June 2019 Newsletter 
Are Probiotics Really Helpful?
Your darling 5 year-old has been bitten by a tick and has developed a large bulls-eye rash. She faces three weeks or so of amoxicillin. To minimize impact on her health, you decide to:

 a.) Give generous amounts of yogurt or acidophilus-containing probiotics during and after the amox.

b.) Forego the above.

c.) Obtain a small specimen of her stool (before the amox). Freeze it. Then, after the amox is finished, administer it rectally.

99.9% of us would probably go with choice "a." But according to a study published last year in Cell by researchers from Rehovot, we may have to think again.....
The Israeli researchers first treated both mice and a cohort of 21 healthy human volunteers with Flagyl & Cipro (14 days in mice, seven days in humans). They then split the mice and humans into three groups:
  • Group 1 was allowed to spontaneously recover over time.
  • Group 2 was supplemented with an 11-strain probiotic for four weeks following antibiotics.
  • Group 3 underwent autologous fecal microbiota transplant (aFMT), where their own fecal samples before antibiotics were frozen and used to re-inoculate their gut a day after the antibiotics finished.
So, what did they find? Surprisingly, treating with probiotics actually delayed the normal recovery process of the gut microbiome - up to five months! In contrast, volunteers that received an aFMT restored their normal microbiome in as little as 48 hours.

What do we make of this? Some doctors are seriously rethinking their blanket recommendation to give patients probiotics during or after a course of antibiotics. If they do, they will probably lean toward S boulardi and away from acidophilus.

Will fecal transplants become the norm when antibiotics are administered before elective surgery or treatment of a an infection like Lyme, MRSA, or even an ear infection?  Time will tell.
Timing of the Newborn Bath
Earlier this year, researchers at the Cleveland Clinic published their findings on the effect of the timing of the first newborn bath on breastfeeding rates. About 1,000 mother-baby pairs were studied

Prior to the intervention, about 500 babies were bathed at the traditional two hours of age. Exclusive in-hospital breastfeeding rate was about 60%. Then, they flipped a switch, and the next 500 newborns got their first bath at about 12 hours of age. Result?  The breastfeeding rate boosted to 68%.
Why have hospitals traditionally put babies into the bathtub so quickly after birth? Infection control is mainly cited. Amniotic fluid can harbor various viral pathogens, for instance. Perhaps, too, there's aesthetics - getting bloody mucus out of one's hair can boost definitely personal appearance!
Besides improved rates of breastfeeding, there are other advantages to delaying the first bath to 12, 24, or even 48 hours of age. These include improved temperature and blood sugar regulation, enhanced bonding, and the better absorption of various nutrients (perhaps including vitamin K) from the vernix.
How old was your youngest at the time of her first bath? Did you participate or did the hospital staff carry it out? Please share your experience on our Facebook where this newsletter will be posted.    
Which Kids Should Take Iodine?
According to the National Health and Nutrition Survey, between 1971, iodine levels in US citizens declined by an astonishing 50%!!

What is responsible?  Dr. David Brownstein atributes the drop to multiple factors, including the widespread use of bromines (white flour, flame retardants), fluorides (toothpastes, meds like Prozac and Prevacid), soy products, and perchlorates (rocket fuel residue).  Perhaps the most significant factor was a reduction in the iodine fortification of cattle feed about the same time the deficiency began.  True, table salt has added iodine and has reduced the incidence of goiter in the US, but studies show it is not well absorbed (the chloride may out-compete the iodine).  

One study Dr. Brownstein cited showed that 12 out of 13 lactating US women have iodine-deficient breast milk.  Not surprising given that only 28% of prenatal vitamins contain iodine.  And deficiency in children has been linked not just to a reduced IQ but also ADHD and even autism.  A  study published a few weeks ago by researchers in the Netherlands confirmed that maternal iodine deficiency, as early as the first trimester, has a detrimental effect on verbal skills.  

Although it is estimated that 72% of the world population is iodine deficient, Japanese women typically consume 12,000 micro-grams (mcg) or more daily.  Whereas here is the US, the RDA for children is 120 mcg -- an astounding 100-fold difference!

Iodine has an amazing array of health benefits:  anti-bacterial (what do surgeons apply to skin before an operation?), anti-viral, anti-parasite, anti-fungal ( try it on toenail fungus), and alkalizing / anti-cancer.  

Has your iodine level ever been checked?  Your special-needs child?  While blood testing is okay, urine iodine / creatinine ratio is the gold-standard.   
What Is Orthorexia?
Orthorexia is loosely defined as the obsessive pursuit of a healthy diet. While some argue that this is a non-disease, we have seen a couple of patients that seem to have had the disorder.
Some years ago, for instance, we saw a 10 year-old girl that repeatedly heard through the media, her family, and even health class that consuming cholesterol is bad for you.  Sound familiar?  Well, not only did she cut eggs out of her diet, she also began drinking progressively larger amounts of water - to the point that her kidneys could no longer concentrate her urine! This rare situation is called nephrogenic diabetes insipidus or psychogenic polydipsia. It took a while to get her back on track.
More recently, we saw a bright middle-schooler who hit puberty a bit overweight. In a sincere effort to improve his health, he began making healthy food choices and reducing portion sizes. Weight loss ensued - 70 pounds - to the point where he ended up in the Emergency Room with a condition called superior mesenteric artery syndrome. Thankfully, he bounced back quickly.
Trying to do a reasonably good job of coaching our teen & tween-age children on healthy diets is just not getting any easier. Suddenly, eating cholesterol-rich foods is good again. In fact, consuming a ketogenic diet very high in fat is also now considered nutritious. It seems a balanced approach where we try to establish a routine of wholesome foods but allow some leeway from time to time will lead to the best outcome.
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