Bambini May 2016 Newsletter 
Practice News
Please schedule your camp and school physicals ASAP!   Few, if any of our clinicians are taking time off in June. That's not likely to be the case in July and August.

Families that wait, especially parents of 7th and 12th graders who face the new meningococcal vaccine mandate could face a difficult situation - including vaccine shortage if there is a run on Menveo or Menactra in the fall.
 
We are currently testing / phasing in a couple new services. One is called TalkSoft, an automated appointment reminder system. It can be programmed to send text messages, emails, and phone calls. Please share your feedback with our staff. We hope it helps in a non-obtrusive way.
 
The other is EasyPay. With it, a credit card can be stored in the portal. Families with high deductible health plans that have overpaid can get a prompt reimbursement. If the day comes (we hope it is soon) that we start offering video appointments, EasyPay could come in handy for co-payments.
 
Scheduling appointments through our portal should also come along sooner than later. Take a few moments to register your kids so well all can be ready when this goes live.  We have looked at services like ZocDoc but these require phone confirmation.  We want to eliminate that hassle. 
 
Finally, is there another doctor coming to Bambini? Will bashful boys have another guy beside Dr. Malak to do their annual sports physical? At this point, our lips are still sealed. We can only say that things look promising.
Maternal Hormones in Breast Milk
Some years ago, we were shocked to learn that human milk is chock full of cholesterol. Yet no commercial formula on the market today contains this brain-building block. Something "they" don't want us to know....
 
We were a little less surprised, then, when we recently starting hearing about the wide range of maternal hormones that make their way into breast milk. These include insulin, leptin, interleukin-6, adiponectin, and ghrelin. We'll come back to some of these in a future newsletter. Again, none of these, to our knowledge, are found in baby formula.
 
Cortisol is a hormone that we hear a lot about these days. Increasing numbers of us are suffering from various degrees of adrenal fatigue - which, depending on the severity and duration, can result in undesirably high cortisol or low cortisol levels. Although there have been no published studies, common sense tells us that lactating moms are at increased risk of adrenal stress (think waking every two hours each night for several months!).
 
Last year, researchers from Duke reported that breast-fed infants have higher cortisol levels than formula-fed babies, and their bedtime cortisol level were more in sync with their mother's levels.
 
We have suspected that breast milk with excessively high cortisol was a factor in at least a couple of colicky babies in the practice. When one mother started holy basil, an adaptogen that balances adrenal function, her baby's symptoms improved.

According to Katie Hinde PhD, director of the Comparative Lactation Laboratory at Harvard University, the density of steroid receptors in the intestinal tract decreases after weaning, suggesting that those receptors are meant to bind to hormones in mother's milk. For interesting observations on how baby girls and boys respond differently to cortisol, read her MilkGenomics blogpost here. 
Do Weighted Blankets = Better Sleep?
Not long ago, researchers from England reported their somewhat puzzling findings on the effect of weighted blankets on children with autism.

They studied 73 children age 5-16. Blankets weighted with either 5 or 10 pounds of steel pellets were used. Presumably, younger kids got the lighter blanket. The blanket was used for about two weeks. A blanket of comparable color and texture but without the weights served as the control.
 
What was the result? Basically, the scientists found no measurable difference in sleep quality between the weighted blanket and the control. But both the kids and their parents liked the weighted blankets, and the parents noted that their kids were calmer when the weighted blankets were used!    
 
We hear favorable comments from parents as well. Blankets stuffed with 12 lbs of organic millet seeds are available on Amazon for about $150. One parent wrote: "My son who has sensory issues loves it. The rest of our family loves it as well and often tries to steal it."
 
Others report that weighted blankets may be helpful for those that suffer with insomnia, depression, anxiety, aggression, OCD, PTSD, ADHD, cerebral palsy, restless leg syndrome, Tourette's, and bi-polar disorder.
Weight Loss Rx with Awesome Side Effect
As Stephen Olmstead, MD recently wrote in the Townsend Newsletter, "eat less and exercise more - easier said than done." In real life, this is just not working. Bambini currently has one patient over 350 pounds and has had two patients soar past 400 (where our scale max'd out).
 
Obesity is now understood to be a complex systemic inflammatory disease. Obese persons have more Firmicutes and fewer Bacteroidetes gut microbes compared with lean folks.
 
So what can be done? Enter probiotics - once again! In 2013, researchers from Japan studied 210 obese patients over a period of 12 weeks. They were divided into three groups -- each given just under 7 ounces of fermented milk (i.e. kefir) containing either zero, 2 billion, or 20 billion colony forming units (CFUs) of a probiotic called Lactobacillus gasseri.
 
Results? The group that got zero had, as expected, zero changes. Both the other groups had a drop of just over 8% in visceral fat (as measured by CT scan). They also found that a month after stopping the probiotic, the difference started to fade.
 
No side effects were reported (...despite the Latin binomial, it does not cause gas!). Other researchers, however, have reported that L gasseri reduces hay fever symptoms in children with asthma, lessens menstrual cramps in women with endometriosis, and hastens eradication of H pylori - a germ associated with peptic ulcers. Now, those are some pretty awesome side effects!
 
Sue, our apothecary manager, has stocked us up nicely on L gasseri. A two-month supply runs about $18.
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