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Her personal experience with postpartum depression led Dr. Erica Krumbeck to focus on postpartum depression (PPD) and maternal mental health. Listen on and find out true health gems about PPD, how to deal with it, her recommended supplementation, how she works (or not work) with vaccines, what to do with flu, ear infections, nutrition, sleep, and other big pieces of advice one can only get from a naturopathic pediatrician.
[00:00:03] Ashley James: Welcome to the Learn True Health podcast. I’m your host, Ashley James. This is Episode 351.
I am so excited about today’s guest. In fact, I announced in our Facebook group, the Learn True Heath Facebook group, that we’re having a naturopathic pediatrician on the show, and it exploded with comments. Within minutes, we got over 30 people commenting. It was just a huge explosion of questions.
[00:00:46] Dr. Erica Krumbeck: Thanks for having me. I’m happy to be here.
[00:00:47] Ashley James: We’ve had some fun scheduling issues trying to get you on the show. I’ve been excited to have you on. Finally, the timing is right. I believe in divine intervention. I believe the universe brings forth the right interviews at the right time, so I know everyone listening, this is the information they are here to receive right now.
I’d love to start by learning a bit about you. Before we get into all the questions that the listeners have, I’d love to understand what had you want to, first of all, become a naturopath as opposed to becoming an M.D.? And then what had you wanted to specialize in pediatrics?
[00:01:24] Dr. Erica Krumbeck: That’s a great one. I’ll try to make it short. I’m sure everyone’s story is a very long story, but I started in undergrad as being a double art and biology major, and strangely enough, I wanted to do medical illustration. That was my goal in undergrad. Part way through undergrad, I realized that most medical illustrators spend their life in a cadaver lab, and that was not super exciting.
So I thought about nursing and medical school. I studied all through undergrad with all my buddies in OCAM and everything. We’re going to med school, and they were all taking their tests and everything. I took a little break. I thought that I was going to eventually apply in med school, and I ended up doing an AmeriCorps program in the health care field in National Tennessee, and I hated it with a passion. It was painful to see the conventional medical approach. I was not happy with any aspect of it. And if we talked about divine intervention, that was probably completely divine intervention, too.
I spent two years in Nashville doing crazy, silly things like playing music and doing this AmeriCorps program and a bunch of other stuff with my soon-to-be, now husband. While I was there, my dad had a stroke back in Seattle, Washington, or Kirkland, Washington, right by Bastier. My childhood home is right behind Bastier University, where I ended up going to naturopathic school.
The long and the short of it with him is he did the whole conventional medical route for stroke treatment. At some point, he plateaued in therapy, basically physical therapy, and didn’t progress any further. At that point, you get kicked off insurance for future therapies, and my family ended up spending quite a lot of money out of pocket doing all these alternative therapies. He was doing acupuncture, [inaudible 00:03:36] therapy, anything in the alternative world, although interestingly not naturopathic medicine.
My dad wanted me to move home, so he wanted me to enroll in Bastier because his acupuncturist was a teacher there. It’s just funny the way the world works. I went and took a tour of the university before I knew anything about naturopathic medicine. I fell in love with the school. The thought process behind naturopathic medicine, before I knew what I was getting into and applied and got in, which I highly recommend not doing the approach that I did for future students because I didn’t know what I was getting into until I was multiple years through school.
I’d tell people in the future, be sure. It’s a huge investment of time and money. It’s a life-long career choice. But for me, it just happened to work out. For me, every day I was in school, I fell more and more in love with this medicine that I stumbled into, which was providential.
And then out of the same process, my husband ended up going to physical therapy school. From my dad having a stroke, it ended up with both of us being in medicine. It’s an interesting thing.
I thought I was going to work way more in mental health when I was in school than pediatrics. I had no focus on pediatrics. I just fell into it. I’m not sure how I fell into it. Somehow I fell into it and started doing a couple of well-child checks and remembering that “I love this. This is great.” You get to play when you’re with kids, and it’s super fun.
I ended up falling into peds, and then when I had my daughter, who’s now seven, I had a severe experience with postpartum depression. She had severe colic, too. That changed the whole course of my career to focus on postpartum depression and maternal mental health, which is so important. I feel like the circle came all the way around for me that I could treat mom’s postpartum and work in mental health even though it wasn’t the field that I thought was going to be in.
[00:06:07] Ashley James: Interesting. Is there a link between postpartum depression and colic?
[00:06:12] Dr. Erica Krumbeck: I don’t know that that that’s been studied, but it makes sense. I mean, for her there’s obviously sleep deprivation as a pretty strong trigger for PPD. In her case, she was waking 10-12 times a night, screaming uncontrollably, could not be calmed in any circumstance. It’s stressful to have a child who’s suffering uncontrollably and to feel powerless in your ability to help your child. I don’t even know the best word—it’s a disempowering feeling and a terrifying feeling. I feel like I can relate to parents now going through something very scary because you can’t help the person that you are meant to help in your life. It sort of makes sense when you have your cortisol levels off the charts for nine months to a year. I don’t know how you could not end up having severe anxiety or depression.
[00:07:16] Ashley James: Absolutely. My son had some colic. He only woke us up six times a night, not 12 times.
[00:07:23] Dr. Erica Krumbeck: But at that point, what’s the difference between 12 and 6?
[00:07:26] Ashley James: Right. I definitely saw that sleep deprivation impacted me. I felt so grateful to have built a team of holistic practitioners around me during the pregnancy, so we had cranio. We had lots of homeopathy and pediatric acupuncture. I even had practitioners who became friends. They came to the house. All of it helped a little—diet and making these little fennel teas, rubbing his belly with essential oils—everything.
Homeopathy for me was the one that had the fastest and the best results, which I was constantly stunned by. But it wasn’t curative, so he still woke us up six times a night. But what a difference between my experience and a typical going to an M.D. experience, where the parents go to an M.D., and the child is possibly put on over-the-counter medication for gas and not guided to shift diet or other modalities that might help with the colic.
Even to this day, there’s not a very strong support structure for women who are suffering from post-partum depression. What do you do now when you work with families, and you see that there might be postpartum depression? What kind of advice do you have for those women?
[00:08:59] Dr. Erica Krumbeck: I’m very vigilant about screening very quickly. I’m checking in with parents very often in that first couple of months of life and even beyond. I started using the Edinburgh Postnatal Depression Screening Questionnaire early on before that become standard of care. Now, I find most OBs, at least in Montana where I’m at, are using that regularly and having moms fill it out regularly. When I first started, no one had even thought about that.
I quickly got involved in the postpartum depression group here of providers and therapists, some of whom had their postpartum depression issues, and so they’re active in creating this group. It just exploded in terms of awareness, so now they’ve done everything.
One of my colleagues became a licensed clinical social worker and had her job at an OB’s office. She created this entire position for herself, and it’s only counseling for moms who have lost babies, who have postpartum depression, who’ve been working with infertility. It’s incredible. It’s been great.
For me, in my office, I’m often screening, but if there are any signs, I strongly recommend the women to schedule with me immediately. I always find room for them in my schedule. I tell them that. I just told a mom this morning that it’s newborns and them that take priority, and I tell women all the time that when mama goes down, the ship goes down. I’m more worried about the health and impact of the parent’s than I am the kid’s most of the time. I also strongly believe now that the purpose of the well child check is not so much to make sure that the child is healthy--I think that’s number two. It’s important, of course. That’s why we’re here. We’re going to weigh the baby, make sure they’re okay. But number one is to encourage the bond between the parents and the child, and that cannot happen without parents having good mental health. I screened quickly, and one of the first things that I’ll do with a woman who has postpartum depression is to get some basic blood work done.
Postpartum thyroiditis occurs in 5% of women. Postpartum depression occurs in about 20% of women, and there’s a really strong overlap there. I don’t think I’ve known any woman with postpartum thyroiditis that hasn’t had postpartum depression. It’s really important to find that and correct that early because it can make a world of difference.
And then we have so many tools as naturopathic doctors, anything from homeopathy to herbs, to nutrients. Basic nutrients, like a good quality prenatal and high-dose fish oil in about half of my patients—just those two alone will be enough to pull them out of postpartum depression or anxiety state. I could talk about that for a whole hour, too.
[00:12:10] Ashley James: I already told Dr. Erica that I would be having her on the show for multiple sessions because we’ve decided that we have so much that we could talk about.
[00:12:20] Dr. Erica Krumbeck: Yeah, I can’t stop. [laughs]
[00:12:22] Ashley James: Please don’t.
[00:12:23] Dr. Erica Krumbeck: I stop in place, but it’s hard to.
[00:12:26] Ashley James: If someone is listening to this currently with postpartum depression, what actionable steps should she take today to help her get on the path? Should she schedule some sessions? She has a newborn, so it’s hard to leave the house and go for counseling. What are some critical things that she should do today to help herself get on the path to feeling better?
[00:12:54] Dr. Erica Krumbeck: I’m going to take a step back and explain something super important first, and that’s the difference between baby blues and postpartum depression. Just as a warning, I might lose my train of thought and forget the question you asked. I want to go through this first because some women think that they have postpartum depression, and they don’t.
Eighty percent of women have what they call baby blues. I don’t like that name because it connotates something negative. What most women describe is the sensation of having every emotion simultaneously. They’re so happy they have their baby, “So why am I crying?” They’re crying, happy, joyful, exhausted, and it’s everything mixed. It feels completely overwhelming. They are just wondering, “What the world is going on?”
That classically happens shortly after birth. Usually, it peaks right around the same day that milk comes in, which is a good way to figure this out. That’s because of the hormone levels that have dramatically shifted. In pregnancy, we have high progesterone levels. We have estrogen levels.
Postpartum, those plummet quickly because the placenta holds that progesterone, and so the placenta comes out. We have less progesterone circulating. And then prolactin inhibits the production of all these hormones as well. Prolactin will peak right when milk comes in, and it’s just overwhelming. Plus we have fluid and blood pressure changes, and you’re usually sleep-deprived—it’s overwhelming.
Baby blues happen to 80% of women. It usually peaks on the day that milk comes in, and it’s typically gone by two weeks. If the symptoms are either not gone by two weeks or starting after two weeks or just continuing to go down, then we’re talking about more like a slide into postpartum depression, postpartum anxiety, postpartum OCD, or something like that. Does that make sense?
[00:14:54] Ashley James: Absolutely. Someone who has postpartum depression might not have a newborn still. It might be a baby that’s three months old.
[00:15:02] Dr. Erica Krumbeck: Exactly. The lowest the progesterone levels get is somewhere around three to four months postpartum. Usually, postpartum depression is at it’s worst at four months, and then slowly, slowly, slowly they start to come out of it.
Sometimes moms feel like they’re in the clear because maybe the baby is sleeping a little better, and then they can’t figure out what’s going on, and their progesterone levels are super low. It’s important to understand that progesterone act on our GABA receptors in our brain. It acts on the same receptors as Valium, so the postpartum state is like a Valium withdrawal state. Sometimes it helps women to understand that.
This isn’t the case for all women, but for a lot who tend to be anxious, they might feel better in pregnancy and then all of a sudden, the anxiety comes back, and it’s very severe postpartum, and that’s just from that progesterone state. So there are some women postpartum, the thyroid is looking good, but postpartum is pretty severe, we will do a trial of oral micronized progesterone to see if it works. It doesn’t work in all women, but the women it does work for, it’s very fast, and it’s very dramatic.
You might have seen that postpartum depression medication was recently approved by the FDA, like within the last couple of weeks. It’s 32,000 dollars, I believe, and it’s like a 72-hour infusion or something insane like that. It’s a pregnenolone or a progesterone analog. It binds on the same receptors.
It’s really silly because you have a 32,000 dollar medication, or you could give progesterone and pregnenolone, which are bio-identical and have the same effect.
[00:17:03] Ashley James: People can go to the health food store and buy topical progesterone cream. Is that the same?
[00:17:09] Dr. Erica Krumbeck: No, I would not recommend that. One, for some reason, oral micronized progesterone seems to have a better happy brain effect. I haven’t been able to figure out why exactly, but that was a trick taught to me when I was in school, and so I’ve been sticking with that. I would never recommend over-the-counter progesterone for a nursing mom. So you’d be careful about progesterone levels, and so I would want to get it either compounded by a pharmacy.
Even if for some reason you did do cream, I don’t think I’ve ever done cream for postpartum depression. I’ve always prescribed oral, and it’s covered by insurance usually, so if you can at least code creatively for it. It hasn’t been FDA-approved for postpartum depression, but if the progesterone levels are documented to be really low, you can code for that.
Most women do not have any inhibition of lactation with oral micronized progesterone. But I always recommend that it’s given under the supervision of a physician just in case that did happen. I’ve warned every woman I’ve ever put it on that it can, and I’ve never seen it happen. We know for sure that estrogen will inhibit lactation, which is why women are put on the mini pill postpartum, and not a combined oral birth control pill.
The mini pill is a progestin, and this is something that is not well known in conventional medicine. I had an argument with a woman who was teaching the postpartum course that I attended last year at St. Pat’s hospital here. She was talking about supplementing women with the mini pill. She couldn’t quite figure out why that wouldn’t help women with postpartum depression. A synthetic progestin that is in either birth control or the mini pill, so either a combined birth control pill or the mini pill inhibits our bodies’ progesterone but does not act on our happy brain receptors.
So it is actually worse, and that’s why Dr. Julian Brayton has this whole book called Beyond the Pills. Breast control pill has been around for decades now. Many women have complained about the side effects of depression. It was only up to a couple of years ago that they finally studied it and found that yes, sure enough, women who are on long-term oral contraceptives have higher rates of depression, and that could be two-fold.
One, they’re not making progesterone, so they don’t have the happy brain effect, and two, now we know of course that birth control pills deplete vitamin B6, which is a super important co-factor in making all our happy brain chemicals. It’s a double whammy. For that reason, I would ask women who are postpartum taking the mini pill that they be cautious about that. If they feel their mood is sleepy, they might want to stop the pill and do oral progesterone, but it is not good for birth control. It is not as reliable as a birth control method. You got to be a little careful.
[00:20:23] Ashley James: That’s interesting. I’ve had a few different interviews about birth control and all the nutrients it depletes from the body is pretty crazy. When you see the cons versus the pros, the cons are just way outnumbered that it affects our mental and emotional health, and of course, our physical health in the long term. Really scary.
Getting back to my question, if someone is listening to this, and they’ve heard you talk about baby blues versus postpartum, and they suspect they have some postpartum, or maybe they even have a diagnosis, what steps should they take right now? Should they go to their doctor and talk about getting on progesterone?
[00:21:09] Dr. Erica Krumbeck: Number one, if you’ve got a naturopathic doctor near you, go to them first. Don’t go to your OB because half of the OBs are a loss. Five or six years ago, I didn't feel like our professionals were doing a great job with this at all. I don’t think that we were talking about it nearly enough. I don’t think we had enough options. Now, I feel like most of us who’ve done anything in women’s health feel pretty darn confident treating postpartum depression. If I have a colleague who doesn’t feel that way, you’re welcome to email me directly. But I feel like most of us feel pretty confident.
So go there first. If you don’t have a naturopathic doctor near you, you can go to your OB. I would request to have your thyroid checked, to get a complete blood count done and check on your iron levels. A lot of women do hemorrhage postpartum. Iron is yet another co-factor in making happy brain chemicals, and so if you feel exhausted, it could be anemia as well. And then I would request anti-TPO antibodies. Those are thyroid antibodies that are elevated in Hashimoto’s thyroiditis, and the postpartum onset of Hashimoto’s is super common, so I would definitely do that.
If you end up having elevated anti-TPO antibodies, your OB is not going to know what to do with you other than give you thyroid medications, so you need to go back to a naturopathic doctor anyway or read a lot. But I think that’s a smart place to start. I don’t know that many OBs truthfully that prescribed progesterone. The midwives in town here at least definitely do, so you might also want to contact the midwife who is much more familiar with this, and then be careful about self-prescribing supplements. It’s easy to get a good quality prenatal multi and high-dose fish oil on board, but a lot of the herbs and certain nutrients that we commonly use for depression are not necessarily safe in lactation. There are a lot of things that are not safe in pregnancy, and in lactation, we have a lot more options for treatment. But even things like St. John’s where I only use basically at the last case and usually not till babies are much bigger, so there is definitely some research that St. John’s can either cause colic in babies, or they can become sleepy, and so that’s not a great choice for a lot of women. 5HTP is a common depression supplement, and that has not been studied for safety even though I know a lot of midwives prescribe it. I’m not comfortable with that if that hasn’t been prescribed. There is just a lot that maybe is not super safe. I will often prescribe a basic B complex for a lot of women though, and one of the good professional brands. You don’t want an over-the-counter one for those, but that can help if you get a little extra – methyl B12 and metafolate. That can perk women up right away.
I would also wait until the baby is a little bit bigger, and so in those first couple of weeks, that’s not going to be appropriate. The baby is going to get stimulated and agitated by that. It’s usually at least a month but often when the baby is two or three months old.
[00:24:32] Ashley James: You mentioned fish oil. I’m such a believer in omegas. What is a good dose for an adult—6 grams a day, 9 grams a day? What are your thoughts on that?
[00:24:56] Dr. Erica Krumbeck: There has been a couple of studies. One, women who have better omega-3 levels in pregnancy have lower rates of postpartum depression. That’s awesome.
Two, women who supplement with fish oil in pregnancy, their babies have a 50% decreased risk of asthma. That’s cool, isn’t it?
[00:25:16] Ashley James: Very cool.
[00:25:18] Dr. Erica Krumbeck: That was on a really high dose of fish oil, and some of those babies ended up being much chunkier than their non-supplemented counterparts. We might not want to supplement that high. I usually recommend a gram in pregnancy. Again, you do need to talk to an OB though because this is a podcast—don’t take medical advice over the internet. That should be the motto for everybody and especially for us.
And then postpartum, yes, I dose high, high. It won’t work if you don’t dose high—at least 6 grams, and yeah, 9 is a good aim. It must be a high-quality brand because what you don’t want to do is get that cheap over-the-counter fish oil, have it contaminated with mercury, and then have mercury toxicity for you and your baby. Please don’t do that. So get a good professional brand on that, and yeah, I dose really high. Moms are losing so many fatty acids because they’re all going to the milk. So you need way more than someone who is not nursing.
[00:26:30] Ashley James: Absolutely. You brought up something—you said certain herbs are not safe in pregnancy or during lactation. Ironically, one of our listeners, just this morning, she wants to be a surrogate, and she really likes the family. She’s passionate about it, and now she has hit a wall with the surrogate family because they’re insisting that she do the flu shot during the pregnancy and the whooping cough vaccine, and she’s never had those vaccines. She isn’t someone that participates in the vaccine in her body, and she’s concerned about this, so a very lively discussion was formed in the Learn True Health Facebook group in support of her, but she wanted everyone’s opinion on it. In doing so, I googled some interesting studies that show there hasn’t been anything definite because you can’t ethically test. You can’t do a study on women that are pregnant. There is no ability to test whether flu shots are safe.
[00:27:48] Dr. Erica Krumbeck: Actually, there are quite a few studies though, and they have been studying vaccinated versus unvaccinated women in pregnancy for both Tdap and influenza. Are you sure you want to start with this one?
[00:28:01] Ashley James: Yeah, I would love to hear. You’re a holistic doctor. I would love to know what are your thoughts if a woman comes to you, and she’s healthy—eats healthy, not deficient in any nutrients at all. Is it healthy to get a flu shot and other vaccines during pregnancy, or is it healthier to not?
[00:28:29] Dr. Erica Krumbeck: Listeners, please don’t send me hate mail. My general approach to vaccinations is to support families wherever they’re at. This is important.
In my practice, I basically lay out the evidence for and against vaccines and allows families to choose. I’m a very strong advocate of that. I might have my own opinions, but I want to keep my opinions out as much as possible and just present what we know.
Now, that’s why I asked if you’re sure that you wanted to start there because the pregnancy topics, they’re almost harder to go over, but at least, we do have some data.
So let’s start with the flu vaccine first because they have been studying vaccinated versus unvaccinated women. They do not do double-blind placebo-controlled trials because that’s considered unethical. But they have been studying the vaccinated versus unvaccinated populations.
The other hard thing is, depending on where we’re at in the research cycle, this is my knowledge to date. If you’ve given me any warning, I will look up probably 87 studies because that’s what I do. I can’t tell you that I’ve read every study up to May 2nd of 2019.
For the influenza vaccine, the last data that I saw showed that women who get the flu vaccine in the first trimester of pregnancy have slightly increased rates of miscarriage. That’s not the case for the second trimester and beyond. There is data that women who do get the flu have significantly increased poor outcomes.
[00:30:34] Ashley James: If they’ve had the flu shots?
[00:30:36] Dr. Erica Krumbeck: No. if you get the flu in pregnancy, the rates of the baby having autism, birth defects, or having early labor—if you get the virus while you’re pregnant, it’s bad.
There is that piece of research that shows that the flu vaccine in the early pregnancy increases the risk of miscarriage, but that doesn’t seem to be the case for the second and third trimester. I don’t know what to say about that.
The really hard part about the flu vaccine is that we never know if it’s going to match from year to year, and so it makes it hard for me to counsel my patients on it because on years that it matches well, that’s awesome. It feels like we can be like, “Hey, look. It matches,” and at least we can have some evidence of efficacy. On years that it doesn’t match, then it’s like, “What’s the point?” There’s always the risk of side effects on all vaccines.
I do want to be clear on that—to be clear and to be unclear at the same time that it’s hard to capture data on a vaccine that changes every year. We never know whether it’s going to match usually well into the flu season, at least until January of that year. Does that make sense?
[00:32:04] Ashley James: Uh-huh.
[00:32:05] Dr. Erica Krumbeck: So at least that’s like an answer/non-answer for that.
For Tdap, this is a little different. Tdap is the pertussis vaccine. It’s tetanus, diphtheria, and acellular pertussis. It does not come as a non-combo shot. Whooping cough is pertussis. Whooping in very tiny babies is extremely dangerous. I have people argue with me on that one, but it really is. It’s very dangerous.
The idea of vaccinating women in pregnancy is—and it must be vaccinated in pregnancy. It doesn’t count if you get it before becoming pregnant. The reason is if you get that Tdap in pregnancy, the woman’s body creates maternal antibodies which cross the placenta and reach the baby so that when the baby is born, they already have antibodies for the first 2 to 6 months of life. Basically, the baby has antibodies against whooping cough before they’re even eligible for their first round of vaccines at two months of age.
This could be another hour-long conversation. They have studied vaccinated versus unvaccinated mothers. They found no difference in neonatal outcomes from vaccinated versus unvaccinated babies. They have found an increase in antibodies in newborns whose moms were vaccinated, which is the point, so that part does work. I don’t know that we have enough long-term data to show differences in whooping cough rates in babies whose moms have had that versus not because there is usually not large enough outbreaks to compare the two populations. They’re trying to keep away.
There is a little bit of question about whether babies whose moms are vaccinated if they’re developing the same immunity from their primary vaccination series as babies whose moms were not vaccinated. That’s a future conversation. But right now, at least the data does support that there is no difference in outcomes. And they have studies tens of thousands of women in multiple countries at this point. They’re not small studies right now.
[00:34:32] Ashley James: What about the concern that the thimerosal crosses the—
[00:34:37] Dr. Erica Krumbeck: Can we talk about the thimerosal?
[00:34:38] Ashley James: Yes. It’s mercury. It’s an adjuvant.
[00:34:45] Dr. Erica Krumbeck: No. Let’s be very clear. I’m excited to talk about this because I want to clear this up, and I get frustrated even by our colleagues who see this wrong all the time. Thimerosal is not an adjuvant. Thimerosal is a mercury-containing preservative that was found in a number of vaccines, primarily the hepatitis B vaccine, up until right around the late 1990s that they switched.
At this point in time, please listen to me: There is no more thimerosal in vaccines. The only vaccines that contain thimerosal in any amount are the seasonal flu vaccines in multi-use vials only and tetanus only vaccine, which I can’t even find anymore, so it’s a moot point. It’s only seasonal influenza vaccines and multi-use vials that we could possibly be exposed to thimerosal.
[00:35:48] Ashley James: So heavy metals are in vaccines then?
[00:35:51] Dr. Erica Krumbeck: Yes. Let’s talk about that. That is aluminum, and aluminum is considered an adjuvant. It is not a preservative. I often hear people say, “They just replaced mercury with aluminum,” and that’s completely not true. It does totally different things.
Again, thimerosal was a preservative. Now, aluminum is an adjuvant, and adjuvate means something that makes the immune system reacts. Let’s say for Tdap, the whole point of the Tdap vaccine is so the body can make antibodies to tetanus, diphtheria, and pertussis. The little ‘a’ stands for ‘acecullar’ in the Tdap vaccine.
If you injected Tdap without aluminum, the immune system would basically wave at it and say “hi” and just let it go because it’s not exciting to the immune system at all. Those vaccines are not live virus vaccines or bacteria because those are bacterial products.
Let’s say MMR and chicken pox vaccines are viruses. They are a live virus, which is why you usually only need one dose to become fully immune from both of those vaccines. There is no need for an adjuvant. The immune system sees the actual virus itself develops antibodies to it and then most, 90-95% of people, are functionally immune.
When we’re talking about bacterial products, let’s say [HEB 00:37:22] pneumococcal, which is a pneumococcal bacteria, tetanus, diphtheria, pertussis—these are all bacteria. There’s no way to inject a live bacteria into us. That would be bad. It would cause sepsis. They take a component of the bacteria and then add aluminum as an adjuvant. When it’s injected, it creates inflammation, specifically designed to create inflammation, so that the body recognizes a vaccine component and creates antibodies to it.
It is hard to have this conversation in a short period of time. That’s why I go over all these details in my Vaccines Demystified course, which I try to set up and be as neutral as humanly possible. But it’s really important to me that everybody understands the difference between thimerosal and aluminum and which vaccines contain thimerosal and aluminum and why.
You can completely avoid mercury. You don’t have to worry about that. Aluminum is a totally different story. It’s in a ton of vaccines. That is something to talk about in addition, but I do want everybody to be clear on that.
[00:38:43] Ashley James: You’d mention your course, and I want to let listeners know the links to all of your websites are going to be in the show notes of today’s podcast at learntruehealth.com. They can go to NaturopathicPediatrics.com, click on ‘Shop’ and they’ll see right there that you have an online course, a webinar that they can take where you go through and explain in a neutral way the pros and cons of vaccines and inform consent fully, inform parents and parents-to-be, so that they can make fully informed choices.
This is a very polarizing topic. We’re not shaming people. I have my very passionate and firm beliefs about vaccines, but I do not impose them on others, and I’m getting the feeling that you are the same. I believe in freedom, and I believe in information, and I do not support an idea that we should ever be forced into any medical procedure. We should use and share information to make knowledgeable decisions.
Your online course, you are offering 20% off to the listeners. They can use coupon code LTH, and all that information is going to be in the show notes of the podcast. I am very interested in having listeners who are passionate about learning more about vaccines to take your course because we want as much information as possible from that neutral standpoint so we can see the pros and cons clearly.
It is when we polarize this, argue for argument’s sake and take a stand because we have a belief, that is where we lose the ability to see the science for what it is. We need to come to the science from a place of non-judgment. I’m glad that you are clearing up these misconceptions.
We’re not saying that anything from a pharmaceutical company is perfect. There’s not one pharmaceutical in the world that doesn’t have a list of side effects.
[00:40:57] Dr. Erica Krumbeck: Absolutely. Let’s talk about all of them. It’s really important. I hear people say that vaccines are not regulated as pharmaceuticals. That’s true—they’re not. They’re regulated as biologics, so they’re regulated under a different type of category. But they are regulated.
What do I want people to understand? So many things. One, I am happy to support families in my office regardless of what they decide. Whether you pick all vaccines, no vaccines, some vaccines, I will support you. This is not about me; this is about you. That’s why I lay out what we know.
The other thing is that all I lay out is the evidence that has been studied. There are things that haven’t been studied. There are questions. There are thoughts. There are concerns in some places. I actually lay those out, too.
This is not about me at all, which hopefully spares me a little bit of hate mail because being neutral or somewhere in the middle means that I’ve gotten hate mail saying that I’m killing babies from both sides. Let’s stop that.
If you have very strong feelings about vaccines, it probably doesn’t help anybody to go to the other side and tell them that they’re killing babies. I want to be very clear about this. The reason we’re also passionate about this subject is that we all care about children very much. That’s why it becomes such a polarizing topic because some people have had experiences, which might not line up with what literature says, which doesn’t make sense, which is so confusing to people.
So we’re comparing, sometimes oranges to apples to bananas. It can be so confusing. I urge everybody to take a step back, take a breath. Let’s examine what we know. We can add life experience in with that. We can talk about it in a way that doesn’t shame or guilt, and talk about how to support our bodies and our kids, and come back together and not make this so heated because it’s not helping anybody.
[00:43:29] Ashley James: I knew we were going to get into the topic of vaccines, having a naturopathic pediatrician on the show. You mentioned some of the concerns that maybe haven’t been studied, but there are concerns nonetheless. I have had some doctors in the show talk about the concern that at least the current vaccine schedule where they feel that it is too aggressive. It’s causing a rise in autoimmune disease by overstimulating the immune response. Have you seen this, or seen any evidence to support that the current vaccine schedule is increasing autoimmune disease?
[00:44:12] Dr. Erica Krumbeck: There is no hard evidence of that right now. They have studied that in multiple places. There are a couple know autoimmune conditions like idiopathic thrombocytopenic purpura in MMR vaccine, and that is a direct link. There are a few other things, particularly with the MMR vaccine. It’s such an old vaccine that we have decades of research now, but most of the autoimmune diseases that a lot of people talk about with MMR, either like Crohn’s or ulcerative colitis—Autism isn’t an autoimmune disease, but that’s a whole another discussion topic.
A lot of the ones that parents have reported, they’ve specifically studied and have not shown to be associated. There is a lot of discussion in the literature right now, and there are some unknowns, particularly about aluminum as an adjuvant and a possible trigger for autoimmunity. It seems like, every time the researchers try to study one vaccine and break it out to see if kids have an increased risk of X, Y, and Z against that vaccine, it’s very rare that they find any direct correlation. Truthfully, it could be due to just variance in the population.
There are so many different things to think about, but for some people getting a virus is a trigger for their autoimmune condition. In that case, it makes sense that if you got a vaccine, it could be a possible trigger for an autoimmune condition. It’s also possible that if you get the disease, that the vaccine is designed to prevent, it could also trigger an autoimmune condition. So remember with autoimmunity, there is always a genetic predisposition and an environmental trigger. Vaccines could be an environmental trigger. There is also a huge number of other things that could be environmental triggers as well. How many environmental things do you think we are exposed to nowadays? It’s a lot.
That was a total non-answer. I’m sorry. We have to be through each vaccine individually, and I do in most cases and in my webinar. Again, most of the research we have is in MMR. I’m breaking my brain trying to think of all the other ones that could be potentials, but I would watch each section individually because I do talk about well-reported adverse events in each section.
[00:47:06] Ashley James: You’re saying that having a virus could trigger autoimmune disease, which could be from the vaccine, but it also could be from getting it naturally.
[00:47:22] Dr. Erica Krumbeck: Right.
[00:47:24] Ashley James: Got it. Measles is quite a hot topic right now. I live just down the street from where you grew up. I’m in Snohomish, in between Woodinville and Monroe, so I know Kirkland. And here in Washington, I believe our passing a bill to take away the ability to opt out of the MMR vaccine, and there are talks of going after religious exemptions as well.
There is definitely fear and concern around an outbreak. I believe 700 cases have been reported in the United States in the last year. What would you like to say regarding measles? Before the measles vaccine, we would get the measles. They’re even showing that people who have had measles naturally and survived and went on to have natural immunity have lower rates of cancer. They see that in some ways, it stimulates and helps the immune system. You have to survive it though.
[00:48:40] Dr. Erica Krumbeck: Yeah. Measles has about a 0.01% chance of death. Again, only the people that have survived—oh, man. I don’t know how much I can do justice to this topic because I think that MMR topic in my course is 25 minutes long. But there’s a couple of things that I want to mention.
We can’t interview the people that died from it. Of all our “vaccine-preventable” diseases, measles probably has the highest permanent complication rate and permanent death rate. It can be just a fever and a rash, but it does seem to have much higher rates of encephalitis. It particularly attacks the neurological system, so permanent deafness and/or encephalitis. Obviously, not in everybody. It never happens to everybody.
The question is—yes, the weak ones—people who are genetically susceptible or have weak immune systems, historically probably would not have survived the measles outbreak. The question now is, “Are you willing for that to be your kid?” because I don’t want my kid to be the one who has the weak immune system and didn’t make it?
There are a couple of other things too. Actually getting measles significantly causes almost a year-long immunosuppression. Folks who get wild-type measles have a doubled risk of all-cause mortality the year following natural infection. That’s pretty significant.
Wow, I don’t like having the conversation this way because I don’t like to present it like, “Hey, here’s a fear tactic,” you know? That’s not what I’m about at all. This is a weird way to have this conversation and be like, “Ah, measles. We’re all going to die.”
That’s the problem with the media, too. We have not had a death this year, but there are, I’m sure, children who are going to have permanent neurological complications from measles.
[00:51:28] Ashley James: I just saw an interview with two doctors about this. I think they were citing some studies that those who have vitamin A deficiency have a much greater chance of having complications or not surviving measles.
[00:51:45] Dr. Erica Krumbeck: Oh, yeah. That’s in a developing world. That has been cited amongst naturopathic doctors and the holistic medical world prominently, so a lot of people have been saying, “Just give vitamin A.” But that only seems to hold true for developing nations.
So if you give a child in a developing nation vitamin A and they get the measles, their survival rate goes way up. That has not been documented to be true in Western nations, but we also have really low rates of mortality in Western nations with measles because we have access to excellent healthcare. The rate of vitamin A deficiency, like natural vitamin A deficiency in Western nations is really low.
[00:52:31] Ashley James: So we’re not diving too deep into this. As you said, you have a 25-minute talk in your—
[00:52:37] Dr. Erica Krumbeck: I kind of feel bad. Again, this is not how I like to present this information. I know we’re in the midst of a measles outbreak right now, and I was thinking about recording an extra add-on piece to my MMR lecture about a couple of these things like measles causing immunosuppression and all sorts of things. I apologized to our listeners because this is not the way that I like to present this in an unbiased format and not a fear-based format.
But I think that we should talk about the actual consequences of measles. It can either be way played up in the media or way played down in conventional and alternative medicine where people say, “It’s just measles. It’s not a big deal.” The reality is somewhere in between. It’s not like, “We’re all going to die” but some kids statistically speaking will, and some kids who get measles infection, even if they have the best treatment, probably are going to have serious neurological complications. I do know of a case of a child with measles who is now partially deaf in the US and Canada. Just be aware of that. There’s somewhere in between, and let’s talk about it. It’s not Shmeasle Measles like I’ve seen Mama Blog talked about. At the same time, it’s not like the world is ending either.
[00:54:07] Ashley James: So you’ve brought up some good points about it—somewhere in between like you said. So measles, if you contract it a year afterward, your immune system is compromised. You can, therefore, develop other complications. You have a percentage of a chance. There’s a chance that you can develop long-term permanent neurological complications and a very small percentage, there is death.
A good chunk of people though go through measles. Like you said it’s a rash, a fever, your body fights it and mounts a response, and you’re done. But even so, even the healthiest of those who survive measles with no complications, still have a year ahead of them. Like getting mono, where they have a year ahead of them being depleted.
[00:54:59] Dr. Erica Krumbeck: That’s a good way of describing it.
[00:55:00] Ashley James: People can go through any virus and end up feeling crappy for a whole year. I’ve heard of even chronic fatigue being a long-term consequence of being exposed to a virus.
[00:55:15] Dr. Erica Krumbeck: That’s specifically those human herpes viruses, and I don’t mean to herpes simplex, like the cold sore virus. It’s a strain of the virus that’s called human herpes virus. Sort of like HHB6, EBV, CMV—these are all not family, and yes, they’re going to cause long-term immune suppression. So yeah, that’s a great way of characterizing actually.
[00:55:35] Ashley James: You painted one side of the picture. Let’s paint the other side of the picture coming from a very wonderful neutral stand. I don’t feel like you’re fear-mongering. You want us to know the truth.
The truth is life is messy, and we could get exposed to anything. You can cut your finger and die of an infection. Not to be morbid, but we are surrounded by unseen bacteria and viruses all the time. The best thing we can do is build up our bodies. Make our bodies as healthy as possible. Make our bodies just as healthy as we can because we’re always going to be exposed to germs, and that’s at least in our control. We can choose to eat at McDonald’s, or we can choose to eat at the organic salad bar? One choice is going to lower our overall health, and the other choice is going to help support our overall health. We do have daily choices. We make 50 choices a day that could build our health or destroy our health.
We have the ability to make choices to build ourselves up. Let’s talk about the other side. I bring up choices because the fear-mongering make us feel helpless. These viruses are unseen, and it leads us to feel like we’re helpless. Therefore, we can’t do anything about it.
And the marketing that is used to make us want to go up and get a flu vaccine, for example, is all the fear-mongering like you said. So no—don’t give in to fear mongering. Let’s listen to Dr. Erica. Let’s listen to the reality of it that there are consequences. There are pros. Let’s look up both of them. So having outlined what would happen if you got measles, this could be someone who’s vaccinated but is a non-responder, or someone who has chosen not to vaccinate.
[00:57:30] Dr. Erica Krumbeck: Right. It’s about 5%.
[00:57:32] Ashley James: So even if you’ve been vaccinated, you have a 5% chance of getting the measles anyway. Here’s the information. Now, let’s look at the other side. What are the known cons of getting the MRR vaccine?
[00:57:46] Dr. Erica Krumbeck: I keep answering a different question. Can I take one step back?
[00:57:53] Ashley James: Please do.
[00:57:55] Dr. Erica Krumbeck: This goes back to our autoimmune piece. Maybe this will help put it together. One of my absolute no-no’s around the time of vaccination or illness is suppressing the fever. This point is totally opinion, so this may not be medical fact at all. This is completely Dr. Erica opinion.
I think that autoimmunity has been triggered by suppressing a normal, natural immune response to either a vaccine or an illness. This is what I’ve been telling my patients not to do. In times of fever, if we suppress the immune system, then I think the immune system gets confused and starts attacking itself. That’s why absolutely, no Tylenol—anywhere around the time of vaccines, and I also want to be clear on this—the MMR vaccine has been studied up, down, backward, sideways. They’ve done studies of 20 million children at this point and have not found an association with autism.
Now, I know you’re going to have a listener who’s going to tell me that their child had a reaction to MMR, and I’m not discounting that. There’s quite a bit of discussion of whether things have been under-reported or not reported. But I do think at least some of those cases were from Tylenol exposure and not from the MMR vaccine itself. There is more evidence now that Tylenol is triggering autism than there is the MMR vaccine, and probably particularly the combination of the two is dangerous. So talking about an event where you’re putting a live virus into the subcu tissue, the immune system is acting upon it and trying to create antibodies against what you have just injected into subcu. You suppressed the immune system. Where does it have to go? It doesn’t know what to do. And so, I think, that’s when we’re causing problems is when we’re starting to suppress fevers.
And you’re right. I hadn’t seen measles, but for sure from having high fevers from a strep infection reduces the rates of cancers. And so I think we’ve suppressed so many fevers. We’re so afraid of fevers now. It’s dangerous. I think that many more people would do better if we just let them have their fever because it runs its course on its own. Does that make sense?
[01:00:26] Ashley James: Absolutely. I love that you brought this up. I had an anesthesiologist who’s turned holistic doctor. She left anesthesiology after her son—her son is autistic, and she saw this world of holistic medicine, and he went from not being able to function in a “normal” school to completely able to function in a “normal school.” He goes to a Waldorf or something, but not having to go to very specialized autistic schools for those in the spectrum
He’s not highly functioning, and she did it with him using holistic medicine. She says that the most important thing in development is a fever. She sees a neurological leap in development after a child has had a healthy fever that wasn’t suppressed.
[01:01:26] Dr. Erica Krumbeck: I’ve never heard of that before, but I completely would believe it. It’s so important to have an immune system that does something. That’s what our immune system is supposed to do. When you don’t, then you’re going to get eczema, asthma, chronic illness.
That’s what our immune system was designed for. Why are we so afraid of that? That is one of the things that I hammer into parents. I wish we would throw out our thermometers. A 105-degree fever can be normal. A fever is not intrinsically dangerous until at 108. It’s shocking to parents.
If you don’t believe me, go to Seattle Children’s hospital and type in [A Fever Mess], and they’ll back me up. For some reason, I put that all over Naturopathic Pediatrics, and again I have people telling me that I’m killing babies. It was just not true.
It’s so pervasive in parenting culture that you must treat a fever, and it’s completely not based on any evidence in any way. It drives me absolutely crazy. There is no degree of fever other than 108, which kids never get to, that is dangerous at all. Kids who do get high fevers often will get febrile seizures. They are super scary. But the studies are really clear that febrile seizures are not dangerous. They are probably dangerous to the parents’ blood pressure. They are really scary, and so I get it. I have total empathy with parents that it’s absolutely so scary, but the kids are okay. It’s just a really scary process.
The warning signs—one, fevers in newborns are not normal. So please don’t [mishear 01:03:13] me that. Any fever from newborn to 28 days is worked up incredibly aggressively in the hospital, and I mean lumbar puncture, IV antibiotics, IV antivirals. They’re aggressive. So that’s anything over 100.4 on a [inaudible 01:03:31] thermometer which is I usually recommend. It needs to be worked up immediately. Even babies who are up to three months of age, a fever is not considered normal, and they need a workup by their doctor within 24 hours, unless they’re looking sick and then they need to go to the ER right away. Anything that children at three months and above, they could get any degree of fever, and I’m not worried about it as long as, A, they’re hydrating, and B, they look okay. They’re going to be fussy. They’re going to be probably sleeping more than usual, but they should not be listless, non-responsive, lethargic—all of those would be warning signs that something is more dangerous. Don’t touch it. Just let it go.
[01:04:12] Ashley James: I love it.
[01:04:13] Dr. Erica Krumbeck: And then I can come back to MMR if you want me to.
[01:04:15] Ashley James: At this point, someone might consider you to be pro-vaccine in your sharing. You’re not pushing vaccines at all. You’re just giving the information. But the information you’ve presented makes them sound safe and a really good choice. Am I wrong? Is there anything you’d like to say to add to this conversation? Do you have any concerns about the safety of vaccines?
[01:04:48] Dr. Erica Krumbeck: Of course. When I’m in a group of alternative medicine providers, I always sound like a crazy pro-vaccine, and when I am in a group of conventional medical providers, I sound like so crazy antivaccine. That’s part of the nature of good old-fashioned Jesuit education, where you’re just like our contrarian no matter what. That’s part of examining the evidence.
So again, I like to present both sides very clearly, and again it’s more because you’re interviewing me and asking these questions that are coming from listeners who, I think, in alternative medicine, tend to be biased against vaccines. It makes me seem like I'm really skewed for vaccines, and part of that also is because I’m discussing things that have become such a part of the culture, and they’re just factually untrue like the thiomersal piece. It’s just not true.
And so we need to talk about that. It’s not true that thiomersal is in vaccines. It’s not there, but aluminum is. There is no aluminum in the MMR vaccine. I do go through a section of aluminum in my webinar as well. I don’t think there’s truthfully great evidence on either side in terms of aluminum itself. There is one large safety study on aluminum exposure and why at least conventional medicine in public health considers aluminum safe in kids, and it’s based on a safety study done in two New Zealand white rabbits. I don't love that. How can anybody make inferences of safety in humans based on white rabbits? That’s just so frustrating.
And so I have a few things in MMR that are incredibly frustrating, too, in terms of immunity. I have a section in my webinar where I say—this is the actual quote from the CDC. It says, “Measles antibodies develop among approximately 95% of children vaccinated at the age of 12 months, and 98% of children vaccinated at 15 months. That’s based on unpublished data. We don’t even have—when I try to find the actual research citation for that, it’s published in a pink book, which is like cites itself in the CDC, which cites itself again. There is no data for that. It’s absolutely freaking up the wall.
So what I’m trying to do is give families evidence, and how can you give them evidence if there’s no data? It’s just like, “Ugh!” I wish I had something. There are no guarantees in life. I wish I could tell you it’s safe to give your child an MMR, and I also which I could tell you, it’s totally safe to let them have the measles. I just can’t. There are no guarantees. Statistically speaking, there is always going to be a child who reacts poorly to the MMR vaccine. We’ve reached the tipping point. At this point, we’re up until this year probably there are more kids having adverse reactions to the MMR vaccine than there were kids getting measles. And then it skews because then people don’t want to vaccinate then it skews to not having coverage to the point where then the measles can come back and spread. I will be very honest about me. I am not comfortable with my children having a wild type measles infection. I don’t love the MMR vaccine at all, but I feel like the odds are kind of in favor of actually getting MMR, so it would be great if no one had to have the MMR vaccine and there’s no measles. That would be ideal right? Wouldn’t it be great? But we don’t live in that world.
[01:08:55] Ashley James: So then it sounds like you did vaccinate your children?
[01:09:00] Dr. Erica Krumbeck: Oh, boy. I usually don’t tell people what I did. [laughs]
[01:09:04] Ashley James: Well, no. My next question then is a relevant question. For those who have vaccinated, how do we support our child in being healthy in the face of all those chemicals? Read the full insert. It’s pretty bizarre—the carcinogens.
[01:09:21] Dr. Erica Krumbeck: I go through all of those though. It’s great because I go through each individual ingredient in my webinar. Some of them look scarier than they are. Some of them are not great at all. Some are more kind of terrible. But some of them are like nowhere [inaudible 01:09:38] People like to publish all sorts of weird things about—I don’t know. The things that some people on the internet have gotten all hung up about on the vaccine ingredients, I’m like, “What?” That’s sodium phosphate. That’s salt. Let’s talk about the ones that we need to be talking about.
[01:09:57] Ashley James: Well, they’re scary. The scary ingredients—like we’re talking about aluminum in your brain or your bloodstream. It’s not healthy in high doses. What do you do to support a child in detoxing and being healthy after a vaccine?
[01:10:18] Dr. Erica Krumbeck: I always feel like legally this is a risky place to talk about all these without having the time for it. In my office, almost all families who come to me who want to vaccinate are vaccinating on an alternate schedule because they come into my office. Why else would they be in my office if they want to get all of them at the same time? They go to a pediatrician down the road.
Almost all of my patients, if they’re vaccinating, they are vaccinating on an alternate schedule. I have an alternate vaccine schedule that only gives one aluminum-containing vaccine at a time. I also go way out of my way to find the vaccines that either has no aluminum, or low aluminum or are preservative-free. I do my absolute best. In some cases, that’s available. In some cases, it’s not available. In my office, I typically only give two vaccines at a time.
The nice part about that, with only giving two at a time, is that you can identify quickly which vaccine is causing the problem and which isn’t. So that makes it much easier. It’s very rare for families in my office to have vaccine reactions. I mean anything other than—I don’t even have any fevers truthfully. I’ve had one child ever show any signs of developmental regression, and we immediately stopped vaccinating and gave them glutathione, and he came back on track.
Interestingly enough, he was an IVF baby, and I don’t know if that was some part of it, but that’s the very first one I’ve ever seen in my office. I am extremely cautious about vaccinating babies. One, and this is probably the other thing that’s happening in conventional practices, is babies/toddlers, whatever age you’re vaccinating, whatever age you choose to start vaccinating, they must be well.
Why are we vaccinating? Not me—I’m not vaccinating when they’re sick. But in conventional physicians’ offices, they’re routinely vaccinating kids who are sick. That’s another guaranteed way to get a vaccine reaction. When your immune system is already doing something, and then you throw in all—of course, they’re throwing in six to ten antigens at once, I guess research says that that’s okay, but that—yeah. That’s why I’m a naturopathic doctor, but it’s probably not the antigens maybe that are even the problem because in some ways the antigenic load is slightly lower than it was in the 80s because DTP, now it’s DTaP and the DTP vaccine, was highly antigenic.
Just so listeners are aware, the DTP vaccine we had in the 80s is different than the DTaP. The DTaP now seems to be well tolerated. DTP then was not well tolerated. The downside of DTaP now is it's not as effective as it was as the DTP vaccine back then.
One, kids must be well. Two, if they're showing absolutely any signs of anything other than fussiness, I'm giving liposomal glutathione immediately. I probably would give it to every child across the board except its expensive, and probably most kids don't need it. Remember, only kids who are genetically susceptible to glutathione depletion are going to have glutathione depletion. But you can supplement lipo glutathione around the time of vaccination, and it works great.
Probiotics have good research for both improving the immune response to vaccines and reducing side effects, which is great. It helps our immune stimulation in our gut, and it makes a big difference there, too. Kids should be supplementing vitamin D to help immune systems, but the two biggies are kids are well, and they do not have fever-suppressing medications.
[01:14:38] Ashley James: When it comes to flu season, when there are large outbreaks, have you ever talked to other clinics and seen that your patients statistically, because they're following your instructions and choosing a healthy lifestyle as possible, that statistically your clinic has fewer cases of flu than others?
[01:15:04] Dr. Erica Krumbeck: I don't know. I have had cases of flu in my office. There hasn't been anybody who was needed to be sent to the hospital. Flu spreads. You might get flu whether or not you're perfect on your supplements, and I want to reduce the guilt for moms a little bit, too. Having your child have a perfect diet and supplementing perfectly doesn't mean that they're never going to get sick. And if they get sick, it doesn't mean you did anything wrong. Sometimes they get sick, you know? They do. Whether they eat the perfect diet, they have the world's best supplements on board, whether you vaccinate or not vaccinate, whether you think you did everything right or you didn't think you did everything right, the most important thing you can do for your child is to be there for them.
It's so important. We have to lay aside the guilt. We are not going to do it perfectly with our kids, but you got to be there for them. I don't want you to go to McDonald's. I think it's terrible. If you do it and you're in their life, you did it. You made it.
[01:16:35] Ashley James: I love it. That's very well said. A lot of mothers look back and regret making some choices around medical things, and then they learn something, and they realize that it might not have been the right choice. But we can't change the past, and feeling guilty about it is not going to help us in the now. We're in our child's life. We're filling them with love, and they're going to have a good outcome in life because we're there for them and just beaming love at them and really caring. Regardless of where we stand on the vaccine—I don’t want to say issue, but—
[01:17:14] Dr. Erica Krumbeck: Conversation.
[01:17:16] Ashley James: Yeah, it's a conversation. It's not a fight. I like that you advocate for an altered schedule because you're doing it in a way that's respectful of the child's immune system, and you're watching. Every time they get one vaccine, you watch to see if there are any issues.
I had Dr. Paul Thompson [Dr. Paul Thomas] on the show, and he also discussed this. That's why I asked you about the flu thing because when I interviewed him, it was last February. His practice is in Portland, and he has four or five other pediatricians in his practice—a nice-sized practice. Thousands and thousands of patients on a Friday where all the local hospitals had four- or five-hour wait times because the flu was prevalent in the community, the entire clinic closed early because they got not one phone call for the flu.
Again, you can be the healthiest person in the world but still catch the flu. It's more about how quickly you bounce back, how healthy your immune response.” I remember when I was a kid, and I had a naturopath that my mom took me to. When I was sick, it was just very quick. I get a fever, I'd go to sleep, I'd wake up, and I was better. It was just, boom, the immune system kicks in, does its job. We don't impede it, and I've seen this in my son. If he gets sick, it's just a big fever, and he sleeps and then he’s better.
It can drag on really long. If someone is diminished, depleted, if their body is toxic, like you said, the person can't produce enough glutathione. Dr. Paul Thompson [Dr. Paul Thomas] was saying he recommends the same thing you've recommended that the family supplement, eat healthily and avoid bad food, get out in the sunshine and move around and do the basic, what we think is common sense. But it's not taught by every pediatrician unfortunately or emphasized as standard.
In his clinic, he's had what seems to be fewer cases of flu because of that advice. So I was curious to know if you'd possibly seen that.
You've already talked a bit about vitamin D, vitamin E, good clean multivitamin, fish oil. Can you recommend what would you want to be in every single family’s medicine cabinet, some go-to either homeopathics or essential oils? What's great for babies and children for us to use when dealing with the common things that come up?
[01:20:24] Dr. Erica Krumbeck: I've got lots, way too many. One thing quickly about that, seeing differences in flu cases—Maybe I just don't know because I'm not comparing directly to other urgent care clinics. They're probably slammed, and I get busy with cold and flu season, but I don't know how to compare the relationship between the two. I did want to say one other thing too about vaccines in my office and that's that in Montana where I am, if kids want to be in daycare or preschool, they must be not completely fully vaccinated but close and on schedule. That's another reason why families have to have their vaccines basically on time if both parents are returning to work.
And so that's different. Just to put that in context for the listeners in case they feel like, “Whoa, she gives a lot of vaccines early.” We're stuck to that based on the vaccine requirements.
So to go to your actual question, hopefully, all kids are being supplemented with vitamin D. All breastfed babies should be supplemented with vitamin D, at least 400 IU daily. I recommend up to a 1000 IU daily way up here in Missoula, Montana, because I've been testing babies’ levels and they're all low—super low.
So I was doing maybe like 3000-4000 IU a week, and I've just upped it to 1000 IU a day because they've never seen one normal. They're super low. But I mean that's up here, too. We're in a different spot than a lot of people in the country.
[01:22:02] Ashley James: What is a normal level for a child?
[01:22:05] Dr. Erica Krumbeck: Still above 30 is like a bare minimum. I see them in the teens, below teens, in babies, and that's worrying.
The theory was that if you give mom a certain amount of IU, 10% pass to the babies. So we used to supplement mom with 5,000 IU and hope that the baby gets, 500 but if mom is deficient, that does not work, and so I stopped doing that. I do not recommend that as a reliable method of supplementing the baby with vitamin D because we don't know how much mom is putting in breast milk. She might be just taking all of it for herself. I do recommend supplementing babies directly with Vitamin D.
My absolute favorite thing to have in our herbal medicine cabinet is lemon balm glycerides. I love it. I have a series of well child guides on the naturopathic pediatrics.com shop. They only go from newborn to 12 months. Right now, I'm working hard on getting the 15 months to 4 years age range, and they correspond with all the well child visits for each age group.
My thought behind this was this—they call them anticipatory guidance handouts that you get at a pediatric visit. All they tell you to do is how not to kill your baby. “Don't smoke around your baby. Always buckle them up in a car seat.” And I'm like, “Really? That's the best you can do. I pretty well could figure that one out.”
What I wanted to do was give families extra information, not just about how to not kill their baby, but how to support them, what's normal sleep times, what's the normal amount of time for babies to fall asleep, what's normal development at that age, what's not normal development, and when is it concerning. I do have a little list of vaccines, and right at the top, it says what is typically recommended at each age. And right at the top, we say we want to support families regardless of how they vaccinate. I still wanted to put that there because I still think it's important for families to know what's typically given at certain ages, whether or not you choose to vaccinate your child.
At the end of each one is an herb guide, and it includes dosages based on weight. I mean babies under four months are too young really to supplement with any significant, meaningful amount. I think I have a little bit in there for fennel at the two-month visit, but at the four-month one, I have an herb guide for lemon balm, which is my favorite ever.
You can make a tea out of lemon balm. It grows like a weed here in Montana, which is great because we have an overabundant supply. But in a glycerate form, it's like a tincture, only they use glycerin instead of alcohol to make the liquid, and you can give it to babies. It's a great substitute for Tylenol. It will not artificially suppress a fever. It will help break a fever that's already ready to come down on its own. It's an anti-inflammatory if that fever is ready to come down on its own.
Another pro tip for parents, dehydrated babies have a really hard time breaking their fevers. It can be helpful to give them even spoonfuls of tea or liquid or something. Nursing them is ideal, but if you can't get something into them, camomile tea, just a spoonful at a time can help hydrate them.
Lemon balm is great for pain relief, too. The same thing—it doesn't block the pain like Tylenol does, which by the way, Tylenol works by an unknown mechanism in the brain. It's centrally acting. It works at the brain itself—a little disturbing because we don't know what's happening. We don't know whether the negative effects of Tylenol are from glutathione reduction or from actually working directly on our endocannabinoid system, which is super disturbing. We don't know what it's doing.
Lemon balm is fantastic. It would be my number one. I would always have a source of vitamin C. I use vitamin C orally for ear infections to help reduce inflammation in the eustachian tube. That's another great one. I have a course of 10 vitamin C mix, which has a little extra antimicrobial and flavonoids support and it tastes delicious, mixed in applesauce for babies six months and up.
Passionflower glycerin is another nice one for a little bit older babies and toddlers and all the way through elementary school children. It's a fantastic herb. I'm an herb lover. I love and adore herbs. Mullein tincture is one of my faves too for coughs. It's super gentle, and it helps both wet and dry coughs, kind of. It's relaxing. It's a gentle mucolytic. I also use it orally for ear infections to help drain mucus and help the eustachian tube to open up.
[01:27:34] Ashley James: What is passionflower for?
[01:27:37] Dr. Erica Krumbeck: It's an anxiolytic. It's mild happy herbs.
[01:27:43] Ashley James: When would you give it to a child—when they're going through an illness?
[01:27:48] Dr. Erica Krumbeck: Teething is great. It's very gentle. It's safe. It's great for nursing moms too. Oh, gosh. I have so many more, but maybe we should stop there so that we can stop at some point.
[01:28:10] Ashley James: Do you have this information that people can purchase as your e-books on your website? Is that correct?
[01:28:17] Dr. Erica Krumbeck: Yes. Right now, there's a couple of different options. One, each of these is available for each well-child guide, so say for two months there's information that's relevant to the two-month timeframe, and then at the end there is an herb guide that I thought is relevant for that age. So herbs that are safe for that age group is what I put and attached to each of the well-child guides.
You can also get all of them from newborn to 12 months as part of the My Infant Health Binder, and my idea behind that—this is what I do for families in my office. The first visit they have with me, they get a three-ring binder as a place to store both growth charts, but also these well-child guides that are about six pages of information, places to write down questions for the doctor, a place to track milestones and development. I have a little section on what to expect.
In the two-month well child guide it says what to expect between two months and four months, which is your next scheduled well child check, and then the herb guide that goes with each of them. My Infant Health Binder has all of them in it plus extra places to store information, particularly for families who have a child with a complex medical health issue.
That could be a full provider list, a full supplement list, and a start and stop date for all the supplements that have been tried—just a way to organize everything. I am big about this because there's so much information. There's more information than I can go over in a well child check. There's more information I want to give than I could possibly talk about in a well child check. For families who do have complex medical health issues, they need a way to organize all that information.
[01:30:11] Ashley James: Absolutely. Anything you want to add before we move on to the next question?
[01:30:16] Dr. Erica Krumbeck: Oh, geez. I’ll say no.
[01:30:19] Ashley James: For those parents who have young children, they can go to NaturopathicPediatrics.com, click on “Shop” and then choose the guides that support them during that developmental stage and use the coupon code LTH to get 20% off, and you're going to be coming out with more guides in the future, which is exciting.
[01:30:38] Dr. Erica Krumbeck: Yes.
[01:30:41] Ashley James: Clone yourself.
[01:30:42] Dr. Erica Krumbeck: Yes, I actually am. This is what I'm working on. This is my new endeavor with NaturopathicPediatrics.com. It is literally how to clone myself because I get emails from people all the time, “Where can I find a doctor like you?”
My practice is closed to new patients. I have 40 people on my waiting list. I can't keep up with demand. There are tons of you guys who are listening who are like, “Whoa, there's so much information. This is so cool,” and I don't have time for all of you.
What I'm trying to do is put more information up on NaturopathicPediatrics.com. I seem never to have time. I'm trying to run a practice, and I have two kids that are 7 and 3, and I'm trying to be a mom at the same time. It's a little bit crazy.
The long-term goal of NaturopathicPediatrics.com is to provide providers, naturopathic doctors or functional docs with trustworthy pediatric resources and references so that I can clone myself so that we can all do this because there's no reason that we can't. Clearly, there's a huge demand for it.
[01:31:56] Ashley James: Great. So then, those who are listening who aren't in your area and you're not taking new patients right now anyway, although I know that you are expanding your practice as well. But for those around the world, they could ask their pediatrician to check out your resources on your website.
[01:32:12] Dr. Erica Krumbeck: Yes. Just started it, but right now it's at NaturopathicPediatrics.com/resources, and there's only a very small chunk of things up on that section. But my goal—I was hoping by the end of the summer, but it's probably not going to happen—is to have a hundred hand-outs on that page. I'm working on that, and I'm also working on finishing all these well child guides up until age 10 and develop templates for all of us too, so there's one place to look for information rather than just the conventional options for everything.
[01:32:58] Ashley James: I love it. I love the work you're doing. I love your website, and I love your mission. Naturopathic medicine saved my life. I was very sick, and I'd exhausted all the resources in conventional medicine. It was like spring air. It was like a light bulb turning on to go from an MD allopathic medical system back to naturopathy.
I grew up with a naturopath, and then I kind of lost my way, and then I came back to it. I had type 2 diabetes, chronic adrenal fatigue, chronic infections. I was on courses and courses of antibiotics. I was miserable and sick all the time. I couldn't even process human language in the morning. My brain was so shot, and I was just in so much brain fog. I felt like a prisoner trapped in my own body. I was going through yoyos of hormone issues. I also had a polycystic ovarian syndrome. I was told I'd never have kids, and I was infertile.
Naturopathic medicine—I had conceived naturally. I have a four-year-old now that I conceived naturally. I look at how big he is. I'm like, “Oh, my God, I can't believe.” He grows so fast. It was all naturopathic medicine in the last eight years that saved my life and got me to where I am now.
That's why I do this podcast because I want everyone else who is going through what they're going through to learn that there are alternatives that can support their body in coming back into balance. Of course, we want to respect science as well. That's why I love the type of work you do.
For me, it was a natural step to bring our newborn to a naturopath pediatrician, and it is much like seeing one as an adult. They spend an ample amount between 30-60 minutes every appointment. I've never seen that with an MD. There are couches, and we sit down, and it is a good long hour, sometimes 40-45 minutes, whatever our needs are, and then we've emptied out, and then the naturopath or our pediatrician is like, “Anything else? What about this?” And we're like, “Wow! We can really empty out.”
Our son had some asthma attacks, and I was concerned. I love Children's Hospital in Seattle. Just always, they've taken such good care of us. Our naturopathic pediatrician said, “We need to do some allergy testing.” It turns out he's allergic to about five different foods and dust mites. We did all the dust mite mitigation. It didn't make a difference.
That's when we turned to the food testing, and we have removed the foods that he was allergic to, the foods he ate every day like avocado, salmon, eggs. I was really surprised that these are foods that he had been eating since he was six months old. No wonder he had been having these problems. We removed the foods he was allergic to or sensitive to, and immediately overnight, the sniffles went away. The wheezing went away.
Unbelievable. I can't imagine how many children have asthma out there with inhalers, steroids, and trips to the emergency room, and it's because they're exposed to foods that are perceived as healthy, but their immune system can’t handle it. If he goes to someone's house that is not vacuumed very well, he'll get wheezy just a little bit. But no more rushing him to the emergency room. Since removing those foods, it has cut down all the problems by 70%, and then the dust mites are the other 30%. But this is the care I don't think I would ever have gotten going to an allopathic practitioner.
What you do as a naturopath, you look at the family unit as a whole. You look at mental health, emotional health. You look at food. You're looking at the whole picture, and I respect that.
A lot of my listeners had questions about ear infections. Can we get into that a little bit?
[01:37:29] Dr. Erica Krumbeck: Yeah, for sure. Remember that ear infections in babies is primarily because the eustachian tube doesn't drain. It's horizontal rather than at a semi-vertical angle like it is in adults. The main reason that kids get ear infections is that anytime they get a cold, the eustachian tube backs up, and rather than draining into the throat, it just stays there behind the ear.
Ear infections are a fluid management problem. They're not an infection problem per se. It's that the fluid persists behind the eardrum. That's what creates a breeding ground for bacteria. It doesn't matter that it's like the bacteria per se. If you can drain it, you don't have to worry about it. It's pretty rare in my office that I have a child that we can't “cure.” I don't know about cure but treat naturopathically. I think I've had two or maybe three kids over the last three years that we finally sent for ear tubes. I think in all three cases, their parents also had a history of needing to have ear tubes placed.
Now Missoula, Montana, also has terrible air quality, and so this is contributing to like a massive tonsillar enlargement all the time here. And so that's also kind of an obstacle to cure that I cannot cure because we have wildfire smoke for at least two months in the summer. There's nothing I can do about that even in the best case.
In the winter when there's not smoke, we sit in a bowl, and so we get all of this air pollution. It’s terrible. Most of the time, kids can be treated naturopathically. There's a sweet little easy eustachian tube massage you can do by putting your thumbs underneath your lobes, putting some gentle traction, and then gently dragging down the neck. It helps pop open the eustachian tube behind your thumb there. It’s hard to describe. I should video that. I might put that up on the nat ped site at some point.
And then using things like vitamin C to help reduce the swelling of the eustachian tube. I'm doing some gentle mucolytic is important. And then I do treat topically with garlic mullein ear drops as well. The eardrum must be intact. It has to be fully there. If the eardrum is ruptured, then it's dangerous to put anything actually into the ear canal. We used to say that those garlic mullein eardrops were antimicrobial. I don't know that the garlic penetrates the eardrum well enough to kill the infection, but they feel amazing. They're awesome. Have you ever tried them?
[01:40:12] Ashley James: Oh, yeah.
[01:40:13] Dr. Erica Krumbeck: People criticize naturopathic doctors like, “That onion ear muff is so pseudosciencey.” Have you ever tried it? It's awesome. The onion earmuff is the other one. You take a half an onion, you either microwave it for 20 seconds or simmer it in a little bit of water, like a half an inch of water until it's soft, wrap a towel around it, hold it against the ear. It is amazing. It feels so good. Why would you criticize us for that? It's so cheap. It's so easy. It feels amazing.
Lots of little tiny ones won't hold still long enough to put the onion over there. But the garlic mullein drops, if you warm them—they must be warmed to body temperature. Stick the whole bottle in a little cup of warm water. The reason for that is if you put anything into the ear canal that's either too hot or too cold, it'll trigger nystagmus in the kids. The eyes will beat, the eyes will go sideways, and it's dizzy. You never want to put something cold in the ear canal, warm it up to body temperature, and it feels great. It's fantastic for pain relief. Maybe there's some antimicrobial benefit. I don't care. It works fantastic.
[01:41:22] Ashley James: It has to be anti-inflammatory. The calendula at least is a very nice pain reliever. I went through a series of ear infections in the last few years, and I figured out I wear studio headphones all day long, and they were trapping all the moisture, and then I was sleeping on a latex pillow, which I think I'm allergic to.
I chucked the pillow, and the infections cut down, and so I would start to feel it coming on, and I used the garlic mullein we have for our son. Oh, my gosh. It feels so good. You're right. It feels so good.
I've done the onion ear muffs. I put them in the oven and then cut it. I just put the whole onion in the oven, warm it up, then cut it in half and stuck it right on my ear. That felt good too, but nothing feels as good if you have an earache as the garlic mullein oil. I'd wait until my son fell asleep and then put it in his ear because he will not sit around for putting something in it. A toddler does not like that.
My understanding is that when a child has ear infections, we look to the diet to make sure that cow's milk, for example, it can cause or contribute. Can you talk a bit about how we can prevent ear infections beyond the fact that it's not draining? As you said, it might be physiological. It's not draining. But beyond that, what can we do to prevent them?
[01:42:54] Dr. Erica Krumbeck: Yeah, so it's still swelling to the eustachian tube. Usually, it's triggered by some cold, so any virus, then there’s mucus from the nose, and it's draining back into the throat. [inaudible 01:43:07] elimination works a certain percentage of the time. I don't know that the kids that have severe or chronic ear infections; I have not seen it be that helpful for it. But again, that may be one because I don't have a ton of recurrent ear infection patients.
It seems like usually once we treat it for most kids, it's gone. Some kids get unlucky and have recurrent ear infections, and we will remove cow's dairy. Maybe I see that help in 30-50%. It could be a confounder though because again I think our air quality is pretty poor here in Missoula.
I think that's contributing to extra inflammation. So yes, cow's dairy products and citrus fruits can be mucus-forming. And so if kids are getting recurrent ear infections, then eliminate those foods, at least around the time that they have the ear infection. If there are kids that have more than two ear infections, then we cut out dairy for the long term.
[01:44:11] Ashley James: Would you say that they could get on lemon balm, mullein, passion fruit, these things you mentioned?
[01:44:17] Dr. Erica Krumbeck: Passionflower. Passion fruit wouldn't work—totally different. Tastes delicious, but it would not work. Yeah, for pain control, if they want to.
[01:44:29] Ashley James: I've heard from my chiropractor friends that often a good adjustment will clear it up.
[01:44:37] Dr. Erica Krumbeck: Yes, that's a great one. I have referred to pediatric chiropractors all the time, and there are different ways of doing it. Some are manipulated in the cervical bones. Some are just doing an endonasal kind of treatment. You can also reach in and gently massage. It's uncomfortable— the opening of the eustachian tube into the pharynx itself.
There are lots of different ways to do it, but yes, for a couple of the kids. I have one family who we finally did send them to the ENT to at least get the consult for ear tubes because here's the deal—for a lot of these kids, they have ended up on recurrent antibiotics. It's very rare for me to prescribe antibiotics for an ear infection. I've hardly ever done it. But when you've got kids who are having bursting eardrums, then we're at the point where we're like, “You know what, what else are we going to do?” In those cases, basically by the time naturopathic therapies have failed, almost all the time I see antibiotics fail, too.
It doesn't seem like the antibiotics are doing anything. Either the eustachian tube is so swollen, or genetically they have such a twisted eustachian tube, it's not going to make a difference. So that's when I refer to the ENT because then our only other option is drainage out of the ear into the ear canal itself because there's no other way to do it. I'm not going to keep having kids be on recurrent antibiotics forever and ever. I'd rather have them put a tube in. But this one family did go to the chiropractor and cleared it in that amount of time. I was thrilled. I was really happy.
[01:46:12] Ashley James: That’s very cool. Do you have other big pieces of advice that someone would have never gotten if they went to an MD and are very happy to get from you?
[01:46:28] Dr. Erica Krumbeck: That's really broad.
[01:46:30] Ashley James: I know it's broad, but like, “Go see a pediatric chiropractor is really effective.” Is there any other kind of effective forms of therapy? Do you have like these big, “I recommend all children only get two hours of screen time”? Do you have any one of those big powerful recommendations that help most children?
[01:46:59] Dr. Erica Krumbeck: So many. One, any child with ADHD, autism, or neurological issues, I strongly recommend turning off Wi-Fi at least at night. It makes a difference. A huge percentage of kids don’t notice the difference, but why do we have Wi-Fi on at night anyway? And then I have a certain number of kids that actually can tell their parents when Wi-Fi is on. That’s so freaky. Turn off that Wi-Fi. That's one.
For constipated kids, dairy protein intolerance is really common in constipation. Oftentimes, a dairy elimination diet will completely cure constipation. Speaking of constipation, because I have a constipation guide in the shop as well because that's a really common complaint. I can't remember how many millions of children statistically we're affected every year—tons and tons and tons.
Probiotics are super helpful for constipation, but I know families do not like laxatives. I hate Miralax. It's never been approved for use in children at all, not to mention long-term use, and it's the absolute standard of care for pediatricians.
I prefer other types of laxatives. Magnesium citrate is a great laxative. There are other ones as well, but I want to explain the point of that quickly. That's when kids are chronically constipated. Their rectum or colon expands, and it makes it so that the colon can no longer squeeze effectively. There is a vicious cycle and chronic constipation where then they become so impacted, and the muscle is stretched out, and the nerves are stretched out, so it can't even squeeze anymore.
The point of long-term laxative therapy, and I mean like 6-12 months is so the stools stay at a mashed potato consistency so that the rectum can shrink back down and kids can regain the control of their bowel. That's important.
Kids with chronic constipation can be allergic or sensitive to all sorts of other things—gluten, eggs. I could go on forever. There are so many other little tidbits. There are about a hundred of them, and there are so many different things.
[01:49:26] Ashley James: Tell us about all the guides you have created so far.
[01:49:30] Dr. Erica Krumbeck: I wish I had time to make so many more.
[01:49:32] Ashley James: I know you will. I mean this podcast evergreen. I've been doing this show for just over three years, and I still get people downloading the first 20 episodes. You'll have people listen to this for years to come. I know that when we all go to your website, Naturopathic Pediatrics a few years from now, you'll have many more, and I love what you've already created. Let's talk about what you've already created. When people go to your website, NaturopathicPediatrics.com and they click on 'Shop,' you have wonderful guides. Just tell us what you're proud of and what you think all parents can benefit from.
[01:50:09] Dr. Erica Krumbeck: One is if there are questions about vaccines, that's the main one. That's my Vaccines Demystified webinar for anyone who has any questions about vaccines. My only caveat with that is if you already have very strong opinions one way or the other, please do not buy it. It's not for you. You won't be happy. But if you're somewhere in between, go for it. You're laughing at me.
[01:50:34] Ashley James: No, I'm laughing because I'm very strongly on one side, but I'm also the biggest open-minded skeptic. I love it when I can be pulled back towards neutral from my radical views because I want balance and I want the science. I would love it. I think people are like me will upload your webinar.
[01:50:58] Dr. Erica Krumbeck: Good. I hope so. Just don't send me hate mail. I gave you the warning. That's the funny part about being in the middle. I said that then I literally get hate mail from both sides, and I just got tired of it after a while. I stopped promoting my vaccine webinar because I got so tired of the hate mail. It's just unbelievable, and it’s seriously from both sides. I've had entire blog posts on the internet about how terrible I am from both sides, which is like phenomenal to me because I do support all families in my office, and I'm happy to support all families in my office.
So the other stuff I've got up in the shop, I have the well child guides from aged newborn to 12 months. Again, I'll be expanding that soon. I have a constipation e-book. I have an ADHD e-book. I am working probably within the next 12-ish months or so. We're probably going to expand that constipation e-book into a whole webinar series that I'm going to do with a pediatric physical therapist who specializes in the pelvic floor for children. So that's going to be exciting, too.
Again, I am such a dreamer, and I have so many more ideas than I ever have time for, and we'll be working hard on developing practice and resource guides for providers as well. So stay tuned, there's so much more. If only I had time to implement all of my dreams.
[01:52:23] Ashley James: Absolutely. When it comes to just making sure that kids are fully nutrified, what advice do you have? For every question I've asked, we could do an entire interview, and I know I'm just not doing this topic any justice by skimming over that. We usually dive deep into one topic for an episode. But I love the tidbits you're providing. I think they're valuable.
Anything you could leave us with in terms of nutrition? Are there some things to look for that you want to let us know about? What tidbits do you have to support us in making sure that we're giving our kids the best nutritional support possible, from diet or supplements and both?
I love the idea of leaving the vegetables out while you're preparing dinner as an appetizer kids can snack on. I love that, and I read once you have to expose a child—I'm talking about like a toddler—you have to expose a child to avenge the new vegetable like eight times, and they're going to reject it like the first eight times before they're going to say yes to it. And some parents get to see the rejection once like broccoli, and they go, “Oh, no. My kid doesn't like broccoli,” and then they never offer it again.
The best psychology is just don't put any emotion on it. Don't shame them or yell at them or whatever. Just keep putting it in their field of vision. Like my son, if I give him a vegetable, he will not eat it. But as he's sitting in the grocery cart, he will eat an entire head of kale, or he'll start peeling a cabbage, or he'll grab asparagus, or bean, or peas, and he'll start munching them.
We have a kitchen garden, and he'll sit there and eat right out of the ground. But it's because it's his will. It's his choice. He's very strong-willed. So if I'm offering it to him, absolutely not. But if he's choosing, it's gangbusters. Do you have any advice like that that can help us to fill our kids with nutrition?
[01:54:27] Dr. Erica Krumbeck: Yes. First, most babies, when they're being introduced to solid foods, are open to everything. Even at 12 months is usually pretty good, somewhere between the first year and the second and a half year of life. So somewhere between age 1 and I'd say 2-1/2, often kids start to restrict their palate and then not like veggies in particular, but sometimes other foods.
Now I got unlucky, and I have, of course, the naturopath’s kid doesn’t like veggies or fruit. He's like the [inaudible 01:55:06] syndrome kid that I talk about on the website. Thank goodness, all I serve is whole grains because that's all he ever wants to eat. This is another key one. He's three and a half, and we're just figuring out he's got sensory issues. He's terrified, shaking uncontrollably if we make him taste fruit. So that's counterproductive. We've gotten to the point for fruit where all I'm doing is having him hold the orange.
It sounds so silly. I know some of your parents, they're watching, listening to this are going to judge me for this. This is legit. But I also know, and this is what the research shows us that exposure to foods, but in my opinion it's, it's well beyond eight times for some kids.
I saw this with my daughter, who was not afraid of fruit. She'd be a fruitarian if she could. It did take her almost four years to eat lettuce, and it was repeat exposure again and again and actually eat it. There's no problem.
Strangely enough now Leopold, my little guy, he'll eat lettuce and spinach, but he's still afraid of fruit. So we're thinking there is some kind of sensory thing. It must be the smell that's too strong.
[01:56:25] Ashley James: I’m really curious. What if you put it in a smoothie, and he doesn't see that it’s fruit? Is it once it's touched his palate and then he's afraid?
[01:56:32] Dr. Erica Krumbeck: No, he will not have a smoothie.
[01:56:35] Ashley James: Is it the color of the fruit? Can he eat fruit if it's hidden, or is it the taste or the color?
[01:56:46] Dr. Erica Krumbeck: I think it's the smell. I think there's a sensory processing issue going on with him, which we're going to get evaluated by OT here really soon. I'm quite positive there. I think that there's like sensory stuff in our family basically, so that's what I'm working on. That's another story.
[01:57:10] Ashley James: He could be a super smeller. There's one woman, I think she's in the UK, she can actually smell Parkinson's. People who are going to get Parkinson's smell different, and she can detect it.
[01:57:26] Dr. Erica Krumbeck: I think that that that's him. The only flavor of anything that he will have is chocolate or vanilla. Anything like Halloween candy, forget it. He's scared of it. Early on, he was afraid of huckleberries, and my husband almost disowned him—Montana man. A lot of huckleberry picking.
We were like, “No, you're going to like this. Of course, you're going to. Who doesn't like huckleberries? Are you kidding me?” So we put some in his mouth, and he started crying, and we're like, “Aw, I'm so sorry.” He does not go huckleberry picking anymore.
[01:58:07] Ashley James: No kidding. Next time, he has a cold, and his nasal passage is stuffy.
[01:58:11] Dr. Erica Krumbeck: It does not work. We've tried that.
[01:58:14] Ashley James: Darn it. I was going to be like, “I fixed it.” Just plug his nose.
[01:58:19] Dr. Erica Krumbeck: Tastes and textures. He will have applesauce and not apples. We've got a lot of sensory things going on with that guy. So we'll be doing some other stuff, which makes supplementing him impossible. He's the kid that I haven't figured out how to supplement because I'm not going to hide stuff in chocolate every day. I feel like that's a no go.
The long and short of it, going way back, what research has shown now is that repeated exposure is helpful. That's what we're doing with Leopold, saying, “You have to experience this vegetable.” At least, we started with the vegetables. The fruits we're still going to work on for a while. They have to try.
So now I tell all families, we talk about my plate guidelines. The food pyramid that they used to do when we were kids, they no longer do, thank goodness, because it was pretty much like all carbs and then a few other things. It was crazy. They've developed the My Plate guidelines, and it's a quarter protein, a quarter starch or grain, a quarter veggie, a quarter fruit.
The long and the short of it is, for families, I don't even care as much what's on the half of the plate that's the protein and green side. I don't really like mac and cheese, but if you are coming from that's all you eat, then okay, let's stick mac and cheese on that one side, the other half of the plate must be fruits and veggies.
What I'll often tell parents hopefully it will progress beyond mac and cheese at some point. Some parents get there; some don't. I don't even care if kids eat all of their fruit and veggie sides. I want them to know it's there because when they see it on their plate, the studies have shown that kids then at least by the time they're in late elementary school or adolescence, they know that that is what a healthy plate looks like and they will eat it eventually. It can take years of exposure.
The other thing is that kids must try, so I often tell the kids in my practice, “Dr. K says you don't have to like your veggies, but Dr. K says you have to try your veggies.” So that means every day they're trying at least two bites of everything on their plate. And then the research has also shown that kids will try veggies if they also have something on their plate that they already like to eat. Hopefully, that's not something junky.
In the case of Leo, it's an organic sweet potato cracker with flaxseeds, which thank goodness he likes. He's got lots of fiber that he has on his plate. Then it is encouraging them to try something else on their plate.
[02:01:02] Ashley James: Coming back to this idea that the universe sets us up for success, by giving you these challenges, you have become so much more knowledgeable in these areas, and thus you can help so many more people. If you had children that had absolutely no issues, you wouldn't need to be diving into learning, about learning deeper beyond helping your clients and your patients. You’re learning for your children, and you have a deeper level of compassion and connection that someone who's the pediatrician who's never had to deal with this and their family could ever have.
[02:01:44] Dr. Erica Krumbeck: Oh, man. I see so many parents judging each other too, and we've got to knock that off. I have so many parents that they buoy themselves up like, “My kid eats all their veggies,” and they're so great and then their next kid doesn't. We got to stop that. I don't want to serve my kid mac and cheese. There's no nutritional value of it. I turn around, and my hubby does it anyway, and it drives me crazy.
[02:02:11] Ashley James: That's what I'm telling. My husband has a younger brother. That happened in his family. I'm an only child, but my parents still managed to do it. They compared me to one of my friends who seemed perfect, “Why aren't you more like Jane?” Every chance they got—“Jane says please and thank you. Jane eats her broccoli.” They could do vegetable shaming with other friends, and it's not productive. It does not help with self-esteem. It doesn't make the kid want to eat the vegetables. It's not helpful at all.
[02:02:45] Dr. Erica Krumbeck: But at the same time, you can't cave. Just because Leopold got fed an Oreo by Grandpa, it does not mean I’m going to feed him Oreos. I'm not going to put an Oreo on his plate. He’s going to have a protein, he's going to have a green, and those grains are going to be whole grains, and he's going to have a fruit, and he's going to have a veggie, even if he cries about having orange on his plate. But it's still going to be there. I'm not going to force him to the point where he's crying because that's counterproductive. So we're just going to work, moving step by step, and we've got to let go of the guilt, and then we’ve got to let go of the shame.
If you have a fantastic eater, that's awesome, and I'm so happy for you. If you have a friend whose kid doesn't eat that, let's get them help because some of the kids—like my guy does need to go to occupational therapy. That's what OTs do—help desensitize kids.
[02:03:38] Ashley James: Yes, I love pediatric occupational therapy. Maybe you could tell us some other reasons that would be good for going to one. I don't think that parents know enough about that resource. What other issues come up commonly that are great to go to a pediatric occupational therapist for?
[02:04:02] Dr. Erica Krumbeck: Any kid who is actually on the autism spectrum should be fully evaluated and should probably go to an OT. It depends on your state. In my state, we have an organization that does all of these screenings. Often, they're called like a 0-3 program. It's different from state to state. If the child is actually on the autism spectrum, most of the time they'll qualify for services, it'll be covered by the state or federal government. If they're not. But a lot of kids do still have some sensory processing disorder, and that's when they’re dysregulated.
There's a lot of symptoms involved in that. It might be sensitivity to noise, sound, taste, texture, touch, inattention, things like that would be an appropriate referral. There are sensory processing questionnaires that you can fill out if you're kind of curious about that.
Sometimes kids are dysregulated, so they're having explosive meltdowns for no reason. They might have a sensory processing disorder. It is not just being completely dysregulated. That's a little hard to tell because toddlers are dysregulated anyways. That's sort of their job is--to be constantly dysregulated.
[02:05:19] Ashley James: When in doubt, you can get evaluated and see if that's going to be beneficial.
[02:05:26] Dr. Erica Krumbeck: Yes.
[02:05:29] Ashley James: We could go on and on for hours. I'm going to ask one last question. We're going to wrap it up and definitely going to have you back on the show because we've got plenty of more topics to explore.
[02:05:40] Dr. Erica Krumbeck: Sure.
[02:05:40] Ashley James: Sleep.
[02:05:42] Dr. Erica Krumbeck: [laughs] You threw that one as last! Oh, boy!
[02:05:49] Ashley James: I'll share what happened with us. Our son, he's an Aries. He’s very typical Aries. He is full of energy. You can't stop this kid. He’s going places. We don't feed him sugar. We feed him fruits and vegetables. He's going to get sugar naturally. I would hate to see this kid on a standard American diet. We had a problem. He had always fought sleep. He wants to be awake. He wants to go. Ever since he was born, he wants to go, go, go.
We discovered this magnesium soak--really effective, very easy to absorb through soaking in it. I interviewed the founder of it, and you can even do blood tests, and you can see that your magnesium or red blood cell count or the magnesium goes up in the bloodstream from soaking in this. We started adding it to his bath, and he started to calm down the evenings and tell us he was ready to go to sleep, which I thought was cool. We have this routine no screen time. We avoid screen time as much as possible.
We're reading books. There's a routine, and that helps. But for those who they feel like they've done everything, and their children still fight sleep, we also noticed that we had to start sleep routine around 5 PM. People think that their kids can go to bed at nine. It's like, no, Kids should be asleep by like six or seven, so maybe talk a little bit about like how long children should sleep and what are the most beneficial sleep routines, especially for children who fight sleep?
[02:07:41] Dr. Erica Krumbeck: Yeah. I have no way of figuring out how to do this quickly. Kids usually need more sleep than we think. The rooms really should be dark, although lots of kids are scared of the dark in developing nations. We are in Western nations. We're one of the very few cultures that do not sleep in the same room or same bed as our children. If you're going to bed share with a baby, you got to do it carefully.
But a lot of other cultures consider us to be barbarians for putting our kids to sleep in a different room than us. For some kids, it can be normal for them to sleep in the same room as mom and dad up until five or six. It's biologically advantageous to be in the same room as mom and dad.
Some of those kids have this heightened awareness, and they would have been great in tribal society because they're thinking like maybe the tiger is going to come and get me, so I better be alert and be vigilant. That would be great if we're going to try, but we're not in a tribe anymore. We should go to sleep, but we don't. It's okay if you still need to sleep with their kids. That doesn't mean you're a bad person.
Magnesium is great. I think it's a great idea to do it in the bath. There are also magnesium topicals. There are tons of magnesium chewies. There are all sorts of magnesium—very safe. If you dose magnesium orally and you dose it too high, you're just going to get diarrhea. So back up the dose. We call that dosing to bowel tolerance. I do think that’s short term, or at least a low dose of melatonin is pretty safe. It's been studied and is pretty safe. There aren't long-term studies on safety in melatonin, but I do think that now we have a lot of melatonin inhibition of our body making its melatonin because we're just too exposed to light, noise, sound, Wi-Fi and everything. In some ways, we might be replacing melatonin to where it's supposed to be. That's just scratching the surface. Yeah, we could do a whole sleep episode if you want.
[02:09:48] Ashley James: I'd love that. That'd be cool. What dosage is a generally good dose for melatonin for children?
[02:09:59] Dr. Erica Krumbeck: I start low at half a milligram or less. Sometimes kids who are dosed too high of melatonin can get nightmares. Don't do that. I'm never dosing melatonin in toddlers. I don't think that there's usually a need for that. It's very rare that I am.
[02:10:24] Ashley James: So you try everything else first.
Anything else first? I love talking to you, and we're going to have so much fun. You're going to come back on this show. We're just going to keep diving into these wonderful topics. I encourage parents and grandparents to go to your website in NaturopathicPediatrics.com and explore all the free resources that are there.
And if you do choose to buy something, use the coupon code LTH, get 20% off. Only write Dr. Erica love mail and none of this hate mail. Dr. Erica is on our side. She's supporting us and getting good information out there. You’re probably going to get some love mail. My listeners are the most loving and passionate individuals. We have a great Facebook group. I'd love for you to join it. It is Learn True Health on Facebook. People can go to Facebook and search Learn True Health, or they can go to learntruehealth.com/group. They'll redirect them to the Facebook group, a very lively and active community of passionate, caring individuals who all want to learn holistic health to improve their health and their family's health.
We've got a lot of parents there, too, so I know that you'll be welcome. There's zero hate speech in our Facebook group.
[02:11:47] Dr. Erica Krumbeck: Yay! Thank you for supporting each other.
[02:11:50] Ashley James: I've been so thrilled that my Facebook group has never attracted bullies or negative people. It's just been grounded down to earth people who want to be healthy and support other people in being healthy. So we've got that great support system there.
I can't wait to have you back on the show. It's going to be so wonderful. Is there anything you'd like to say to wrap up today's interview? Just anything you felt has been left unsaid?
[02:12:18] Dr. Erica Krumbeck: The only thing I would tell parents is don't Dr. Google and trust yourself, but don't trust Dr. Google. It will always convince you that you have cancer.
[02:12:28] Ashley James: It's kind of scary. It’s a big bag of worms we can open. But you can go to NaturopathicPediatrics.com.
[02:12:37] Dr. Erica Krumbeck: Yeah.
[02:12:39] Ashley James: Thank you so much, Dr. Erica Krumbeck. It's been such a pleasure having you on the show. Can't wait to have you back.
[02:12:46] Dr. Erica Krumbeck: Thank you so much. I appreciate it.
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