Tag Archives: prevention

Dr. M’s SPA Newsletter Volume 16 Issue 4 – Relationships

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Literature Review:

A) “Establishment of the gut microbiome during early life is a complex process with lasting implications for an individual’s health. Several factors influence microbial assembly; however, breast-feeding is recognized as one of the most influential drivers of gut microbiome composition during infancy, with potential implications for function. Differences in gut microbial communities between breast-fed and formula-fed infants have been consistently observed and are hypothesized to partially mediate the relationships between breast-feeding and decreased risk for numerous communicable and noncommunicable diseases in early life. Despite decades of research on the gut microbiome of breast-fed infants, there are large scientific gaps in understanding how human milk has evolved to support microbial and immune development.” (Davis et. al. 2022)

Main Takeaways:

First 1000 days matter a lot for microbial and immune development: Infancy is a critical window when the gut microbiome is assembled and the immune system is learning to respond to microbes and external exposures. Patterns set early can ripple into infection risk, inflammatory diseases, and atopy later in life.

Enjoy,
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 31 – Poly Vagal Theory, Stephen Porges, PhD

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I think that this is an important time to pause and relook at Polyvagal Theory before continuing with Beyond Behaviors.

Polyvagal Theory: Current Status, Clinical Applications, and Future Directions (Porges, S. 2025)

“Social behavior and the capacity to manage challenge are dependent on the neural regulation of physiological state.” S. Porges


When I dove into Stephen Porges’s 2025 review of the Polyvagal Theory (PVT), I felt like I’d stepped into a crossroads where neurobiology, clinical practice, trauma science, and human experience collide. This paper isn’t merely a summary of three decades of work (all of which I have read); it’s a spirited defense of a paradigm that’s been both celebrated (by me) and contested (by others). What follows is an honest appraisal of what the article teaches us, where it sparks real insight, and where it may fall short, especially through the lens of evidence-based medicine and developmental neurophysiology. (I also went deeper into his 2022 paper in Frontiers in Integrative Neuroscience for the biophysiology of the ANS)

At its heart, the article argues that the autonomic nervous system (ANS), through a set of hierarchically organized circuits centered on the vagus nerve, is not just a background player in stress and homeostasis, but a core regulator of social engagement, physiological flexibility, and behavior. Dr. Porges situates his theory as an alternative and expansion to classical views that treat sympathetic (fight/flight) and parasympathetic (rest/digest) branches as functional opposites. Instead, he proposes a three-component hierarchy: the ventral vagal complex (VVC) supporting social engagement, a mobilization circuit mediated by the sympathetic nervous system or fight or flight state, and a dorsal vagal circuit that facilitates shutdown or immobilization under extreme threat…..

Enjoy,
Dr. M

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 Women and Children First Podcast #100 Wayne Koontz, MD – Vaccines and Disease over 50 years

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Today on Dr. M’s Women and Children First Podcast, we welcome Dr. Wayne Koontz, a founding partner at Salisbury Pediatric Associates in Salisbury North Carolina, where he has spent over 5 decades caring for generations of families with compassion, wisdom, and a deep commitment to community health.

Dr. Koontz earned his Undergraduate degree and his Doctor of Medicine from Wake Forest University, where his early love of science and service began to take shape. He went on to complete his pediatric residency at Dallas Children’s Medical Center, part of the University of Texas Southwestern Medical School, where he received outstanding training in both academic and clinical pediatrics.

As one of the founding physicians at Salisbury Pediatrics, Dr. Koontz helped to build a model of child-centered, family-oriented care that has served the Rowan County. His commitment to children’s well-being extends beyond the clinic, reflecting a lifelong dedication to preventive medicine, developmental health, and the nurturing of strong physician–family relationships.

It’s an honor to have Dr. Koontz with us today to share his clinical insights as they relate to infection and vaccination from a longevity based pediatric career. Dr. Koontz has a unique perspective to share as his 50 plus years of experience cover the prevaccine infectious disease based practice of pediatric medicine all the way to the current vaccine centric and reduced infectious disease burden reality. That is a timeline worthy of exploration.

So lets explore.

Dr. M

Dr. M’s SPA Newsletter Volume 15 Issue 25 – Tough Conversations

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Speaking Truth in Love: The Weight of Avoidance in Pediatric Metabolic Health

After completing the second round of our Asthma and Obesity Metabolic Pilot Program at Salisbury Pediatrics, I left the clinic reflecting deeply on what I witnessed. It crystallized a truth that is uncomfortable but undeniable: the greatest health threats to our children today are not infectious or accidental, they are metabolic. Diseases once reserved for adulthood: insulin resistance, fatty liver, hypertension, early vascular aging are now appearing in children who should be free to run, play, and thrive.

In modern society, conversations about weight and metabolic dysfunction have become relatively taboo. This is not to say that children of normal or low weight are immune; they, too, can be at risk. However, the excess-weight group carries the highest statistical burden. Too often, clinicians hesitate to speak truth to families for fear of offending, shaming, or overstepping. In doing so, we risk silence becoming complicity and allowing preventable disease to take root in the very children we are charged to protect.

Much of this epidemic is not born of individual failure but of systemic neglect. Government-funded, poor-quality school meals, cheap processed foods, and relentless marketing of sugar and refined carbohydrates have built an environment where metabolic injury is almost inevitable. When a child’s daily fuel is engineered for shelf life instead of cell life, the outcome is not accidental, it is predictable. Our pilot program lab results are a painful window into that truth…. and a literature review on eczema and anaphylaxis.

Enjoy Dr. M

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