Anxiety in kids, antibiotic use, and self regulation for kids with Dr. Elisa Song, integrative

This week on The Less Stress Life Podcast, I am joined by  Dr. Elisa Song.  I love Dr. Elisa Song’s calming demeanor. In this episode about anxiety in kids, antibiotic use and more, she gives so many practical pearls you can start doing with your kids now to set them up for success. We talk about the unsung hero of health, the nervous system. We talked about the gut, brain exercises, immune resilience, calming nutrients and what to do about recurrent infections. 

KEY TAKEAWAYS:

• What is integrative pediatrics
• What  parents need to know about Food as medicine for kids with anxiety. 
• What lifestyle factors are especially important for kids with anxiety 

GUEST SHARED HELPFUL TIPS ON:

•  Gut Brain Exercises for  resilience psychologically & immune resilience
• Recommend supplements for children with anxiety
• What to do about recurrent infections

ABOUT GUEST:
Dr. Elisa Song, MD is an integrative pediatrician, pediatric functional medicine expert, and mom to 2 thriving children. In her integrative pediatric practice, Whole Family Wellness (www.wholefamilywellness.org), she’s helped 1000s of kids get to the root causes of their health concerns and helped their parents understand how to help their children thrive – body, mind, and spirit – by integrating conventional pediatrics with functional medicine, homeopathy, acupuncture, herbal medicine, and essential oils. Dr. Song created Healthy Kids Happy Kids (www.healthykidshappykids.com) as an online holistic pediatric resource to help practitioners and parents bridge the gap between conventional and integrative pediatrics with an evidence-based, pediatrician-backed approach.

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Website :  www.healthykidshappykids.com 
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IG: @healthykids_happykids 
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Transcript

[00:00:00] Dr. Elisa Song: , we are not teaching our child skills for resilience psychologically, physically, or immunologically. It's all tied together because psychological stress creates the same amount of inflammation as physical stress or infectious stress or toxic stress. 

[00:00:17] Christa: Stress is the inflammation that robs us of life, energy, and happiness.

[00:00:23] Christa: Our typical solutions for gut health and hormone balance have let a lot of us down we're overmedicated and underserved at the less stress life. We are a community of health savvy women exploring solutions outside of our traditional Western medicine toolbox and training to raise the bar and change our.

[00:00:43] Christa: Each week, our hope is that you leave our sessions inspired to learn, grow, and share these stories to raise the bar in your life and home.

[00:00:59] Christa: All right. [00:01:00] Today on the Less Stress I, I have Dr. Lisa Song, who is an integrative pediatrician, a pediatric functional medicine expert, and mom to two thriving children in her integrative pediatric practice, whole family wellness. She's helped thousands of kids get to the root cause of their health concerns and helped their parents understand how to help their children thrive.

[00:01:18] Christa: Body, mind, and spirit by integrating conventional pediatrics with functional medicine, homeopathy, acupuncture, herbal medicine, and essential. Dr. Song created healthy kids, happy kids, as an online holistic pediatric resource to help practitioners and parents bridge the gap between conventional and integrated pediatrics with an evidence-based, pediatrician backed approach.

[00:01:35] Christa: And we're so happy you do that. Thank you, and welcome Dr. 

[00:01:38] Dr. Elisa Song: Song. Thank you, Krista. I'm 

[00:01:39] Christa: honored to be here. . So I was just telling you off air that, you know, we've had other pediatricians, but I feel like you don't get enough opportunity to pick a pediatrician's brain or to talk through all the things. And we were also discussing, and I was sharing that I feel in years of working with kids, that there's three main ways that stuff presents.

[00:01:58] Christa: And, and you'll hear that a lot [00:02:00] of the topics kind of go under this umbrella. It seems like when kids have stuff going on, it affects their mood longer term, it affects their skin, right? Like it's one in five or it affects maybe the parent. A noticing GI stuff or something with that. So those are the big ones in addition to probably other things you see in your office.

[00:02:17] Christa: So I'm glad we're gonna cover a little bit of all of that today. Yeah, 

[00:02:21] Dr. Elisa Song: absolutely. 

[00:02:22] Christa: But, but will you tell us a little bit about how, I think it's really amazing and interesting when people decide to get trained conventionally and then say, this isn't working for me, I don't really like it. I wanna do something different.

[00:02:35] Christa: How did that transition happen? Especially in a time where everyone else has those. . A lot of people are having those same feelings. 

[00:02:41] Dr. Elisa Song: Yeah. It's interesting because a lot of people come to integrative medicine, functional medicine because maybe they've had a health concern where conventional medicine has failed them or they have a family member where that's been the case and that's actually not my story.

[00:02:55] Dr. Elisa Song: I mean, knock on wood, right? I mean, thankfully, you know, I've been healthy, my children have been [00:03:00] healthy, but I actually, you know, when I was in college at Stanford, this is long before I even thought I was gonna be a doctor. I knew I wanted to work with kids and I stumbled upon this conference. This is now, I'm gonna date myself.

[00:03:14] Dr. Elisa Song: It is back in the late eighties , and it was conference of the American Holistic Medical Association, which isn't even around anymore. It's a, it's been taken over by a different umbrella, so, Whatever got into me as a junior to go to this conference I did and my mind was just blown. I mean, I grew up in a medical household.

[00:03:31] Dr. Elisa Song: My mom was an obgyn, so, and I didn't see anything in conventional medicine that I really wanted to do . So I told my mom, nah, I'm not gonna the med school route. , I'm gonna be a lawyer, right? Or I'm gonna be a teacher. I'm gonna be a public rights advocate for children, a civil rights advocate. And, and I, you know, people took the LSATs.

[00:03:49] Dr. Elisa Song: So I went to this conference and my mind was flown. There were speakers who were just getting known. So Joan Boko from Boston, Andrew, we [00:04:00] Deepak Chopra. I mean, these names that, you know, were just starting to become known. And I was like, oh my gosh, what? Thing called, you know, natural medicine and integrative medicine.

[00:04:09] Dr. Elisa Song: It wasn't even called integrative then. It was called alternative, right? Mm-hmm. . And so that really kinda, you know, lit a fire under me thinking, well, maybe there's another way to practice medicine now I can work with kids. So I got applications to Best year, you know, in Seattle as a, to consider being a naturopathic doctor.

[00:04:27] Dr. Elisa Song: Nobody knew what that was at that time. Mm-hmm. , um, my mom would've supported me, but you know, it just, Super encouraged. So that's how I found myself in medical school, conventional medical school. But every step along the way, I had this integrated mindset, the American Medical Student Association. I helped create a holistic, you know, medical student arm to that in residency at U C S F, I chose to do electives that I created on holistic approaches to juvenile arthritis.

[00:04:54] Dr. Elisa Song: I mean, really, you know, amazing. And then, Finished residency and I was like, I don't know what [00:05:00] I wanna do , right? Like, I don't wanna be in the hospital. I also didn't really see in private practice what I want to do because it was crazy, right? You're seeing 20, 30 somebody's 40 patients in a day and all you're doing is write a prescription after prescription after prescription for amoxicillin or you know, whatever other medicine and.

[00:05:21] Dr. Elisa Song: Luck would have it. I stumbled upon this Food as Medicine conference. Mm-hmm. , and I said, I'm gonna go see what it's about. And again, mind loan. I heard about functional medicine. What is this thing? This was early two thousands, and the keynote speaker was Mark Hyman. Hmm. I was like, all right. This is it. So when I actually ventured into opening up my private practice, it was with this in mind, I took functional medicine courses, I took homeopathy courses, I took acupuncture, you know, essential oil courses.

[00:05:51] Dr. Elisa Song: I was just like, I need to know all of the things that can help our kids. Cuz conventional pediatrics is not doing everything we [00:06:00] want it to do. It's great at some things, but it's not great at helping kids thrive. So, I mean, that's kind of how I landed here and I'm so glad. I just, I wouldn't practice any other.

[00:06:09] Dr. Elisa Song: Yeah. How long have you had your private. So I opened up this practice in 2004, so it's been about 18 years now, almost 20 years. And this was back when, I mean there still is such a lack of pediatric functional medicine training. Um, and back then, I mean, I was one of the handful across the country that was doing pediatric functional medicine, so it felt, you know, really lonely at a time.

[00:06:33] Dr. Elisa Song: So, I'm so glad. I mean, you are spreading the word, you know, doing podcasts like this and really getting information out to practitioners and parents who, you know, really now are aware that there's another way, but need more solid education and information on how to do that. 

[00:06:50] Christa: Yeah, for sure. Oh, what I heard there was a lot of blazing your own trail.

[00:06:54] Christa: Not gonna lie, , you're like I, you said I created my own elective so I could do the things [00:07:00] I wanted and that's wonderful. I have an intern like that as well. Who right now she's doing this elective because otherwise, where else would she get it? . So yeah. All right. So you know, on the thought of mood, skin, and gi, let's actually start with kind of a really challenging one, which is with anxiety, child anxiety.

[00:07:17] Christa: So what are some of the first things that you think about when someone comes into your office and mom is like, this kid is stressed or anxious, or there's probably quite a spectrum there. Where does your brain go first? What 

[00:07:28] Dr. Elisa Song: do you do first? . Well, and I, as I'm sure most of the listeners are aware of, you know, in functional medicine we always look at the gut first.

[00:07:36] Dr. Elisa Song: And this is, you know, regardless of whether there are any actual gut symptoms, most kids don't actually, though a lot of kids have no idea how often their pooping , you know, or what their poop looks like. But you know, even without a parent gut symptoms, whether it's, you know, skin or immune system issues or brain mood issues, we.

[00:07:57] Dr. Elisa Song: Look at the gut first, and you know, for anxiety, [00:08:00] this is especially important. Well, let's back up and just really just, you know, say that acknowledge that there's been a mental health crisis in our children for, I mean, for decades. Right? You know, the pandemic, there's a mental health emergency declared mid pandemic.

[00:08:13] Dr. Elisa Song: It's been there this whole time. Right. You know, we just now are maybe, maybe waking up to it. I hope that this. Fall to the wayside , you know, like it too often does, but you know now, even before the pandemic, by the time kids are 18 years of age, it's anticipated that one and two are diagnosed with any mental health disorder.

[00:08:32] Dr. Elisa Song: So one and two, and suicide for our kids, 15 and up, even 12 and up. It's a second leading cause of death. Second leading cause of death. And this is only behind accidental injury, which often has to do, you know, with mental health concerns. Mm-hmm. , and this is far above any infectious disease that we can think of.

[00:08:51] Dr. Elisa Song: Far above. And so, and these mental health concerns, they start in childhood, right? They don't just start all of a sudden when your kid's, a [00:09:00] teenager, you can see some warning signs even early on. And one of the risk factors is having had antibiotics as a kid. In fact, having had antibiotics as a toddler can increase your risk of, you know, psychiatric conditions by up to 50% by the time you're an older kid or a teacher.

[00:09:17] Dr. Elisa Song: So we always look. , is there gut imbalance? Is there something called gut dysbiosis with abnormal bugs in the gut? Because that absolutely needs to be corrected first, with an understanding that, you know, 90% of our neurotransmitters, especially serotonin, which is involved in relaxation, managing anxiety, sleep, 90% of that is made by our gut microbes.

[00:09:39] Dr. Elisa Song: So we need to make sure we have healthy gut microbes if, if we are going to really make a shift in your child's. and behaviors. Right. Regardless of what's going on. For sure. 

[00:09:50] Christa: So it takes a couple of months to really maybe see all the shifts that you'd like to see in the gut. I think, I mean, I think that's a reasonable amount.

[00:09:58] Christa: Oh, at least, yeah, maybe a few, [00:10:00] maybe a few weeks. You start to see some changes. A couple of months is a reasonable timeline to invest maybe three, four months. Overall reasonable timeline to invest to rebalance gut dysbiosis. , two questions. You said there are warning signs for later anxiety, so I wanna hear about some of those warning signs.

[00:10:16] Christa: And then after that, what do you do next after addressing gut dysbiosis? 

[00:10:21] Dr. Elisa Song: So in terms of warning signs, I mean, this is, I guess I should say, let's step back and think about, you know, what it, we consider anxiety. Mm-hmm. , you know, and what consider stress because. . In our modern world, the words anxiety and the words stress are thrown around like candy, right?

[00:10:37] Dr. Elisa Song: It's like mm-hmm. . Oh, I'm so anxious today. Oh, I have so much stress. What we have to remember is parents, and this is where it takes for us as parents, to recognize how we are responding to stress and quote anxiety. Mm-hmm. , how we manage that ourselves, because stress has. , basically a four letter word in our society, right?

[00:10:57] Dr. Elisa Song: Mm-hmm. , stress by itself is not a [00:11:00] negative or a bad thing. Stress is our body's response to a particular threat, right? What we perceive as a threat, whether it's, you know, a deadline that's due , you know, for a project or homework, or whether it's, you know, friend drama or whether it's a baseball tournament that's about to happen, right?

[00:11:17] Dr. Elisa Song: Mm-hmm. , it's, it's just a physiologic response, and there is something. Peak performance curve where, you know, when we have too little stress, we're not performing. Mm-hmm. Right? We're apathetic. You know, we're disinterested. We lack motivation, right? Mm-hmm. This is what can happen when we bubble wrap our children too much.

[00:11:36] Dr. Elisa Song: Try to avoid every single stressor. We wanna make life so happy for them that we don't want them to ever be unhappy or worried. There is a problem with that because if you never have. , little bit of stress. You never get motivated, and you also never learn how to overcome challenges. Mm-hmm. , you view every challenge as an obstacle that must be avoided.

[00:11:55] Dr. Elisa Song: Right? Then as we get a little bit more stress, right? That physiologic [00:12:00] response, that deadline happens. We all have had this experience, we have this stressor, we have a deadline, you know, we have a problem, and then we're on. We are in the zone, we're focused. We get it. , right? And then when that deadline, that thing is done, that stressors resolved, we've overcome it.

[00:12:17] Dr. Elisa Song: Then we get back down to, you know, a lower level of stress. When we have too much stress, it's all the time. We have deadlines all the time. We have, you know, friend drama, social stress, social media all the time. Then we get to the curve where there's too much stress and we lose performance again. But this time we're burnt out, we're irritable, you know, we're tired, we just can't get up and do.

[00:12:39] Dr. Elisa Song: right? Mm-hmm. . So stress can be healthy, just like inflammation, right? Mm-hmm. , inflammation isn't a bad word. Inflammation is our body's natural response to fighting something. . Mm-hmm. , right? Whether it's an infection or an environmental toxin, we need that inflammation to help resolve whatever's going on.

[00:12:54] Dr. Elisa Song: But when inflammation is. Too high, we're too sustained and chronic. That's when we see [00:13:00] problems. So I think by shifting that, you know, when we see ourselves trying to avoid every single stressor for us and our children, you know, when we see our children unable to manage any frustration as a toddler, you know, that, you know, putting this circle into the square peg and you know, just having huge meltdowns.

[00:13:17] Dr. Elisa Song: Or we find ourselves saying, oh honey, let me do it for you. And fixing everyth. , right. We are not teaching our child skills for resilience psychologically, physically, or immunologically. It's all tied together because psychological stress creates the same amount of inflammation as physical stress or infectious stress or toxic stress.

[00:13:38] Dr. Elisa Song: So that's one thing we just, we need to just. , make sure that we are not using avoidance as our, you know, guiding coping mechanism. Right. I love it. . And so, and, and when we think about it, you know, as we think about what can help them sustain that, there's a couple of things, right? So the what next, right? So we know most kids with.

[00:13:58] Dr. Elisa Song: Anxiety or mood [00:14:00] disorders or behavioral concerns, not even diagnosed with anything. You're just worried about, you know, their mood or you're worried about their behaviors. It's, it's interfering with their social relationships and school progress or whatever it is. You know? Yes, we look at the gut, but that's a longer term road in functional medicine.

[00:14:15] Dr. Elisa Song: Integrative medicine, when we're trying to really, um, truly heal from the inside out. It's not a quick fix, right? It's not like you could take. , you know, and Ativan, or Xanax, and then oh, of a sudden you're relaxed. Right? That is temporary. That's short. There's a time and a place for that, right? If needed, right?

[00:14:31] Dr. Elisa Song: When kids are in crisis, when adults are in crisis, we might need that quick fix. Mm-hmm. , but we need the long-term healing so that you're not constantly going back and forth from crisis to crisis. So we, we look at. , we look at the vagus nerve. Mm-hmm. right now, while we're talking about that stress, that normal healthy stress response, right?

[00:14:51] Dr. Elisa Song: In our world, we have so many constant stressors that keep our sympathetic nervous system activated, right? Our fight, [00:15:00] flight, or freeze response, it is always on the go. Our sympathetic nervous system has plenty of muscles, right? When we think about muscle, . What doesn't get a workout enough is our vagus nerve.

[00:15:10] Dr. Elisa Song: That autonomic parasympathetic nervous system response, that balance is out the sympathetic. So we have to every day think about how are we gonna give our parasympathetic vagus nerve response more exercise so that we can balance out the sympathetic. So that's also absolutely so important. We can start that even when kids are toddlers, but this is something as parents, we need to start doing as well.

[00:15:34] Dr. Elisa Song: So we can model that, show our kids how to. . Um, I love that. 

[00:15:38] Christa: Right. I was going to ask what recommendations you make for vagus nerve stimulation, and I always feel like an efficacious dose looks like this, and it takes about three weeks to see that change from that. And there's so many free things we can do for vagus nerve stimulation, but do you ever have them use devices or tools for vagus nerve stimulation to try to get to this point?[00:16:00] 

[00:16:00] Christa: Yes, because that can help. 

[00:16:01] Dr. Elisa Song: Yeah, 100%. So there are things and that, you know, I would say starting with, you know when kids are toddlers and you know, as your kids get older, we wanna do these things, as you said every day, that that really, the only cost is time and it's the best investment you'll ever make with your time.

[00:16:17] Dr. Elisa Song: right? So just learning how to do diaphragmatic belly breathing, right? Mm-hmm. , let's just sit together. You know, you're five minutes on your way to school, right? As you're, a lot of great things can happen on your drive to school or your walk to school. A lot of amazing things. , right? Mm-hmm. . So you can spend, you know, five minutes even as you're driving.

[00:16:35] Dr. Elisa Song: You know what we're driving. Let's just, you know, have some silence and let's practice our belly breathing. You know, we're gonna breathe and imagine a balloon filling up in our belly as we're breathing in, keeping our shoulders down. And as you exhale, you're gonna imagine that balloon deflating. Remember, keep your shoulders down so we're not breathing with our upper chest.

[00:16:51] Dr. Elisa Song: Right? You could do that in that drive to school, or as you're walking to school, we do our belly. , right. Practicing mindful moments, and this is one of my favorite, because [00:17:00] the ability to stop and notice what's around you and notice what's going on inside you doesn't take a lot of time, but that mindful moment is that it creates that ability to self.

[00:17:11] Dr. Elisa Song: Regulate, no matter what's going on, which is so important for success. In fact, self-regulation is one of the markers for success. You know, as teenagers and as adults, right? You have to stop and think before you do or say something that you regret, right? That is so important. But how do we do that? And again, on the way to school.

[00:17:31] Dr. Elisa Song: you know, driving or walking, you just, you do something called a Five Senses Meditation. Mm-hmm. . But what I tell, I've explained to kids and parents is, you know, stop, look, and listen. Right? Because we all learn that when we're crossing the street. You stop, you look around, are there any cars coming? Then you listen for cars and you go, so the stop, look and listen.

[00:17:49] Dr. Elisa Song: When we stop, we give ourselves permission right then and there to stop what we're doing. Right? Whether it's, you know, talking mile a minute or walking to school, you know, while we're looking at our. , [00:18:00] right? , uh, we stop and then we look and look means using all of your five senses to notice what is going on around you.

[00:18:09] Dr. Elisa Song: We close our eyes first because our visual stimulation is our most powerful that we use all the time, and we allow our other senses to first come up to the surface. So as we close our eyes, just say, you know, honey, what do you hear? You know, let's take a moment. Do you notice the birds tripping in the tree, or did you hear that airplane flying overhead?

[00:18:27] Dr. Elisa Song: What do you. Is it the fresh cut grass? Maybe it's, you know, the barbecue in the backyard, , right? You know, notice what you taste in your mouth. Is it the mini toothpaste that you just brush your teeth with? What do you feel on your skin? You know, is it the tag on the back of your shirt? Is it the wind blowing your hair?

[00:18:45] Dr. Elisa Song: And then finally open your eyes and then notice what you see. And you will see things that you hadn't noticed before because you were too busy, right? Mm-hmm. , is it the dandelion that you were just about to step on that you might wanna pick and blow, right? And make a wish? And then the final listen, right?

[00:18:59] Dr. Elisa Song: [00:19:00] Stop. Look and listen. When we listen, we take that moment to integrate all of that. Listen to what our body and mind are feeling in that moment, right? Two minutes of your time. So these are things we can do every single day. We can practice gratitude every single day, and that engages your vagus nerve. So what I would want parents and practitioners to recognize is it's these little moments when we are practicing our vagus nerve.

[00:19:24] Dr. Elisa Song: Fork that make a huge difference. It doesn't have to be fancy hours, long meditation, you know, silent retreats, fancy stimulators. It's a little things that count because our Vegas interviews to know how to get back into that state at any moment. Mm-hmm. Right? Mm-hmm. . And yet there are times. when kids are really going through, you know, huge periods of stress crisis, you know, emotional trauma where we just need to passively engage their vaness for them.

[00:19:49] Dr. Elisa Song: Right. And for older kids too, who are just not into sitting still and have, you know, doing a. Uh, 10 minute, 50 minute, 30 minute guided meditation or breathing [00:20:00] meditation with an app. Right? Don't like to use the word meditation because for a lot of kids, they roll their eyes. Ugh. I do meditation. I did that in school.

[00:20:08] Dr. Elisa Song: right? So, but you know, we really wanna consider it brain exercise, right? Vagus nerve. Work. It's so much more than beyond what we envision meditation to be. This is something that we all need to do. So I do use some devices as a practitioner. I might do ear acupuncture, do some ear electrostim to target.

[00:20:29] Dr. Elisa Song: There's a branch of the vagus nerve that goes right through the ear. . Right. That's why you're can be so successful. And there are little devices, there's a little, um, stimulation device that I give sometimes I've given to parents and taught them how to use exactly where the points are to stimulate mm-hmm.

[00:20:44] Dr. Elisa Song: So that's one option I love, and you know, Krista can see this, but you could, we're on audio, but I, I wear my Apollo neuro device. Mm-hmm. , um, all. and you can, there are different settings that stimulate your vagus nerve, improve something called heart rate variability. [00:21:00] The heart rate variability, as some of you know, is one of our best measures for optimal vagus nerve function.

[00:21:07] Dr. Elisa Song: We want to optimize our heart rate variability and this Apollo neuro device that says little. To your skin has been found to improve heart rate variability and I know because I track it with my aura ring . Mm-hmm and for sure it makes a huge difference. And I've had kids, I just spoke with a kid yesterday who you know has an a d D and anxiety and you know, his teachers, when he doesn't wear the Apollo nerve, they stop and say you should get it.

[00:21:32] Dr. Elisa Song: Cuz it really helps. Right. So there are some passive ways that we can actually, our Vegas are 

[00:21:37] Christa: for. Awesome. Thank you so much for sharing that. And that felt so nice to stop and talk about bringing awareness into the parasympathetic nervous system and honestly saying that we can be the start of the change for kids with anxiety and I, it takes a lot of skill building.

[00:21:53] Christa: You know, you are just not successful on hour one, day one week one all the time. Yeah. But it's continually [00:22:00] practice on your own and modeling that. And I hear that similar message echoed from different practitioners. A interview, so, you know. Yeah, good advice. Stacks, , 

[00:22:09] Dr. Elisa Song: so, yeah. Well, and sometimes you want that quicker win too, right?

[00:22:13] Dr. Elisa Song: Right. Yeah. And as you said, you know, it can take two to three weeks to start noticing a difference. Mm-hmm. takes two to three months to solidify the improvements. Mm-hmm. and then another. , you know, long while to really make it thick. Right. 

[00:22:26] Christa: And I think when you are not doing those things, it's, you have to think of it just like a muscle that it will atrophy and you will go, you will slip backwards.

[00:22:33] Christa: Absolutely. Absolutely. I love how you brought up self-regulation too. I think that's such a thing that I had awareness around. I mean, some examples of self-regulation can convene around food and just feeling like you have to eat everything in that time. Yeah. Or for me, it was speaking really quickly. and having to slow that down a lot.

[00:22:51] Christa: trying to jam so much into things. Yeah. But those are, there's so many opportunities or, or ways to look at our own self-regulation and awareness as our first best friend, but 

[00:22:59] Dr. Elisa Song: [00:23:00] absolutely. The other, you know, just a few quick tips for parents. Mm-hmm. , who have anxious children, there's a series of books by Dr.

[00:23:06] Dr. Elisa Song: Dawn Hefner. H U E B n e r. She's an amazing child psychologist. I'm lucky enough to call her a friend now, and she has a whole series of books that they're basically self-help books for kids to teach them cognitive behavioral tools to manage, recognize when their stress is getting overwhelming, stop that and manage it.

[00:23:26] Dr. Elisa Song: So her original series were the What to Do series. So what to do when you Worry Too much. Mm-hmm. . So they're children's. Children's books. Yeah, that you can work with them for older kids and teens. Outsmarting Worry is a great, you know, workbook. You know, it's really quick, easy. I use the tools in both of them, so that's a great resource.

[00:23:44] Dr. Elisa Song: And you know, if you're just needing to stop the process, just. when you're in that fight or flight, sometimes we just need to break that. Not even, sometimes you need to get out of that fight or flight mode. Mm-hmm. before your brain, your child's brain can access any tools We're trying to teach them, so, you know, [00:24:00] using things like ny mm-hmm.

[00:24:02] Dr. Elisa Song: Right? Mm-hmm. , uh, dose up pretty high for kids. Mm-hmm. , magnesium, you know, vitamin D, getting those in, optimizing those can help your kids break out of that fight or flight. I would say the two things that I would start. , you know, immediately for more immediate results are gonna be thin and magnis. But there are others, you know, working with your functional medicine practitioners.

[00:24:20] Dr. Elisa Song: C. But we do need those. See, I'm not gonna say that doing the VA or work will automatically shift your kids into a less anxious, you know, well-balanced child takes work, but we need to be able to have them access the work and do the work and. , you know, really looking at some of the things that will give some quicker win.

[00:24:39] Dr. Elisa Song: Mm-hmm. . 

[00:24:40] Christa: So I think you've brought this up a little bit already, but just to acknowledge medications, and I think this, you said it kind of depends on the severity and sometimes you need that quick win to get to a stable place. Yeah. Right Before you can work on some of these underlying things. Any other things we should think about when thinking about medications for moot stuff and anxiety and.[00:25:00] 

[00:25:00] Dr. Elisa Song: Yeah. And you know, some of you listening, you know, you might already be on, or your child might already be on medications and there's no, you know, blaming or shaming with that. Right. The, the concern with the SSRIs, the serotonin, selectively uptake inhibitors in particular that are most commonly used for depression and anxiety in children.

[00:25:19] Dr. Elisa Song: is that there are black box warnings on them for kids of teen, and there can be an increased risk of suicidality initially. So we need to monitor our kids very closely for that. Then we wanna think about how is this S S R I working, right? When you have your two neurons brain cells, right, that are communicating, one will release serotonin into the space between the neurons called the synapse, and then the other.

[00:25:44] Dr. Elisa Song: Take it up. Right. What the SSRIs do, they, they inhibit that re-uptake of serotonin, so they keep serotonin in between those synapses for longer. So your brain thinks there's more serotonin than there actually is. Right. SSRIs can work really well in the [00:26:00] beginning. Mm-hmm. , the experience that many, many have though, is eventually the SSRI stops working.

[00:26:05] Dr. Elisa Song: It just, it fails. Right. This is for kids and adults, or sometimes it doesn't work at. , right? That's in the vast majority of kids eventually, right? It just won't work. Now, when we think about why that's happening, one of the reasons is, well, you need nutrients to actually make serotonin for the S S R I to even act on if your body, if your gut microbiome isn't healed and you're not making.

[00:26:29] Dr. Elisa Song: a lot of serotonin. There's just, eventually your brain runs out of it. There's not gonna be a lot in your brain in the synapses to even make a difference. Mm-hmm. , you also need all the, you know, there's certain nutrients that your body needs to promote optimal serotonin response and production like vitamin b6.

[00:26:46] Dr. Elisa Song: right? And all your methylation factors. And so, you know, we wanna think, you know, if your child is at the point where you're thinking they really need an S S R I, we still wanna do that work to support their healthy serotonin levels. We still wanna do the gut [00:27:00] work and we still need to give them the tools.

[00:27:03] Dr. Elisa Song: To manage their stress in a healthy, productive way so that they don't always necessarily need the S S I. Right? Using a medication. It's basically trying to manage symptoms, but not giving your child tools to manage and thrive through adulthood. So it has to be a multi-pronged approach. 

[00:27:20] Christa: Man, we could have ended it there and then just done a total part too.

[00:27:24] Christa: But , I wanna, it was so beautiful. I want to go through some of these somewhat rapid fire questions from clients, from audience members that come up so often with kids. Kind of switching gears a little bit after this beautiful treatment of anxiety and mental health in children. So one thing you said to bridge this, is that these skills that you build, Going to cross over to immune resiliency as well.

[00:27:49] Christa: Yeah. Overall resilience. And I think that's a gorgeous definition as I continue to ask every guest, like, tell me your definition of terrain. And I feel like that was a bit of your definition of, of terrain [00:28:00] partially. So there's a few different questions and so some have to. Has to do with like blood work, immune support, recurrent infections.

[00:28:08] Christa: Let me start with recurrent infections. A lot of kids are experiencing recurrent infections, like u t i, ear infections or other commonly recurring infections. What 

[00:28:17] Dr. Elisa Song: are your thinking about? Well, I, you know, it, it still comes back to the gut , right? I don't, I don't wanna sound redundant, but you know, it sometimes there's just, you gotta go back to the gut.

[00:28:26] Dr. Elisa Song: Mm-hmm. . And the reason is it's always helpful to understand the. Right, because I can say, tell my kids and tell, you know, the parents in my practice, well, we're gonna work on the gut now because it's so important for your immune system. Mm-hmm. . But you wanna understand why, if you're gonna really make it a priority.

[00:28:41] Dr. Elisa Song: And so what I have kids and parents think about are, you know, just notice your tonsils, right? We all, were born with tonsils. Tonsils are part of our lymphatic system, a really important part of our immune system. What we also wanna recognize is that our entire GI. is lined with these tonsil like [00:29:00] patches.

[00:29:01] Dr. Elisa Song: Mm. Called our pires patches, and those pires patches make up 70% of our immune system, right? We have more of our immune system lines in our gut than in our bloodstream, right? We always think, oh, our white blood cells and our, you know, our neutrophils and all of our other immune cells that are in our bloodstream.

[00:29:20] Dr. Elisa Song: they're actually the heart of our immune system lies in our gut, and those PIs patches communicate directly with the immune system in our blood to decide is what we're experiencing a friend, can we just ignore it? Right? Is it Foho? Do we need to go on the attack and fight it? And if it's an infection, kill it, or do we not know what to do and we attack the wrong thing?

[00:29:42] Dr. Elisa Song: That's what happens in auto. I. , right? We think this piece of whatever is we're exposed to is something to be attacked, but actually looks very similar to something in us. Let's say our thyroid, right? Mm-hmm. , and then we start developing thyroid antibodies. What's what's alarming is, you know, there's been a [00:30:00] long range study of something called a n a anti-nuclear antibodies, very non-specific autoimmune marker, and these researchers tracked ANA levels across different popul.

[00:30:12] Dr. Elisa Song: the population that had the most rapid growth in the percentage of people who are positive Ana or our teenagers, right? Our teenagers are developing these signs of autoimmunity long before they develop autoimmune disease. So we need to be aware of this and so we start with the gut and we make the gut happy, right?

[00:30:29] Dr. Elisa Song: We wanna feed our gut microbes, all of those amazing nutrients. I mean, fiber really is, I mean, we can talk about fiber, you know, to, we're blue in the face, but. We have a fiber gap. I mean 70 to 90% of kids and adults don't get enough. Fiber is what our probiotics need to feed themselves, right? Act as prebiotics, but also for metabolize those fibers into butyrate.

[00:30:51] Dr. Elisa Song: Mm-hmm. and into all of these amazing. Nutrients that support our immune system and actually support our gene, right? Our [00:31:00] microbes and, and how our microbes, uh, metabolizes the foods we eat can shift our epigenetics. So it's just so we always start with the gut no matter what's going on. Mm-hmm. , I. 

[00:31:10] Christa: Want to point out a couple things.

[00:31:12] Christa: One is that I have a great fiber episode that I'll make sure lands before this because we can have kind of like when you say meditation, we have preconceived notions about fiber and what is t well tolerated depending on what happens in the gut. So we go through that all in that episode. And then the other thing I wanna say that I think is worth mentioning is that now that the gut has been popular, at least 20 years.

[00:31:34] Christa: Really. I don't know if you see this, but I'm seeing like such a shift where people think that they've already addressed the gut. Mm-hmm. or they've had some testing done and it didn't show something. And so there's just a, a bit of a disparity in gaps between how different people do different things, different testing, how we read that, how we address it.

[00:31:51] Christa: So, yeah. You know, if at first you don't succeed, try again. I 

[00:31:54] Dr. Elisa Song: would. . Yeah. And I love that, Chris. I'm so glad you pointed that out because it is true. I mean, you can barely pick up even [00:32:00] a conventional journal or even the newspaper, well, nobody picks up the newspaper anymore, but you know, on your newsfeed, right online and not see something about probiotics or microbiome this or gut that.

[00:32:11] Dr. Elisa Song: And so it's become more and more mainstream to think about, you know, the gut and how that affects our health. And as you said, so many people go through the gut work. , I've treated my gut dysbiosis. I've worked on my leaky gut, but I'm still not feeling well, or I feel well temporarily and I keep going back, right?

[00:32:29] Dr. Elisa Song: My kids have, you know, my kids went into remission from the juvenile arthritis after their gut repair and, but it's coming back now that there's another antibiotic course or stress. So the key is really, I mean, when we're talking about resilience, we need to have gut resilience, right? Mm-hmm. , we can do anything, everything.

[00:32:48] Dr. Elisa Song: You know, throw tons of money and supplements at testing and, and healing our gut, and we can heal the gut, right? We know how to do that, but the key is to keep it there and keep it resilient, right? And [00:33:00] sometimes you can't get to that healing place. What's really required? , this is absolutely required is the vagus nerve to kick it into gear.

[00:33:08] Dr. Elisa Song: Mm-hmm. in order to keep our gut in that healthy state. So that's where this piece, and in functional medicine, you know, when I started training, do my functional medicine training back in like 2002, 2003, it was called the four R program. Right? The, for our program to heal leaky gut, remove, replace reinoculate, and repair those.

[00:33:30] Dr. Elisa Song: They're still the foundations, right? But now, I mean, oh, thankfully there's this recognition that the piece that we actually need is a fifth R, and I think the fifth R really and truly is the most important R if we're gonna have ultimate thriving. , right? And resilience. And that fifth R is rebalancing, restoring that gut-brain connection, right?

[00:33:51] Dr. Elisa Song: Mm-hmm. the mind body connection. It's not optional and unfortunately it's what, you know, most functional medicine practitioners are not as well versed in, right? [00:34:00] And I don't mean, because we can all say Go use the, you know, the Insight timer app, you know. , go take a yoga class. That's not enough. Right? We need to really impart that this piece is as important or maybe more Im important than any of the other four Rs that you're doing.

[00:34:16] Dr. Elisa Song: Right? So I'm so grateful that, you know, I FM really changed that, added that fifth R, but we're still not doing enough to hone in, you know, to hammer in. to parents and kids and practitioners that this is not an optional, I'll do it when I feel better. This is, we must do this in order to feel better and to stay feeling better.

[00:34:35] Christa: I couldn't really agree more. That's like at least half of the conversation, if not more. That is the reason we go backwards most of the time. Mm-hmm. , like you said, there can be some. a new course of antibiotics or a new point of infection. But if immune resilience looks good, which the main reason it doesn't look good is under some kind of overstress.

[00:34:54] Christa: Right? Yeah. Um, some, you know, so a poor vagus nerve or poor parasympathetic nervous system [00:35:00] exercise if we wanna be fancy. Right. And that's a great way to say it cuz that makes us like, oh, okay. It's not just like this four letter word that I've heard over and over and over and that word doesn't even mean anything to me anymore.

[00:35:10] Christa: Yeah. . And I think that's the other thing. I think most of the rest of these questions boil down to gut reflux meds and kits. It's the gut allergies. Start with the gut . Yeah. Um, eczema. Start with the gut. Really the only last one, you know, you brought up thyroid. Do you see thyroid being a big issue in pediatrics?

[00:35:29] Dr. Elisa Song: Yes, for sure. I mean, adrenals also are an under-recognized problem for a lot of kids. Mm-hmm. , um, and they go hand in hand. Mm-hmm. , right? Mm-hmm. . Yeah, for sure. Um, you know, I'll, I'll tell parents and kids to think about, you know, the adrenals are, think of your body. They're like a car. The adrenals are your gas tank.

[00:35:45] Dr. Elisa Song: The th is what's pushing down gas pedal. So we need both, right? But we can't keep pushing on the gas pedal. It's when you're tired. If. Continually filling up a tank. So oftentimes I'll th start with adrenal support. Mm-hmm. , I love Ashwaganda for kids. Mm-hmm. , [00:36:00] ashwaganda for kids. Pregnant, you know, pregnancy, postpartum, 100%.

[00:36:05] Dr. Elisa Song: Ashwaganda can support, of course, adrenals, but also thyroid, and also supports blood sugar regulation, because that is the other piece, right? When we're talking about what is inflammatory to our children today, of course, psychological, persistent, chronic toxic, psychological stress, I would say is one of the.

[00:36:21] Dr. Elisa Song: Inflammatory sources for our children. Another top is sugar. Mm-hmm. , right. Sugar and ultra processed food. Yeah. And so, you know, if we recognize those and you know, work on those, no matter what's going on, you're gonna see improvement. Mm-hmm. , and this is for yourself too, as a parent listening, right. If you just really mindfully, and I'm not gonna.

[00:36:42] Dr. Elisa Song: Tell you to say never no to the sugar because that's not gonna work. Mm-hmm. , right? Anyone with kids, it's gonna backfire. Right? You need to teach the kids the why, right? Mm-hmm. , you know, when they have the sugar or when they have that, I always think about like the, the rainbow frappuccino thing, right?

[00:36:56] Dr. Elisa Song: That's just so horrible with all those, you know, artificial [00:37:00] colors and preservatives in it. When they have that, then just. Again, take that mindful moment. Pay attention to how their body and their brain feels afterwards, immediately, and then that night and even the next day. Right? Notice how their skin looks, or how accurate their basketball shot was, or how well they, you know, rehearse their lines in their school.

[00:37:22] Dr. Elisa Song: Play whatever is important to them. Have them notice if they're performing and achieving their best, whatever that is for them. You know, after eating these foods or not having those foods and having stronger. . Right? And then they can make those decisions We need to empower kids with not just a, well, I'm not doing it because mom told me not to.

[00:37:40] Dr. Elisa Song: I'm doing this because I know I have prom in a week. I want my skin clear, so I'm not gonna have that sugary, you know, fake thing. Right? Or, you know, I have my violin rehearsal coming up and I, I know my brain thinks better, you know, that I get less anxious about performing when I don't have. those things, right?

[00:37:58] Dr. Elisa Song: We want them to make those [00:38:00] connections for the rest of their life. 

[00:38:01] Christa: Oh, absolutely. You can help cultivate awareness in someone. And kids are just like adults. We do love a little instant gratification. I know my daughter, yes, we did a little experiment around her last menstrual cycle and she's like, so something I could do all the time.

[00:38:15] Christa: And I was like, that would be fine. And it was just cute because it was like a more instant gratification and that's why she was interested. We're all like that, you know? We're humans. Yeah. So I do wanna ask this last question because it. come up all the time. What's your advice to parents and what about immune support?

[00:38:29] Christa: When there's been antibiotic overuse? 

[00:38:32] Dr. Elisa Song: Yeah. The first thing when we think about antibiotics is there is a time and a place for analytics for sure, right? Antibiotics can save lives, and I, you know, I have prescribed antibiotics. Of course, I prescribe them way less. Now that I know how to use my homeopathy.

[00:38:49] Dr. Elisa Song: Essential oils, herbal medicine, in fact, ear infections, ear AEs are the number one reason for a visit to the pediatrician's office, and in the last nearly 20. being in [00:39:00] practice in an integrative way. I mean, I could probably count on the fingers of like both my hands at times. I've had to use antibiotics for ear, which is awesome, right?

[00:39:09] Dr. Elisa Song: So first we need to know when are they really necessary? Are there other options? What can we do to support your child's immune system so that perhaps they don't, you know, get so many infections that then lead to bacterial infections. So, I mean those vitamin D number. , right? Optimizing those levels. Think vitamin C, oftentimes a dog.

[00:39:29] Dr. Elisa Song: Recommend kids supplement those you know, through the wintertime. Then you know when kids do need antibiotics, right? And when they need that, because up to 70% of antibiotics prescribed to kids are inappropriately prescribed. And we are at the point now where just in by 2050 antibiotic resistance is expected to be one of the leading causes of death in the.

[00:39:48] Dr. Elisa Song: So we need to judiciously use antibiotics. There's a movement for antibiotic stewardship, just like we have, you know, global, you know, environmental stewardship. This is really important. But [00:40:00] when antibiotics are necessary, antibiotics are the biggest disruptor to our gut microbiome, the most important. And so we wanna make sure, yes, you, you can take the probiotics 100%, but probiotics aren't just, it's not like throwing, you know, jack's magic beans onto the ground at all of a sudden, you.

[00:40:15] Dr. Elisa Song: Beautiful Beanstalk grow up. You need the nutrients to feed those probiotics, even if there's a prebiotic in that probiotic, you have to get the fiber in. You know, you have to get the phytonutrients in all those colors of the rema. They're gonna feed your good gut bugs if your child is up for it. Get those fermented foods in because a recent study found that fermented foods actually increase the diversity and number.

[00:40:40] Dr. Elisa Song: Beneficial bacterial species in your gut than fiber does. Fiber has amazing benefits in, in improving your metabolic markers in your gut, but it's, it was fermented foods that actually went out. So getting those in, getting in fatty fish, of course, you know, wild be, make sure it's sustainable, make sure it's low mercury.

[00:40:57] Dr. Elisa Song: But fish oils, omega three s have been found also [00:41:00] to. , not just support the gut lining, but also act as prebiotics, you know, even olive oil. So getting in, you know, all that rich, you know, really moving towards that Mediterranean diet. If that, if you, I don't like to prescribe a particular diets, right? But you wanna get in those healthy fats and, and nourish your gut microbiome.

[00:41:15] Dr. Elisa Song: Get in bone broth. You know, that's such a rich source of glutamine in collagen to help support your gut lining. You may need to take a little extra glutamine, a little extra zinc during this time for gut repair. So there's so much we can do if your child has been on antibiotics. Or I'll also say antiacid medications, right?

[00:41:32] Dr. Elisa Song: Because that's another. Big, big, big microbiome disruptor, especially early on in life where we know that antibiotics and antiacid medication use in the first six months of life can significantly increase your child's risk of virtually every single allergic disease by the time they're four. So this is anaphylaxis, eczema, allergy, hay fever, hives, so, at that point when they're little itty bitty ones, right?

[00:41:56] Dr. Elisa Song: You might not be GE getting in all the supple, but you could certainly get in probiotics [00:42:00] into them. You can get in omegas into them. Even at that early stage as you're introducing foods. Be mindful of really making sure they're getting in all those rich sources of fiber, getting in this phytonutrients and, and as a mom, if you're, if you're nursing, you know, make sure that your gut is healthy cuz your gut microbiome, your.

[00:42:17] Dr. Elisa Song: Glands also have their own microbiome. Um, we wanna pass on all those good gut bug to get into your baby as well. And 

[00:42:23] Christa: if you ever feel like you listened to this and said, I wish I'd had known this before, hindsight's always 2020 when something happens. And so there's always things we can 

[00:42:30] Dr. Elisa Song: do to help. 100%.

[00:42:32] Dr. Elisa Song: That is always, you know, I do hesitate sometimes to. . Think about, you know, what happens when kids are babies or you know, how they're born or how they're fed, or when they got antibiotic use. That's just tells your child's story. Mm-hmm. . Okay. So we need to look back. We tell their story so we know how to move forward.

[00:42:47] Dr. Elisa Song: But it's so important to not sit there and dwell in, you know, guilt or anger or frustration. You didn't know, right? Your doctor probably didn't know. We only know what we know at the time, and it's really through no [00:43:00] fault of your own that your child might be in the state that they're in right now, but now you're here, right?

[00:43:04] Dr. Elisa Song: Listening to Krista, listening to this podcast, you're listening, you're doing the work, and we move forward from there because we can always move forward. , it might take a little longer than if you started younger. That's okay. Right. But, but we can always move forward. 

[00:43:16] Christa: Yeah. Thank you so much for the work that you do and for coming on today.

[00:43:19] Christa: Where can people find you online? 

[00:43:22] Dr. Elisa Song: So, the best place to find me is either my blog, my website, healthy Kids, happy Kids. Dot com and then also on Instagram and Facebook. Instagram is Healthy kids, underscore Happy Kids. And then you can find me on Facebook as well. So that's where I, I post, I have articles, I have social posts.

[00:43:38] Dr. Elisa Song: I don't post a ton, but when I post, I'd like to make them juicy and meaty and full of information. So . Yeah, she's 

[00:43:44] Christa: a great person to follow. Thank you so much for coming on. 

[00:43:47] Dr. Elisa Song: Oh, thank you for, 

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[00:44:04] Christa: That's review this podcast.com. Less stressed life, and you'll be taken directly to a page where you can insert your review and hit post.