Bambini December 2016 Newsletter 
Parent Forum
Bambini will host its first parent forum on Saturday January 21st at 1:30 PM (snow date 28th). Dr. Malak will be all yours for an hour of Q&A. Any common concern will be fair game - ask those questions you don't get time to address during an office visit!

We will also take a few minutes to talk about the Bambini Club, a membership option that we are working to bring on in early 2017. Light refreshments; this event is complementary. RSVP to:
Autistic Spectrum Help
The number of children on the autism spectrum continues to climb at a disturbing rate. We just saw a two year-old boy who was breast-fed several months, on delayed vaccine schedule, and on nutritious diet come down with the disorder. Fortunately, the number of practical treatment options continues to grow as well!
For instance, last month researchers from Egypt published a report on vitamin D in children age 3-10 with autism. Kids in the treatment group were given 5,000 units of D3 daily (those under 35 pounds were given a little less). There was marked improvement at the four-month mark. This comes as no surprise to us. Bambini has been recommending vitamin D3, especially for kids on the spectrum, since we opened our doors. Nice to finally see a double-blind study.
Next, a short blog entry by Dr. Patrick Nemechek from Phoenix entitled "How I Reverse Autism in Children" recently came through our inbox. The title certainly caught our attention! Like most of us that, Dr. N recognizes that kids on the spectrum have disordered bowel flora or "dysbiosis." He has found that giving kids 2-4 gummies of inulin (a prebiotic vegetable fiber) per day along with fish oil not only quiets down their small intestine bacterial overgrowth (SIBO) - but also calms neuro-inflammation and gets these kids talking. Go figure! The Bambini Apothecary just sold out of these gummies. You can get them on Amazon, but we should be restocked by next week.
Finally, a very interesting article published in Nature a few weeks ago also caught our eye. Teams from both Arkansas Childrens Hospital and SUNY Downstate, under the direction of pediatric neurologist Richard Frye MD, examined the effect of massive doses of a form of vitamin B9 on 48 autistic children with a mean age of seven years.
It has been known for some time now that mutations in the MTHFR gene are associated with an increased risk of autism. We test all our patients on the spectrum for these mutations. More recently, a condition called cerebral folate deficiency has been identified. These kids make antibodies against the folate channels that pump folate across the blood-brain barrier; they go on to have regression and neurological troubles.
The researchers gave the children in their study up to 50,000 mcg per day of leucovorin (another name for folinic acid), an active form of folate that is used, for instance, to "rescue" children when they undergo chemotherapy. A typical children's vitamin contains 200-400 mcg of folic acid, a less active form of vitamin B9.
What did they observe? After 12 weeks, the children that were treated with the leucovorin had marked improvements in language. Children with good glutathione levels did the best.
They also found that children with folate receptor antibodies (FRA) had better responses. Because these huge doses of leucovorin run about $200 per month, it may be practical to test your child for FRA. The test also runs $200. We have our first patient scheduled to get tested next week.
What causes these antibodies? It seems that exposure to cow's milk sets them off. We're not sure but suspect that raw milk is much less likely to trigger them. If a child with high levels of FR swears off cow's milk and addresses leaky gut issues, over the course of time, the antibodies should recede, and the monthly bill for folinic acid could be history.

Word about this treatment may already be starting to get out. Some of the Canadian pharmacies we checked for high dose leucovorin were out of stock.
Practice News
1.  Bambini will be closed on Monday December 26th (Christmas holiday observed) as well as Monday January 2nd. We will be open as usual from 9-12 noon on both December 24th and 31st.
2.  Beginning in January 2017, Dr. Malak will be seeing a limited number of  new patients for help with complex problems such as autistic spectrum, PANDAS, ADHD, auto-immune, and mood disorders.  These Consult Service visits are on a self-pay basis. We hope to expand this service to other clinicians over the coming months.

Appointments will generally be 45 to 60 min and are especially suitable for families traveling from a distance. A portion of these slots is for records review if you've brought them along and for entering notes in our medical chart. Click here for additional information; contact  Mark or Dionna for pricing and scheduling.
3.  Since September, Bambini has been hosting a monthly meetup of integrative clinicians from the local area. The December event was well attended. The theme for the January 10th meetup is oncology.  Do you know an oncology clinician (physician, nurse, therapist) with functional medicine interests?  Click here to forward an invitation. 
4.  How honored and grateful we are that so many of you took the time to nominate three of our clinicians for recognition by Hudson Valley Parent Magazine! Once again this year, Dawn Prati C-PNP topped their list of favorite nurse practitioners. Somer Delsignore C-PNP (who is joining Ken Bock MD in Red Hook in January) and Dr. Malak were cited as well.

We really do appreciate your support - even sending us over the 1,500-Likes mark now on Facebook - more than any other regional pediatric practice.
Teens & Stretch Marks
During annual check-ups, we commonly see teens that have rather suddenly developed stretch marks. Some of these are associated with excessive weight gain and show up on the lower abdomen and thighs. Girl may get them on the breasts as they develop. Taller boys can get them on the lower back during their growth spurt. Some degree of self-consciousness can ensue.
Fortunately, in our experience, stretch marks that come on during the mid-teen years often resolve on their own by late teens. To move things along, however, there are many, many suggestions out there! While the most common recommendations include topical cocoa butter and vitamin E, Dr. Mehmet Oz likes topical vitamin C, tretinoin (also called Retin-A) cream, and micro-dermabrasion done at home. Dr. Josh Axe, on the other hand, suggests vitamin k, essential oils, coconut oil, gelatin, and aloe vera.
What we might add includes:
  • Achieve a healthy weight
  • Reasonable sun exposure
  • MSM (as lotion and orally)
  • Green tea extract (topical)
  • Onion extract (topical)
  • Sea buckthorn oil (topical)
  • Argan or jojoba oil (topical)
  • Cod liver oil (oral or topical)

With so many options to try, rushing off to a cosmetic dermatologist for laser treatment should certainly be a last resort.  How about you?  Have you found an effective home remedy?  Share it with others below the link to this newsletter on our Facebook page. 

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