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Non-intervention: Don’t Just Do Something; Stand There!

submitted by jwithrow.

Journal of a Wayward Philosopher
Non-intervention: Don’t Just Do Something; Stand There!

February 26, 2015
Hot Springs, VA

The S&P opened at $2,114 today. Gold is up to $1,215 per ounce. Oil is back up to $50 per barrel. Bitcoin is up slightly at $237 per BTC, and the 10-year Treasury rate opened at 1.94% today.

Don’t just do something; stand there!

I chuckled when I heard this spin on the popular cliché in regards to the proper approach to natural childbirth. Then it occurred to me that this call for non-intervention is applicable for pretty much every other subject we take interest in here at Zenconomics: finance, economics, health care, education, government, all of them. Modern culture has taken a hyper-invasive approach in each of these areas to most everyone’s detriment.

Non-intervention in childbirth is based on the understanding that the mother is perfectly capable of delivering her child without any external ‘help’ save the support of her partner and her health care team. Non-intervention in childbirth operates on the firm belief that the mother’s body is perfectly designed for the task at hand and we have a lot of historical evidence to support this position.

We don’t know for sure how long the human race has been around. History textbooks tend to start the timeline around 10,000 B.C. and they say we were all cavemen for about 25,000 years prior to that. I have seen compelling alternative studies that suggest the caveman story is largely false and that humans existed at least 100,000 years ago with relatively the same genetic structure and cognitive ability. Regardless of the timeline, what we do know is that children have been born naturally according to the non-intervention principle for 99.9% of human history. Modern hospitals did not take shape until the turn of the 20th century and 95% of all children in the U.S. were still born at home in 1910. The number of homebirths plummeted to 3% by 1960 and looks to have bottomed at 1% in 1980. Approximately 5% of all births in the U.S. are currently homebirths outside of the hospital.

The data shows that complications do occur during natural labor about 10% of the time and the vast majority of these cases are minor but best addressed in a hospital setting. This is the primary risk when doing a homebirth but the risk can be mitigated with an emergency back-up plan. Fortunately, the possible complications are well-documented and they can be detected early simply by monitoring the baby’s heartbeat during labor which is now very easy to do thanks to the advancement of technology.

U.S. hospitals are extraordinarily good at handling emergency complications but this has led to a hyper-invasive approach. U.S. hospitals view childbirth as an emergency situation and employ all manner of invasive interventions during every birth whether or not a complication arises. This interventionist approach actually increases both the probability of a complication occurring as well as the severity of that complication because invasive interventions have unintended consequences. This is why you hear about so many birth horror stories in the U.S. Standard interventions like planned inductions, synthetic labor enhancing drugs, drugs for pain relief, and the restriction of free-movement disrupt normal physiology which can have undesirable effects on both mother and baby.

Non-intervention in childbirth is about trust. We must trust in the magnificent creative power that permeates the Universe. We must trust in the chaotic order and balance of the natural world. We must trust in the innate strength and wisdom of the mother. And we must trust in the majesty of childbirth.

The non-intervention philosophy is simple, holistic, and comprehensive. This applies to natural childbirth just as it applies to holistic wellness practices, free market economics, sound personal finance, childhood education, and the role of government which we will look at tomorrow.

Non-intervention requires a commitment to research, knowledge, and understanding which will cut through unsubstantiated fear and propaganda. It requires strength of will and a calmness of mind capable of tuning out the noise while tapping in to the inner wisdom we all possess. Perhaps most of all non-intervention requires an acceptance of personal responsibility: we are each personally responsible for every choice we make.

Non-intervention is not complicated but it does fly in the face of modern culture. We are constantly inundated with messages of insecurity, materialism, conformity, status, fear, intolerance, and hate from mainstream media sources – especially from the television “news” programming. These messages almost exclusively hold intervention as the solution to any problem and this outlook has shaped modern culture as most people buy right in to this way of thinking. But an amazing internal transformation occurs within those who tune out the noise and embrace the philosophy of non-intervention.

Our midwife made a profound statement to wife Rachel and I during our initial informational interview and the wisdom of her words still echoes in my head:

”A good midwife knows when to sit on her hands.”

I am convinced that this ability to sit patiently on one’s hands with a calm mind while the crowd screams for action is the peak of self-discipline.

Until the morrow,

Joe Withrow
Wayward Philosopher

For more of Joe’s thoughts on the “Great Reset” and the paradigm shift underway please read “The Individual is Rising” which is available at http://www.theindividualisrising.com/. The book is also available on Amazon in both paperback and Kindle editions.

The Homebirth Advantage

by Ronnie Falcão, LM, MS– ICPA.org:

When it comes to what’s best for you and your baby, you can consider a midwife-assisted home birth as safe an option as birthing in a hospital or free-standing birth center. At a home birth, your privacy will be respected and you can enjoy birthing in an intimate, family atmosphere. By birthing at home, you’ll be treated like a woman going through a natural process. Too often in hospitals, birthing women are made to feel more like patients with a dangerous condition.

Homebirth midwives carry the same equipment and medications found in a birth center. These includes hand held Dopplers and state-of-the-art machines for continuous monitoring of the baby’s heart rate, if necessary. Midwives also bring suctioning equipment and an oxygen tank to every birth, in the rare event they are needed. Anti-hemorrhagic medications will be on hand to prevent postpartum hemorrhaging, as will suturing equipment in case you tear.

In fact, midwives practicing in homes or independent birth centers can do everything that a midwife in a hospital could do. A 2009 Canadian study compared safety rates for planned home births and planned hospital births attended by the same cohort of midwives. They also evaluated the safety of planned physician-attended hospital births for a matched population of low-risk women who could have opted for home birth or hospital-birth midwives. Of the three groups, the home birth group had the highest safety statistics, including the lowest rate of interventions, serious perineal tearing and hemorrhaging. Babies born at home required resuscitation less often than those born in the hospital, and were less likely to experience meconium aspiration. Thus, the study indicated that home births were not only safer for low-risk mothers than any other birthing environment, but that they also called for less medical intervention.

One key difference is that professional midwives, in whichever setting they practice, work to recognize problems that could potentially interfere with a safe birth, and seek to correct them before they become major problems. They are also trained to handle life-threatening emergencies that can occur suddenly during a birthing, such as shoulder dystocia, postpartum hemorrhage or placental problems. Interestingly, each one of these emergencies occurs beyond the point when a cesarean section is still an option.

During the hours leading up to a birth, if a cesarean becomes necessary, there is a safety margin of 30 to 75 minutes in which to assemble a surgical team. For this reason, many midwives recommend that women labor within 30 minutes of a hospital as their emergency backup plan. This provides the same safety margin as women birthing in hospitals.

A landmark study on home birth safety was published in the British Medical Journal in June 2005. Like the 2009 study, this study showed that home births and hospital births had similar overall safety rates, but that there were fewer interventions and fewer complications for the home births. This prospective study with a rigorous research design is was most comprehensive North American study regarding birthing location options. A suite of home birth safety studies from the United Kingdom in 1996 also showed home to be as safe as or safer than a hospital for low- and moderate-risk women. In a 1999 review of all the literature on the relative safety of different birthing locations, childbirth researchers Luke Zander and Geoffrey Chamberlain concluded, “No evidence exists to support the claim that a hospital is the safest place for women to have normal births.”

Safety Begins at Home

There are several reasons why midwife-attended home births are safer than hospital births for most women. The first is that birth is a natural bodily process that works best without interference. A home birth with a midwife attending assures you that risky medical intervention will be kept to a minimum. (For example, Pitocin and epidural anesthesia, routinely administered in hospitals, introduce significant risks to both mother and baby.) Most problems that arise at home can be corrected with position changes or by providing the mother with food or better hydration— safe and helpful tools which are, ironically, often forbidden in many hospitals.

The second reason that home birth is safer is that the infection rate at home births is less than half that of hospital births. There are several reasons for this. First, the baby is born with the mother’s antibodies, passed through the placenta. These include immunity to the family’s household germs. Hospitals are notoriously germ-infested, and a mother isn’t able to offer herself or her baby the same degree of immunity from that environment. Second, homebirth midwives know not to wash off the protective, antibacterial vernix covering the baby’s skin. Third, because mothers and babies are never separated, the baby’s immature immune system is able to function optimally, without the stress and disruption of the baby being taken from its mother. Furthermore, the continuous mother-baby interaction fosters successful breastfeeding, which is the baby’s best protection against infection from the moment of birth. Midwives provide continuity of care and comprehensive mother/baby care at a level impossible in the assembly-line nature of hospitals.

Many women wonder whether they’ll be able to give birth at home without drugs; in fact, most women do just fine. Many women who have had babies both at home and in the hospital assert that birthing is much less painful at home, in familiar surroundings, with birth attendants who could cater to every need.

Childbirth classes teach about the fear-tension-pain cycle, whereby fear increases tension, causing the cervix to constrict rather than dilate, which in turn increases pain. It’s a process that’s counterproductive to birthing. When fear is absent from the birthing environment, the opposite cycle can play out: confidence-relaxation-comfort. That is, the more confident you are, the better able you are to relax, and the more comfortable you’ll be. This allows your body to secrete endorphins, which are the natural pain relief intended by nature for the mother’s body during natural childbirth.

As a laboring woman’s body produces more oxytocin to increase the effectiveness of her contractions, she also produces an equivalent level of endorphins for pain relief. (These endorphins aren’t produced if the mother is under stress or feeling afraid.) It is not uncommon for women to become increasingly relaxed as labor progresses, due to their endorphin levels climbing as the intensity increases. It’s easy to imagine how being in your own home can increase your confidence and ability to relax. A birthing tub provides even greater comfort, immersing the mother in the warm weightlessness of water.

Water birthing offers the woman the option of laboring and birthing in a tub. When a baby is born in water, the baby continues to receive all of its oxygen through the placenta until it is above water and using its lungs successfully. Thus, there is no risk of drowning, even if the baby crowns slowly over several contractions. The buoyancy provided by the water seems to help the mother and baby find the optimal position for birthing. In addition, the warm water increases blood flow to the uterus, which not only provides the necessary oxygen to the baby, but facilitates cervical dilation and reduces pain. Babies born in water are usually in excellent condition, and they are easily comforted by the familiarity of warm water.

The experience of birth for the baby at home is usually very gentle. We know that babies recognize voices during late pregnancy, so it is believed that the baby recognizes the midwife’s voice as someone nonthreatening and familiar. Homebirth midwives don’t use any devices that go inside the uterus or might be uncomfortable for the baby, and women are encouraged to birth in a position they choose. Positions chosen by the mother, such as an upright position, or on her hands and knees, tend to minimize stress on the baby and facilitate an easier birth.

Many homebirth couples choose to catch their own baby, and the assessment of baby’s well-being right at birth can be easily done with the baby still in the mother’s arms. Some midwives don’t ever hold the baby until the mother feels ready to have the baby weighed. Most parts of the newborn exam can be performed with the baby in the arms of the mom or dad. And because there is no rush to cut the cord, the baby receives all of its nutrient-rich cord blood, as nature intends.

Families who already have a little one at home appreciate how much easier it is for the older sibling to adjust to a new baby when their mom doesn’t mysteriously disappear for a few days. It may be wise to have a special family friend or a professional child doula there to care for the older child during the birth, but many siblings happily participate during the birth or sleep right through the excitement.

Easier Than You Think

The logistics of planning a home birth are often not as complex as couples assume. Babies born at home get a birth certificate and social security number, just like hospital born babies. (Your midwife can provide the necessary paperwork.) Birth kits with disposable supplies can be easily purchased online. Even larger items, such as birthing tubs, can be affordably purchased or rented.

Home birth provides an opportunity for a safe and satisfying birth experience, putting the needs of the baby first. She’s the most important person during the event: Shouldn’t she be treated like it?

Article originally posted at ICPA.org.

Antibiotics and the Aware Parent

by Claudia Anrig, D.C. – ICPA.org:

Acute Otitis Media is the most common upper respiratory condition treated in pediatric offices and the treatment of this condition continues to be the most controversial in the medical community.

The majority of children suffering from Acute Otitis Media will automatically be placed on antibiotics despite growing evidence that suggests there’s only a marginal benefit from this form of care.

The pediatric community is being confronted primarily by mounting evidence that the standard use of antibiotics may be an outdated practice with little value and what appears to be greater risk to the child.

When prescribing antibiotics for your child your pediatrician should be willing to answer the question, “Does this case warrant a prescription”?

Let’s consider an observation published recently by the American Academy of Pediatrics and the American Academy of Family Physicians:

“Each course of antibiotics given to a child can make future infections more difficult to treat. The result is an increase in the use of a larger range of—and generally more expensive— antibiotics. In addition, the benefit of antibiotics for Acute Otitis Media is small on average and must be balanced against potential harm of therapy. About 15 percent of children who take antibiotics suffer from diarrhea or vomiting and up to 5 percent have allergic reactions, which can be serious or life threatening. The average preschooler carries around 1 to 2 pounds of bacteria – about 5 percent of his or her body weight. These bacteria have 3.5 billion years of experience in resisting and surviving environmental challenges. Resistant bacteria in a child can be passed to siblings, other family members, neighbors, and peers in group-care or school settings.”

Scientific Evidence

Scientific evidence puts forth the following information:

• Children with high temperature or vomiting improved after an average of three days.

• Children with high temperature or vomiting were likely to benefit from antibiotics, although it’s still reasonable to wait 24 to 48 hours since many children will improve when left to their body’s own natural defenses.

• Children without high temperature or vomiting were not expected to benefit from immediate antibiotics.

Considering this information it’s best to take an option to observe stance since 80 percent of children with Acute Otitis Media get better without antibiotics within 48 to 72 hours.

With this scientific evidence mounting, ask yourself a few questions:

Will my pediatrician continue to prescribe antibiotics to my child based on his or her old programming and habits despite growing evidence that suggests antibiotics make little difference?

Does my pediatrician continue to have concerns that there’s a risk for dangerous complications, such as Acute Mastoiditis, despite the fact that it’s documented as a “rare occurrence”

As a parent, what do you need to know?

• That there is mounting evidence from the research community that the use of antibiotics has very little effect on Acute Otitis Media.

• That your doctor may be prescribing antibiotics based on old habits or the concern of developing acute mastoiditis, which has proven to be rare.

• That when delaying the use of antibiotics for 72 hours, even if your child is suffering from fever and vomiting, 50 percent of all children improve within that time period.

• That children with Acute Otitis Media but without fever and vomiting receive very little benefit from the use of antibiotics (this child should not begin antibiotics unless their condition worsens).

• It’s your child and you can take the initiative by asking your pediatrician to consider waiting 72 hours before introducing the antibiotic.

Prevention is the Key

New guidelines set forth by the American Academy of Pediatrics and the American Academy of Family Physicians recommend that the clinician take an active role in preventing Acute Otitis Media. A few suggestions included:

• Altering child care center attendance • Breastfeeding for the first 6 months • Avoid supine bottle-feeding (bottle propping) • Reduce or eliminate pacifier in the second six months of life • Eliminate exposure to passive smoke

A Healthy Alternative

Take the common sense approach to otitis media and consider chiropractic care. The Fallon study with 332 participating children suggests that chiropractic care may be more effective than drug therapy.

Be aware that your chiropractor is not opposed to antibiotics when necessary, but the chiropractic profession acknowledges that over usage is prevalent in our country and that the habits of medical doctors may not have caught up with the latest research.

A Final Thought

For the overall wellness of your child, participate in all decisions when it comes to the usage of antibiotics and seek other non-invasive forms of care. Remember, it’s your child and you have a say in his or her care. Most importantly, initiate healthy lifestyle choices for your family and include regular chiropractic care as part of your family’s achievement towards wellness.

Article originally posted at ICPA.org.

Children May Not Need Antibiotics for Acute Infective Conjunctivitis

by Pathways Magazine – ICPA.org:

Antibiotics are not necessary for most children with acute infective conjunctivitis, according to the results of a randomized, double-blind trial published in the June 22 Early Online Publication issue of The Lancet.

“We have shown that symptoms resolve without antibiotics in most children with acute infective conjunctivitis,” lead author Peter W. Rose, from the University of Oxford, England, said in a news release. “The health economic argument against antibiotic prescription for acute conjunctivitis is compelling.”

The authors note that each year, one in eight schoolchildren has an episode of acute infective conjunctivitis annually, and that standard clinical practice is to prescribe a topical antibiotic. However, there is little evidence to support this practice.

“Parents should be encouraged to cleanse their children’s eyes if an antibiotic is not prescribed,” the authors conclude. “Parents should be encouraged to treat children themselves without medical consultation, unless their child develops unusual symptoms or the symptoms persist for more than a week.”

1 in 8 schoolchildren has an episode of acute infective conjunctivitis annually, and that standard clinical practice is to prescribe a topical antibiotic. However, there is little evidence to support this practice.

Article originally posted at ICPA.org.

Treating an Ear Infection

by Joseph Mercola, DO – ICPA.org:

I know antibiotics are not good for my baby, but what do I do if he gets an ear infection?

Avoid dairy. Identify food allergens. Try this safe, economical solution!

The treatment of ear infections in this country is a huge problem. Most of the chronically sick children I see were given antibiotics frequently for recurrent ear infections. The sad tragedy is that nearly all of these are preventable by simply changing the diet. Avoiding milk and dairy is the single largest issue, but clearly other food allergens contribute.

Even with the best diets though a child may get an ear infection. This does not mean that the child needs antibiotics. The simple solution is to put a few drops of breast milk in the ear canal every few hours. This usually works to clear up the infection within 24–48 hours and is far safer, less expensive and a better solution than putting the child on antibiotics. If the mother is not breastfeeding, it is likely she knows someone who is. All that is required for the treatment is about one half ounce of breast milk, so obtaining that from a friend will work just as well.

If you know someone who has a child with ear infections please share this article. You may make a huge impact on the future health of that child.

Article originally posted at ICPA.org.

The Wait and See Prescription – Avoiding Antibiotics

by Darrel Crain, DC – ICPA.org:

Earaches bring more unhappy children to emergency rooms and pediatric offices each year than just about any other health disorder. Antibiotics remain the most popular medical treatment for earache, with doctors reportedly writing 15 million prescriptions per year in the United States alone. It is estimated that at least half of the prescriptions are unnecessary and ineffective for helping this problem.

Due to the widespread overuse of antibiotics, drug-resistant germs have been reproducing as fast as frolicking rabbits, constantly evolving new levels of drug resistance. For over a decade our health leaders have been sounding the alarm to doctors to stop writing so many prescriptions for antibiotics because of growing drug resistance as well as serious health risks to the user.

“The risks of antibiotics, including gastrointestinal symptoms, allergic reactions, and accelerated resistance to bacterial pathogens must be weighed against their benefits for an illness that, for the most part, is self-limited,” according to the authors of a study about earache published in the Journal of the American Medical Association (JAMA) in September 2006.

Antibiotics are weapons of mass destruction intended to assassinate select gangs of bad-boy bacteria. Unfortunately, most of the hardworking, honest bacteria in the body get murdered at the same time, wiping out the body’s mighty microbes that normally do important work such as digesting food and making vitamins.

The earache study published in JAMA was a test of something called the “wait-and-see prescription” to help kids with earaches. This method has apparently been tried previously, but never before in an emergency room.

Half of the 283 children in the study diagnosed with acute otitis media (AOM) were sent home with a standard prescription, the other half with the wait-and-see prescription (WASP). The only difference between the two groups was that the parents in the WASP group were told to wait at least 48 hours before filling the antibiotic prescription.

“Everything comes if a man will only wait,” Benjamin Disraeli pointed out more than 150 years ago.

An unbelievable two out of three children avoided antibiotics with this innovative wait and- see strategy. “The WASP approach substantially reduced unnecessary use of antibiotics in children with AOM seen in an emergency department and may be an alternative to routine use of antimicrobials for treatment of such children,” according to the study.

The WASP concept may well be one of the greatest advances in medical science since the discovery of hand washing. The immediate benefit will be in the fight against two very pressing medical problems, microbial drug resistance caused by widespread antibiotic use, and antibiotic-induced chronic disease. But I can imagine applications throughout the medical profession. How about “wait-and-see surgery” for example?

The WASP study is sure to be criticized because it was only an observational study, not a clinical randomized trial (CRT). The CRT is considered the gold standard in medical science, so if the only thing you have is observational and anecdotal evidence to support your clinical practice, you might as well just use the paper to line your birdcage.

Which brings us to children who visit the chiropractor’s office for their earaches… Critics of chiropractic complain that there just isn’t any science to verify the ability of the chiropractic adjustment to enhance natural healing of the ears. The fact is, a significant number of studies have been published that describe the neurology and verify the benefits of chiropractic care for children, but alas, no clinical randomized trials.

And that reminds me of the famous parachute study, published in the British Medical Journal in December of 2003. The authors of this study write, “parachutes are widely used to prevent death and major injury after gravitational challenge,” yet the placebo-controlled, randomized clinical trials have never been done. I’m thinking that at this point it may be difficult to find people willing to jump from an airplane wearing a placebo parachute. It looks and feels like the real thing when you put it on, but when you pull the cord nothing happens.

“The perception that parachutes are a successful intervention is based largely on anecdotal evidence… As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomized controlled trials,” write the authors.

Now I may be wrong, but it seems to me that people seeking good health are mostly interested in getting well as quickly as they can with having to worry about additional health risks. The wait-and-see prescription is not a recommendation to just ignore health problems and hope they go away, it is simply more evidence that the watchword for medical interventions is “less is more.”

Common sense suggests that if you need to jump out of a plane while still up in the air, you might want to strap on a real parachute without waiting for the double blind studies. I agree with the authors of the JAMA study who conclude, “Individuals who insist that all interventions need to be validated by a randomized controlled trial need to come down to earth with a bump.”

Article originally posted at ICPA.org.

Antibiotics and Ear Infections

by Linda Folden Palmer, DC – ICPA.org:

In cases where the immune response lags behind a bacterial infection that is dangerously decimating the body, the 1950s advent of antibiotic medications saved the lives of millions of people who would have otherwise succumbed. However, the overzealous use of these wonder drugs has now created a new realm of powerful diseases we are unable to fight with existing antibiotics.

Once a resistant bacteria has been created in response to antibiotic therapy, it has the power to transfer its resistance to other microbes, developing new resistant strains. This has been an especially significant issue for the young, who have been chief targets for antibiotic misuse because they are more susceptible to infections and infections are more worrisome in them. Powerful, antibiotic-resistant strains spread easily around day care centers.

Tuberculosis and pneumonia were once conquered with antibiotics, but we are now threatened again by TB epidemics and increased pneumonia deaths. The excitement over antibiotics has also led to reduced hygiene in hospitals. Hospital sanitation peaked decades ago, when its importance was first widely recognized. Now 10 percent of the patients in hospitals acquire infections, a large portion of which are resistant to antibiotics due to their expansive use in hospitals. Three percent of these patients die from their infections.

Antibiotics have many possible side effects, including diarrhea, malabsorption, cramping, yeast infections, agitation, rashes and blood disorders. By wiping out much of the normal flora throughout the body, antibiotics leave patients, especially children, far more vulnerable to other infections, such as thrush (oral yeast), and dangerous intestinal microbes that cause diarrheal illness. Infectious diarrhea follows antibiotic use at rates ranging from 5 to 39 percent, depending on the drug. The most common intestinal infection caused by antibiotics is colitis from clostridium infection, which has a 3.5 percent mortality rate.

Significantly, antibiotics are generally inappropriate for treating ear infections. They have no effect on viruses and are certainly inappropriate for colds and flus, where they can lead to secondary infection. Yet the majority of children visiting physicians with these complaints will receive antibiotic prescriptions. This is unfortunate. Most of the time, children are better off left to fight illness with their own immune systems, while their parents and physician provide careful monitoring.

Article originally posted at ICPA.org.

Whose Prescription Is It, Anyway?

by Author Howard Markel, MD, PhD – ICPA.org:

Attention Deficit Disorder and Ritalin

The boy is 14 years old and has one of the most severe cases of attention deficit disorder (ADD) that I have seen as a pediatrician. He fidgets; there are nonstop hand gestures, leg swinging and tapping. More troubling, he simply will not pay attention to any adult attempting to engage him in conversation, placing him in great jeopardy of flunking out of school.

During his first office visit, the boy explained his predicament to me: “It’s like I’m in a room with 20 big screen HDTVs blaring away in surround-sound. And on them are all the newest videos from MTV. The problem is that I can’t decide which one to watch, so I try to watch them all.”

His mother is less focused on her son’s perpetual motion than on his angry outbursts and what she sees as his refusal to listen to her. The day we met, she had already decided what she wanted to do. I was being told to write a prescription for Ritalin.

As every pediatrician knows, stimulant drugs like methylphenidate (Ritalin) cause most people to speed up their actions and thoughts. But for those with ADD (with or without hyperactivity), these drugs can slow them down, reduce overactivity, increase attention span, and can even improve relationships between a child and parents or other family members. There are, however, some nagging problems: none of us is exactly certain how these drugs work or what their long-term benefits and risks might be. Sometimes, they cause intolerable side effects such as tics and sleep disturbances.

The young man was clearly unhappy with his mother’s decision and let it be known with a slew of scowls and outcries of “Shut up!!” I asked him why he would prefer not being able to pay attention to his schoolwork, to which he replied: “You just don’t get it. I’m a lot more fun when I don’t take Ritalin. I crack great jokes in class and my friends think I am really cool. But when I take that stuff, I’m zoned out. I’m like a log. Ritalin ruins my life.”

This description went a long way in explaining why many teachers (and not a few parents) of kids with ADD prefer their charges to be medicated and why many children resist such attempts. Left untreated, however, many of these kids create problems with disruptive behaviors and can destroy the normal dynamics of a classroom and at home.

Here was my dilemma: The boy’s mother, and not the young man, wanted the prescription. The law defines a 14-year-old as a minor, but given that his condition was hardly fatal and essentially a behavioral issue, to whom should I have listened? The mother, who wants a more controllable child, or the boy, who simply wants to be what he perceives to be his true self? After all, the essence of adolescence is finding out who you are and figuring out who you want to be. As a pediatrician, I am supposed to be assisting youngsters in this difficult process.

That day, I listened to the parent and wrote the standard prescription for 40 mg of Ritalin a day. Like millions of youngsters with ADD, he takes 20 mg before going to school in the morning and another 20 mg at lunch.

Every month, I see the boy to renew his prescription for Ritalin and to make sure that there are no serious side effects. At each visit, he greets me with a deep-rooted but quiet anger. His fidgeting and outbursts seem to have diminished, but there has been little improvement in his schoolwork. Last year, he barely passed the eighth grade and his mother admitted that 2 of his teachers simply elected to pass him to avoid a repeat year with him. Nevertheless, she is delighted with the results.

When the boy is on vacation from school, I have noticed a definite change in his demeanor. Typically, when school is out, pediatricians give children with ADD a “drug holiday.” When he does not take his medication, his fidgeting and inattention are back in full force but he beams with joy, at least when I see him, and tells me that without Ritalin he can again enjoy cutting up in front of his friends.

But in his mother’s defense, I don’t live with him and have no real idea how disruptive his ADD behaviors can be at home. In cases like these, I have to listen to the parent that does live with him. I remain terribly conflicted about pharmacologically altering this young man against his will. Using potent pills to treat a disorder we do not completely understand flies in the face of prudent medical practice, and yet we pediatricians do this all the time with our ADD patients. More than a century ago, the great physician Sir William Osler observed that “the desire to take medicine is one feature which distinguishes man, the animal, from the rest of his fellow creatures.” In the practice of pediatrics, we are often compelled to include the parent’s desire in that rubric.

But still, I wonder, am I doing the right thing?

Article originally posted at ICPA.org.

Nutritional Considerations for ADHD

by Pathways Magazine – ICPA.org:

Early Use of ADHD Drug Alters Brain

Ritalin use in preteen children may lead to depression later in life. Ritalin and cocaine have different effects on humans. But their effects on the brain are very similar. When given to preteen rats, both drugs cause long-term changes in behavior.

One of the changes seems good. Early exposure to Ritalin makes rats less responsive to the rewarding effects of cocaine. But that’s not all good. It might mean that the drug short-circuits the brain’s reward system. That would make it difficult to experience pleasure—a “hallmark symptom of depression,” Carlezon and colleagues note.

The other change seems all bad. Early exposure to Ritalin increases rats’ depressive-like responses in a stress test. “These experiments suggest that preadolescent exposure to [Ritalin] in rats causes numerous complex behavioral adaptations, each of which endures into adulthood,” Carlezon and colleagues conclude. “This work highlights the importance of a more thorough understanding of the enduring neurobiological effects of juvenile exposure to psychotropic drugs.”

my.webmd.com/content/article/78/95700.htm?lastselectedguid={5FE84E90 -BC77-4056-A91C-9531713CA348}

Consider Fish Oil Over Ritalin

Children with attention-deficit hyperactivity disorder (ADHD) have problems paying attention, listening to instructions, and completing tasks; they also fidget and squirm, are hyperactive, blurt out answers, and interrupt others.

It is conservatively estimated that 3-5% of the schoolage population has ADHD. Although drugs, such as Ritalin, are frequently used to treat ADHD, they are fraught with complications. Disadvantages include possible side effects, including decreased appetite and growth, insomnia, increased irritability, and rebound hyperactivity when the drug wears off.

One would not expect to find that a single cause or even a handful of factors could explain why ADHD appears to be so rampant in our society. Because it is accepted that both genetic and environmental factors play a role in ADHD, many other factors—both intrinsic and extrinsic— could influence an individual’s fatty acid status.

Inefficient Conversion of ALA (Flax Oil) To EPA And DHA

A possible cause for the low fish oil status of the ADHD children may be impaired conversion of the fatty acid precursors LA and ALA to their longer and more highly unsaturated products, such as EPA and DHA (fish oil fats).

It appears that children with ADHD just are not able to chemically convert the plant omega-3, ALA to fish oil very well. The problem is further worsened when omega-6 fats are consumed and the ideal omega-6:3 ratio of 1:1, progresses to the typical standard American ratio of 15:1. Many of these children have ratios which are even worse and can be as high as 50:1.

This study provides the research evidence supporting the use of the omega-3 fats found in fish oils to effectively address the underlying deficiency that is present in most of these children and appears to be contributing to the ADHD.

Two books worth having for your lending libraries:

Smart Fats: How Dietary Fats and Oils Affect Mental, Physical and Emotional Intelligence
by Michael A. Schmidt

Omega 3 Connection
by Dr. Stoll

Article originally posted at ICPA.org.

ADHD and Non-Medical Care

by Pathways Magazine – ICPA.org:

Parents seeking treatment for their child with ADHD (attention deficit hyperactivity disorder) often pursue alternative treatments to those offered by conventional medicine. A study conducted in Australia investigated how many parents with ADHD children did seek some form of alternative to stimulant medication. This study published in the January 2005 issue of the Journal of Paediatric Child Health revealed that over two-thirds of families with an ADHD child sought alternative care. Families of 50 children out of 75 respondents attending the Royal Children’s Hospital in Victoria reported using at least one form of alternative treatment for ADHD.

Diet modification was the most common form of alternative treatment pursued by these parents (66 percent of those who tried alternatives). Other treatments that parents had tried included vitamins and minerals (32 percent), aromatherapy (24 percent), dietary supplements (24 percent), chiropractic (20 percent), naturopathic therapy (16 percent), herbal therapy (14 percent), and neurofeedback and behavioral optometry (10 percent each).

Parents were also asked their goals in seeking alternative treatment, and 89 percent wanted to minimize their child’s symptoms. Avoiding side effects of prescribed medications was rated as important by 67 percent of families.

Most importantly, nearly 60 percent of families rated at least one type of alternative treatment helpful for their child.

This study shows the frustration and general dissatisfaction among parents with the pharmaceutical approach to children’s attention problems. Parents are seeking a holistic approach to these children’s problems, and this study shows the perceived benefit that parents experience from these holistic methods of treatment.