chance in life to be as successful, thriving as possible. And I'd say the biggest contrast when, when I try to explain to families what the difference between a functional medicine approach is versus a conventional pediatric approach. I mean, we need conventional pediatrics. I mean, we need to have medications, um, that are necessary when they are. And conventional medicine's great at putting out fires. But it, it places us in this disease-based model. So as parents and as practitioners, we have in mind, oh my gosh, I want to prevent this from happening to my child. I want to prevent this disease. And when we look at functional medicine, we can, what we hold in our mind is that picture of a child thriving to their optimal potential. And, and we move towards that instead of running away towards something. So it's, it's a subtle mindset shift, but it's the only way we're going to make a difference in kids' health.

It's so important. And I mean, I graduated in medical school in 1987. I trained in family medicine and took care of kids. The amount of disease in kids now is staggering. Yeah, the amount of chronic disease is staggering. You know, one in 10 kids has ADHD, 40% of kids are overweight, one in four teenage boys has pre-diabetes or type 2 diabetes. We used to call adult onset. Yeah, depression, suicide, you know, behavioral issues, ADHD, autism, they're just exploding. You know, we had Suzanne on the podcast the other day, and, you know, she's a pediatric neurologist. And we've gone from like one in 10,000 kids with autism to one in 36 kids today. And I remember giving talks about this, you know, 20 years ago, it was like one in 100. Now, and it was 1 in 69. Now it's 1 in 36. It's like, what's happening with all the allergic disorders, autoimmune diseases, gut issues, behavioral issues, ADD, mental health issues? What's going on that our kids are now so sick? I mean, I get it if you're like 70, you get chronic illnesses. But you shouldn't really then either, but if you do the right things. But I, I, I mean, this didn't happen. I mean, we didn't, so what the heck happened? Yeah, it's time to wake up. But it was time to wake up decades ago.

Part of why I was so drawn to functional medicine was that New England Journal of Medicine study back in 2005. I mean, this is 20 years ago, where researchers noted that for the very first time in history, our kids are expected to have shorter lifespans than us, their parents. I mean, first time in history, with all of our medical advances. And so we should have woken up then. And that was entirely due to lifestyle-related diseases. Yeah, I mean, even during the pandemic, the World Health Organization said that eight in 10 people die of noncommunicable lifestyle-related diseases. And so when I think about, you know, what's going on with children, why have things changed? Because like you, I mean, my, I, I don't ever remember a kid puffing away on an inhaler or, you know, have carrying EpiPens. And, um, there was no such diagnosis as sensory processing disorder. Now, so many kids have sensory issues. And when I volunteer in my kids' classroom, it's heartbreaking to see the number of kids who are, you know, rolling around on the floor, not comfortable in their bodies or their brains. And, um, on field trips, carrying bags of medications for these kids.

So I think functionally, not to be simplistic, but I really think that at, at kind of that deeper, truly root cause level, our kids' microbiomes have completely changed. I mean, when you look at, um, the protective factor of breast milk and bifactor, and we know how important bifactor in that developing infant microbiome is to supporting those butyrate-producing species like F. Prausnitzii and Roseburia. Well, those are bacteria, folks, if you don't know what you're saying about, they're the good guys, the ones we want. And we want a lot of bifido. But the, the breastfed baby of today, their gut microbiome looks much more like the formula-fed microbiome of the baby 100 years ago. I mean, there's been a drastic shift.

Formula-fed microbiome 100 years ago? They had formula 100 years ago? They did. Yeah. And so when you look at that, this, this loss of all of this bifactor and the loss of butyrate, which is, you know, it's a postbiotic, right? Our master regulator of health. I just, I want, I really want to see more research on that because I feel like if we could shift that, and we know that bifactor is really important. When we lose bifidobacterium, we tend towards a Th2 skewing of our immune system. So that means, guys, more eczema, asthma, allergies. Guess what we see an explosion? Right? We, we can see a, a T17 skewing. That's autoimmunity. And guess what? The age group with the largest just increase, like double the rate since the 80s, triple since the early 2000s, the rates of autoimmunity are exploding in our 12 to 19 year olds. Why is that? Right? That's sort of, you know, at that underneath level. But why are their microbes changing?

Just to be clear, what you're saying is, breastfed kids today don't have a good microbiome because there's something changed about the breast milk? Possibly? The formula is the same as formula-fed kids 100 years ago? Well, were formula-fed kids' microbiomes okay then? Well, I don't think back then. No. Well, back then, babies' microbiomes were nearly 100% bifidobacterium, which is not the case now, right? So, I mean, we can think about why that's that has occurred. I mean, even during the pandemic, there was, um, a research paper by Dr. Hazan that could predict that people who had lower levels of bifidobacterium had more severe COVID outcomes. So there's something, you know, about bifidobacterium that really is helping to inform our immune system. And in those early infant stages, that zero to three years of age, that critical time where your microbiome is literally kind of imprinting your immune system, setting the stage for either optimal immune development or suboptimal. If we don't understand the factors to start with a healthy gut microbiome in life, it's a lot harder to change later. It's not impossible, but it's a lot harder.

I mean, you devote a lot of your book, "Healthy, Happy Kids," to the gut microbiome. And it's really how you start out as the fundamental way that that things are being disregulated. And for people listening, as we've heard many times on the podcast, that the gut microbiome is linked not just to allergies and autoimmunity and eczema, but also to obesity, also to mental health disorders, also to ADHD, autism, learning disabilities. So the microbiome is huge across the whole spectrum of the things we're seeing in kids today. And there is an incredible phenomenon that's happened, which is a wiping out of this particular species called Bifidobacterium infantis, which is, I think, what you're talking about. And "infantis" means, you know, infant. It's right. And it comes generally from the mother, who's gives it to their baby as they pass through the birth canal. Yep. But the problem is, we've given so many antibiotics over the last 60, 70 years to people. I don't think there's a woman on the planet who hasn't probably had antibiotics, or maybe for certainly in America, who hasn't had antibiotics at some point in their life. And these are super sensitive bacteria that just wipe them out. So even if you're, you know, even if you're giving a vaginal birth, these kids still may not, may not get this. Yes.

Y. And there's actually a company that has actually created a, this strain, it's a baby probiotic. It colonizes the gut because often, and this is, I think, so important for people listening who are having kids or planning to have kids or have grandkids, about to have grandkids, that this, this probiotic should be a mandatory part of prenatal care and early, early infant care. Because it's easy to give, it's safe, and it actually colonizes, which most probiotics don't. As you get older, they just pass through. So it colonizes, establishes. And it shows, it's been shown to actually reduce the burden of asthma and allergic disorders and all these things that, that you're talking about. So can you talk about why we've seen this decline and kind of almost absence of this? And, and how people can actually start to rebuild? And just to, you know, point out the probiotic, it's this particular one. It's great. Good research behind it. It's indicated really only for, for breastfed babies. And, and here's, here's why, because bifido feeds on human milk oligosaccharides, these prebiotics found in breast milk, primarily something called 2'-FL, 2'-fucosyllactose. So what I wish is that all babies would get, not just this probiotic, but also, we can now, we have, we have manufactured 2'-FL as a prebiotic. I mean, that should be mandatory. Because even if a baby is then formula-fed, this bifidobacterium species feeds on the 2'-FL, requires this. So, I mean, could you imagine a different world that we would have? It would be quite amazing. And this is really a really simple, very safe intervention. It should be standard of care in pediatric and, uh, and maternal infant child care. Right? But it's, I bet you there's not too many pediatricians or even OBGYNs who even know about this.

I think the awareness is growing, but I think there has to be more of an awareness. I think taught, I mean, really from medical school, right, on the impact of, of the developing gut microbiome. I mean, we know that antibiotics or antacid medications, as you noted, antibiotics, I mean, they wipe out. And some antibiotics insidiously preferentially kill off your beneficial probiotics and preserve things like Clostridia, the bad bugs, the bad bugs, right? And so antibiotics or antacid medications, which can do the same thing, given in the first six months of life, that one of the critical windows, nearly double, significantly increase the risk of virtually every single allergic disease. Yeah. And the same thing with data. This is not, you're not just making this stuff up. Stanford, NYU, UCF trained physician who understands science and is using the data to inform your opinions. It's just data that's being ignored by most pediatricians and most healthcare facilities. And you're bringing it to light to helping parents actually learn how to optimize their kids' health and deal with some of these. Because most of the things we're talking about, obesity, allergic disorders, autoimmunity, eczema, all these things that kids have, are really preventable if we start early, even even before the mother conceives, and with things to do for the mother, and then after the, during pregnancy and after. It's so important.

I'm going to guess that many of the listeners, their kids are already born, older, maybe grown, maybe they're thinking about grandkids, right? Um, we got a bunch of young listeners too. So yes, for sure. And, you know, deal time to optimize a mom's microbiome is before you conceive. I mean, that, if we, if we truly implemented functional medicine preconception programs in every single OBGYN office, I would be out of a job. Right. Great. But what are the factors that perpetuate, you know, this, this declining, this changing of our gut microbiome? I mean, you mentioned one of them, right? Antibiotics. I mean, that's the, the single biggest significant acute disruptor of the microbiome. In some studies, up to 70% of antibiotics prescribed to children are inappropriately prescribed, whether for viruses or maybe broader spectrum, like two, two, quote, too strong. Um, but the other two that are just insidious, every single day, we have to point out for our children today and our teenagers today, chronic and unmanaged psychological stress can significantly disrupt the gut microbiome. Can immediately, within an hour, trigger leaky gut and IL-6 release. And so we, we need to, you know, really figure out how are we going to help our kids manage their gut-brain connection. So leaky gut, for people listening, is when your barrier gets disrupted in your gut, and food particles and bacterial toxins leak in, and your immune system reacts, creates inflammation, and that leads to all the things we've been talking about, from mental health issues to obesity to allergic and autoimmune things. So yeah.

And, um, and then the other thing is, as you will know, you know, one of your first books, um, really, our, our ultra-processed world. I mean, these ultra-processed foods. You know, the research behind the effects on children of anything lags behind the adult research. But now we're really seeing that research. So especially these food emulsifiers that can directly harm the gut microbiome. Um, I mean, the FDA allows some emulsifiers at levels in infant formula that are known to be harmful. So I mean, that's one thing. But then we have all of the packaged foods, the, the artificial dyes, the emulsifiers. And I mean, I have to cringe at some of the, the things that my kid says, oh, so and so is eating this, can I try some too? We have that conversation. Um, but, you know, that is one of the most kind of insidiously inflammatory things. And, and it's not even just the quote junk food. It's the foods that, you know, we as parents, when we're trying to make healthy choices for our kids, we don't have the knowledge. I mean, collectively, um, lack enough of the knowledge about how to read these labels, really from a functional medicine, you know, microbiome-friendly way. So that, so that we're really doing good for our kids. So that, that has to get out there. And sadly, I mean, the truth is, the food industry and the FDA are not going to help us here. So we need to get the word out.

Yeah. You know, we're actually on, I don't know if you know this, but I'm working on a nonprofit called the Food Fix Campaign. And one of our efforts is child-friendly food labeling. So we can grade foods like make the grade, A to F. Yeah, A is grade, and F, you fail. Right? And it gives people a sense of, of agency around what they're choosing. Because reading the front of package labeling, or reading the ingredient list, or reading the nutrition facts label is super confusing. And it's designed to be that way. It's designed to create confusion and misinformation. So that people think they're getting something healthy when it's not. Yeah.

Now, I want to look back to what you said about breast milk because it really is an important conversation. 25% of the calories in breast milk are from what you just described as these oligosaccharides. They're the type of sugars that humans cannot digest, that are only designed to feed the good gut bugs. Think about that. Yeah. Yeah, absolutely. And formula doesn't have it. Yeah. And when you, you look at the, the microbiome of formula-fed kids versus breastfed kids, it's very different. There's more butyrate-producing species with breastfed kids, which is the healthy short chain fats. And there's more propionate-producing species with the formula-fed kids, which can cause autism and all kinds of weird things. It's a toxic metabolite. And so, um, what advice would you give, you know, parents preconception, and women who are pregnant, and then early, early after birth to do to help their microbiome and their children's microbiome? And I, I did, and by the way, I did do a podcast, a solo podcast on preparing to conceive, oh, from a functional medicine perspective, like what you need to do to get things ready so you can actually maximize your chances of having a healthy baby. Because it's not just your gut microbiome, it's your whole epigenetic programming that you can modify while you're, while you're preparing to conceive and, and during, during pregnancy. Yeah.

What can parents and, and mothers and do before they get pregnant, during pregnancy, and after to deal with this microbiome crisis that we have? Well, and, and I want to also really, um, point out, I mean, some, so something so important that you said, that while even before we conceive, even on Dad's part, because we all think, oh, it's all about the mom, right? But even on Dad's part, there's so many things that we can do to help support optimal epigenetic programming to live in our modern world. That is so important. I mean, we have this power. And, you know, part of it is microbiome, part of it is psychological stress during pregnancy and before. But so for a mom, I mean, what, what I would say is, if you are trying to conceive, then make sure all your nutrients are optimized. Don't just take your doctor's word for that your vitamin D levels are quote normal. Because if they're out of 22, that may be normal, but it's not optimal for you as a mom, pregnant, and for your baby's developing immune system, for their brains. We know that that low vitamin D levels in moms can increase the risk for, let's say, things like autism later on, right? Um, also making sure that, that to the extent possible, either working with a functional doc to get a stool analysis. Make sure you know you're there. Yep. Check your poop. Check to make sure that you have all the good stuff in, and any abnormal bacteria, any, any inflammation, any leakiness is addressed. Um, do take care of that before you conceive, before, before. Because the, you know, the, um, I mean, there, there's, it's coming to question whether or not, um, you know, the, the womb is actually sterile. Um, so, but, but primarily, we still believe primarily the way that babies get inoculated is through the vaginal canal or, you know, through the abdomen, right? The abdominal wall and skin if there's a C-section birth. And so, you know, that's, that's something that we just have to make sure. I mean, there are even tests that can look at Mom's oral microbiomes, which we know is so important for fertility, and also vaginal microbiomes. So try, kind of like head to toe, you know, inside out, optimizing your microbiome. Um, if you don't have a functional medicine doc to work with, then making sure you're doubling down on on food as medicine for your microbiome. So we know worldwide, um, I mean, in the United States in particular, um, 95% of people don't meet fiber requirements. And our fiber requirements in the United States are are kind of shamefully low anyway. So you need to do that. Why fiber? Because fiber, it's the prebiotic that feeds your microbiome. Eight and 10 Americans don't get enough color. There's a color gap, right? And the phytonutrients actually can act as prebiotics and and modify your epigenetic future. So, I mean, just all those things and fermented foods and all of that. So you got to, I mean, more, more than taking a supplement. Yeah, which, yes, take a probiotic supplement. Because there are, microbiome is really, really determined by your diet. Prim. Yes. Primarily.

Yeah. Now, you know, there are some good studies, older studies, that looked at *Lactobacillus rhamnosus* GG, which is a, um, the most widely studied probiotic strain in children. And found that moms who took this *Lactobacillus rhamnosus* GG during the third trimester and while nursing, if they had a family history of atopy, like eczema, asthma, their infants had a significantly reduced risk of eczema, asthma. So great. Sure, take that. That's easy to find over the counter. Yeah. You find it in CVS or Walgreens. Absolutely. I mean, yeah, anywhere. It's so easy now, right? Um, this particular strain, I, it's called *Lactobacillus* GG. We'll put the show notes. That's right. Yeah. Um, the other thing too, is really, I mean, we're so stressed, we're so busy nowadays. But, but really and truly, part of the prescription for pregnancy needs to be helping to support mom's mental health. Because we know that transgenerational impact of prenatal psychological stress on your baby's risk for metabolic disease, obesity, heart disease later, even your grandchildren's risk. And so supporting that as much as possible. We don't have villages anymore. But we really need to for mom. Know that taking that time out to go for a walk in nature, to spend that 10 minutes, you know, meditating while nobody is awake and your toddler's still asleep, you know, all of that. It's not just indulgent, it's actually really, really important. It is medicine. Yeah.

So that's powerful. You talk about the, the Gut Reset program and the five things for microbiome magic in your book. Can you kind of unpack that a little bit? And, uh, you know, cuz, you know, it's kind of in a way, discouraging because we're, we're in a world where we've all taken antibiotics, we're, we're exposed to things like glyphosate, which D our microbiome. A third of babies are born by C-section. Yeah. Every little kid gets antibiotics in their first year of life. Like, it's just kind of a disaster in terms of the, the risk factors for messing up our microbiome. And it, it determines so much of our future health and so much of our children's health, even while they're kids, as you mentioned. So how do you think about this, uh, Gut Reset program that you talk about, and the five things for microbiome magic?

As a pediatrician, I always try to approach things with some fun, you know, some joy, some hope. Because as you said, it can be like, oh my gosh, the world is against me. How can anyone be healthy in this world? And we can. So just, you know, empowering kids and parents to know there are simple steps that we can take to be healthy. And that, you know, for our children, when we do that as a family, even if they push back as teenagers, right? I mean, the inevitable pushback. Right? My kids are pre-teen, teenagers, and, you know, there's going to be pushback. That's part of life, right? But if you lay those foundations, they're going to go back to it. I mean, the teenagers who, you know, knew how to cook, yeah, right? I mean, they were much more likely to choose vegetables when they were off to college, right? I mean, it's, it pays it forward. Um, and so, you know, the Gut Reset is, is really akin to the five R's of functional medicine on how to heal the gut microbiome. But the foundation. So the reset would be really, if your child has any sort of persistent health concern, and we have to presume if your child has a persistent health concern, chances are they have a leaky gut. Chances are they could have gut dysbiosis, right? Maybe not, but in an abnormal balance of of bacteria, yeast, parasites, I mean, whatever else. I mean, viruses that we're not really yet able to measure yet, right? But the foundation of that reset. So the R, first R, is returning to those five things for microbiome magic. Those are the fundamentals, the essentials. I mean, many people listening have heard the saying that you can't outs-supplement a bad diet and lifestyle. Well, you can't heal your microbiome, you can't outs-supplement a poor diet and lifestyle for your microbiome. There's, I mean, I could tell you 10 different supplements to take, right? And you might get a little better. And in fact, I've had kids, you know, going through the, the Gut Reset when they're like, okay, not changing the diet, I'm not going to go to bed, you know, get eight hours of sleep, right? They can get better on the, on the supplement plan. And they can even quote go into remission. But here's, here's the thing. And as practitioners listening, we've all had this experience where your patient gets better. I mean, that's awesome, right? Um, they're in remission. But then what happens six months later? Yeah, they slide back. They start sliding back, right? I mean, what we want is, I don't even want to call it remission, right? I want to call it, okay, this is your new state of health, right? This is, this is your new normal now, right? And so I had parents who are kind of, you know, just holding their breath, waiting for the next shoe to drop, because they're like, okay, when's the next time they're going to flare in their PANS, PANS, or when's the next time, you know, that their rheumatoid arthritis is going to flare? So those five things. Um, I had this opportunity, it was so fun for my kids. Um, they go to a public charter school and rely on parent volunteers to teach some of their quote electives. And so for their third and fourth grade combined class, so 8 to 10 year olds, I created a six-week curriculum. We call it "Healthy Belly, Happy You." It's great, so fun. I mean, we taught all about their microbiome, but made poop. Kids, I bet they love. I mean, poop with kids, all about poop, right? And connected the dots to why they're, they're these tiny little microscopic friends are so important for, um, not missing school so much because you're sick, or getting along better with your friends, or being able to sleep better in school, running faster down the soccer field, right? So connected the dots. And these kids, they learned how to look at packages, read food labels, check the sugar, make sure there's nothing artificial. They were going home telling their parents, Mom, I shouldn't have more than 25 grams of added sugar in a day. And look at, look at this, they have like this package of, you know, whatever it is, let's say, or let's say Boba tea, it's 35 grams of sugar. Now, some kids, of course, my kids too, included, they may choose to have that. But at least they know they're making that informed decision, right? And then they know, okay, how can I get my microbiome to bounce back from that? Right? We made kombucha, that's so fun, and sauerkraut. I mean, that's a way to do it, right? Um, so we just spoke about the five things that they have to do every day anyway. So why not just do it for themselves, but for all their trillions of microscopic friends? You're not alone. You're not alone. You're not. And really and truly, you know, with, I mean, the numbers keep changing, right? But whatever, 10 times more bacterial cells, you know, on and in us than human cells. I mean, who are we really nurturing? Right? And so, you know, we have to eat every day. So why not eat to support your microbiome? We have to breathe and drink and sleep and move our bodies. Even if you're a couch potato, you're still moving, right? So how can we do each of those five things in a way that that supports your buddies, supports you? And they were all into it. So, and, you know, we go through each of these in the book. But, but I would say the two most important things, um, are number one, nourishing your gut microbiome. And that includes what kind of things you get in. So we've already talked about that, right? Fiber, color, fermented foods, prebiotic foods, prebiotic foods, right? Creating symbiotic meals, right? That means pairing, you know, a fiber-filled food with a fermented food. So, I mean, just think like yogurt and, you know, nuts and and granola, right? I mean, right there, right? Or blueberries on top. But equally important, especially for our kids who are, you know, quote picky, and for parents who are like, okay, they don't let a vegetable touch their plate. Like, I, I got to figure something else out. Sometimes even more impactful is to teach them how to read food labels to know what to keep out. Yeah, right? The things that are are really especially harmful to their gut microbiomes. And I don't make it too complicated. But, you know, really talk about these food additives. You know, what was hilarious in doing research for the book? There are over 3,000 FDA-approved food additives. Right? And the list, it's called "Everything Added to Food in the United States." I mean, what a silly list, right? But, but three, over 3,000 to make our food taste better, sweeter, saltier, have a better mouthfeel. I mean, it's, it's creepy, right? Bad. And these things aren't really food. And they're, and they're mostly not regulated. They mostly haven't been tested. They're often not allowed in other countries, like in Europe. That's right. And, and we use them here, right? Now, Kellogg is is getting a bit of a, a backlash because it, it produces foods in America that have certain colors and additives that they don't allow in Canada and other countries. And they remove those from other countries' products that they sell. Where they sell Kellogg's, but they don't remove it in America. So our kids are getting exposed to very harmful things that they're protected from in other countries. It's true. You know, they were big to-do about getting rid of the artificial colors. You know, this was, I mean, this was probably about 10 years ago. You know, I was really excited. And then they pulled back, right? They said, well, you know, first of all, we're not removing those because they're actually harmful. Right? Right. Um, second of all, no, the American people, they actually prefer the brighter colors and they prefer X, Y, and Z. I mean, come on. They might also prefer, uh, cocaine in every corner in a vending machine. So, so it is true. I mean, Europe, I mean, Europe already, for for years, has had a warning label that, you know, food with artificial dyes and preservatives can affect children's behavior. And, and attention and focus. And so, um, teaching kids how to keep those things out is really impactful. And I'll just, I'll tell you a quick story on just how I, we had had, you know, before when we bumped into each other in the hallway and we were chatting about just how quickly kids can get better, you know, compared to adults. And it's true. Yeah, kids aren't filled with all the, you know, the, the toxins, whether they're physiologic toxins or, um, environmental toxins and psychological toxins. 100% more resilient. And so small changes can have profound results. And, um, you know, there's this one kiddo, he was probably about six years old, tons of behavioral concerns, tons of sensory issues. He didn't feel right in his skin. He was getting into fights with every kid on his soccer team, not a good thing. His occupational therapist was really astute and referred to me and said, I don't think this is just sensory issues, right? There's something else going on.

Y sat with a mom who was just, I mean, exhausted at her wit's end. One of the things that was heartbreaking for her was this was her son. Yeah. He just couldn't stand touch. So when she would kiss him, he would wipe it off, right? He just moved away from her hugs. I mean, that's heartbreaking as a mom, yeah, of course. And so as we sat and talked about different tests that we might do, just to figure out, dive a little deeper, could there be some, yeah, what did you find? Well, I mean, this kiddo did end up having PANS. Okay? So that's sort of, you know, the, the backstory there. There was something different going on for his sensory issues. But as, what is that you just said? PANS. So PANS, Pediatric Acute Onset Neuropsychiatric Syndromes, which is a mouthful, but it just means kids have these weird neuropsychiatric problems. We don't know what it is. Yeah. And, uh, it's called the syndrome because we have no clue how to deal with that. That's right. We actually do. From. We do absolutely. And, uh, for some kids, an abrupt, pretty dramatic onset of OCD, food restrictions, aggression, separation anxiety, cognitive decline, handwriting decline. PANS can have many different causes. So that's where, as a functional medicine practitioner, you need to do the digging. Because it could be mold, you know, mycotoxins. It could be infections like strep. And when it's caused by strep, it's caused PANDAS, right? So Pediatric Acute Neuropsychiatric Syndrome Disorders Associated with Streptococcal Infection. That's another mouthful. But so he ended up having that. But here's the thing. After his soccer practices and games, often there would be treats of like the bright neon blue Gatorade, right? And the Skittles. And, you know, and the family otherwise was was pretty healthy in terms of their diet. But it was just this thing that, well, it's a treat after soccer, right? All his friends are doing it. So, you know, as we were thinking about the testing, I said, look, let's just do one thing right now. One thing. Let's just remove all of the artificial colors and preservatives from the fine gold diet.

Fold was this the fine pediatrician back in the 70s who said food dyes were causing ADHD? And I mean, there was something to it. It's not every case. But yeah, as a pediatrician, I think it's really important to not just say to do something, but make it concrete. So we, we went through and figured out, okay, the Gatorade. Okay, what's an equally acceptable, non-artificial, no artificial sweeteners either, no sucrose, no aspartame, um, hydration drink he can drink? Yeah, I mean, how about coconut water? Right? But there are other hydration drinks that are much cleaner than than the Gatorade, right? Um, the Skittles. What could be replaced that with? You know, so, so we really concretely discussed what swaps to make. Yeah. And then she went home. She was a little overwhelmed by everything, right? As, as can happen in that first visit. It's like drinking from a fire hose sometimes. But, but she was committed. And Mom took out the artificial dyes. Sent me a message two weeks later. Two weeks. Right? Two weeks. I have the message from her in in my portal. And I just, it makes me tear up every time I think about it. And she said, she just wanted to thank me because for the first time she could remember in so long, he didn't wipe away her kiss, right? For the first time. And he even asked for a hug. That's amazing, right? So, I mean, two weeks is not that long. And so that's where the mindset shift has to happen. Because a lot of people think, oh, I'm depriving my kid. Or maybe it's like your partner, Grandma. I mean, we're, we're not depriving your kids, right? We're helping them thrive.

I mean, I want to pause there for a sec because you, what you said was just so important. That there are these kids walking around with all these health issues that are treated by traditional medicine, usually with medications or with nothing. Like there's no treatment for sensory issues with kids, just like, you know, behavioral therapy or other kinds of therapies that really don't work that well. And what you're saying is that there are underlying biological causes of many of the things that are correctable. And that kids respond really quickly and really well to these things in ways that sometimes adults don't. So being a pediatrician has to be extremely satisfying when you're using this approach, when you're not, you're just kind of putting Band-Aids on everything. And it can be very frustrating. I think pediatricians have one of the lowest job satisfactions and the highest burnout rates. And it's because they're really kind of just on this treadmill of traditional care, which isn't actually helping their patients. Your case reminded me of a boy I took care of who was 12 years old, who was so disruptive, severe ADHD, kicked out of kindergarten. You know, I mean, who gets kicked out of kindergarten? You know, was on ADD medications. And he had all these other issues that were not quote psychiatric, right? He had stomach aches, he had anal itching, he had asthma, he had allergies, he had headaches, he had anxiety, he had insomnia. Like he had a whole muscle cramps. I mean, he had all these things that were really problematic, but were treated by all these different specialists. He was on seven different medications. Yeah. And what we found was that he lived on a diet of processed food. And we did a bunch of testing. And I want to talk about testing because I think it's an important thing for, for how we, of figure out what's going on with our kids. And we did a number of tests and we found he was severely nutritionally deficient in almost everything. Vitamin D, B6, magnesium, zinc, you know, just like omega-3 fats. He had high levels of all these trans fats in his blood. He had from all the processed food, he had high levels of inflammatory fats. He had high levels of really toxic stuff in his system like lead. And his gut was a mess. He had overgrowth of yeast and leaky gut and food sensitivities. And he had gluten antibodies from eating gluten that he was sensitive to. And, you know, all I did was really do what you're talking about, was reset his gut, put him on a whole foods diet, get rid of the bad bugs, put in some probiotics, get him, get him the nutrients he needed, some multivitamin, D, fish oil, zinc, magnesium, B6. Two months later, the mom brought him back and said, he's a completely different kid. He's got no ADD, he's off all his medications, he has no more headaches, no more stomach aches, no more asthma, no more any of the other things he was suffering with. He stopped drinking all the sodas and everything, drinking all the junk food. And, um, his handwriting, which was the thing that that blew my mind, went from completely illegible to completely perfect penmanship. Yeah. Yeah. And I was like, wow, like, this is crazy. When you see something like this, you go, as a doctor, you go, either you dismiss it because it doesn't fit your paradigm, or you go, wait a minute, there's something I've been missing. Yeah. And that the body and the brain are connected in ways that are so important.

So whether kids got sensory behavioral issues, or whether the kids got allergic autoimmune issues, it's so important to get, uh, the proper evaluation. So how do you start to think about looking at these kids who are, who are stuck? One is prevention, right? We talked about that. Getting the mother's health and the father's health, great preconception. They both need to be on the right supplements, correct the things that are off, fix their guts, get rid of the metals, all the things we talk about. Now, you can listen to my podcast, "Preparing to Conceive," because it talks about what to do for both men and women. But then we have all these kids who are suffering. And these kids with chronic illnesses, these, I mean, these kids who are on multiple medications, and who are stuck in this treadmill that they're on for life, and that are going to have consequences their whole life long from these conditions. And then maybe allergies, tying into autoimmunity when they get older. And it's just kind of a mess. So when you have these kids who come to see you, and they have, you know, ADHD, or autism, or autoimmunity, or they're allergic to everything, or they have eczema, how do you start to think about assessing these patients and helping these parents think about taking care of their kids in a different way? With the child present too? Ian, we, I always want to educate and inform kids in an age-appropriate way. So I think that's where, um, making sure kids are on board with the whole plan is really important. That they understand. Because if Mom comes home and just says, okay, we're going to overhaul your diet. And all, I mean, it's, it's not necessarily. For some kids, it might be. But for many kids, it's not going to work. Right? I'm kind of showing the kids their test results, like, here, look at this. You're allergic, or look at this, you've got.

Yeah. Across the board, when I tell parents and kids when they're sitting in front of me, if they have any sort of attention concerns, behavioral concerns, um, focus concerns, anxiety, I mean, so many kids are suffering from anxiety nowadays. And when I tell them that 80 to 90% of the serotonin in their bodies is made by their gut microbiome, right? And then usually there's a pause, and parents and kids are like, what? So that's a perfect segue into, listen, let's think about all the things that are happening that are disrupting your gut microbiome. And so that's an easier in to say, let's look at the foods. Right? It's not just about like what you're eating, it's just, it's about, okay, what factors are, you know, harming your gut microbiome? And, you know, guaranteed, no matter what kids have, we can kind of link it to that. That's an easier way, I think, to have a conversation around food.

And you have to, you have to work with their goals, right? For, for parents, it might be, you know, to, what do they want? They want to feel better, stomach, want to do better in school, want to, yeah, yeah. Um, the foundations, as you said, I mean, we always talk about the foundations of food is medicine. And that sometimes is the hardest thing to, to change, honestly, right? For, for a lot of kids. And talking about, I mean, even for this one teenager who came in, and he's been gluten-free on and off, and it, I mean, he knows it makes a huge difference for him. But he's, he was having a flare of his, um, sometimes the kids just want to eat that pizza. Well, so he was having a flare. And he came to me and we did some testing. He's like, just please, please don't tell me I have to go off the gluten. And I'm like, look, I'm not going to tell you you have to. But I'm going to tell you, you know, what decisions are going to help serve your body and your brain and make you feel better, right? And he took some time to think about it. And of course, I expect that in a teenager, right? But especially for teenagers, you know, I, I let them know that we're working as a team. And the decisions you make, I mean, teenagers, they're all about, you know, trying to make it be an adult, you know, independent. But if you're going to be given the opportunity to make adult decisions, then you have to make them like an adult, and make them with information, right? Um, but the foundations, really, you know, healing the gut are, I mean, the foundations, right? But do you test kids? I mean, do you do testing and diagnosis?

So I do. I mean, when I, the first thing I'll test is blood work for nutrient deficiencies. You have to optimize. So the foundations are the.

CBC, I do a ferritin, yes, complete blood count. A ferritin, which looks at iron, that looks at iron stores. I'd like to do a comprehensive metabolic panel. That's fasting because I want to see what their blood sugar is doing. Even for fit, active, slim kids, so many more kids are showing signs of insulin resistance, yeah, pre-diabetes in kids, right? Yeah, even for kids that don't fit the overweight. You measure insulin levels. So I measure fasting insulin, fasting blood, uh, blood sugar. In the comprehensive metabolic panel, I look at their liver enzymes specifically too, because AST and ALT can start to creep up. Um, I do hemoglobin A1c, but that's rarely high. I mean, because it's just the average blood sugar, right? So if they're, most kids are kind of roller coastering up and down, right? So if they have lows and high highs, their A1C might look perfect, right? Um, I do a red blood cell zinc, a red blood cell magnesium, 25 hydroxy vitamin D. So those are kind of my foundations. I do an omega-3 profile. It's not always, not always available, but I do add that omega-3, omega-6 profile. So, and also for the young kids, you can only take so much blood at a time, but those are my foundations. Um, lately, I've been, you know, really trying and seeing a lot of nutritional deficiencies in these kids. 100%. 100% of kids have, I mean, I'm not going to say 100%, maybe 99.9%. Okay.

Wait, just stop right there. Stop right there. So what you're saying is, in the world's most affluent country, where you're probably seeing a fairly high-end population, yes, of people, not people who are highly underserved, many who are already, who are already quote healthier, parents are very proactive, they're coming to see you, and in this population, you're seeing almost 100% of kids have one or more nutrient deficiency. MH. And I'm going to say, I'll back that up a little bit and say nutrient deficiencies and insufficiencies, right? Not optimal levels. Yes. So suboptimal, bottom of the barrel, right? Um, and the most, the most common is zinc. Yeah. Okay. Zinc is, is the most common nutrient insufficiency and deficiency. Sometimes it's shocking how low a red blood cell zinc is. If you were to eat, you'd have to eat the equivalent of eight oranges today to get the nutrients that your grandma had with one orange. I mean, it's probably not quite as simple as that, but our food is less nutrient-dense. It's depleted from the glyphosate, from, you know, we're not talking about processed food, we're talking about like fruits and vegetables and food that should be nutrient dense, right? So that's why even kids who have the quote healthiest diet, it's, it's not uncommon to see these nutrient deficiencies. And by the way, what you're talking about, Lisa, is not something that most doctors or pediatricians will check. They don't check nutrient levels on kids. It's just not done. Maybe you'll check an iron level on a little kid, but, but that's really unusual. It's unusual for parents listening who are thinking, there's no way I'm going to get my kid to do a blood draw. Um, there's a numbing, alocane, pyo, numbing cream that is magic. You put it on your elbows and, I mean, kids just. Is that EMLA? EMLA cream. Um, EMLA. Yep. I would highly recommend that, at least for that first blood draw, that you use EMLA so that your kid doesn't feel the poke and, you know, just have a distraction, right? This is, this is screen time has a pass for this, where, you know, they can, they can watch Dora, they can do whatever, right?

Um, so our food is depleted. Ultra-processed foods deplete our nutrients even further. Explain why. Well, so some of these kind of anti-nutrients, right? I mean, they, they compete with absorption for our proper nutrients. Even if we're kind of pairing it with healthier foods, and ultra-processed foods, they're devoid of most nutrients anyway. So the thing with the ultra-processed foods is when you read labels, I used to say, if you can't pronounce something, put it back. But some of those things are things like riboflavin and, you know, methylcobalamin. They add them to, they have to add back vitamins and minerals. Like, always say they're enriched because they're so impoverished in the first place. They have to eat. That's right. Why would you need to add back, you know, nutrients to a food? To a real food, right? Um, and so, and I also think our kids have a higher need for nutrients. Yeah. More stresses, more nutrient. Yep. Less nutrients getting in, more use of them. Because of psychological stress, you need zinc, you need magnesium as co-factors for many of your neurotransmitters. You need your B vitamins. All of these are getting depleted. Also, when you eat ultra-processed food, you're not getting all the co-factors that you need to metabolize that food. So basically, in order to process your food in your body, you need a lot of vitamins and minerals to run the chemical reactions to turn the food into energy and do everything else. So that you're kind of in a double whammy. You're not getting the nutrients and you need more of them. I mean, it's, yeah, it's like a double, triple whammy, you know, it's. Um, and zinc especially, just as a little pearl for parents listening and for practitioners. If you have kids who are super picky, sensory, you know, cover their ears when they're in a public toilet, or parents have to, the kids have to leave if they run the blender or the vacuum, or maybe they, they know to buy seamless socks or cut off all the tags on the shirts. So if you have a kid like this, you know exactly what I'm talking about, right? Um, and, and that can be one of the most challenging things. Well, zinc deficiency alters your taste profile. So it can trigger pickiness, low appetite. Also, there's, there's amplification. It's called auditory gain, where sounds sound louder. The sensory issues, the tactile tags, socks, shoes, all of that. If you have a pediatrician or, or physician who is not ordering tests for you, or you're not able to find a practitioner to order tests, sometimes just supplementing with a little extra zinc, and parents will say, oh my gosh, they got out the door in five minutes, not 20, because I had to tie their shoes over and over again because they weren't tight enough, right? Or their palate is actually expanding a little bit. It could be a symbol of that. But knowing that zinc is one of the most common nutrient deficiencies in kids, it can be so profound. Just to, I mean, there are clinical clues that kids may be deficient. But I always look. Ever use a zinc taste test? The Tally use? Yeah. I mean, sometimes it's harder for kids, but yeah, you basically take this zinc liquid, and if you don't taste anything, then you're deficient. That's right. So instead of doing a blood test, you can actually do a, just like a test in the office or at home. Totally. Zinc sulfate. Yeah.

So this is amazing. So that sort of speaks to, you know, the need for, for supplements. Because you think, oh, kids are healthy, they're young. Well, they don't need supplements. But do kids need supplements? And if so, what supplements are non-negotiable? And, uh, you know, what, what should kids be taking? You know, especially if I don't, and not Flintstone vitamins. Not Flintstone vitamins, please. If I have the opportunity to check lab work, then I will supplement individual nutrients based on the lab work. You know, many, many kids are going to have, especially if they have chronic issues, they will have issues with methylation and need more methyl factors. But I have yet to see a young kid with an elevated homocysteine. Maybe on their urine. Um, so I will do urine organic acid tests because they're so much easier to get. So much easier to get a poop test than a blood test. Sometimes a pee test than a blood test. Sometimes if we want to look at methylation stress, you can look at methylmalonic acid or figlu for formiminoglutamic acid, right? These are just markers of folate or B12 deficiency that you can see in the urine. Yeah. Um, and then, you know, even on, on stool testing, if I see inflammation or digestive insufficiency, right? They're not digesting, they're not absorbing their fats, or, you know, their proteins, or their carbohydrates. I might do digestive enzymes. But across the board, I would say virtually all kids need extra vitamin D. Even in the middle of summer, when kids are out at summer camp and they have that golden tan, even then, when I've measured kids, they are not optimal. Yeah. Right. True. So, and in the northern hemisphere where we live, um, apart from summer, you're really not going to get enough conversion through your skin in any other season. And unless you're running around half naked in a bathing suit for, you know, at least half an hour a day, and from 10:00 to 2:00 in the afternoon, not lathered in sunscreen, not lathered in sunscreen, you're not going to get exposures that are going to make a difference. Maybe for a life card, you'll be all right, but that might be fun. Um, but so almost all kids, and I would bet their parents, need vitamin D. So vitamin D3. Do they need K2? I'll add K2 when they get older, for sure. For teenagers. Almost all kids need an omega-3. Yeah. A fish oil. Right. So important for, add depression, skin health, hair, all of it. And their kids' hormones. If, if kids have, um, atopy, eczema, asthma, I'll make it a 3-6-9 fish oil, omega-6 supplement with GLA. So that's an omega-6, guys, found in borage, black currants, even evening primrose. It's really good for autoimmune and atopic conditions. Yeah. People think all omega-6s are bad. They're not. They're not good or bad. They just, it's the quantity we have. And it's certain types are actually really beneficial, like you're talking about GLA, which is from evening primrose or borage oil. Yeah. Yeah. Yes. So important. So I would say those are my staples. And I, I will say, I am forever on the hunt for a high-quality children's multivitamin that I love. You haven't found one? I mean, I found a few that I'm okay with, right? And none is perfect, but there are some that are better than others. What I would move away from are some of the over-the-counter gummy vitamins. Gummy vitamins. Now, some, like we carried a gummy line that was awesome because each gummy only had 0.5 grams of sugar. But some of them, if kids are getting the gummy vitamin D, and some extra gummy magnesium, and, you know, gummy vitamins, I mean, in that like handful of gummies that they're gladly chomping away on, you know, before they head off to school, they might have had like four teaspoons of sugar in that one sitting, right? And so we don't want to send our kids off with with a mouthful of sugar. And how parents go about finding good products, like, you know, omega-3, vitamin D, and multi, um, maybe zinc if they needed, magnesium, probiotics. I mean, it's, it's kind of a zoo out there to find the right. It is. It is kind of a zoo. I mean, I use the practitioner brands, brands, right? Because now they're available to consumers of Pure Encapsulations or Designs for Health, available to consumers. I think Thorne, now is available to consumers. So, um, it's much easier to find. And what I tell folks is, either purchase from your practitioner who you know is, you know, storing, handling things well. If you're going to buy from Amazon, make sure you buy it from the manufacturer's store, not from like, Judy's health food store. Yeah, cuz a lot of these, like, you might, they might buy a lot that's almost expired, that might have it on sitting on the tarmac, you know, in a warehouse that's at 120 degrees, and it's a problem out there. So you have to be careful for products you buy on Amazon.

I want to sort of dive into a topic. We talked about the gut, we talked about diet, we talked about testing and supplementation, and there's so much more in your book, Healthy Kids, Happy Kids. Everybody who's had a kid, is going to have a kid, or is going to have a grandkid needs to get this book. Um, let's talk about a controversial subject here, which is vaccines. Because it's a question I probably get most, which is, should I vaccinate my kid? How many vaccines should I get? Should I get all of them? Should I get none of them? Should I get some of them? When should I get them? What's the schedule? Should I take them on? Are they safe? Do they cause autism? And, and one of the challenges in medicine today is that it's become a bit of a religious phenomenon in the conversation. It's not a scientific conversation anymore. And I want to have an intelligent conversation about vaccines because they are, like any other intervention in medicine, whether it's Tylenol or aspirin or even a supplement, it's an intervention that has potential benefits and potential risks. And for some reason, we're not allowed to talk about any of the risks in medicine. It's literally heresy. I was at the Cleveland Clinic and I literally had to write a public statement saying that I was not against vaccines. Oh my gosh. By the Pediatric Institute, because they somehow kind of got wind that I talked about some of the challenges in vaccines. And I was like, wow, you know, this is, this has gotten to be almost like pro-choice, Republican, Democrat, Arab-Israeli. It's like, wait a minute, like, this is not so polarized. We have science, we can talk about these things intelligently. And they're not all good, they're not all bad. And what's happened in, in, you know, since I was trained is that there are so many more vaccines than they were, and there are so many more recommended. And I just want to sort of lay a little bit of the stage for people because I remember, uh, getting recertified for my board, my board certification, and I went to a UCSF prep course because, you know, you kind of forget stuff. So you go to like a week-long prep course to kind of, kind of refresh your memory about it. Get well, here's what you have to refresh your memory about, right? It's the conventional stuff that you're not doing anymore because, you know, there are other functional. Yeah, yeah. But, but even, you know, even so, I mean, it was really, it was, it was a good background. And it was like, what is the latest things we should be doing? And a pediatrician got up from UCSF and this was probably like, oh gosh, been 15 years ago more. He got up and he said, you know, here's the vaccine schedule that's recommended now, but I gotta tell you, this is a lot of vaccines. And I, like, I was like, he was kind of almost sheepishly saying, this was the standard of care recommendation. And, you know, there were eight jabs that kids got. Now there's like, I think 70 plus vaccines they can get. And part of that had to do with the indemnification of vaccine manufacturers, who basically were going to get out of the vaccine business because it was too risky and it was too hard to do studies. And so the government said, no, we think vaccines are important. We're going to protect you. You guys go ahead and do your discovery, make the vaccines. We're going to take all the liability. So we're going to, if somebody sues you, they can't sue you, they're going to have to sue the government. And we're going to settle in vaccine court. And there's over $5 billion of settlements in vaccine court for vaccine injury. So it's not like a trivial thing. There's whole fields now of scientific inquiry around vaccinomics, which is understanding how do you match your vaccine schedule or your dosage or your type to your particular genetics. And so I think, I think we need to have a sort of intelligent conversation because you'll hear vaccines cause autism. Well, no, they don't. It's, it's a whole consequences of different insults that maybe make kids predisposed when they get an insult, whether it's an infection or some kind of stress or a vaccine that then triggers something. But can you talk about, as a pediatrician, how you help parents navigate this landscape of vaccines? Yeah. When they're, you know, come to with their first baby visit and throughout the early childhood years, how do you advise them to think about this and to customize this approach to intelligent vaccine use? Yeah.

I love so much of what you said because really, I mean, in our, in our kind of modern day of medicine, where hopefully we truly are moving more towards precision, personalized medicine, why not have that same approach to vaccines? It has become a bit of a religious, and simply, it's heresy. You get, you get canceled if you say anything against vaccines, right? Yeah. And you're almost, if you just want to have a discussion, you're immediately branded as 100% anti-vaccine, which, you know, what I've always told, I'm pro-science. How about we, like, you know, my friend once said, you know, I'm, I'm for safe planes. It doesn't mean I'm anti-flying. Yeah. Yes. 100%. I mean, that's what I tell families is, look, I am not 100% vaccine or 100% anti-vaccine. What I am is 100% your child, right? And that is the only thing that is important here. And what we need to do, just like everything else, I mean, even with medications, we know with some of, uh, some of the, you know, genetic snip testing that this little child might actually need more, a higher dose of a certain medicine than a full-grown man because of the way they metabolize, right? And so, um, just as you said, vaccinomics is this field that is trying to figure out how to make vaccines more effective based on your genomic profile. Aders omics is the flip side, which is not, they're many fewer or way fewer studies on aders omics, which studies the genomics behind who may be more risk for adverse reactions to vaccines than there are on vaccinomics. But we need to get there, right? And we're not there yet. So how do we then think intelligently about what is right for this one child? And this is where we have our public health, you know, outcomes that we'd like. But when you're in the office, you're looking at this individual child, right? And so we have to look at family history because we know that certain vaccines, like Hepatitis B, is in the literature known to temporarily cause a skewing towards autoimmunity. Yeah. So if I have a child in front of me where every single family member has some autoimmune disease, am I going to be more worried about them getting Hepatitis B, especially at that young vulnerable age when they're an infant, maybe, right? And that's a vaccine that is protecting against a disease, Hepatitis B, caused by intravenous drug use and sexual activity. And we're giving it to babies in the hospital the day or two after they're born. Why? Because we have them captive and we might not get them back. But it makes no medical sense. It would maybe make medical sense if, you know, Mom or someone in the family has it, right? But apart from that, it's true. So this is also where we have the science and then we need to really let our logical, more rational part of our brain kick in. Why would a newborn who doesn't have risk factors for contracting Hepatitis B need it right then and there? Could they wait until they're, you know, pre-teen, teenagers, thinking about becoming sexually active? Like, why not? And that's what I always ask my pediatrician friends who maybe are not on the same boat, like, if you can explain to me a compelling reason why a newborn who has zero risk factors should get this right then and there, and we know that they're not going to get lost to the healthcare system, you know, they're reliable families, you know, then, then tell me, right? Um, the other thing that, that, you know, we, we really want to think about is from a logical standpoint, that infant Hepatitis B dose that, as you said, like a one-day-old would get, is the very same dose that in my office, I would give to a 17-year-old, you know, teenage football player who weighs 200 pounds. So you have a seven-pound baby on one hand, a 200-pound teenager, young adult on the other hand, same Hepatitis B dose. So it, that also doesn't make sense to me, right? So as I kind of walk through and I think about what do kids need to get for, let's maybe daycare, school reasons, and for some families, they don't have the option to stay at home or, you know, homeschool their kids or move to another state. Let's say if your state does have more restrictive, um, vaccine policies and doesn't allow you to choose a more flexible schedule for your child, well, our hands are kind of tied then. So the way I try to really think about it is, you know, when I give vaccines, it's sort of interesting that the state is interfering in medical decisions. I think that's absolutely. I mean, this, this should be what happens. Imagine, imagine, you know, the government deciding which statin you should be on or which blood pressure pill you should be on or when you should get it. Or I mean, it's kind of odd, right? And it's, it's a public health issue, I get it. But, but, uh, it's, it's a little bit heavy-handed. And I think, you know, one of the things that I, I have a challenge with the vaccines and I think, you know, we talk about evidence-based medicine. Now, each of the vaccines have been tested in, in as single vaccines, uh, for relatively short periods in small groups of people. So we don't really know how they work long term in large groups of people. But what, what's not done, and this I think we don't practice evidence-based medicine in this context, is we've never looked at the concoction of all the vaccines in the dosing schedule that we've given to kids. When you give so many vaccines at once and in what that does to their immune system, to their biology, to their proteomics, to their metabolomics, to their epigenetics, to the immune system. We don't, we don't even look at it. So essentially, we sort of, vaccines are staple. We don't need to study them. End of story. Just give them. And it's just the most unscientific thing. I mean, I think vaccines have been one of the most beneficial things that humanity's ever discovered. But like, do kids need every single vaccine from the minute they're born? I don't think they do. Like, they need the important ones. Yeah. I mean, to your point too, I mean, same thing with, you know, environmental toxins or ultra-processed food ingredients. Maybe we've tested in isolation each ingredient or each toxin, but not the concoction, as you said. And many are found to have harmful synergistic, meaning it's not just 1+1 equals two bad, it's like 1+1 might equal 10 times the bad. Um, so, you know, when we think about this vaccine schedule, what, what I try to work with families on then is, I like to do one at a time, right? At first, right? Because then if a child is going to have a reaction, we know exactly which one the reaction. So you do, you don't like, for example, a lot of these vaccines come in cocktails, like MMR, measles, mumps, and rubella, or tetanus, diphtheria, and pertussis, like DTaP. So how do you deal with those? That's a great, great point. Because with those, we don't have an option. There used to be a separate MMR. Now there's only just MMR. Um, and the Tdap, you could potentially get, you know, tetanus separately, but it's hard to, hard to find, right? I would say one grouping. So polio separately, um, DTaP separately, MMR separately, varicella separately. If, if given the choice, I do think, you know, knowing how profoundly a baby's immune system changes in that first month of life, first three to six months of life, you know, first year of life, you know, if we can wait a little bit, just to let their immune system start to do its thing, set a good healthy microbiome. If only for the fact that we know that an optimal gut microbiome can improve vaccine efficacy. So if that's our only goal, then then even, I mean, that's a really profound statement you just said. Let's get the kids healthy and optimize their microbiome before we start vaccinating them. And that should start even preconception. Yes. Right. And then when the mother's pregnant, taking her probiotics, and then maybe getting the baby, uh, Bifidobacterium infantis early on, and the right prebiotics that you mentioned. Yeah. And let's get their guts healthy. And what I've seen is kids who are somehow compromised are the ones who have trouble with vaccines. Kids who have had tons of antibiotics, ear infections, who have gut issues, who have these kinds of problems early on, when they get vaccines, they're the ones who tend to have the issues. Do you see that? You know, yes and no. I mean, I would say my population, um, my patients, we work so closely together around vaccine schedules, and I support them. I give supplements before and after to help them with their methylation. And we know a lot of these vaccines can stress the mitochondria, so I provide mitochondrial support. You know, I optimize their nutrient levels. I make sure they're getting vitamin D. And, you know, many of these vaccines will have not just aluminum, but formaldehyde and other ingredients. So how do I get them to clear that out faster? Well, I'm making sure they're taking extra glutathione and vitamin C and Epsom salt baths. So, um, I mean, knock on wood, most of my kids do so well. And I, I really do think it's because we've prepped them. We allow space in between vaccines for the body to do its thing, hopefully mount effective immune response, because that's why we're giving the vaccine anyway, settle back down to baseline before we do the next one.

So are there any resources for parents, people listening, that they could go to to learn about how to do this more intelligently and scientifically? Okay, I'm going to be totally honest. I mean, it's, it's been hard for me to be able to share a lot of this publicly, right? Because you get canceled, right? I mean, that's the truth of it. I do, you know, at, um, you know, at practitioner conferences, I, I try to teach practitioners the science behind different vaccines, what we know about aders omics, what we know about vaccinomics, what supplements may be beneficial, um, what lifestyle factors, because we know exercise before and after vaccines may reduce vaccine, um, adverse reactions while improving efficacy. A good night's sleep, you know, they found the sleep two nights before actually improves vaccine efficacy. Um, reducing the sugars around. So I try to help other practitioners so that they can help their individual patients. But then on a, I know that there are some physicians who have, um, uh, you know, vaccine, um, online education programs for for families. Um, I haven't taken them, so I don't know what exactly they say. I think I do think that they're on the same page as I am, that it's not a never, it's not a follow the schedule 100%. It's a, let's be smart about this, evidence-based and personalized. Yeah. And I, you know, there's a, a colleague of mine years ago, she wrote a book, was quite a while ago now, 2001, called What Your Doctor May Not Tell You About Children's Vaccinations, as a guide to understand, you know, how to make knowledgeable, responsible, science-baked choices about vaccinating their children. So I, I people to check that. I might be a little dated, but I think it's probably still. And I think there are so many more vaccines than even when that book was written, sure. You know, so it's kind of crazy. But you're really such an incredible resource for parents. Uh, I was joking before when we were going to get a snack, I said, you know, you're kind of like the new Dr. Spock. For those who don't know who Dr. Spock was, he was a doctor in the '60s and all parents read his book, you know, Dr. Spock's Guide to Raising Your Kid. I remember what the title was. I met him actually when he was in his '90s. Really, really cool guy. Um, but he, you know, my mother read that book. I was at home and all, every parent had, every parent really should go out and have this book, Healthy Kids, Happy Kids. You can get everywhere books are sold. You can go online and you can find the book at healthykidshappykids.com. Check it out. It's called Healthy Kids, Happy Kids, an Integrated Pediatrician's Guide to Whole Child Resilience. And that's really what this is about, making your kids resilient so that they don't have to suffer from so many of these childhood problems that we're seeing from, um, allergies and autoimmunity and gut issues to ADD and autism, to learning disabilities, autoimmunity, and in mental health disorders, depression. All these things are related to these things we're talking about. And we, we in traditional medicine, we treat them all as separate little individual issues. But if you get to the root causes, which we're talking about, which is your nutrition, your gut health, your nutritional status, toxin levels, and many things that we can actually do something about, then these kids get better. And they're incredibly resilient. And they respond really well to these approaches. And it's quite, I've seen just so many miracles in my practice. I know you have too. When you start to apply this, it's really satisfying. So parents out there listening, if you're struggling with any health issue with your kids, just immediately go get this book right now. Thank you so much. And Alisa, thanks so much for what you've done to bring this field forward, being an advocate for functional medicine approach to pediatrics. Uh, we really need you. The world needs you. And, uh, thanks for everything you do. Oh, thanks so much for having me. If you love that last video, you're going to love the next one. Check it out here.