Transcript: Supporting Your Kids’ Immune Systems During the School Year

Transcript: Supporting Your Kids’ Immune Systems During the School Year

Maureen: Hi everyone, and thank you for joining us for Beyond The Lunchbox Snack Session on supporting your kids immune systems during the school year. So we are so excited to have Dr. Joel Gator Warsh with us today to answer all of our questions on this topic. Dr. Gator is a board certified pediatrician in Los Angeles, and he specializes in integrative medicine and is the owner of, and host of the Raising Amazing Podcast. He has been featured in numerous documentaries, podcast, articles for his expertise, and he hosts the Integrative Pediatric Summit. So thank you so much and welcome Dr. Gator.

Dr. Gator: Thanks for having me here. I’m excited.

Maureen: I am so excited to talk about this as a parent myself. Many of our kids have headed back into the classroom in the last few weeks. And now that kids are in close quarters again, it’s also more likely for them to share their germs. Meaning that inevitably our kids may come home with a cold, if they haven’t already, this school year. So just a little story, my son, this is the second year of So I was very unprepared last year when he first came home from preschool and within a couple of weeks, he was sick and then proceeded to bring home virus after virus into our house all year long, and you know, as when you don’t have children, you’re not used to getting sick so often so it was a huge change for us. So I’d really love to hear from you on how we can do a better job at avoiding sharing germs in the classroom, and what we should do when our kids do get sick, and then, really importantly, how to support a healthy immune system at home. So let’s let’s just dive into the questions here. First of all, do you see an uptick in common childhood illnesses when kids head back into the classroom in your practice?

Dr. Gator: Oh, yeah. Definitely. I think it’s one of those, you know, funny not funny things as a pediatrician, because there are so many parents, when their kids first go to school, that are extremely concerned because they feel like their kid has an immune deficiency. There must be something going on because their kid is just sick and you know, they get virus after virus, maybe two or three in a row. It’s like been two months and they’re like, they’ve always been sick. And that’s just a reality I think of going to school and daycare for the first time. I don’t know that there’s any, you know, magic in terms of preventing all illness from a toddler when they go into daycare. It’s really just the reality of there are a bunch of kids here around and somebody’s gonna have something and someone’s gonna send their kid back to school too soon or one kid’s gonna start getting sick and the parents don’t even know that they’re sick yet and they’re all touching the same things and you know, there’s secretions everywhere. There’s, you know, boogers and and touch in there, you know, everything goes in their mouth and whatever. So then it’s a place where there’s going to be illness passed around. So I think that’s just something that We have to be reasonable with our expectations and if you send your toddler to school and you think they’re not going to get sick, that’s probably not realistic, but that doesn’t mean there aren’t things that we can’t do to support them, to decrease their risk and to you know, hopefully help them to get over things faster. But yeah, they’re gonna get sick. There’s no magic supplement out there that’s gonna prevent all in this. That’s just not not reasonable.

Maureen: Absolutely. I had to come to that realization very quick last year. Obviously, as a parent, you’re like “it’s good that they’re getting sick all the time?” But then the benefits of course of being around other kids and learning and socializing are so important too.

Dr. Gator: I think that it’s important also to mention that getting sick is not a bad thing. Right? You don’t want your kid to get super sick to the point where they’re in the hospital or you know, God forbid, having something horrible happen, but getting sick is actually important. You want to be exposed to germs. You want to be exposed to viruses. You want your body to build up antibodies. That’s why as adults we don’t get sick that often, right, because we’ve been exposed to most things and our bodies have antibodies. And it trains our immune system how to work and how to fight off pathogens and over time, we get less and less sick. And we don’t get sick as commonly. So I think it’s a good thing, and that’s something to be mindful of, but again, you get three to five viruses of winter when you’re a toddler. So that what’s normal. So going in there thinking you’re not gonna get sick is not reasonable.

Maureen: Yes, it makes sense. Okay. So now that we’ve established that it’s going to happen, are there anything that important things that we can do and have our kids do to prevent picking up every potential virus that is in their classroom?

Dr. Gator: Good question. So number one the basic stuff that, you know, we hear about all the time in terms of washing hands and kind of the sanitation of the location… Well, even before that. It’s how many kids are you around? Right? So if you can send them to a daycare with a smaller group of kids, just not that many kids then there isn’t too many people that you’re exposed to. You’re still around some kids, but you’re not around 30 kids and that probably decreases your risk a little bit, having a place that’s at least slightly mindful of that and making sure, you know, they are washing hands, having good policies around kids, you know, not coming in when they are sick. I think that really helps hopefully being around a group of people. If you have this opportunity where you kind of know them or you know, people are reasonable in terms of not sending their kid to school sick—and it’s a big difficulty for families. You need daycare because you need daycare, right? If you’re working, you’re doing whatever else, it’s not like you can just be home with your kids most of the time. So you got to send them. But people send their kids back a lot of times too fast. But if you’re in a group of people where everyone’s a little bit more mindful of the situation, then hopefully they keep their kids out a little bit longer and that just decreases your risk of exposing the other kids. So that’s kind of one big piece. And then the other piece is what can you do yourself for your own children, your own family, to kind of keep their immune system as strong as possible. And that just goes back to the foundations or what I call the “seeds of health” being stress, environment and toxins, exercise, diet and sleep. So these are the foundations that we all know, it’s not rocket science, but these are things that we often forget about and they’re vital to our health, and they’re vital to our immune system. If we keep our children healthy and strong when they are exposed to viruses, which they will be, then then hopefully their body is in a place where they don’t get sick. Or if they do get sick, then they fight it off quickly. And did you know with Covid, we saw that people that have multiple conditions, or more stress, or just weren’t taking care of themselves. Well, we’re more likely to get sick and more likely to get more sick. And that’s not new information. This isn’t true of all viruses, right? And that’s what we need to do as parents and thinking about what can we do within those, you know, five major arenas. We can just improve a little bit here and there to strengthen their immune system.

Maureen: Yeah, that’s great information and we’ll definitely dive a little bit more into that as we get going. But one thing that I have felt a little confused about… I always err on the side of caution here, because I don’t want to be the one parent that’s sending my kid back and getting all the other kids sick if they still have a little bit of a runny nose. Many schools do have great sick guidelines, but then you know, every virus is different, every cycle of the illness is different, and it can get a little confusing as a parent. Do you have any guidance here for us who are a little like, “when should we send our kids back? When is it safe?” When we feel like maybe they’re not 100%, is it okay to still go back? Are there any like guidelines that you give your patients when they come in?

Dr. Gator: So there’s two sides to that. The first side is, when is it safe for your kid to go back. And the other side is, when are you still contagious or can pass things on the other kid? Because most kids are better after a couple of days with a virus in general. Three to five days is the worst of it. So usually your worst around day two to three, and then you start to get better and you’re mostly better by day five. Sometimes you’re still coughing. It’s all the runny nose that could be weeks. Sometimes with a runny nose or a cough, contagiousness definitely varies by virus, but for most of the viruses, you’re contagious those one or two days, even before you know that you’re sick to those couple of days after. So it’s usually three to five days, up to seven days, where you’re most contagious. Some viruses you can be contagious for a couple of weeks even. Again going back to Covid is like, okay, people are staying out for two weeks, right? Because most people were most contagious in those three to five days, but to be super safe, people were staying out longer. So what kind of precautions you want to take is up to you and what you’re able to do, within reason, because usually kids can go back after a few days. Most of the daycares have their rules around no open lesions, no fevers for 24 hours, improving, but you can’t necessarily keep your child out from coughing, because they might be coughing for two months with a virus, and that doesn’t mean they’re still contagious. So yeah, I would say at least if you can keep your kid out for a few days when they’re at their worst, that’s great. If you can keep them out one extra day, then you feel like you really need to that’s probably gonna go a long way for the other kids. And if you can keep your kid out for the whole week, I think that’s great. That’s all reasonable. People need to get their kids back to school for work. And also, you don’t want your kids missing everything. It’s a fine balance you have to walk there. You want to keep everyone safe, but your kid is missing out too, if they don’t reasonably need to. So it’s hard.

Maureen: I struggled with it all last year. I think we had a new virus come in every month to our house and was I like, “here we go again.” I have another kind of related question. So we’ve talked about our young kids, especially daycare setting or maybe early preschool, they’re going to be getting sick more often than older kids. But is there a time when a parent should be concerned that their child may be getting sick too often?

Dr. Gator: I think if you’re getting three in a row, it doesn’t mean that you should be specifically concerned, but you certainly should be getting checked from a medical standpoint. It’s really the degree of severity of the disease, or not recovering appropriately that makes me more concerned as a doctor. So I’m not super concerned about a kid that gets sick two or three times in a row with minor colds. I think it’s good to get checked, but that’s not too uncommon because once your immune system goes down and you get sick, then you’re much more likely to get other things and a lot of times kids go back to school too soon. So they’re not fully recovered and then they’re just way more likely to get a second thing before they’re back to 100%. But if you’re getting things where you need antibiotics every time or you need to go to the hospital, or it’s putting you out for multiple weeks, or you’re sick for three months at a time every time, you know, things like that where it seems way outside of the norm… that to me would be way more concerning than a kid that gets a cold, you know, three or four times. Because again, you go back to what’s normal. Kids are gonna get sick two three times in a row. They’re gonna get three to five viruses in the winter. That’s a lot. I mean, every virus is gonna be a week to two weeks. That’s most of the winter that they’re sick with something. So It’s just how it is. And I think, again, going back to what’s reasonable is is fine. But again, there’s so much that you can do to help them shorten it, to help them be as strong as they can be. Not every kid gets sick five times in the winter. That’s not true for everybody, but that’s what average.

Maureen: Right. That really helps to clarify things for me, the severity of of how sick they get and how long it takes them to recover. That’s really helpful. So I’ll give you a situation, and I know I’m not alone in this, so in my house and many other houses, once one of our kids get sick usually from school, the rest of the family inevitably gets the virus as well. Which usually means that our family is in some sort of sick period for two to three weeks depending on who gets knocked down first, and who’s next, and who recovers. So my question is, and I know that some people have have written and asking this as well, is it better to try to keep our kids separated who are sick in our family? I know it’s a valiant effort from getting the virus and separating our kids. Or do we carry on knowing it’s inevitable that we’re all going to to get whatever that bug is that’s entered our house?

Dr. Gator: Yeah, I get that question a lot in the office too. And it’s a reasonableness thing sometimes, right? If you theoretically can do it, it might help. It probably won’t. Most families don’t have separate houses or separate areas where you can live completely separately. So you’re probably going to be exposed to each other. Realistically, you probably already exposed everybody before you even knew that you were sick. Yes. So, you can separate as much as you reasonably can. Now sometimes there are kids that are very sick. You have a child in the family with cancer or something like that where you know, it is really important that they absolutely don’t get sick. So then yeah, you do whatever you possibly can to keep them separated as much as you can reasonably. But you might live in an apartment, and how are you gonna separate two kids in an apartment? or five kids? You might not have a separate areas. You might be the only parent at home. There’s only so much that most people can do. So you do whatever you can within reason. I think for the most part you don’t need to separate them. I don’t think it matters that much. I think you’re gonna get it regardless, and you’re probably not going to keep them totally separate anyways, and they probably already passed their germs. So I don’t think people should stress about that. Unless you’re in one of those very specific situations where there’s something, you know, another kind of reason where we need to do it for medical reasons. I mean, I don’t tell people to do that. I say if they want to try, good luck! It’s just it’s probably not gonna actually work.

Maureen: I will say that over the past year, I was successful once at keeping my youngest, who was still a baby, it was important to me to keep her from getting his stomach bug that my older child had and that felt easier than a respiratory. I don’t know if there’s anything behind that, but it felt easier to keep them separated for that. But I wasn’t successful and I tried and then I stopped trying and I just like, you know, it’s just it’s hard when you’re you have your kids home alone. They want to play together. They play with the same toys. They eat at the same table. They share the same bathroom like yeah, so I feel like sometimes we as parents need to give ourselves grace in those situations. Even though it’s not fun having everyone get sick.

Dr. Gator: It is the way that it is though. The other thing to remember is, the older you get the more antibodies you have to things. So if a younger kid gets something a lot of times the older kids, the adults, don’t get it. Doesn’t mean that you can’t. You certainly can. Sometimes everybody gets it, You can bring the flu home or whatever. But a lot of the diseases we’ve already had. And unless you’re unlucky, if your toddler get something, you usually don’t.

Maureen: I’ve been unlucky. So on this note, what are good hygiene practices that we should have at home? If we want to keep our homes as clean as we can, especially with the idea that our kids are bringing home germs all the time. What should we be doing?

Dr. Gator: The big one when they’re coming from school is to make sure we’re washing hands when we get home. You want to use a good soap. I don’t think using too much in the way of the alcoholic based cleaners is great. I think it’s fine if you need to use it, but irritates the hands a lot and you don’t want to be killing everything all the time. So you can just get by in general with a good soap and a good hand wash after being being in school. And then in terms of hygiene at home, I think if we are sick then, just like you said, trying to keep away from spitting on things and sharing objects and you do what you can within reason. You can’t do anything if you don’t even know they’re sick. But once you know they’re sick, don’t share things. Don’t kiss on the lips. Things like that. The ways that we pass things on —and you did talk about respiratory versus stomach bugs— and it is actually different. It’s a lot of times much more contagious as a respiratory illness, because you’re breathing and coughing and near somebody. And the air is much easier to pass on, and droplets because you’re sharing drinks or sharing food or whatever. With a gastrointestinal disease, a lot of times you have to touch some sort of secretions to get it. So it’s a little bit harder on some of them to pass it on. So yeah, I agree with you that’s probably easier. But it’s really just common sense for when it to comes to hygiene at home, and you just do as much as you can to avoid it. And also when kids are sick, that’s the time to boost your immune system, you know, make sure you’re doing you know, wellness shots, immune shots, they should take supplements. Whatever it is that you do at home to boost your immune system in that short-term. Do whatever you can to get stuff in your body to keep your immune system as strong as possible. Ideally, you’re doing it before and continuously, but when you know kids are sick, that’s a good time to to take those elderberry shots or whatever it is that you’re doing.

Maureen: Yeah, definitely. So as parents, how would we know when we should take our child for immediate care when they’re sick versus when we can just monitor them at home? This is usually one of those questions that I’m always calling into the nurses line for so, do you have any good guidelines for us?

Dr. Gator: Yeah. First is if you’re ever worried, it’s always reasonable to get checked and call in. You know, for us as doctors we’re always happy to chat with you and happy to see your kids if you’re worried about something. So you should never be worried for you know, more than a day or two or even right away. If you’re worried call us. That’s fine. The big ones when it comes to kids is respiratory for the most part. So generally if you feel like your kid’s having significant trouble breathing— in terms of breathing really fast, unable to catch their breath, turning blue in the face. Those are obviously emergencies. That’s what you want to get seen for most emergently. If they’re extremely lethargic, not just tired, because everybody’s tired when they’re sick and they want to rest more, but lethargic. Meaning not waking up at all, not feeding, not responding. That’s certainly very concerning. Serious, serious pain. So yeah again, you might have some some stomach aches and a little bit of pain. But if they’re seriously in pain or can’t be calmed down for hours, or it seems like it’s getting worse if they’re older kids and you know, they’re screaming and crying and it’s way outside of normal, that would be concerning. Dehydrations the other big one. So if you’re vomiting a little bit, if you have a little bit of diarrhea, but you’re still drinking some you’re probably not going to get dehydrated. But if you have a really bad stomach bug where you can’t keep anything down and you’re vomiting, vomiting, vomiting and diarrhea, diarrhea, and not drinking, then that’s where you start to get, you know, majorly dehydrated in general. And that’s where you’d want to get care and potentially get an IV or something like that. So those are the the big categories. It’s obviously very kid-dependent and situation-dependent. So that’s where you always err on the side of getting checked. But those are your big categories.

Maureen: Okay, good. Thank you for clarifying that for us. So when our kids do get sick, what is the best way that we can support our kids naturally? And I feel like we can kind of separate this out a little bit since there’s many different viruses and many different symptoms that they might have. So maybe we could just run through the big ones. Like if they have a respiratory, if they have a stomach bug, or a fever, how can we make them feel comfortable and support them through these viruses?

Dr. Gator: Great question. So before we go into the viruses, let’s step back and maybe talk about some of the foundations first. because that to me is gonna get you farther than anything else. You can give kids supplement or you know, a wellness shot when they’re sick, but it’s already kind of too late at that point. I mean, it probably helps a little bit, but you need to have your body at a place where it’s strong and has everything that it needs from the first second, and the other stuff, that’s just bonus. Number one overall is food, right? That’s the big thing that we have a lot of control over. We know that we eat way too much sugar, and sugar effects your immune system. So generally trying to decrease sugar in the diet is very helpful. Making sure that we’re getting all the nutrients and the vitamins that we need. When you have food that’s preserved and full of chemicals and you know, “food”, but not really real food, then you’re not getting the nutrients that you need. And you’re literally built of what you eat. Our immune system needs all those nutrients to function properly. And if your children are not eating a healthy well-balanced diet, they’re not getting their foods and veggies, or they’re not eating real food on a consistent basis, then there’s no way their body’s gonna function optimally and and that has to give somewhere. And if you get sick, you’re just less likely to be able to fight that infection off as well as you would if you’re you’re optimally fed. So that’s a big category. Same thing with toxins. So that’s another big category, and it goes with food but it’s what are you exposed to you on a daily basis? What is in your food in terms of chemicals and toxins? What are you spraying down in your home? What are they touching? What are they wearing? Everything that comes in contact with your body or goes in your mouth, if there are chemicals and toxins that your body has to deal with, then it doesn’t allow your body to function optimally. And we can detoxify some degree. We’re amazing creatures and we have a liver and kidneys and we can get things out but we can only do so much, and there’s chemicals in the air that we breathe. There’s chemicals in our water. There’s chemicals in our food and at some point it’s too much. I think we’re getting there with so many kids and that’s why we’re seeing chronic disease rates skyrocketing, because we’re just unable to handle all the chemicals that we’re coming into contact with, and so that leaves our immune systems in a weakened state. So whatever you can do to improve things, 1% here, 1% here, 1% here, that goes a long way for most kids, just to have a little bit more of a buffer to be able to handle whatever comes your way. So to me that’s the bigger category. Any sort of immune supplement is getting your kids into a state where they’re generally healthy, so that way whatever comes your way helps. Yeah. So that’s kind of point one. Then back to your question. In terms of supplements, the things that are I would say most commonly recommended by practitioners would be immune support in general. It depends on the age, because kids that are really young are a little bit different than older kids. The older you get, the more that you can reasonably take. Generally under six months, there’s not a lot that you would give a child in terms of supplements. There’s very little. It’s hard because there’s very little research on supplements in general, especially when it comes to kids. Most of them are thought to be fairly safe. But, you know, just never know so you always want to start low and maybe talk to your doctor or your practitioner about anything you’re gonna take. When it comes to upper respiratory, honey is the thing that has the most evidence. You don’t want to give honey to kids before one. But after one, that’s a great tool to have in your arsenal. Good quality Manuka Honey or something like that really does have the most evidence when it comes to coughs, colds, runny noses. So that’s a good thing to have at home. Elderberry syrup has a lot of evidence to be helpful for respiratory infections. Vitamin D is a great thing to give for every age. That’s good for babies even, too, in general because you’re recommended to give vitamin D. So that’s an easy one. You can pretty much give across the board for most people vitamin C. And there’s lots of vitamin C shots out there and you know, there’s all sorts of supplements and that one’s generally thought to be pretty safe and good for immune support. And then multivitamins. So just making sure that you’re getting a little bit of all the nutrients that you could get. But again, if you’re doing things for immune support, then a lot of times you need more of something. So if you take a vitamin, then you probably get a little bit of vitamin D. You might want a little bit more when you’re sick and then there’s immune blends. There’s so many companies that make great products. I don’t need to get into all of them. But there’s immune blends that are for kids that may have Echinacea or glutathione or elderberries. Honey is in a lot of them. Things like that where you boost up the immune system while they’re sick and do it for a couple of days. The little amounts of researcher that we have tends to show that it might help a little bit. So nothing’s magical, but maybe it’ll shorten up your virus by half a day or quarter a day, but that can make a big difference for people. Oh and zinc. That’s other big one.

Maureen: Okay, great. So, that is really helpful to know because especially when you have a kid at home and you’re not sure how to help them. Understanding that you can turn to some supplements to help boost their immune system. It is great to know. My next question is, and this is something that I think I learned over time, it’s one of those things that, when you’re a new parent, you might be a little bit more afraid of. I want to talk about fevers for a second and talk about the number that you’re seeing on the thermometer, and whether or not that is something that should be a causation for us to to go be seen or if it’s more about how the child is acting, or their behavior. So when we have a temperature on the thermometer, and it’s very high, is that cause for concern? Is that an emergency in and of itself or is that just part of the puzzle?

Dr. Gator: Okay, another great question. These are the questions that I’m getting all the time. Yeah, these are my normal questions. So first of all, when it comes to fevers, you to break it up by age, because it depends on age as a child. So it’s very different for a newborn baby than just our kids. So let’s just start with a baby because it’s a different situation. So in the first month, but realistically two months, a baby has a fever, that’s an emergency that needs to get seen right away. The reason being a baby does not have a strong of a immune system as the rest of us, and babies get sick really, really quickly. So if a baby has a fever, it’s an indication that they’re sick with something. And we don’t know if it’s a little cold or they have meningitis and are about to get really sick. So pretty much every baby, in least the first month, gets a full workup in terms of blood work and other things, the hospital will monitor you to make sure it’s not something more serious. Because a baby gets sick so fast that you want to catch it before it gets there. So Usually that first month or two pretty much always get seen. You will almost always get a full work up unless you know, they look perfect. There’s a little cold then they might not do the full workup, but they would at least see you. So you would always get seen the first two months. That’s something to go in for and a fever being above 100.4. The big tip for fevers in that first, you know, month, two month age range is… Everybody has all sorts of different kinds of thermometers at home these days, and the forehead ones are very common and they’re great to have, but they’re not extremely accurate. They can range a lot and that makes a big difference for a baby. So if you have a one month old and you get a fever temperature reading on your forehead thermometer, then make sure you recheck it rectally. Because rectally is gonna be the most accurate. If you’re gonna say there’s a fever in a baby, you want it to be an actual fever. And if it is a real fever, you want to get checked, but you don’t want to get a full workout and like a lumbar puncture or things like that if you really don’t need it, because you’re thermometer was just off. So just make sure it’s a real fever. I would always have a rectal thermometer at home just in case to recheck it before, you know, you make the phone call. As you get older with fevers, generally a fever is not an emergency. A fever is actually a good thing. It’s your response to an infection, right? In general, it just means that you’re sick. But you’re supposed to have a fever. Your body raises the temperature to fight off the infection. That’s a good thing. As you’re getting older with kids, you’re more worried about the symptoms that are coming along with the fever then just the fever. If you’re having fevers for more than three to five days, you definitely want to get seen. If your fevers are on the higher end meaning, you know, 103 to 105 or higher pretty consistently, then you’d want to get seen. But more of what would trigger you to go in on that first day or two should be the symptoms, along with a fever. If your child has a little bit of a runny nose, but they’re still playing, they’re still happy, they’re still drinking, they’re still eating, they’re otherwise well, but they have a 101 temperature… there’s really not much to be worried about that point. Assuming your kid’s otherwise healthy and yes, you can always go get seen if you’re worried, but there’s really not much that anyone’s gonna do at that point, because it’s probably a cold and it’s gonna be bouncing around for two three days. So again, it goes back to you if they have a fever but they have trouble breathing. That’s what you’re worried about. I much more worry about a child with a 101 that’s having trouble breathing than a child with a 104 that’s running around and playing. Right? So it just depends on what the symptoms are. You’re always welcome to get seen, I’ll say it again, but it’s the symptoms with the fever, not the fever. Because the fever in of itself is not bad, especially if it’s a lower grade fever. 101, 102, 103ish and they’re happy. In general you don’t need to do anything. Just let it run its course. You can do a medication if you want to. You can lower that fever if it’s causing them pain or if it’s been going on for a while, if they’re not able to sleep, but otherwise for the most part you could just leave it alone and let the body fight off the infection.

Maureen: Mm-hmm. I feel like that is such important, helpful information for parents, especially when like, I have been guilty of panicking when I see a high fever. But if my child’s still out there playing then it makes me feel a little bit calmer having heard what you just shared with us. And I think that’s very valuable information, especially if you’re a new parent, too. So I’d like to switch over and talk a little bit about antibiotics because a lot, you know, a lot of our kids have had to take them and they are necessary and life-saving in many situations, but they do interfere with your gut microbiome. They don’t pick and choose what bacteria they get rid of when we use them. So is there anything we can do before choosing to use antibiotics? Especially ear infections are a big thing with kids, and a lot of times with ear infections they run a course of antibiotics. How do we know? So is there anything we can do ear infection wise and then also just antibiotics in general. How do we know when an antibiotic is necessary?

Dr. Gator: The big thing with antibiotics is to use them as minimally as possible. But sometimes you need it. Right. Sometimes you have a bad pneumonia and you need antibiotics. Sometimes you have a strep throat and you need antibiotics. Sometimes you have a bad ear infection, you need antibiotics. So as an integrative practitioner, I’m not against Western medicine at all. I think it’s amazing that we have these tools that can save your life and sometimes you do need them. But you just don’t want to jump to using it way before you need it. Just because there has to be a good reason and that’s really where, you know, if you’re discussing with your doctor Or if you’re at urgent care, and somebody just wants to give antibiotics, you should be asking what you’re treating, right? There should be something that you’re treating for antibiotic. You shouldn’t be taking it just because there’s a fever and there’s a little cold and you’re like, yeah, you know, there might be a little bronchitis, let’s just treat it. There should be something that they’re worried about that they feel is bacterial to treat it, because most infections are viral and antibiotics not going to do anything. But if you do have an infection that is bacterial, that needs an antibiotic, that’s fine with ear infections specifically. The standard guidelines are if it’s a minor ear infection, meaning in one ear, not super painful, not super high fevers like 105, then you can generally wait a day or two. At least 48 hours is what’s in the guidelines. You can keep an eye on how they’re doing and you can get a prescription if you want to, but don’t necessarily need to start it, and just see how they’re doing. A lot of times they might have some ear pain or pressure, and even might have an ear infection when you look at it, but it could be viral in nature or it could clear on its own. A lot of times it does, and that’s why the guidelines are to keep an eye on it for 48 hours. So if you rush in because your kids ear just starts hurting and they give you antibiotics, that’s a good time to talk to the person that’s giving it to us and say like hey, what are you seeing in the ear? Does it look really bad? Do you think that we for sure have to do antibiotics right now, or would it be okay to wait a day or two and see how it goes? And a lot of times the doctor would say no, you know what, like I do see it, but if you want to give it a day to see how it’s going maybe do some pain relievers tonight and then if it gets really bad, you can just start it, and if it gets better then you can avoid doing antibiotics. So it depends on the situation. There’s gonna be situations where it is warranted, but specific to ear infections, if you can hang in there for a day or two, most of the time it gets better on its own. And you can avoid that course of antibiotics. That’s what I see. I would say 9 out of 10 times when a kid comes in for mild ear pain, maybe even more, they don’t need antibiotics and you know, once in a while, it’s been three four days. It’s not getting better. They’re miserable, there’s fevers and you know, it’s time to do it at that point. So it’s just about balance and using it when you really need it, but I’m not using it when it’s more mild. Being in contact with your practitioner, because sometimes three hours of them having ear pain, I’m probably not going to prescribe them an antibiotic at that point, but I might in a day. It’s about following up and being like, okay, it’s actually getting worse. Can we recheck it?

Maureen: Yeah. That’s really helpful information that we might not know. As parents, we panic. Your kid’s tugging on their ear—Okay immediately to the doctor, but it’s nice to hear that. Let’s assess and be calm and watchful over it. I don’t think I understood that originally when I had kids. So I’d like to talk about the gut microbiome now, and now that we’ve kind of talked through what to do when our kids do get sick, I really want to focus back in on how to support their immune system and definitely try to get them through this this part of the school year without getting too many illnesses, and be able to jump back on their feet as soon as they can. So can you help explain to us what the gut microbiome is and how it affects our immune system?

Dr. Gator: Yeah, but it goes back to number one. I think most people at this point think that bacteria are bad. We think that bacteria makes us sick and this is a bad thing. We want to avoid all bacteria all the time. But the reality is we are made up of so many little creatures, right? We’re made up of bacteria and viruses and there’s parasites and there’s fungus and there’s all these things that are in our body. And some of them are good and some of them are bad, but most of them are good, right? We have a microbiome, which is basically micro, small, biome like environment. So the environment of billions and hundreds of billions and trillions, who knows what the number is, of little things all through your gut, especially, but all over your body, on your skin, everywhere that make up who you are. And they’re more bacterial cells in your body than there are human cells from the research that we know. That might be crazy to think about, but it is the reality, we’re made up of so many things and everything is kind of living in in harmony and working together to break down your food, and to send us signals, and to do whatever it’s doing in there, right? It’s doing everything to control our body and to be a part of this harmony that is human. And we’ve grown together over generations and generations. So our gut microbiome is that environment that’s inside our gut, starting from our mouth all the way and on to the toilet, is basically what we’re built of. And when you take an antibiotic, it’s something that kills bacteria, which is good if you’re sick, but it also kills the good bacteria, and it can affect that. And that’s where we talk a lot these days about antibiotics stewardship, because we don’t want to take antibiotics just because, because you get good and bad with everything that you do. Just like with any medication that you take or anything that you do. It’s going to affect your body. And if you eat crappy food, that affects your gut microbiome too. And this is where I think we’re seeing a lot of our chronic disease starting to stem and come from. We’re throwing off this delicate balance. And when things are out of balance, then it’s much more easy to get sick, it’s much more easy to not be able to break things down. It’s much more easy to get a chronic disease and that’s what starts that cascade over time to lead us to being more unhealthy. So that’s kind of the general microbiome is thinking about this magical little world in there, and and they’re just billions of billions of little creatures that are living in harmony. But if you get too many of the bad guys or not enough of the good guys, and things are thrown off and chaos ensues. That’s what’s happening in our body just in general, because we’re exposed to so many chemicals always. Yeah, absolutely. So, how can we support a healthy gut microbiome? Number one is diet. Number one always is going to be eating healthy food, making sure that we’re getting that good bacteria, that we’re eating every day, that were getting prebiotics and probiotics through food, and we’re not throwing a lot of chemicals in there consistently that destroy our gut. One of the big ones that we we know of these days is glyphosate that was in food. It’s a chemical that sprayed on food, and it was actually an antibiotic at first so we know that that affects your gut microbiome significantly. So it’s buying organic as much as you can, within reason and within your price range, it does help a little bit, and getting out triggering chemicals as much as you can. You can do a probiotic. Sometimes that can be a little bit helpful depending on the situation. So that’s something you can always talk to your doctor about, and that might help a little bit, but the big thing is really thinking about the environment. Think about thing about a fish, you know, a fish swimming in a bowl. And think about their environment. If there’s a whole bunch of chemicals and dirt and other things that are in the fishbowl, you can give that fish as much food as you want to and you can give that fish as many medications as you want to, but if they don’t have a healthy environment to swim in then they’re not going to survive very long. That’s the same thing for our gut and inside of our body. We have to provide a good environment for all these microbes to live, and if we destroy that environment through all these chemicals, then it’s not a surprise that we’re going to get sick.

Maureen: Yeah, it’s really a fascinating topic once you dive into it. And really it helps you understand, you know, holistically what you should try to focus on for yourself. And not just what you put in your body or what you put your on your body, but what you use in your house. It really affects your overall health and wellness. And it’s interesting what you’re saying about how you know, that does affect your body and how often you are getting sick. It was really eye opening when he said because your body is busy fighting off these other things. They might not be able to fight off this virus that comes your way because of all the other things that you’re in contact with. So it’s really really important.

Dr. Gator: Before you go on, because and I think that goes—kind of taking it full circle a little bit back to the beginning. I think everybody should be thinking about it, but you certainly should be thinking about it if you have a kid that is getting sick very frequently. Because there could be something in your environment or something that you’re doing or something that they’re exposed to that is a major trigger for them, that’s throwing their body off. Everybody has things that they’re sensitive to and things that can make us a little bit less healthy, but everybody’s genetics are different. Everyone’s situations different. Everyone’s at a different place. And for some kids, if you can figure out some of those triggers you can figure out oh, you know, they’re really sensitive to gluten and I’m giving them a lot of pizza and that’s really throwing them off. You get that out of their diet, and that lets their body get back into harmony, and their gut microbiome back into better place. Then they start to get back into balance, and then they do handle those viruses a little bit better. Or maybe there’s there’s some chemical in your home. Maybe there’s lead in the paint and they’re eating paint chips or they’re breathing in. I don’t know. There’s so many things it could be. And that’s what can get overwhelming at times, but you have to be a little bit of a Sherlock Holmes as a parent, especially as a parent whose kid is getting sick every other week for a whole year. You’re like, okay. Well then what is it that I could do to try to improve their environment? And you may never figure it out exactly, but you don’t always have to. You don’t always have to figure out every single trigger and every single problem and every single thing causing information because, again, your body’s magical. But if you can decrease a few things for them, you can improve their eating a little bit and you can improve what they’re exposed to you with toxins, and you can get rid of some of the chemical cleaners, and you can clean up their diet a little bit, you can give them a little bit more food and they get a little bit more veggies, and they do some smoothies, and you get them out for a little more exercise and they start playing a sport then you know, all these things. It’s like, okay, one percent here one percent here, and then all of a sudden, magically, they’re doing better. You never figured it out. Maybe it was tomatoes. That was the problem just deleting tomatoes, but they everything else is better, then they’re better. And that’s what you care about at the end of the day, right?

Maureen: Yeah. No, I love that. You’re looking at the whole. Everything that you’re doing and coming in contact with and it all matters. And it’s really important as a parent to understand that because sometimes you just think, oh, just don’t come into contact with those germs. But no, it’s how your body is functioning even before those germs are there. So, you know that we have this topic of picky eating. It’s something that many of us, including myself, have to deal with our kids and we, intentionally, we want to get them the most nutritious food. Do you have any pointers for us? Especially when we talk about how important it is for the gut microbiome and and not getting a sick as often, to get our kids healthy foods if they are the “I only want to eat pasta and waffles” and I don’t know, chips or something food, which I can say that is my child. So what do I do?

Dr. Gator: A great great great question. Number one: exposure. You got to keep exposing them to the foods that you want them to eat. Even if they won’t eat it. Just keep exposing it to them. You don’t have to force them to eat it. You don’t have to make that the only food that’s gonna be there at the table, but just keep exposing them to the better foods, because all the research shows that sometimes it’s gonna take a hundred tries before they’ll eat it. Sometimes it’ll take 50 tries. So the more exposure you get, the more likely they are to eat it. And you might not eat a carrot today, but you might in a year from now. So just keep offering different things, try different techniques. Use the rainbow. Try to get them to eat different colors. If they’re old enough—most kids can do it if they’re like, a toddler—but take them shopping with you or to the farmer’s market. I think if they come with you and they pick things out, they’re way more likely to eat it. So you can go to the shopping market and use the rainbow and say, okay, I want you to pick one thing that’s red, and one thing that’s blue, one thing that’s green, and hopefully they’ll pick some things they’ll be more likely to eat. Farmer’s markets are great for that. Especially if they have taste testing because, you know, you might not like a plum but there’s 30 different kinds of plums. So maybe there is one that you would like. And if you can get them to try different ones and different colors, maybe you can find one that they like. And then you just keep adding one food at a time. One more thing that they actually will eat. Again, they might like the pasta or the bread and all those things, and they get addicted to it, but it doesn’t mean they won’t eat other things too, potentially, if you can find the things that they will like, or the way that it’s prepared that they like. And if you can just keep adding one thing here, one thing here, one thing here. It does start to get you to a better place. Smoothies is a great way to get things into their diet that they wouldn’t otherwise eat, because a lot of times you can figure out one kind of fruit or one kind of veggie or something that they do like. Let’s say it’s apples, and then you can make it heavy on that. So that’s what most of the flavor is, and then you can get a few of the other things in there, even just a little bit. And that’s a good way to get in a little bit of nutrients. A multivitamin is good as an addition, but it’s not as good as getting in food. I think that that can help. Those are the big ones. I think it’s just, keep trying, don’t get too discouraged. Lots of kids are picky. But we do have some part in this and you have to keep in mind that if you don’t have crappy food in your house, they won’t eat the crappy food. A lot of the crappy food is more addictive and sometimes you got to get rid of that, because most kids won’t starve themselves. That’s very rare that they’ll starve themselves. But if they do have the option to get chips and they’re, you know, the teenager or tween or something like that, then that’s what they are gonna be much more likely to go for it. But if there aren’t any in your house and the only thing there is a fruit, then they might be like, ugh, but they’ll eat whatever they’ll eat because they’re hungry and at least it’s there. So you have to be mindful too of being a role model. Having good food available and not having the bad food available. And that does tend to help you maneuver kids through to a better place for the most part. There’s certain situations where it’s not always going to work. But mostly from what I’ve seen, if you work at it hard enough and you prioritize it, then you can get there. And also sometimes it’s us too. So we’re not the best cooks, you know, some parents are not the best cooks and the kid might eat broccoli prepared a certain way, but they won’t eat it the way that you’re preparing it. So, yeah, I also tell parents, sometimes, take a cooking class. Go learn. There’s so many great books out there and online courses and you know, even in-person courses that you can go to and maybe you just learn some new skills. We’re not all taught how to cook. Or maybe we know what we know but but there are a thousand ways to prepare most things. Maybe it’s the way that you’re preparing it, and if you prepare it a little differently then maybe they would be more likely to eat it. Yeah, so I think we just we have to take a step back and say, okay, what do we have control over and what can I change from what I’m doing? And try all those different things. And see if you can get them to a little better place. They still might be picky, but picky and only eating hot dogs and chicken nuggets is very different than eating those plus, you know, 10 veggies or something. It’s still better, whatever you can get in.

Maureen: Mm-hmm. Yeah, so patience and persistence for us parents out there. For sure. I had an a-ha moment with something that you just said. Not having the junk food available is a big thing that I will be working on in my house. I know my husband comes from a very snack-centered home. So he brought 10 different types of snacks into our house. And it’s great, but it’s also not good when your kids go for the cookie instead of the apple slices you put out, because they’re there. That’s a really basic but important thing I personally was overlooking. So yeah, lots we can do as parents to to help our kids here. We’re going to be wrapping up right now, but I really appreciate you taking this time to talk with us. We talked about the logistics of when our kids get sick, but also how we can help them holistically and really support their immune systems overall so that they can be healthier people when they do come into contact with these viruses that they most certainly will, because now we are back in school. So thank you so much Dr. Gator. I really appreciate you taking the time to be with us today.

Dr. Gator: Thanks for having me. Stay healthy everyone, right? Thank you.