Bambini November 2015 Newsletter 
Novel Way to Prevent Strep
s we all know, cootie season has begun. Among the bugs of greatest concern to parents of school-age children is strep throat - an infection cause by Streptococcus pyogenes.

Although most sore throats (in our experience around 90%), are viral, it's important to distinguish strep from viral causes (this requires a rapid swab and culture) for three reasons. Treatment of strep with an antibiotic:
  • gets children feeling better much faster
  • reduces household and classroom spread
  • lessens the chance of complications (PANDAS is the one we see the most)
But frequent or prolonged use of antibiotics can lead to "C diff" - a form of colitis that is now at record levels. More than half a million cases are occurring a year! Wouldn't it be great if there was a safe, natural way to prevent strep throat in kids?
Well, some super-interesting research came out of Italy last year on a probiotic strain called S salivarius K12. Francisco Di Pierro and colleagues from Milan enrolled 61 children with recurrent strep in their study. Half received S salivarius, the other got a placebo. What happened? The treatment group had a 92% reduction in strep infections!
How could that be? It turns out that these bacteria produce compounds called lantibiotics such as salivaricin A that inhibit disease-producing germs like strep.
But it gets better! The Italian doctors also found that the incidence of viral sore throats in the treated children were reduced as well - by 80%!! Researchers are still trying to figure that one out, but it appears that this probiotic not only reduces IL-8 (an inflammatory cytokine) but also increases interferon-gamma (an anti-viral made by our immune system).
Side effects? Here's an important one: researchers from New Zealand reported in 2013 that S salivarius reduces dental plaque and the tendency toward cavities in children!!! Last month, Di Pierro's group confirmed that finding as well. Can it get any better? Bambini's apothecary has obtained an ample supply of S salivarius chewables called Throat Health by Life Extension ($19 for 30 day supply).
Can Fish Oil Help Kids Sleep?
Does your child fall asleep as fast as you'd like? Some say up to 40% of school-age children have trouble nodding off. Researchers at Oxford discovered something rather surprising that can help.
The study evaluated the sleep patterns of 395 children aged 7 to 9. In addition, they performed a blood analysis on these children to measure their levels of DHA, an omega-3 fatty acid.
When the folks at Oxford looked at measures of total nightly sleep, they found a parallel with blood DHA levels: lower levels of DHA meant children slept poorly, while higher blood DHA levels meant better sleep!
To see if they could do something about that, they took 362 of those children and gave half 600 mg of DHA and the other half placebo for 16 weeks. Result? DHA treatment led to an additional 58 minutes of sleep and 7 less wakening episodes per night. Who'd have guessed!?
If your child has sleep trouble, ask us to order an omega-3 level. If it's low, a little DHA might be a big help. Both cod liver and fish oils contains about 500 mg of DHA per teaspoon; algae oil has almost 1200 mg (but it's pricier).  We stock all in the apothecary.   
Hot Tubs and Kids on Spectrum
It's been observed for quite some time that children with autism (ASD) can go into brief remission following a fever. This is rather frustrating, since in our experience, most of these kids rarely get fevers. If only we could give them a little fever on a regular basis....
Well, that's exactly what Eric Hollander MD, a professor at Albert Einstein College of Medicine in New York, did. He observed that children with ASD and a history of positive response to fever had improved social behaviors when bathed each day in a hot tub at 102F compared with water at 98F!
He also studied the effect of infecting older patients with ASD with a worm called TSO. A notable drop in repetitive and ritualistic behavior occurred! Although these studies were presented at a scientific meeting two years ago, they have not been published. So details are lacking.  (Research that doesn't involve a pharmaceutical, as we know, is tough to get funded and published).
TSO therapy (we have never had a family pursue this) is said to be expensive, and it takes some chutzpah to infect your child with worms. Hot water, on the other hand, is readily available. It might take some conditioning, patience, and careful attention to the water temperature (note that the 98F water had no effect).  
Proteobacteria and Celiac Disease
Celiac disease (CD) has been linked to a genetic mutation that is carried by about 1% of the US population. Yet only about 1 in 50 of children with this gene seem to develop the disease when they consume gluten, a protein found in grains wheat, rye, and barley. That seems to be the case in our practice. Out of over 6,000 patients, we can count the number with biopsy-proven CD on one hand.
But the incidence of both CD and gluten intolerance has been increasing over the last 50 years (hundreds of children in our practice seem to have trouble digesting wheat). What's going on?  
In 2013, researchers from Spain reported that children with active CD had microbiomes that were more heavily colonized with Proteobacteria (bad guys) than kids without active celiac. Moreover, Firmicutes (good boys) were less abundant. In particular, cooties like Enterobacter, Staph, and Klebsiella were more plentiful in patients with active CD than in controls.
Earlier this month, Elena Verdu from McMaster University and colleagues reported their findings on a study of mice implanted with the human DQ8 gene, which imparts a moderate boost in susceptibility to CD. Specifically, they studied the effect of colonization with different species of bacteria on the development of celiac in these mice. Like the researchers from Spain, these doctors found that having Proteobacteria was bad news. In other words, celiac gene + gluten + Proteobacteria = celiac disease!
How did they get these mice colonized with Proteobacteria? They gave them an antibiotic shortly after birth. Interesting!
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