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! **

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.

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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