From Pregnancy to Parenthood: The Microbiome’s Impact with Dr. Elisa Song | 135

Today we have the absolutely honor of talking with Dr. Elisa Song. She is a Stanford-, NYU-, and UCSF-trained integrative pediatrician and functional medicine expert who is on a mission to revolutionize children’s health. She has been at the forefront of integrative pediatrics since 2004, blending conventional medicine with holistic tools like functional nutrition, homeopathy, and lifestyle medicine to help children heal and thrive.

In this conversation, we explore how the microbiome influences every stage of a child’s development, from pregnancy and birth through childhood. Dr. Song shares insights into the effects of antibiotics, the importance of parental microbiome health, and practical ways to foster resilience in both parents and children. This is an empowering conversation that will leave you feeling inspired and ready to finally commit and rebalance your whole family's gut health with the Women’s and Children’s Gut Rebalance Kits.

Juniper (00:00)
Elisa, welcome to the podcast. is an absolute honor to have you here. And as I share with you right before I push the record button, Oh, what I would have given to have you in my life when my son was really unwell. And when my adventure in the microbiome world first began, will you please just take a moment to introduce yourself voice, your experience, your knowledge is so powerful. So you are real gift to all of us moms. Thank you.

Dr. Elisa Song (00:31)
thanks so much. I so appreciate your kind words. And I'm honored to be here. My passion is really to educate moms and kids. a lot of it stems from me being a mom and diving into this and wanting the best for my kids. Just seeing the state of health right now that children are encountering and at risk for, it's time to change. so.

I am an integrated pediatrician and pediatric functional medicine doc. I'm in the San Francisco Bay area. And I started my practice back in 2004. So it's been quite a while. know, I started it. was one of the first integrative. And back then there was no term integrative pediatrics. It was kind of alternative medicine, right? And so, you know, when I started, it was kind of the Wild West out there with really trying to apply adult functional medicine knowledge to pediatric populations.

Juniper (01:17)
Yeah.

Dr. Elisa Song (01:27)
So I found my way and just had the honor to really build this beautiful practice of families who, you know, it runs a gamut from well kids whose parents realize that the way healthcare is working is really not serving our kids to really help them thrive. It's not providing true sort of preventive resilience, you know, in our kids to families and families who want to seek an MD who can also offer alternatives to medications and know that when medications are necessary, how to do some of the mop up as you're well aware, right? Especially to the microbiome in our children. To families who have...

Juniper (02:08)
Yeah.

Dr. Elisa Song (02:16)
Sick kids, whether it's mental health concerns or ADHD or autoimmune conditions, eczema, asthma, allergies, all of which are on the rise and are looking for ways to actually heal from the inside out rather than just kind of use band-aid solutions. so it's been a journey and I've loved every bit of it. And I incorporate, of course, conventional pediatrics, but I also do diet and lifestyle, functional medicine, homeopathy, acupressure and acupuncture, essential oils. Homeopathy is a big part of my practice. So I like to tell parents, look, we're not gonna throw the baby out with the bath water. There is a time and a place for conventional medicine. However, we know that many, many conventional medicines are overused and inappropriately used and without an understanding of some of the unintended consequences that may be trading short-term benefits for longer-term future health problems. So being aware of that. And I started my online business Healthy Kids, Happy Kids really out of this recognition that so many families don't have access to this information and they don't have access to an integrated pediatrician near them and are want to do the best for their kids, but don't necessarily want to trust Dr. Google, right? And so that I'm honored to be a resource for families and for practitioners. mean, I will say it's one of the most inspiring things when a conventional pediatrician or family practice doc writes me or messages me and says that something, podcast they listen to like this or...

Juniper (03:44)
Yeah.

Dr. Elisa Song (04:06)
my book that they've read has opened their eyes and now they're looking at getting more training in this other way of thinking. I mean, that inspires me every day too.

Juniper (04:17)
my son, he was born in 2014 and... Even then, was not something that I could find. I I took him to 17 different healthcare professionals looking for answers and not a single, and across the board, Ayurvedic doctors, pediatricians, allergists, lactation consultants, everybody. I was just trying to connect the dots because I knew that his really bad skin rash, his reflux, his colic, his, as he was getting older, that really

Dr. Elisa Song (04:26)
Yeah.
Yeah.

Juniper (04:52)
sour smell in his diaper, undigested food, behavioral issues. I knew it was all connected, but there was not anyone until we finally met with a naturopath who he, you know.

Dr. Elisa Song (04:53)
Yeah.
Yeah.

Juniper (05:06)
validated what I knew all along. It was all connected and he helped me bring it back to his microbiome and taught me how to heal his gut and I had to fight so hard and that is why I have created my business Only Organics is to share the healing that he taught me and when you heal the body from the foundation, when you heal from that microbiome, it is absolutely amazing.

What your body is capable of and how much your body can actually heal itself when your microbiome is healthy. And even for me, know, after I learned all of this with my son, was like, well, there's like no negative side effects of healing my own microbiome. I'm going to, I'm going to apply this to myself and my whole family. And as someone who's lived my entire teen and adult life with ADHD,

Dr. Elisa Song (05:37)
Yeah.
Mm-hmm.

Juniper (06:04)
I don't experience that chaos in my head like I once did and it's because of my microbiome. And so I think I want to, there's so many ways that we could take this conversation. But

Dr. Elisa Song (06:12)
Yeah.

Juniper (06:18)
I think we should focus some time on two key things, antibiotic use and how this impacts a woman's pregnancy, child developing in utero into early childhood. And you know, what happens when a mom takes antibiotics during birth or early life for that baby or if that baby directly needs antibiotics. So I want to talk about that.

Dr. Elisa Song (06:41)
Yeah.

Juniper (06:45)
And then I would love to just really talk about, you know, these really formative stages of our life. So the importance of a mother's microbiome during pregnancy, postpartum, and those really early formative years for children.

Dr. Elisa Song (07:04)
Yeah, that's such an important conversation because so much of integrative functional medicine and conventional medicine is still focused on what to do when something goes wrong. It's still, even in our functional medicine world, which I'm so grateful to have found, but there's still not a lot of discussion on, could we actually prevent

Juniper (07:20)
Yes.

Dr. Elisa Song (07:32)
one in two kids from having a chronic disease, could we actually prevent eight in 10 adults from having a non-communicable chronic health concern that really will be the defining parts of our end of life? mean, that starts. I always tell people, look.

In this day and age where everyone's trying to biohack their longevity, well, know what? Longevity actually starts before you're born. You know, it starts with, you know, mama's health and actually mama's and papa's microbiomes. mean, papa's are not, you know, out there, you know, not, not responsible for any of this. We're all, if we understood that and we created a world that nourished our microbiomes, then I mean, so many things, as you said, would fall into place.

Juniper (08:09)
Yeah.

Dr. Elisa Song (08:23)
There's one of the doctors who I respect so much, and he's done so much to bring the awareness of microbiome and gluten intolerance and celiac disease to the world, is Dr. Alessio Fasano. He's an Italian pediatric gastroenterologist now at Harvard. many people know that Hippocrates, the founder of modern medicine per se, is credited with saying that all disease starts in the gut.

But Dr. Fasano, he has said, the gut is not like Las Vegas. Whatever happens in the gut does not stay in the gut. And we know that because of, yeah, isn't that amazing? Because the ripple effect of simply focusing on the gut microbiome, restoring microbiome resilience, and really having that solid foundation of a healthy gut microbiome,

Juniper (09:03)
Ooh, I love that.

Dr. Elisa Song (09:21)
which is not just the probiotics in your gut. It's a whole ecosystem, right? The whole terrain. Microbiome is your microbiota, the microorganisms, and the sort of ecosystem that they live in and the genes that they bring to us. And so just by shifting our microbiome, we can have healthier brains, healthier immune systems, healthier metabolism, healthier hormones. And so rather than

Juniper (09:26)
Yes.

Dr. Elisa Song (09:51)
as you intuitively knew as a mom way back when, kind of trying to fix individual pieces of what was going on with your son, if we work on the microbiome, then there's actually so much less other work to do. And then it's more about the fine tuning, right?

Juniper (10:07)
Exactly. Yes. And this is where this conversation is so powerful. You know, for my son, was, well, let's treat his skin with this and let's treat his digestive issues with this. I get a message every single day. my child is constipated. I've been told to give him Miralax for ever. treating these individual symptoms is really so much at first it's wreaking havoc on our bodies because we're not addressing the root issue, but it's

Dr. Elisa Song (10:17)
Mm-hmm. Mm-hmm.
Yeah. Yes.

Juniper (10:38)
It's so much more complicated than just going straight to the foundation, straight to the problem, right?

Dr. Elisa Song (10:43)
Yes, yeah. Now, one thing, of course, the foundation is early in life, even again, as we mentioned, mother's microbiome, her gut microbiome, and her vaginal microbiome are so key to how babies start off in life. And we know this from several studies that look at what happens when an infant's microbiome is disrupted very early on in life. So there are two big studies that I point to.

There's one study that came out in 2016, and this looked at nearly 800,000 children who were exposed to either antibiotics or antacid medications in the first six months of life. Now, those two, antibiotics, antacid medications, are very big immediate disruptors of the gut microbiome. And so this study followed those babies out into early childhood and found that by the time those babies were four years of age, they had a significantly increased risk of virtually every single allergic disease. Eczema, asthma, hay fever, food allergies, hives. and the researchers conjectured, now mind you, this was 2016, this was a while ago and microbiome still wasn't kind of on the map like it is now and it still needs to be on the map more.

But the researchers conjectured that perhaps there was something going on with that disruption in the early gut microbiome that informed how the baby's immune system developed in life. We also know there's such an intimate gut-brain connection. We know that babies and children who have gut issues often have correlated behavioral concerns, attention-focused concerns. And is it a chicken and egg thing? Because behavioral concerns are psychological stress can also trigger gut microbiome disruption. But this other study was a very large study, looked at nearly a million births in Finland, and also looked at antibiotic use in early childhood or antibiotic exposure. And this included in utero exposure, like when a mom takes antibiotics for a sinus infection or a UTI when she's pregnant, or even group B strep. know, vaginal group B strep in receiving antibiotics and found that those children, younger children who were exposed to antibiotics early in life had a significantly increased risk of mental health concerns by the time they were older kids and teenagers, by up to 50 % sometimes. And the younger, the antibiotic exposure, especially before six months of age.

And the more rounds of antibiotics exposure, the higher the risk. So we know that that disruption early on can really affect how the baby's brain is also developing. Now, I always pause here, though, because a lot of moms listening are going to think, my gosh, but I had antibiotics when I was pregnant. Or my child received antibiotics when they were three months old, and now they have X, Y, and Z. Well,

The reason you and I are doing this work is because it's never too late to restore microbiome health, right? Never too late to heal. But the first part of healing is to first understand and know.

Juniper (14:06)
It is never too late to heal.

Dr. Elisa Song (14:15)
And I will say there is a time and a place for antibiotics. It's just that we have to know when they're necessary and also know how to do the mop up.

It's really, know, knowledge truly is power. And even if those antibiotics were years, years, years ago and your child now is eight or 12 or 15, we can still restore. It might take a little bit longer, but that's okay. I mean, this is...

You know, we really want to think of microbiome resilience for a lifetime, not just this, you know, one-off, let's fix it and not worry about it. It really has to become a way that we live and think about, you know, our every day. How do we support and nourish not just me, but the trillions of tiny, you know, friends in my tummy that are living inside of me?

Juniper (15:02)
feel so connected with you. don't know that I've ever really had a conversation with anybody who, I mean, I just see the entire world through a microbiome lens now. Like every single part of my life is filtered through this microbiome, hyper awareness.

Dr. Elisa Song (15:19)
hard not to when you know

Juniper (15:20)
I can't unsee that. so everything you're saying, it's a really beautiful conversation because this is for those who have needed antibiotics and it's also for those maybe who haven't because wherever we are on this spectrum, all of our microbiome are... of fighting their own battle all the time with our exposures whether it's two medications or just the toxins and chemicals in our foods and in the air and in the water and so having this awareness is power no matter what stage of your life you're in but

Dr. Elisa Song (15:45)
Yes. Yes.
Yeah.

Juniper (16:01)
I feel that it is especially lacking, this awareness is lacking in our mother bearing years. And I mean, I had natural childbirth with midwives and I was told to take a prenatal vitamin, but I was never really educated on how much my microbiome mattered.

Dr. Elisa Song (16:09)
Yeah. well, and it's, you the research has been there, you know, and you look back, you comb through the research. And really, when I was writing my book, I was trying to find out when did we first learn about the connection between leaky gut and pediatric health conditions? Because it's fascinating to me how still in many conventional medical institutions, leaky gut is still something that's kind of poo-pooed as, this is, I mean, no pun intended. But as, I just realized as I said that. But, you know, really is not considered a valid concern. Now it is changing a bit, which is great. I mean, there are, you know, conventional docs who are now beginning to recognize that increased intestinal permeability is a real phenomena that underlies so many chronic health concerns. But the first report that I could find in PubMed on the connection between leaky guts and a childhood health concern was 1983. 1983, leaky gut and childhood eczema. I mean, is, as we're talking right now, that's almost 40 years ago. And to not have this more in the forefront,

Juniper (17:28)
Ow.

Dr. Elisa Song (17:41)
There's a paper from the 1980s looking at mothers who, where there's a family history for that baby on maternal or paternal side of atopy, right? Eczema, asthma, hay fever, allergies. I mean, those are so much on the rise, right? And so we should be aware of this. Now this one paper looked at mothers, gave them one probiotic strain.

Lactobacillus rhamnosus GG, which is super easy to find over the counter at CVS or Walgreens. It's called culturel. But mothers who received that antibiotic during their third trimester and for the duration of nursing had a significantly decreased risk of their babies developing atopic disease. I mean, why not? Why not share the information? Why wouldn't an OBGYN or a pediatrician know that simple, safe intervention to suggest, right? And so, I mean, there's so many things that, you know, they say it takes, you know, an average of 17 years for the research to get translated into clinical practice, but this has been way over 17 years. And it's time, it's time that parents and practitioners really understood this is grounded in science and evidence. 

It's not just... this woo-woo thing that, it's a fad that's gonna go away. It's something that we really need to embrace as the future of how we need to be practicing medicine from a microbiome-centric standpoint, as you said.

Juniper (19:18)
Absolutely. I mean, in so many ways I can relate as a mom who saw my child suffer for two and a half years without answers. When the naturopath said, his gut is imbalanced, we need to heal his microbiome.

My first thought is how can it be that simple? How can it, how can that be the answer? we have jumped through so many hoops. We have fought so many battles. How can it be that simple? But the answer is that our microbiome is not simple. It's very complex and the intricacies and connections it has to every single part of our body is so profound and

Dr. Elisa Song (19:39)
haha
Mmm.

Juniper (20:03)
I get these questions quite frequently from moms. I think it's gotta be something different for my child. It's gotta be something bigger going on. And the answer, the truth is that our microbiome is so significant for our overall health.

Dr. Elisa Song (20:19)
That's right. things, you know what? A lot of the things in life, many of the solutions in life, if we think about it, they're actually simple solutions like getting restorative sleep every night or moving your body every day. Those are simple solutions. And yet simple doesn't mean it's easy. And simple, these simple changes and working on the microbiome are things that, as you said, can be so profound.

Juniper (20:29)
Yeah.

Dr. Elisa Song (20:46)
but we have to put in the work. It is not just about popping a pill and saying, microbiome is fixed. I mean, this really is how we're living and eating and breathing every single day. And the biggest fallacy for a lot of families and even practitioners is, well, fixing your microbiome is just about taking probiotics, which is so far from the truth.

Juniper (21:06)
Yeah.

Dr. Elisa Song (21:09)
And the other thing too, to your point when you said, well, a lot of parents think, it really be that simple? I do want to also point out that for some families, the question that I get is, I had a natural delivery, no antibiotics, was eating great, doing everything right, but my child still has eczema. They still have colic, they still have behavioral concerns.

Juniper (21:33)
This was me. Yeah.

Dr. Elisa Song (21:38)
And so here's the thing, one thing that you said before is so key, you know, in our modern world, we just have so many forces that are really acting to disrupt our gut microbiome. In fact, all of these forever chemicals and hormone disrupting chemicals that people are aware of, some researchers are calling for them to no longer be called endocrine disrupting chemicals, but microbiome disrupting chemicals because they don't just disrupt our hormones. They have so many other effects on infants like IQ and testicular development and all of that, but that has less to do with the disruption directly to their hormone access but more to their gut microbiome, which then affects their hormone access. And there was one fascinating study that looked at, was a Scottish pathologist who 100 years ago was analyzing babies' poop. I mean, was looking at microbiomes of breastfed babies back then compared to formula-fed babies back then. mind you, 100 years ago, I don't know exactly what formula looked like back then, but it was different. And there were some babies who just couldn't receive breast milk for whatever reason. And what he found was that the breastfed baby 100 years ago had nearly 100 % bifidobacteria species. And the breastfed babies had a lot more diversity in their microbiome. Fast forward now, 100 years later, and the breastfed baby's poop looks much more similar to the formula fed baby's microbiome of 100 years ago. So there's a difference here. 

It's not... you know, even if we're doing all the quote right things, most of us are still starting off our vaginal microbiomes and our gut microbiomes in pregnancy in a less than ideal state. So I love, love, love when, you know, families are, you know, on the pregnancy journey and thinking of conceiving if both moms and dads can pause a little bit and take that time, you know, three to six months to really focus on microbiome resilience and supporting your nutritional levels and psychological stress and all of that. a lot of times nowadays, we're just in such a rush, rush, rush to get pregnant that we lose sight of the fact that if we just pause, nourish our microbiomes, A, it's going to be easier to get pregnant.

Juniper (24:14)
Yeah.

Dr. Elisa Song (24:31)
B, you're gonna have a healthier pregnancy and delivery outcomes, and C, you're gonna have a healthier baby. So stopping the rush and focusing on your microbiome can make a world of difference. So I encourage mamas who are listening right now and trying to conceive their first or second or third baby and feeling like time is running out and I have to really get on this and my doctor's saying I have to do X, Y, and Z, taking that moment to do the microbiome work for you and your partner is really gonna be so worthwhile.

Juniper (25:06)
Well, something that you said, our exposure is so high and simultaneously, chemilkized farming has really changed the microbiome that's available in our foods. And so we really have to be intentional. It's a very intentional work to restore our microbiome and then maintain that balance in our bodies. And...

Dr. Elisa Song (25:17)
Yes.

Juniper (25:31)
this work does take time. There's some people, I've been following your healing method for six weeks and I've three weeks and I've not really seen a difference in it always comes back to time. How long have you lived your life with these symptoms or how long have...

Dr. Elisa Song (25:46)
Mm.

Juniper (25:54)
you maybe not been focusing on your microbiome, it's going to take time for your microbiome to heal. And when you can pause preconception to really consider that, I mean, you are setting yourself and your baby up for such a beautiful experience because It not only is going to impact your baby from the very beginning of their life, but also maybe we could talk a little bit about a mama's postpartum period, the difference between, you know, when her microbiome isn't healthy and strong versus when it is and that different experience. the statistics are alarming in postpartum depression rates and what that period looks like for

Dr. Elisa Song (26:43)
Yeah. Well, you know, our microbiome is so instrumental in making so many substances that are called post-biotics that nourish our health, our body, our brains, our immune system. 

So when your microbiome becomes depleted, many are the beneficial flora, the probiotics in your gut that are designed to make your vitamin B12 make Butyrate which is a short chain fatty acid that supports your mitochondria and your brain health make the vast majority of our serotonin that helps us feel calm and relaxed and helps us sleep or dopamine that helps us stay focused or Acetylcholine which helps us connect and know the the dots in our brains, you know when we don't have that after birth and were depleted, which, know, pregnancy and delivery, they're a huge stressor on your body, right? That's why many women, you know, at the three-month mark, hair is falling out like crazy, right? Because your body just went through this massive, massive change and stress. I mean, it is a stress to your body. And so we need that microbiome restoration, the healthy microbiome to be able to recover. There's a microbiome mitochondria connection.

Juniper (27:49)
Yes!

Dr. Elisa Song (28:08)
that's really intimate. mean, what's fascinating is, you know, our microbiota are, I mean, they're ancient, right? I mean, they evolved long before we did. And same thing with our mitochondria. I mean, they kind of evolved together inside of us. So there's microbiome mitochondria crosstalk. And mitochondria, for people who aren't aware, they are the cellular powerhouses of our bodies, they create cellular energy. So I'm not talking about rah rah, I'm super hyper. 

I'm talking more about the energy to repair the damage done on a daily basis. The energy to have endurance both physically and mentally. The energy to detoxify and push out from your cells and your body the things that don't belong. And so when we don't have that foundation of cellular energy, we know that mitochondrial disruption and microbiome disruption are some of the underlying factors in chronic disease in both kids and adults, but very much so for adults. 

And so even once your baby is born, making sure that you're nourishing your microbiome, is going to support your recovery, your postpartum mood, postpartum anxiety, energy, resilience, and also support your babies developing microbiome and their gut immune system connection and their gut brain connection. this is where really prioritizing mother's nutrition and health postpartum is so key. 

It's not a, I'll do it when I have time after the diapers and the dishes and the cooking and all of that. It's really, you have to do this, not just for yourself, not just for your baby, but to really have a sustainable future together.

Juniper (30:00)
Yeah. Well, and I love that word sustainable because when you do put in the work, I mean, it really, think there's like this transitional period that I experienced that I see in so many families is there's this transitional period to really learn and adopt a microbiome lifestyle. And once you get there, it really just becomes what life is and it's not hard. I mean, my family, we are,

Dr. Elisa Song (30:26)
Yes.

Juniper (30:37)
prioritizing our microbiome every moment of every single day with every choice that we make. And it's not a big effort because it's the lifestyle that we choose to live. so when you put in that work to initially learn how to adopt a microbiome lifestyle, it becomes second nature and it becomes a way of living that translates to your child and future generations.

And so the work can be hard and there can be imbalances that you have to work through. But once you get to this place, it's so beautiful and it really makes parenting, for example, so much easier. It makes sleep so much easier. It makes our everyday functions come with so much ease and joy because our bodies are functioning optimally.

Dr. Elisa Song (31:34)
Yeah, and you know, it really, really and truly is a microbiome lifestyle. that's, you know, I mean, that's exactly why I wrote my book, because I want parents and children and teenagers to understand this is not something that is rocket science per se. You know, we have to do the, we may have to do the work initially to restore and repair the gut if your microbiome has already become disrupted.

But then the way to keep your gut microbiome in a healthy state is with the things and the choices that we make every single day. And they're not difficult things to learn how to do. I mean, in the book, I call them the five things for microbiome magic. And these are five things that we're already doing every single day. We're already eating every day. We're breathing. We're moving. We're hydrating and sleeping. 

And so if we just learn a little bit more about the why and the of doing these in a way that nourishes your microbiome, it becomes second nature to, let's say you're at the grocery store when you're, these are my kids, they're teenagers now, when they're picking up a bag of chips, they know to turn it over, takes all of two seconds, turn it over, glance at the labels, and they know the key word is to know, maybe I'll choose something that doesn't have monosodium glutamate and pick up another bag of chips. 

And now in our, day and age now, there's so many options out there that are better for you and better for your microbiome. And so, you know, simply just having those habits in place. And it's all about learning new habits and then just making those a part of your daily life. And I promise you, I kids, adults, it's, I mean, it doesn't take that long. I had one kiddo who we were talking about, you know, we did a little fun sugar cube game and teaching kids about why sugar is really so disruptive to their microbiome and how they're thinking and how they're feeling and, do you ever get too worried about things and feel like it's too hard to manage or have trouble sleeping and you're just sitting there at night and you're worried that I'm never gonna be able to fall asleep and tie it back to the microbiome and to the sugar. 

And so once they realize, oh, okay, well, I shouldn't have really any more than about six teaspoons of added sugar in a day or 25 grams. I mean, they're kind of making a little math fun project, right? And then have them realize, like, my son came home the other day. I don't want to throw my son under the bus all the time, but he's the one who wants, like, the boba and the chips and all that stuff, right? And so, you know, he wanted to have a boba tea with his friends. And so said, you know, let's just make an informed decision, right? Just look and see what the ingredients are. And he said, well, there's nothing artificial in there. There actually is some strawberry in there. I'm like, OK. Well, what about the added sugar? And he's like, well, it has 42 grams of added sugar, right? Which is, if you want to do the math, about 4 grams is 1 teaspoon. That's like 10 and 1 half teaspoons of added sugar in one go and think about how easily you could slurp down a boba tea compared to you can't spoon in 10 teaspoons of sugar that quickly, right? And so then we had a discussion because I, you know, I'm a mom and I don't want to say no to everything and I also don't want them to develop an unhealthy attitude about, they have to sneak or they have to hide or they build resentment. So, you know, we said, look, if you're going to make this choice, It's an informed choice. 

You know that that is more sugar than you should have in a day. So we really need to cushion that and support your microbiome really fully with nourishing meal with lots of fiber and phytonutrients around that. And we're going to, it takes that sugar out of your sugar bank so that the next few days, yeah, we're not going to have that boba for the next day or the next day after that.

And then also he recognizes now that when he does have more sugar, it affects his soccer performance and it's really important for him. That he wants to excel on his soccer team and that's a goal of his. He's starting to get more aware of the effect on his skin. So he's choosing, making those choices. it's really, it's about informing and educating all the way along. And it's so much easier if you start when they're babies, little babies changing their diapers. look, what a healthy poop. my gosh, that must mean that the little friends in your tummy are so happy and, you know, just kind of weaving in the conversation so that it's when they're on their own, they are more empowered to make those decisions for themselves.

Juniper (36:39)
And that's just it. When we empower ourselves and we learn all that we can, we empower our children to get there. And it really is this beautiful, tedious dance, right? Of raising really aware children without, we don't want to instill fear. We want to empower them with knowledge so that they can make their best choices because there are some days where maybe I want a boba tea. I love those little bubbles, but you know, we have to, we have to make these choices very intentionally. And I think that that's, it's so powerful and it puts us in a position where we are the leaders of our life. We are not victims to the choices that we make and how, what more could

Dr. Elisa Song (37:08)
Hahaha
Yes.

Juniper (37:31)
we offer our children.

Dr. Elisa Song (37:34)
Yeah, I love that. it's interesting as I was thinking, we're just into 2025 right now. we go through, as many people do this exercise of, what is our word for the year? What are we setting forth as we move into 2025? And my word for the year is what you just said, intentional, right? Really having every moment, every interaction with... your children or your friend or every bite that you put into your mouth or the time that you start getting ready for bed. Just having those be intentional decisions, intentional choices that serve the goals that you want. To be healthy and happy and vibrant, right? To be there for your kids and to have your kids be healthy and happy and vibrant. And so, and... the more that we incorporate those intentional decisions every day, the quicker they become second nature. then your kids, mean, every stage in childhood brings different joys and different challenges. And so it is something that as they see you going through struggles, wanting that boba tea, I know I really want this, I'm going to have this. I mean, my weakness is donuts. And so they know, okay, well, usually I don't have a donut, but if it's there, I probably will have that donut. And yet it's gonna be an intentional decision to have this, enjoy it fully, no guilt. And then... for the rest of the day and even the next day make those intentional choices to make sure that my microbiome can bounce right back.

Juniper (39:32)
Yes, and isn't it so, it's so gratifying. You know, my son, I have four kids, my oldest, they're 14 and he just turned 11. And when they make a choice and then they come to me and they say, oh Mama, that was so good, but I don't think I should have done that because now my brain feels kind of foggy or I feel really tired or like letting them make those connections and seeing them connect what they're putting in their body to how they feel, how they sleep, how they're able to interact in the world is so beautiful.

Dr. Elisa Song (40:09)
Mm-hmm.
Yeah, yeah, that's exactly what we want for our children. It's not, because it's not realistic to say for most families, we're never gonna do this. And you never, you don't wanna live in a mindset of I can't do this. It's more, you know what, I can do this, I can make this choice, but I'm gonna make an informed choice. the faster kids make those, connect those dots on what they're putting into their bodies, have their living, how they're thinking, and then the outcome and how they feel, the faster they can decide whether they're going to continue with those choices or if they're going to maybe shift. So that's exactly what we want for our children. that comes with, I do think that comes with us as parents letting kids know, I had the donut, but now, yes, see, my tummy's really not so good the next day, right?

Juniper (41:13)
Yes, exactly.

Dr. Elisa Song (41:14)
Right? And I didn't sleep that well. I did eat it and enjoy it, but now I'm having some consequences. And so next time, I don't know, would I make the same choice? Maybe, maybe not. But having them watch us go through those same struggles, because it's not enough for us as parents to say, you shouldn't have that, because it's not good for you. It's like, well, let's just recognize if, yes, this is not ideal, but now we need to pay attention to how your body and your brain feel.

Juniper (41:43)
And you know, a way that I really like to filter it through my mind so it doesn't feel like, you know, because as soon as you frame something as I can't have this, suddenly it's like, I'm so restricted. feel, I feel like I'm trapped in this situation and that's a very disempowered place to be. And so instead I try to kind of look at it as like, get to say yes and no to everything. And when we say yes to something, that's saying no to something else and vice versa.

Dr. Elisa Song (41:56)
Yes.

Juniper (42:13)
And when we look at our food and we eat that way, like right now, am I going to say yes to feeling my best and showing up as my best self? Or am I going to say yes to indulging in this treat? And it can be that, and that's okay. But when we make that choice with intention, it's so much more powerful than just saying, I can't have that. You're not going to succeed in your microbiome lifestyle.

Dr. Elisa Song (42:33)
Yeah.

Juniper (42:38)
Okay, so we have talked about the importance of a mama's and a dad's microbiome preconception.

Pregnancy, postpartum, how important it is for a child's development. Can we kind of dive into antibiotics a little bit deeper? You speak about antibiotics differently than I've ever heard a doctor speak about antibiotics in such a different light and in such a different way. And just like with food, I love that you have this very healthy relationship of sometimes it's okay, sometimes it's needed, but we are overprescribing them. We are over using

Dr. Elisa Song (43:24)
So I mean, have, you know, with antibiotics, of course, I antibiotics are considered one of the most important public health inventions of the 20th century. And, truly in a time where even minor infections were killing people, they were so important. They were life-changing, and they can be life-saving. But now we are... really at the point in the 21st century where we're seeing the consequences of this overuse and inappropriate use of antibiotics. And we can think about that from a public health perspective and also an individual health perspective. From a public health perspective, the overuse of antibiotics is now leading to a time where by 2050, some world health experts are really concerned that antibiotic resistance is going to become a leading cause of death worldwide. A leading cause. And this is going to be a time where a simple skin infection or maybe an ear infection or whatever it might be could become life threatening. We never want to get to that point. Now, the pharmaceutical industry is calling for development of new, you know, different antibiotics, but we're just going to be in that same place all over again eventually. we really have to understand, you know, that good antibiotic stewardship, only using them when they're necessary and using them, you know, really judiciously is very important because in some studies, especially in children, up to 70 % of antibiotics that are prescribed to children are inappropriately prescribed, either for viral infections where antibiotics don't do anything for, or stronger antibiotics that are needed. so we really, mean, especially as a mom, when you're going into urgent care or to your doc and they're prescribed antibiotics, it is, I think, we need to be advocates for our children to make sure that those antibiotics are appropriately used. Now, from an individual health perspective, we also have to recognize that antibiotics, they kill bacteria, but they don't really care which bacteria they kill. I mean, they're gonna kill, hopefully, the bad stuff, but also the good stuff, our probiotics, right along with them. And some antibiotics have been shown to... actually preferentially kill some of the beneficial flora at the expense of saving some of the not such good flora, which is why we see C. diff infections, right? All the good bacteria have been wiped out. Now all of sudden, the C. diff can overgrow, and we have a C. diff infection. And then with that, we know every round of antibiotics, even as an adult, can increase the risk of psychiatric and mental health concerns after that course.

And so, three months down the road, six months down the road, if all of a sudden, as an adult or a teenager who started on doxycycline for their acne is feeling anxious or can't sleep or having a hard time manage, not enough people are connecting the dots to say, could it be because of the antibiotics and the disruption to their microbiome, right? Or the disruption to their gut immune system connection and maybe an increased risk for autoimmunity later on. And so, you know, it's really, it's both concerns for me as a pediatrician, this public health concern and absolutely this individual health concern for this kiddo in front of me. And that's where, when we, you know, look at, I mean, that's why I love using more natural medicine tools and using homeopathy and essential oils and herbs because... those are not going to have the same disruptive effect to the microbiome. And given that most illnesses that children encounter are viral, there's so much we can do for viruses that don't involve antibiotics at all and shouldn't involve antibiotics. so now when antibiotics are needed, though, it's also important that even if your practitioner isn't aware that you as a parent understand, okay, these antibiotics, I'm gonna trust that they're necessary. We're gonna finish the whole course so we don't develop antibiotic resistance. But we're also gonna really, really double down on our microbiome lifestyle and really restore and repair whatever damage has been done by the antibiotics so that our kids will bounce right back and not have some of the unintended long-term consequences.

Juniper (48:26)
a very trending conversation right now, that it takes two years for your gut to restore itself after one round of antibiotics. And I like the significance of that conversation because it really, it really highlights how big of an impact that antibiotics are making on your good bacteria. But

Dr. Elisa Song (48:34)
Mm.

Juniper (48:49)
A lot of us are starting those antibiotics with maybe not the healthiest microbiome in the first place. And what is your experience in this?

Dr. Elisa Song (49:00)
Well, I mean, I guess it depends on the organism because some organisms will bounce back more quickly than others. And so it may be that certain species do take longer. However, most of these studies are not controlled for diet and lifestyle. And when we're really focused on feeding the good guys and getting all the nourishment to bring back those healthy probiotics to our gut microbiome, I do think that the restoration can be faster. Because we know, diet can change your microbiome for better or for worse within 48 to 72 hours. It doesn't take that long to shift. But the key here is that we want to keep them there. 

And so that's where, when we think about post-antibiotic repair, I would recommend taking a probiotic supplement, maybe taking some nutrients to restore your gut lining, prevent leaky gut from happening. And really importantly, getting back to the basics of the fiber, phytonutrients, fermented foods for your microbiome, keeping out those ultra processed foods so that we're not inadvertently killing off the beneficial flora that we're trying to restore and making sure that we're... moving our bodies, hydrating and sleeping enough to really give those beneficial bacteria a chance to really come back and want to call your gut their home again. Right? I mean, it's kind of like, you know, we're trying to call in all the good neighbors into your microbiome.

Juniper (50:36)
Well, I'm so curious your perspective on this. So when we were healing our son, I was told, you know, to avoid wheat and dairy as these feed a lot of the bad bacteria and the yeast. And so is this something that you also recommend?

Dr. Elisa Song (50:53)
Yeah, you know, I would say if your child has any health concerns and we're working on their gut, I do absolutely think it's worth being off of gluten and dairy. know, gluten and dairy, they both have proteins that are highly inflammatory, even to people who don't have celiac disease and people who don't have dairy intolerance or dairy allergies. 

The gluten and the casein proteins can directly trigger something called zonulin release, and zonulin is a marker for leaky gut. So even for people who don't have, as I mentioned, celiac disease, gluten can trigger leaky gut and can trigger a gut imbalance, gut dysbiosis, where we don't have enough of the beneficial flora or maybe some, we have too much abnormal bacteria or both.

And so, you know, during that time of healing, I do think it is important. In general, I think that, you know, variety is so important for your microbiome. I mean, just like, you know, we need lots of different kinds of vitamins and minerals and phytonutrients to survive and thrive. So do our microbiota. And the truth is most people are living on a, you know, kind of a daily dose of gluten and dairy in some form or another whether it's bagels and cream cheese in the morning and quesadilla at lunch and pizza at night. And so just in general, not having them on a daily basis I think is very important. And so for our family, are, I mean, my kids don't necessarily have a gluten or dairy intolerance that we've really been able to identify in terms of clinical symptoms. 

Although my daughter does get those rough bumpy patches on her arm keratosis pilaris, which is very common. She even herself calls them gluten bumps because she notices when she has, like over the holidays, more gluten is involved, her gluten bumps come back. And so she's mindful of trying to minimize that for herself when she can. And so in our house, we are pretty much gluten free. My son loves gluten sourdough bread, so we'll have that for sandwiches sometimes, right? But also what I don't want families to do then is remove the gluten and just have rice, rice, rice, rice, rice products every day or corn, corn, corn, corn products every day. It's, know, that variety is so important. And when we have that variety, we are less likely to develop an intolerance to that food and it gives our gut and our immune system a from kind of a daily onslaught of the same things.

Juniper (53:42)
Yeah, I love that. We choose to be gluten and dairy free because we just feel so much better. And I do get the question of, well, if I'm eliminating the dairy and the gluten, am I going to develop an intolerance to it? And you kind of spoke to this that...

Dr. Elisa Song (53:50)
Yeah.

Juniper (54:03)
This reaction that it has in our body is actually, mean, all of us experience this reaction in our body to the proteins in wheat and dairy. And it's not necessarily an intolerance. It's just this reaction that happens inside our body. And it's happening whether we are avoiding them or not.

Dr. Elisa Song (54:21)
Mm-hmm.
Yeah, well, and I think too, because some people will comment, well, you know, I felt fine or okay, you know, when I was eating these, and then I stopped them. And now when I even just have a little bit, I feel terrible. Well, when we think about it, before you've cleaned up your diet, if you're living at a kind of low grade simmering level of inflammation, and you just even don't realize how poorly you feel, because you don't feel terrible, but... you're still, you're not feeling your best, right? And so then when you clean up your diet, clean up your gut, and you realize how good you can feel, how much more energy, or I don't have that back pain when I wake up in the morning, or wow, I'm so much more clear, I'm remembering my words more easily, right? And so then, you know, when you have a little, you know, a piece of gluten here or there or dairy, and you react to it, now your body is having the reaction that it did probably when you first had that food.

But you've covered it up, you know, after a while by having them every day and just living with a constant state of low-grade malaise, you know, just not feeling that good, right?

Juniper (55:35)
Yeah, I have this conversation with mamas every single day and you just put it into words so beautifully is it's not that you've developed this intolerance or this new reaction is that your body was always reacting that way. Now you just feel so good that you notice the difference a lot easier.

Dr. Elisa Song (55:54)
Yeah. Yeah.

Juniper (55:57)
Okay, Elisa, this has been such a pleasure to have you here and to chat with you. you are gift to so many mamas listening and so thank you for what you do and for your heart and for making this awareness so easily available.

Dr. Elisa Song (56:15)
Well, thank you so much for having me and I'm just so honored to be able to chat with you and all of the mamas listening.