Dr. Joel (“Gator”) Warsh joins our CEO Ron Spreeuwenberg on this episode of The Preschool Podcast to discuss resiliency in children and the role that integrative and holistic pediatrics plays in children’s lives. Dr. Warsh gives several key takeaways our listeners can implement in their lives right now to start seeing a difference in themselves and their children.
As a doctor, Joel mentions he has seen an increase since the pandemic around anxiety, depression, mental health overall in children in his practice. Dr. Warsh provides us with a few tips on supporting young children with regard to their immune systems.
- Get back to the basics. Factors such as stress, environmental toxins, exercise, diet, and sleep can play a key role in your immune system response. Lowering stress and environmental toxins can play a huge part in your immune system. Ensuring your diet, sleep and exercise are at healthy levels are important too. When families and educators make sure children are getting adequate amounts of sleep, eating well, and keeping stress levels low, the better response their immune system will have should an illness or disease become present.
- Immune Support. While there are many supplements available for adults and children to increase their immune system, vitamin D, vitamin C, and Zinc can be easily found in food and are easily the most important vitamins to increase during stressful times. Ensuring your diet is full of foods that are high in these vitamins and minerals can go a long way!
While stress may be inevitable in children’s lives, Dr. Warsh gives us an example of a few signs that educators and parents can look out for as early warning signs:
- Verbally: Depending on their age and language skills, the child may verbally tell you they’re feeling nervous or have a headache, or are generally achey in their body. Some young children may not know how to put their feelings and emotions into words and may state they have a “tummy ache”.
- Physically: As a parent or educator, take note of when the child tells you they have a stomach ache, headache etc, and consider what may be triggering it. While it could be related to food, ongoing stomach aches can indicate anxious and stressed feelings in young children.
- Behavioral concerns: Young children who are stressed may be acting out more or may withdraw from activities they once showed interest in. It’s important to take note and observe these different behaviors.
Joel explains that there is a growing issue recently that we’re stressed more now than ever. This in turn means that our bodies are always inflamed. Social media consumption, news consumption, lack of movement can all present chronic stress. Joel states that “our bodies can handle a little stress, but if we have too much stress that’s when we get sick and our body can’t handle things.”
As a parent we can’t take away all stress from children but we can certainly minimize it.Dr. Joel Warsh
Joel has a few key takeaways he wants our listeners to consider for themselves and for children:
Remember: You’re not alone. Others are going through this pandemic is different ways. Others may not fair as well as you so consider how you can help others in your community.
Talk about this with others. It’s important to keep open lines of communication with your network and health care professionals who can help you with how you feel.
Go back to basics. Make some small changes in a positive direction with regards to sleep, diet, exercise etc. and you’ll start to see other positive changes in other parts of your life.
Episode 249 Transcripts:
Dr. Joel WARSH:
And also talking to your kids. I think it’s really important not to shy away from these topics. Talk to them at their level, but just see where they’re at. Try to understand their fears and what they’re thinking about and trying to answer their questions.
Joel, welcome to the Preschool Podcast!
Thanks so much for having me!
We’re delighted to have on the show today Dr. Joel Warsh, who also goes by Dr. Gator. He’s an integrative and holistic pediatrician based out of Los Angeles, California. And we’re going to talk to Joel today about resilience in our youngest kids while we’re dealing with COVID-19. And keen to learn more about integrative and holistic pediatrics. Joel, tell us a little bit about yourself.
I grew up in Toronto, Canada, did all the regular training science. Undergraduate, went to med school in Philadelphia, came out to Los Angeles to do my pediatrics training, love all the Western training. But I got a little bit frustrated with the regular system and the super short visits and treating everything with medication. So, that’s what really spurred me to start learning integrative medicine and natural medicine. And I’m not against Western medicine at all. I just think that there’s a time and a place.
And so I started learning a lot more about natural medicine and blend the two together. And that’s where I practice today. And I opened up a practice in Los Angeles and started www.IntegrativePediatrics.com and have just been kind of growing that movement.
I think a lot of people are really into balance right now, and I think we’re really out of balance in the world. And we’re very dichotomous on many things and we’re very western or very holistic. And really, I think the best way for most things is somewhere in the middle. And so that’s really what I preach and talk about and practice at my office.
Very cool. And tell us a little bit about trends or things you’re seeing differently since the onset of COVID-19.
So, the biggest trend that I’ve seen is an increase in mental health concerns. So I would say that that was a still certainly an issue before. But the pandemic put some gasoline on the fire. And really every other visit has been more about mental health and kids having more anxiety or depression, frustration, missing their friends, having to deal without being in school, all of those little things. I think mental health has certainly become a much bigger issue in pediatrics.
And then also just different discussions around the pandemic with parents about their fears and their concerns and just general health and wellness. And also, finally, maybe another really big one is just immune support. So, just a lot of questions about, “Well, what can we do to keep our bodies strong? What can we do to keep our kids’ bodies strong? What can we do to, if we do get sick, how do we keep ourselves as strong so that our immune system has the best chance to fight off whatever infection comes our way?” And I think people are just thinking about health more than they ever have in the past.
So, a few things to unpack there. Let’s start with immune support, actually. Any tips for parents out there and early-childhood educators, as well, who are spending time with multiple children from different households every day, potentially?
Yeah, so, the big one that I think we all or many people have really forgotten about is this just those foundational factors, what I call the seeds of health. So, stress, environment and toxins, exercise, diet and sleep. These are the big foundations of what keeps our immune system strong.
So, if you’re really stressed out, research has been done many, many years. [Experts] did the landmark studies back in the late 1990’s where they took viruses, they put them in people’s noses; they gave them to people that were stressed or not stressed or people that were sleep deprived or not sleep deprived. And every single study showed that if you’re more stressed out, if you haven’t slept well, if you don’t eat well, then you’re more likely to get sick.
So, these are things we’ve known for a long time, but it’s just really something that we haven’t really focused on. So, just getting back to those basics and making sure your kids are getting their eight hours of sleep if they’re older; making sure that they get off their phones if they’re really stressed; making sure they eat a healthy diet; trying to get those chemicals out and making sure that we get some exercise.
Because especially with the pandemic, it’s been much harder to get outside, especially depending on where you live. You might be in a cold environment where it’s not so easy to get outside if you’re at home. Even if you are somewhere where there’s restrictions and there might be restrictions on going outside. So, really focusing and planning into your day whatever is reasonable or whatever is within the rules to get outside and get some exercise and go for a hike or go for a walk or do some exercise in your home, whatever you can do.
But these are never things that we had to necessarily think so much about or our plan in our day. But they’re extremely important. We need those, we need that time to exercise. Our body needs the time to detoxify. We need to do that. And if we’re not doing it naturally, we have to plan it in our day. So, just thinking about those foundations or the seeds of health is number one key to having a strong immune system.
And then second would be just immune support in general There’s a lot of immune support, supplements and herbs out there. The stuff that has the most research behind it so far, especially in the pandemic, would be vitamin D, vitamin C and zinc. So, just taking a supplement or just making sure that we have a multivitamin or that we boost up our levels to make sure that they are optimal, it’s pretty low-risk with these things.
And there definitely has been shown to be some benefits. So, just maybe speaking to your doctor about what’s an appropriate level for you, but just making sure that we have our levels boosted up. So, that way we are as strong as we possibly can be.
That makes a lot of sense. Simple is oftentimes the best answer, I think. And it’s like when you’re in college or in school and you’re studying really hard and you’re stressed and not getting good sleep and everybody’s getting sick all the time.
Oh yeah, I always remember, every time I had a big test, it’s like your body’s amazing and it’s it never seems to get sick while you’re studying. It’s like right after. You do the test, and you’re like, “Okay, fine, great, I can relax now.” And then the wave hits you and then you get sick. And that’s happened to me many times in my life that I’m sure it’s happened to many other people, too.
Yeah, totally. And you use the term “seeds of health”. And one of the pieces you mentioned there was stress. And so, of course, lots of people are dealing with stress right now. But also something we may not spend a lot of time talking about or even thinking about is that children have stress, too. And I guess to start off, what are some of the signs that a parent or early-childhood educators might see or notice as early warning signals, let’s say, that a child might be somewhat stressed?
So, it’s a really good question. First of all, depending on the age, they might just be telling you that they’re stressed out. They might look more nervous; they might be acting more anxious. But if they’re not overtly stressed out in terms of telling you it, then a lot of times the symptoms will be vague medical symptoms. So, stomach aches, headaches, nausea, as well as acting out, behavioral concerns. Those are the bigger things that we see.
So, it’s like the vague medical type concerns or just more acting-out behavioral concerns. So, hopefully, if it’s the older kids, they’ll just be saying it or you’re just talking to them about the stress or the anxiety. But if they’re not talking about it, then those will be the things I would be looking for as a doctor.
And how do we think about sort of medium- to longer-term impacts if we’re not addressing stress in children? And I guess the other obvious question there is, what can we do about it?
The issue with chronic stress is that inflammation in the body. So, inflammation isn’t bad in the short term. It’s the fight or flight response. If we have a tiger near us, we can run away or we can fight if we need to. So, that’s what stress and inflammation was created for. But the issue these days is that we’re always stressed. There’s just this chronic stress that we’re having every single day. We watch the news; we go on social media. We seem to have this low level of chronic stress.
And what is important to realize is your body can handle a little bit. We’re like a bucket: there’s water flowing into the bucket and there’s a hole at the bottom and the water flowing out. But if you have too much stress or too much water going into the bucket, then it overflows. And that’s when you get really sick or that’s when your body can’t handle things.
And so really what you want to do, as a parent, is that you can’t necessarily take away all stress in your life. But you want to minimize what you can minimize. And so depending on the age of your child, depending on where you are, what issues you’re facing, just trying to be a shield as best as you can.
If it’s the social media phone technology issue, then just trying to make some holidays from social media. So, one hour a day, we can’t be on the phone; no TV during dinner. Whatever it is that you can do just to minimize or decrease that stress as much as possible.
And also talking to your kids. I think it’s really important not to shy away from these topics. Talk to them at their level, but just see where they’re at, try to understand their fears and what they’re thinking about and trying to answer their questions.
And really, if it’s something that’s more severe or if you have significant concerns, then you should definitely get in touch with a professional, have them see a therapist. There’s lots of therapists working in telemedicine right now where at least you can have them spend some time with a trained professional to discuss and decompress everything that’s going on and talk about and work through some strategies of how to decrease your stress.
There’s all sorts of different programs and plans and talk therapies And then on top of all that, there are stress reduction techniques like meditation and yoga, gardening. So, it just depends on the child. But I think the first key is to identify the problem. The second key is to be open about it and plug them in. And the third is to work on techniques to decrease the stress.
Yeah, it makes a lot of sense. And it’s funny because it’s one of those things that, when you explain it, it makes a lot of sense. But sometimes in the moment, it’s hard to step away from the phone or do the things that you should do, like going outside for a walk, versus keeping the TV on or something. But then when you do go and do those things, you feel much better after. It’s like I always think about it, like going to the gym: it’s hard to get out and go to the gym to do some exercise. But if and when you do, you feel great after.
Oh, it’s so true. You’re like, “Ugh, I don’t want to go, it’s cold out, whatever”. And then you get there and you’re like, “I don’t want to do this.” And then you start working out for five minutes and then you feel amazing after. And it’s a momentum thing where you get into this momentum of, “Okay, I’m not doing anything, I’m sitting and it’s just easier.” And then, “I’ll sit and watch some TV.” And that turns into two hours, that turns into three hours, as opposed to forcing yourself to get out. But it’s always easier to just continue to do what you’re doing than to make a change.
But if you want to see a change in your life, then you have to be an active participant in it. And you have to make a plan and stick to it. It doesn’t mean you have to go every single day, but you do have to be an active player in your own health. And no one’s going to do that for you.
Yeah, totally. And I find the same with our kids, too. Sometimes you have to convince them to get outside and get some fresh air. But then within two minutes of them being outside there, you can see their energy levels are boosted already.
Yeah, you can. And I think it’s also just really important to note that there’s no medication or pill that’s going to make you healthy. There are things that can help; there are things that can help you in the moment. If you are sick with an infection, of course, an antibiotic is a great thing. It can save your life.
But at the end of the day, especially in North America where we’re too about the quick fix. And health is not about a quick fix. You’re not going to be healthy by taking a medication. You’re going to be healthy by eating right every day; you’re going to be healthy by exercising all the time; you’re going to be healthy by keeping your stress level down.
And it’s not a quick thing. This is months and years and a lifestyle choice. It’s not a, “Well, if I just take this pill, I’ll be healthy.” If you have a thyroid issue, sure, you need your thyroid medication. But in general, you need to change your lifestyle, not look at a quick fix because there is no quick fix for health. It’s the way that you live that keeps you healthy.
Yeah, and tell us a little bit more, then, about your practice, Integrative Pediatrics. And on this subject, like, how do you work with patients and clients to be more proactive, I guess, versus this more sort of reactive approach that has become quite common in the health care system?
So, I would say that I have a pretty self-selected group of patients that are already, for the most part, pretty holistic-minded when they’re coming to the office. But it’s really just more about where you put your focus. And the focus in our office is more about discussion and it’s more about prevention and it’s more about the foundations, as opposed to treatments.
And it doesn’t mean we don’t treat things – certainly there’s ear infections and sore throats and all the normal stuff. But a lot of the time, the families are just more open to natural medicine in general. So, there are so many times where, if a kid comes in with a little bit of a cough, it’s not asthma; it’s not anything serious; it’s not an pneumonia.
So, we have other options that we discuss. And I’ll go through the medical and the natural things that people can try. And we’ll say, “Okay, well, it seems like it’s just a virus. You don’t need to do anything at this point. You seem pretty healthy but you can maybe try some vitamin C or elderberry or honey,” if your kids over one [years old], “and try those things first. And if it’s getting worse than you text me, let me know. We can recheck and then decide if we need to do more.”
And the reality of that is that most kids never need a medication at that point. And medications have side effects, too. And every time you take an antibiotic, it doesn’t just kill the bad bacteria, but it kills the good bacteria. And then you can have side effects from that. So, we just try to minimize the medications as much as possible.
And then when you start to do that, you see we don’t need medications that often. I used to do prescriptions before I was really doing holistic medicine. I’d do prescriptions multiple times a day, I’d do antibiotics. But now it might be like once a month or once every couple of weeks where we’d need a prescription.
And that’s just a change of the mental framework in the way that things are done. Because parents want to do something when their kid is sick but they don’t necessarily want to do a medication But if that’s the only thing that you know as a doctor about how to treat with a medication, that’s what you’re going to prescribe.
But if there are other options available when it’s safe, then that really can be very helpful to your toolbox and you can continue to preach that balance. And if you are preaching it and people are seeing that they’re healthy, then they will live that way. And then you see healthier children and healthier families.
What do you think about the future of medicine and a more holistic approach to our health, in line with what you’re practicing with your families and your patients? Do you think this is going to become more common?
I hope so. Patients certainly want it; people want this. There’s no question. There’s really no downside to it if you practice it in the right way. The issue with natural medicine is the woo-woo people out there that go way too far and have a bad infection and then you treat it with a herb when you really need a medication. That’s the thing, you have to have balance.
And I think at the end of the day, I’ve seen it, we opened up our practice and we got full very, very quickly because there’s just so many people that want this. And why wouldn’t you want to do something natural first if it works as well or better as the medication you want to have? You want to have both, you need to have balance.
When you went to a doctor a couple hundred years ago, they gave you herbs. They didn’t have medicines. So, that was what was treated forever. And also around the world, they don’t necessarily do medications like we do in North America. They do it sometimes. But Chinese medicine, Ayurveda, there’s a lot of wisdom out there that’s been used for thousands and thousands of years. And we need to continue to study that and learn how we can balance both worlds and bring them together.
And that’s what I hope to see in the future, is not the arrogance of modern medicine but the understanding that we have amazing technology and amazing medications and things that can and do save lives. But at the same time, there’s lots of other practices out there that are very useful. And we need to work together. We need to do whatever’s best for our kids on that day.
And instead of just having a doctor, it’d be really great if you have your pediatrician and you also have your naturopathic doctor and you also have your Chinese herbalist and you also have your yoga teacher or whatever. Like, if you have a team that all works together and maybe one day we have a center where it’s kind of like you go to the dentist and you go first to see your health coach. You talk about your diet and your stress and you exercise for 45 minutes. And then you go to the doctor after and they check your ears and make sure they don’t have ear infection or something like that.
Because the doctors are still a very vital part of the team. But you can only focus on health so much in a three-to-five minute visit. You need longer. We need to focus on prevention. And that’s going to take a team approach.
Yeah, that’s cool, I like that idea. And I know we’ve kind of covered that in the Preschool Podcast in terms of children’s development and learning, as well, sort of that model of having multiple different specialists or practitioners. Because there is more than one way to do things. And so it’s interesting sort of how that kind of aligns to that view.
And it’s interesting, too, just thinking personally about some of my experiences. Like, I have some friends, for example, who have kind of gone the opposite way of trying the medication approach and all different kinds of more prescriptive health and medical treatments and then gone to sort of the more natural methods, because the other ones weren’t working, and have found success with that. So, it’s almost like going back to that first point you were making about the seeds of health and going back to that as the fundamental thing that really helped them with whatever their ailment was.
Yeah, I mean, that’s such a good point, it’s such an important point. Because that’s how most people find natural medicine, is they do the regular system for years, it doesn’t work and then they go to somebody natural and they get better. And that was one of the things that made me learn natural medicine in the first place because I was seeing friends and colleagues and kids, they would have problems for years and they would go to some natural person. And they would get better and say, “Well, what am I missing in regular medicine?”
But it shouldn’t be that way. We shouldn’t need to wait until the medical system has failed you because you shouldn’t need one or the other. They should be working together. And it’s like, Okay, you went to the doctor, you don’t have cancer. Great. Well, what can we do to make you better? Okay, let’s go work on the natural stuff. You don’t have the autoimmune disease. Great. You need the doctors to do the medical part to make sure of all the serious stuff. But then we we’re not really trained in all of the other stuff that’s out there. And so there are so many practitioners that have other tools in their tool belt that can help prevent medical concerns or help you when there’s nothing available in the medical system.
Yeah, totally, totally some awesome tips here, some great advice from Dr. Gator. Joel, before we wrap up, lots of folks out there – early-childhood educators, especially – are dealing with a lot of stress and anxiety. Children are under additional stress. What would you like our listeners to take away from this conversation, in dealing with a lot of the challenges we’re dealing with today?
I think the first thing is to recognize that it’s okay, recognize that we’re all going through it. Everybody – the whole world, basically – is dealing with a new stress. There’s no textbook on how to deal with the pandemic. And we need to just band together.
As a physician, we are in a unique position to see that so many people are dealing with it. Most people are dealing with these things alone and they don’t realize that everybody else is suffering just like they are. So, just know that you’re not alone. Reach out to your friends and family, talk about what you’re going through.
And then go back to the basics there. There’s so much that you can do at home. Don’t get overwhelmed. Just think about the little things like sleep and stress and diet and just make some small changes. And if you start making some small changes in a positive direction, then you’ll start to see that you’re feeling better. And it’s like a snowball going down the hill. And once you start rolling, then things start to improve. And that’s what I have seen thus far. And hopefully things are on the up and up at this point. And we’ll see more and more improvement and we’ll start to come out of the pandemic stronger.
Totally. Awesome, Joel. If our listeners want to learn more about Integrative Pediatrics or get in touch with you, where can they go to get more information?
The best places would be www.IntegrativePediatrics.com. Or you can find me on Instagram at @DrJoelGator or the Raising Amazing Podcast.
Awesome. Dr. Joel Warsh, also known as Dr. Gator, thanks so much for joining us on the Preschool Podcast today. Awesome having you!
Thank you so much!