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Does Formula Affect Breast Milk Supply?

January 8, 2018 by  
Filed under Uncategorized

by Jennifer A. Gardner, MD

As a pediatrician, I’m frequently asked if formula affects breast milk supply. This is an important question, because nearly half of all mothers who plan to exclusively breast-feed end up supplementing with formula. Plus, a recent survey1 conducted by store brand formula found that three out of four moms use infant formula at some point during baby’s first year. Additionally, 17 percent of moms planned to wait until their baby was six months old to introduce infant-formula feeding; but only four percent made it that long.

So, does baby formula affect breast milk supply?

The answer, simply put, is yes and no.

The good news is that supplementing will not stop milk production, but it could decrease it. Fortunately, there are many approaches a family can take to minimize the risk of decreasing the mother’s breast milk supply.

First, whenever possible, introduce the bottle only after successful breastfeeding has been established. This avoids nipple confusion and helps ensure a healthy supply of breast milk. Since this strategy isn’t always possible, sometimes supplementing is considered earlier because of an inadequate milk supply.

In this case, supplement with formula only as needed. Your goal to maintain adequate milk supply is to empty the breast with each feed. This means breastfeeding as much as possible and pumping when you do bottle-feed. When you pump and add the breast milk to formula, your baby gets the volume and calories he needs, and you get the signal to keep producing milk!

A baby must work harder when breastfeeding versus bottle-feeding. You can use a special nipple that makes the baby work harder so she doesn’t associate bottle-feeding with easier feeding!

In the end, the decision to supplement or when to supplement is a very personal one. You must weigh the benefits of formula with the potential for decreased milk production. The survey also discovered that 35 percent of moms chose to feed their baby with infant formula so they could share the feeding responsibilities for baby with their spouse. While this decision may be difficult, there are no right or wrong decisions. What we know is that all babies do best when the mother is relaxed and confident with feedings. If supplementing with formula reduces your stress level, this may help with breast milk production.

Whether moms choose to breastfeed, formula-feed, or use some combination of both, parents should feel confident in their decision. In fact, did you know that all infant formulas sold in the United States must meet the same FDA standards and offer complete nutrition for baby? That means even cost-saving store brand formula is nutritionally comparable to nationally advertised brands.

And remember to give yourself credit. I tell my patients that any amount of breast milk is beneficial to your baby. There’s never room for guilt in the feeding relationship.

About the author: Jennifer A Gardner, MD, is a mom of a three-year-old son, a pediatrician, and the founder of an online child wellness and weight management company, HealthyKidsCompany.com, in Washington, DC.

My Feeding Prescription

January 5, 2018 by  
Filed under Uncategorized

by Jennifer A. Gardner, MD

One day, I entered an exam room to find a new mom quietly sobbing into a tissue as she held her newborn baby. I sat down next to the mom, and we began to talk about her difficulty breastfeeding. The new mom tearfully told me that latching on was a challenge, and her milk supply was suffering.

The mom had expected breast feeding to be natural and easy. But even after lactation consultants and multiple doctor visits, she felt frustrated, guilty, and pressured. She felt tons of pressure—from her family and even from her husband to make breastfeeding work and not to supplement.

As she cried, I knew that I was observing the culmination of so many tumultuous emotions and deeply entrenched expectations. Reality was not meeting expectations.

I offered the mom reassurance. I explained that we mothers are told that breast is best and natural. But it doesn’t always come easy!

After I could tell the mom felt a bit unconvinced, I moved on to finding a solution. I’ve learned in my practice that in cases like this, the best thing to do is what works.

I knew that if this mom needed to supplement with infant formula while we worked on increasing her supply then that’s what would be best for her and the baby.

I gently explained this to her. But still the mom was worried. She agreed that supplementing with infant formula was best for her baby—and for her. But she didn’t believe that her family would accept this advice.

So together, we hatched a plan. I wrote her a prescription to supplement with a bottle—filled with either breast milk or formula.

With relief, and a gentle smile, the mom agreed to give it a try. And out came my prescription pad!

I asked the mom to keep me posted on her progress. She told me that her milk supply steadily increased over the next few weeks. Plus, she said that she felt more confident and relaxed.

The new mom and I even laughed when I told her breast is best, but sometimes a bottle (breast milk or baby formula) can be a girl’s best friend!

Many new moms find breastfeeding to be a challenge. Store brand formula conducted Baby’s First Year[1] survey earlier this year and found more than half of moms experience issues when it comes to breastfeeding baby, with low breast milk supply being the top concern. The new trend of “fed is best” echoes that whether moms choose to breastfeed, formula-feed, or use some combination of both, parents should feel confident in their decision. In fact, did you know that all infant formulas sold in the United States must meet the same FDA standards and offer complete nutrition for baby? That means even cost-saving store brand formula is nutritionally comparable to nationally advertised brands.

The survey also found that sometimes the pressure for mom to breastfeed is too much. One out of three moms experienced situations where they felt the need to justify to others why they use infant formula to feed baby. Additionally, one out of 10 new moms lied about breastfeeding baby to avoid criticism from family and friends.

The fact is that nowadays three out of four moms use infant formula during their baby’s first year. And that is perfectly ok! Moms need to do what is right for their baby and for themselves.

About the author: Jennifer A Gardner, MD, is a mom of a three-year-old son, a pediatrician, and the founder of an online child wellness and weight management company, HealthyKidsCompany.com, in Washington, DC.


[1] Store brand formula Baby’s First Year survey was conducted between February 13-20, 2017, among 2,000 nationally representative Americans between the ages of 18 and 65 who currently have a child between the ages of one and three, using an email invitation and an online survey.  Margin of error is +/- 3 percent.

New Year Resolutions for People with Food and Latex Allergies

January 3, 2018 by  
Filed under Uncategorized

New Year Allergyby Sonal R. Patel, M.D., M.S.

For many, January is a time to review the past year and set goals for what to accomplish in the coming months. For families with life-threatening allergies, this review may also include strategies to better prepare for an anaphylactic emergency.

“After the hustle and bustle of the holiday season, it’s important to circle back with family and review the year—celebrate what worked, and modify what didn’t,” says Tonya Winders, president and CEO of Allergy & Asthma Network, the leading patient education and advocacy organization for people with asthma and allergies. “Use this opportunity to recharge the family’s understanding about allergies and how best to manage them.”

The Network suggests the following New Year’s resolutions for managing life-threatening allergies:

Replace fear with facts. Schedule an appointment with your allergist to review your food or latex allergy diagnosis: Do you know exactly what you are allergic to? Is it time for new testing? What is working or not working in your prevention program? Make a list of questions in advance and be sure to include food-allergic children in the conversation. Help them understand how to prevent exposure and respond to symptoms.

Practice prevention and build confidence. Educate your kids by reading food labels with them, both at home and the grocery store. Focus on words related to their specific allergies. In addition, talk with them about situations they find difficult to handle, such as being offered snacks that may contain allergens at school or parties; role-play to help them build confidence. Always be prepared for accidental ingestions.

Organize medications. With life-threatening food, latex, or other allergies, it’s important to carry two epinephrine auto-injectors with you everywhere, every day. Learn when an epinephrine auto-injector may be indicated and how it can be properly used and stored. Devise convenient and creative ways to keep them close at hand. Check expiration dates on your devices and put renewal reminders on your calendar. Make sure school forms are completed.

Build a safety net of family and caregivers who understand. Allergy & Asthma Network offers free resources to share with family and friends. Visit AllergyAsthmaNetwork.org for a wide range of information. Download or call 800-878-4403 for Understanding Anaphylaxis, Living Confidently with Food Allergy, or Living with Latex Allergy, free guides to help you manage your condition.

Increase community awareness: Become an advocate. States and towns across the country are passing laws and implementing new strategies for food and latex allergy safety in schools, healthcare facilities, restaurants, and more.

With some creative thinking, patients and families with life-threatening food and latex allergies can be more aware and prepared in 2018.

Allergic to Christmas?

December 20, 2017 by  
Filed under Uncategorized

by Sonal R. Patel, M.D., M.S.


’Tis the season for Christmas trees, poinsettias, mistletoe, and scented candles. But if your nose looks like Rudolph’s, it’s a little hard to feel jolly. Although allergies typically peak in the spring and fall, the holidays may surprise sensitive sufferers with a gift of unexpected triggers. Here are some common holiday allergens/triggers, along with some advice to help you stay merry and healthy—rather than sneezing, coughing, and scratching—during the holiday season.


  1. Trigger: Christmas Trees

Mold is the biggest problem with live Christmas trees. Often, they are cut in advance and kept in humid environments, promoting mold spore growth. Within just two weeks of bringing a tree into your home, indoor mold counts can increase significantly, according to one study.

The sap contains terpene and other substances that can irritate skin and mucous membranes; plus, pollen stuck to the tree may be released inside and lead to reactions. Given this, you might think an artificial version is better, but they could harbor dust and mold from their time in storage, also triggering allergies.

Precautions: Slip on gloves and wear long sleeves when handling your fresh tree to avoid the sap coming into contact with your skin. Before schlepping your tree inside, give it a good shake (or a blast with a leaf blower) and spray it down with a garden hose (especially the trunk) to help remove some of the pollen and mold. Then sit the stump in a bucket of water and let the tree dry for a few days on a covered porch or in a garage. For an artificial tree, give it a good wipe-down before decorating with lights and ornaments. Follow the package directions carefully when spraying artificial snow or flocking. Inhaling these sprays can irritate your lungs and trigger asthma symptoms (in my opinion, it’s better to avoid these products altogether).


  1. Trigger: Foods

The most common food allergens are milk, eggs, soy, fish, shellfish, peanuts, tree nuts, and wheat. Of those, peanuts and tree nuts will most often make it into holiday dishes without people knowing, and they have the potential to cause severe reactions.

Precautions: It’s a good idea to let your holiday host know about your food allergies; it’s important to ask about the ingredients in each dish; and it’s very nice to volunteer to bring something that’s safe for you and shareable with others. But what’s crucial is to be prepared with an epinephrine auto-injector (EpiPen), an emergency dose of antihistamine, and an inhaler if you have asthma. Learn which foods and recipes are unexpected sources of allergens at FoodAllergy.org and AAAAI.org.


  1. Trigger: Cocktails (Sulfites)

You raise a glass to your loved ones, your boss and colleagues, friends and neighbors, and even the strangers sitting next to you at a bar. There’s lots of celebrating at this time of year, but be mindful of what you’re using to toast. Some people may experience mild wheezing or other symptoms from the sulfites in wine, for example, and certain alcoholic beverages contain major food allergens.

Precautions: There aren’t good tests for sulfite sensitivity, but your reaction to dried fruit—high in this sulfur-based preservative—could be an indicator. Pay attention if you have asthma, as sulfites can trigger symptoms. Maraschino cherries contain small amounts of sulfites as well. Stick with organic wine for a sulfite-free sip. Other triggers to be aware of: Tree nuts may be found in specialty beers, particularly seasonal ales; milk is in Irish cream and white chocolate liqueurs; and egg whites may be used to add froth to specialty drinks.


  1. Trigger: Travel

Staying in a hotel for the holidays may be wonderful, but not if you have allergies. Pillows and bedding can harbor a lot of dust mites. You may have difficulties with some of the detergents they use as well. If you will be staying with family, their pets may trigger your symptoms.

Precautions: Consider bringing your own pillow, or at least a dust mite cover for the pillow you’ll be using. Also make sure you get a nonsmoking room. If you’re allergic to your family’s pet, take your medicines with you. If possible, avoid petting the animal, and wash your hands after direct contact.


Other Holiday Triggers

Stress: Be aware that stress can lead to asthma attacks. Chemicals released by the body during stressful times can cause the muscles around your airways to tighten, making it difficult to breathe.

  • Poinsettias: This festive plant is a member of the rubber tree family and contains compounds similar to those found in latex, so stay away if you have a latex allergy. Certain groups of people—such as healthcare workers and people with spina bifida who have had numerous surgeries—are more likely to be allergic to latex. One study showed that 40 percent of latex-allergic individuals were also allergic to poinsettias.


The key is to be prepared and plan ahead. Consult with your doctor in advance.


Building Resilience in the Face of Tragedy

October 24, 2017 by  
Filed under Uncategorized

by Monica Lee, MD


Being told by a neurologist that your son has Autism Spectrum Disorder is more than hard; it is absolutely devastating. Dreams of grandchildren and attending his class of 2034 graduation at my alma mater no longer seemed reachable. The diagnosis was made when he was 2 1/2 years old. At the time, we didn’t really know what it meant. I also didn’t have time to deal with my feelings then. As a doctor, I’m trained to just “deal with it” no matter how tough a situation gets. I also had other personal and professional issues taking up my mental bandwidth at the time. We ended up getting two more consults, one from a psychologist at the Regional Center and one from another neurologist.


I never dealt with the grief process, and as a result, I ended up in a therapist’s office three years later. I was told I have been persistently grieving and letting the diagnosis permeate other aspects of my life. It was decreasing my confidence in areas where I used to have the utmost confidence. Apparently, I held on to feelings of guilt and inferiority from having a son with autism and somehow felt apologetic for it all the time. It wasn’t until I started to feel more compassion toward myself and to divest myself of fault that I started to feel better.


Sheryl Sandberg’s book Option B has helped me understand this as she writes about grieving for her husband, who passed away unexpectedly in his midforties, leaving her with two young children. She talks about avoiding the 3 Ps of grief:

  1. Personalization: the belief that we are at fault
  2. Pervasiveness: the belief that an event will affect all areas of our life
  3. Permanence: the belief that the aftershocks of the event will last forever

We build resilience by avoiding the 3 Ps. She says, “Resilience comes from deep within us and from support outside us. It comes from gratitude for what’s good in our lives and from leaning into the suck.…We all live some form of Option B.” We have all been affected by some sort of loss or tragedy: cancer, job loss, divorce, the death of a loved one. The question is how we can make the best of it. The quote of hers that I found most profound and that I think of almost every day is: “Option A is not available, so let’s kick the shit out of Option B.”


And so we are persisting, getting our son the best ABA (Applied Behavior Analysis) therapy we can find and mainstreaming him in school with a one-on-one aide whom we fought hard for during the IEP. We have worked with the school system, advocates, ABA therapists, and speech therapists for the best possible situation to meet our son’s needs. I am dialing back on work to be more mentally and physically present for him. Most of all, I am starting to believe it is not my fault, it will not affect all areas of my life, and I will not be grieving forever. I have learned to be grateful for every milestone he makes, every smile and giggle, every kiss and hug. To quote Cheryl Strayed, “You don’t have a right to the cards you believe you should have been dealt. You have an obligation to play the hell out of the ones you’re holding.”


about the author: Monica Lee, MD, is a mom of one son and an ob-gyn in the LA metro area.

Applied Behavior Analysis

September 20, 2017 by  
Filed under Uncategorized

by Monica Lee, MD


“Point to red” is a common refrain I hear daily. My son says it out of the blue several times a day. He is probably thinking about one of his Applied Behavior Analysis (ABA) therapy sessions he gets at home six times a week. A therapist will sit with him at the dining room table and repeatedly ask him to point to red and reward him with a treat when he does. They will continue this until he masters the task at 80 percent in two consecutive sessions. Ever since he started 15 hours or more of therapy a week, he has been making huge improvements each month. I kick myself for not starting this therapy sooner. His Behavior Interventionists (BIs) work tirelessly with him every day to help improve his joint attention, speech, and social skills. ABA is a growing field where there are just not enough workers to fill the need. BIs are entry-level workers who receive several weeks of training and then usually independently work with children with autism. They get paid just above minimum wage and are subject to often rough treatment from their subjects, who often kick, bite, and scratch when frustrated.

I have no excuse for not starting ABA that first year after my son was diagnosed. I was still in shock and too depressed to read anything educational. I couldn’t even get through the Regional Center’s parent training program. Because of his declining skills, we tried speech therapy right around the time he was two years old. He made no progress after a month of weekly sessions there. And all the speech therapist could say to us was how much he was likely to have autism. A few months after that, we started ABA for three hours a week; it was not enough. We wanted to keep him at the same day care since we had such a difficult time getting him child care, but the day care declined to let an ABA therapist work with him there.

Finally, I moved and we needed different child care anyway. We tried a neurotypical preschool, but he didn’t do well there, so we finally had to get a nanny. That is when he really started to improve. We were then able to get at least 15 hours of ABA a week in a consistent and peaceful environment. He was finally potty trained when he was five and a half, and he even started answering questions with “yes” and “no,” which was something I never thought he would be able to do. He is now able to name relatives in photos. We also found an amazing speech therapist who works with him twice a week. And just two days ago, he finally greeted me excitedly at the door with, “Mommy, Mommy, Mommy.” This was something he had never done before and hasn’t replicated since, but it gives me so much hope. He is almost six years old, and I hope with the help of ABA and speech therapy, this will be the year he will start calling me “Mommy” consistently.

Here are some tips if you suspect your child might have autism:

  1. Get a diagnosis from your pediatrician, pediatric neurologist, developmental pediatrician, or psychologist ASAP.
  2. Have your pediatrician then refer your child for ABA therapy, speech therapy, and occupational therapy. Most health insurance carriers in California will cover this. If not, switch to one that does or move to a state that does.
  3. If you live in California, your Regional Center will cover costs for therapy not covered by your insurance carrier.
  4. During a child’s first five years, his or her brain is most “plastic,” or flexible and able to change and make neural connections based on what the child experiences. This means that the earlier an autistic child receives therapy and the more hours of therapy he or she receives, the more likely you will see progress. Studies show that if children get 40 hours or more of early therapy for two or more years, they have a much higher chance of having a normal IQ.*

About the Author: Monica Lee, MD, is a mom of one son and an ob-gyn in the LA Metro area.

*Lovaas OI, “Behavioral Treatment and Normal Educational and Intellectual Functioning in Young Autistic Children,” Journal of Consulting and Clinical Psychology 55, no. 1 (Feb 1987): 3–9.

Breast or Formula? Do I really have to choose?

September 14, 2017 by  
Filed under R.McAllister

by Rallie McAllister, MD, MPH

Life is like a giant flow chart. Every minute of every day, you’re making decisions, whether you realize it or not – surprisingly it adds up to about 35,000 decisions a day!

Bath or shower?

Turn left or right?

Chicken or fish?

There are some things in life we feel so strongly about, we make a choice once and that’s it. For example, many decades ago you probably decided if you were a Republican or a Democrat, and you probably haven’t looked back.

Fortunately, other choices in life aren’t so definite. For example, no one minds if you bag your groceries in paper one day and use plastic the next.

In parenting, some moms feel tremendous pressure to choose between breastfeeding or formula feeding. My experience is a great example of how this doesn’t have to be a defining moment. It doesn’t have to be a limiting choice. It’s perfectly fine—better even—to choose both.

I got the best of both worlds by breastfeeding and formula feeding with all three of my sons, and I would not change that experience for the world! For all three of my kids, I started nursing. But early on, I supplemented with formula. I found this to be beneficial for two main reasons.

One, my husband could also feed our babies. This was incredibly valuable for me, and it was also a very positive experience for him and for our sons. And I’m not alone, in fact, 35 percent of moms chose to feed their baby with infant formula so they could share the feeding responsibilities for baby with their partner, per a survey conducted by Perrigo Nutritionals, the makers of store brand infant formula.

Two, adding formula helped me to transition back to work. Before my sons were born, I had bought a breast pump, and I worried a lot about how I was going to pump at work. Turns out I didn’t anticipate everything I could have. The first day I returned to work, I pumped—in the teeny supply closet they offered me. I put my pumped milk in a sealed container in the office refrigerator.

Imagine my surprise when the office administrator told me I had to move it to the biohazard refrigerator instead because milk was a body fluid. She wanted me to put my baby’s milk in with the throat cultures and stool samples!

I found that supplementing with formula meant that I no longer had to pump at work. That convenience factor helped simplify one aspect of my otherwise chaotic life. For many working moms, “convenience” is the number one factor for choosing to feed baby with infant formula. I nursed my sons at home before and after work, and then they drank formula during the day.

This flexibility helped me, and it also helped my babies as well. My sons thrived on the seamless combo of breastfeeding and formula feeding.

If you decide to combo feed and you receive formula samples at the hospital, rest easy knowing that you can switch from the nationally advertised brand to a less expensive, nutritionally comparable store brand formula when you return home with baby.  In fact, a clinical study by University of Virginia researchers found that switching from one brand of formula to another is safe and well tolerated in infants.

In the study, babies who switched from a big-name milk-based formula to a store brand milk-based formula didn’t experience an increase in spit up, burping, gas, crying or irritability compared to babies who stayed with the advertised brand. No matter what you decide – breastfeeding, formula feeding, or supplementing with formula – please know that all three or a combination of these options will support your baby’s healthy growth and development.


About the author: Rallie McAllister, MD, MPH, is a family physician and mom of three sons in Lexington, KY. She’s the co-author of the Mommy MD Guides books, including The Mommy MD Guide to Your Baby’s First Year.

About the survey: Perrigo Nutritionals, the makers of store brand formula, conducted the survey in February of 2017, among 2,000 nationally representative Americans between the ages of 18 and 65 who currently have a child between the ages of one and three.  Margin of error is +/- 3 percent. To learn more about store brand formula or to discover special promotions or offers, visit storebrandformula.com.

My Top 5 Breastfeeding Essentials

August 30, 2017 by  
Filed under J.Reich

By Jennifer Bright Reich

When I was pregnant with my older son, I was determined to breastfeed. With the confidence one has before children, I didn’t give breastfeeding much thought.  I just figured I would do it, no problem.

Then my son was born.

Within hours of his birth, my fantasies of serenely nursing my baby went out the window. My baby cried a lot, he wanted to nurse all of the time, and it hurt.

It took all of the determination I had to continue, but I’m proud to say I did.  I asked my friends who had nursed their babies and my own mom for advice. I would have done just about anything they suggested to make nursing easier. If someone had told me it would help to nurse my baby while standing on my head, singing “I’m a Yankee Doodle Dandy,” I’d have done it. Willingly.

Fortunately, it didn’t come to that, because I found the following five essentials that made nursing so much easier.

#1: Boppy: A friend gave me a beautiful blue Boppy® nursing pillow with sweet little honeybees on it.  I loved it on sight, and it was the absolute nursing (and sanity) saver. I sat on my sofa or nursing chair, rested the Boppy® pillow on my lap, and then put my baby on the pillow. We were both so much more comfortable in that position. My boys are 12 and 10, and I still have this pillow! Visit www.boppy.com for more information.

#2: Glider rocker: Before my son was born, I bought a glider rocker with ottoman. I “test sat” quite a few chairs before buying this one. I chose it because it was extremely comfortable and quiet.

#3: Nursing bras: I’m not well endowed, so I was actually not going to buy nursing bras. I didn’t think I would need them.  That idea went out the same window as my nursing fantasies. When you’re nursing, exhausted, and half asleep, the convenience and comfort of a nursing bra are key! ThirdLove just came out with a nursing bra collection as well. Visit www.thirdlove.com for more information.

#4: Nursing pads: Mother’s milk doesn’t switch on—or off—like the light in the fridge. I leaked a lot, and I wore nursing pads in my bras to keep the milk from leaking through, and staining, my clothing.

#5: Palmer’s Cocoa Butter Nursing Cream: For the first few weeks, nursing was painful as both my son and I learned what we were doing. This cream eased the painful, cracked nipples and really saved my nursing hopes. Visit www.palmers.com for more information.

Breastfeeding is one of many things in parenting that seem like they should be easy, but aren’t. But also like so many things in parenting, sticking with breastfeeding—or finding a nursing/formula combo that works for you and your family—offers many rewards to your baby—and you!

About the author: Jennifer Bright Reich is a mom of two sons and co-author of The Mommy MD Guide to Your Baby’s First Year. She lives with her two sons and three cats in Hellertown, PA.

A Promising New Drug for Autism!

August 17, 2017 by  
Filed under Uncategorized

by Monica Lee, MD


When I walk through the door, I am usually greeted by my son sitting next to his therapist. She will prompt him to say, “Hi ___.” He usually ends up saying, “Hi Brenda, please” (his nanny’s name). He is five, almost six. You might find this a bit peculiar, but I am used to it. You see, having a child on the spectrum means you have to be okay with your son never calling you mommy. On the outside, I remain cool and calm since I have no other children and have never been called mommy, so you know, it’s not like I’m really missing anything. Inside, of course, is another matter. I would pay a lot of money to hear my son call me mommy on his own.

Through the years we have heard of many different alternative therapies for autism including GABA, cannabis oil, and Vayarin, but all the studies relating to them were unsubstantiated and the safety could not be proven. So when I heard about suramin, my heart did a little leap and is still pitter-pattering. The article I read was in The Economist, a well-respected journal, and it seems the drug has already been used in the past to help people with African sleeping sickness and river blindness. Researchers reported some amazing results in the autistic boys taking the drug, including one boy speaking a full sentence for the first time in 12 years! Another boy, who is five years old, started smiling and actually said to his mom, “I just don’t know why I’m so happy.” And on top of that, it has been shown to be effective in a small randomized controlled trial, the gold standard of clinical trials! After reading the article, I immediately sent it to different friends who might be interested in such developments, aka other MD parents of kids on the spectrum, and they were as excited as I was. My son’s dad was just as excited and wanted him to try it right away.

Being the doctor that I am, I delved deeper into suramin and found out that the research is being conducted at UC San Diego, which is within driving distance of Los Angeles, where we live! However, when I looked up the trial in the database at ClinicalTrials.gov, I learned that the lead researcher, Dr. Robert Naviaux, is not recruiting at this time for new subjects. Wikipedia says I can potentially get the drug from the CDC (Centers for Disease Control and Prevention), but this gives me pause because the drug needs to be given intravenously and also I wouldn’t want to dose the medicine and monitor my son myself. This whole journey has made me wonder how far I will go to see my son act normally. How amazing is this idea of hope based on a single article I read online. Now I will be sitting at the edge of my seat waiting for larger phase 3 clinical trials of this drug to demonstrate safety and efficacy.

Here are some tips if you start getting excited about a potential treatment for your child:
1. Consult first with your pediatrician. The doctor may have first-hand knowledge and access to many more databases and sources of information than you do.
2. Make sure that the treatment is safe. Confirm that it is FDA approved and has gone through phase 3 clinical trials at least or has been used for other purposes and safety has been demonstrated.
3. Call into question the sources proclaiming efficacy of the herb, treatment, or remedy. Does the source tend to gain financially if you buy what they’re advocating? Is it government regulated? Does the source have a good reputation or is it nonprofit?
4. Check ClinicalTrials.gov to see what trials are being conducted in your area and if they are recruiting new subjects.
5. Remember that we all want to see our children get better, and we want to keep them safe too!

About the author:  Monica Lee, MD, is a mom of one son and an ob-gyn in the LA metro area.

How the Movie Buck Changed Me as a Parent

July 31, 2017 by  
Filed under Uncategorized

by Monica Lee, MD

I get really frustrated with my son. He is five and has autism, and it has been really difficult for the last three years. He was diagnosed when he was two years old when he started to lose words. A friend noticed and sent us a long e-mail about how he needed to be tested. At first we were taken aback, but we knew she was right. It took us several months to make sure he didn’t have hearing problems. We got him ear tubes and sedated him for a complicated hearing test. Then we had him see a neurologist and a psychologist. But we still couldn’t believe our son had autism. So nine months after the first diagnosis, we finally saw a more “traditional” pediatric neurologist than the first “maverick” one and got basically the same diagnosis.

At least that helped explain why he never asked for anything with words, but would pull our hands to what he wanted. But what hurt the most was when he was stubborn and didn’t want to do something that we thought was necessary, like brush his teeth or get into his car seat when we had to go somewhere. He didn’t have the words to tell us why. When he was younger, we just kind of made him do our bidding. I remember when we would have to hold him still to brush his teeth. Or the time when, unbeknownst to us, he put a piece of foam in his ear and, weeks later, I could smell something rotting. We had to straitjacket him for the doctor to remove it.

A friend made me watch a movie one day, and it changed my perspective on getting the behaviors I wanted. The movie was Buck. It is a documentary based on the real-life horse whisperer. It is about a man who was severely abused as a child and who used that knowledge to help people train horses. He uses only gentle persuasion and never a hard hand. He gently tugs the reins to help guide the horse to his bidding. Anytime he sees a violent and fearful horse, he recognizes that the horse has been abused. The friend who showed me the movie is a golf instructor, and he uses the same principles as a guide in his life and with his clients on a daily basis. After watching this film two years ago, I have let go of my frustrations and tried to use only gentleness and reasoning when dealing with my son. I think it has brought us closer together. Now when I want him to do something, I whisper gently in his ear and am patient if he doesn’t want to do things the first, second, or third time I ask him. The trick is to make him understand that it won’t hurt, and that it is good for him and might actually be fun. He is less frustrated, and so am I.

My son now gets intensive applied behavioral analysis therapy six days a week, and he is showing improvement on his monthly evaluations. The therapists use the same positive reinforcement principles I’ve learned to guide behavior changes because science shows that they produce longer-lasting change than negative reinforcement does.

I think that this principle of positive reinforcement can be used to improve any child’s behavior, including those without learning or behavioral challenges. Some ideas of positive reinforcement include:

  1. Giving a reward for A’s on a report card.
  2. A hug and a kiss for any kind act they might perform, such as sharing toys.
  3. Taking a child to a homeless shelter to give to those in need so that they understand the intrinsic feeling of good that comes from charitable giving.
  4. A monetary reward for chores they might do around the house.

There are so many ways, can you think of others?

About the Author: Monica Lee, MD, is a mom to a 5-year-old son and ob-gyn practicing in the LA Metro area.



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