So here’s the deal: as in life, with supplements you pay for what you get. I would rather my patients throw their Costco multivitamin in the garbage and not take anything at all.  It sounds rather harsh, but I cannot in good faith have my patients take something that I know is harmful.

In the last few years several studies have shown an increased risk of death when taking multivitamins.  Yikes.  Here is one study in older women. Here’s another that shows cancer deaths are increased. Here’s one that shows that women who take calcium have a higher risk of cardiovascular disease (heart disease, heart attack and death).  And here is an older, landmark study that showed that taking beta-carotene causes increased risk of death in smokers.

Yet, in many other studies multivitamins or single vitamins have been shown to decrease certain cancers, prevent neural tube defects (and autism!), reduce the risk of heart disease, decrease the risk of osteoporosis, and on and on.

Okay, so what’s going on here?

The first thing you should know is that where a vitamin comes from is very important.  In the beta-carotene study the researchers were shocked to discover that supplemental beta-carotene was associated with higher death rates.  They were studying it because they knew that smokers who consumed high levels of beta-carotene in their diets were much, much less likely to die.  So what gives?  Well, the supplement they manufactured for the study was synthetic.  It is simply not processed in the body the same way as natural beta carotene.

The second thing you should know is that many molecules have chirality, or “handedness”.  Technically your left hand is identical to your right hand – but they aren’t, right?  One is a mirror image of the other.  In nature most molecules are “left” handed.  But when molecules are made in a laboratory it is difficult to sort out the left from right handed molecules.  Both end up in the supplement, and where one may prevent a disease, the other may cause it!

You should also be aware that there are many different forms of vitamins and minerals.  Some are better absorbed, some are better utilized and some are the equivalent of flushing the vitamin straight into the toilet.  Vitamin B-12, for example, can come in cyanocobalamin or methylcobalamin.  Methylcobalamin is much better utilized by the body, but most multivitamins only contain the cyano type.  Folic acid can also come in a 5-methyltetrahydrofolate form (say that 3 times fast), which is absolutely essential for the ~20% of the population with an MTHFR gene defect (come see me if you want to get tested).  Iron in the form of ferrous sulfate is fine for “normal” people, but people with gut dysbiosis tend to get dramatically worse on it.  Instead I advise using iron picolinate which greatly increases absorption.

Finally, there are the fillers.  Titanium dioxide, polyethylene glycol, modified food starch, hydrogenated palm oil, modified corn starch (GMO), Red No 40 Lake, Blue No 2 Aluminum Lake, Yellow No. 6 Aluminum Lake are all found in the most popular brand of vitamin.  Many food dyes are carcinogenic, and for the majority of my sensitive patients they aggravate the nervous system (causing ADHD, migraines and other symptoms). Other fillers are cheap additives to fill space and hold the tablet together.

So skip the multivitamins that contain these types of fillers or synthetic versions of the vitamins.  See a nutritionist or naturopathic physician to get a personalized recommendation for a multivitamin as each person can benefit from a slightly different formula.

Here are some of Dr. Erika’s favorites.  They all contain the correct “handedness,” and are forms that are absorbable and useable by the body. Remember though, that each person may need something slightly different, you should always check with your doctor first.

Babies/toddlers: VitaSpectrum by Klaire labs or Pediatri Vite by Genestra/Seroyal.  (Note: I do not believe that most breastfed babies need a multivitamin).  These do not contain iron – have your child’s iron levels checked before adding a liquid iron, or food-based iron (no need to supplement iron if they have good iron levels).

Kids: Pure Pals or Pure Pals with Iron by PURE encapsulations.  Kids this age usually do need iron, though you may want to consider the iron-free formula for kids who have digestive complaints or are on the autistic spectrum.

Women of childbearing age: Thorne Basic Prenatal multivitamin, or New Chapter Organics Perfect Prenatal Multi.

Postmenopausal women: Vitanica’s Senior Symmetry (even though you’re not a senior yet, it has the best formula!), or Meta-Fem by Thorne.

Men under 40: Clinical nutrients for Men by Integrative Therapeutics.

Men over 40: Al’s Formula by Thorne, or Clinical Nutrients 50+ by Integrative Therapeutics.

Athletes, or anyone undergoing intensive detoxification: Nutrient 950 by Pure Encapsulations, or another personalized multivitamin (depending on their specific biochemical needs).  This has very high levels of active nutrients, which are needed for anyone under oxidative stress.  Anyone who has been exposed to heavy metals, pesticides or is doing a detoxification program should be on a similar high-level multivitamin.

Yes, these are physician-grade products, so that means they are not available over the counter.  Lots of naturopathic physicians sell these in their office (you can call them).  I don’t like to do that, so I have my patients order them online through Natural Partners (my patients get a sweet 20% off).  They are more expensive – that’s because they are pharmaceutical grade products.  These companies literally test every single batch that comes off the assembly line for purity and potency, and that is why Dr. Erika trusts them.

So seriously, skip the Centrum.

The post Skip the Centrum! (A guide to a good multivitamin) appeared first on Montana Whole Health.

This recorded lecture includes all the latest research regarding vaccines, vaccine adverse events and immunology.  Written and recorded by Dr. Erika Krumbeck, naturopathic physician (and worried Mom) who specializes in pediatrics and vaccine safety. Also included is an e-book workbook filled with the data included in the lecture and a blank vaccine worksheet.

This is not a “pro-vaccine” or an “anti-vaccine” webinar.  This lecture presents all the facts regarding vaccines in a non-biased, non-judgmental atmosphere.  This course also sifts out the facts regarding the link between vaccines and autism.  You will learn about the adjuvants in vaccines and what effects they may have on the body.  There is also a brief discussion on allergies and what to do with children who have other health conditions like asthma or severe allergies. Learn which vaccines are live virus vaccines, and which vaccines contain aluminum (and why this is controversial). Other topics include: thimerosal, the MMR scare, autoimmune disease, nosodes instead of vaccinating, breastfeeding instead of vaccinating, the use of Tylenol, abortion and pro-life parents, how to use VAERS, use of probiotics, glutamine and vitamin A when vaccinating.

Learn what vaccines are associated with multiple sclerosis, asthma/allergies, eczema, intusussception, febrile seizures and more.

This webinar teaches the facts about immunizations – what disease each vaccine is designed to prevent, when it is most appropriate to give them, and what is actually in each vaccine.  We will go over the actual data on the incidence of disease as well as the chance of having an adverse vaccine reaction.  You will also learn how to prevent vaccine adverse reactions and what not to do when vaccinating your child.

Vaccine information from someone you can trust. Learn about vaccines away from the media hype, internet hearsay and celebrity endorsement!

The best $18 you’ll spend this year.

Click on the images below for a sneak peak of the presentation and e-book:

The post Vaccines Demystified webinar available for sale. appeared first on Montana Whole Health.

April is national Autism awareness month. 1 in 88 American children have a diagnosis of autism, a number that has been climbing rapidly (a 1,148% increase, according to the Autism society).

As a physician specializing in pediatrics it is frustrating to continue to hear the conversation centered around vaccines causing autism.  I believe we are doing the autistic community a disservice by continuing to wage a war of words regarding autism and vaccines.  Though no study has looked at the totality of vaccines, at least the MMR vaccine/Autism link has been emphatically disproven in literature.

Celebrity-driven fear has shifted the conversation toward vaccines in the past decade.  Meanwhile a host of studies have shown other environmental, genetic or drug-induced associations with autism.  Studies have shown a link between exposure to vinyl flooring and autism, the culprit being high levels of phthalates. There is research showing associations between autism and flame retardants, heavy metals, defects in detoxification pathways (sulphation or methylation) or glutamine dysfunction. Some preliminary research shows an association between Tylenol use and autism.  When parents notice a change in their child’s behavior after a vaccine I always wonder – was it the Tylenol?

There are so many questions that need to be answered before we can move on with prevention and diagnosis of this common, disabling condition.  Please, autism is too complex a disease to be blamed solely on vaccines.

-

Dr. Erika’s response to the many comments posted below:

“Thank you all for your comments, I truly appreciate your thoughts.

There clearly is much more to be said about the autism/vaccine debate than can fit into the Missoulian’s 300 word space. My point regarding autism is that we need to move beyond just vaccines – that autism is a multifactorial neurological process that is much too complex to be explained away by vaccinations.

I understand that many parents have seen regression in their children after vaccines – this post isn’t to diminish that observation in any way.

I think that Dr. Natasha Campbell-Mcbride (Author of the now famous “Gut and Psychology Syndrome” book) has a very intelligent answer to this debate. She basically states that vaccines can end up being the “straw that broke the camel’s back,” so to speak. I agree. For children who are genetically predisposed (low sulfation and methylation abilities), with environmental insults the vaccine ends up being the last thing that completely depletes glutathione. When that happens the body’s ability to scavenge free radicals is compromised which leads to oxidative damage, especially in the brain (or possibly at the blood-brain barrier). The result is regressive autism.

My point is that it is not the vaccine that is the culprit, necessarily. Epidemiological research shows us that rates of autism are similar in vaccinated and unvaccinated children – if not the vaccine, then something else would likely end up being the “final straw.” Many of the parents in my practice have the same hunch.

To that end, I believe that MMR is actually LESS likely to cause or be a partial culprit in precipitating autism compared with other vaccines. (Actually, one piece of literature shows LOWER rates of autism in children vaccinated for MMR!) As a physician I am much more concerned about the aluminum-containing vaccines like DTaP, PCV and HiB which I think place a greater strain on the body’s ability to detoxify. It is incredibly unfortunate that no study has ever been performed comparing the full CDC schedule of vaccines vs. unvaccinated children. It is also very concerning that the latest Cochrane review for the MMR vaccine states that safety data is lacking (though they did state that there is no evidence to support an MMR-autism link, since that is one thing that HAS been studied).

So no, I am NOT a “pro-vaccine” physician, though I am also in no way an “anti-vaccine” physician. There is much that needs to be worked out in science. Physicians like myself need to educate our patients to weigh the pros and cons of vaccinating vs not vaccinating. These vaccines were developed for a reason – to save parents the anguish of potentially devastating diseases. Some are more severe and more common than others, and some are much more likely in certain situations.

I am 100% supportive of parents in whatever decision they make, as long as they are aware of all these “pros” and “cons.”

Please read Jeff Walsh’s comment above as well, there is definitely a gut component to autism – I very much agree.

Okay, so I tried to respond to as many comments as I could! Please let me know if you have additional questions.”

© Showface | Dreamstime Stock Photos & Stock Free Images

The post It’s time to move beyond the autism/vaccine debate. appeared first on Montana Whole Health.

Annika getting dirty.

Have you guys heard of something called the “Hygiene Hypothesis?”

The Hygiene Hypothesis states that much of the chronic disease in the First World is due to lack of exposure to dirt and “healthy” microbes.  In our Lysol-friendly American households we come into contact with way less germs than developing nations (or really any other nation for that matter).

What’s the consequence?  HUGE healthcare costs for our whole country because of the higher incidence of chronic disease.

So two weeks ago we talked about the difference between the Th1 and Th2-mediated immune systems.  If you haven’t read that post you should read it now.  (I know it’s a little heavy in immunology jargon – just bear with me.)

Lots of studies have shown that use of antibiotics in the first year of life leads to increased incidence of asthma, eczema and allergies (Th2-dominant diseases).  Ditto for the use of household cleaning products, lack of siblings, lack of daycare, etc.  Basically – the more germs, colds, flu’s and parasites you are exposed to the less likely you are to develop asthma, eczema and allergies.

What’s interesting is that at the same time as Th2-type illnesses have increased, so have Th1-dominant diseases like Multiple Sclerosis, Inflammatory Bowel Disease, and Type I diabetes.  Some authors suggest that exposure to bacteria and viruses helps stimulate our T-regulatory cells, which are the “balancing” cells of our immune system.

Okay, enough immunology.  What’s the take home?

Avoid antibiotics whenever humanly possible. Knock on wood, I have yet to have to prescribe an antibiotic in my practice.  We have LOTS of other options for stimulating the immune system and healing infections and illnesses naturally.

Throw out your Lysol.  Toss your Triclosan-containing soaps. (It’s an endocrine disruptor, leads to antibiotic resistance, and may be a carcinogen.)

For the love – get rid of those ridiculous aerosol products that claim to remove bacteria from the air.  YIKES!  We do NOT need to remove normal, healthy bacteria from circulating air! If your home stinks it’s time to clean whatever is making it stinky, not cover up the odor with harmful chemicals.

Use an alcohol-based hand sanitizer only when soap and water are not available.  And avoid the commercial name-brands, they are full of strange chemicals.

Let them get dirty.  Our bodies were meant to be exposed to soil.  We have lots of “probiotic” supplements and fermented foods to supply us with good intestinal bacteria, but what about skin flora?  I really think our skin was made to have contact with dirt and healthy bacteria in soil.  In fact, Dr. Erika has a hypothesis that many skin conditions could be improved with regular exposure to dirt.  (Okay, not open wounds, please don’t go home and rub soil into your cuts.)  But it is super important to avoid pesticide and herbicide-laden soil (no Roundup) – we need good organic compost.

Remember all those mud-pies we made as kids?  Turns out they may have benefits.  Small doses of healthy bacteria may be enough to stimulate the immune system and activate those T-regulatory cells that reduce chronic disease.  So…

Let them eat dirt!

The post Let them eat dirt (The Hygiene Hypothesis) appeared first on Montana Whole Health.

Annika is due for her 12 month appointment in a few days and she’s been speaking a couple of words (and rapidly picking up more it seems). I know that’s pretty normal, but I wanted to find out how many words other kids are speaking at that age and whether or not she was “advanced” for her age.

Bad Mom.

Annika a few months ago.

First of all because I should not be comparing. Secondly because “advanced” or “gifted” children aren’t “better” than any other kid. Thirdly because anytime I Google anything about parenting I always end up feeling guilty. And if you follow my writing at all you know my number one thing I cannot stand is Mom Guilt.

So no, Annika is not “gifted.” At least not compared to the other kids whose Moms claim they are speaking full sentences at a year and writing at two years. (Actually, ironically, my husband started writing really early, at around 3 years of age, but he didn’t speak until almost then either!) Nope, Annika is perfectly developmentally normal.

Thank God.

The one thing I’ve learned as a physician who sees lots of children is that every kid has their own uniqueness. Every child has something that makes them so unequivocally them. It is such a privilege as a physician to see children grow up and be nourished in what makes them individuals. It is so exciting to see their gifts and talents exercised in this world.

Some kids have great math skills, or reading abilities, or are awesome spellers. But for most it is something that cannot be measured on any standardized test. I’ve seen brilliant, witty, hilarious kids who are on a mission to light up whatever room they are in. I’ve seen some who take such great pleasure in reading – they share that passion with their parents or their friends. Some kids just LOVE sports and you can see them glow when they throw that baseball.

For a lot of children it is so subtle. Annika is a really sensitive kid – she gets big crocodile tears whenever another child cries, even across the room (and even when the other kid is faking!). I cannot wait to see how this sensitivity will be used to benefit others. She already wants to share her stiff, sucked-on crab puppet (her favorite lovey) with everyone. Maybe it is her way of making us feel better?

But that sensitivity IS her gift. She is the balance to the insensitive world.

What is your child’s gift? How can you nourish it?

The post Be happy with the child you have appeared first on Montana Whole Health.

It’s spring here in Missoula and you know what that means: hay fever season is just around the corner. If you’re a hay fever sufferer and you feel like the only way to cope is to dress yourself in a hazmat suit then you probably want to read on.  Ditto if you have asthma, eczema or food allergies (the anaphylactic kind).

Allergies, asthma and eczema are all interrelated.  In fact, many patients who have one of these symptoms actually have all three. This blog post will explain why these issues are primarily an immune-system balancing problem.  Skip the first part if you struggle with biology and immunology.

What is Th1 and Th2? What does this have to do with my immune system?
The immune system is a complex, integrated collection of cells and chemicals that protects against disease.  The primary function of the immune system is to recognize the difference between normal cells (“self”), and invaders (“non-self”).  The immune system must then protect “self” and work to eliminate “nonself,” which can include viruses, bacteria, parasites, even cancer cells.   The human body has an incredibly intricate system of defense, and uses multiple mechanisms to keep invaders (pathogens) out.

One of these mechanisms is called the adaptive immune system.  The adaptive immune system consists of special types of white blood cells called B cell and T cells (often called lymphocytes).   B cells make antibodies against foreign invaders so the immune system can “remember” the pathogen and quickly eliminate it in the future.  T cells are responsible for either actively killing (killer T cells), or helping to kill (helper T cells) the pathogen.

T lymphocytes activate and regulate the immune system by making cytokines, which are chemical signals that tell other cells in the immune system what to do.  Of all the types of cells in the body, helper T cells are considered to be the biggest producers of these cytokines.  There are two main types of helper T cells: Th1 cells and Th2 cells.

Th1 cells work to eliminate invaders that occur inside our cells (viruses and some intracellular bacteria).  Th2 cells aim to destroy pathogens that occur outside our cells (bacteria and parasites).  Th1 cells and Th2 cells each create different cytokines which triggers different effects in the body.

(Thanks to North Carolina State Wiki for this image. No copyright was listed.)

Why is this important?
A healthy immune system can “choose” which types of cells to produce and can easily switch back and forth between Th1 and Th2-type responses.  An unhealthy immune system can get “stuck” in one of these responses – leading to excessive production of only one type of cytokines.

Most people in the developed world get “stuck” in a Th2 response.  This is because our bodies are not exposed to as many parasites and bacteria as in the past (thanks to Lysol, toilets, and water sanitation systems).  An immune system without an invader to fight will start attacking anything it can – pollen, food particles, dust, dander, etc.  When Th2 becomes switched on it activates eosinophils and IgE-type reactions which leads to the symptoms we recognize as “allergies”.  For some people this can become severe, leading to asthma, eczema, and anaphylactic reactions.

Much of the balancing of the Th1/Th2 response occurs in pregnancy and early infancy.  Once the immune system gets “stuck” in an abnormal pattern we have a much more difficult time correcting it.  This is why treatments that aim to balance the Th1/Th2 ratio can take a long time to work.  It is very important to stick with it to see results!

How can I balance my immune system?
Naturopathic doctors have several strategies to balance an “unhealthy” immune system:

Probiotics and prebiotics. “Probiotics” refers to beneficial bacteria that normally reside in healthy human intestines.  “Prebiotics” refers to the types of food that promote the growth of these healthy bacteria.  Probiotic bacteria have been shown to alter Th2 cytokine production in both healthy and “allergic” people.  Probiotics also appear to stimulate the immune system in the gut called GALT (Gut-associated lymphatic tissue) which promotes healthy immune activity.

Fish oil. Fish oil blocks inflammatory cytokines by irreversibly binding to immune system enzymes.  Irreversible is good!  This means that when the body needs an appropriate immune response it can still have one.  For fish oil it is absolutely essential that you buy a high quality product – they are frequently contaminated with mercury (since some types of fish are high in mercury).  I like one called Finest Pure Fish Oil from Pharmax, which seems to be pricey but actually has the highest concentration of EPA and DHA per dollar.  Nordic Naturals is good too.  (No affiliation with these products, just for your information.)  They can be hard to find, e-mail me if you need helping locating them.

Vitamin A and vitamin D.  Vitamin A, in combination with appropriate amounts of vitamin D, seem to be able to turn off inflammatory immune responses.  The combination of these two nutrients can take immature T-helper cells and switch them to an anti-inflammatory version called T-regulatory (T-reg) cells.  This can be helpful for patients who have either excess Th2 OR Th1 responses.  BUT – please note that vitamin A and vitamin D, which are both steroid molecules, can be toxic in high levels.  You always need to consult a physician before you take either of these vitamins in levels higher than recommended by the FDA (the “daily recommendation”).

Herbs, fungi, etc.  Naturopaths have a long botanical formulary: ~300 herbs, many of which are anti-inflammatory or immune modulating.  There are lots of options for herbal formulations to alter your Th1/Th2 ratio.  That could fill up a whole blog post itself, so e-mail me or schedule an appointment if you have more questions.

Naturopathic doctors have many other tricks to balance the immune system – usually it depends on the individual and their own particular biochemistry.  Don’t give up if the first thing you tried didn’t work!  Every time a patient comes to me and something hasn’t worked it just gives me more information.  There are many different types of biochemistry – we just have to figure out what works for you as an individual.

Here’s two of many references I used for this:
Ghadimi D, et al. “Effects of probiotic bacteria and their genomic DNA on TH1/TH2-cytokine production by peripheral blood mononuclear cells (PBMCs) of healthy and allergic subjects. Immunobiology. 2008;213(8):677-92.

Abrahamsson TR et al, A Th1/Th2-associated chemokine imbalance during infancy in children developing eczema, wheeze and sensitization.  Clin Exp Allergy. 2011 Dec;41(12):1729-39. doi: 10.1111/j.1365-2222.2011.03827.x. Epub 2011 Aug 1.

Image courtesy of: © Velkol | Dreamstime Stock Photos & Stock Free Images

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If your child’s insurance card looks like this then we are able to bill your insurer directly.  Unfortunately we cannot take Medicaid at this time.

Dr. Erika Krumbeck (or “Dr. K” as her little patients call her) is a naturopathic physician specializing in pediatrics.  She offers well child checks and office visits for chronic and acute problems.  If you are looking for holistic, patient-centered care for your child consider a naturopathic physician for your child’s pediatrician.  A member of the Pediatric Association of Naturopathic Physicians, she offers a unique approach to solving your child’s health problems. Dr. Krumbeck treats children of all ages, offering adjunctive care for children 0-2 months, and primary care for children 2 months and up.

“I believe that healthcare should be more than just treating your child’s symptoms.  This is why I take extra time to listen carefully so we can uncover the underlying cause.  I offer safe, gentle and effective alternatives to medications to restore health naturally.  I use a caring, collaborative approach to provide individualized treatment plans that work for your child and your family.  I want your child to flourish!”

The post Now accepting Healthy Montana Kids insurance! appeared first on Montana Whole Health.

This last Saturday I had the wonderful pleasure of teaching a short class on imaginative play at Walking Stick Toys here in Missoula.  Walking Stick Toys is an awesome toy store dedicated to selling all natural wood, wool, silk and cotton toys – toys that are healthy and stimulate the imagination!  I love it!

For those of you who missed the class, or want a refresher, here are my notes:

Intro:
Why play?  Play is a fantastic way to learn. Play engages the brain in a way that no other activity can. It uses language, spatial reasoning, planning, cooperation, strategy and social understanding.  Play often involves math and physics and sometimes reading and writing as well.

Researchers actually use imaginative play as an evaluation tool to assess a child’s development.  Normal children have robust imaginations and are able to use objects creatively, whereas developmentally delayed children often have difficulty with this.  Researchers particularly use imaginative play to assess the social development of autistic children.

Point number 1: Reinforce repetition.
Kids are scientists.

Here is a scene that every parent has experienced: your child dropping food off his highchair onto the floor.  It was funny the first time, but after eighty five hundred times the cuteness ceases and it just becomes really annoying.  Annoying to the parent, that is! Your child is still enthralled with the sequence of events that occurs after dropping the umpteenth cheerio to the floor.  Why?  Because it is a great experiment! The cheerio dropping experiment involves physics (gravity), object permanence (the cheerio still exists even though it is out of sight), and lots of sociology and psychology (how do Mom and Dad react to me dropping it?).

In science we call this using a large sample size.  The large sample size helps us predict overall trends.  In the cheerio dropping experiment, for example, your child learns that when she drops the cheerio 95% of the time it lands within a 2 square foot radius, and perhaps 4.5% of the time within another square foot radius.  Rarely the cheerio rolls across the floor, and never does the cheerio fall upwards or sideways.

So though the cheerio experiment is incredibly boring to the parent, it is still our job to encourage our child’s repetitive play.  It is an important part of their development!

Point number 2: Safety.

Research has shown us that the most important thing for proper brain development is a safe environment.  This is most important during the first year of life, when parts of the brain are forming connections that will persist for a lifetime.  One center in the brain is called the amygdala, and is responsible for perceiving fear and other emotions. The amygdala in normal, healthy adults is linked to the memory centers of the brain – which is why certain memories are tied to emotional feelings (and vice-versa).  In children who come from extremely dysfunctional homes this amygdala gets wired inappropriately, leading to false associations between emotions and memories, making it difficult to learn new information.  Children who have large, healthy amygdalas have been shown to have greater language development.

So safety is the first priority for the developing brain in infancy.  But I would also argue that it is important for children to be in an atmosphere of safety to facilitate imagination and imaginative play.  Children who are discouraged from using their imaginations are less apt to play in this manner, and thus less apt to receive all the good benefits you can get from creative play.

Point number 3: Play needs rules.

In the 1972 there was a famous research study done called the Stanford Marshmallow experiment.  Researchers brought kids into a room and showed them one marshmallow (sitting on a desk).  They explained to the children that if they could wait fifteen minutes that they could then have two marshmallows to eat instead of one.  The researchers then left the room.  Some kids ate the marshmallow right away, but most at least attempted to wait.  Only about a third of the children were able to wait the fifteen minutes.

Many years later the researchers looked at the data again and saw a new correlation: the children who could wait had higher SAT scores later as adolescents.  Researchers concluded that the ability to govern self-control was more important in determining test scores than reading, writing and math abilities alone.  Pretty interesting!

A Russian psychologist named Vygotsky established a theory that imaginative play develops the same type of self-regulation that stimulates intelligence.  When children play they adopt certain rules that regulate their play.  I’ll use the example of my nephew and his grandmother – they used to play “Postman” and customer.  My nephew had to wait for his grandma to “call” the post-office requesting her package, then he had to ring the “doorbell” and wait for her to answer before delivering it.  In this he learned self-regulation by waiting, but also by restricting himself to the role of Postman (i.e., he can’t be both a Postman and a customer, nor can he be a Postman and a Fireman at the same time).

There’s a whole preschool development program called Tools of the Mind that is dedicated to using research-based methods to increase a child’s learning.  They use Vygotsky’s theory to set up a curriculum that stimulates self-regulatory behavior in children.  In their classroom they have children write up a “Play Plan” before each day. (E.g., “Today I am going to play Fireman with my friend.  Then I will build with Legos.”)

So to encourage your child to self-regulate, make sure to enforce the “rules” of whatever game they are playing.  The best part is that the child themselves can set the rules.  Also ask your child what they are doing or what they are playing – this will help them be more self-aware in addition to elucidating the rules of the game.

Point number 4: Play helps children understand the world around them.

The famous psychologist Piaget theorized that children use play to make sense of the world around them.  I’m sure you have all seen this: a child sees a major event and in the subsequent days (or weeks or months) she re-creates the event using her toys.  Piaget used the example of a fire in a neighboring house – the child sees the firefighters, trucks and hoses as well as the flurry of activity during the event.  For the next month he uses blocks as “houses” and pretends being a firefighter using his hose to put out the fire.

Piaget called this accommodation and assimilation.  The child uses her play to repeat the event enough times to make sense of what happened (in a controlled, safe environment).  When your child does this – encourage it!  It is also a great time to talk things through with your child, or provide “alternate endings” to traumatic events through play.

Point number 5: Praise effort not intelligence.

This one is so hard to remember, but is so key to boosting your child’s potential.  We all do it – when our child does something brilliant, or brings home a good test score, the first thing out of our mouths is “You’re so smart!”

Wrong! We need to say something entirely different: “You must have worked so hard!”

Why? Research has shown that kids who are praised for intelligence develop fewer learning strategies than kids who are praised for effort.  Kids who are taught that they are smart learn that their identity is “smartness” – they often become more concerned with “being smart” than they are with learning.  When these kids finally do get a bad grade the logical conclusion is that they are no longer smart, and thus can’t increase their test scores.

In contrast, the child who is praised for effort learns that his bad grade is due to either lack of effort, or not understanding the problem.  Both of these are solvable dilemmas.  Children praised for effort are consistently more creative problem solvers. They also appreciate learning for the sake of learning rather than for a test score.

Interestingly, other societies do not have the same approach to intelligence and learning that we have here in the states.  Carol Dweck, a researcher who established the “Praise Effort not Intelligence” theory, also studied societal beliefs about intelligence.  She found that in the states many people generally believe that smart people are smart from birth and stay smart.  Contrast this belief with what she found in many Asian societies: that anyone can be smart given hard work.  Interesting, since in our American culture we often think of “Asians” as “the smart kids!”

So there you go – praise your child for “working hard!”

Whew!  That was long, and I barely scratched the surface of my lecture.  I hope you enjoyed it!

For more reading, I suggest checking out the Tools of the Mind classroom curriculum.  Also read the book Brain Rules for Baby – which is where much of my initial research for this talk came from.  He has a whole book full of interesting ways to increase your child’s intelligence.

The post Play Smart! (How to increase your child’s intelligence with imaginative play) appeared first on Montana Whole Health.

It’s gray and a bit lazy here in Missoula. I love the snow, and I love winter (it is my favorite season). “Real” winter is one of the reasons we moved here. But the “real” winter has faded away in the last few days, with drizzle replacing snow, and mud replacing the white-covered grass up here at the house.

So we’ve been feeling house-bound, Annika and I. Or at least I have. We can’t tell if she’s teething or going through a growth spurt, but she alternates refusing to eat and nurse to gobbling up anything we give her. Today we’ve attempted 4 naps and she’s only taken 1. She’s learning to walk, but is still too afraid to do it on her own, so she wants us holding her hands constantly. All this has led to an exhausted Momma and Daddeeee. (I love the way she says Daddy – it comes out “Duh” (space) “Deeh.”)

My gluten-free snack foods have been bugging my tummy again, as grains often do. (And as they do for a lot of my patients also!) So I bought almond flour and coconut flour and I’m getting into Paleo cooking again.

This afternoon I modified this recipe to make some GF, DF, SF cookies that would be better on the blood sugar than my normal fare.  Besides the fact that high grain diets can contribute to dysbiosis, I have found that grains and baked goods made with regular flours tend to spike blood sugar rapidly.  The problem?  Blood sugar spikes lead to blood sugar crashes, which none of us need – especially not an exhausted Mom at three in the afternoon.

I popped the cookies into the oven not knowing what to expect.  Yesterday I modified another recipe for pumpkin paleo cookies, which started out at a disaster (eventually recovered by extra time in the oven and liberal application of honey just before eating).  But 5 minutes into bake time I knew we had a winner.  These cookies will fill your house with the most delicious toasted pecan and caramel smell! Even Jason, my olfactory-challenged husband thought they smelled delicious.

These cookies really beg for some afternoon coffee, or “Fika” in Swedish (pronounced “Feeka”).  Afternoon coffee is to Swedes as Tea is to the British.  Just like the Brits, Swedes require small snacks for their coffee break – often sweets like cinnamon rolls, applecakes, sweet breads, marzipan cakes and cocoa balls.  But here in the states, my Swedish family usually eats store-bought cookies or scones unless we have a special occasion.  These cookies are firm enough to dunk – an important Fika characteristic.

So as I sit here listening to Annika lament about her 2nd nap over the monitor, I am a bit homesick.  I hope these cookies brighten your day as they have mine.  (Miss you Mom.)

Gluten-free, Dairy-free, Soy-free Paleo Almond Pecan cookies

2 c almond flour
1/2 c chopped pecans (preferably toasted pecans)
3 Tbsp coconut sugar (I cheated and used regular sugar, making it not-so-paleo)
1/2 tsp baking soda
1/2 tsp salt
1 egg yolk
2 Tbsp maple syrup
1 Tbsp molasses (Organic is a must! The way they refine molasses means that any pesticides will get concentrated along with the sugar.)
2 Tbsp olive oil
1 Tbsp applesauce or finely chopped apple
1 tsp vanilla extract

Preheat the oven to 350ºF.

Mix the almond flour, pecans, sugar, baking soda and salt in a large mixing bowl. Add wet ingredients and stir thoroughly to saturate all the nut pieces with the wet ingredients. Grease a baking pan with GF cooking spray, organic grass-fed butter (not DF, obviously), or Spectrum Spread (which is what I used). Roll small golf-ball-sized pieces of dough into a ball and flatten with your hand; place on greased cookie sheet. (Should make 12 cookies.) Bake at 350ºF for 15-20 minutes.

Hey look – the sun came out!

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It was six weeks after Annika was born, on a Friday, that it hit me.  Annika was having another one of her “colic” fits of uncontrollable crying.  (The crying that is completely unsoothable, regardless of how many of Dr. Karp’s “S’s” I try.)  Annika’s uncontrollable crying lasted about 45 minutes.  My uncontrollable crying lasted 3 hours.

It sounds stupid to say that I didn’t know I had postpartum depression, but I didn’t.  I thought, it’s just sleep deprivation from never getting more than 2 hours at a time all night long.  It’s social isolation, from never going anywhere since Annika would scream in her carseat. It’s just sadness from having a kid who is obviously hurting, and there is nothing I can do about it.  (Don’t worry, everyone said.  It’s just colic, she’ll grow out of it.  So 3.5 months later we finally got a diagnosis of silent reflux. In the meantime we suffered and she suffered, while we heard every piece of parenting “advice” from well meaning friends and strangers with babies obviously “easier” than our own.)

Somehow I didn’t put the pieces together until I saw one of those little mini quizzes on babycenter.com.  “You might have postpartum depression if…” I answered “yes” to every single one of the questions.

And then I got scared.

What if I can’t provide for my daughter?  What if I hurt her? (I ask myself, as I cling to her, wearing her and soothing her and nursing her and caressing her all day long and all night.) “Babies with mothers who have PPD are more at risk for _______” they say.  Oh dear Lord, another thing I need to worry about now.

Thank God for my midwife (a naturopathic doctor, too).  Jason begged me to bring it up at my 2 month visit with her.  (Actually, I think he brought it up.)  And thank God for the passage of time.  Once we learned it was reflux and treated it, Annika slept better and cried remarkably less.  Then she learned to sit up, we moved to a place where it is sunny (sorry Seattle), and I finished my stressful board exams.  It feels like ages ago since I sat there in our tiny one-bedroom apartment sobbing for hours.

It was a horrible experience, but now, on the other side of things I am glad I went through it.  My heart for postpartum Moms has swelled.  I understand what it is like to have a sick kid, and how awful and scary and out of control it feels.  I know what to look for in colicky babies and when to not call it “colic!”  And I definitely know how to identify and treat Moms with PPD.

So, from a Mom and a doctor who went through postpartum depression herself, here is what I wish someone had told me:

1. It’s not your fault.  Let me repeat: it is not your fault! You did not do anything wrong to get postpartum depression.  It is not your body failing you.  It is not because of any wrong choice you made in pregnancy.  It is not because you aren’t strong enough, or healthy enough, or smart enough or wealthy enough.

Let me explain.  During pregnancy progesterone levels remain high and then precipitously drop after childbirth.  Though we typically think of progesterone as a reproductive hormone, in actuality it has effects in multiple places, particularly the brain. Progesterone is converted to allopregnanolone (or 3α,5α-tetrahydroprogesterone) in the central nervous system and strongly acts on GABA receptors.  Just to give you an idea of what GABA receptors do – alcohol, valium and other sedatives act on these receptors, which is why most people feel generally relaxed and happy on GABA-acting drugs.  So basically your brain is going through a valium-like withdrawal after pregnancy.

If that weren’t enough, the process of pregnancy also depletes many of our nutrients we need to maintain good brain chemistry.  Pregnancy depletes B vitamins necessary to make neurotransmitters like serotonin and norepinephrine.  It also depletes minerals like magnesium, which makes people feel relaxed.  Many women are also low in essential fatty acids like DHA and EPA (Omega-3’s) after childbirth.  Studies have shown that women who are deficient in omega 3’s are more likely to have postpartum depression. There are so many physiological reasons why women get postpartum depression.

2. You are a good Mom. You are the best Mom for your baby.  Having postpartum depression is tough.  It makes it hard to get anything accomplished during the day – laundry goes by the wayside, meals are straight from the freezer, and there are baby supplies scattered all over the house.  But that doesn’t make you a bad Mom.  Your baby still relies on you to get its needs met – in this early stage that basically means food, shelter, clothes and safety.  If you can still accomplish these basics then you are doing a great job.  At this point you know your child better than anyone else in the world.  You know the ins and outs of your child and what they need and when.  Trust your instincts and don’t let anyone tell you to do things differently if it doesn’t feel right.

3. Get help. Get help in any way that you can.  Visit your doctor.  If he/she isn’t concerned, then find a new one who is.  Find a doctor who is willing to do bloodwork and find and treat the underlying cause of your depression.  (Every Mom with PPD should be tested for thyroid function, anemia and vitamin D at the minimum!)  Find a doctor who will support you in any decision you make.

Talk your heart out to counselors or good friends.  (I remember the best people to cry out to were other Moms who had “been-there-done-that.”  It never got old to hear them say “It gets better.”) Vent your frustrations to someone who has the energy to listen heartfully (skip your spouse – they are going through enough themselves).

Find a Mom’s support group, a breastfeeding support group, church group, play group, or depression support group.  Being around a group of Moms who have babies the same age as yours can be very helpful – you’ll be surprised at the number of times other Moms are feeling the exact same way that you are.

Get help around the house.  Find friends (or friends-of-friends) who may be willing to do a little housework or cook a meal or two.  It can make a big difference.

4. Your safety is your top priority.  Don’t feel guilty for needing some assistance, whether it be housework, vitamins, herbs, counseling or medication.  Do what you need to do to stay safe.

When I went to my midwife Jason begged her to give me a prescription for an antidepressant.  Not to take, but to have just in case.  I never needed it, thankfully, but it was nice to know that if things got really bad I could have some pharmaceutical support.  I know in the natural childbirth community there can be some guilt attached to using any type of drug.  In my practice I’ve had wonderful success treating postpartum depression naturally.  The vast majority of women I see will not need any pharmaceutical, but I will never hesitate to recommend an anti-depressant for someone who really needs it.   If you need it to stay safe: take it!  (Don’t worry, I have a great program for getting patients off their anti-depressants when the time comes – you won’t need them for a lifetime.)

One woman on babycenter.com in my birth club group relayed her story of how she ended up in E.R. for postpartum depression.  She was scared for her safety and her child’s safety and so she went.  She told everyone in our group what a positive experience she had, and that she felt unbelievably cared for and supported, not judged or talked down to like she thought she would.  If you need emergency support, don’t hesitate to call 911 or go to your local emergency room.  Or call the national postpartum depression hotline: 1.800.944.4PPD.  They will NOT take your baby away from you for getting help!

I hope this helps.  Here are some more resources:

A brief quiz on PPD.
Babycenter.com’s advice on postpartum depression and anxiety.
Babycenter.com’s community group: all mom’s who are dealing with postpartum depression and anxiety.

Don’t forget that PPD can come in all shapes and sizes – some women may have anxiety, OCD or other mood disorders not limited to depression.  If  you want my help I am happy to do so – you can call (406) 552-5041.  Even if you just need a few minutes to talk to another Mom who is been there before…

Photo courtesy of Stockfreeimages.com

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