Picky Eating, PANDAS Syndrome, & Anxiety: Is Your Child’s Brain Under Attack? | Dr. Elisa Song

Dr. Song: [00:00:00] of mother's vaginal and gut microbiomes

The microbiome, really, for babies and toddlers, and really all kids, they're going to shape how their immune systems develop, how their brains develop, how their hormones and metabolic systems develop. 

Dr. Brighten: Mom's microbiome becomes baby's microbiome, which is why women have to have that microbial diversity.

It's so important. So, how do we cultivate, you know, the two year old's gut, the five year old's gut, the ten year old's gut? How do we cultivate gut health? 

Narrator 1: Dr. Elisa Song. 

Narrator 2: Is a Stanford, NYU and UCSF trained holistic pediatrician on a mission to revolutionize how parents care for their children. As 

Narrator 3: the founder of Whole Family Wellness, one of the nation's leading integrative pediatric practices and the creator of Healthy Kids, Happy Kids, 

Narrator 2: Dr.

Song blends conventional medicine with functional and holistic approaches to help kids [00:01:00] thrive. With decades of experience and a passion for empowering parents, 

Narrator 1: She's helped thousands tackle everything from colds to chronic conditions like ADHD, anxiety, and autoimmune illness. with a focus on healing from the inside out.

Dr. Song: If your child is really selective, has a very narrow palate, chances are, there are some nutrient deficiencies or insufficiencies that are actually exacerbating the pickiness. So looking at that, and the number one is really, what do you wish every parent knew 

Dr. Brighten: about their child's nutrition? 

Dr. Song: I would say, I want every parent to know that it really.

Dr. Brighten: Welcome back to the Dr. Brighten show. I'm your host, Dr. Jolene Brighten, I'm board certified in naturopathic endocrinology, a nutrition scientist, a certified sex counselor, and a certified menopause specialist. As always, I'm bringing you the latest, most up to date information to help you take charge of your health and take back your hormones.

If you enjoy this kind of information, I invite you to visit my [00:02:00] website, DrBrighten. com, where I have a ton of free resources for you, including a newsletter that brings you some of the best information, including updates on this podcast. Now, as always, this information is brought to you cost free. And because of that, I have to say thank you to my sponsors for making this possible.

It's my aim to make sure that you can have all the tools and resources in your hands and that we end the gatekeeping. And in order to do that, I do have to get support for this podcast. Thank you so much for being here. I know your time is so valuable and so important, and it's not lost on me that you're sharing it with me right now.

Okay. Don't forget to subscribe, leave a comment, or share this with a friend because it helps this podcast get out to everyone who needs it. All right, let's dive in. Dr. Elisa song. Super excited to have you on the podcast. Well, this worked out perfectly. I know. So I want to talk, we're going to be talking pediatric health.

So for all the moms listening, for the grandmas [00:03:00] listening, for all the parents listening, like you definitely want to share this one because it's going to be, I know it's going to be good just from our conversations. We have the first question I want to ask you though, is, what's the best way to What do you wish every parent knew about their child's nutrition?

Dr. Song: Oh, wow. I would say I want every parent to know that it really matters. Mm hmm. It really does. I mean, I'm gonna, I'm gonna throw my stepdad under the bus a little bit. He's awesome, right? But I remember as a kid, well, no, I was in medical school and one of our nephews was having a lot of behavioral concerns.

Uh huh. Um, just, you know, some OCD, anxiety, and he was young. And, um, He only would eat five foods, the same brand of chicken nuggets, the same brand of like go gurt type thing. I mean, there was like in the fridge and the freezer, the same thing. And so I remember telling my, my stepdad, I was like, you know what, it matters what you feed him.

And at least maybe at your house, you could feed him nutrients that help his brain or help his immune system. Cause he was [00:04:00] constantly getting ear infections and antibiotic after antibiotic. And he looked at me, he's like. Do you think that really matters? And I was like, what? It totally matters. I mean, these are the building blocks for everything, right?

Even their future cardiometabolic health. And for our women, our T our girls, their future hormone health. So it makes a huge difference. 

Dr. Brighten: Yeah. So, I'm curious though, because I'm sure people listening this, like right now we're in the phase of a toddler. So my first, he would eat anything. He's still, he's like, Ooh, can we go get bone marrow mom?

Like that kid. I love it. Like in, and it's always like the most nutrient dense. stuff. I'm like, you are like gold star in, in the eating. My toddler is the, he's the embodiment of everything people say about toddlers. Very obstinate tantrums, like, and now he's in this really picky phase. So we're getting very creative in our house of how we, we get things in.

But a lot of people face that and some kids do have food aversions. If all they're going to [00:05:00] eat is go gurt, like how can you build a nutrient dense diet working with what the kids will eat? 

Dr. Song: I mean the first thing with that I would say, if your child is really selective, has a very narrow palate, chances are there are some nutrient deficiencies or insufficiencies that are actually exacerbating.

The pickiness. Okay. So looking at that and the number one is really zinc. So a lot of kids are Insufficient or outright deficient in zinc and zinc changes your taste preferences. It changes your sensory issues so if you have kids who are really sensory about the, the smell, the texture, the feel of the food in their mouth, or other sensory issues like the tag on their shirt, or they can't do the blender or the, you know, the vacuum in the house.

Yeah, that to me is like, okay, they need zinc and zinc is Just by optimizing their zinc levels with a little supplement, you know, maybe for a month or two can make a huge difference I actually was just down in LA speaking with a mom [00:06:00] who said that she heard me Listing off all the signs of zinc deficiency and she's like, oh my gosh, I'm checking out the boxes.

That's my daughter So she started her daughter was eating like three foods at the time So she started zinc like a liquid zinc that she bought off the you know off the internet off Amazon. And, uh, as she said, within like not even two months, like a month and a half, her kid was wanting chicken, able to have a little bit of broccoli on her plate, like expanding, was actually having five more foods than when she had before the zinc.

So that's just a little pearl. I would say that's something, um, you know, to really help support kids. Um, actual sensory experience of food and then, you know, from the behavioral component, it's just, I mean, all the things that we as parents try to do, but really, um, you know, getting your kids engaged.

Involved in the grocery shopping list, the food meal list, and even if they're not going to take a bite, at least they've had a hand in it and then eventually they may want to take, they're much more willing to have a little, even [00:07:00] touch it on their tongue if they've had a say and like, Oh, you know, I kind of want to, you know, look at this vegetable today or maybe go to the farmer's market and pick out something brand new.

Dr. Brighten: My toddler, he will. Always eat broccoli. Okay, so this is like the way he'll always eat broccoli and carne. He's like carne, mas carne, right? Uh, so, and I bring that up so people know that, like, sometimes the, the pickiness can look like different things. I'm grateful for that, but he's also got the sensory thing of like, if he's eating peanut butter and it gets on his hands, he's like, get it off.

Now, get it off. Now, you mentioned zinc supplementation. Uh, for children, because, you know, ideally it would be diet first, but if we've got it, fooded versions, we're starting with supplements. What are you looking at for zinc? 

Dr. Song: So there's different forms of zinc. Uh, there are, I would say, you know, zinc picolinate, zinc glycinate, those are probably a little bit more easily absorbed.

Um, I've, I think I've had kids do well on [00:08:00] zinc sulfate, but usually I'll use the picolinate or the glycinate form. Um, Zinc can really, uh, one of the most common side effects is that it can upset your tummy. And I think, you know, adults experience this too. I remember taking a whole bunch of vitamins in the morning and just feeling so nauseous.

Oh, I've done it. I'm sure a lot of other people relate to that. And it's probably the zinc that is one of the biggest culprits. Yeah. So taking it with food. You know. or taking it at night before bed so that you're not feeling, you know, kind of gross during the day. Um, and you know, the dosage, you can start with a liquid one or a chewable one.

The zinc capsules, there's one zinc capsule. It's called zinc 30. I mean, it's super tiny. So if your kids are at the age where you're thinking, Oh, maybe they can learn how to swallow pills, which by the way, I've had a three and a half year old patient learn how to swallow pills so they can do it when they're young.

Um, but that's a really good kind of starter size. It's smaller. it's super tiny. Um, but looking at zinc and probably, you know, ideally I would check a blood. a red blood cell zinc level, because sometimes I am [00:09:00] floored at how low kids are and how much zinc they actually need to get to optimal levels. So if you don't have that option, then starting off, I mean, a toddler maybe start off with five, to maybe 10 milligrams.

If you have a middle school age kid or an elementary school age kid, you could start maybe 10 to 15 or even 25 to 30 milligrams depending on what's going on. I mean, if they're getting sick frequently, if they have eczema or if they have, you know, diaper rashes that aren't healing, um, for boys, you know, our boys, if they have delayed puberty, that's another sign that they probably need a little zinc because zinc is really important for testosterone.

So if there's any other signs of zinc deficiency, then I might start with a little bit. of a, you know, on the higher end of the dose and then see if you can check levels once you've started. 

Dr. Brighten: For people who want to start optimizing the diet, what are the best food sources of zinc? 

Dr. Song: Animal proteins really.

So, I mean, it may be the weather's okay on the [00:10:00] zinc, but you know what's even, even then I see some kids who are total meat a sores and you're like, wow, they still need a lot of zinc. Yeah. Right. Right. Um, but so it's, Zinc levels are highly correlated with animal protein intake, shellfish, you know, shrimp scallops are really high in zinc.

Um, they're also really high in cholesterol and choline, which is so great for brain development. Um, but apart from that, your legumes, nuts and seeds are really good sources of zinc. And I had one mom who, she was so smart and, you know, they were vegetarians. So, you know, I thought, well, you know, chances are they're going to need a supplement.

But what she did was she took some pumpkin seeds and ground them in a coffee grinder to powder and put the powder into everything, into soups, into salads, mix it with her kid's oatmeal, put into smoothies. And this kid's zinc levels went up really amazingly well. And if you're having trouble getting zinc levels up, A lot of people have heard at this point now that quercetin is a zinc ionophore, right?

That it helps zinc get into the cells. But that really [00:11:00] helps too. So that's where I think on a vegetarian diet or incorporating more fruits and vegetables with your zinc source, so many plant based foods like red apples or red grapes or, you know, vegetables. purple onions and capers and watercress. They have, they're high in 

Dr. Brighten: quercetin 

Dr. Song: that then when you have it with your zinc source, it helps the zinc be utilized better.

Dr. Brighten: That is such a great pearl for people. I always love like food combinations. Like, you know, the fact if your child's low in iron and you are vegetarian, making sure you couple it with vitamin C rich foods because your body really is designed to to, you know, absorb these things, but sometimes it needs assistance.

But as you were saying, you said in certain circumstances, you know, kids are meat itarians, but they're not actually absorbing their nutrients. What's going on there? 

Dr. Song: Well, I mean, I always focus and in functional medicine, we focus on the gut microbiome. It is so important. children. And we know this. I mean, even before conception, the health and the state of mother's [00:12:00] vaginal and um, gut microbiomes really impacts that baby's developing microbiome from birth.

And the microbiome really for babies And toddlers and really all kids. They're going to shape how their immune systems develop, how their brains develop, how their hormones and metabolic systems develop. And also really importantly, they're going to, it's going to really determine how well they're absorbing the nutrients from their food.

And also, oh, by the way, your microbiome makes all of these amazing, um, B vitamins like folate and vitamin B12 and vitamin K. And also, um, you know, really helps us to support and sustain and Our immune system in our brains with all of these amazing. Postbiotics like GABA and serotonin, which help your kids stay calm and relax and can help with some of the anxiety around, you know, foods or new sensations.

If that is something that that's really more stressful for them. So, I mean, it's, it's amazing. And so, postbiotics. When we take a closer look at their microbiome, [00:13:00] whether it's through a stool test, a specialized stool test, or simply by trying to support their microbiome with food if we can, and also with targeted supplements, that can make a huge difference.

Dr. Brighten: What are you looking for in a stool culture? 

Dr. Song: So the stool test is really fascinating, and I love talking about stool analyses because a lot of people listening, I'm sure, have maybe done a functional stool analysis for themselves. themselves. And, um, when we look at children's. microbiomes, their microbiomes are completely different than adult microbiomes up until about the age of three, three and a half years of age.

After that, their microbiomes take a little bit more of an adult like pattern, but even then their microbiomes are constantly developing just like they are through childhood, through their tween years and even their teen years. And what's really fascinating is we're also finding distinct microbiome differences between boys and girls.

As soon as puberty hits, those hormones cause a divergence, obviously in a lot of different areas, [00:14:00] but also the microbiome. So when we look at babies microbiomes, for instance, one of the things that a lot of people don't realize is for adults, we think, oh, we want a lot of microbial diversity. All those trillions of tiny microscopic organisms, you know, our probiotics, we want a lot of different kinds.

Mm hmm. So. For babies, it's the exact. opposite. We want very little diversity. In fact, for an infant, their microbiome should be nearly 80 percent to even 100 percent bifidobacteria and not a lot of other stuff. And then on the flip side, we have for training their immune system in an appropriate way.

There are actually bacteria like these bad E. coli or Klebsiella or Cytobacter that we don't want to see at all in adults, but for babies we need a little bit, maybe up to 5%. Okay. It's sort of like this training because babies are brand new to the world. And so just like, you know, they need to encounter different pathogens, different stressors to train their bodies, their microbiomes need that same stress too to develop [00:15:00] into a healthy pattern.

It's the same reason why we see, you know, kids who live on farms. Yeah. With lots of parasites and animals. Yeah. They tend to have less eczema and asthma because their immune systems were trained early on to tolerate those things. 

Dr. Brighten: Yeah, that is fascinating. When you are talking about microbial diversity happening, you know, at puberty and how that really differentiates, this is something I'm actually speaking on this weekend.

This is my talk is about how the loss of estrogen in menopause decreases microbial diversity. And one of the key things that I really want everyone to understand is that mom's microbiome becomes baby's microbiome, which is why women have to have that microbial diversity. It's so important. So how do we cultivate, you know, the two year olds got the five year olds got the 10 year olds got the pubescent teen.

I've got the preteen in my house right now. So how do we cultivate gut health? 

Dr. Song: Yeah. So, I mean, in my book, I talk about the [00:16:00] five things for microbiome magic and the reason I looked at this in five things is because these are five things that we're doing every day anyway. Yeah. And they're things that I don't want a teenager or a mom or a kid to feel like, Oh my gosh, I have one more thing to do because, I mean, we all have a lot of things to do and to add one more thing can feel like, Oh I'm not going to do that right now, but these five things we're doing every single day anyway, we have to eat, we have to sleep, we have to breathe and move and drink.

But if we do them in a way that is really gut centric, in a way that allows our microbiome to flourish. So many things will fall into place. I mean, Dr. Alessio Fasano, he is a pediatric gastroenterologist at Boston Harvard Children's and, um, really the, the leading expert who brought the idea that celiac and non gluten sensitivities, um, are the foundations for so many pediatric and adult chronic illnesses.

And so he is [00:17:00] credited with saying that your gut microbiome is not like Las Vegas. Hello, we're in Las Vegas. Your gut microbiome is not in Las Vegas. What happens in your gut does not stay in your gut. And we know that because your gut microbiome influences pretty much every single organ system. I mean talking about hormones and in our tween teen years as kids are going through puberty, the Rise in certain sex hormones clearly impacts what microbes want to grow and then vice versa The composition of your microbes determines how you're processing and metabolizing all of your sex hormones And so it's not isolated and whenever we have anything going on with your kids whether it's eczema Or whether it's ADHD or anxiety or an autoimmune illness, we have to look and see, well, what's going on in the microbiome?

How do we set the foundations of microbiome resilience? This is even before we start thinking about supplements. I mean, we have to have those foundations because A patient coming to me with [00:18:00] eczema or asthma or anxiety, I could get them on a ton of supplements and do all the testing and get them into quote remission, but unless you have the foundations, the basics of how we're eating, breathing, sleeping, hydrating, and moving to nourish your microbiome, you're going to fall right back.

You're going to get right back into maybe three months down the road, six months down the road, the eczema starts to come back or the anxiety starts to creep back in. And so the foundations really, really matter. 

Dr. Brighten: Okay, so people can certainly read your book to get all five, but can you give us one of the five that people could implement right now?

Dr. Song: Well, I'll give you two of the five. Okay. Okay. 

Dr. Brighten: I'll take it. 

Dr. Song: Not that there are, um, It's not that one is more important than the other because when we think about, you know, sleeping, or hydrating, or moving, what's fascinating is an optimal amount of sleep, or an optimal amount of movement every day has been shown to optimize your gut microbiome independent of diet.

Yeah. Which is fascinating. So if you have a kid who's eating three foods, Then don't [00:19:00] start with diet. That's going to stress everyone out, right? Start with movement or start with optimizing sleep. And then, you know, all of that will kind of move the needle forward. Because what's fascinating is you start optimizing the microbiome, let's say by optimizing sleep, that actually changed your taste preferences.

think that we're in control of our food cravings, but it's really not us. I mean, a lot of microorganisms, like if you have, you know, candida or yeast overgrowth, your cravings for sugar. Well, guess what? That's your candida telling your brain like feed me, feed me, feed me. And same thing with other preferences for these ultra processed foods.

So everything's going to move the needle. But when we think about what we want to get in and nourish our gut microbiome, it's also really important to think about what we want to keep out. So. Things that we want to get in. I have a whole gut rainbow chart with our three F's. So our fiber, our phytonutrients, which I know is a pH, but it sounds like an F.

Um, and fermented foods. So just simply every day thinking with [00:20:00] every meal or snack. I tell kids and you try to, you make it fun, right? I mean, you can kind of gamify it in a little way. There's handouts that you can use. But if you think about making every meal pop with plants on purpose, just one more thing, what's one thing that they can do now, phytonutrients is an interesting one because that's the color in our fruits and vegetables.

And so, you know, let's say for you guys, if broccoli is always going to be a hit. Great. Well, go to the farmer's market or the grocery store, see if they have purple broccoli, because that's a different phytonutrient and that still counts as making your meal pop. It's still something a little different, right?

Um, but I would say as our kids get older and you between, I have teens, they're going out with their friends, you know, they're making their own food decisions. So teaching them how to be really, really savvy food label leaders. being food label detectives to know, okay, this food, I don't want to buy this food.

I do. It's okay for my gut, my brain, my immune system. And that's really important because as much as [00:21:00] I would love to say, you know, that our kids are going to eat out of packages and, you know, eat all kind of processed foods once you're out in the world with their friends. They're going to be making some choices on their own.

And so we do this exercise with my kids, you know, my son, his kids want to drink the prime, right? With like the sucralose and the potassium and you know, the colors and the whatever. So I said, yeah, you know, let's think about you. You want to play, I mean, you have a soccer tournament coming up. Yeah.

Probably not helping you, you know, be at your best. So I tasked him with running up and down, you know, the, the refrigerator aisle while I was shopping to say, why don't you read the labels and choose a drink that you can have with your friends that you'll feel good about and I'll feel good about. And so he ran up and down and he picked one and I Oh, this actually looks okay.

Um, it's called liquid death. Oh yeah. Yeah. 

Dr. Brighten: The best water branding ever. 

Dr. Song: And you know, sure. It has a little bit more sugar than maybe I want, but it's not [00:22:00] exorbitantly high. Yeah. It's better than a Frappuccino and no, no artificial sweetener. So I'm like, Okay. And then he feels cool drinking. It's got a really cool bottle.

Yeah. I mean, everybody wants to drink something with a skull, right? Like, 

Dr. Brighten: at least you're 12 and you're like, liquid death. I'm so badass. That's right. 

Dr. Song: So, so that was, I mean, you just want to make it a win win, right? So teach your kids how to do that. And then I would say, The second thing is really learning how to regulate your nervous system.

I mean, we all as a society, um, you know, when we're thinking about, we're just talking about our aura rings before, right? Sometimes you can't stand when it tells you, but, um, but what it's really good at is tracking heart rate variability, which is a measure of, I mean, it's one of the best measures of current and optimal current and future optimal health.

Yeah. The other fascinating thing is, um, it's, it is a measure of how your vagus nervous functioning, how well your, your, um, autonomic nervous system is able to get into that rest, digest and restore state. Well, [00:23:00] we know historically kids heart rate variabilities have been decreasing over the past decades.

Oh, wow. Yeah. There's a cardiologist. Yes. There's a cardiologist in Germany who's been measuring them in kids with ADHD and kids without ADHD. And he's, and he noted, yes, there's been a decline. I mean, since the eighties, what 

Dr. Brighten: do they see between ADHD and non ADHD children? 

Dr. Song: So yeah. ADHD kids do have lower heart rate variability in general, too.

Yeah. So that makes sense. But globally, and I would bet that adult, I mean, I'm sure there's got to be some studies looking at adult heart rate variability and how it's decreased over the decades. We know our gut microbiome diversity has decreased over the past century. Yeah. I mean, there's a reason why, you know, we're all even, even at our healthiest, quote, healthiest state, even for babies who are born prematurely.

Um, you know, by vaginal delivery, breastfed exclusively, doing all the right things, we're still seeing, you know, kids who are having concerns because our modern life is just not supporting our microbiomes and our [00:24:00] brains and our hormones and all of that. So when we learn how to regulate our nervous system, we're By diaphragmatic breathing, you know, belly breathing or using apps like, um, the, there's a, a breathe app or an oak app, or actually the breathe app I don't think is around anymore, but the calm inside timer, all of those things make a huge difference in turning on that parasympathetic switch every day so that whenever we have this sympathetic fight or flight switch response turned on, which is pretty much all day.

All the time, right? Um, our, our autonomic nervous system, our parasympathetic nervous system knows how to kick in so that, you know, if you're, if you make it to school on time, you, you did your test or you got through the soccer tournament. Okay. There's no more saber to tiger anymore. There's no reason to be in that fight or flight.

So we have to kick in on purpose, our Vegas nerve. And we're not doing that enough. I mean, adults are not doing that enough. And so I feel like this is something that, that moms, dads, parents, and [00:25:00] kids can do together. And I mean, I have a whole chapter on it. It's that important. 

Dr. Brighten: Yeah. I want to ask this question.

As a pediatrician, what are your thoughts about the amount of homework children are being 

Dr. Song: given? You know, it's interesting because, um, some schools now, I mean, I'm in California, um, they, they really are trying to move away from the busy work of the homework, right? Um, I just, I think that, you know, I mean, we all know kids and adults are overscheduled, right?

But our kids, I mean, it's so challenging for me as a mom. I'm trying not to overschedule them, but they want to play soccer, right? And they want to be on the team. Well, okay, my daughter's in high school right now. So that means they get the late Field times. Yeah. So her soccer practice is eight to nine thirty.

Dr. Brighten: Oh my gosh. 

Dr. Song: Right? I'm going to 

Dr. Brighten: bed around that time. Oh yeah. I'm asleep by nine thirty. I tell, I'm like, 

Dr. Song: Peter, you're picking her up. Right? Cause I'm like, my goal bedtime is nine thirty. Yeah. So, so then, you know, she's got the homework and if she hasn't done it [00:26:00] beforehand, then she has to stay up a little bit late.

So it's really not conducive to mental health, to cognitive health, I mean, to immune health, right? I mean, overall health in general. So, um, I think that there's a lot that is just. Busy work that some of the more progressive schools are really starting to recognize and not just sending kids home with sheets just to do sheets.

Dr. Brighten: Yeah. 

Dr. Song: Um, and, and really moving more towards project based, taking kids interests, building on that, you know, teamwork, a lot of the tools and the skills that they're really going to need to have. Beyond high school. Yeah, because I mean, at work, most people, they're not filling out busy work paper. They really need to use your critical thinking and their teamwork skills to really succeed in this world.

So yeah, and I worry about the impact of all of the busy homework on their their psychological stress levels, which also I mean, really, in terms of what impacts your children's gut microbiomes the most, I would say the number one immediate is [00:27:00] antibiotics. I mean, antibiotics everywhere, not just, you know.

I think that one should 

Dr. Brighten: be pretty obvious to most people. So that's, but 

Dr. Song: then the one that a lot of people don't realize is chronic psychological stress, because psychological stress can trigger leaky gut within an hour. And so really, you know, understanding that piece of it, and not having no stress, but trying to trying to figure out how do we manage that.

Yeah. And like 

Dr. Brighten: you were saying, you know, tonifying the vagus nerve, working on, you know, the Building that parasympathetic activity and those practices around it. Because when you are faced with stress, you can't always avoid stress. So it's, what do you do in that moment? But I asked the question about homework because you know, as a mom, it's something that once I became a mom, I looked back and I was like, most of that was the biggest waste of time.

It did still. A significant chunk of my childhood. I should have been learning other skills from my parents. I should have been, you know, I didn't know how to cook when I became an adult. I'm like, I should have been in the kitchen. I should have been doing other things. I should have been riding my [00:28:00] bike and like living it up.

Um, but there is, I see a lot of people starting to push back because when you look at school systems like Finland, who is very focused on, you know, Internal happiness and less about just having to always be productive and chase external validation. They're not doing that kind of busy work. Some of the best school outcomes that have been measured, they are not giving oodles of homework or any homework at all.

And it's something that in the U. S. I'm starting to see a lot of moms push back on, and I really only see the old school teachers being like, You need to do all of this homework. And there, I feel like the newer generations or teachers are like, we do need to do something different here. Like we can evolve.

We can do things better. I also just think it's like really hard to be a teacher. So I don't want anyone to walk away from this, think I'm dragging a teacher. Cause I just think, especially in the U. S. Is there like, that is like one of the hardest, most uncompensated [00:29:00] jobs there are. 

Dr. Song: And I think with the, with the homework issue, I mean, I do see a lot of schools in my area too.

I mean, they're giving time during class time to do some of the work and they're doing a, they have extra periods or my, my daughter has something called a flex period where you can actually do a lot of your work there. That's great. Now that relies on the child. being willing to use their flex time, but also having like 

Dr. Brighten: fully functioning, you know, executive function, which is so important.

Most people don't have until they reach their 30s. It takes a while for the brain to get there. And especially if you have a neurodivergent child, they're going to have, you know, three plus years behind their cohort in terms of that executive function development. 

Dr. Song: Yeah. And so it's, I mean that the executive functioning piece is so key.

That's something that I feel like I mean, even more, I mean, more than the academics. That is the single most important skill that, that we need to be working [00:30:00] on as our kids are in middle school and high school, because you have good executive functioning skills. You're going to be successful, whatever you do, whatever you choose, you know, post high school, whether it's college or career, I mean, whatever it is.

But if you don't have that down and I look back and I wish that someone had sat down with me and, and just. taught me and educated me around what executive functioning skills I need to work on because I still don't have great executive functioning skills. And so, you know, and it's really important for, for me to really impart to my kids.

It is this project. It's less about the project. I want you to learn about X, Y, and Z, but it's more about the process, how you organize, how you manage your time, how you break that project up into chunks. And that is something we need to model and teach our kids. And so, um, I also think though, it's interesting.

My kids went to a very progressive, I mean, my son's still in eighth grade. He's graduating progressive charter school. In fact, it was the [00:31:00] first charter school in California and we've loved it. Very small. My daughter's graduating class was, had the, the highest number of eighth grade graduates in any class and, and that was, I think, I think it was 35 kids who graduated, so small.

Oh, wow. Yeah, yeah. Um, and they have really not had homework. So, the interesting thing is, when they have had something due, a project or a responsibility, um, It's been really challenging to get them to then sit down and actually do it. And so I think there's a, it's not the homework. It's more having something that you're responsible for and completing it.

Dr. Brighten: Yeah. 

Dr. Song: That I think is a, is really important for kids to have when they're young. Um, whether it's, you know, some, some. Job at home that you give them mm-hmm . To help out, you know, with the family or, you know, a little like a reading log that you do just to make sure that you're responsible for something.

Mm-hmm . Because that's when kids, I mean, there's one, you know, Harvard men's study, [00:32:00] I mean, from decades ago that tracked these young men at Harvard all the way through when they were elderly and they found one of the, the most important factors in happiness as an adult was if they had chores as a kid.

Yeah. Yeah. And so it's not that you give them 10 chores and you're, you know, it's like Cinderella, you know, mom, but it's like, I'm responsible for that, and I may not want to do it all the time, but I'm responsible and I accomplish it. And that is really important. 

Dr. Brighten: There are three things I've done with my son to help with the executive function.

I will link to the, so one, there's an executive function workbook I think is really good. Um, on Amazon ADHD superpowers, I believe is the out school class. Um, so for kids with ADHD, it looked at. What, where are your deficits at if you have ADHD and how do we actually, like, how do we improve that? You know, things like you're bad at, like, I remember the one he was like, mom, she talked about how, like, we're [00:33:00] bad at listening to people.

Cause we get so excited with our thoughts and then we jump in. And so he was taught like how to have a conversation. And, uh, the other thing. That we did is I actually made a chart. So he's at the age, he wants to play video games, right? They want screens all the time. And man, do they try to wear you down.

Um, and we have a chart that we keep on the fridge with a dry erase pen that he has to check off everything. And the rule is don't even ask. Yeah. Until you've gotten through things. And I mean, some of the things are as simple as like, have you fed your dog, walked your dog, which he loves doing, but it's still something that he's responsible for.

He has to go through his to do list. What other tips would you have for people building executive function in their children? 

Dr. Song: You know, I think. Yeah. Okay. We just have to show different tools, different ways to do that. Um, I, the lists are really important, but it's how they keep the list too. Right. And so whether they have a binder and they have a list on the front of the page, or now my, my daughter does have a cell phone.

So. [00:34:00] I showed her my what I do on my notepad. I just have a to do list to check and you and you have to organize that list too. Because if it's this like rambling 100 things to do, you're like, Oh my gosh, I have so much to do. So so we prioritize in terms of Okay, this is what I have to do today priority.

This is what I can do if I have time if I get to it. Right. And these are the things I can put off till later. Yeah. And so really figuring out what the priorities are. We also I mean, I love the idea of reverse engineering, and I think that's sort of that is one of the most important, um, tools that I've learned as an adult.

So if they have a project, 

Dr. Brighten: same, I think I'm like, man, my ADHD would have been so much better if I learned reverse engineering, but the first time I heard that I was like, Yes. Oh my gosh. Let's explain. What is reverse engineering for people who don't know? 

Dr. Song: So reverse engineering means you have this goal in mind.

And so, you know, for, for me, let's say, [00:35:00] okay, in, in 2025, one of my goals is I have this, you're going to love it. I have this amazing kids multi for their microbiome. All in one supplement that I'm coming out with. It is so good because I've looked for, for decades for the perfect supplement for kids. And so this is going to be awesome.

So that, so I have this in mind, but that's, there's a lot of steps in there. And if you think about all the steps, Steps, you know, from the beginning without a clear plan, you can get overwhelmed, right? So then you reverse engineer. I have this idea and I want to make it a huge success. So you work backwards and you think, what are all the things I have to do to get to this point?

So same thing with a kid with a, you know, let's say, um, a high school project. So my son in eighth grade, they have a what's called a personalized learning project. And you have to choose a project. And over the course of two years, you work on the project and you present it. So his goal was to learn how to use a camera to [00:36:00] shoot video and edit.

And create some short and long form videos as, you know, quote ads, right? He was gonna help me with my business, right? But that's a lot of steps. So then you reverse and so we have this goal in mind. So you reverse engineer, you go back in time. Okay, in order to do that, what are the individual pieces that will get me to that end goal.

And so that's really important because otherwise, you know, you start working on a project without thinking about the end goal all the time. And then you get diverted to this thing. You get to that thing. And you know, there's a shiny object syndrome. Oh, I'm going to look at this thing. And it's if that's not leading to your goal, then that has to be put aside.

And you keep working towards your goal. 

Dr. Brighten: We have talked about executive function. And I realized we'd never really defined or explained what that is. So let's say tell people what executive function is. 

Dr. Song: Well, it's interesting because You know, as a pediatrician, this term executive function really is. was not around when I was in medical school or residency in training.

Now that was, I mean, I finished my [00:37:00] residency in 2000, right? So, I mean, it's been a while, but really it wasn't until I'm going to say, maybe 15 years ago that this idea of executive functioning came to be, and it's distinct from ADHD. Now, a lot of kids with ADHD, they have executive functioning skills, but you can also have executive functioning problems without having ADHD.

So it's kind of the sin alone. And there's, there is, I mean, some schools are even, you know, really thinking about should that qualify for Services. Right. So executive functioning is really, I mean, in lay people's terms, the ability to, you know, have a problem in front of you and be able to see the solutions and kind of stop and regulate yourself enough to, you know, follow that path.

Yeah. Right. And that is one of the hardest things to do without getting overwhelmed, without getting lost in the plan, without feeling, you know, confused and scattered. Right. Um, there's actually a really good book called, um, [00:38:00] Gosh late lost and and scattered or something like that. That's a really good book for for parents And uh huh, and so and it's even you know, and it's not just work I mean, it's it's even things like, you know, getting your backpack ready getting out the door for school Think of all the different steps that have to happen.

It's not for some people. It's It's so easy. They get up and they get dressed, eat breakfast and their backpack's ready to go and they're out the door. But think about all the different steps that go into that, right? And so for some kids, I mean, they, they go to their backpack and their shoes are still in the room and they go back to the room and then their homework is still in the living room where they finished.

And so it's all these different pieces. So there's another book called Where's My Stuff that's actually a good one too, right? 

Dr. Brighten: I saw this, um, mom, uh, online, uh, she had this great book. system where she had laminated pictures of what was needed and put them all on the wall by the door and then had lights, the light system.

So these like little lights that you push a thing on. Oh my gosh. I love it. Yeah. And so she had [00:39:00] all of those lit up and then her child would go and be like, Oh, okay. I grabbed my backpack, turn off the light and like just, and it was a push. And I was like, I need this in my life. Like I'm like, not just for my child, but for myself, like this would be amazing just to have this little light system.

system of, um, you know, remembering all your stuff. But, um, it's, you know, people might feel like that's excessive, but even things like putting up a chart in the bathroom that says like, you know, brush my teeth. Like, you know, when I went to the bathroom, did I wash my hands? Like these kinds of steps of like the visual reminders can really help with training the brain to say like, here are the steps I need to take.

And I just bring that up because as you said, You don't have to be neurodivergent to struggle with executive function. I think it is something that you, as you said, we only like really put a name to this 15 years ago. If we had known about it sooner, certainly our generations would look a lot different in our function.

That's something that we can start now really instilling in our children. I want to shift the [00:40:00] conversation because, um, I think it's just really important for people to know that you literally helped me. Save my child's life. Uh, you did. I'm going to try not to cry. Um, so, uh, people who follow me are aware that my child developed pandas, pediatric autoimmune neuropsychiatric disorder associated with strep.

Doesn't always have to be triggered by strep in the case of pans. I do want to talk about that because. I always get questions and people needing resources around this. So help people understand what is pandas. 

Dr. Song: So, you know, pandas, as you mentioned, it's a, it's a pediatric neuropsychiatric disorder that develops after a strep infection.

The strep infection can be a classic strep throat infection. I have had kids so develop pandas after a skin strep infection, like called impetigo, or for some kids. It's perianal or perivaginal strep where you get this bright red ring around your bottom, [00:41:00] basically your anus or your vagina and which is common in kids.

Now, it's fascinating for me to think about how our kids immune systems have changed because when I was in residency in medical school, we didn't see pandas, right? Pandas is an autoimmune brain inflammation that develops after strep. Now, In residency, again, this is 20 years ago, the autoimmune reaction that we would see after strep was a kidney infection.

Yeah. Acute glomerulonephritis. And we use the same blood tests, the anti DNAB strep antibody, except that would let us know, oh, this glomerulonephritis, this kidney problem is due to strep. Mm-hmm . 

Dr. Brighten: Now. 

Dr. Song: Um, we don't really see much glomerulonephritis anymore, hardly. Immune systems have shifted, so for kids, instead of developing this autoimmune kidney problem, they're developing autoimmune brain problems.

Yes. Right? 

Dr. Brighten: Which both are very scary. Very scary. There's no good trade off here. 

Dr. Song: [00:42:00] Now, with, you know, with the, the autoimmune brain inflammation that occurs and these, these, I mean, literally your kid's brains are on fire, they can develop a whole host of neuropsychiatric symptoms. The most common are increasing anxiety, separation anxiety, OCD, tics, food restrictions, um, cognitive decline.

So kids who, you know, were brilliant at math. And then the, like the next day after the strep infection, they're like, I don't know what two plus two is. I mean, Like that, the things go, the fine motor, handwriting decline gets, handwriting gets very messy, clumsiness, um, you know, sensory issues peak. And sometimes it can be abrupt and dramatic, like you have this one kid one day who's calm and regulated, the next day they're screaming, you know, OCD, you can't get them out the door.

Um, um, Or it can be a little more subtle and gradual where you're like, they're a little, getting a little more stuck on things. They're having a harder time, you know, getting out the car to school. [00:43:00] Um, Oh, they're starting to not want to eat certain things. And then all of a sudden, you know, a month later, you're like, how do we get to this point?

Right. Where everything's now is really a huge problem. Um, and as you said, it can occur. When it, when it occurs after strep, it's called PANDES, but PANS is sort of the overall umbrella that can be triggered by lots of different infections. I had one kid, it was triggered by influenza A and that was, and she still had very high influenza antibodies, you know, months into it.

So, um, but more commonly we can see, uh, infections like Lyme and co infections or Epsom bar, herpes roseola virus. Um, sometimes molds toxins can be a culprit. So, um, it's just to say that if your kids are having a change in their behaviors, increasing anxiety, OCD, just, you're not sure what's going on. Um, and there may be something situational, like maybe I've had parents, you know, who baby sister was born and behavior started or parents are going [00:44:00] through a divorce or a new school and you're like, Oh, it's probably the transition, right?

It might be. But then if things aren't getting better and they're progressively getting worse, I always want to think, could this be pans or pandas? Even a sub, you acute case that's just kind of simmering. Um, and I've had some parents where we look back and we see, wow, you know, when they were a toddler, they had strep.

Dr. Brighten: Yeah. 

Dr. Song: And, um, and, you know, and pandas and pants can go like this, right? So they went through a really hard time. And then things got better, but not back to baseline and they thought, Oh, it's a, you know, terrible twos or, you know, it's just toddler years. And then, you know, now they're six or seven and you're like, no, it's something's not right.

And you do the testing and we find out that, yeah, it's pans. 

Dr. Brighten: Yeah, for my son, we had gone to the Notre Dame. We were in Paris at the time. It was a completely different child that we woke up to. Screaming, violent, like we were so scared and I remember, I mean, I was like, is he [00:45:00] possessed? Is this a thing?

Possession? Is it real? Because this was no longer my child. He was completely different. And I remember, I don't know if you remember this, we were on a Zoom call chatting and he came up behind me and whacked me in the head with something and you were like, That's pandas. Like your child just attacked you.

He's screaming. He's cackling. So it can, um, I mean, it feels, and I have heard so many other moms say the same thing. It feels like a possession. This is no longer my child. I don't recognize them. It is as common as one in 200 children 

Dr. Song: and probably more. Yeah. You know, it's very, um, we're recognizing it more and more.

And so, um, it's, and it's something that unfortunately still not enough providers recognize it. 

Dr. Brighten: Well, that's exactly what I was going to ask you. One in 200, probably underestimating how many are actually impacted. Why are providers so reluctant to even recognize that this could be a condition? 

Dr. Song: I don't know.

I mean, because the research is there now. We have now, you know, years and years of solid [00:46:00] research from Stanford and, you know, Mayo and these amazing clinics and amazing professors at highly, you know, respected academic centers who are doing the research and finding the, you know, the pathophysiologic basis determining what parts of the brain are impacted, what kinds of antibodies are, you know, reflected in this.

And, and yet, I mean, one of the, you know, Dr. Jenny Frankovich is really one of the pioneers in PANS PANDAS research, and she's just down the street from me at Stanford. Oh, yeah. I mean, literally. And, and so, and we communicate, you know, and, and so, uh, you know, we're here in the Bay Area, right? Mm hmm. You would think that PANS PANDAS would be a recognized, um, Recognize diagnosis so that kids don't have delay in their treatment.

Yeah, right. Because some of the some of the surveys find that parents go through, you know, 567 doctors before they actually get the appropriate diagnosis. [00:47:00] Or, you know, it takes, you know, three years to find a doctor who believes the story doesn't believe it's just bad parenting, you know, and yet even for me in the Bay Area where we have, you know, the world's, you know, um, PANS, PANDAS clinic.

I have psychiatrists in the community and pediatricians in the community who are like, no, it's not, not such a thing. Even at Stanford, the neurology department doesn't really, does not really put credit, you know, to PANS, PANDAS. I mean, I had a patient who was hospitalized under the, the neurology department and, um, It was a struggle to really even get, have that communication with them.

So I don't know, I really have no idea why there's this, this, um, um, kind of resistance to believing it's a phenomena, especially when you have these kids who, you know, are screaming, violent, aggressive, and you're like, you have the videos to show this is not the same kid and, and, you know, antidepressants don't do a thing, right.

You know, CD [00:48:00] medicines. I mean, they marginally help and yet you put them on anti inflammatories, you put them on antimicrobials, you get them IVIG or whatever the immune treatments are, and all of a sudden they're back to baseline. So that shows that, okay, it's not just in the kid's head, it's not just in the parent's head.

I mean, it is, it's heartbreaking that, that, you know, I would say around me there probably are more practitioners who believe in PANS than I do. Then other places but even then not enough. 

Dr. Brighten: Well, I think a big part of it is is that in medicine It's completely acceptable to gaslight women to act like they're hysterical and it's usually the mom who's advocating And so it's very easy for doctors to fall into that trap of, she's just a hysterical woman and like she's overreacting about her child.

But you know, there's like professional me, like as a doctor who's like, let's try to have conversations and there's mom me. And when I see these doctors saying like, [00:49:00] this is not real, like you're making it up. I'm like, best not, best not meet me in a dark alley. Cause you're going to catch hands. Like, There are so many parents who have struggled with this.

And I remember you telling me like, just try ibuprofen, just try ibuprofen. And we did that. And within 24 hours, things improved. We eventually had to do, you know, prednisone antibiotics. And then I, you know, as going through all of that, I really switched to this like really gut building protocol, mitochondrial supporting, and it's been a long journey for us.

He's finally, I don't think he's had a flare. in quite some time when he his trigger now is when he loses teeth. So I'm like, I just cannot wait until those teeth are gone. I mean, 

Dr. Song: that is such a common trigger because you think about it when your teeth are wiggly, um, or let's say even a teeth cleaning, cause that can set some kids off too.

You have little micro cuts in your gum or in the case of teething major, I mean your gum is, and so any of your mouth [00:50:00] bacteria, which can include strep, right? Right. Um, can get into your bloodstream and that is such a big trigger for kids. Yeah. So, uh, you know, yes, let's hope his teeth come out soon. 

Dr. Brighten: We're so fortunate.

So when we were in Portland, we still fly the kids back to see Dr. Stacey in, um, no podent dentistry for people who are like, which one are you talking about now? She has, um, you know, uh, feed your good guys. Like, yeah. toothbrush company and everything. But, um, when I talked to her about it, she was like, okay, tell me more about this condition.

And she's like, you know what we can do, we can do ozonated water. So while we're cleaning his teeth, like we're actually like helping cut down like the microbes and yeah, she really, um, helps develop a protocol so he could get his teeth cleaned because you know, teeth cleaning is going to be a trigger for him.

And yet at the same time, you can't just not clean your mouth. But you need to have these. Things done, but I'm like, it's quite a trek to go to Portland, but she's been someone that I'm like, you get me? Yeah, she's awesome. You know, my kids. Um, [00:51:00] and so I think it's really important to find these providers. We, I talked about, you know, doing the anti-inflammatories.

You talked about immune system regulation. What, and you, you mentioned iv, um, IG G and. That's something that was like a big push right now for insurance companies to start covering and that's the other thing is that in doctors Not accepting the medical research that exists. They are Preventing people from getting adequate treatment.

Let's talk about that What happens to the brain when it's not treated when they're just medicating them putting them in psych wards What is happening to that child's brain? 

Dr. Song: Well the the brain what we know is I'm sure there are other autoimmune antibodies that will be, will be elucidated, but there's something called the Cunningham panel through Molecular Labs, where Dr.

Madeline Cunningham has identified four autoimmune antibodies that target the brain, right? And these four antibodies target different parts of the brain. And when you think about what happens in an autoimmune illness, like let's take arthritis, juvenile arthritis, [00:52:00] or, you know, rheumatoid arthritis in adults.

When you have antibodies targeting that joint. There's inflammation, there can be joint damage, I mean, that's what we want to prevent. And so the same inflammation is going on when we have these autoimmune antibodies attacking the brain. And so, you know, we, part of the work, you know, really, um, supporting kids with PANS and PANDAS is bringing the fire down.

That's where the anti inflammatories come into play, reducing, kind of regulating, modulating their immune system. So the autoimmune piece starts to go down. Yeah. And healing the brain. I mean, you have to heal the brain and restore the brain, which you can do. But these medicines like, you know, kids are often placed, um, SSRI, you know, anti anxiety medicines are placed on anti psychotic medicines like Risperidone.

They're placed on Lamictal as mood stabilizers. I mean, they have this whole polypharmacy that only marginally help because they're not getting to the root problem that there's inflammation. And so if we don't deal with the [00:53:00] inflammation, we're not going to really have much symptom relief there. 

Dr. Brighten: Mm hmm.

Can pandas be reversed, be cured, be something that children grow out of? What is the long term look like? 

Dr. Song: Um, it's, you know, pans and pandas, as I mentioned, is sort of this waxing and waning course. I mean, a lot of kids in the beginning when they're starting treatments, um, every time they get a cold or a teeth cleaning or whatever, they'll have a flare in their symptoms and then they'll go back down to baseline.

What I look for as I'm working with kids is the, the time when they get a cold and they don't have a flare, right? Then I know. Okay, their immune systems are acting in a more normal way. They're just not, it's not overreacting to every little insult that's going on. And so, yeah, I mean, kids can absolutely, absolutely recover from pans and pandas.

It's not, as you said, it's not a short road, it's not like one course of antibiotics and you're done. Um, and it takes some perseverance and, and trust that, okay, there's a flair, there's But farther fewer between and then you get to the point where, okay, things are [00:54:00] pretty good, right? Um, and you know, grow out of it.

I don't know necessarily that kids will grow out of it without any intervention. I think that they do need some support because what I see with some kids where it's, you know, it's perhaps it's taken a while for parents to really come to the diagnosis and now they're in their late teen years and you know, maybe not as, significant of flares, but they're still left with underlying like OCD and anxiety.

And that's harder and harder to manage once the brain has really started to mature. Now, the, the awesome thing is our brains have so much plasticity, even adults. And, you know, for boys, I mean, their brains are still developing into the late 20s and for girls too. And so, um, there's so much we can still do.

So it's never too late, but the earlier we start, I think the faster we see resolution. 

Dr. Brighten: Absolutely. And I think when you partner with a good practitioner who, who is willing to partner with a parent, I think that's so important to hear what your child's [00:55:00] triggers are, to understand that it's trial and error sometimes.

So we know that like, if he says, I have a loose tooth. We have to start ibuprofen. If he is going to have a dental cleaning, we have to start ibuprofen. It's so funny. During the pandemic, I had made this video on YouTube of just like preparing for the pandemic, preparing to go into quarantine. And I had this big bottle of ibuprofen and I had so much hate.

People were like, I cannot believe that you would have ibuprofen in your house. And that's disgusting. And I was like, You don't have a game with pandas. Like, I don't know what's going to happen with COVID. Like I, and oddly enough, that kid has gotten COVID a few times and never has a problem. Like he is like spikes a fever and is fine like the next day.

And I'm just like, and as you know, I got so, so sick from COVID, um, four months on oxygen sick. And I was the whole time I was just so worried about him and I'm like, okay, well. That's not his trigger. That's not his trigger, but I know other parents were saying like, Oh, COVID [00:56:00] absolutely was a trigger for my kids, pandas and things got worse.

And that's why I think, you know, just like how we look at PCOS and we're like, there's probably like four different conditions actually that we're all calling PCOS, I think with this pandas pans, we're going to start to understand that like, okay, there, there's a lot more nuance. It probably, I probably still won't be on the planet by the time we get there, but I do think we're going to get there.

We'll 

Dr. Song: get there. We'll get there. And this idea, I mean, I, I love that you brought up the whole ibuprofen example because as much as we would love to use food as medicine and natural treatments, there is a time and a place for some, I mean, even antibiotics, there's a time and a place. We don't use it lightly, but you know, with pans and pandas, I mean, that is one of the things where if we're not sure, if we're like, Hmm, I suspect maybe this child has PANS or PANDAS.

I will use ibuprofen, Mochin or Advil, as a sort of, quote, diagnostic test where, you know, like, like we did for you guys, right? We said, [00:57:00] just let's try ibuprofen, we'll do, you know, three times a day, let's try it for a week. And just notice. 

Dr. Brighten: Yeah. 

Dr. Song: If your kid. has less anxiety, less OCD. They're, they're coming back.

Dr. Brighten: Then 

Dr. Song: we know we still don't necessarily know that it's pandas, but we know inflammation is playing a big role in their behaviors and we need to figure out what's causing that inflammation. 

Dr. Brighten: Yeah. And I think it's important for people to understand that I'm not, my kids not on ibuprofen nonstop. It's just that I know inflammation is going to spike.

Instead we're using things like schizandra and curcumin and uh, SPM. You mentioned choline before, which is so important in brain health. I think that is something that, uh, you know, we put it in our prenatal. We make sure that I, you can't ever put enough choline in a prenatal. I want people to understand that you have to eat your choline.

Um, it's so important. you know, preconception to have that on board, but also, you know, in the panda's case, but for all children, can you give, you know, the, [00:58:00] the why, why do we want choline? And where do we find that in food? 

Dr. Song: Well, choline is going to be found in egg yolk, highly in egg yolk. It is a beneficial compound that I it is a must for me in, in a kid's multivitamin to, I mean, just like in a prenatal, it's so important for mom's health, but really for your baby's developing brain in utero.

But even once you're born, it's so important. And a lot of the multis don't have calling or they have just a teeny little bit. So Colleen's very important for brain development. Um, and, and, you know, it's really, when we think about phosphatidylcholine and the impact that phosphatidylcholine has on brain connectivity, you know, neuron, communication.

We can see why it would be such an important piece of supporting our kids brains, whether or not they have PANS. It's also really important for supporting mitochondrial health, which I mean, of course, is important for adults, but I mean, I see many, many, many kids who need mitochondrial support simply just by living in our modern world.

You know, we need [00:59:00] mitochondrial support. So choline is definitely a very important supplement. 

Dr. Brighten: What are some other nutrients that you like for mitochondrial support? 

Dr. Song: For mitochondrial support. So your CoQ10 is one of them. CoQ10 carnitine which is an amino acid that's really important for fatty acid oxidation and mitochondrial health.

Ribose can be really helpful. So those are probably my three main and then we have our supportive. So our antioxidants to help reduce the oxidative stress that mitochondrial stress triggers. So your vitamin C, A, E, glutathione all are really helpful and phosphatidylcholine. 

Dr. Brighten: I love all of those. I'm very keen to see the research developing on NAD now that that's really taken off.

That's something I've put my son on. I mean, our whole house takes NAD because I'm like, this is a, this is a very good thing for people who have autoimmune conditions, which, yeah. So, I just want to wrap up this conversation [01:00:00] with, you know, when it comes to approaching your child's health, you're in the pediatrician's office, what are some tips to advocate for yourself?

Because I think sometimes that's the hardest part is when you look for help to actually receive that help. 

Dr. Song: Yeah. I mean, I would say when you're looking for a pediatrician and you're interviewing the pediatrician to see, okay, is this going to be a good fit for my family? It's really asking the questions to find out how they're going to partner with you and, you know, letting them know that, yes, you will use medications if absolutely necessary, but you would love to first have that dialogue on, you know, is this antibiotic really necessary?

Are there alternatives? How do we recover from antibiotics if they are necessary? And just seeing what your, your, uh, your pediatrician has to say. Now a lot of pediatricians aren't going to have those alternatives at their, you know, uh, right on, on hand to really, um, recommend to you, but you want to gauge, are they open to it?[01:01:00] 

Yeah. You know, are they open to, if you have a naturopathic doctor you're working with or an acupuncturist or, you know, an herbalist or homeopath that you work with, how open are they to, um, having you work with them in partnership, right? And so, you know, if you get that sense that, oh, homeopathy, no, that's, that's kind of, and you know, not acceptable, it's quackery, it's whatever, then that's not the right doctor for you.

Yeah. Right? So that, I mean, I'd say, I mean, the parents who come to me, they're choosing to come because I can offer a lot of those modalities. I can make homeopathic suggestions. I can do acupuncture, you know, I can recommend different herbs, essential oils, but I'm not going to say that's the majority of pediatricians, right?

There is a growing number who, but not enough. And so right now you're probably looking for, okay, I need a team to help support my child 

Dr. Brighten: and 

Dr. Song: I need a pediatrician who's going to be open to being part of that team. [01:02:00] team. 

Dr. Brighten: Mm hmm. That's very, very helpful information. We're going to have to have you come back and talk all about homeopathics because a medical doctor talking about prescribing homeopathics, I think you just piqued a lot of people's interest in 

Dr. Song: that.

It's so important. I mean, it's, it is actually homeopathy is really one of my preferred first lines of treatment for babies and, and kids because they're so safe and gentle yet they can be really effective. 

Dr. Brighten: Yeah. Yeah. It's one of the things that, you know, like, People, I think they always jump to like, Oh, homeopathy, like you're going to prevent a heart attack.

And it's like, look, if you're having an M I a myocardial infarction, we're going to send you to the hospital. But it is something that like, I even think about like, you know, with my dog, uh, who's passed away now, she would get so scared with fireworks and there's homeopathics we would use for her and they would work.

And I'm like, Look, the dog's not placebo in here. The dog has no idea what's going on, uh, but we're going to have you back. We're going to have that whole conversation for now. Everybody needs to grab your book if they [01:03:00] want to jump ahead and get in on that information. But I want to say thank you so much for sharing your time and your wisdom with us.

It's been such a great pleasure to speak with you. 

Dr. Song: Yeah. Well, I, I always love hanging out with you. I'm so glad I ran into you here. 

 

Dr. Brighten: Yeah, same.