A medical perspective: Alternatives to going all-natural

Natural is a loaded word when it comes to parenting. While it feels good to make choices that stem from nature, following an all-natural course and all the rules that come with it, can lead to stress. There are a lot of conflicting messages out there when it comes to what is healthy for our children: Is it ok to delay vaccines? Is it ok to use formula? What happens if your birth doesn’t go as planned?

Jessica Rolph is joined by Pediatrician Dr. Mona Amin on today’s episode to discuss alternate vaccination schedules, natural birth, cesarean deliveries, early nutrition, and even the nature vs. nurture debate. Tune in to hear the of straightforward medical advice that has made Dr. Mona’s podcast PedsDocTalk hugely popular.

Key Takeaways:

[1:49] Dr. Mona’s advice about babies, vaccines, and alternate schedules.

[6:55] Dr. Mona addresses parents who are concerned that there is a link between autism and vaccinations.

[8:16] What about the concern that babies on their first pediatric appointments are just too young to get so many vaccines?

[10:08] Dr. Mona shares aspects of her personal birthing experience and what she learned from it.

[13:34] There’s evidence that babies born by cesarean miss out on this transfer of essential bacteria from their mother. Is there anything that can be done about that?

[17:01] Dr. Mona provides her perspective on the homemade vs. packaged baby food debate.

[21:09] Dr. Mona talks about the age-old nature/nurture question. What is more important, genetics or the environment?

[23:25] Learn why owning your parenting decisions is so crucial.

Mentioned in this episode:

Listen to Dr. Mona’s podcast PedsDocTalk 

Transcript:

Baby vaccines

Jessica: Thank you for being on the show, Dr. Mona.

Dr. Mona: Thank you for having me. I am so excited to be here.

Jessica: So it seems like getting vaccinated it is on everybody’s radar these days, but what is your advice when it comes to babies? I had a situation where I’ve actually ended up following an alternate vaccine schedule with my first two children, and switched pediatricians, and he was… My new pediatrician is very insistent on us getting back on track and back on schedule. I really would love to hear from you. We trust you so much. Tell us what the real deal is with vaccines and alternate schedules. 

Dr. Mona: Well, we know that vaccines are a hot-topic issue now, especially in this pandemic with adults and the COVID vaccine. This is public health in front of our eyes right now, showing the power of vaccination. As peds, we see and talk about vaccine hesitancy all the time. Even before a pandemic, we were talking about vaccines with all of our families, educating parents on what to do, what is best, what is the best outcome for a child.

Why are vaccines important?

Now, a few things I want to remind our listeners is that vaccines are created for illnesses that have potential to cause death or harm. So you’re not going to create a vaccine for a child if the data is not showing that that illness is going to be detrimental to that child. So we look at all the illnesses that children get, and if a children can potentially die from that illness, or if they can be left with permanent damage such as hearing loss, neurological devastation, etcetera, then we’re going to create a vaccine for that illness. Examples include meningitis, measles, chicken pox as examples of what we see in terms of long-term complications. So I talk about chicken pox a lot. Many people think, “Oh, well, we had chicken pox when we were younger. It’s perfectly fine if my kids get it.” But the reality is that chicken pox, in some cases, can cause hearing loss, and it can also lead to shingles later in life. So if a child gets the chicken pox vaccine earlier at one year and again at four years old, they won’t get chicken pox, they won’t get shingles, and they won’t have that risk of hearing loss.

So we have to understand why vaccines are created. And I like to start with that because I like to re-affirm everyone’s belief that we are not creating it for every illness. The example is hand, foot, and mouth. Every kid gets hand, foot, and mouth at some point in their childhood, perhaps, but there won’t ever be a vaccine for hand, foot, and mouth because we don’t see children die from hand, foot, and mouth. We don’t see long-term complications. So we are protecting kids from the things that can cause harm.

Now, the other component is that vaccines are heavily-researched, so it’s one of the most trusted thing in modern medicine, and it’s constantly monitored. And I’m using the example of COVID again. We created… The vaccine was created, they studied it in a group of people, and then every few months, they’re looking at data, they’re looking at data. The same thing is happening for our children’s vaccines. Every single vaccine our kids get is heavily-monitored. Parents can submit reports, but also, physicians submit reports that, “Hey, we saw a child have this outcome. This is happening.” And this is reported by parents and doctors all across the country. So every three months, there is a board that looks at the safety of a vaccine that’s on the market. So that’s one thing I want to reassure parents about.

Vaccination schedules for babies

Now, in terms of your question on, is it necessary? Well, what about schedules? Do we need to follow the schedule? The vaccine schedules exist because that’s what was studied in terms of the most effective way to build immunity in that child for those vaccines. So spacing is what was studied. It doesn’t mean that if you space that you are going to automatically be lower immunity for that illness. But we don’t know. We don’t study spaced vaccines, right? The only schedule that is studied is the schedule that we have. And so we don’t want to take that risk. Just say like, we say that you should get the DTaP at the two-month and four-month, but the family comes two months and then they come again at eight months. We’re subjecting that child to a spacing that may potentially cause them to get DTaP issues… Let’s use diphtheria or tetanus or pertussis in this example. They could be exposed to pertussis, and then they may not be protected because they didn’t get the vaccine boosters at the time that was recommended.

So when you are thinking about spacing, I think it’s a really important conversation to have with your child’s clinician on what they feel comfortable with. I do have some families that space. I will say 95% of my population is on schedule, but the 5% of my population wants to do one at a time. They want to come back every couple weeks. To me, I look at, “Okay, as long as we’re not going months, months apart between these vaccines, then we’re probably going to be okay.” But it is a probability.

So when you’re thinking about these decisions, it’s important to know, “Well, do I want to go on schedule? Do I want to space it out?” But the most important thing is, “Do I want to vaccinate my kids?” And as a pediatrician and mother, I do support vaccination. I think the benefits outweigh the risk, because we want to protect the children against those illnesses.

Myths of vaccines and autism

Jessica: That’s so helpful. I remember doing the… Bringing my baby back a week later, or at most, two weeks later, and then realizing that so many of the vaccines were bundled anyway. It can be very complex if you decide to do an alternate schedule, but it can be done, and it’s really helpful to have this data from you. What do you say to parents who are concerned that there is a link between autism and vaccinations? 

Dr. Mona: So there are many research studies. The HealthyChildren website, this is the website from the AAP, they actually have a section that lists all of the studies that show that vaccines are not related to autism. One study that was done, when this all started back in late 1999, early 2000s by Andrew Wakefield, that was withdrawn from that paper. He actually was not forthcoming about his measures in that study, he was stripped of his medical license. But that whole movement caused a lot of the hesitancy with autism and vaccines. But we know, based on every research study that keeps coming out, larger populations, internationally, that we are seeing that still, what we know is that autism is a genetic component, and there is no correlation or causation with autism.

Jessica: And then for those teeny-tiny babies, when you bring them into their first appointments, they’re just so little, and then you’re giving them… It seems like you’re giving them lots of vaccinations. The vaccination schedule starts when they’re very young.

Dr. Mona: I want to remind you that the studies that we do for that is the youngest age, again, for the two-month visit when we give those regular vaccines, HepB is given earlier than that; this is all done on studies and monitored, like I said earlier, right? So this is all things that have been monitored and studied to show safety and efficacy for that child. So parents commonly say, “Well, it seems like so much for their immune system that their immune system will be in overdrive.” There is nothing to show us that a baby’s immune system would be in overdrive. Some people say, “Oh, if you get vaccines, then you’re more likely to get sick all the time and allergies.” Nope, I don’t see it at all. And I look at the data, but I also look at what I see in my office. Healthy kids come with vaccination.

So if I started to see at any point, or if any of my colleagues started to see at any point that, “Huh. Are we seeing correlations or causations with vaccines and certain illnesses?” We would sound an alarm. This is not something that we hide from anyone, right? So when parents are coming into the office and your pediatrician’s saying, “We trust this, we want it.” It comes from our own integrity. Every time the parent comes back, I ask, “Well, how did you do with the vaccines?” Every single parent gets asked that question. We talk about everything, we make sure everything is going good. And I’ve been doing this for eight years. There is nothing about the vaccines that concerns me or my colleagues.

You know, I have colleagues that work and have been working for 30, 40 years and same thing, we talk about the history of vaccines, we talk about what we have in the market now, and the vaccines that kids are getting. And it is… There is a large checks and balances that I think many parents don’t really realize is going on, not only between the CDC and the reporting system for adverse side effects, but also just in our clinical experience.

Natural birth: Prepare for the unexpected

Jessica: Let’s back up and talk about birth. So women oftentimes feel this kind of unspoken pressure to have a natural birth. Would you share with us a little bit about your personal birthing experience and what you took away from that? 

Dr. Mona: Oh, absolutely. So I’m going to be really forthcoming here. I thought that I would have a vaginal delivery, breastfeed my baby, no epidural. I did HypnoBirthing, I saw a chiropractor, I saw a massage therapist, I did everything to prepare myself for a “natural birth” And I’m putting it in quotes because of course, there’s some debate on that. You know, what is considered natural? But yeah, I was in that boat. I was like, “I don’t want to have antibiotics if I don’t have to have antibiotics.” So when I found out my son was GBS negative, I was very happy because I’m like, “Okay, great. I probably won’t need antibiotics.” I ended up needing it all.

So I needed to be induced. So the Pitocin that I had caused my contractions to be out-of-control pain, so I ended up getting the epidural. I ended up getting a C-section. I ended up needing antibiotics because I was spiking fevers. I ended up formula-feeding my baby because of birth trauma. So everything that I had planned didn’t go according to plan. And I want to mention that I had the mentality also that this is what I was going to do. I wanted to hire a doula. I am a physician, but I’m really into natural things also, which I think maybe that’s why when I, when you hear me talking about how I’m so pro-vaccine, maybe it makes you feel a little bit more secure about coming from someone who is more natural. But I definitely wanted all of that and I didn’t get it.

And our experience was very unfortunate. Ryan got stuck in my pelvis during the C-section, they couldn’t get him out. It was this big to-do. You know, 16 months later, I still have very vivid memories of everything that happened. But the biggest thing that I remember was after that, being so, so disappointed that first, when I had… When I realized I had to go in for that C-section, I cried. I was like, “Well, I’ve been waiting, I’m dilating. Why can’t I dilate?” I felt like a failure. I felt like, “Well, why couldn’t my… “ I was 9 cm and not moving. I was like, “Why? What could I have done differently?” I really couldn’t have done anything differently. In the C-section, when they were having me sign the consent forms, I felt sad. I had some of the nurses talk to me and they were like, “Don’t worry, you can try for a VBAC. And I had four C-section babies, and they’re healthy.” And I’m like, “I know. I know, I see it all the time, but I just had that vision that I would have that vaginal delivery.”

And then when the trauma happened and Ryan didn’t allow skin-to-skin for over 12 hours, my breastfeeding journey failed before it even could begin. I didn’t have milk supply, I was in the ICU, I couldn’t… I was pumping, I was septic. I decided to end my journey because of how sick I was. And I had to make that choice that, “Hey, I want to try pumping and I want to try breastfeeding, but I also need to heal myself. And if I’m not alive and if I’m not able to take care of my son, then it won’t matter if I’m breastfeeding or formula-feeding him.” So I realized that the importance comes down to mom’s health, mom’s mental health, and that was something that was really hard when you had that expectation to begin with.

C-sections & essential microbes

Jessica: Yeah, that is so… It’s so much in terms of these ideas of what we think is going to happen when we have a birth, and then what, the reality of that. I think that there’s just a lot of mental shift in letting go, too. There’s evidence that babies born by cesarean miss out on this transfer of essential bacteria from their mother. Is there anything that could be done about that? Or how did you think about that? 

Dr. Mona: Yeah, so one of the biggest things that can help with that is obviously, breastfeeding can help because you’re introducing some of your immunoglobulins and things like that to the baby afterwards. The other thing is considering things like probiotics. There’s a big movement with probiotics. I think it’s not harmful, it’s something that you do have to clear with your child’s pediatrician in terms of giving it to the baby. I think if a mother ends up doing a C-section, I think the mother should take probiotics to help with their gut flora, to also help with the fact that sometimes, they do need antibiotics and other medicines. It’s no harm in doing it. And then for the baby, it’s something to consider. There is going to be a lot more research studies about this, I’m sure, in the next five years, because the microbiome and gut flora is such a hot topic.

I also want to remind families that so much of our health of our babies is also the foods we end up giving them when they start solids. So yes, you are breastfeeding or formula-feeding your baby for six months, a year, and then you’re starting the food, and then maybe you’re breastfeeding a little bit, obviously, after one year. But there’s so much of what we do and give our children in terms of immune health comes from the foods that they eat later in life. So around the sixth-month mark, when you start solids, that has a huge effect on immune system. And so even though a child may have missed out on that, the stuff that we get from the vaginal delivery like the enzymes and the immunoglobulins and everything that comes from the vaginal delivery and coming just through the birth canal, that bacteria, the non-sterile environment, there are ways that we can make that better or different as the child gets older. So it’s not a one or done, “Well, I didn’t have a vaginal delivery, so my child’s going to be destined for allergies and sickness.” You know, my son’s 16 months, has never had a cold, I didn’t breastfeed him, he was a C-section baby. So that, I think, goes to show you that it’s not all-or-none here. There are other things that we can do to keep our kids “healthy.”

And the other component is it’s a large part of it is genetics. We talk about, “Well, there’s so much that comes through the vaginal canal.” But a lot of our innate immunity is what our mom’s immunity was, what our dad’s immunity was. And so I don’t want a parent to feel they really caused harm with their child by needing a C-section, right? Sometimes, it’s the safest way to get baby out. Sometimes, you chose to do formula because it was the best thing for you as a mom. So I really want to really re-affirm your beliefs and say, “Your child will turn out amazing. A lot of it is the environment that we live in. A lot of it is genetic. And a lot of it is the foods we eat later in life.”

So it really is a package deal here. It’s looking at, what can I do as a mother or father to give the big picture for my child? If I didn’t breastfeed, fine, I’m going to formula-feed, but I’m also going to focus on nutritious foods, either way, when my child starts solids. So when you look at it from this angle, it’s going to really empower parents, I believe, to make the best decision for themselves, but also, make the best decision for your mental health, what you think is best on your resources, too. Because I see so much guilt and a lot of that guilt is created by social media. A lot of that guilt is created by people who don’t understand the middle ground approach that we can take to our children’s health.

Homemade vs. store bought baby food

Jessica: I love that and you’ve… This is just perfect lead in to my next question, which was is talking about homemade versus packaged baby food. Obviously, there was this kind of big report that came out about packaged baby food. Where do you come out on the making the effort to make homemade, whether that’s baby-led weaning, preparing some food according to baby-led weaning standards, or preparing homemade purees versus packaged baby food? 

Dr. Mona: That’s a great question. And I am very respectful of parents’ resources and time. So when I give you my answer, please know that I take care, like I said, of a variety of different socioeconomic statuses in my office, okay? So I get it that sometimes, I have mothers who are working four jobs. They do not have the time to sit there and make homemade baby food. I will say, though, when you look at it and break it down by time, it’s not that much more time. It does maybe require a little bit of more mind space and mental space to plan, but it actually, if you meal-plan, homemade food is actually not that much more time-consuming because you can just do it the week, you can freeze the food, you can thaw it, you can put it in the fridge. I am a big proponent of homemade baby food, if we can make that happen. I’ll get into what you will look out for if you’re buying baby food. But when you home-make food, you are looking exactly at what’s going into that. You know exactly if you’re putting any seasonings in it. You know if you’re adding any sugar to it. You know everything that’s going into that food process.

Metals in baby food

In terms of store-bought baby food, they are regulating store-bought baby food. That report that came out is very alarmist, and the terminology that they used was a little bit based on fear, and then they… It got released into media, and it caused a big uproar. None of the stuff that they mentioned was anything that we did not know. As a summary for any of our listeners that may not know, they talked about how there’s heavy metals in baby food and how there needs to be more tighter regulations. We know that metals exist in food. Why is that? Plants, right? They grow on the earth, so fruits and vegetables. There are naturally-occurring metals that happen in the earth, so of course, you’re going to see metals in baby food. If you were to test your own baby food for metals, there’s going to be metals if you make it at home because metals exist in our vegetables and our fruit.

Now, of course, what we’re looking at with that report is that how much of the metals are coming through the manufacturing process, and that’s what I think the take-home is, just to reduce the any additional metals that can come from the manufacturing process, which right now, there is no harm or concern that it is to a level that’s concerning for our children.

Balance your options

What we do want to do, as parents, is balance the options. So if you are using store-bought, I encourage you to try to consider moving in home-bought baby foods. If you are making your food at home and you just don’t have the time and you’re tired, it’s okay to buy some store-bought baby foods. When we meal-plan for our son since he was a baby, and we started baby-led weaning and purees, I really looked at balance, right? I looked at convenience items. I looked at what can I make. And I balanced it. So feeding your child a jar of spinach that you buy from a grocery store is not going to be good for every single meal. And that goes the same as if you were to make spinach. We don’t want to give your child spinach for every meal.

And then with the beauty about baby-led weaning, we could do a whole other baby-led weaning talk, is that when you start baby-led weaning, you are literally giving the child what you eat. When you give the child you eat, you’re not panicking about any of the metals or foods that in your food, so we should not matter… It doesn’t matter for kids, either. So when you start to look at baby-led weaning, you’re giving your child exactly what you eat, obviously, in a texture that they can handle. But that is going to give them the nutrients that they need, that is what the family is eating. And that is why I think it’s great when you can start to incorporate your diet with your child’s diet, too.

Nature and nurture

Jessica: So helpful. And so at Lovevery, we talk a lot about the environment, and you’ve touched on this, but the power of the environment and really, just kind of the intention that we bring to our child’s experiences, those early experiences, as really helping to improve their outcomes. There’s also genetics. So this is the age-old nature-nurture question. Where do you land on this? Can you share some thoughts with us? 

Dr. Mona: Yes, I love this question. I am a believer that it’s 100% nature and 100% nurture. So you can’t divide it. Our life and our health is so much of both of those things. I am a big nature and nurture researcher, meaning I am constantly looking at things that are happening in a child. I look at my own experience as a child. I talk to my sister, I talk to my husband, and I’m always looking at things of, “Is this something that was a child’s nature? Or was this something that maybe was in the environment for that child?” And like I said, because it’s 100% of both, sometimes, you won’t be able to tease out, “Well, which one was it?” And so I am a big believer that what we put into our bodies is very important, right? And that’s why I keep going back to foods, and the water versus sugary drinks. All of this is so important to me. But also, the environment that the child’s in.

I know I’m talking to you and I love Lovevery. That is part of the environment. Even if you’re not using Lovevery toys, what sort of nurturing environment are you giving your child the space to have emotions, the space to explore? Not hovering over them at every moment is so important, in my opinion, for development. Allowing them free-range to just be able to explore their environment, but you are there with boundaries, you are there if they need you. So all of this is so important, and I love this because I just think it’s… Parents often think that, “Oh, I’m doing something wrong. You know, I’m parenting my child and it’s not sticking.” And I tell them, I’m like, “Actually, it’s a little bit of both. We need to have boundaries as parents, but we also have to understand that not every child is the same.”

So it’s really important that we understand, as parents, what are the different strategies I can do to handle a certain situation? So with sleep: Do I want to do sleep training? Does my child need a little more of a gradual approach? With feeding, does my child take easy to purees? Maybe baby-led weaning is better. With tantrums, does my kid respond better to timeouts? Do they respond better to more positive parenting? We’ve got to be open to the different styles of parenting, even within our own families, because sometimes, one method won’t work because you’re addressing a child’s nature. And so we can’t always blame the nurture, vice-versa, we can’t always blame the nature, too.

Do what’s best for your family

Jessica: Such words of wisdom. Thank you for that. Are there any final thoughts you want to share with parents listening in? 

Dr. Mona: I think the biggest thing is always remember that I know that when you are in a decision, let’s say, let’s bring up the breastfeeding versus formula. I know that when you’re making that choice, how hard that choice can be when you had an expectation, especially, right? If you didn’t have an expectation or you didn’t have any guilt associated, you’re not going to have any problem with that decision, right? You’re just going to say, “Okay, formula’s great. I’m going to do formula.” I didn’t have guilt because I know formula-fed babies turn out amazing. I didn’t have any guilt when I had the C-section after the fact because I know C-section babies turn out amazing. And with all of the decisions we make as a parent, it’s important to own it, it’s important to understand that that is your decision and that is your story. And run with that, right? Don’t think about what everyone else is doing. Look at your child, look at the things that make your family what it is because in the end, that is going to be the most important thing. What makes you happy and what makes your child happy is going to provide the best outcome for you.

Jessica: It’s been so wonderful talking to you, Dr. Mona. You’re the pediatrician that we all want to have in our communities. So thank you, thank you for being there for all of us today.

Dr. Mona: Yes, So kind, I love it. I’m so happy I got to talk to you, Jessica. I’d love your… Your company has done so much for this world and I love your products, so it really is such an honor to connect with you.

Get more straight-forward parenting and medical advice from Dr. Mona @PedsDocTalk. As a reminder, Dr. Mona’s answers are for the purpose of education only and do not constitute medical advice. If you have a concern about your child’s growth or what formula to use, please consult your child’s pediatrician.