Infant/Toddler Pedcasts

Dr. M’s SPA Newsletter Volume 16 Issue 2 – School Food

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School Based Nutrition – Why is it happening this way?

There is a quiet experiment happening in American childhood, and we should stop pretending it’s benign.

In the 1970s and 1980s, when I attended school, school food was far from perfect, but it existed in the context of something essential: it was mostly prepared on site, minimally processed (but changing in that direction) and not laden with additives and chemicals (Yet). Oh, and most children still ate meals prepared at home at almost every other occasion. Dinner wasn’t aspirational or Instagram-worthy, but it was routine. Real food. Cooked by someone who knew the child, at a table where nervous systems could downshift. School lunch was a supplement to that structure, not the metabolic foundation of a child’s life. That has all changed in a short 50 years. Mirroring the change in weight and childhood disease prevalence.

• 1970s – some processed foods begin to enter school cafeterias at scale
• 1980s – preservatives and additives become routine
• 1990s – ultra-processed foods dominate

In 1994, new standards were added: This table lays out how much of each food group schools were supposed to offer over a week under the 1994 standards. These were the first nutrition-focused meal standards the USDA put into place:

For Breakfast (all grades K–12):
Fruit: 2.5 cups/week
Vegetables: 0 cups/week
Grains/Bread: 0–10 oz equivalent/week (depending on combinations of grains and protein)
Meat/Meat-alternative: 0–10 oz equivalent/week
Milk: 5 cups/week

For Lunch (split by grade levels):
Fruit: K–3 also 2.5 cups; grades 4–12 get 3.75 cups/week
Vegetables: still 0 cups/week (no separate vegetable requirement yet)
Grains/Bread: at least 8 oz eq/week
Meat/Meat-alternative: 7.5 oz eq/week for breakfast; 10 oz eq/week for lunch
Milk: 5 cups/week

(Hopkins 2015)

What’s notable, reflected in the structure of this table, is that vegetables weren’t required at all yet, and the standards were very much food-group based, not ingredient-level nutrient quality checks. That created space for schools to rely on industrially produced entrées and sides that technically met volumes of grains or proteins but could still be ultra-processed products with long ingredient lists, many of these foods would meet a NOVA class 4 classification (the worst type). Think fruit cup in sugary syrup…..

Dr. M

Dr. M’s SPA Newsletter Volume 16 Issue 1 – Beyond Behaviors Part 3, Mona Delahooke, PhD

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Chapter 3 – Individual Differences

Dr. Delahooke starts Chapter 3 by allowing Margaret Mead to remind us that each child is absolutely unique: “Always remember that you are absolutely unique. Just like everyone else.” This is more than a witty paradox, it is the hinge upon which all effective pediatric care swings. When we take individual differences seriously as neurobiological fact, we can finally stop confusing adaptive survival responses with defiance, stop labeling children as problems, and begin the real work of supporting the mind body systems that shape behavior from the inside out.

Let us review what we have learned in Beyond Behaviors so far – We are invited to descend below the waterline of the behavioral iceberg. What we see at the surface: the tantrum, withdrawal, rigidity, hyperactivity, the refusal to transition is merely a set of observable outputs from deeply personal internal variables. The sensory wiring, physiological states, immune triggers, thoughts, feelings, memories, and the child’s moment-to-moment sense of safety. Without diving into these subterranean layers, we risk treating smoke while ignoring the fire, which is the general state of current pediatric psychiatric medical therapeutics. We mostly treat the smoke. We don’t often ask about the fire. Her central thesis is simple, clinically robust, and profoundly humane:

Children behave according to the state of their nervous system, and their nervous system is shaped by individual biological, emotional, and sensory differences.

Once we understand this, behavior becomes not a moral test but a window into the child’s internal world…..

Dr. M

Dr. M’s Women and Children First Podcast #104: Maeve O’Connor, MD – Allergy and Immune Literacy


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Today, I’m joined by Dr. Maeve O’Connor, a board-certified allergist and immunologist practicing in Charlotte, North Carolina.
Dr. O’Connor’s training reflects both rigor and range. She completed dual undergraduate degrees at the University of South Carolina Honors College with a Bachelor of Science in Biology and a Bachelor of Arts in Spanish before earning her medical degree at the University of South Carolina School of Medicine. She then completed her internship and residency at the University of Texas and its affiliated hospitals in Houston, where she served as Chief Medical Resident.

Her subspecialty training in Allergy and Immunology was completed at the National Jewish Medical and Research Center in Denver consistently ranked the number one respiratory hospital in the United States where she developed deep expertise in asthma, allergic disease, and immune dysregulation. She further expanded her clinical lens through fellowship training in Integrative Medicine at the University of Arizona from 2013 to 2015.

Clinically, Dr. O’Connor works at the intersection of pediatrics, immunology, and real family life where eczema isn’t just a rash, food reactions aren’t just labels, and immune symptoms rarely fit neatly into algorithmic boxes. Her work emphasizes careful diagnosis, evidence-based treatment, and avoiding both over-medicalization and missed pathology.

In a time when allergy medicine is often reduced to test results and avoidance lists, Dr. O’Connor brings a grounded, thoughtful approach helping families and clinicians distinguish what’s truly allergic, what’s inflammatory, what’s developmental, and what’s simply noise.

Today, we’ll explore how allergic disease actually presents in children, why mislabeling is so common, how early immune signals shape long-term health, and how pediatricians and specialists can collaborate more effectively without fear-based medicine.

This is a conversation about immune literacy, clinical nuance, and doing better for children in a world where their immune systems are under increasing pressure.

I’m excited to welcome Dr. Maeve O’Connor.

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 28 – Feeding Infants


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Food in Infancy
What do we know?

“Humans are the only mammals who feed our young special complementary foods before weaning and we are the only primates that wean our young before they can forage independently. There appears to be a sensitive period in the first several months of life when infants readily accept a wide variety of tastes and this period overlaps with a critical window for oral tolerance. As a result, infants should be exposed to a wide variety of flavors while mother is pregnant, while mother is nursing and beginning at an early age. There also appears to be a sensitive period between 4 and 9 months when infants are most receptive to different food textures. There remains debate about when it is best to begin introducing solid foods into an infant’s diet however, the available evidence suggests that provided the water and food supply are free of contamination, and the infant is provided adequate nutrition, there are no clear contraindications to feeding infants complementary foods at any age. There is emerging evidence that introduction of solid foods into an infant’s diet by 4 months may increase their willingness to eat a variety of fruits and vegetables later in life, decrease their risk of having feeding problems later in life, and decrease their risk of developing food allergies, and the early introduction of solid foods into an infant’s diet does not appear to increase their risk of obesity later in childhood.” (Borowitz S. 2021)

Food Introductions — What’s the best way to approach it?

As infants begin the shift from exclusive milk feeding to solid foods, a range of opinions inevitably emerge on how to navigate that transition. It’s tempting to get lost in modern guidelines, but an anthropological lens is often more revealing. Long before the age of purées in jars and puffed snacks in canisters, human infants ate what their parents ate. It was delivered in whole-food form and mechanically softened by chewing, cooking, or crushing. These early first foods carried important evolutionary advantages…Plus a piece on Hell Yeh or No by Derek Sivers

Enjoy,
Dr. M

Dr. M’s Women and Children First Podcast #101: Sandy Newmark, MD; Elisa Song, MD; Leslie Stone, MD – Autism Etiology?

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Today’s conversation takes us upstream—to the source—of one of the most pressing and emotionally charged topics in modern pediatrics: the rise in autism spectrum disorders. Autism rates have continued to climb in 2025, but what if much of what we call “the epidemic” isn’t simply genetics or better diagnosis, but a reflection of deeper biological, environmental, and developmental changes affecting the human organism before birth?

To explore this critical question, I’m joined by three extraordinary clinicians who have dedicated their lives to understanding the roots of children’s health and disease.

Dr. Sandy Newmark, Clinical Professor of Pediatrics at the Osher Center for Integrative Medicine at UCSF, has spent the past two decades at the intersection of conventional and integrative medicine—focusing specifically on children with autism and ADHD. His approach blends deep compassion with scientific rigor, examining how nutrition, toxins, inflammation, and the microbiome shape the developing brain.

Dr. Elisa Song, Stanford-, NYU-, and UCSF-trained integrative pediatrician and author of Healthy Kids, Happy Kids, is one of the leading global voices in pediatric functional medicine. As founder and Chief Medical Officer of Healthy Kids Happy Kids and Tiny Health, she’s pioneering microbiome-centered strategies to reverse chronic disease in children and reshape how we think about wellness from the inside out.

Dr. Leslie Stone, family physician, obstetrician, and co-founder of GrowBabyHealth.com, brings a lifetime of experience delivering and caring for over 5,000 babies. Her groundbreaking work in the science of Developmental Origins of Health and Disease—the DOHaD model—shows how what happens before and during pregnancy programs a child’s long-term health, resilience, and risk for conditions like autism.

Together, we’ll discuss the emerging evidence that the autism epidemic is not a mystery of genetics alone, but a story written in inflammation, metabolic disruption, environmental exposures, and the developmental stressors of modern life. We’ll explore how integrative and functional medicine are reframing prevention—not just treatment—and what it will take to truly turn the tide for the next generation.

This is a conversation about hope, science, and the possibility of rewriting the future—one mother, one child, and one generation at a time.

Dr. M’s SPA Newsletter Volume 15 Issue 26 – Back To Sleep

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Back to Sleep and Sudden Infant Death Syndrome (SIDS)

Sudden Infant Death Syndrome (SIDS) is defined as “the sudden death of an infant under one year of age which remains unexplained after a thorough case investigation, including a complete autopsy, examination of the death scene, and review of the clinical history.”

During my time at the University of Virginia, I trained under neonatologist Dr. John Kattwinkel, a champion for newborn health and one of the leading figures in shaping national safe sleep policies. In the early 1990s, he chaired the American Academy of Pediatrics (AAP) Task Force on Infant Sleep Position and SIDS, which laid the foundation for the landmark Back to Sleep campaign.

At that time, SIDS claimed roughly 14 infants per 10,000 live births in 1988. Following the campaign’s launch in 1994, the rate plummeted by over 60%, reaching about 5 deaths per 10,000 live births by 2006. Despite this dramatic improvement, recent data suggest that the decline has plateaued…..

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 20/21

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Flu season is around the corner and we should take a look at the virus for preparation purposes.

Influenza

Every few years, I revisit this virus in my writing, not only to keep it on your radar in preparation, but also because of the significant illness and death it continues to cause. It’s never wise to dismiss its potential impact. Influenza reliably returns each year, difficult to escape even with strict isolation.

The flu is different from the common cold in many ways as the flu has:

1) Rapid onset with high spiking fevers

2) Muscle and headaches

3) Little to not sneezing and sore throat

4) Rapid and robust cough onset

Influenza season is beginning in the United States this fall. Who gets sick? In short, people of all ages. Seasonal influenza has a reproductive rate of just over one, meaning that each infected person typically spreads the virus to one or two others through coughing or sneezing in close proximity. The virus also survives on surfaces for up to 24 hours, creating another common route of transmission, especially in children. Young kids frequently touch surfaces and each other, then touch their faces, providing the perfect pathway for infection. Because of this, schools remain a major hub for flu transmission across the country.

Preventing the virus from taking root in your body is the key to avoiding a bad outcome.

Things that I think of as critical to avoiding or preventing this infection:

1) Keeping your vitamin D level greater than 50 ng/ml is an important way to prevent influenza infections. Get tested and supplement accordingly. As always the sun is your natural route to normal D levels

2) Get adequate sleep based on your age to keep your immune system in great shape. Sleep is very important for immune health…… and more on asthma driving mental health issues.
Dr. M

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