The Relationship Between Nutrition and Behavior {EP 57}

Robyn: In today's episode, you're going to hear from Dr. Nicole Beurkens, a holistic psychologist who specializes in looking at the whole child when doing the detective work to figure out what's contributing to these big, baffling behaviors. Dr. Nicole is especially curious about the relationship between nutrition, brain health, and behavior. So that's where we deep dive today. Dr. Nicole does a great job distilling down the science like why nutrition, nutrients, and things like our gut microbiome, contribute to behaviors. As well as offers us some concrete practical steps on how to start addressing nutrition in your family, especially if food and nutrition is let's just say a touchy topic. 

Robyn: Today's episode is sponsored by The Club. My virtual community of connection, co-regulation, and of course, a little education for parents of kids impacted by trauma and more parents of kids with big, baffling behaviors who are turning to a community that's open, welcoming and focused on connection and co-regulation. The Club was an idea I had last year, that really, y'all, has just so far exceeded what I ever even thought was possible for a virtual community. And really, that's only because of the extraordinary caregivers and professionals who make up the very fabric of The Club. The way they bravely show up for each other and themselves has far exceeded what I ever thought was going to be possible. If you need to feel seen, to be gotten, and understood. We would love to have you. If you head to RobynGobbel.com/TheClub, you'll be able to add yourself to the waiting list and be the first to know when we open our doors again for new members. 

Robyn: All right, so let's get going with Dr. Nicole. I met Dr. Nicole on Facebook of all places. I was just following her professional page, didn't know a ton about her but you know had hit the ‘like’ button one day. And then one afternoon, I noticed that someone said something in the comments of one of her posts that led me to think that Dr. Nicole might not live terribly far from me. I had absolutely no idea. And indeed, Dr. Nicole is just about 25 minutes from my front door. Even though my family and I moved here well over two years ago now a global pandemic has definitely thwarted many of my hopes for getting involved in the professional community, meeting new friends, and really just leaving the house at all. So I was super excited to learn about a like minded professionals so close and reach out to Dr. Nicole. We got together, hit it off and ultimately we've swapped podcasts. Dr. Nicole is the host of the Better Behavior Show podcast, and I'll be a guest on her show this winter. We had a really fun afternoon interviewing one another so let's not wait any longer to hear what she has to say about nutrition, brain health, and behavior. 

Robyn: Welcome to the show, Dr. Nicole, I'm so happy you have- had the opportunity to just spend some time connecting with me today. And for me to introduce you to my audience. It's gonna be a lot of fun.

Dr. Nicole Beurkens: It is! I'm so happy to be here.

Robyn: So we're going to talk about nutrition, and parenting, and behaviors, and how we can use nutrition and food as part of our co-regulation and self regulation journey. Before we dive into that, tell my listeners just about you, and what you do, and how you've come to be able to chat with us about this today.

Dr. Nicole: Yeah, my personal and professional journey has been somewhat winding through a variety of different things. So I started out as a special education teacher, actually. Working with the kids that nobody else really knew what to do with. This was back in the mid 90s, when Autism Spectrum Disorders wasn't a huge thing yet. And so those kids were kind of hanging out there and misunderstood, and kids with more severe, emotional, and behavioral kinds of disorders. And I loved the challenge of that I had no problem with being the teacher was like, ‘sure, give me these kids, I'll close my door’. Like nobody bothered us, because they didn't really care what was going on in there, as long as things were quiet. And I loved the challenge of like, figuring out what made those kids tick and just building a relationship with them. And so that was my first career and after several years, I began to hear from more and more of the parents, like, ‘listen, what you're doing in the classroom is great, like we so appreciate that, but we're struggling at home, like we- we need to know how to understand our kids, we need to know what to do’. And that really got me passionate about focusing more on families, and focusing more on the parent pieces of things. By that point, I was already starting to have my own children. And you know, so I decided, you know, I'm gonna go back to school and I went and got my doctorate in clinical psychology. Really, so that I could work with kids and parents and families from the time that they first started having concerns all the way through that sort of really stressful maze of evaluations, and diagnoses, and treatments. And open my own private practice really specializing in working with kids through young adults and their parents. Very parent and family focused approach to supporting those kinds of needs, whether it was neurodevelopmental stuff. Whether it was trauma based stuff. Whether it was you know, what we might call like, mental health kinds of disorders. And you know, at that time, I had three- three little boys. I have four kids, they're now 15, 18, 19, and 21. But they were little, little, little at that point. And so I was having the experience of being a parent, too. You know, everything always sounds really good and seems so simple when you're like, learning about it and telling other people what to do. And then when you are a parent suddenly go, oh, right, like actually doing this is the whole 'nother thing.

Dr. Nicole: And then we had our fourth, our daughter came to us through adoption a few years later. And so I was doing my thing, building my practice, working with families using all the tools that I have learned in education, and child development, and psychology, and, you know, all that good stuff. And started to really feel a sense of frustration of like, okay, I'm getting good results, like kids are improving, families are stabilizing, things are going better. But some kids were sort of plateauing or it was like, we just couldn't fully get to what was going on. And then at the same time, I was noticing some things in a couple of my own children too. My daughter being one of them. These connections between physical symptoms and health stuff, and what was going on from a brain and behavior standpoint. And, you know, I have all these kids come into the clinic, and when I would take a history of them, it was like, ‘oh, by the way, you know, they've been constipated their whole lives’, or, ‘you know, this kid would have a history of chronic ear infections or chronic strep throat or, you know, all these kids with allergies and asthma’. And, you know, I thought, I don't know that this is really a coincidence. Like, it just hit me one day, like there's too many, you know, commonalities here and I should have delving into the research literature and was really shocked to find such an extensive body of literature that has only grown over the last, you know, decade talking about and demonstrating the connections between what is going on physiologically for kids and what's going on from a brain and behavior standpoint. And that got me passionate then about saying, ‘okay, what- what else do I need to learn about this to be able to support not only my own family, but all of these families at the clinic’? And that led me down the path of nutrition science, and integrative health. And so I went back and got another master's degree in nutrition and integrative health so that I could become board certified in that and really bring that into the work that I do as an integral piece of that. Like we can't help our kids fully, to develop the brain pathways that they need for emotional and behavioral regulation, for learning, for all of those things, if we aren't addressing this brain body connection, and aren't looking at the foundations of what do we need to be giving kids on a physical level, and more specifically on a nutrient based level to help them with that. So I really, like now, and really, for the last decade, merge all of those experiences. You know, my- my professional journey has taken a winding path. But I'm so grateful because it allows me to pull together all of these experiences and all of these different pieces of- of knowledge and expertise into sort of the holistic approach that I use with families.

Robyn: I love that so much for so many reasons. And one is that it is absolutely so crucial. I mean, it's just this can be this missing link. I've seen it be- it's not my area of expertise by any stretch of the imagination, but I know enough to know when to get another professional involved. Like when to say, ‘ooh, I really think we need to make another referral, or an assessment, or have you work with somebody else who knows something about stuff I know nothing about’. And so, obviously, it's just so important to like, be filling in all these missing pieces. But I love, love, love so much that when I can connect with mental health professionals who also have the ability to see beyond just mental health. And to ultimately, in a practical level, like in the room with parents, to offer a reason for challenging behavior that isn't the parents fault, right? 

Dr. Nicole: Right!

Robyn: Like anytime we can go like, hey, like, yes, I talked about attachment, I talk about relationship, I talk about parenting, and I know you do too. And it is a huge part of things. But anytime we can be like, and there's lots of other things that could be involved too. So let's make sure we're not getting like really tunnel visioned and overlooking pieces that it doesn't matter how regulated you are as a parent, if your child's physiology is my very, you know, clinical def- I would say something like if your child's physiology is like on fire- 

Dr. Nicole: Yeah!

Robyn: It doesn’t matter- the rest of these pieces don't matter. Like we have to get that piece, you know, under control is probably not exactly the right language, we have to pay attention to that piece of things.

Dr. Nicole: It's so true. And I think so many parents are, you know, getting more of this great information about, you know, understanding more of what's going on in their child's brain and understanding the impact of trauma, and understanding the importance of specific parenting strategies, and how they bring themselves- like this is all amazing, wonderful stuff. And

Robyn: And [laughter]

Dr. Nicole: if there are physiological pieces getting in the way of that, if a child gut microbiome is totally out of whack. If they have chronic underlying infections that aren't being treated. If they are having chronic sensitivities, or allergic reactions to things that they're eating. If they are constipated all the time, or having diarrhea all the time. If these kinds of things are going on, yes, you need those good neuroscience, relational neuroscience based approaches. You need to be doing all that good parenting stuff, and you're gonna hit a wall. And you're gonna feel so frustrated, because you're going to be like, ‘Robyn, Dr. Nicole, I'm doing all the things. I am like doing all the things you're telling me, I am focusing on my own regulation, I'm doing this and my kid is still overflowing constantly, we cannot get ahead of this’. And that's a good indicator where you go, okay, there is something else here that we need to be digging into. And to me, yeah, that's the exciting part about understanding these connections is that opens up such a whole nother realm of possibilities of how to support physical, emotional, you know, mental regulation in kids and for ourselves as adults. And some of this is real low hanging fruit, that when we address this, it makes all of the hard stuff that much easier for kids and for us. 

Robyn: Yes. Oh my gosh, yeah. So what- my first question was going to be, and you sort of just answered it, but it was when- what are your clues? You know, especially maybe, as, you know, a mental health professional. Like parents come to me, and I assume similar for you too, like, a behavior problem. They don't come to me for a nutrition problem. And so I tend to first- I mean, I do take a lot of, you know, historical data intake that helps me right off the get go get some ideas on if there could be something more physiological going on. But sometimes that's not easy to see and an initial, you know, time with families. And so it really often is sort of exactly what you just said, when I've worked with a family for long enough, I know them well enough to be like, okay, you've got this one piece well under control. You're not perfect parents, none of us are. You're solidly good enough. And, yeah, there's still something going on. And then that's when I say, ‘okay, it's time to get someone else involved’. And so I just sort of wonder, like, what's your with- as a mental health professional also has this huge, you know, background, what is- what are some of your cues and clues, that it's time for a family to look at some of these physiological pieces?

Dr. Nicole: I think for sure, it's if they've been doing good, consistent work. And you've been doing all the things, you know, this is a family who is engaged in therapy process. They're moving along with stuff, and they're just- they've plateaued. Either they can't even get any traction, and nothing seems to be making a difference with the child, or they sort of made progress for a while, and now they're just stuck. That's a big indicator. The other thing is, I think, you know, even in basic intake histories, and so for professionals listening, you know, some of the information to gather right up front, that's red flags. For those of you who are parents or caregivers, if these things are present for your child asking about this stuff, or bringing this stuff up, in the realm of nutrition, it would be things like if the child has a very limited, picky diet. If the child has any diagnosed food allergies, or issues around that medical kinds of issues, which, you know, as professionals, we often need to specifically ask about. Unfortunately, we still exist in a world where we have this artificial divide between medicine and mental health. Between physical health and, you know, brain and behavioral health. And where that comes into play then in appointments is, as you said, Robyn, often parents are coming in, and they're like, ‘well I'm here for this brain based behavioral problems’. It doesn't even occur to them to raise the fact that you know what, my kid is MiraLAX dependent to have bowel movements, and often will go a week without pooping. It doesn't even occur to them to bring that because they're like, that's not what I'm here for. And so we need to know enough, even if you don't have expertise in this, to- to probe a little more to say, okay, let's talk about, you know, medical or health history. And just to ask some basic questions there. Has your child been diagnosed with things like, is there a history of, you know, lots of different medications? Often when we ask the medication question in mental health people just go to Oh, you're talking about psych meds? 

Robyn: Right? 

Dr. Nicole: So I actually want to know, does your child use an inhaler every day? Is your child on MiraLAX to have bowel movements, are there other prescription or over the counter medication? So these are some of the things that we want to be probing for that help us in, you know, the nutritional and the physiological realm in terms of asking about that stuff. And the other one, and we're not going to delve into this, because I think we stay pretty much focused on nutrition, but sleep is another big one from a functional medicine and integrative, you know, health perspective. We need to be asking about sleep. Because when kids aren't getting enough quality sleep, it creates this cascade of effects in the body and then in the brain that will make it very, very difficult for you and parents to make significant progress. So that's another piece that I think often gets overlooked. And again, parents may not raise it. Or you may ask, you know, well, how does the child sleep? And they'll go, ‘oh, okay’. It's like, well, what is ‘okay’ mean? You know, I've had parents be like, ‘Well, I mean, it takes him like three hours to fall asleep and then he wakes us up four times a night, you know, doesn't seem that tired in the morning’. And it's like, oh, my gosh, we need to deal with that. Because it's going to get in the way of everything else you're doing. So hopefully, that gives a couple like really tangible red flags that parents can be aware of, and also that professionals can be thinking about.

Dr. Nicole: Absolutely. So I love to consider professionals adding some of this stuff to their intake paperwork. I know it was on mine. And yeah, MiraLAX was always- always made me go Okay, but why? So not only the impact of the MiraLAX, but also why? Like, what- what's happening, what's causing us to even need this? So that was always a big one for me to ask and just get really curious about any kind of GI history, you know, because my area of expertise has always been adoption. I've worked with so many internationally adoptive families, and learning about you know, what countries their child has lived in. Some places of the world, it's more common to see parasites and other really just any sort of gut related thing just always sort of piqued my curiosity. I wanted to just write it down, make sure I was looking at all these pieces. And I completely agree with you on sleep as well. That's like if we're not sleeping well, kids or grownups, that's like, not like, we have figured that out, because our brains just don't work right. My very clinical statement. Brains don’t work right. [overlapping conversation] Yes.

Dr. Nicole: Yeah. And I think you know, what's interesting, you know, with the adoption piece of things, because we also at our clinic, see a lot of both domestic and international adoption situations. And, you know, when you start to think about the gut/ brain connection, which is just a fascinating area of research that is, like exploding. I mean, the number of studies that I'm seeing on a daily and weekly basis around this. But you know, we see a lot of these patterns, especially in kids adopted internationally, who, even- even at very young ages, who come home with their family in a totally different geographical place, totally different culture, with totally different foods. And what we often fail to realize, because a lot of these kids, they've got chronic sort of snotty, runny noses, or congestion, or frank allergy kinds of symptoms, or they've got gut issues and all of this. And what's so fascinating about that is it makes perfect sense when we understand the gut microbiome, that community have all of those beneficial and problematic microorganisms that naturally live in our GI tracts and have so much to do with our digestion, our brain function, all of that. When you bring a child, even at a very, very young age, even if you adopt that child in early infancy, and bring them to a totally different home environment with you. Their genetic history, their bodies, evolved generations back to have micro biomes, communities of microorganisms in their GI tract for a completely different climate, geographical location, food, scene, all of that. And when we transplant them here, and we start exposing them to things in our geographical environment, and our climate, and the foods that we eat, very often, their GI systems, their microbiomes are not equipped to deal with that. And so what do we get, we get a lot of these kinds of issues, and it's not anyone's fault. But these are the kinds of things that parents who are adopting internationally, I feel, need to know and understand. So that, number one, we can make sense of it and expect it and not be freaked out about it. But also that we can take steps to help support their microbiomes to make that transition, as opposed to just going years and years and wondering, why is my kid always sick? Or why does my kid always has this I have this post nasal drip? Or why is my kid such a picky eater can't seem to digest? And it's like, yeah, a lot of that was really predictable. If we understand the connections between the microbiome, and culture, and geography, and all of that. And unfortunately, there's still the bulk of our medical providers, and certainly the vast majority of our mental health providers and our educators who just don't yet have that information.

Robyn: Yes, I love how you said this two part piece is like one, it helps us kind of prepare for it. Predict it. We can see the behaviors through the lens of having more information and just how crucial that I mean, if as a parents, you know, I have a child who's struggling, and I can, you know, think about these pieces you just talked about. Gosh, the relief there, as opposed to saying so focused on, I'm doing something wrong. I'm doing something wrong. I must be doing- and especially as an adoptive parent, and I've found adoptive parents is so much more vulnerable to the clearly I'm doing this wrong. I have no idea what I'm doing. This is all my fault. Right?

Dr. Nicole: Or the blaming of the child? 

Robyn: Yes. 

Dr. Nicole: Because that's the reality too, right? Oh, look at this kid that I got. You know, oh, I didn't- I didn't sign up on the special needs list. But look, I've got this kid with issues. I mean, these are sort of- these are the uncomfortable, but real things that happen. And it's like, no, it's not your fault. And it's not your child's fault, right? This is a reality. And so how- how do we support and how do we handle this? And I think just like you talk about so much the how we handle it needs to go beyond just looking at the surface level behavior. Yeah, looking beyond that surface level behavior also means getting really curious about this kid's physiology and how the brain and body are or aren't working together. That's part of that curiosity of what's going on here. And looking even beyond just the social emotional factors or the educational factors or, you know, the sensory factors and going even a layer deeper and saying what, on a physical level, can contribute to this type of dysregulation to the brain not being able to manage these kinds of things?

Robyn: Yes, I talked so much about felt safety, and there's something in the- I'm not sure if it's been in the trauma informed community, the parenting community, somewhere, it got misunderstood that felt safety was all about relationship. And so, I talk- I am- I talk about felt safety all day long. Every day. Felt safety, felt safety, felt safety. We’re not experiencing felt safety, we got to start there. And then but again, I've somehow- I've had parents connect with me in a way that makes me realize, like, oh, you're understanding felt safety to be all about, like your relationship with your child. Like, no, no, no. One of the places that we're, you know, getting data from it helps us determine if we're safe or not, is our physiology. And if our kids could be not experiencing felt safety, because of allergies, you know, sensitivities. I mean, and then way more than that, too. So I also kind of want to toss that out, because I know my audience hears me talk about felt safety so often, that this is a contributing factor to not having a really good, solid foundation of felt safety, if the body isn't feeling right. If it's if there's something happening internally that is going to, you know, what I- the language, I use this kind of pull a child's physiology into, quote unquote, protection mode in their- in their brain in their body. And so to have a piece that we're focusing on, as I just think parent is just so relieving to be like, Oh, wait, you mean, there could be something going on here that's not my fault, or like a result of my child's character? Like, no, no, it's like, no, let's look at what's happening physiologically. So for a family who's- who's listening now, and who has been thinking in the past, like, I think there's something else going on with my kid. And their mental health provider isn't a you? And, you know, brings both to the table. Where do- where do they go? Like, what is their- what is their next step?

Dr. Nicole: Yeah, I mean, it's tricky, because unfortunately, this information is not in the mainstream of how medical or mental health professionals operate. We're getting there. There are more pediatricians, and physicians, and nurse practitioners, and PAs who get this. But still, by and large, when parents bring these kinds of questions or concerns, they don't get real far. And certainly not in mental health, either. So I think it's not- first of all, it's being aware that these are real issues. There is real science. There are entire bodies of research literature connecting these things. And just because the practitioner that you raise the question with, or are speaking to maybe doesn't know what to do with that, or tells you that there isn't, doesn't make it true, right? So you need to be working with people who are at least willing to be curious and open. Some of the amazing pediatricians that my clinic works with on a daily basis, they are- will be the first to say I don't- I don't especially- like I don't really know. But I know that it's an issue. I don't know exactly what to do about it. But I know that this is an issue. And I'm willing to order whatever tests you need. Let's get you to somebody who can help you dig into this, and I will be happy to collaborate. That's the kind of providers that you need to be working with, especially if you have a child with complex trauma, developmental trauma, multiple diagnoses. Like all of this kind of stuff, you need to be working with curious, collaborative providers who will operate as a team. That's critical. The other thing is that the internet has now, you know, it's a double edged sword, right? With how much information is out there and sorting through what's good and what's not. But there's never been a time in history where it's been easier for families as well as professionals to learn more about this. So whether it's the information that I'm providing, or it's other people in the integrative and functional medicine space, you know, we've got fields now called integrative psychiatry, holistic psychology, nutritional psychology, nutritional psychiatry. These are real fields now that exists, where you can improve your awareness, your knowledge, you know, the internet's made it possible to connect with other families dealing with this stuff, and what have they done? Who have they seen? What have they found helpful? So I just think, you know, spending some time digging into it and saying, ‘hmm, I want to understand more about this. Let me seek out, you know, some more information so that I can access resources that are going to be beneficial’. Because to your point about felt safety, you know, and the physiology of that. Any of us as adults, like, probably the easiest way to connect to this is, you know, think about the last time that you were constipated, or had a stomach bug, or a bad headache, or migraine, or you know, kind of flu like, maybe a bad cold or anything like that. And think about what that was like. And think about whether you were like, totally on your A game, ready to take on the world, and everything on your list that day. Or whether that those physical symptoms really took precedence and kind of filled your mental cup. You know, you didn't have a whole lot left. Like we are generally not operating at our best mentally, emotionally, behaviorally when we've got one of those kinds of things going on. So I use that as an example because it immediately helps us to realize, oh, oh, wait, so my kid who poops once a week and has been chronically constipated, like, oh, yeah, that's not just about pooping. That's about how that's impacting their ability to regulate, and function, and feel safe in the world, and like, have enough mental bandwidth to learn, and remember, and regulate themselves, right? Or the kids with chronic infections, the kid who's always sick, the kid who you’re- and, you know, week after week, and month after month, with strep throat, with ear infections, or the kid with the post nasal drip, you know? You think, ‘oh, those are just physiological things’. No, they- just those symptoms themselves, experiencing those physical symptoms, really takes quite a bit of the bandwidth that they have to operate and be in the world, and learn, and develop. And so when we can start to look at it through that lens, suddenly, I think we have a lot more empathy, but also on a very practical level, we go oh, yeah, well, all the parenting strategies, like I don't need another Instagram account for parenting strategies at that point, right? Probably what I'm doing is- what I need is to figure out why my kid is constipated all the time and how to actually fix that. Or why my kid,you know, can't breathe well all the time and is like literally feeling unsafe, because they're gasping for breath. Like, that's where I need to focus and find somebody to help me figure out how to solve that.

Robyn: I'm laughing at the idea of having a stomach ache. And going to Instagram and looking for, like relational help because I keep fighting with my husband. It’s like, no, that's not what I need. Like, I need to feel better. 

Dr. Nicole: Yes!

Robyn: Like, that's where I would go. And as an adult, I have maybe some more resources available to me, if for no other reason to even notice I have a stomachache, right? But as kids and maybe interoceptive challenges, or maybe I've just felt bad always, every day. I don't have the even ability to say like, I don't feel good.

Dr. Nicole: No, some kids don't even realize because it's their norm. 

Robyn: Right! 

Dr. Nicole: Don't even know that they're supposed to feel a different way. And, you know, I think the other piece here, and where the nutrition piece becomes so important, is we often as adults aren't aware of really what it would feel like and be like to function optimally. Because we're so used to having a brain and body that operates sub optimally. It's our normal. Whether it's because of the diet that we're eating, or the sleep, we're not getting, or whatever. We just get used to that. And that's like what's normal. And we don't even have a sense of like, how well we could do and how much more patience we could have, or how much better regulated we could be, or how much better our memory could be, or whatever. If our own, you know, physiology was functioning better. If we were feeding ourselves handling, you know, our physiological health in a way that was more supportive. And so, you know, I think- I think that this often just goes undetected. Our idea, especially in the US of what's normal, kind of gets in the way. And I'm not interested in what's normal, I'm interested in what's optimal. Especially when a child is really, really struggling. We need to be focused more on, okay, what's going to optimize this kid's functioning? Or something's really not working, how do we like- I don't care if their blood work comes back, quote, unquote, normal.

Robyn: Yes.

Dr. Nicole: That doesn't tell me anything about what actually is optimal for this child. Clearly, something's not working for this child. And what's really interesting in that realm, um, some beautiful studies that have been done showing, just for me thinking about like nutrient levels also for kids, we can send them for standard bloodwork to look at nutrient levels. Things like iron, things like magnesium, vitamin D, B6, whatever. Name your nutrient. And those results can come back all in the quote unquote normal range. And a typical healthcare provider will look at that and go, everything's normal. What's interesting- two things about that. First is we have studies showing that just because bloodwork is in the average range does not mean that those nutrient levels are sufficient for that person's body and brain function. So that's the first thing. But the second thing is we have studies showing that for kids diagnosed with ADHD and related kinds of, you know, quote, unquote, behavioral disorders, there- they don't need to have bloodwork or nutrients that are showing in the clinically abnormal range to benefit from something as basic as a therapeutic multivitamin. That we know we have beautifully done, you know, double blind placebo controlled studies now showing that therapeutically dosed micronutrient formulas benefit the vast majority of kids with these neurologically based behavioral kinds of issues, even in the absence of having frank deficiencies or abnormal bloodwork. And to me, that's like, wow, that's amazing. Why isn't that getting out into the mainstream? Like, that should be a basic strategy that we're using medically, mental health wise, whatever, with any kid struggling with this stuff. And yet, most people will look at you like I don't even know what you're talking about. 

Robyn: Yes.

Dr. Nicole: So that's why I'm so passionate about professionals and parents understanding this. Because something like starting your child on therapeutic doses of one of those multi nutrient formulas, it may be a total turnaround for your kid. It may not. But it's at least going to help some things get better, to me, especially with really complex kids, anything simple that we can add into the mix that makes it more possible for all the other stuff to work, we should be doing that. We should be doing that.

Robyn: I just so completely agree. It especially it feels like because there is such an emphasis on the relational aspects that anything we can do to say yes, and let's create that foundation that then can contribute to those other pieces falling into places. And the work! The hard, hard, hard work we're doing on those other pieces really allowing like for that to bloom and- and grow. Oh, my gosh, I love that so much it is- you know, I feel so much anytime we can give a family a very practical ‘do this now’. Because there is so much that's not that, right? Like so much is long term. So much is explor- you know, there's so much that's not. So whenever we can do something that's pretty simple, pretty immediate, pretty just do this one thing right now. Like, absolutely, absolutely.

Dr. Nicole: Well, and I think some parents when they think about or they hear about nutrition, immediately, sort of a wall goes up. They get overwhelmed. Like, oh my gosh, you're gonna tell me to stop feeding my kid all these things. Like I'm gonna have to do all this fancy cooking, this is gonna get really overwhelming. Like, I can't do that. And honestly, I've had a lot of parents in the clinic, you know, who that's their initial reaction. But we can recognize nutritional interventions across a spectrum of difficulty and intensiveness. Right? 

Robyn: Yes.

Dr. Nicole: And to me, my job is to educate parents around what all the options are, and what may very well be helpful. And then they get to decide what's reasonable, what they are interested in, what they feel like they can do. And so, you know, on the more basic end of things, we're talking about strategies like helping regulate and stabilize your child's blood sugar throughout the day, by minimizing the amounts of added sugars in the foods that they're eating, by making sure they're drinking enough water, and that you're reducing things like sodas and sugary sports drinks, and juices because hydration with water is so important. That we're looking at how to push in more nutrient dense foods like fruits, and vegetables, and nuts and you know, quality animal proteins as opposed to everything being processed, packaged, not very nutrient dense food. And there's lots of ranges within that. But those- those are some of the basics, right? Looking at the fruit snacks that your child loves to eat on a daily basis. And saying, wow, when I look at the nutrition facts panel on this, there's 18 grams of added sugar in these. Hmm? Well, we want to stick below 25. Like those are all the recommendations that 25 is the max amount of added sugar for a two to 18 year old. Okay, so if my kids eating like 17 grams of sugar just in this little packet of fruit snacks, yikes! And saying I don't have to take away fruit snacks, but what can I find at the store? Can I find the type, and there's lots available now, that has like no added grams, or four added grams of sugar. That's just a simple example where we don't have to take away everything a child loves. We don't have to completely- like you don't have to be like a hippie, organic farming, let me make my bread and everything from scratch. I mean, you can if you want. That's not the mom that I am. You don't have to do that in order to improve the nutrient density and the quality of your child's diet. And why that matters so much: two main reasons when it comes to brain function and behavior. The first is that when our blood sugar is on a roller coaster all day long. Kid eats, you know, sugary cereal, and milk, and juice for breakfast. Blood sugar spikes. Sixty to ninety minutes later, it crashes. Then they eat, you know, sugary fruit snacks and whatever else for snack. So they're on this blood sugar roller coaster. Not only is that problematic for their physical health concerns, like obesity, diabetes, those kinds of things as they age. But it also puts the brain on this roller coaster. And one of the biggest things that stabilizes and regulates mood and behavior in kids, and in adults, stabilizing that blood sugar. Because guess what, when your blood sugars like this, so is your mood. So is your anxiety. So is your capacity to manage whatever's going on. So nutrient density, taking out a lot of those added sugars and pushing in foods that just stabilize that. That have more fiber that the kids not going like this from a blood sugar standpoint all day long. That's key for them being able to regulate their emotions and their behaviors. But the second piece of why that's important that we want more nutrient density is because nutrients are literally information for our brain and body. Our brains and our bodies cannot function normally without the right building blocks. Without the right pieces of information. So let's take things like anxiety, or irritable mood, or you know, any of those kinds of things. And we think about neurotransmitters. The brain chemicals that allow the brain to function properly and to regulate. People hear about things like serotonin, or norepinephrine, or dopamine. Those are you know, common neurotransmitters that people think about in relation to mood, behavior, anxiety. Well, what are those neurotransmitters made of? Those neurotransmitters are literally created in the gut, in the brain, in the body from amino acids. Amino acids are these little building blocks that the body and the brain piece together to make serotonin, the feel good neurochemical. Dopamine, the reward and pleasure neurochemical. Where do amino acids come from? Amino acids come from our diet in the form of protein. Proteins are made of amino acids. So guess what's happening? If your kid is eating a primarily carb heavy, sugar heavy, processed heavy diet that doesn't have enough protein in it, you literally aren't getting enough of those amino acid building blocks so that your child's gut, and brain, and body can create the neurotransmitters that are needed. That's one simple example of why nutrient density, why nutrition becomes so important to mental health and to your child's ability, literal ability, to regulate their emotions and their behaviors.

Robyn: I love that. I'm wondering if you have an easy quick tip or trick, and you might not and it's fine to say like no, that's not covered in easy tip or trick, that's fine. There's lots of things to fall in that category. But you know, so many of the families that I work with, like food is- food is like a firework show every day. Like there's fighting, there's arguing, and that's a whole different podcast episode. But, you know, because of our- because of our kids’ like complex trauma histories, or their microbiome and all these pieces. These kids actually are often like really craving carbs. It's like carb, carb, carb. Give me all the carb, give me all the carb. And then it's like to intervene and in a way that helps to balance out their diet, or decrease a carb, or increase nutrient dense, or- or increase just protein.

Dr. Nicole: Right.

Robyn: Can feel like, to families, especially with kids with relational trauma, where such an emphasis is on how do I improve the quality of our relationship, and especially around food and feeding? So how can those- like I'm positive I've got so many parents listening right now that they're like, yes, I want my kids to eat more protein, and they won't. So where- what could be like just a easy step toward not causing tons of relational strife? And also looking for easy ways to improve, you know, the quality of our children's diets, or decreased sugar and carbs or increased protein, any quick tips or trips?

Dr. Nicole: Yep! A few things. This is the reality for a lot of families. 

Robyn: Yeah. 

Dr. Nicole: There's two ways to do it, there's bite the bullet. Which, sometimes labs are helpful for that. I'm like, look, there's no slow way into this. Here's the deal, your kid's gut’s full of yeast. If you want to get through this, you know, as quickly as possible, we're gonna have to bite the bullet. It's going to be awful for the first week to 10 days, and then it's going to get better. 

Robyn: Yeah. 

Dr. Nicole: But you know, some people choose that route, and others are like, ‘no, I need to tiptoe into this’, which is fine. So a couple things, first of all, is getting more water. And we want focus on pushing in before removing. If you just start taking away, that's going to create a lot of relational distress, particularly if you have a child with trauma around neglect, malnutrition, food, insecurity, whatever. So we don't want to pull out first, we want to push in. Water is a great way to think about that. Okay? Juice, my kid drinks a lot of juice. I'm gonna slowly start to water their juice down, I'm not gonna take juice away. 

Robyn: Yes.

Dr. Nicole: But we need to get off of all this sugary juice, low hanging fruit there, right? So it's like, okay, slowly, day by day, week by week, maybe over the course of a month, six weeks, whatever, I'm gonna water down more and more of my child's juice, let their palate acclimate to less of the sweetness so that I can get them more on water. That's one simple example. Or I'm just not going to buy soda pop and bring it into the home anymore. I'm not going to micromanage you, especially if they’re a teen, what they're doing outside the home. But some of those things where it's like, we just don't need to have those. We're just not bringing those things into the house. For some of the food related things, we're pushing in stuff. So maybe we're finding, you know, some snack or meal options that they really like. And we're finding a more nutrient dense version. And we're putting some of that on the plate with the other to sort of acclimate them to it. So we can do this one piece at a time, especially if you have a really explosive child, if you are still really in the beginning stages of figuring out all of this relational, and safety and all of this stuff, start with one, one simple shift at a time so that you and they are not overwhelmed. The other piece here that I think is really overlooked in this discussion about helping kids eat more nutrient dense diets is exposure. Not even necessarily focusing initially on the eating, what goes in their mouth. But on making sure that we're exposing them to the process of food, of picking out foods, of cooking, that of what we're eating. So often I will have parents be like, well, you know, he eats his chicken nuggets and french fries, you know, at the counter when he's hungry. And then we- the rest of us have our meal later. And I'm like, well, here's what's problematic about that from an expanding the diet standpoint. He's not getting exposed to the sights, the smells, the sound, anything about other foods. He's staying in his little bubble. So some of the simple starting points there can be getting your child at the store or the farmer's market with you just to help pick things out. They don't need to eat it.

Robyn: Right.

Dr. Nicole: Just getting comfortable and feeling safe around different foods, helping you prep things, cooking in the kitchen. That's something toddlers and preschoolers can do! Helping you stir, or pouring things in, or exploring letting them play with food. Having them help you put dishes of food on the table. Even if none of that is going to go in their mouth, they're not going to eat it. They're they're engaging with it. Maybe they're serving what the rest of you are eating. Maybe they're putting some on their plate even though they don't have to eat it. This is how we help kids' nervous systems start to feel safe around foods that are outside of their little bubble that they feel comfortable with and want to eat. So especially if you've got a picky eater, or a kid with feeding difficulties, or a kid who's just really rigid around that. Don't think about the eating right out of the gate. Think about exposure, and building a sense of safety and comfort around lots of different foods. And then that naturally then leads into them being interested in and eating more of the things that you're making available.

Robyn: I love thinking about things from this very practical scaffolding place that I talked about scaffolding so much, and we can apply scaffolding to almost anything. And even in this very specific, which doesn't feel- you know, when you’re in the middle of this big chaotic, you know, ahh feeling- plus, and then we haven't even touched on this, this would be a whole ‘nother episode, all the shame that comes up for us around parents- as parents, like we're not feeding our kids, quote unquote, correctly. We're not- all that stuff as a whole ‘nother episode, right? But if we can just get super practical and like, really think about this from a scaffolding place that- just like you said, just having all- everybody have mealtime at the same time, even if your child is still eating what they're used to eating, you know, just starting with that as a one tiny little piece of scaffolding and getting them more involved. And I loved what you said too, about like you just having it on their plate, even if it's an expectation is they'll- never- they're not- they won't eat it. But that is just there. That's- that's just one tiny little step in that scaffolding process. I think anytime we can take these big, huge, overwhelming challenges and like, look at like, no, no, we can really scaffold these issues, like tiny little steps by- step by step is so regulating and empowering to us as parents. So that's

Dr. Nicole: Yeah, and it's important for us and our kids. I mean, you're already overwhelmed, and they're overwhelmed and all the things, you know. You want to do it in a way that's- that's manageable, and that supports regulation- doesn't, you know, add to that. And, you know, certainly there are times and places where more significant, big changes and interventions need to happen. You know, and parents can make a choice about what they want to do with that. But, you know, I'm thinking about one little girl who very, very significant history of abuse, neglect, early- early trauma in her home of origin, and then was in a couple of foster environments, and then ended up being adopted by the foster mom who had her finally in that chain of events. And very dysregulated on many levels. Of course, reasonably so. But mom had been doing all the things, right? Mom had been learning about all these things, you know, that- that you teach around, you know, parenting, and trauma, and developmental trauma. And she had done all the things all the wraparound services, taken advantage of all of the mental health and, you know, Department of Health and Human Services support, had had the child into her physician. They were seeing a psychiatrist. She been put on all kinds of medications. Which actually made this particular child a lot worse. The kid was just melting down constantly, totally dysregulated, very big problems at school. And she brought her in. And I think she was eight at the time when I met her. And on taking this- this history, and this is a kid who had chronic UTIs for several years that nobody could figure out how to make the urinary tract infections go away. She'd been on all kinds of antibiotics. She was a sugar and carb fiend. Some of you have a kid like this. Didn't matter how much bread, doughnuts, whatever she would literally at times go to the cupboard and be taking it and balls of sugar and flour and oats out of the cabinets. Right? So I'm taking this kids history, I'm looking at all this and I'm like, this is not a psychiatric problem, all of the psychiatric medications, and she'd been on all of them. And, you know, just the things that this poor mother had been told were absolutely ridiculous from a mental health and psychiatry standpoint. And I said we need to run some tests. Mom was desperate, she was open to whatever. And said we need to run some tests. I said I have some ideas about what's probably going on here. So fast forward we ran a specific type urinalysis on her, did a bunch of blood work and here's what popped up. Number one, she was borderline anemic. So iron deficiency was a big problem. We think about that for adults is just making us tired. Iron deficiency in a child is hugely problematic for their brain development and function. So she wasn't sleeping well, and the iron deficiency was causing major issues. But the other thing that cropped up, she had major immune system sensitivities to wheat, gluten, and dairy. 

Robyn: Yes. 

Dr. Nicole: And her microbiome testing showed that her body, not just her gut, was full of a yeast called Candida that we all have. But when it gets way out of hand and way overgrown, creates huge brain based dysfunction. These kids are hyper. They are impulsive. They are wetting all the time, like all of these things that happen.

Robyn: Yes, yes.

Dr. Nicole: And so I was able to help mom see that, actually, a lot of what was going on for this kid, was these underlying physiological pieces, identified that the urinary tract infections that were being being treated as bacterial, the reason they weren't going away is because they were actually yeast infections in her urinary tract. Which guess what, when you put a kid on an antibiotic for a yeast problem, it makes it work worse.

Robyn: Oh, no! It makes it worse!

Dr. Nicole: So well meaning practitioners had been doing all of these things, but she wasn't getting better. So I said, look, there's gonna- there's no tiptoeing around this. We can't make change, like little changes that are going to make a huge effect here. There's some big things that need to be done. And it required a radical overhaul in her diet, getting rid of the gluten and the dairy, really cutting down on the sugar, and aggressive protocol of antifungal supplements. We even use some antifungal medications initially. And replenishing nutrients using therapeutically dose supplements. Mom was like, I don't have choice, I got two other kids at home, like we got to get this under control. And this mom went after it. She made the changes, it was hard at first. I got an email from her four days later after implementing this and she said, she hasn't wet at all today, the rash around her mouth is going away, and we had the most beautiful afternoon together that we have had, like ever. And that kid went on over the next weeks and months to just have this radical shift in, not only her physical health, the urinary tract infections went away, the bowel movement issues she was having resolved, the sleep got better, but she was able to be in school and in the classroom and not having constant problems. She was able to not go from zero to 100 in a second. So mom could actually pause with her and like, process and try to problem solve some of the things. Now, did not mean that this child's problems 100% went away. But it made everything stick better. It suddenly made it possible for her to engage with the world and other human beings in a way that could move her forward, as opposed to just constant chaos and- and you know, issues. So I share that as sort of just an extreme example. But I think these are the kinds of stories that we need to be talking about. Her parents know that this stuff is real, and that there are solutions to these things.

Robyn: And in a way, I honestly wouldn't even say like the symptoms you described, like those symptoms aren't even extreme to me. Like those are the families I work with, including, you know, fist-fulling sugar, flour, and oats from the pantry. Right? And it is very easy, especially if you have a child with a trauma history, and you've just gotten into trauma informed parenting. Which is so amazing. But a challenge with that is we tend to just lump everything in that like this is a trauma symptom, this is an attachment sympt- you know, symptom. You know, it's like, well, let's just go a little further than that. Like the fistfuls of sugar, and brown sugar, and flour. You know, let's just pause and consider that this isn't a behavioral issue at all. And again, like, that doesn’t even sound extreme. Like I'm like, I know those families. Those are the families that are coming to my office and the relief of yeah, it's not easy to overhaul your pantry like that, or you know, rip the proverbial band aid off by any means. But you know, to be given some hope that oh, there could be a physiological reason for this. It’s not because my kid is bad or because my attachment relationship with him is bad, that there's something going on that's causing my kid to fistful brown sugar out of the pantry. Right?

Dr. Nicole: Exactly right. And to realize that no amount of punishments locks or whatever else are going to solve that problem. You have to get into the underlying physiology of what is it either nutritionally, hormonally, neurochemistry wise, gut microbiome wise. There's always something driving that behavior. 

Robyn: Yes.

Dr. Nicole: I think this is the big, you know, takeaway message of all of this, for me at least. That it's never just one thing. And when we start to silo stop, and we think, okay, I have found the parenting approach, or I have found the diet, or I just need to find the school. We're thinking about it wrong. It's never one thing. It's needing to take a much more holistic approach and saying, it's all of these things. It's all of these things. It's having the relational, and the parenting stuff down. And working consistently at that, even though it's not perfect. It's having a supportive, appropriate school environment and situation for your kid. It's having the right type of medical interventions. It's using the right kinds of nutritional and dietary, and, you know, integrative medicine supports. It's making sure that your kids aren't overusing screens. It's making sure that they're sleeping well. It's not any one of these, it's all of these. And while that may sound overwhelming on the surface, I actually think it's pretty freeing because it frees us up as parents of like, our job in life is to just spend enough time, energy, and money finding the fix. It doesn't exist. That's not what it's about. So like, just allow yourself to feel the relief of that and realize that it's all of these different pieces that are actually going to make the big difference. It's that holistic way of looking at and understanding what's going on.

Robyn: I absolutely agree. And especially that piece that you just said. Like it that can feel overwhelming at first. And if we allow ourselves to really lean into it. I think it absolutely can- it can invite us actually to feel more more freed. Like, okay, it's not just you know- that's a really dysregulated brain wants one answer. 

Dr. Nicole: Yes!

Robyn: Wants one thing to fix all the problems. And I get that! I want that too.

Dr. Nicole: Yep!

Robyn: And it just doesn't work that way. And since it doesn't work that way, we might as well lean into the truth, that it just simply doesn't work that way. Well, this has been so fun, so wonderful. Tell my listeners where they can go and learn more about what you're doing, what you're offering, how can they find you, and get more of you?

Dr. Nicole: Yeah, my website has tons of free resources and supports, videos, articles, all kinds of things for parents and professionals. That's DrBeurkens.com. So D-R-B-E-U-R-K-E-N-S.com, my podcast, The Better Behavior Show, where we dig into all of these underlying, you know, root issues that can influence behavior. That's on my website, or whatever, you know, podcast players you'd like to listen to. And then on social media, I'm @DrNicoleBeurkins, and primarily hanging out on Instagram and Facebook, just because that's like the amount of bandwidth that I have. But I put lots of info about all this holistic stuff on there as well. And for people who really want to, you know, understand more how to dig into these things, how to dig deeper, and, you know, figure out what some of these root level physiological issues are actually have a course that I released fairly recently that's available and some other, you know, kinds of opportunities as well. And then, of course, my clinic, where we do consultation with people, both throughout the state of Michigan, as well as you know, around the world. And that is HorizonsDRC.com. So those are just a few places for people who want to learn more and just kind of dip their toe in like exploring this whole realm. I hope that those resources are helpful.

Robyn: Awesome. So everyone I- those- there'll be live links to all that stuff in the show notes. And then also over on my blog, there's always a really long form summary of my episodes on my blog, and all just- live links. So you can just click, click, click and get access to all of that awesome stuff that Dr. Nicole's putting out to the world. So, oh my gosh, thank you. It's been just delightful to spend the afternoon together and to really- take to explore something I haven't explored on the podcast yet. So I'm just really grateful for your time and just everything that you're doing out in the world and helping families so thank you. 

Dr. Nicole: Thank you. 

Robyn: Gosh, y'all, I thought that part about how our gut microbiomes are formed over like generations, and really tended to be what our bodies need while living in a certain environment. And then how that can be disrupted when kids are adopted into families out of their culture and communities was super fascinating. Such an interesting thing to consider. I know food and nutrition can be really hot topic for families of kids with big behaviors. So I hope you're feeling encouraged by Dr. Nicole's advice to just take small steps. Because even small steps can make a big difference. Thank you so, so much for joining me today on our podcast. I'm so, so grateful for you. Thank you for your commitment to kids,and to families, and for just making the world a better place by embodying the science of relationships. I'll see you next week.