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Why Do Pediatricians Deny The Obvious?

By Judy Converse, MPH, RD, LD

It's 2006, and for the first time in history, U.S. children are sicker than
the generation before them.

They're not just a little worse off, they are precipitously worse off
physically, emotionally, educationally and developmentally. The statistics
have been repeated so often, they are almost boring. Obesity affects nearly
a fifth of children, triple the prevalence in 1980. (1,2) Juvenile diabetes
is up 104 percent since 1980. (3,4) Autism, once regarded as having a purely
genetic etiology, increased more than a thousandfold in less than a
generation. (5,6) The incidence of asthma is up nearly 75 percent. (7,8)
Life-threatening food allergies doubled in the past decade. (9) The
prevalence of allergies increased nearly sixfold. (9) Almost one in 10
children - between four and five million kids - have been diagnosed with
attention-deficit disorder. (10) Nutrient deficiencies, not seen for decades
in U.S. children, are prevalent again, or still persisting. (11-14)

Much of this happens more often to boys than girls, between whom gaps have
widened steadily since 1990: Boys are 47 percent more likely to have
learning and developmental disabilities than girls, 60 percent more likely
to have repeated a grade, twice as at risk for autism, and 200 percent more
likely to commit suicide. (15) They may also have poor vitamin A status more
often than girls, (16), which increases risk of infection and
life-threatening complications like pneumonia. (17)

What happened? Many have argued that the increasingly aggressive vaccination
schedule is partly to blame. (18-23) In the 1980s, more vaccines were given
earlier in infancy, as were more multivalent doses, most of which contained
mercury. In the 1990s, genetically recombined vaccines came into use for the
first time, and were used universally on day-old infants, who had never
before been vaccinated with anything. Indeed, children are currently advised
to get 54 vaccine doses by age 12 - a circumstance unprecedented in human
history, and one that coincides neatly with the escalation in child health
problems. If true, by vaccinating so zealously, rather than making children
healthier, as school districts, federal health programs, corporate health
infrastructures, and pediatricians insist, we have traded mostly benign or
treatable childhood illnesses for incurable, lifelong, extremely costly
disability and disease. It means that current vaccine policy and practice
create more morbidity and mortality than they prevent in U.S. children.

Compelling evidence to support this has been much discussed on this site,
and dutifully brought to the attention of vaccine policy authors: the
Centers for Disease Control and Prevention (CDC), the National Institutes of
Health's Institute of Medicine, the American Academy of Pediatrics, the
Advisory Committee on Immunization Practices. Even governing public health
bodies in the U.K. have now heard the dissenting voice of Peter Fletcher,
MD, former chief scientific officer at Britain's Department of Health. He
recently chastised his peers for turning a blind eye to the avalanche of
published science and anecdotal evidence showing that MMR vaccine can cause
inflammatory bowel disease and autism. (24) Efforts to refute these concerns
(25) were dubiously funded by vaccine makers and had fatal design flaws that
made autism incidence vanish in the data set. (26) This rebuttal was never
widely read by pediatricians, who continue to believe MMR, and all other
vaccines, are not only safe but essential.

With our children's very lives at stake, why do parents and governments
remain loyal to the medical culture that may have led them to this? And as
the ship sinks beneath their feet, how do pediatric providers manage to deny
the obvious: Many children in their highly vaccinated practices are sick a
lot, don't develop normally, can't sleep, can't tolerate or won't eat a
typical diet, become overweight, acquire preventable nutrition problems that
cause lifelong damage? Worse, how do they defend that they have virtually
nothing to offer, other than symptom-masking drugs?

When I was to become a mom, I asked a relative with three children what her
most sage advice might be. "Throw out your television," she declared. To
this I might add, Fire your pediatrician. Besides stumbling under the
influence of the pharmaceutical trade, which positions itself alluringly at
every step of a doctor's education and practice, pediatricians have
succumbed to managed care structures that discourage referrals, dictate
visit duration and procedures, and restrict prescribing.

As low-tech skills have faded from pediatric practice - things like spending
more than three minutes discussing questions, (27,28) listening to parents,
completing a thorough exam for signs and symptoms of nutrient deficiencies,
interpreting the growth chart rather than just adding a dot to it - so has
quality of care. This has left many children slipping through the cracks of
a fracturing health care system, (29) and dumped them into a bin where they
languish with autism, chronic illness and infection, growth regression,
unexplained skin rashes and allergies, and myriad, difficult to label
developmental, learning or functional delays - problems that place children
at even higher nutritional risk. (30,31)

It often felt like my office was this bin. Coming to me via referrals from
my state's zero-to-three program, non-profits serving children with
developmental delays, schools, occupational therapists, speech therapists,
and parents through word of mouth, my nutrition practice served children
from all northeast states and beyond from 1999 to 2005. These children were
from mostly insured, educated families with good enough incomes to pay me,
since most insurance policies refused nutrition care, except for the most
horrific of diagnoses in children. They were also usually followed at one of
the region's major medical centers because most of them had serious
developmental delays and had to see a litany of specialists. In other words,
they got a lot of top-notch health care.

Every child I met had nutritional failure issues. Not one of their
pediatricians noticed.

Every child I encountered had a nutrition issue severe enough to impact
growth, learning, development, behavior - or all of the above. Nutrition
problems in these children preceded developmental lapses by several weeks,
months or years. In every case, the parent brought concerns for changing
signs and symptoms to the doctor's attention. No treatment was offered these
families regarding appropriate nutrition measures. Indeed, parents usually
reported being told it was of no consequence or that there was "no proof"
nutrition measures could help.

This is astounding because it simply could not be more wrong. Decades of
classic nutrition science, too voluminous to cite here, are the bedrock of
U.S. government and worldwide programs that have existed for decades: World
Health Organization; UNICEF; Supplemental Food Program for Women, Infants,
and Children; School Lunch; Head Start; Zero to Three; the National Health
and Nutrition Examination Survey (NHANES); Pediatric National Nutrition
Survey. The creators of these programs knew that malnutrition in children
affects weight first, then height, then head circumference - i.e., the
brain - last. More subtly and especially in children, it affects cognition,
self regulation, epithelial tissues, hair, skin, nails, bowel habits, immune
function and many other functions and tissues even earlier. By the time a
child's development or outward appearance has been impaired by a nutrition
deficit, the deficit has already been there a long time. This does not have
to look like kwashiorkor to create lifelong disabilities for kids: Chronic
marginal nutrition status is a powerful deterrent to growth, learning,
infection fighting and development.

Pediatricians are not paying this much mind, if we are to believe our
largest data set on child nutrition status: According to the most recent
NHANES, poor status and/or poor intakes for iron and vitamins A, D, E, and C
were present (32) - all of these being, at the very least, critical
micronutrients for immune function. Even the most obvious of child nutrition
issues - obesity - is addressed by pediatricians with their overweight
patients only about a third of the time. (33)

Applied nutrition is a low-tech tool, and it pulled most children I worked
with out of the health care system dumpster. Why isn't it part of every
pediatrician's repertoire?

First, it takes too long. A nutrition care visit requires a bare minimum of
20 minutes; I typically took 90 minutes for new patients and an hour for
follow-ups. Parents were eager to pay for the help because it worked. Their
children stopped getting sick, grew again, stopped having allergy symptoms,
slept better, ate better, and focused better in school - all without
medication.

Second, pediatricians - indeed, all physicians - are not required to study
nutrition beyond a cursory level, nor are they expected to apply it
therapeutically in practice. This means they may well miss subtle or overt
signs of nutrition problems and, if even if they notice them, they won't
know how to correct them.

Third, unlike drugs, foods and nutrients can't be patented, so there is no
profit in recommending them. No profit means precious few clinical trials,
no free conferences to educate doctors about nutrition, no complimentary
lavish buffets, no free air line tickets or corporate jet travel for
senators or doctors, no seductive sales reps in the office handing out
samples of omega-3 oils for your kids - but if you wait a few minutes, you
might score some free Abilify or Risperdal.

Fourth, routine pediatric care is now focused on vaccination above all
else - this being the number one topic discussed at well baby visits (34) -
and with marginal to no training in clinical or applied nutrition,
pediatricians let the most pedestrian of child health problems metastasize
unchecked, sometimes to tragic proportions, as I routinely observed. See
paragraph two.

In 1998, the American Dietetic Association released a position paper
affirming that health practitioners [be] able to identify nutrition risk and
recognize when nutrition referrals are necessary. (35) National child health
trends - not to mention the children in my own practice - unabashedly
illustrate that this is far from being a reality. When given a test on
infant nutrition, pediatricians scored just above an average grade and lower
than medical residents. (36) They showed "discrepancies" in their knowledge
and practice of infant nutrition, which prompted the survey authors to
caution that quality of care could not be maintained.

Perhaps this explains why a young toddler came to me with a gastrectomy tube
left in for 12 months, on the wrong formula, with no plan for transition to
oral feeding. Or why a constantly sick two-and-a-half-year-old I met was
offered only growth hormone injections for growth regression of a year's
duration, when a simple lab test confirmed that he just needed a gluten-free
diet. There was the five-year-old who had gained 30 pounds because of a
Neurontin prescription she didn't need (prescribed for "possible" seizures
that were not detectable on EEG, but concerning signs of which resolved with
removal of dietary opiates). And there were many infants who could not
tolerate breast milk or cow's milk formula only to be given equally
irritating soy milk, when what they really needed was elemental formula -
expensive, but effective; finally, their families could get some sleep and
the babies stopped getting ear infections. There was the school-age boy who
was incontinent, had garbled speech, dysgraphia, and a developmental
diagnosis that markedly impeded academic effort. No one noticed that he ate
fewer than half the calories he needed daily and had a litany of food
intolerances. A new meal plan, high-calorie hydrolyzed soy formula and
supplementation permitted him to remain dry all night and, at school, to
write neatly, and speak more clearly - all without Concerta or Straterra,
which is where his pediatrician's referrals had led. Another child with
autism on multiple psychiatric medications saw vast improvement using
nutrition measures - for the first time in years, he stopped a daily ritual
of smearing feces on his bedroom wall. Still his psychiatrist was
incredulous and refused to be supportive when I asked if - given the
improvements - this family could initiate a review of his medication doses.
In each case, nutrition measures reversed the chronic health and even many
of the developmental problems these children had, but not soon enough to
avoid preventable, egregious, and costly suffering for entire families.

Vaccines may create nutritional failure by inflicting early and severe
injury to gut tissue and digestive function, (19,20) by increasing the risk
for bilirubin neurotoxicity at birth, (37-39) by setting off inflammatory
responses that consume nutrient stores (40-42) or secondarily via brain
injuries impair feeding skill and gut motility. (43) If over-vaccination is
triggering food allergies in children, this too creates nutritional risk:
Children with food allergies have significantly lower height for age and
have poor intakes of essential nutrients compared to kids without food
allergy. (30) This means they don't grow as well and may not learn as well
as peers. Biased to a belief that vaccine injuries only exist as extremely
rare and severe anaphylactic events, and lacking skill to recognize
disabling nutrition failures in children, pediatricians are least equipped
to help the burgeoning generation of sick children they are arguably
creating.

Vaccines do not create health in children. Nutrition status does. Immune
function depends on nutrition status, not on how many vaccines a child
receives. Even though adults and children are more vaccinated now than ever,
the CDC found a nearly 20 percent increase in number of reported "unhealthy"
days between 1993 and 2001. (45) We're just plain sicker than we used to be,
despite using more and more vaccines. The sooner families have more options
for child health, the better. Whether they find a pediatrician willing to
listen and read independent research on vaccines, or whether they work with
a pediatric naturopath or other providers skilled in tools beyond
pharmaceuticals, change is urgently needed.

* * * *

Next: Vaccines, chronic inflammatory responses and nutrient status: Do shots
rob infants and children of critical nutrients?

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