Healthy Kids, Happy Moms Read online

  One in every eleven children has asthma in the US.1

  One in five has eczema (and it’s on a steady increase in industrialized countries).2

  One out of four children experiences recurrent ear infections by age seven.3

  One in twelve has food allergies.4

  One in three has food sensitivities.

  One in eighty has celiac disease.5

  One in five is obese.6

  One in five has mental or behavioral impairments such as ADHD.7

  In other words, we’re sicker than we’ve ever been, and if our children are the future, the future is not healthy.

  In this book, we’ll explore children’s health—especially chronic illness—through a new lens: through the eyes of an integrative pediatrician and an integrative pharmacist/mother of triplets. When you learn how to see and pay attention to the signs that your child’s body is showing you, the path to healing is more clear and easier to follow.

  This book is loaded with case studies and a step-by-step guide to addressing chronic childhood illnesses using my HKHM program. With that said, this program is not appropriate for children who have severe food allergies; are underweight; have a G-tube; have severe pickiness or disordered eating; have a serious illness such as lupus, cystic fibrosis, chronic Lyme disease, or cancer; or have an undiagnosed illness.

  GENETICS AND ILLNESS

  Early in my career, while taking a family medical history, I listened for incidences of family illnesses to help discern whether the child’s issue was an isolated case or could be due to genetics. Now I know how to look beyond genetics for further insights by identifying inflammation from food and other sources.

  Here’s a case from my own coffers. At the age of forty, I discovered I had a gluten sensitivity—as do one of my sisters, both of my parents, and one of my nieces. None of us meet the medical diagnostic criteria for celiac disease, but we all had health issues that either resolved completely or improved significantly when we stopped eating gluten. These included constipation, hemorrhoids, stomach pain, bloating, excess gas, weight gain, brain fog, joint pain, rosacea (red rash on the cheeks), anemia, and lack of energy. This certainly sounds like something with a genetic basis, doesn’t it?

  Celiac disease is an autoimmune condition where the body reacts to gluten. Gluten is the protein found in wheat, barley, and rye. The disease can cause a host of different symptoms including gastrointestinal (GI) issues such as abdominal pain, constipation or loose stools, hemorrhoids, stomach pain, bloating, weight gain or weight loss, skin rashes, low energy, difficulty focusing (brain fog), or fatigue.

  Dr. William Davis, a cardiologist who wrote the book Wheat Belly, would describe what my family members and I have as antibody-negative gluten sensitivity. We have many celiac disease symptoms, but our bodies don’t make the classic antibody we test for in conventional laboratory tests. (We’ll discuss testing in chapter 4.)

  The discussion about gluten and my family always reminds me of my beloved paternal grandmother who we called Gram. She had stomach issues and ulcers her entire life and ended up dying with lymphoma. Individuals with undiagnosed celiac disease who continue to eat gluten have a three times higher rate of lymphoma than the general population.8 The good news, however, is that once you go off gluten and your gut heals, your risk of lymphoma decreases to the same rate as that of the general population.9 I now suspect that she may have had celiac disease, or possibly what the rest of us have, but she was just never diagnosed with it.

  I will tell you more about my experience with gluten later, but the upshot is that a conventionally trained medical doctor with little nutrition training on the subtle differences among food allergies, food sensitivities, food intolerance, histamine intolerance, and celiac disease would likely have told me that I didn’t need to be off gluten because I didn’t have celiac disease or a true food allergy to wheat. If I’d started eating it again, my symptoms would have all come flooding back, and I would have ended up with a diagnosis of fibromyalgia or chronic fatigue syndrome.

  My personal medical situation is part of what motivates my passion for identifying food sensitivities in children. It took me more than ten years to realize that the food I was eating was causing my GI issues. It took me that long, despite the many years of conventional and integrative medical training I had been through. The purpose of this book is to shorten the learning curve for you parents.

  Now, back to my grandmother for a moment. Assessing a family medical history includes understanding ethnic tendencies toward certain diseases, which can also provide significant information. For instance, celiac disease is more prevalent in people of Northern European descent, specifically Irish, Scottish, and English. I have Irish, Scottish, and German roots, so I need to pay attention to my symptoms, my family’s history, and my ethnic background. Sickle cell anemia is another good example: it is more prevalent in people of African, Central and South American, Middle Eastern, Asian, Indian, and Mediterranean descent.

  Because of my personal experience and my integrative medical training, the way I interpret a child’s history now is very different from the way I did fifteen years ago. Conventional medicine trains doctors to look for the diagnosis and treat it with medications and/or surgery. In integrative medicine, we are trained to look for patterns and view all symptoms as related, aiming to uncover the underlying cause of the inflammation. (We’ll talk about this more in chapter 2.)

  One system is not superior to the other—they simply have different perspectives and scopes. Each system has its place. Conventional medicine, better sanitation, and improved nutrition are the collective reasons our children are far more likely to live through childhood now than they were a hundred years ago. It’s also the reason women typically survive childbirth and why we survive inflamed appendices, childhood kidney infections, and other formerly fatal ailments.

  GENETICS AND EPIGENETICS

  Looking through an integrative medical lens and taking into account an emerging field of research called epigenetics, we now know that our environment—including things such as food, environmental allergies, environmental toxins, infectious diseases, and stress—can influence our individual genetic expression.10

  The old model told us that our genes are fixed and whatever diseases our parents or grandparents had, we will also likely have. For example, if your father died of a heart attack at forty-five, there’s a good chance you will have a heart attack at forty-five. What epigenetics shows us is that certain things such as heart disease are not set in stone. Rather, it is the interaction of our DNA (genetic makeup) with all aspects of our environment that impacts our health. One good example is green leafy vegetables. Research has shown that a component of green leafy vegetables (methylators) can turn off genes that we don’t necessarily want turned on.

  The researchers took pregnant mice that were overweight, yellow, and diabetic. They fed them methylators during their pregnancy and the babies came out brown, normal weight, and non-diabetic.11,12,13 I’ll never forget when Chris Magryta, MD, my friend and a brilliant integrative pediatrician here in Charlotte, told me about this research. It’s drop-your-jaw, fall-off-your-chair kind of info for us doctors. To be able to change the genetic expression of the offspring was just not heard of. Epigenetics gives us a huge bag of hope for all children. We can start where we are and make great headway.

  Epi means above, so epigenetics refers to the material above the genome that can cause activation and deactivation of genes, without a change in the underlying DNA.

  When I review the family history, I highlight certain aspects to give parents an even more compelling reason to make nutritional changes that can have such a profound impact on their child’s health.

  family history of chemical dependency and addiction

  Another crucial part of the family history pertains to chemical dependency and addiction. These often can lead an individual to self-medicate for some undiagnosed or untreated issue, such as anxiety, depression, ADD/ADHD, anger,
learning issues, or chronic pain.

  If a child is struggling in school or dealing with anger or anxiety, that child may be showing signs of a particularly important aspect of the family history. Is it possible that Grandpa, who was an alcoholic most of his life, actually had anxiety? Was alcohol the only way he knew how to manage?

  If we explore the family history in this way, it helps us better understand our children. If we can recognize anxiety in a child at the age of seven versus twenty-seven, imagine all the tools with which we can equip that child. Even more, think about the stress, relationship dysfunction, miscommunications, and heartache we can potentially help her move through more gracefully, by identifying and treating her underlying anxiety.

  Figuring out what health issues your family members may have struggled with can be the most challenging part of this process. Some families don’t talk about health issues, especially those related to mental health. It also might be difficult to remember illnesses grandparents experienced.

  I take epigenetics into account with every child I am seeing, even those with underlying genetic changes. For example, we know a child with Down syndrome has an extra copy of the twenty-first chromosome. This mutation is fixed and will result in certain cognitive and physical changes. For example, the anatomy of the ear canal, Eustachian tube, nasal passages, palate, and back of the mouth may be smaller than that of a child who does not have trisomy 21, putting them at higher risk for issues such as ear infections and sleep apnea. To solidify the concept of epigenetics, I’ll share a case from my clinic.

  Epigenetics taught me to look at children’s illnesses and inflammation in the context of their environment and not assume simply because they may have different anatomy from other children that their inflammatory issues and illnesses are set in stone.

  CASE STUDY

  MARCUS

  SYMPTOMS: EAR INFECTIONS, SINUS INFECTIONS, SLEEP APNEA, CONSTIPATION

  Marcus’s transformation blew my mind. His constellation of symptoms was extremely complicated, but his mother turned his health around just by listening to a talk I gave at our local children’s library. After my presentation that day, she went home and made the changes I talked about. Six months later she brought nine-year-old Marcus to see me.

  What she had done with his health was beyond impressive. Marcus’s mother was another sign to me that I needed to compile this information into a book, so every interested parent could access it.

  Marcus was a cute boy with Down syndrome and autism. I distinctly remembered his mother, because she’d asked great questions during the talk. I thought, Wow—this mother gets it! I share his case here because he is an example of one aspect of genetics that is fixed. He has an extra twenty-first chromosome, and green leafy vegetables will not change that; however, the constellation of inflammatory symptoms that he was struggling with can be shifted.

  In the office, we reviewed his history. Marcus had nearly every one of the common childhood inflammatory illnesses that I am addressing in this book. Marcus had six sets of ear tubes for recurrent ear infections, surgery for recurrent sinus infections, and he had such bad sleep apnea that he had his tonsils and adenoids removed, and part of the base of his tongue was resected. (These procedures helped to open his airways, so he could get enough oxygen while sleeping.)

  He also had severe constipation and eczema. His skin was very dry and rough, and he’d been on countless rounds of antibiotics.

  After the library talk, Marcus’s mother took him off dairy and gluten, started a probiotic, increased his omega-3 fats with fish oil, and started a vitamin D supplement. His lifelong constipation resolved fairly quickly, and his nasal congestion improved somewhat. However, even though the ear infections slowed, he was still requiring antibiotics every three to four months.

  His mother and I decided to do some IgG food sensitivity testing on him. (I’ll discuss this more in depth in chapter 4.) I don’t order this test often because it doesn’t have strong scientific reliability. In situations like Marcus’s, I find it helpful when we interpret the test results in the context of his overall clinical picture and keep its limitations in mind.

  His test results were positive for many foods, including gluten and dairy. Mom felt confident she could remove the additional foods from his diet, and since she loved to cook, she proceeded to shift his diet yet again, while keeping him off gluten and dairy.

  Normally, we remove these foods for three to six months and then add them back. However, Marcus was doing so well with these foods out of his diet that she kept his IgG-positive foods out of his diet for an entire year. She also decided to take all grains out of his diet.

  One year after being on this anti-inflammatory diet, she exclaimed, “He’s never been better!” It was the first time in his life that he went an entire year without a single antibiotic.

  He did continue to experience some mild nasal congestion, but his parents controlled it with a saltwater nasal rinse using a neti pot. Marcus’s mother taught him how to do the rinse himself.

  He was still on the autism spectrum, but he was significantly less hyperactive and less aggressive. (Previously, they’d tried a stimulant medication for the hyperactivity, but it didn’t help.) Furthermore, the ear tube fell out of his right ear (the one from his sixth set), and his ENT doctor thought for sure Marcus’s ear infections would return. They never did.

  Marcus is a testament to the power of nutrition. Changing your child’s diet can be a tremendous amount of work, but the effort is worth it in the end. Once the child’s systemic inflammation has decreased and his system is back in balance, you typically don’t have to be as strict with the diet. But that depends on the child and how sensitive his body is.

  Our conventional medical system trained me to look at Marcus in parts. Sleep apnea is separate from constipation, which is separate from recurrent ear infections, eczema, and hyperactivity. Integrative medicine taught me that all of these are related and worsened by inflammation, and once we figured out the inflammatory triggers, we could begin to decrease that overall body inflammation.

  As we decreased Marcus’s excessive systemic inflammation, some of his chronic congestion and mucus buildup improved. This allowed his Eustachian tubes to drain more effectively, potentially lessening his recurrent ear infections. Air could also pass through his nasal passages more easily, possibly lessening recurrent sinus infections. His gut inflammation lessened, improving his constipation and eczema, and with less inflammation and better nutrient absorption, his immune system could start functioning more efficiently, so he did not end up on antibiotics once a month.

  As you can see from Marcus’s story, this transformation doesn’t happen overnight. We slowly and methodically work to rebalance the overriding inflammation in these kids. That’s what we’ll explore in the following chapters.

  TAKEAWAYS

  Integrative medicine is a powerful combination of conventional medicine partnered with natural and nutritional therapies. The blend of both systems taps into the body’s innate healing capabilities.

  One in two children today suffers from a chronic illness.

  Epigenetics is an emerging field of research outlining the way our genes interact with the environment. Nutrition is a powerful tool to optimize gene expression and overall health.

  Armed with the right information, guidance, and structure, the nutrition and supplement recommendations I make in section II of the book offer the possibility of changing your child’s health forever.

  CHAPTER 2

  to understand illness, first understand inflammation

  MARCUS’S STORY IN CHAPTER 1 is a profound case for understanding the role that genes, nutrition, our environment, and epigenetics plays in our overall health. We removed certain foods as a part of an anti-inflammatory diet for Marcus and saw profound improvements in his many inflammatory conditions (eczema, recurrent ear and sinus infections, constipation, and hyperactivity). But before we go any further, we need to have a shared understanding of what
I mean by inflammation and its role in our health.

  When most of us think of inflammation, we see images of a hot, puffy, red, irritated, and painful body part, like when a cut gets infected. However, inflammation is more than an acute response to injury, and it’s not always just localized to one part of our body. Inflammation is an intricate, complex response by the whole body to what it perceives as a threat.

  This means the body can have an inflammatory response for many reasons—not just from infection but also from irritants, allergies (food and environmental), and even stress. If we think of inflammation as the body’s self-protection mode, we can understand how and why inflammation can become chronic and spread throughout the body.

  To some extent, we need inflammation. If we cut a finger, we need the inflammatory process in that area to stop the bleeding. If we sprain an ankle, we need white blood cells to go to that area and begin to repair the damaged tissues. But when inflammation goes unchecked, and the body keeps mounting an inflammatory response to the same trigger, it leads to chronic inflammation and disease. Integrative medicine teaches us that we need to look not only at why the body is responding to a trigger but also at what that trigger is.

  A HELPFUL INFLAMMATION ANALOGY

  Think of a glass of water. The glass is the body, and the water is the inflammation in the body. Our bodies have a baseline level of inflammation, depending upon the five contributing factors to inflammation (genetics plus food, environmental allergies, environmental toxins, infectious diseases, and stress, both emotional and physical), which I’ll talk about shortly.