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Keeping Kids Healthy. Dr. Emily Maiella Naturopathic Physician 432 Greenfield Rd Montague MA 01351 413.230.4462. With pediatric patients. Herbal Safety Types of Herbal Preparations Compliance Issues Dosing Specific for Children Childhood Illnesses Parental satisfaction.

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keeping kids healthy
Keeping Kids Healthy

Dr. Emily Maiella

Naturopathic Physician

432 Greenfield Rd

Montague MA 01351


with pediatric patients
With pediatric patients

Herbal Safety

Types of Herbal Preparations

Compliance Issues

Dosing Specific for Children

Childhood Illnesses

Parental satisfaction

immune support prevention and acute
Immune Support(Prevention and Acute)

Vitamin D


Elderberry (Sambucus)


Be prepared. Have medicines on hand.

cold and flu prevention
Cold and Flu Prevention

Basic Prevention, try to have the whole family on the following….

Research backs it up!

Randomized trial of vitamin D supplementation to prevent seasonal influenza A (H1N1) in schoolchildren.

DESIGN:From December 2008 through March 2009 a randomized, double-blind, placebo-controlled trial comparing vitamin D(3) supplements (1200 IU/d) with placebo in schoolchildren. The primary outcome was the incidence of influenza A, diagnosed with influenza antigen testing with a nasopharyngeal swab specimen.

proves really effective
Proves really effective!
  • RESULTS: Influenza A occurred in 18 of 167 (10.8%) children in the vitamin D(3) group compared with 31 of 167 (18.6%) children in the placebo group. The reduction in influenza A was more prominent in children who had not been taking other vitamin D supplements and who started nursery school after age 3 y. In children with a previous diagnosis of asthma, asthma attacks as a secondary outcome occurred in 2 children receiving vitamin D(3) compared with 12 children receiving placebo
  • CONCLUSION:This study suggests that vitamin D(3) supplementation during the winter may reduce the incidence of influenza A, especially in specific subgroups of schoolchildren.
  • Am J Clin Nutr. 2010 May;91(5):1255-60. Epub 2010 Mar 10.
how vitamin d works
How Vitamin D works….

In a study published in the journal Nature Immunology, researchers from the University of Copenhagen found that when a variety of white blood cells known as a T-cell comes across a pathogen (virus, bacteria, tumor, fungus) in the bloodstream, it extends a receptor in search of vitamin D. If the WBC encounters the vitamin, the T cell becomes "activated." If there is not enough vitamin D in the blood, the cell remains passive and no immune response occurs.

how vitamin d works8
How Vitamin D works..

The body produces vitamin D upon exposure to sunlight. It can also be found in eggs, fatty fish, fortified milk and in supplement form. Once activated, (by vitamin D) a T-cell transforms into one of two kinds of cells. One type seeks out and destroys all traces of the infectious agent, while the other records information about the pathogen and transmits it to other parts of the immune system. These latter ("helper") cells help the immune system respond quickly should infection with a similar pathogen occur at a later date.

can t help but to share
Can’t help but to share

Side note: all of the other conditions which Vitamin D is extremely helpful for:

Colon and breast cancer prevention

Auto-immune conditions of all types

Multiple sclerosis


Effect of Lactobacillus gasseri, Bifidobacterium longum, B. bifidum on common cold episodes: a double blind, randomized, controlled trial

The aim of this study was to investigate whether the consumption of Lactobacillus gasseri, Bifidobacterium longum, B. bifidum, during at least 3 months influences the severity of symptoms and the incidence and duration of the common cold.

METHODS:A study was performed over at least 3 months during winter/spring periods. 479 healthy adults (aged 18-67) were supplemented daily with vitamins and minerals with or without the probiotic bacteria. Cellular immune parameters were evaluated in a randomly drawn subgroup of 122 volunteers before and after 14 days of supplementation. During common cold episodes, the participants recorded symptoms daily. Stool samples were collected before and after 14 days of probiotic supplementation to quantify fecal Lactobacilli and Bifidobacteria using qRT-PCR.

probiotics shorten duration
Probiotics shorten duration
  • The total symptom score, the duration of common cold episodes, and days with fever during an episode were lower in the probiotic-treated group than in the control group:
  • A significantly higher enhancement of cytotoxic plus T suppressor cells (CD8+) and a higher enhancement of T helper cells (CD4+) was observed in the probiotic-treated group
  • The intake of probiotic bacteria during at least 3 months significantly shortened common cold episodes by almost 2 days and reduced the severity of symptoms
  • Clin Nutr. 2005 Aug;24(4):479-80.
how probiotics help
How probiotics help….

From the very first breath you take, you're exposed to probiotics.

On the way through the birth canal during a vaginal deliver, a newborn gets dosed with bacteria from their mother’s birth canal. This event starts colonization in the infant's gastrointestinal (GI) tract of 'good' bacteria. N

New research now shows many caesarean-section infants have less-than-optimal health after birth. This is most likely because they are not exposed to the mother's healthy bacteria in the birth canal which would then serve to populate its own GI tract.

probiotics for life14
Probiotics ( = for life)

As you mature, you're faced with many threats to the beneficial bacteria in your gut... from chlorinated drinking water... to overly-processed foods.The 'good' bacteria in your gastrointestinal system can only provide you with optimum health if the proper balance of different types of bacteria is maintained in your gut.

This is where probiotics can have a profound effect... not just on your GI health, but on your overall health as well.

The intestine is the largest immunological organ in the body and contains 70% to 80% of all IgA-producing cells. When exposed to a virus (etc) by the oral route, a secretory immune response is obtained, which is mediated by secretory IgA.

probiotics increase the number of IgA-secreting cells, which migrate from the Peyers patches to distant mucosal sites such as the respiratory glands. This is where the gut and respiratory tracts interface.

the gut and eent inteface
The Gut and EENT inteface

the mucosal barrier also makes up our mouth, throat, eyes, the upper part of our lungs, nasal cavity, the urethra in men and women, and the vagina in women. So those external surfaces are also covered in secretory IgA.

  • Probiotics also increase T-cell production of TNF-α in response to adenovirus exposure and influenza A (variant of H1N1) exposure
for your own research
For your own research….

probiotics and eczema, allergies and asthma


Most common serious acute respiratory illness in infants and young children

Can manifest with mild cold-like symptoms

Can also be severely acute and can include coughing, quick/short breaths (fast breathing greater than 50 breaths per minute), labored breathing and lack of oxygen. Infants- want to sit up (more fussy laying down b/c they can’t catch breath).

cough rsv
      • RSV affects nearly ALL infants by the age of 2, most are not acutely affected.
      • 125,000 children hospitalized each year, 1-2 % of these will die from it.
      • Infants less than 1 year of age are most severely affected.
      • Generally seasonal between Fall and Spring of every year.
      • Can affect adults as well.
      • Spread easily by physical contact. Can live for half an hour on hands or five hours on countertops and used tissues.
      • Infants born prematurely, with chronic lung disease, immunocompromised or with some forms of heart disease are at a greater risk.
      • Exposure to tobacco smoke, daycare or carrier siblings are also at higher risk.
      • Nasal congestion
      • Nasal flaring
      • Cough (often croupy or barking)
      • Tachypnea/labored breathing or SOB
      • Hypoxia (cyanosis)
      • Wheezing
      • Fever
      • Symptoms usually appear 4-6 days after exposure
  • Sequela
        • Can be mild cold or lead to pneumonia and bronchitis can set up for damage towards asthma-
        • Can lead to otitis- drainage more thick mucous than other colds and viruses can lead to separate infection to ear.
        • Respiratory failure is a concern.
        • Asthma-may get asthma 6 months later not uncommon
rsv treatment

Thyme and Eucalyptus essential oil rubbed on chest and under nose. Gaia herbs makes a really nice chest rub, formulated by Dr. Mary Bove

  • Quercetin powder (1/4 tsp twice a day) opens up airways mildly, mucolytic, and for inflammation, for acute cough. 500mg 2x/day, mix it in applesauce.
  • Vitamin C 50mg x age in years, twice a day.
  • Echinacea 1 drop for every 2 lbs. body weight given every 2 hours
  • Composition Essence Gaia makes it- children - eclectic formula. 5 drops in warm water. Tastes sweet and warming. Put it in drinking water. Use it when things are more severe than in a mild cold.
rsv cough treatment

Wet or dry cough formulations with antivirals

  • Glycyrrhiza (wet or dry)
  • Melissa officinalis
  • Lobelia (wet)
  • Prunus serotina
  • Viburnum spp.
  • Verbascum
  • Hyssop
  • Thymus vulgaris
  • Inula
  • Anise
cough rsv treatment
  • Homeopathic Treatment (Spongia, Pulsatilla, Drosera, Ant-t for barking cough) Antimonium and carbo veg (likes to be fanned)-hypoxia and blue
  • Humidifiers-humidifying room, and essential oils on stove in water, can get oils in air with humidifier but may get germs into air. Use hot-air humidifiers.
  • Hydrotherapy
        • Steamy bathroom
        • Constitutional hydrotherapy

-Wet/warming sock treatment (for warming sock treatment, go to my website for print out)

syrup of thyme and ivy leaves
Syrup of Thyme and Ivy Leaves

1234 children and adolescents (623 boys and 611 girls) ages 2-17 with acute bronchitis and productive cough

Non-interventional post-marketing surveillance study

Treatment days: 0, 4 and 10

Acute bronchitis with productive cough in children and adolescents can be treated safely and effectively with the thyme and ivy syrup. A ten-day treatment using age-appropriate dosages led to a clear improvement in the symptoms or cure with very good tolerability.

Marzian O. “Treatment of acute bronchitis in children and adolescents. Non- interventional postmarketing surveillance study confirms the benefit and safety of a syrup made of extracts from thyme and ivy leaves” MMW Fortschr Med (2007 Jun 28) 149(27-28 Suppl):69-74


Treatment of acute infectious viral or bacterial diseases of the respiratory, urinary and GI systems.

  • Randomized, double-blind, placebo controlled clinical trial
  • •152 Patients with acute pharyngotonsillitis
  • •6 grams daily for a week
  • •Relief of fever and sore throat
  • equal to paracetamol (over the counter pain reliever)
  • Lower doses found not to be as effective
  • Thamlikitkul V., Dechatiwongse T., Therapong S, et al, J Med Assoc.Thai 1991;74(10);
andrographis acute and preventative
Andrographis: Acute and PREVENTATIVE
  • 107 healthy children
  • 200mg /day of andrographis ( 11.2mg andrographolides) or Placebo for 3 months (equals 1 gram herb)
  • By the 3rd month –significant decrease in the incidence of colds in the andrographis group compared to the placebo group.
  • The relative risk of catching cold was 2:1 times lower for the andrographis group.
  • (Caceres DD, Hancke JL, Burgos RZ, et al. Phytomed 1997;4 (2) 101-104)
  • This is a great herbs to initiate for prevention if your child has a history of ear infections, chronic bronchitis
  • Increase the dose, triple it if on a preventive dose if child gets sick.
  • Andrographis treatment can significantly shorten the course and duration of the common cold
  • Hancke J., Burgos R., Caceres D., Phytother 1995: 9:559-562
andrographis pediatric dosing
Andrographis Pediatric Dosing
  • Prevention use .5-1 gram powder, .5-2 mls liquid extract daily
  • Acute infection use 2 grams powder or 4 mls 1:2 liquid extract
  • Combine with warming herbs such as ginger, cinnamon, and astragalus
  • Safety, toxicity and contraindications;
  • No significant adverse effects have been noted.
  • High doses may cause gastric discomfort, anorexia, and vomiting.
  • Contraindicated in pregnancy (animal studies)
  • Acute bacterial infections of GU, GI and respiratory systems.
  • Good for an alternative long term antibiotic.
Long used in both Chinese and Ayurvedic medicine, this intensely bitter herb has powerful antiviral activity.

Bitter tonic, immune stimulant, anthelmintic, antihepatotoxin, cholagogue and anti-inflammatory.

It can be used for colds, influenza, sore throats, Lyme disease, hepatitis and other viral infections. In India it is considered superior to quinine for malaria.

It is also used for infestations of intestinal parasites such as Giardia, Blastosistus hominis and Dientaoeba fragilis.

sambucus nigra elderberry
  • Elderberry Extract Inhibits Several Strains of Influenza
  • Controlled, double blind study
  • 6 day outbreak of influenza B
  • Significant improvement of symptoms in 93% of group in 2 days
  • In vitro studies have shown inhibition of influenza types A and B
  • J. Altern. Comp. Med 1995
sambucus elderberry
  • The fruit has always been an anti-flu remedy, but don’t forget about the flower parts too! Great fever herb.
  • Keeping it in mind for all chronic viral infections, herpes etc.
  • Start in September, end in January for prevention.
anti viral action of berry
Anti-viral Action of Berry
  • Constituents neutralize the activity of the hemagglutinin spikes found on the viral surface. When these hemagglutinin spikes are deactivated the viruses can no longer pierce cell walls, enter the cell and replicate.
  • Influenza viruses A and B, Herpes simplex virus type 1 (HSV-1)
  • Zakay-Rones Z, Varsano N, et al. Inhibition of several strains of influenza virus in vitro and reduction of symptoms by an elderberry extract (Sambucus nigra L.) during an outbreak of influenza B Panama. J Altern Complement Med 1995;1:361-369.
  • Zakay-Rones Z, Thorn E, et al.Randomized study of the efficacy and safety of oral elderberry extract in the treatment of influenza A and B virus infections. J Int Med Res 2004;32:132-140.
  • The berry helps to colonize good gut flora b/c of the phytophenols. High Anti-oxidant and anti-inflammatory qualities.
  • Indicated for those respiratory infections that have a lot of mucus, b/c kids swallow the mucus, and that alters the flora. And remember what happens when the flora gets altered…trouble!!
not just anti viral 2011 elderberry study
Not just anti-viral! 2011 Elderberry Study
  • Inhibitory potential of the extract on the propagation of human pathogenic H5N1-type influenza A, influenza B virus, and clinically-relevant human respiratory bacterial pathogens
  • RESULTS: a standardized elderberry liquid extract possesses antimicrobial activity against both Gram-positive bacteria of Streptococcus pyogenes, group C and G Streptococci, and the Gram-negative bacterium Branhamella catarrhalis in liquid cultures
not just anti viral 2011 elderberry study36
Not just anti-viral! 2011 Elderberry Study
  • The liquid extract also displays an inhibitory effect on the propagation of human pathogenic influenza viruses.
  • CONCLUSION: elderberry liquid extract is active against human pathogenic bacteria as well as influenza viruses.

Krawitz C, Mraheil MA, Stein M, et al, Inhibitory activity of a standardized elderberry liquid extract against clinically-relevant human respiratory bacterial pathogens and influenza A and B viruses. In: BMC Complement Altern Med (2011) 11:16

elderberry dosage
Elderberry Dosage
  • Minimizes those post-viral bacterial infections!
  • Elderberry fruit syrups- standardized to 30-38 percent elderberry
  • Powdered extracts- 500 mg (capsule) 2-3 times daily for 3-4 days
  • Liquid form, dosed at one tablespoonful (15 ml) three times daily
  • Acute viral infections- treat at least three days

Pain and or discomfort in or around the ear. An earache develops when the tissue lining the middle ear or eustacian tube swells.

Immature Eustachian tube (the tube that connects the middle ear to the throat). In infants and young children this tube is much shorter and is angled. It is therefore much easier for bacteria to migrate from the nose and throat up into the middle ear space. As the child grows this tube becomes more vertical, so germs have to travel "up hill" to reach the middle ear. This is one-reason children "outgrow" ear infections.

otitis media
Otitis Media

Inflammation of the middle ear with the development of a bacterial infection. Immune response to this infection causes a collection of fluid in the middle ear space or a rupture of the tympanic membrane due to the fluid build-up.


Earache may be due to acute ear infection (otitis media), water or fluid in the ear (swimmers ear/ otitis externa) or inflammation/ blockage of the eustacian tube due to allergies, associated respiratory infections (eg. colds), travel (air or to higher altitudes) and sometimes accompanies teething and physiological obstructions.

earache otitis media

Ear pain or discomfort, with or without respiratory symptoms


Drainage from ear if tympanic membrane bursts

Sleeplessness (ear pressure increases while lying down)


Change in eating habits

Change in hearing

Refusal to nurse on side that hurts, pain worse when lying down.


earache otitis

More frequent in the winter

Teething- assoc. with fluid production

consumption of cows milk in early childhood

feeding position (bottles while lying down)

smoking in household

fetal alcohol exposure

genetic predisposition (eg. Children with Downs Syndrome)

Family predisposition decrease in IgG2 or IgA

prior episodes of otitis media

poor nutritional status

daycare setting

early introduction of solid foods

Underlying viral infections (RSV or Influenza),

Underlying food or environmental allergies

Association with pacifier use


Have your child seen immediately if……

  • Ear pain accompanied with fever >105.0 F (R/O severe infection, mastoiditis)
  • Any fever in infants < 12 weeks old.
  • There is pus, blood tinged or other abnormal colored fluid draining from ear.
  • Pointed object was inserted into ear canal (eg. Pencil, stick, etc>) (R/O perforated eardrum)
  • Child is in severe pain and cannot nurse, sleep, etc.
  • Stiff neck or headache ( R/O meningitis)
  • Vomiting or Chills
earache at home

Keep child in upright position (when sleeping prop up on pillows.

Use heat to help bring circulation and soothe the area.

Warm onion treatment: cut onion in half or in very slick slice. Bake for 15 minutes or microwave for about 2 (until steaming) Wrap onion in gauze or clean cloth (should feel warm but not too hot!) Apply to ear area until relief is felt. Repeat as necessary.

Warm olive oil infused lavender essential oil or commercially prepared eardrops infused with garlic and mullein.

(Never place anything in ear if a ruptured or perforated eardrum is suspected)


Keep child well-hydrated and decrease sugar intake

Give immune support teas made with herbs such as lemon balm, echinacea, chamomile, garlic, and astragalus.

Zinc, Vitamin C, Essential fatty acids (omega 3 and 6)

If antibiotics are used or have been used in the past supplement with probiotics to help restore normal gut flora.

homeopathics for earaches
Homeopathics for EARACHES
  • Homeopathy: Some of the more commonly used to treat ear infection include:
  • Pulsatilla- weepy, clingy, wants to beheld, extremely changeable mood, better in open air, fever 100 to l02, little or no thirst, refusal to drink
  • Belladonna- earache comes on suddenly with intense pain, may have fever up to 104, hot and flushed face, dilated pupils
  • Chamomilla- extremely irritable and changeable, does not know what he wants, worse in the evening, needs to be carried back and forth
  • Antibiotic treatment is most likely indicated if there are signs of systemic bacterial infection, mastoiditis, or other complications.
  • Antibiotics: risk of resistant strains, increased risk when child has been treated with antibiotics in the last 3 months. The absence of overt symptoms does not mean bacterial infection is cured.
  • Pain reliever and anti-inflammatories (ibuprofen or acetominophen. are often given to reduce pain and fever. But I usually recommend riding the fever out.
  • New research is suggesting that 80% of uncomplicated ear infections will resolve within 4 to 7 days without antibiotics.
  • Aspirin and salicylate containing compounds should never be given to children.
  • Surgical techniques are often done to treat children who have chronic recurring incidence of ear infections.
  • before undergoing such extreme measures underlying causes such as food allergies or nutritional deficiencies should be ruled out.
  • Myringotomies can cause permanent scarring and thickening of the eardrum.
playing more breast feeding less
Playing more, Breast-feeding less
  • Common in early childhood, greatest risk age 2-5. b/c stop breast feeding, put everything in mouth, and increased socialization.
  • Increased incidence in the pre-school setting due to exposure to increased number of bacterial serotypes at a time when structurally the eustachian tube is most at risk for congestion.
side note swimmers ears
Side note….swimmers ears
  • Otitis externa: inflammation of the ear canal secondary to loss of protective cerumen, contact dermatitis, underlying otitis media, staph or pseudomonas infection.
  • Swimmers ear prevented with drops of vinegar and 70% ethyl alcohol
tx management

Encourage breast feeding

Avoid cow milk dairy in the preschool population

Treat/avoid known food sensitivities

Treat/avoid environmental allergens

Avoid second hand smoke

Careful dental hygiene especially when a tooth is lost

Ear lavage to remove impacted cerumen (wax)

Cod liver oil (tsp.)-to decrease ear wax and prevent formation

Bioflavonoids and a multi vitamin with zinc

Vaccination: HIB- has brought number of fx’s down, including conjunctival infections.

general immune support
General Immune Support

Vit C-50mg X age in years given every 2 hours during illness.

  • Esberitox: echinacea tablets full dose when sick,
  • NAC-mucolytic: dose > 2 years old 500-600 mg 2-3 times a day
  • Thymactive (homeopathic thymus gland and homeopathic echinacea)
general immune supports
General Immune Supports

Herbs: glycerite or tincture tolerated: echinacea, astragalus, sambucus, thyme (if baby under a year of age and still nursing, treat through mom). You can use Glycerites in the ear directly, as they pull water from the middle ear, thereby decreasing pressure.

local treatment for pain relief
Local treatment for pain relief

Warm Garlic-mullein oil based drops daily before bed. 3-5 drops per ear for 3 days. Tx with both ears put in cotton ball and lie down soon. 4 cloves of garlic mashed into olive oil make it at home. Some oil will come out. Rinse with H2O2 in the morning to visualize ear drum. Do not put in drops when rupture is diagnosed or suspected.

Baby Tylenol PRN-best if don’t have to. Add a drop of aconite tincture to the ear oil and that cuts pain right away.

Ear drops for pain relief: allium, calendula, hypericum, verbascum, lavender, vitamin E in an oil base.

Thyme and eucalyptus oil rubbed behind the ears.

earache otitis at home
Earache/Otitis at Home

Tilt up head of med or mattress

Onion ear muffs prn (as needed) for pain and antimicrobial treatment when TM ruptured-draws out pain and inflammation.

Cranio-sacral therapy with mobilization of the temporal bone

manual therapies
Manual Therapies

Warming socks-use it in all kids, wet socks.

Contrast hydrotherapy over ear.

Warm applications to ear including hair dryer

Lymphatic drainage

earache follow up
Earache follow up

Continue treatment for 24 hours after child stops complaining of pain

If not better in 48-78 hours, adjust treatment

Return to doctors office after resolution to visualize membrane-make sure they are better

Children with frequent recurrent AOM or chronic effusion should have their hearing assessed to prevent language delay-3 months of continuous effusion have hearing tested.

propolis and acute otitis media clinical study
Propolis and Acute Otitis Media Clinical Study
  • Efficacy of a propolis and zinc suspension in preventing AOM
  • 122 children aged 1-5 years with a documented history of recurrent AOM
  • 3month trial
  • Prospectively, blindly, randomized 1:1 to receive the suspension plus elimination of environmental risk factors or elimination of environmental risk factors only

Marchisio P, Esposito S, Bianchini S, et al. Effectiveness of a propolis and zinc solution in preventing acute otitis media in children with a history of recurrent acute otitis media. Int J Immunopathol Pharmacol (2010 Apr-Jun) 23(2):567-75

propolis and aom clinical study
Propolis and AOM Clinical Study
  • The administration of a propolis and zinc suspension to children with a history of rAOM can significantly reduce the risk of new AOM episodes and AOM-related antibiotic courses, with no problem of safety or tolerability, and with a very good degree of parental satisfaction.

Marchisio P, et al. Int J Immunopathol Pharmacol (2010) 23(2):567-75

echinacea herbal blend effectiveness of an herbal preparation
Echinacea Herbal Blend Effectiveness of an herbal preparation
  • Echinacea 50mg, propolis 50 mg, and vitamin C 10mg in preventing respiratory tract infections in children:
  • A randomized, double-blind, placebo-controlled, multicenter study.
  • during a 12-week winter period
  • 430 children,
  • aged 1 to 5 years, two-times per day dosing
echinacea herbal blend effectiveness of an herbal preparation63
Echinacea Herbal Blend Effectiveness of an herbal preparation

A preventive effect of the product containing echinacea, propolis, and vitamin C on the incidence of respiratory tract infections was observed.

(Cohen HA Varsano I Kahan E Sarrell EM Uziel Y.,: Arch Pediatr Adolesc Med (2004 Mar) 158(3):217-21

probiotics and gut flora
Probiotics and Gut Flora

Probitocs, REALLY one of the most important tonic medicines for children.

Astragalus, helps to build SIgA

High phyto-phenols, helps to build the microbiota.

Astragalus, slippery elm, marshmallow

Chronic cycle with child, if can get to take andrographis, that’s really great.



Viral, bacterial or allergic

discharge: viral or allergic

swelling and redness of the lids: bacterial

if chronic, consider food allergy or allergy to dust, chemicals or pollen

viral or bacterial
Viral or bacterial?
  • Bacterial 50% of cases with Hib and Chlamydia (neo-natal) as the most common cause in developed countries. Bacterial infections are the most common in preschoolers, and are often accompanied by earaches)
  • Viral 20% of cases (adenovirus pink eye seen in older school aged kids and are usually accompanied by sore throats)
  • Culture negative, allergic 30%

Bright red conjunctiva

Edema (swelling)


Discharge, watery, stringy or purulent with matting of the lashes

Itching and stinging


Allergic shiners



Foreign body sensation

Preauricular (in front of ears) lymph nodes may be painful or swollen

Sore throat and fever associated with adenovirus

Herpetic vesicles (did mom or dad touch a Herpes lesion and touch the baby)

Conjunctival papillomas (warts) associated with HPV

tx management for conjunctivitis

Prophylatic erythromycin

Systemic treatment with erythromycin for infections caused by Chlamydia.

Breast milk lavage. It is powerful medicine.

Compress with black tea bags or Stellaria (chickweed)

Lavage with Chamomile, Hydrastis or Calendula. Wiping from inside to outside, with a clean cotton ball every time. Use a few drops in the eye or lavage.


Dental caries (tooth decay) is caused by a specific group of cariogenic bacteria, like Streptococcus mutans, which convert dietary sugars into acids that dissolve the mineral in tooth structure.

Another significant contributing factor is the imbalanced flora in the mouth (and to some extent the gut)

This occurs when carbohydrates (or sugars) break up into sugars and bacteria act on it. Watch out for those teething biscuits and other carby snacks!

Look into gut flora and try probiotic mouth rinses.

3 factors interrelated to cause caries
3 factors interrelated to cause caries
  • susceptible tooth surface
  • the presence of caries-inducing bacteria
  • a substrate capable of maintaining bacterial growth

the main bacteria responsible for caries is Streptococcus mutans and the favorable environmental bacterial growth is acidic

dental plaque (made of polysaccharides, bacteria and salivary glycoproteins) accelerate the development of caries by acid production as well as by resisting the buffering and remineralization attempts of the saliva

sugary foods are implicated in causing caries (they lead to an acidic oral milieu) esp. if they are sticky (ie fruit leathers, dried mangos, prunes, raisons…)

licorice root and cavities
Licorice root and cavities

Taste nice and traditionally used in pediatric medicine.

Great compliance

Not only an incredible anti-viral (one of our best…)

Study with dental caries and tooth decay caused by strep mutans

licorice root for dental caries
Licorice Root for Dental Caries

(Glycyrrhizol A), an active compound of licorice roots, has strong antimicrobial activity against cariogenic bacteria

Two pilot human studies indicate that a brief application of these lollipops (twice a day for 10 days/21 days) led to a marked reduction of cariogenic bacteria in the oral cavity among most human subjects tested.

Licorice herbal lollipop could be a novel tool to promote oral health through functional foods and these sugar-free lollipops are safe and their antimicrobial activity is stable

SM numbers were reduced for 22 days after the last lollipop

  • Hu CH, He J, Eckert R, et al. “Development and evaluation of a safe and effective sugar-free herbal lollipop that kills cavity-causing bacteria.” Int J Oral Sci (2011 Jan) 3(1):13-20
insomnia restlessness adhd
Insomnia, Restlessness, ADHD

A combination of valerian and lemon balm is effective in the treatment of restlessness and nervous-sleep time problems

918 children, 12 years

Children were evaluated for therapeutic efficacy and tolerability.

Distinct and convincing reduction in severity was found for all symptoms in the investigators' and parents' ratings.

lemon balm and valerian
Lemon balm and Valerian

In conclusion, the preparation was effective in the treatment of younger children with restlessness and dyssomnia and it was very well tolerated.

Lemon balm helps to activate the parasympathetic, and relaxes the muscles, BUT it really helps to center the mind. Combine with gotu kola for mind-centering. Lemon balm can be used to calm and stimulate, good for acute and chronic situations. School aged-anxiety.

(Muller SF, Klement S, Phytomedicine (2006 Jun) 13(6):383-7)

lemon balm and infants
Lemon Balm and infants

Lemon balm tea can also be given to infants with irritable digestive tracts, and consequently the sleep disturbances that come along with that discomfort. Can be expressed thru breast milk and/or given to the infant. Brew 1/2 of tea, with 1 tsp if herb. Brew for 3 minutes and not more. Nice punch for kids.