497:Dr. Joel Warsh on Raising Healthy Kids With Integrative Pediatric Care

The Wellness Mama Podcast

497: Dr. Joel Warsh on Integrative Pediatric Care and Combining Western and Alternative Medicine

00:00 / 00:56:43

Today on the podcast, I’m here with Dr. Joel Warsh, a board-certified pediatrician in Los Angeles who specializes in integrative medicine. We talk all about raising healthy kids using integrative pediatric options by combining Western and alternative medicine. One of my favorite quotes from this episode is, “It’s not a doctor’s job to tell people what to do, it’s a doctor’s job to teach people what to do.” And he does a lot of teaching in this interview.

We touch on different aspects of pediatric care and integrative medicine today, including all the hot topics such as what to do about a fever, ways to address things like eczema and allergies, why all childhood illnesses are on the rise, what to do about behavioral issues, why the vast majority of illnesses can be resolved at home, why he rarely prescribes antibiotics, and so much more.

He offers peace of mind for parents about how most childhood illnesses pass quickly on their own and don’t actually need care, but he gives advice on what to do if you encounter one that does require medical attention. So, without further ado, let’s learn from Dr. Joel.

Episode Highlights With Dr. Joel Warsh

Why parents are increasingly frustrated with the current medical system
How working with your pediatrician should be a partnership
The reason illnesses are on the rise, even in children
Difference between conventional care, which treats acute illness, and optimal care
Why diabetes rates in children have doubled in the last two years
His SEEDS of health for kids: Stress, Environment, Exercise, Diet, and Sleep
The number one thing we can do to change our health
Why cooking at home is one of the best health changes you can make
The benefits of working with a team of doctors instead of a single doctor
How often medication is actually necessary vs. the vast majority of illnesses that get resolved without it
Why avoiding antibiotics when they aren’t needed is so important
The reason he almost never prescribes antibiotics and uses them less than 1% of the time
Why a fever isn’t usually a bad thing and what to do about it
Natural ways to tackle a fever or minor illness
Why it’s important to remember that it’s normal for kids to get sick
How Western and alternative medicine are starting to blend together
The three big things that parenting books get wrong about raising healthy children
How kids are more frequently labeled with behavioral concerns now
What the most important thing often missed in medical care
How changing our kids’ diets can improve symptoms and reduce chemical exposure/overload

Resources We Mention

More From Wellness Mama

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Katie: Hello and welcome to the “Wellness Mama,” podcast. I’m Katie from wellnessmama.com and wellnesse.com. That’s wellnesse with an e on the end. And this episode is all about raising healthy kids using integrative pediatric options, basically, combining Western and alternative medicine. And I’m here with Dr. Joel Warsh, who I’m really excited to share with you today. One of my quotes I loved the most from this episode with him is, “It’s not a doctor’s job to tell people what to do, it’s a doctor’s job to teach people what to do.” And he does a lot of that in this interview.

He is a board-certified pediatrician in Los Angeles, who specializes in integrative medicine. And we go into a lot of different aspects of pediatric care integrative medicine today including all the hot topics like, what to do about a fever, ways to address things like eczema and allergies, why all childhood illnesses are on the rise, what to do about behavioral issues, why the vast majority of health can be resolved at home, why he almost never prescribes antibiotics, and so much more.

He gives some really practical advice on this and a lot of peace of mind for parents in knowing that most childhood illnesses pass quickly and on their own and don’t actually need care, but what to do if you encounter one that does. So, without further ado, let’s hear from Dr. Joel. Dr. Joel, welcome. Thanks for being here.

Dr. Joel: Thanks so much for having me.

Katie: Well, I’m excited to chat with you today because, as you would expect with a platform called Wellness Mama, I have a lot of moms listening and get a lot of questions about children’s health and also about parents being frustrated, trying to find good options for their children’s medical care. And we’re gonna definitely go deep on that today. But before we do, I have a note in my show notes that you are on an episode of “House Hunters,” and I would love to hear a little bit about this story.

Dr. Joel: Yeah. So for our last house we moved into, just before we moved in, we applied to “House Hunters,” and we got accepted. Then they said it wasn’t to do with the application, it was just random, but I don’t know. You know, what…because I feel like since we applied they must have put us in the subsystem. But it was super fun. And we had to do…we were working with them every week for a few months, and they were coming in, we did several rooms, we did the kitchen, and it was an amazing experience. Very weird. It’s a lot of work. You would think it’d be like lots and lots of fun. And it was fun, but it was actually a ton of work filming every week and, you know, getting in there and smashing walls and all the fun stuff that you see on TV.

Katie: How fun. Well, that’s…maybe I’ll see you on TV one of these days when I’m watching reruns.

Dr. Joel: Every once in a while, I get somebody who, like, on a plane or just randomly, “Oh, you know, I saw you guys on…” you know, because it’s like those are the shows that rerun all the time.

Katie: Oh, that’s fun. But surprisingly, definitely not what you’re most known for, which is your work with children and children’s health specifically. And I think this is a really important topic in general, but especially right now. I hear from an increasing number of parents who are frustrated or feel like there’s a mismatch between what they want for their children’s medical care and what the system is recommending. And I think there are so many directions we can go today, but I’d love to hear from the physician side, do you feel like parents are frustrated with the current medical system? Are you seeing that on your end as well?

Dr. Joel: Yeah, I think, I mean, I’m definitely seeing that on my end. I think, you know, we’re noticing just a lot of people very frustrated with how the medical system is working these days and just in general with doctors. It’s really unfortunate that so many people are not feeling like they have the right connection with their doctor. And I think it’s so important, especially for a kid. You’re going in so frequently to see your pediatrician, and they should be a part of your family. And when your values don’t align, or you feel like you’re not being listened to, or you feel like you’re not being heard, or your values are being dismissed, I think that’s a big issue. And we definitely get a lot of parents coming to our office, you know, crying in the interview and just so frustrated with their experiences at other offices because they just feel like they haven’t been heard or their opinions are not valued or are not respected, or even just kicked out of offices just because they have a difference of opinion.

And I think that is not the way that medicine should be done. We should be…it should be a partnership, we should be working together. We’re part of that family. And I think our job as a doctor is to teach, and to discuss, and to have conversations, as opposed to imparting our own viewpoints or opinions. I think, you know, we definitely have a lot of training. And so what we’ve learned is definitely helpful, but I don’t think it’s a doctor’s job to tell people what to do, it’s to teach them what to do. You know, obviously in emergency situations, that might be a little bit different, but in general, there’s so many different viewpoints and opinions and reasonable perspectives out there. And we really need to, I feel like, come together and respect each other’s opinions, as opposed to, fostering this division and anger, which seems to be pervasive across social media and just everything that we see these days. And it even is seeping into medical care, which is really sad to me because I don’t…you know, a doctor by nature, the word means is teacher, right? That’s what it comes from docere. And our job is to teach people based on everything that we’ve learned, what the best ways to keep their children healthy are that we feel, but it’s not necessarily to tell them what to do.

Katie: I love that outlook and that idea of teaching versus telling. I think I’ve said many times on here, you know, each of us are our own primary healthcare provider because we’re the ones putting food in our own mouths and exercising or not exercising and making daily lifestyle choices. And that, of course, applies to our children as well. And, like, I definitely, as a mom, take that responsibility. You know, I put a lot of weight in that responsibility of being that partner for my kids in their health as well. And I’ve seen in my own life, you know, the best outcomes seem to happen when you have a knowledgeable provider and also a patient who’s invested in doing the work and who is well researched. And I think often it seems like there can be tension there when there doesn’t necessarily have to be. Like you said, if there can be a partnership and a teaching, then it seems like a great dynamic and a benefit to both parties involved.

And, I know for me, when my oldest son, who’s now 15, when he was born, I read in “Time Magazine” that his generation was gonna be the first in two centuries to have a shorter life expectancy than their parents. And I know you see the stats as well about the rates, everything on the rise right now. We’ve seen the stats in adults going up for a long time. It seems like we’re now seeing this in children as well. So, from the physician side, what’s wrong with the current system? Why are we still seeing everything, all these problems on the rise so much?

Dr. Joel: Yeah, it’s terrifying, right? I think if you look at the statistics, any reasonable person looks at the statistics, it’s terrifying, this is the first generation where the life expectancy is going down. Chronic disease rates are skyrocketing. There are studies that are showing now maybe 50% of kids have a chronic disease there, you know, for sure over 50% of adults have a chronic disease and are on medication, autism rates are skyrocketing, and the numbers just keep going up, and up, and up. And that shouldn’t be the case. If you have two children, one’s gonna have a chronic disease. That’s horrible. There’s no…we don’t need to have that. There’s no reason for that. It means that we’re failing. We’re absolutely failing in our current medical system.

And, you know, my opinion on that, strongly, it’s not that, you know, doctors are not doing a good job. Doctors are great people and, you know, we’re here to help patients, and pediatricians are amazing human beings that are helping kids. But the system was not set up for the current issues, right? For so many years, we were focused on fighting infections and acute illness. And so we’ve migrated so much of our focus on treatment. So you get sick, here’s how you treat it. And that’s really important. You know, if you get sick, you wanna…you know, it’s amazing that you have an antibiotic and that can, you know, get you better if you have a pneumonia or something like that. But a lot of what we’re seeing these days are chronic diseases, are things like asthma, and allergies, and autoimmune conditions. And the system was never built for that because a lot of those conditions are exacerbated by the way that we’re living.

And you really can’t treat lifestyle in two or three minutes in a doctor’s visit. You need to spend a lot more time and focus on the complete history, you need to discuss, you know, their diet, and their sleep, and exercise, and toxins, and all of these things that are surrounding us that are creating the problem. And we’re so focused on treatment right now, but that’s not where we need to go if we wanna shift the focus and change the paradigm of health and focus on wellness. It’s great to treat somebody, but that doesn’t necessarily mean that they’re in optimal health. We wanna get to the kids before they get sick, right? And, you can go do some lab work as a 5-year-old and everything comes up normal on the labs, but that doesn’t necessarily mean that they’re optimally healthy. It just means that they’re not at the point where they have a horrible disease yet.

And that’s, again, where, I think, medicine is absolutely failing because we’re not focused on keeping these kids into optimal health so they never get sick. We’re just catching them at the point when they do get really sick. And that’s a big mistake. That’s a big mistake. And that’s a big issue with where healthcare is going because the current system just isn’t set up to spend the time that you need to spend to work with families to teach them how to be healthy. Because as you said, a lot of health comes from the family. We have a lot of responsibility. Doctors, you know, can diagnose and look for major disease, but we’re not there with you every day. And most of our health comes from the food you bring home, and what you cook, and what you’re surrounded by, and what you do, as opposed to a medication.

Katie: Absolutely. It’s definitely staggering to see these rates, especially in kids. I know it seems like, I have a note from you, especially in the last couple of years, even things like diabetes seems to be pretty drastically on the rise in children. Do you think this is stress related? Is this diet related? I know there’s a lot of inputs in this equation. But what do you see as some of the bigger causes of this?

Dr. Joel: Yeah. It was all over the news, you know, a few weeks ago. I mean, it almost brings a tear to…you know, when you look at that. The diabetes rates in several studies in, you know, young adolescents doubled. Doubled in the last two years. Doubled. That’s insane. Why is that happening? Why are we okay with that? Why are we allowing that to happen? And a lot of it, I think, is…well, I mean, most of it is to do with the way that we’re living. I mean, people were stuck at home, they were eating crappy food, and they weren’t exercising, and those are the things that lead to chronic disease. We know this, we’ve always known this. And certainly, for diabetes, we know, you know, a lot about what causes diabetes even in comparison to many of the other conditions, and those rates have been on the rise because obesity rates are on the rise and poor eating is. But, you know, in the last year or two, for sure, people across the country and across the world ate 10 times worse. They weren’t cooking. They were stressed out. They were miserable. They were stuck at home. They weren’t exercising. And what else would happen if that’s going on?

I mean, it’s just an indicator. I think it’s another major light bulb, but it’s like, “Guys, we need to take care of our health.” We need to think about this. And I really hope that if there’s one good thing to come out of the pandemic is that there’s a focus on health and a realization that chronic disease and comorbidities and the way that we take care of ourself, that is the main thing that leads to disease. And whether it’s, you know, pandemic versus any other disease, this has always been true. This is not new. And if you have other issues, then your body has to deal with those things. And if you get exposed to any virus, anything else, then it’s gonna be much worse for you in general. So we need to focus on keeping our body and our immune system as strong as possible. So that way we can deal with anything that comes our way.

Katie: Yeah, exactly. So what are some of those starting points with your patients? Because obviously, like, as a doctor, you’re also…I’m sure you have your frustrations and limits and that you only see them for the short amount of time and you’re trying to impart all this to them. And then the parents are the ones who have to actually implement these steps at homes. What are some of the starting points that you give your patients to start kind of reversing that trend?

Dr. Joel: Yeah. So for me, I call it the SEEDS of health or the foundations of health being, S for stress, E for environment and toxins, other E for exercise, D for diet, and final S for sleep. So those are the big, you know, foundations that I like to just…you know, it’s always fun to have a mnemonic, just easier to remember. But those are the big ones. And I would say if there’s two major ones, it would be diet and toxins because those are really things that you have a lot of control over. And those are things that you can make a big change today and that can have a huge impact on health. And I think the interesting thing is, and I’m sure you’ve seen this, too, you know, whenever you talk to anybody in the health and wellness sphere, anyone that knows anything about what they’re talking about, they always bring it back to diet. Everybody does.

Everybody always says, you know, the number one thing that you could do to make a change is to eat healthier. To think about what you’re eating or to cook more. And that is absolutely true. You know, when we talk in our office about diet and what you’re doing, that’s what you have a lot of control over. And it doesn’t mean that you can never eat any sugar or never have a piece of cake. But if you control 95% of what your kids are eating and you cook most of the time, then you have a pretty reasonable understanding of what’s going into their body, and we’re made up of what we eat. And if we’re eating crappy food, then we’re not gonna be healthy.

Katie: Yeah. It’s so encouraging. I know, like, like you just said, many health practitioners are saying this, but it’s because it’s very true. And, I think it’s also a tough one with kids, especially when we live in a society that has kids’ menus that are designed to be specifically unhealthy. And it seems like they’re almost trained from a young age to prefer these hyper-palatable foods that are not nutrient-dense at all. But it can make such a difference. And it seems like, especially in kids, it can make a difference so quickly because their bodies are so adaptable and so rapidly growing. Do you get pushback from parents? That also is like a big piece to change. Do you have parents that resist that?

Dr. Joel: Sometimes they do. I feel like, you know, because of what I do and because of, you know, more integrative focus, I get a very select patient population that’s looking for this. So I feel like a lot of people coming in are already somewhat health conscious, but certainly, there is some pushback sometimes. And definitely, when I, you know, talk on events, you know, podcasts and things like that. I think a lot of people when they’re messaging me are coming from a very different place. And you know, the couple of pushbacks that are the most major that I’ve seen when I’m speaking is, number one, cost and, number two, time, right? Those are two big, big factors for everybody. And those are reasonable factors because it can be more expensive to cook, you know, with organic food and to buy all your own produce and things like that. And also people are busy. And so they don’t necessarily have time every day to come home and spend an hour and cook a meal.

And those are reasonable concerns, but I just come back with, “But this is important.” You know, this is maybe the most important thing. And, we can see what’s happening with our health because we’re not prioritizing this. And to me, this is a, you know, make it or break it moment. We have to raise the flag. We’re in the point of no return at this point. Every kid is gonna have a chronic disease if we don’t change something. And so it’s just something that, I believe, parents have to prioritize at this point and do whatever they can within reason to spend more time shopping and cooking. Because ultimately, that’s the number one thing that changes health. And we see it all the time. I have kids come in that had eczema for years, and they just change up their diet and it gets 75% better in 2 weeks. You know, that happens just because their bodies get the nutrients that they need. And, again, we’re literally made up of what we eat, and if you’re not giving your body all the nutrients that it needs, then how are you expected to function properly?

Katie: That’s a great point. And I would say the audience listening, typically, like, they’re very highly educated and into the more natural side of things. I’ve heard from people who say things like, “I wanna do XYZ, but my doctor won’t let me.” And in my mind, like, my thinking’s, like, well, you’re hiring the doctor. Find a doctor, you shouldn’t be using it, allow type language, with your doctor. It’s your health. You are still responsible. Even if you’re working with a practitioner, you are still responsible for your health. But I hear that language a lot, especially in women, like, in, like, pregnancy, I hear that languaging a lot. But also I hear it with parents talking about their kids, like, “Oh, my pediatrician won’t let me.” So it makes me think like how…from a doctor’s perspective, what is some languaging that parents can use to work with their practitioners better? And also, how can we find doctors who are aligned with our kind of philosophies for our children so we avoid that friction point?

Dr. Joel: Yeah. That’s a wonderful point. And I would say, you know, even before getting into the second half of that question, there’s a big difference between talking about something that’s gonna keep your kids healthy versus something that could be dangerous. And I definitely feel like a pediatrician’s job is to keep you and your family safe. And there are things that you can do that can be dangerous. For example, “I wanna give my, you know, 3-month-old honey,” and that could…there could be a risk of botulism. So we do have a responsibility to inform you of dangers, and I think that is absolutely reasonable. But it’s not our job, I think, to tell you what you must do within reason of safety. And, I think everybody has, you know, a varying opinion, and some people are, let’s say, vegetarians or vegans, or there’s all sorts of different ways that people choose to live their life.

And as long as it’s, you know, reasonably healthy, then there’s no reason why you shouldn’t support families in their decisions. And if you’re doing something that’s completely reasonable and safe and your pediatrician is not supportive of that or your lifestyle, then that’s not the right doctor for you. And I think that people are afraid to make a change or feel like they can’t make a change. But I promise you this, you know, doctors are, by and large, very good people. And if you don’t feel like the doctor is the right fit for you, then we have absolutely no problem with you, you know, changing to a doctor where you do feel that the fit is right. You know, I don’t wanna take care of any patient that doesn’t wanna be in the office, and doesn’t love being here, and doesn’t feel like I’m the right fit for them.

And, so if you are just hitting up against a wall and you’re like, “They’re not listening to me. They don’t agree with my lifestyle. This is just not working,” it’s totally fine to go out there and search and find, you know, somebody new, and that’s…you should do that. You should have somebody in your family that you…that supports you and that you love because at the end of the day, a lot of healthcare is about discussion and trust, and you need to have that bond so that way you can trust them when something comes up. And if you don’t even trust them with your diet or what your lifestyle is and, they’re, you know, looking down upon you for what your choices are, then trust and the bond is gone and the relationship is broken.

And my wife’s a lawyer, and, you know, she would call like a breakdown in communication or breakdown in trust. It’s like, if that happens, as a lawyer, you’re bound, you’re duty-bound to dismiss that client. Right? And I think that’s the same thing in medicine, is that we really need to have the right patient match for us, whatever that is. And so if you…yeah, if you don’t feel like you’re having the right doctor, then you should go search out to find somebody else. It’s not that hard. You know, these days, with the internet, you can definitely go Google, like, you know, if you’re looking for something more natural, holistic pediatrician or natural pediatrician, or ask your friends, or go on a Facebook group and into whatever, whatever you’re into and say, like, “Hey, I’m in this area. You know, who loves their pediatrician?” and just interview a few doctors. I think that’s totally fine.

So that was, I think, the first part of your question. The second part of your question was about bringing up information, you know, that maybe they don’t agree with. And I would say this, number one thing is, please don’t bring in, you know, information from Facebook or, you know, from some random article thing that you read that isn’t reputable. That’s never gonna work with a doctor. I mean, I don’t have a problem talking to families, but a lot of doctors, they turn off, you know. If they’ve gone through 10 years of medical school and then you bring in some, you know, blog post from somebody, and you say, “This is what this mom said,” a doctor’s gonna turn off, you know, right there. They’re not gonna listen to you. So just make sure that you wanna bring it up in a way that speaks to a physician, which is bringing in research and asking them reasonable questions and asking them for their opinion on something, not telling them something, but asking their opinion.

Say, you know, “I read this and this,” or, “I was looking into this research study,” or, “One of my,” you know, “friends, who’s a doctor, told me about this. What do you think?” And just ask them, a lot of doctors are very happy to discuss new research. We don’t always know…you know, we don’t know everything, obviously, there’s so much going on at all times. And if you present good evidence and data, then a lot of times a doctor will read about it, and they’ll think about it, and they’ll look into it. But if you present it in a way where it’s, “I was on this Facebook group, and this mom said this,” you’re done, they’re not gonna listen to you. And they’re not gonna respect that point of view and whether that’s right or wrong, it’s just about making sure that you’ve present it in a way where you feel like your physician is actually gonna listen to you.

Katie: That’s a great point. And I know a lot of people listening are much more naturally minded. And I think on a personal level, I think there’s a great balance. And you can use natural remedies and traditional medical care when both are needed. I don’t feel like they’re in conflict at all. But I know, like, some people have gotten pushback from their doctor about using natural remedies. And I mean, to your point, of course, they need to be safe. Like, there’s a huge concern that you wanna make sure anything you’re doing with your child is safe. But for people, parents who are more naturally minded, can they bring up and talk to their doctor about natural remedies? And like, what’s a good way to kind of bridge that? Because not all of those might necessarily have the PubMed studies that, you know, a new pharmaceutical might. But a lot of them also have hundreds of years of use, and our grandmother’s knew about them, but what’s the way to kind of start that conversation?

Dr. Joel: Yeah. So, you know, first off, for me, so I did all the regular training. I trained at a normal allopathic great medical program, and I just got a little bit frustrated with the regular system. And so that’s what led me to start learning about natural medicine. And I absolutely agree with you. I believe that both worlds should live in harmony and both things…you know, you should be doing the best of both worlds, natural medicine and Western medicine. It’s not one or the other, and medicine shouldn’t be, there shouldn’t be all these terms, right? There shouldn’t be Western medicine, and homeopathy, and natural medicine. And it should just be medicine we should do whatever’s best on the day for the patient. And there are so many remedies that have been used for thousands of years that are much safer than medications and should be tried first in a situation where it’s safe or reasonably could be tried in a situation where it’s safe as opposed to a medication because there could be side effects, but you also wanna be able to identify when something is more serious, where medication is needed and maybe something natural isn’t the right option.

And so that’s where someone who knows both worlds can be really helpful. But if you are going to a more traditional, you know, Western medical doctor, you absolutely can bring it up there. There’s research on everything. There really is. I mean, there’s not as much research on some things, but there’s definitely some data out there. And if you reasonably bring in, like, “I read these six articles, and they all showed that elderberry syrup can be really helpful for, you know, this cough that my child is having,” you know, “Seems like after today’s visit, it sounds like it’s not a pneumonia, you know, is it okay to try this?” you know, most of the time they’re gonna say, “I don’t know,” or, “It doesn’t seem like it’s an issue if you want to. That’s fine.” So that’s where sometimes, you know, you doing it yourself, but at least you’re bringing it to them to make sure there’s no interactions.

But if they really give you a hard time, then maybe that’s not the right doctor for you. Or a lot of people that I know work with two practitioners. So they work with a Western doctor, and then they work with a natural practitioner, whether it’s a naturopathic doctor or a Chinese medicine, you know, acupuncturist doctor who knows about supplements, or there’s so many other practitioners out there. And, there’s nothing wrong with having a team, right? There’s nothing wrong with going to your Western doctor and, you know, ruling out the pneumonia. And then once that seems fine, then talking to your natural practitioner and say, “Hey, we went to the doctor, this and this is going on. You know, is it okay, or what else can I do?” You go to your cardiologist for your heart. You go to your neurologist for your brain.

You know, there’s all these specialists out there, and why can’t a natural practitioner just be part of the team? And a Western doctor is fantastic at ruling out serious things, but we don’t have, for the most part, the training in natural medicine. And there’s nothing wrong with working with two different people that can, you know, work in conjunction. And that, to me, is where, you know, if you don’t have a natural doctor near you, there’s naturopathic doctors everywhere, and that’s where you can have both, and lots of people do. And I think that works really well for somebody who wants both.

Katie: That’s a great point, too. It can be a team versus a single doctor and having someone in the local area for anything acute and for regular care, and then also having someone who understands the integrative side. Probably not as much of the people listening, but I think there will be some of these. I think there’s also the other case. And you probably have experienced this as a doctor as well. Parents, especially when children are sick, wanting a quick solution, wanting their kids to feel better, which I totally get. But I’ve also heard from more integrative holistic doctors who say, like, parents are often the ones pushing, like, “Can’t you just give them an antibiotic? Can’t you just give them a medication? Can’t you just…?” So I’m curious, what percentage of the time do you feel like kids actually need some kind of acute Western care like that compared to…because I’ve read statistics about the vast majority of childhood illnesses, not chronic disease, but childhood illnesses resolve on their own and kids have amazing immune systems. What percentage of the time do you feel like intervention is actually necessary versus when it can be resolved with rest and hydration and the kind of more, like, traditional methods?

Dr. Joel: Almost all the time. Yeah. I don’t know if there’s a number, but I could say…I can just say, you know, I used to work at a major children’s hospital, and it was very common practice before I started really being in a natural world to just give antibiotics all the time because it’s easier, it’s quicker, and sometimes that you’re right, if people come in, they want something. And if the only thing in your toolbox is an antibiotic, that’s the only thing you’re gonna give because a parent’s coming in, their child is sick, and they want to do something. They don’t want their kid to suffer. And so if the only thing that you can give them is an antibiotic, then that’s what you give them. As opposed to, if you have a knowledge of all these other natural tools, then you can say, “Hey, do this, this, and this. You know, try elderberry syrup, try vitamin D, try vitamin C, try this, you know, whatever. And, if it’s not getting better, let me know. And then we can think about doing the antibiotic.”

And then you can try some of these other things and it gives time for the body to heal and you support the immune system. And whether you were gonna get better on your own or not, you know, who knows, probably you would, but at least they’re doing something, and you’re supporting the immune system, and you’re not hurting in any way. You’re not doing anything that causes a side effect. And if you avoid the medication…antibiotics do a lot of good and a lot of bad, right? They’re killing bacteria. And so you need it if you need it, but it also has some side effects. And if you can avoid using antibiotics, this is like prime medicine, antibiotic stewardship, not using antibiotics when we don’t need to, that’s a big deal.

And so if there are other things that you can do, great. And, you know, I would say, you know, my office now, I almost never give antibiotics. Not never. We certainly do it when you need it. And, you know, things like strep throat or pneumonias, yeah, you need an antibiotic. But that’s definitely less than 1% of the time. And I probably give an antibiotic maybe once or twice a month, as opposed to, you know, several times a day in my new practice. And, that’s a big difference in terms of training. Because people here don’t want an antibiotic, and they definitely wanna try things first. And then you realize that over time, you don’t need the antibiotics very often.

And even just giving somebody a prescription, like, for an ear infection and saying, “Hey, try these three things, and if it’s not getting better in two days, then do the prescription,” 99.9% of the time, it gets better on its own. You never need the antibiotic. And that’s just the reality of kids, is they’re resilient and they usually don’t need it. But, again, that’s where Western doctor does make a big difference. Because there are times when you do need it. There absolutely are times when you need it. And so you need to pick out those times appropriately but not give it just because, not give it just because, “Oh, there’s a little bit of cough and congestion. Well maybe it’s a little bit of bronchitis and I wanna give you something. So here’s your antibiotic, take it for 10 days.” They’re gonna get better anyways at least 9 out of 10 times.

Katie: That’s encouraging to know. And that’s, like, I think, a great place for that melding of natural remedies with traditional care and there being a place for both, like you said. I’m gonna bring up a controversial one because this one comes up from parents a lot and I’m really excited to get your practical advice on this, which is fevers. Because there’s so much information out there about if we should let a fever run its course, if we should try to bring it down, and then all the methods for doing that in various directions. So I’m curious how you guide parents on handling fevers with children.

Dr.Joel: So first of all, I gotta break up into two different age ranges because, for a newborn baby, it’s a very different thing than for an older child. So if your child’s under 2 months and your child has a fever that’s above 100.4, you absolutely have to get seen, especially in the first month you have to go to the hospital. So that’s totally a different situation just because a newborn doesn’t have a strong immune system yet, just like when we’re older, and so they can get sick really easily. So, you know, we’re talking about older kids, you know, 2, 3, 4, whatever age, you know, for the rest of the conversation. But in terms of a fever in general, if the child’s over 2 months, usually you don’t need to do anything.

A fever is not a bad thing. A fever is a body’s response to infection or something going on. You’re raising your temperature, let’s say if you’re sick, to fight the infection, to make your body an uninhabitable place for the bacteria, or the virus, or whatever, and so, hopefully,it can’t replicate and cause more damage. There’s nothing wrong with having a fever. You want to have a fever if you’re sick, you just don’t want to get such a high fever that it can…you know, they’re miserable. And that’s usually when people would use, you know, a Tylenol, or acetaminophen, or something like that. So I usually tell parents, you know, don’t worry too much about the fever, worry about the symptoms with the fever. I’m much, much more concerned about a child who has 101 temperature that’s really lethargic, not drinking, having trouble breathing, than a kid with a 104 who’s running around and playing.

You know, if you have a fever that’s above 103 consistently, then yes, you should definitely get seen. Certainly, if you have a fever for a few days, you should get checked out. Certainly, if you have any symptoms with the fever that you’re worried about, you should get checked out. And if your child’s miserable, you know, go ahead and do, you know, a medicine if you want to, if it makes them feel better, if it lets them sleep. But if your child’s pretty happy and they have a 101 or 102 fever for an hour, you know, that’s fine. Let it run its course, let them watch TV, let them rest. And in general, you don’t need to use it.

And you know, like everything for me, I’m not against Western medicine. I think that there’s a time and a place for everything. And there’s nothing wrong with using acetaminophen, Tylenol, whenever, Motrin if you need to, if they’re miserable, but don’t use it just because. Don’t use it just because they have a 99 temperature and they’re a little bit unhappy. Use it when you really need it. If they have a 103 and they’re miserable and they’re crying, you know, if that’s gonna make them calm for a couple hours and let them sleep, great, go for it if you want to. But you don’t need to use it just becaus. There’s a reason the temperature is being raised in your body. And in general, you wanna let your body do that. But it doesn’t mean you shouldn’t get checked out by your doctor if you’re worried.

Katie: Great point. So just in general, if the child doesn’t need anything to bring the fever down and they’re comfortable, it sounds like an illness typically could run its course faster if you let the body keep that process and not bring it down. Is that…am I understanding correct?

Dr. Joel: There’s conflicting research on that. I’ve definitely seen studies where it shows that if you don’t give your child, you know, Motrin, or Tylenol, or acetaminophen, then the length of a virus is shortened, maybe, like, half a day. So it’s not a huge effect. But I think just in general, anything that you take has potential side effects and your body has to deal with that, too. And your body is very smart. Your children are…you know, we’ve evolved over time to fight the diseases that are in this world. And one of our main defense mechanisms is having an immune system, and it raises your temperature for a reason. So there’s nothing wrong with letting for, you know, a couple hours, a day, two days to have some bouncing-around fevers to fight off the infection. If everything else is okay, if you’re comfortable and there’s no major symptoms, then sure, there’s nothing wrong with having fever. Again, the fever is your body raising your temperature to fight the infection.

So that in and of itself is not the concern. It’s the symptoms with the fever that is much more of a concern. And, again, if you want to use it, I think that’s okay. But in general, most viral illnesses run their course in three to five days. You know, you get a cough or a cold and you have some symptoms, then it gets better. And if you do nothing, it’s still, most of the time, gonna get better, but you can support through that and help them through it as best as you can to, hopefully, make it a little better and a little bit less miserable.

Katie: And I know you are on the integrative side, which I wanna talk about specifically what that means in a minute. But in those instances, when it’s, like, mild illness that there’s not medication needed, are there any, like, comfort measure tips that you give to parents that are helpful? Maybe even if it’s just like rest, and hydration, and soup or, like, anything that can help with that process?

Dr. Joel: Yeah. Again, it obviously depends on the specific situation, but just in general, if we’re talking, like, a cold, you know, regular old virus, you know, those things, like you said, rest is number one, lots of fluids. So you’re drinking and peeing a lot. This is a time when it’s totally fine to be on the couch, watch movies, do whatever you need to do. Yeah, soup, you know, bland-type foods. And, if you can get some immune support is usually good. I don’t feel like it hurts. You know, if you can get a multivitamin in, if you can get some, like, vitamin C, or vitamin D, or elderberry syrup, or…there’s so many different immune supports out there, and I don’t…I’ve never seen any study that shows major harm. It’s certainly something to talk to your specific doctor about if you wanna try things. But just really being there for them is the main thing for when they’re sick.

I mean, just I think that we sometimes forget about what we went through as kids. Just think about when you were a child. Just think about when you were sick last time, you know, what did you want? You just want…you don’t feel great. You don’t necessarily wanna eat a lot. You don’t probably wanna drink, but your mom was probably there forcing you to do it, or one of your parents was there, like, you know, “Drink this, drink this.” You know, you wanna get some fluids in, extra rest, maybe you give them a nice little bath or some Epsom salt, things like that. And just rest, you know, usually you’ll get better in a couple of days.

And the world is very fear based right now, which is unfortunate. And we’ve seen a lot of scary stuff over the last few years. And parents forget that most viruses are not that scary. And every kid gets sick multiple times in the winter. And, you know, three to five times is not unheard of, and being sick for half the winter if in a toddler is not unheard of. And so most viruses are short, and they’re not super concerning, and the kid gets better on their own after a couple days. We’ve just forgotten about that because we’ve seen so much scary stuff. So I think that we just need to remember, yeah, kids are gonna get sick. Your kid will get sick. Everybody gets sick, especially if they go to daycare. That’s a part of the deal, and they will get better. And if you have a worry, then go see your doctor. But other than that, it’s really just rest.

Katie: Yeah, exactly. That makes sense. And I have a much smaller sample size, with only six kids, versus the, I’m sure, hundreds or thousands that you see. But with mine, kind of just taking that wait-and-see approach, I’m not at all opposed to using conventional care when needed, but my thought has always just been let it run its course if it can. If there’s anything concerning, I go in, obviously, but with 6 kids, the oldest now being 15, we’ve never needed antibiotics. And obviously a small sample size and it’s not medical advice, but we’ve never needed antibiotics. And we really only have used pain medication one time, which was recently, which was a bike accident with my daughter where she had road rash really bad. But that’s been my experience from the mom’s side at least, is most things do resolve theirselves really quickly. And, like, grandma was right about hydration, and soup, and rest being the biggest healers. And that’s true for parents as well.

I know you list that you’re an integrative pediatrician, and I feel like there’s a lot of different terms that float around in the medical world. Can you explain what that means specifically and maybe how it differs than a more traditional pediatrician?

Dr. Joel: Yeah, so for me…yeah, exactly, there’s no one term, there’s no specific definition, but to me, it’s blending the best of Western allopathic modern medicine with natural holistic and alternative medicine. So it’s just doing, you know, a little bit of both and blending the best of both worlds on any day. And to be…I don’t think it…you know, it shouldn’t be called integrative medicine. It shouldn’t be called integrative pediatrics. It just be medicine or pediatrics, and everybody should be doing this and learning about it. But I think that, you know, right now that’s not the case, and blending those two worlds together is really helpful. But I do hope for time that a lot of this natural stuff does bleed into regular medicine and just becomes regular. And that is happening to some degree. I mean, acupuncture is, you know, well documented to be helpful now, and pain clinics and hospitals, they have acupuncture as opposed to giving them medicines. And, you know, aspirin was from willow bark. So, like, that was a natural medicine before. And vitamin D is being, you know, given to babies now and kids and things like that. So things are slowly seeping in, but medicine’s very slow to change.

Katie: Yeah. It’s encouraging to see those changes starting to happen, though. Another question I have in the show notes for you that I’m really excited to go down this tangent with is the idea of what do the parenting books get wrong about raising healthy children? Because obviously, we’ve talked about, like, acute stuff and that’s only a part of it that, hopefully, doesn’t happen very often with our kids. But raising healthy children is a daily endeavor. So from the doctor’s side, what do you feel like the parenting books are getting wrong in this equation?

Dr. Joel: So, I think there’s three big things. Number one, a lot of what we’ve talked about already in terms of…so there’s, like, the pediatrics medical-type books, and there’s the, you know, the parenting-type books. But I think when you talk about those two kinds of books, number one most important thing that’s missed is prevention. Is talking about, you know, diet, sleep, exercise, and how to have an optimally healthy child versus how to keep them well. A lot of the books talk about, “Okay, how do you treat a cough? How do you, you know, do X, Y, and Z?” But very little talks about how do you actually keep them healthy? And we discussed a lot of that. So that’s what, I feel, is a big part missing. That’s number one.

Number two would be balance. I think that by and large, whether you talk about social media books, you know, parenting books, we’re very divisive these days, unfortunately, and it’s very one-sided, and you had a book that’s, like, super woo-woo and out there and telling you to take, you know, X, Y, and Z thing that’s never been studied versus, you know, completely medical-style parenting book. And it’s gotta be a blend of both. Somewhere in the middle is right for just about everything. And when we’re so divisive and, we’re on, you know, one side or the other, and one side is right versus one side is wrong on whatever health or medical decision, that is where we’re harming our kids, because the right answer is somewhere in the middle and you gotta be open to everything and to taking information you’ve never heard of before or that might seem different, or weird, or out there. And, at least just listening to the other side, because sometimes there are pieces to that that can be, you know, really helpful for you and your family.

And I think the third big one is this one-size-fits-all mentality that you see, you know, in all the books, like, “Oh, you have…take this smoothie and your child is gonna be totally healthy,” or, you know, “Have celery juice every single day, and you’ll never have a disease.” And that, to me, is just not how kids are. Like, there’s no one thing that is going to keep your child healthy. There’s no one way to do things. We make parents feel bad. It’s like, “Oh, you know, if you don’t sleep-train them at this time, your kid is gonna never go to Harvard,” or, “If you do sleep, train your kid, you’re gonna have all these.” It’s like this one way to do things. And, that I think is really harming to parents right now because it’s just increasing this stress level of, “What do I do?” And you read something online, and one article says carrots are the best thing for you, and the next thing says carrots will kill you, right? And you’re like, “What do I do? How do I know how to parent my child?” And then you just live in this world of stress.

The reality is, we need to give people information, let them take it all in. And then you have to decide for yourself what is best. There is no one way. There’s lots of ways to do things. Present the information, present the research and the data, give people all the best information. And then you have to take that in context of your own family and your own situation. And then do what you feel is best. Because there are so many ways to handle almost every problem in parenting. And if a book is telling you this is the way to do it, the only way to do it, and if you don’t do it this way, then your child’s gonna have all these issues, in general, that extremism is not helpful. And it’s probably not correct because the next book’s gonna come along with even better research. And it’s gonna say the exact opposite thing. And that is how science and medicine and parenting works. We always are learning and evolving. So pushing people to extremes is not the answer. It’s giving people information and balance, and letting them make an educated decision that is least stressful for them because there’s enough stress in the world.

Katie: I am so glad you brought that up. Because I said before, you know, if you just look at the research data, you could almost at any given area, whether it’s, like you said, carrots or broccoli or anything, you could make a case for it being great for you and horrible for you. And the reality is, like, the truth is somewhere in the middle, and the same thing with, like, all these different health approaches. Because I, in my own health, tried so many different approaches before I figured out what worked for me. And I realized there’s so much wisdom. All these experts have learned something, and there’s something to be learned from every one of them. But at the end of the day, we’re all so individualized and personalized that I had to figure out what worked for me. And so it’s like being willing to do that experimentation and take ownership for your health yourself or, in this case, your children’s health, I think, is such a really important thing.

I’m also curious, it seems like behavioral problems, like, specifically once they get labels, are on the rise right now as well. And there seems to be a lot of kind of conflicting information about medication being the best approach versus lifestyle interventions. Are you seeing a rise in behavioral-related issues with kids, and if so, what kind of approach do you take in those instances?

Dr. Joel: Yeah. It’s definitely…I mean, it’s way on the rise. It’s insane how much things like, you know, ADHD and autism and other behavioral concerns have skyrocketed over the last few decades. You know, I don’t even remember when I was growing up the term ADHD or autism. I mean, I’m sure there were kids that had it or had symptoms and just wasn’t labeled. But, it’s very common now. It’s very, very common. And that, again, is a failure of the medical system because it’s easier to give a label and it’s easier to give medications than it is to do the real work, to try to help a family and a patient who needs to make lifestyle changes to make those changes so that they can function appropriately.

There are absolutely kids, no doubt about it, that absolutely have the diagnosis, and medication can be helpful. No question about it. I’m, again, not against medicine, it’s just medicine should be the last option. It should always be the last option. It should never be the first thing that you think about. You should always discuss what lifestyle changes you could make, what is going on in their life. Is there something else that could be contributing or causing the symptoms as opposed to just giving a label and giving a medication. Because maybe you’re exposed to lead in your house. Maybe you’re super sensitive to gluten, or sugar, or other things. And you’re just not feeding them the way that they need to be fed. And if you make those changes, then their body calms, their inflammation calms, and they’re not as hyperactive anymore, and they can focus a little bit more, and they never need that medication.

If they need it, fine. That’s totally fine. But our job should be not to give medication. It should be to have healthy children. And if medication helps to get us to the place that we need to get to, sure. If they need that to focus, great. But if you can do something else besides giving a medication to a child every day for the rest of their life, then why would we not do that first? Why would we not try every other option before giving them a medication that has side effects that, of course, over 5 or 10 years, is going to cause some issues probably to your body because your body has to deal with the medication every day? And then it just doesn’t work after amount of time because, you know, you need more, and more, and more over time. So yeah, again, if you need it, fine, but let’s work to find other solutions that can either replace need to give medication or at least work alongside the medication. So maybe you need a lower dose.

Katie: And another specific area that, I think, is especially relevant to children is the area of things like eczema and allergies, which also seem to be on the rise. I know I had one of my children, when he was younger, had eczema and we were able to resolve it with lifestyle changes, and now he’s completely fine. But I know I hear from a lot of parents and I’ve seen firsthand how tough it is when your child is going through that. How do you guide parents on things like eczema or childhood allergies, which seem to be on the rise?

Dr. Joel: Again, a lot of it goes back to the exact same places, it’s (bad) food and chemicals. And most of the time, if you start there and you focus on how do we support their bodies? How do we support their immune system? And how do we move them towards a healthier lifestyle? Then usually these things resolve on their own. Yeah, sure, you know, if you need a cream, you need a steroid cream, great. You know, you do it in the short term, but that doesn’t solve the problem. If you’re sitting on a tack, right, and your bum’s hurting, you can give somebody Tylenol, but if you don’t remove the thing that’s causing the pain, if you don’t remove the tack, then, you know, you’re not gonna get better.

It’s the same thing with eczema. You know, it depends what the triggers are for that child. But you have to figure those things out. You have to think about, is it a gluten sensitivity? Is it a dairy sensitivity? Do they have some environmental triggers in their home? Do they have mold? Do they have, you know, trees that are giving them allergies? Are the food that they’re eating…are they sensitive to the dyes or the chemicals? Whatever it is. And if you start to alter some of those things, and start to make different purchases, and start to clean your house with different products and use healthier soaps and cleaners and all of these things, a lot of times they start to get a little bit healthier. And then you can maybe support their immune system and make sure they’re getting all the vitamins and nutrients that they need, and magically, they start getting better.

And, it’s not magic, it’s just logic. But it seems magical to parents that, you know, you make these changes, 3 months later, their kid is 25% better, 50% better. But if you give the body a chance to heal, then it does it on its own. And then you can, you know, focus on other things and trying to figure out, sometimes you do testing, whatever it is, but the simple things get you a lot…usually, they get you a fair amount of benefit. Even before you have to go digging for the, you know, crazy things that you would never even think of, just the basics is usually what you need to do. And you can do that. And that’s the encouraging thing, is anybody can do that at home, right? Anybody, every parent, you know, you have the opportunity to make huge health changes and health benefits just by simple things that you have control over.

And there was a study out of Berkeley that was looking at the toxins in urine. And they were looking at kids who were eating a regular diet, and then they switched them over to an organic diet and checked the urine a week later. And the chemicals, most of them were down by 90% in the urine in 1 week. One week, they were down by 90%. And, you know, how amazing is that to think how resilient our body can be, that if you make these small changes, you don’t have to do everything, but if you buy one more type of food organic, and you change one cleaner, and you exercise a little bit more, then that is gonna give your kids such a bigger benefit than anything else that you can do and any medication and anything else. And you have control over that.

Katie: And a question I love to ask for the end of interviews is if there’s any areas that we haven’t talked about already that you feel like are not well known or misunderstood, specific to your area of expertise.

Dr. Joel: Yeah, well, couple things. I would say, number one, being a pediatrician does not mean I know everything about being a dad. Everyone’s like, “Oh, it’s must to be so nice to be a dad.” And, yeah, I mean, certainly, it helps if you, you know, your kid’s sick or if they’re not feeling well, you kind of have an understanding, but you know, being, a parent is very different. No book, nothing prepares you to actually be a parent. And, so, yeah, I think it’s a little helpful, but I think it’s misunderstood that, you know, it’s not the easiest thing in the world to just because I’m a pediatrician. That’s number one.

Number two, I would say that integrative medicine is not woo-woo. That’s not what it means. It’s not necessarily out there. It can be. And some people give it a bad name, and people that are very hyperbolic and, you know, say, “Take X, Y, and Z for everything,” or use remedies that are never studied or don’t make any logical sense, that gives it a bad name, but integrated medicine does not have to be woo-woo. And anyway, it can be a blend of regular medicine with natural remedies. And remember, which one is really alternative? Modern medicine’s been around for not that long. Alternative holistic medicine has been around forever. Modern medicine is really the alternative medicine. Everything else been around for thousands of years. So there’s gotta be some reasons for most of this stuff to be helpful. So that’s number two.

And then number three, I would say, is that, you know, I’m very lucky with where I work to work with a lot of celebrities and prominent figures, and everybody thinks they’re, you know, way different and it’s a totally different world, but, you know, they’re very much exactly the same as everybody else. And they have the same parenting issues and the same parenting questions and the same concerns. And so I think, for me, as a pediatrician in that world that I work, you know, a big misconception is about, you know, the patient population, but parents are all the same. We all have the same fears. And, when you have a child, you have a child, and nobody’s prepared for it. And, you know, having more money or fame doesn’t help you to be a parent. Right? That nothing prepares you for that. It’s all the same. We’re all going through it together. Whether you’re a pediatrician or a big famous movie star, you’re still worried if your kid has a cough.

Katie: I love that. That’s a great point. And lastly, if there’s a book or a number of books that have had a profound impact on your life. And if so, what they are and why.

Dr. Joel: Yeah. There’s so many great books I’ve read over my time. I would say, as a child, one of my favorite books was always the Guinness book of World Records just because I love, you know, reading through all the interesting things and just, it really made me realize that no matter who you are and what you do, there’s amazing parts of everybody, and there’s so many amazing things. And you can be, you know, the greatest domino stacker ever, or you could be, you know, lifting the most weight, or you can get the most people to jump for hours together. There’s so many things that you can be great at no matter what you are and who you are. And, that, for me, just as a child, that really influenced me in terms of just remembering that, you know, be who you are, love who you are, and don’t let anybody change that because, you know, there’s magical, amazing things that anybody can do. And, there’s so many cool ways that you can live your life and be celebrated as opposed to, you know, being different.

Katie: I love that. That’s a great one. I’ll link to it in the show notes. My kids are big fans as well. And, ironically, like…side-note story is last year, I got to actually set a Guinness World Record with a group of moms for longest distance walked on Legos. We felt like that was an appropriate record for moms.

Dr. Joel: Was it, like, eight steps?

Katie: Almost several miles, actually. We walked several miles within an hour.

Dr. Joel: Oh, I was joking because, you know, that’s one of those things that you don’t understand until you’re a parent. You know, you see the beams and it’s like, you don’t understand how much the Lego hurts until you have a child.

Katie: It is a special breed of pain for sure. Oh, well, Dr. Joel, this has been such a fun conversation and so helpful. I will make sure to link to you as well in the show notes, but where can people find you online and keep learning? And do you work with patients remotely?

Dr. Joel: So sometimes I work with patients remotely, but as a medical doctor, for the most part, you’d have to be at least seen in the office at the beginning. So most people would be in the Los Angeles area. And as well, I do mostly regular pediatrics. You know, in terms of the office, we do integrative medicine, but, you know, we generally are someone’s pediatrician. So, you know, mostly if you’re in the LA area, you can give us a call, but anyone can give us a call. I’m always happy to chat. But the main area would be, I would say, on Instagram, which is @drjoelgator, or you can find me at integrativepediatrics.com. And there’s lots of stuff on there that you can find me, or just reach out, you know, online.

Katie: Perfect. Those links will be in the show notes. Thank you so much for your time. It was great to get to chat with you today.

Dr. Joel: Thanks for having me on.

Katie: And thanks, as always, to all of you for listening and sharing your most valuable assets, your time, energy, and attention with us. We’re both so grateful that you did. And I hope that you will join me again on the next episode of “The Wellness Mama Podcast.”

If you’re enjoying these interviews, would you please take two minutes to leave a rating or review on iTunes for me? Doing this helps more people to find the podcast, which means even more moms and families could benefit from the information. I really appreciate your time, and thanks as always for listening.
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