With the holidays fast approaching and a brand new year just around the corner, now is as good a time as any to get your household on a healthy track.

Eat healthy this during the holidays without missing out.

We understand that holiday traditions are important, and that there are certain not-so-healthy dishes you and your family simply can’t live without. Good news, you don’t have to. There are many ways you can have your festive cake and eat it too. For instance, here are some helpful tips from the Mayo Clinic on how to modify traditional recipes with healthy ingredients. You can also pack in additional vitamins and nutrients by sneaking in pureed vegetables. Click here to learn how.

Another great way to ensure that you and your family stay holiday healthy is to choose organic fruits and vegetables for every dish you make. Also, if you can, make sure the meat you buy comes from an organic farm. As we covered previously, organic farming methods can make all the difference to you and your child’s health.

If you’re in the mood to start new healthy holiday traditions, check out this collection of delicious organic food recipes from Organic Authority.

Make your 2012 resolution a healthy one.

Don’t let leave these tips behind–bring them with you into the New Year! Resolve to make more informed choices about what your child eats, and create a healthy household by making organic meals at home. After all, establishing a nutritious diet early on will set your child up for a lifetime of healthy eating for many New Years to come.

From all of us at Getzwell Pediatrics, we wish you a happy and healthy holiday season!

Please call us at 415.826.1701 to discuss how to improve your family’s health through eating healthy and other preventive strategies we specialize in.

We’re all familiar with the old adage ‘you are what you eat’. Well, that’s not all. New studies shed light on just how influenced your baby is by what you eat, too!

This fascinating article from NPR reveals exciting research about how what you eat during your pregnancy can help shape your baby’s taste buds and flavor preferences.

According to Julie Mennella from the Monell Chemical Senses Center, your baby consumes several ounces of amniotic fluid a day, which is flavored by the foods and beverages you ingest. She notes that at about 21 weeks, your baby can actually taste these flavors!

Garlic, vanilla, carrot, anise, and mint are just few examples of the endless flavors your baby can experience in utero.

Expand your baby’s palette before their first bite.

Not only does your baby directly benefit from the nutrients you consume, these studies also indicate that babies develop memories of the flavors they are exposed to prenatally.

As a result, babies whose mothers consume varieties of spices and herbs are likely to prefer these foods and flavors from very early ages. Developing a sophisticated palette before birth can really help set the stage for lifelong healthy eating habits.

The proof really is in the pudding.

We cannot stress enough how important a nutritious diet is to your baby’s overall health. Exposing your child to fresh produce and tasty spices before and after birth really is the first step in preventive health.

To learn more about this topic, check out our previous post on what more you can do to arm your child with a lifetime of healthy eating habits. Additionally, our greening the womb series points out the importance of healthy eating during pregnancy and how it influences your child’s life-long health.

Give us a call and let us help you choose a nutritional plan that’s fit for you and your little one– 415.826.1701.

“Eat your vegetables!” — a classic, and common plea from desperate parents to kids with turned up noses. And yet many could argue that our hectic lifestyles and the convenience of packaged foods have quieted this age-old battle.

But just how important are fresh fruits and vegetables for your child? The answer is clear and simple: CRITICALLY.

The link between diet and health is undeniable. According to this recent New York Times article, many life-threatening diseases scarily prevalent today – heart disease, Type 2 diabetes, and certain cancers — are entirely preventable, even reversible, with a healthy diet and exercise. Take this alarming statistic, for instance, nearly 90 percent of heart disease is lifestyle related. 90 percent!

Preventing disease is all the more reason to ensure your child eats a healthy diet, and much to your surprise, doing so doesn’t have to be an uphill battle.

Help your child develop a healthy palate from the get-go.

Did you know that introducing fresh fruits and vegetables into your baby’s diet can set him/her up with good eating habits in the future? New research from the De Montfort University has revealed that babies who start on solids of fresh home-cooked meals are more likely to consume more fruits and vegetables throughout childhood than those regularly fed packaged baby food.

As the article indicates, there is growing concern that the prevalence of pre-packaged products has interfered with children getting their recommended vegetable servings. These foods are not as rich in vitamins and nutrients, nor are they as flavorful as freshly prepared dishes.

Such is why early exposure to a variety of fresh fruits and veggies is important to your child’s health–they stand a greater chance of forming a sophisticated taste for healthier foods—which in turn can lead to healthy habits and disease prevention.

How can you get more veggies into your veggie-resistant child?

There are fun and creative ways to ensure your veggie-cautious child is getting his or her daily dose of fruits and veggies. A recent study with preschoolers revealed that with the help of a food processor, you can easily fortify some of your child’s favorite dishes with vitamins and nutrients by mixing servings of pureed vegetables. A carrot here, a cauliflower there –they’re none the wiser and you can rest easy.

What else can you do to keep your child on a healthy regimen? Eat your vegetables! Children learn by example and they’re usually interested in whatever you’re having. Taking the time to make home-cooked meals can really make all the difference for you and your family. Promoting healthy eating will grant them the greatest gift of all—lasting health.

Want to learn more about building and maintaining healthy eating habits? Give us a call and we’ll provide custom nutrition counseling for you and your baby – 415.826.1701.

What is it about breast milk that provides such a boost to babies’ health?  Researchers are still working to answer this question.  We know that newborns take approximately 6 months to develop their immune system, making them incredibly vulnerable to disease.  During the first 10 days of life, a breastfed newborn ingests colostrum, a yellowish fluid known as “first milk,” and breast milk, both of which contain more infection-fighting white cells (also known as leukocytes) per milliliter than there are in the same volume of blood.  Macrophages and neutrophils are types of white blood cells that comprise approximately 90% of the leukocytic load, and their job is to engulf and absorb harmful bacteria.  The remaining 10% of these disease-fighting cells are lymphocytes, primarily T-cells and B-cells, which identify and eliminate invaders while developing antibodies in the newborn.  These lymphocytes produce Secretory IgA, which protect the newborn against environmental exposures and interferon, an antiviral substance.  Mother’s immunoglobulins (IgA, IgG, IgM and IgD) are also found in breast milk, and they protect babies from pathogens by coating the superficial layers of the intestines and other mucosal surfaces that serve as points of entry into baby’s body.²

Gut ecology is of special interest to those in the field of functional pediatrics because a healthy gut is typically indicative of over all health.  Research has shown that approximately 75-80% of immune function originates in the gastrointestinal tract.  Breastfed babies receive beneficial bacteria from the bifidus family that produce Gram-positive bacilli in the gut flora and discourage the multiplication of pathogens.  In contrast, babies who consume cow’s milk formula develop Gram-negative (potentially pathogenic) bacilli.  We know that complex sugars in breast milk help to feed the bifidus strains of beneficial bacteria in the infant’s gut.  Just last year researchers at UC Davis revealed that these same complex sugars are not digestible and mimic the surfaces of other cells.  This surface similarity encourages viruses and bacteria to dock with the indigestible complex sugars and not the infant’s gut cells, and this allows babies to flush out viruses and bacteria from their bodies!³

Breast milk has had approximately 200 million years of mammalian evolution to develop systems to protect the most vulnerable members of the species.  GetzWell Pediatrics supports the Surgeon General’s initiative and acknowledges that whenever possible “breast is best.”  We are a Breastfeeding Friendly Business and have a host of resources available to support breastfeeding mothers.  If families are unable to breastfeed, we are also prepared to provide individualized supplement programs to best protect their children.

To learn more about the benefits of breast milk and/or breastfeeding alternatives, give us a call at 415.826.1701. We also invite you to check out our previous post on how breastfeeding reduces risk of fever after vaccines.

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¹ http://www.surgeongeneral.gov/topics/breastfeeding/calltoactiontosupportbreastfeeding.pdf

² Varney, Helen, et al.  Varney’s Midwifery: Fourth Edition.  Jones and Bartlett Publishers, Inc.  2004.

³ Wade, Nicholas.  “Breast Milk Sugars Give Infants a Protective Coat.”  New York Times.  August 2, 2010.

Barker, D.J.P. “Fetal Origins of Coronary Heart Disease.” http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2550226/pdf/bmj00601-0037.pdf

Giscombe, C. L. & Lobel, M. (2005). Explaining disproportionately high rates of adverse birth outcomes among African-Americans: The impact of stress, racism, and related factors in pregnancy. Psychological Bulletin, 131(5), 662-683. Retrieved from PubMed database.

Glynn, L. M., Hobel, C. J., Sandman, C. A., Schetter, C. D. (2008). Pattern of perceived stress and anxiety in pregnancy predicts preterm birth. Health Psychology, 27(1), 43-51. Retrieved from PubMed database.

PVC shower curtains:  http://www.chej.org/showercurtainreport/documents/VV%20national%20final.pdf

Paul, Anne Murphy.  Origins: How the Nine Months Before Birth Shape the Rest of Our Lives. www.anniemurphypaul.com/

Steingraber, Sandra.  Having Faith, An Ecologist’s Journey To Motherhood. www.steingraber.com

Center for Environmental Health: www.ceh.org

Making Our Milk Safe: www.safemilk.org

Campaign for Safe Cosmetics: www.safecosmetics.org

Physicians for Social Responsibility[SF chapter]: www.sfbaypsr.org

Breast Cancer Fund: www.breastcancerfund.org

Pesticide Action Network: www.panna.org

Childbirth Connection: www.childbirthconnection.org

Children’s Environmental Health Network: www.cehn.org

Coalition for Improving Maternity Services: www.motherfriendly.org

Collaborative on Health and the Environment: www.healthandenvironment.org

TEDx The Endocrine Disruption Exchange: www.endocrinedisruption.com

Environmental Working Group: www.ewg.org

Healthy Child Healthy World: www.healthychild.org

Natural Resources Defense Council: www.nrdc.org/breastmilk

Science and Environmental Health Network: www.sehn.org

Sandra Steingraber: www.steingraber.com

UCSF Report: Shaping Our Legacy: www.prhe.ucsf.edu/prhe/pubs/shapingourlegacy.pdf

Women to Women Discussion on Endocrine Disruptors: www.womentowomen.com/detoxification/endocrinedisruptors.aspx

Washington Toxics Coalition’s Early Exposure Study: www.watoxics.org/publications/earliest-exposures

Dr. Mark Hyman: www.drhyman.com

Institute for Functional Medicine: www.functionalmedicine.org

** A special thanks to EcoBirth for helping to compile resource links! **

For those who have been following GetzWell’s Facebook posts, you know we have been delving more deeply into how human health is inextricably linked to the health of our food supply and the sustainability of our planet.  As Dr. Hyman tells us, “The ecology of eating — the importance of what you put on your fork — has never been more critical to our survival as a nation or as a species.”  I couldn’t agree more.

Let’s harness the power of our forks and “vote” by purchasing local, sustainable and organic food whenever possible.  The “extraordinary thing is that we have the ability to move large corporations and create social change by our collective choices,” says Dr. Hyman.

In Health,

Julia Getzelman, MD

Over the last fifty years, increasing numbers of children in the US and other developed countries have been diagnosed with asthma, diabetes, obesity, autism and many other health conditions that were once rare in children.  The typical medical explanation for this trend has been that our genetic make up, lifestyle choices and environmental exposures after we are born are the principal contributors.  However, recent research provides significant evidence that the intrauterine milieu and our 9 months of fetal life play a vital role in determining an individual’s lifelong health.

Recognizing the impact of this research and the importance of the fetal environment, many parents-to-be want to know what steps they can take during pregnancy to optimize both the physical and emotional well being of their baby.

Studies have demonstrated the “power of your plate” in pregnancy, emphasizing the importance of prenatal nutrition.  For example, women who gain excessive weight during pregnancy tend to have heavier toddlers, and lower birth weight babies have an increased risk of diabetes in adulthood.(2)  In addition, exposure to pesticides, antibiotics and hormones (used to grow animal and plant foods), and bisphenol-A (from canned foods) may disrupt the developing endocrine and immune systems of babies.

A recent study involving public health data derived from more than 650,000 children born in California from 1992 – 2002 suggests that the closer two siblings are born together, the higher the risk for autism in the second child.  The data showed that siblings born fewer than 12 months after the first child are much more likely to develop autism compared to those born 25 or more months after the first baby.(3)  A likely explanation is maternal nutrition and fatty acid deficiencies as a result of the first pregnancy.

Scientists are also exploring the possibility that conditions in utero not only impact the physical health of the fetus but also emotional and mental well being.  Catherine Monk, professor of psychiatry at Columbia University, reports that even before birth a mother’s moods may affect her child’s development.  There are measurable signs of stress in the fetuses of women who are depressed or anxious during pregnancy.  In addition, there have been increased rates of premature delivery and low birth weight among babies born to depressed women, suggesting there are links between a mother’s mood and an infant’s sensitivity to stress, and perhaps even temperament, after birth.(4)

Unfortunately, environmental toxins play a significant role in fetal development in today’s world.  As an example, on a daily basis most of us are exposed to polycyclic aromatic hydrocarbons (PAHs), pollutants that come from burning fossil fuels, among other things.  Pregnant women pass this chemical to their developing babies, and significant DNA damage due to PAHs has been found in the cord blood of newborns.  PAH pollution during pregnancy is also linked to adverse birth outcomes including low birth weight, premature delivery, and heart malformations.

Although there are many things as we cannot control about our environment, we can and must take proactive steps to reduce toxic exposures, eat wisely and minimize stress during pregnancy.  See Greening the Womb Intro for practical steps you can take to make a difference in your baby’s health.  Additionally, Dr. Getzelman offers prenatal nutrition and greening the womb consultations for pregnant women and couples who want to become pregnant.  Please contact us at GetzWell for additional information and to make an appointment: 415.826.1701 or reception@getzwell.com.

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1. Paul, Annie Murphy. “Time” 4 October 2010: 50-55.

2. Paul, Annie Murphy. “Time” 4 October 2010: 50-55.

3. Cheslack-Postava K. Pediatrics. 2011; doi:10.1542/peds.2010-2371.

4. Paul, Annie Murphy. “Time” 4 October 2010: 50-55.

• Colds are caused by viral infections of the nose and throat.
• The average healthy child will experience between 6-10 colds a year.
• While colds are not serious, about 5-10 % of children will develop a bacterial complication (e.g. ear infection).

Typical Cold Symptoms

• Runny or congested nose—it’s okay for mucus to be clear, cloudy, yellow or even green!
• Fever of 100° F or greater that lasts for up to three days (72 hours)
• Sore throat or hoarseness
• Red, watery eyes
• Coughs that last up to three weeks

From Cold to Worse (When symptoms require a trip to GetzWell)

• Earache or discharge from the ear
• Fever that lasts more than three days
• Fever that went away for 24 hours and then returns
• Sore throat that lasts more than five days
• Coughs that last more than three weeks or a worsening cough
• Respiratory distress or wheezing

Treatment and Immune Support

• Comfort measures
  • Humidity—Try a cool-mist humidifier in the room and nasal saline drops to help moisten mucus membranes.  Suctioning mucus with a “nose frida” is often helpful.
  • Elevate the head while sleeping to reduce post-nasal drip stimulated coughs.  Fold blankets or towels under the crib mattress to elevate.
  • Increase fluids to help reduce congestion and prevent dehydration (milk counts too as it’s NOT linked to increased phlegm production).
• Immune Boosting Products and Treatments
  • Oscillococcinum: A homeopathic remedy that can safely be used at any age at both onset of cold symptoms and as weekly prevention during cold season.
  • Cold Calm: Another homeopathic medication that can be used at onset of cold symptoms at any age.
  • Echinacea/Eyebright: An herbal tincture that can be given daily during cold and flu season as a daily immune system booster.
  • Echinacea/Astragalus: An herbal tincture that can be given at the onset of a cold for deep immune support.
  • Probiotics: A daily supplement that helps to boost both the innate and acquired immune responses.
  • Chestal: A homeopathic cough medication that can be used to reduce cough (contains honey and shouldn’t be given to children less than one year due to risk of botulism).
  • Honey: A simple natural product found to be effective at suppressing cough (not for infants under one due to botulism).
• Over-the-Counter Products
  • There are NO cold and cough formulations approved by the FDA for use in children under four years old and in general they are ineffective at curing the common cold.
  • Ibuprofen can be given to reduce fever.  Please contact us for correct dosing as dosage should be based on a child’s weight, not age.

A: My goal in counseling parents about solids is to emphasize healthy eating and to teach them how to positively shape their child’s taste preferences. A growing body of research shows that babies’ palates are influenced before birth. Maturing in the “amniotic soup” infants taste the foods their mothers eat. This process of “sampling” foods continues for breast-fed children, as mother’s milk takes on the flavors of what she consumes.

While processed rice cereal is a common first food, it has limited nutrients and can be constipating. Minimally manipulated and tasty whole foods such as fresh vegetables, fruits, eggs, and meats are superior. A variety of organic and richly colored foods tastes better and ensures more nutrients, antioxidants and fewer toxins. Exposing children to variety early on will encourage interest, acceptance and openness to trying new foods and flavors.

Feeding your baby can be a fun process of introducing the many different flavors and textures of whole foods. You can gradually add seasoning with herbs and spices, garlic or onion.  Our little ones love tasty food as much as we do!

Q: Shouldn’t I only give one new food every 5^th day?

A: The rule of “one new food every 5^th day” has not resulted in fewer allergies in kids. While the American Academy of Pediatrics says not to limit any first foods, this conflicts with the advice most pediatricians give. In fact, emerging research suggests that introducing more variety from the get-go results in babies liking more things. Don’t be discouraged if your baby makes faces or seems not to like something on the first try. Sometimes kids need to be exposed to a certain flavor 15 to 20 times before liking it! Stay the course, continue to offer the same food (perhaps prepared a little differently) every few days, and your patience will pay off.

Q: My two-year-old is a terrible eater. I’m afraid I cave in to his bad habits by giving him things like bananas, crackers and pasta. How do I change?

A:  It’s our job as parents to provide nourishment so our child grows and thrives. Because we fear our child may “go hungry” when he won’t eat what we’ve offered, we risk giving in to the notion that allowing something highly processed–and usually white–is better than nothing at all.

Healthy children don’t starve themselves. If they eat less one day, they typically consume more the next. Providing consistent limits and structure, even with foods and meals, helps your child feel safe and secure. While it will require a lot of patience and conviction up front, this approach will be better for everyone in the long run.

Gather as a family for dinner and model enjoyment of the food you’ve cooked. Take your child to the grocery store or farmers’ market and invite him to participate in the selection of ingredients. Sticking to the periphery of the store and avoiding the center aisles will ensure exposure to whole, fresh food rather than packaged/processed stuff. At home, involving your kids in meal preparation can be a fun and new way of engaging them with food.

Wean yourself off the “fallback” snacks and foods. If your child refuses a food you offer, require him to take a single bite. If he decides not to eat what you’ve cooked for dinner, that’s OK. Remind him that he’ll be extra hungry for breakfast and let him know what his morning food options will be (e.g. eggs prepared just the way he likes them, whole cooked oats with a little maple syrup, almond butter and cinnamon, fresh fruit and plain yogurt, or a healthy smoothie).

A picky eater’s behavior won’t change overnight, but you may be surprised by what happens if you set some ground rules, consistently stick with them and involve your child more in the kitchen.

Author: Julia Getzelman, MD

In the traditional model, insurance companies set prices for physician services that encourage a rapid turnover, high volume practice. An insurer might set a price for a 5-7 minute visit at $35, for instance, but only pay $50 for 15 minutes or $70 for 30 minutes of care. In order to cover the exorbitant overhead that accompanies an insurance-based practice (including an entire staff of billing specialists and collection agents), physicians must see as many patients per hour as possible to make their practices viable. This turnstile approach has led to a ‘quick fix’ culture in medicine and discourages the development of meaningful relationships between families and their care providers. GetzWell Pediatrics categorically rejects this system as it isn’t the best way to care for kids (or anyone, for that matter).

Moreover, just because GetzWell is fee-for-service does not mean patients cannot use their insurance. In fact, most patients with PPO insurance receive some, often significant, reimbursement (subject to the specific terms of each policy). It is a very easy process to seek reimbursement or credit from insurers following office visits. Each time a patient receives care, GetzWell generates a ‘superbill’ reflecting payment along with a description of services. By simply mailing or faxing the superbill directly to the insurer, most families report they are reimbursed or otherwise credited within 4 weeks (based on the specific terms of their policy).

By remaining ‘out of network,’ GetzWell’s doctors and patients collaborate to make important health care decisions without interference from insurance companies. Insurers are relegated to a still important but secondary role whereby they cover some primary care costs plus emergencies, severe illness and catastrophic matters. As a result, the quality of care at GetzWell is unsurpassed and many unique services are available including:

• Individually tailored care plans to fit the needs and lifestyles of patients by focusing on the underlying causes of illness and health and not merely suppressing symptoms;
• Guidance about safe vaccination and individualized vaccine schedules based on each child’s risk factors and the family’s beliefs and lifestyle;
• 24/7 direct access to GetzWell pediatricians by phone and email;
• More time spent per visit in order to answer questions, get to know parents and children, foster trusting relationships, provide education and discuss options as part of a holistic plan of care (e.g., a typical well child visit lasts 40 – 45 minutes in contrast to about 12 minutes in a traditional pediatric practice);
• Options outside of typical prescription medications including food and lifestyle interventions, homeopathy, supplements, and developmental/emotional advice;
• A combination of Western medicine and complementary and alternative approaches to illnesses or chronic problems that cannot be “fixed” by typical 20^th Century approaches;
• A collaborative team comprised of board certified pediatricians plus an experienced certified lactation consultant, a pediatric nurse practitioner with a specialty in children’s development, and a psychotherapist with a focus on families and mothers (because transitioning to parenthood is one of life’s toughest yet most rewarding challenges!).
• At GetzWell, we love what we do and this is reflected in the warmth with which families are greeted upon entering the office, the undivided attention patients receive at every visit, the unparalleled access  and, most importantly, the result—having a child who is unusually healthy, seldom or never requiring antibiotics or other prescription medications. We value each patient, family and interaction and cherish the opportunity to practice medicine in a way that’s consistent with our deepest principles and beliefs.

GetzWell’s mission is based on the conviction that parents and trained health care professionals, not the insurance companies, should decide how kids are cared for. This is why we are ‘out-of-network.’

Please call us at 415.826.1701 to schedule an appointment. We look forward to meeting you!

GetzWell Pediatrics         1701 Church Street          San Francisco,  CA      94131                www.getzwell.com.

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