#313 - Parenting at Your Child's Pace: The Integrative Pediatrician’s Guide to the First Three Years

Joel Warsh, MD, is a Board-Certified Pediatrician in Los Angeles, California, specializing in Parenting, Wellness, and Integrative Medicine. He grew up in Toronto, Canada, and completed degrees in Kinesiology, Psychology, Epidemiology, and Community Health before earning his medical degree from Thomas Jefferson Medical College. He completed his Pediatric Medicine training at Children’s Hospital of Los Angeles (CHLA) and worked in private practice in Beverly Hills before founding his current practice, Integrative Pediatrics and Medicine in Studio City, in 2018.

Dr. Gator has published research in several peer-reviewed journals on topics including childhood injuries, obesity and physical activity. He has been featured in numerous documentaries, films, summits, podcasts and articles including CBS, Fox, LA Parent, MindBodyGreen, and many others. He is also the founder of the supplement line Tiny Roots Apothecary, the Parenting Masterclass Series Raising Amazing which can be found at RaisingAmazingPlus.com

https://parentingatyourchildspace.com/

Follow Joel on Instagram https://www.instagram.com/drjoelgator/

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Episode 227 - Integrative Pediatrics 

Transcript

Joel Warsh, MD: 0:00

In the short term, you got to take ownership over your own family, and that's where, you know, even the title of the book, Parenting at Your Child's Pace, it's not comparing yourself to other people and taking charge of your own family, your own child, and making those decisions for yourself and realizing that your doctor is not necessarily going to do that. Even if you have the best doctor, even if you're with an integrative doctor that spends three hours with you, it's up to you. It's up to what we learn, it's up to what we purchase, and if we get that, then I think we can make changes. And as that starts to happen, then doctors will start to change too. I mean, it's definitely moving that way slowly. There's certainly people that are more interested in it, but you can't really compete with big corporations. Not in the current model.

Rachel: 0:43

I'm Rachel.

Jessica: 0:43

And I'm Jessica and this is All Things Sensory by Harkla.

Rachel: 0:47

We are both certified occupational therapy assistants and together with Harkla we are on a mission to empower parents, therapists, and educators to help raise confident and strong children of all abilities.

Jessica: 0:58

On this podcast, we chat about all things sensory. Diving into special needs, occupational therapy, parenting, self care, overall health and wellness, and so much more.

Rachel: 1:08

We are here to provide raw, honest, and fun strategies, ideas, and information for parents, therapists, and educators, as well as other professionals to implement into daily life.

Jessica: 1:20

Thank you so much for joining us.

Rachel: 1:25

Hey there. Welcome back to all things sensory by Harkla. We are so happy to have you here today for another exceptional interview. This is a repeat interview. We have had this guest on in the past, which we will talk about, and I'll tell you who it is. It is Dr. Joel Warsh. He's known on Instagram as. Dr. Joel Gator Warsh, and he is an excellent resource in the pediatric medical world. And we're having him back on today because he did a thing, and he wrote a book, and it's a really great book for new parents. His book is called Parenting at Your Child's Pace, the integrative Pediatrician's guide to the first three years. And Dr. Joel is an award winning board certified pediatrician. He specializes in integrative medicine and parenting in Los Angeles, California. He completed his pediatric residency at the children's hospital in Los Angeles, and he is currently in private practice in California as well. He's published research in numerous peer reviewed medical journals, and he wrote this book that kind of combines all of his expertise and the things that people are constantly asking him about online and in his practice, and he put it into one fantastic resource for you. So depending on when you're listening to this, the book is launching in August of 2024. It's If you're listening to this beforehand, then stay tuned. If you are listening to this episode after it's already launched, go to Amazon and grab it. You can find everything in the show notes linked for you. But with that, we will jump in and meet Dr. Joel. Hello, Dr. Joel. Welcome back to All Things Sensory.

Joel Warsh, MD: 3:08

Thanks for having me back on the show. I'm excited to chat again.

Jessica: 3:11

Yes, we interviewed you back in 2022. So it's been a couple years and we're going to start with our five secret questions. And we're going to ask you the same ones we asked you last time and then compare your answers and see if anything's changed.

Joel Warsh, MD: 3:29

Ok.

Rachel: 3:29

Yeah. So one of the, one of the cool things about being a repeat guest is we get to really like check how in tune you are with your answers.

Joel Warsh, MD: 3:38

Yeah. I don't remember them at all. So then probably won't be that in tune at all, but we'll see.

Rachel: 3:41

Some people go back and listen to their episodes and, you know, just to listen, but I'm like, good thing you did. Okay. First question. We're going to start out really, uh, really spicy. Who is your celebrity crush?

Joel Warsh, MD: 3:56

Hmm, celebrity crush. I don't know. I mean, I feel like these days, I'm more into like intelligence. So I feel like my crush is like to get on to some like really cool show or something like that. So like, I don't know, maybe Oprah or something like that, just to be on like, a really cool show. But I mean, it's a different kind of crush. But I don't know, I'm doing a lot of podcasts these days and things like that. So it's just interesting to talk to really cool people.

Rachel: 4:21

Are you on? Have you gotten on Oprah's podcast yet?

Joel Warsh, MD: 4:24

I've not been on Oprah's podcast yet. Maybe one day. We'll see.

Jessica: 4:27

Your answer last time, you said Pamela Anderson when you were younger.

Joel Warsh, MD: 4:32

Oh yeah, that's true. When I was younger, yeah. Not anymore. I guess, yeah, it makes sense.

Jessica: 4:38

Next question. What does your morning routine look like?

Joel Warsh, MD: 4:42

So now my morning routine looks like, usually I'm

getting up around 6 o'clock, 6: 4:46

30. I have two kids, so usually one of them is waking up. I mean, it depends, because it depends on the morning, right? We have a newborn right now, so the morning could be 4, could be 6, could be 7. You never really know, but the older ones usually get up at 6:30. So that's usually when I'm getting up and then helping to make breakfast, getting everything ready for the older one, and then trying to get myself ready for work.

Jessica: 5:09

It's still similar to what it was last time.

Rachel: 5:11

Yeah.

Jessica: 5:12

Yeah.

Rachel: Get to the office by 8 to 8: 5:13

30. Get the toddler ready, yourself ready. Keep it calm. You said keep it calm, which I like that.

Joel Warsh, MD: 5:20

Yeah. Harder with two kids, but still usually pretty calm.

Rachel: 5:23

Good. What book are you reading right now?

Joel Warsh, MD: 5:27

Um, the book that I am reading right now is Jonathan Haidt's Anxious Generation. It's a good book. Social media.

Jessica: 5:34

Okay. No, that's a good one.

Rachel: 5:36

Yeah.

Joel Warsh, MD: 5:36

It definitely wasn't reading that one before since it didn't exist.

Jessica: 5:39

No.

Rachel: 5:40

No, you said how to raise an adult.

Joel Warsh, MD: 5:43

That was a good book.

Rachel: 5:43

Yeah.

Jessica: 5:45

Next question. Would you rather fight one horse sized duck or five duck sized horses?

Joel Warsh, MD: 5:56

Um, I'm gonna go with five duck size horses since they're smaller.

Rachel: 6:01

That's not what she said last time.

Jessica: 6:03

You wanted to fight the horse sized duck last time.

Rachel: 6:07

Don't you love this? He's like, I really like intelligence.

Joel Warsh, MD: 6:09

I feel like I like my answer better. Little horses seem easier to fight. I don't know.

Jessica: 6:17

Not a very intelligent question.

Rachel: 6:18

No, these are not the best questions. That's okay. The last one, which is very on brand with us. What is your sensory quirk?

Joel Warsh, MD: 6:26

My sensory quirk? I think, um, just tight, tight clothing. It's always been since I was little. Um, I mean, it doesn't bother me as much, but for sure when I was little I didn't like, like, tight clothing on myself.

Jessica: 6:37

Okay.

Rachel: 6:44

Well, we had you on the podcast in the past, and now we are having you on again to kind of give our listeners a little update and talk a little bit more about the book that you just wrote that's launching soon. So kind of fill us in, fill our listeners in, maybe if they have no idea who you are, tell us who you are, what you do, why you do it, all the beautiful things.

Joel Warsh, MD: 7:06

So I'm an integrated pediatrician. My practice is in Los Angeles, California, and I have been working here for about a decade. But more recently, I've gotten into doing more social media, online stuff, and the books, just because people kept asking me to do more and to kind of get out there and speak more. And it's something that I really wanted to do. I love working in the practice, but you can only help so many people. And I feel like, especially with the integrative medicine, integrative parenting that I do, there's not a lot out there for kids as it comes to blending those worlds. And so that's what really has helped me to kind of build my my instagram following and social media following. And then now kind of move into the book space and really try to talk to parents about helping to de stress, to talk about integrative parenting, integrative medicine, and also focus on our health. Because kids health is worse than ever, I think, and I think we need to really focus on prevention and getting to kids before. Um, you know, 50 percent of kids have a chronic disease now, and so that's why I really want to start at the beginning, start with pregnancy, start with the first few years, and get to parents before those issues ever happen.

Jessica: 8:10

Yeah, can you explain what integrative pediatrics is?

Joel Warsh, MD: 8:15

So to me, it means blending the best of modern medicine with integrative, holistic, alternative practices. So I did all the regular medical training and trained at a great Western program. But I got a little bit frustrated with the regular system, and so that's what led me to start learning about integrative medicine. And I'm not against Western medicine at all. I always say that every time I talk about this. It's, it's really, not about, um, not liking the things that are in Western medicine. I think we have amazing medications that can save your life. You can go to the hospital and, and get an MRI. All these things are wonderful. But there are so many other modalities out there, like supplements, acupuncture, um, herbs. There are so many things that other practitioners use, and other countries use, and other individuals use, and we just don't use it that much in North America. But they have a lot of evidence, they can be really helpful, and they certainly, in general, have lower side effects than medications, and so if we can blend those together, um, then, then, whatever we can do to help kids to be the healthiest, I think, is important.

Rachel: 9:15

I think that's so, that's so helpful, too, because In my head, I was like, well, I just, it makes me wonder why every pediatrician doesn't have this same mindset and it just kind of goes into learning, right? You're not learning about all of these integrative strategies necessarily in school and it's exposure. And do you feel like there's a way that we could increase the pop? I don't want to say popularity, but kind of the popularity. The awareness of more of the integrative side of things.

Joel Warsh, MD: 9:45

So, okay. So that's a really good question. I think it's two parts. The first part of the question of why it's not, you know, more in medicine, why it's not done. I think it's because it's not taught. Like you said, we learned pharmaceutical medicine because that's what has been studied. We come, I think, from a different paradigm from many years ago, where the big concern was infectious disease. I mean, certainly we're still worried about disease, but people used to live till they were like 40, right? So the, a lot of the study, the research medicine went around helping people to live longer. But now that that has happened, and now that we have medications, and we have better sanitation, and people are living longer, then new issues have started to come in with chronic disease. I mean, we live in a world where it's filled with toxins. Our food's not very good, but yet medicine hasn't really switched over. It doesn't really talk a ton about prevention. It doesn't really teach a lot about food, and diet, and exercise, and sleep. And we learn a little bit, but that hasn't really changed. And medicine is really good at like diagnosing something that's a problem. So, oh, you have this and this and this symptoms. We want to make sure it's not cancer, right? But it's not very good at spending two hours with you going through your diet, going through your home. It's not a very practical thing within the current system. So most doctors just kind of don't have the time and do what they need to do and what they're trained to do. And, but that isn't what most families actually need in general. They need it in those specific situations, but there's a, there's a big disconnect there. Um, it just hasn't changed yet.

Rachel: 11:13

Yeah, makes sense.

Jessica: 11:14

I like how you said preventative too, because that's kind of the approach we take with our clients. In the clinic setting is like a proactive approach to the things that are happening of instead of like, trying to fix a problem when it occurs, let's take a step back and see are there things we can do before the problem starts to help with it. Whatever it is that could potentially go wrong.

Joel Warsh, MD: 11:39

Yeah, no, definitely. And that's, and that's the reason why I start this book. The first chapter of the introduction chapter is, is very different than any other parenting book. I mean, the main part of the book, a lot of it is similar and in terms of like, there's a lot of questions that you would be aware of, like potty training and tantrums and those kind of things. I definitely give a different spin since I'm an integrative doctor, but most parenting books are written by therapists. Some of them are by moms. Some by therapists. The old books used to be written by pediatricians, not really the new books. So, there's a big health component to most of the parenting books that is is missing. I mean, the therapist books are fantastic. I've read pretty much all of them, and they're great, but it's just different, right? It's a different mindset. It's a different training. And there's not a lot of discussion around health. And I think that's a key Aspect of it. And so that's why I focus in the first chapter on health and the foundations of health, the things to focus on the stuff that parents can actually do, along with kind of talking about stress and and de stressing parents and kind of the difference between parenting 50 years ago versus now and try to bring people into the modern parenting world. But I think a big thing that's unique about the book is there's that integrative aspect to it, which I think is very helpful. Because I'm trying to help and inform people of some of this stuff from day one when they're reading their pregnancy book, their parenting book versus when their kids sick in the office five years from now.

Rachel: 12:58

Yeah, exactly. So your book, The Integrative Pediatrician's Guide to the First Three Years, you talk about seeds. Can you break that down because I thought that was a really beneficial topic in the book.

Joel Warsh, MD: 13:11

Yeah. So in the first chapter, as one of the big, you know, meaty chunks of it, I talk about the Dr. Gator smoothie and it's kind of a play on smoothies and that, you know, when you watch like a daytime TV show or something like that, there's always like the guru air quotes that's talking about their magical smoothie that cures everything. And so I wanted to play on that a little bit and say, okay, what's the Dr. Gator smoothie to health? And it's not an. actual smoothie of like, you know, celery juice or whatever. It's really the foundations of of health and so it starts with seeds. I say like, start with a big scoop of seeds. So stress, environment, and toxins, exercise, diet, and sleep. And then there's a whole bunch of other things that would go in there, like getting sunlight, getting out into nature, getting being a part of a community, friendship, love. You know, those kinds of things that really go into our actual wellness and not a magical smoothie, but like, obviously you want to eat healthy. But, but that's just one, one part of it. We want to have a, these different parts that go into the smoothie a big part of it. Part of that because those are really the basics and the foundations, not rocket science. Basic stuff, but we're not very good at these days.

Jessica: 14:18

Well, yeah, it's it's meeting our biological needs, right? We we all have those biological needs: food, water, air, getting outside, that social network. Like you said, it's all very important to our overall health.

Joel Warsh, MD: 14:32

No, no, definitely and we have um a chronic disease epidemic in kids. I mean, 50 percent of kids or so have a chronic disease. That means if you have two kids, right, one of them is going to have a chronic disease and that is nutty. You know, at 18 years old, 50 percent of teens have a mental health diagnosis. Like those numbers are ridiculous. Like that should not be that way. We shouldn't be here, but we are and if we don't take this seriously, then, then all kids are going to be sick. And we don't want that. We're all on the same team here. We all want kids to be healthy. You know, if you're a parent, you want your kids to be healthy. If I'm, you know, as a dad, I want my kids to be healthy. As a pediatrician, I want to help people to be healthy. It's not to scare people. It's just to bring everybody back into reality of where we are and the realization that if you live the normal American lifestyle, then your kids have a very high chance to have a chronic disease. But if you are mindful of these things, then there are little changes that you can make in your environment in their food that can make a big difference. And all the little things add up because your kid doesn't have to be sick. They weren't most kids were not sick 25 years ago. So yes, we're much better at infectious disease. We're not better at chronic disease, we're much worse, so now we need to come back somewhere in the middle and think about some of these basic things that we used to do and how do we mold those in with some of the new things that we do to live longer and to be healthier. Because life expectancy is going down for the first time ever and that's, that's insane that we're, we're here, right? That's insane.

Rachel: 15:57

Do you think there will be a shift from more of that, like, here's your medicine, here you go, versus like that proactive approach? Do you think we'll see that that shift here happen soon in the medical world?

Joel Warsh, MD: 16:12

I'm not sure if it's going to happen in the medical world soon. I think it has to happen in the parenting world or in our in our own world. Medicine is very slow to change. And the most difficult thing about medicine is that it's based on research and science and data, which takes a long time. And that's good. I mean, obviously want to be making recommendations based on science and data. But the problem is that the best research and science and data comes from medicine. It comes from companies because it takes a lot of money. So they're doing the research. They're biased and that's what we have. We don't necessarily have a ton of the best studies on vitamin D or exercise. I mean, there certainly is some, but it doesn't keep up and it's going to take a long time to change. So I feel like it. Um, and that's where, you know, even the title of the book, like Parenting at Your Child's Pace, it's kind of not comparing yourself to other people and taking charge of your own family, your own child, and making those decisions for yourself and realizing that your doctor is not necessarily going to do that. Even if you have the best doctor, even if you're with an integrative doctor that spends three hours with you, and you know, you have some magical world that you can, you you . , fantasy land that you can actually go to like that. Then they're still not with you every day with for all your all your everything that you're doing. It's up to you. It's up to what we learn. It's up to what we purchase. And if we get that, then I think we can make changes. And as that starts to happen, then doctors will start to change too. I mean, it's definitely moving that way slowly. There's certainly people that are more interested in it, but you can't really compete with big corporations, not, not in the current model. So I think it comes down to us, like us and our own families and being mindful ourselves. And then the companies will change based on what we purchase.

Jessica: 17:54

Yeah, yeah. I like that because it really gives us ownership over our life instead of just letting life happen to us. Like, we have that control. We have that control to help our children and teach our children. So I like that. We could probably end the podcast right here at this point. I mean, that was the best advice. I did want to ask you, can you explain chronic disease and give us some examples?

Joel Warsh, MD: 18:22

Yeah, so chronic disease is acute infection. I think it is what people understand our acute disease like you get sick. You get a cold, you get better. A chronic disease would be something that's more long term or chronic as the name the name says. So it's something that you might be taking a medication for every day or something that comes and goes, but but it's not something that's really quick and gets better. So eczema, allergies, autoimmune conditions, mental health conditions, and there's a long list. But basically anything that's long term and an illness or a condition that would be chronic disease.

Rachel: 18:57

I am curious if, I mean, you've been doing your practice for a while now, and I'm curious if you notice a difference in your patients who have kind of been following this more like integrative side of things versus maybe patients who come to you who have kind of gone down that traditional route and then they kind of switch over. Have you noticed any differences between between them?

Joel Warsh, MD: 19:25

I think so. It's, it's hard to say a little bit because I have a very self selecting population. People that are coming to me, um, are generally somewhat health conscious. Not all of them, but I mean, if they're seeking out an integrative doctor in the first place, then there's probably some, some differences there. Also, mostly I see kids from newborn at this point, so I'm not getting a lot of those, those older kids. But for sure, I mean, the easiest example, for me is the kind of difference between when I started my practice to practicing before my practice. I mean, kids are so extraordinarily healthier in my current practice than they were in the old practice. I mean, I could be giving antibiotics left and right before versus now I don't even remember the dosages anymore. Because it's barely ever have to give them out. You know, obesity rates in kids could be like 25, 30, 40 percent by statistics, but in my practice, almost none are overweight or obese. And that's not because I'm doing anything magical. I think it's just because the parents are more, more conscious of it. But it just tells me that if you are conscious of these things, then you can make the difference. And that, that's what I think is really the big moral of the story there for me. It's not anything that I'm doing magically. It's more just, there are certain families that are conscious of their decisions and therefore the outcomes are overall much better. I, I, you know, kids still get sick, they still come in for colds, um, there's still some chronic conditions, but it's not at the, I know what the statistics are and I know that's not the case for my patients. So they're, they're definitely much lower. Now, what the reason is, I don't know, but I'm just assuming it's their lifestyle based on, you know, common sense to me. I think that's what makes sense

Rachel: 20:57

Yeah. I want to say common sense, but I feel like sometimes common sense is not as common anymore, unfortunately. But yeah, no it is I mean like you mentioned with the seeds like it's it's like meeting those biological needs and being aware. Like going outside in the morning, going outside in the afternoon, taking your sunglasses off, you know, sleeping, drinking enough water, drinking water, you know, hydrating. All of those like basic things and just kind of putting on that, that lens of, you know. What can I do now that will improve my health outcomes or my child's health outcomes later, you know?

Joel Warsh, MD: 21:35

Yeah. Yeah. And I think it's one of the most important things is to realize that the little things make a difference, and that's what adds up, because most kids used to be healthy. They didn't have a chronic disease. So therefore you don't need to make huge changes. It's just little things and a really good example was a study that I really like out of Harvard. It was on soup. It was on cans of soup. So they took a bunch of participants and they gave them five days of canned soup and they gave them then five days of homemade soup. In a can of soup, there's BPA, right? So that's on the lining on the inside of canned soup. So they measured the urine levels of the patients for BPA. Um, after the five days of canned soup, and then after the days, the five days of homemade soup, and the BPA levels were a thousand percent difference in the urine, and that's just five days. And to me that's just one of those really good studies where it's really simple, but it's like very eye opening, it's like, look, you can make soup for your kids, or you can give them a can of soup, and if they love it, and you give it to them five days in a row. A thousand percent difference, that's just one chemical, but think about that chemical, plus the next chemical. What's the next chemical? And you're talking about that big of a difference in just a couple of days. Now how much of a difference is it going to be if you're mindful? Okay, I'm going to make soup. Okay, I'm going to buy this bag of chips that has the better ingredients. Okay, I'm going to, instead of buying the packaged chicken, I'm going to make the chicken. Instead of buying the chicken nugget, I'm going to make the chicken nugget. Like each of these little things adds up and it's like a thousand percent here, a thousand percent here. That adds up over five or ten years and that's what I think is happening. It's these like little decisions with the crappy food and too many toxins and chemicals and it adds up and our bodies just can't handle it at some point.

Jessica: 23:05

Yeah. Yeah. They just get overloaded. Crazy.

Rachel: 23:08

Yeah. And I think too, I mean, kids are just being born with their little time. I mean, I use the analogy, like their toxin bucket, right? Babies are just being born with toxin buckets that are over, like, you know, basically overflowing and then we add more and more and more. And I just feel like it's a recipe for disaster. So, you know, do you have any suggestions for detoxing? You know. Let's say someone's coming to you and they're like, you know, we're overloaded with our toxins. You know, how can we detox before we kind of jump into this new lifestyle we're going to try to achieve?

Joel Warsh, MD: 23:44

Yeah, so that is a really good question. I'll start with this. So number one, start by reading labels. I think that's the key in terms of prevention that everything you buy from now on flip over the label if there is a label and read what's on there. If there's a long chemical name then it's probably not good for you. If you don't know what it is, it's not good for you. Don't buy that thing. Buy the, buy the product with the words you actually know. That's going to get you a long way. So to me, that's like the first step in, in detoxifying is just picking out products that don't have as many toxins and therefore you don't have to deal with it. Then the second step, if you want to detoxify a child, I mean, assuming that they're not extremely ill, and obviously there's other ways to do things if they're very ill. But presuming they're just a fairly healthy kid, you want to do detoxification and you can really just start with the basics. Like, how do you get things out of your body? Pee, poop, and sweating. So, if they're older kids, you know, get them outside, get them moving. You don't necessarily have to throw them into a sauna. You know, when they're four years old, that's probably not very good for them. So, when we're older, there's a lot of research that shows that getting in saunas is good for you. But for kids, I think it just really means getting them to exercise a little bit more. So, do that. Make sure they're drinking a ton of water or liquids. It'll help them pee things out. You want to take magnesium or make sure that they're just drinking a ton so they get a good. You know, some good fiber so they can get better poops. I mean, those are the, the big things to start with. You don't need to do anything magical. You don't need to do a whole detoxification protocol for a kid, but you can certainly for a couple of weeks, like really mindfully increase those three pathways to help them to get things out. At the same time as decreasing the intake and your body's pretty magical. It'll, it'll do a pretty good job. It'll improve things pretty quickly if they, if you give it the chance to. But a lot of times we're just constantly bombarded with. with toxins and you never get a chance to really get more out than is coming in.

Jessica: 25:28

Yeah, I like those because I feel like those are super tangible tips that parents can implement every day. Just a simple walk around the block and get a drink of water. Let's, you know, when we're grocery shopping today, instead of buying the canned soup, let's buy the ingredients this week to make the soup ourselves and just super simple things to do.

Joel Warsh, MD: 25:52

Right, and I want to say, it's not complicated. I mean, we know that it's not complicated because we know the areas on the Earth that are the blue zones where people live the longest and they're not doing anything magical. They're just exercising and eating healthy. They're just in communities where, you know, I don't know if you've watched the films on it, but it's like the grandmas that are, so strong like they're bigger muscles than me. Because they're working in the kitchen and they're still working every day and they're rolling and they're like 103 years old and you're like are you 50 are you 105 like you don't even know. But they're they're just working all day the uh you know the people are working on the farms and and they're walking up and down hills and their life is exercise. They're not exercising. They're not going to the gym i mean you can go to the gym if you want to but it's not i don't think it's something that we can actively do. I mean, I think we need to actively think about it, but I think we need to build our lives to be healthy in terms of making sure that we're getting healthy foods. And that's the only option and also exercising. And that's the only option. And that might mean for us in modern society, every day, you're dropping off your kids at school, drop them off from a few blocks away and walk. That might mean going up and downstairs instead of taking an elevator, like whatever it is that you can just add physical activity as a requirement into your day, I think that is going to get us most of the way. Because That's where people are the healthiest in the world.

Rachel: 27:09

Absolutely.

Jessica: 27:10

Well, and think about walking, walking aids in digestion. So if your child's not even going on a walk every day, then they're probably not digesting their food. They're not pooping and peeing. So if you can just incorporate a walk after dinner, then you're going to help that, that process.

Joel Warsh, MD: 27:27

Mm hmm. No, definitely. Yes. It's not. I said it a couple times, but it's not rocket science. It's basic stuff. But this is what we need because it's not what we're doing. Society has been built for cheaper and faster, but not healthier and it's great that we can, you know, make cheaper food, I guess. That's a good thing. But you lose something for that and we lose health and that is where we are. I mean, we've been marketed to for so many years. And, and, you know, we're not cooking as much. A lot of adults, parents don't even know how to really cook, or they don't do it very often. We're not spending family time. We're in front of screens, everything's in front of a screen, and that has just moved us to a place where our lifestyle is not healthy. And so we just have to mindfully kind of dial that back a little bit and, and you know. You don't again, you don't have to go to the gym every day, but you do need to walk. Like we do though.

Jessica: 28:22

Yeah.

Rachel: 28:23

Well, I, uh, I want to sidestep a little bit because there's a very important topic that we need to discuss. You mentioned it in your book a little bit. But I want to open the can of worms that is crawling in your book. You talked about You know, how if you had a 10 month old come in and say, Hey, you know, my child's not crawling. You, you would have been like, yeah, it's fine. You know, it's not, you know, just, let's focus on walking. They're all right and then when you had mentioned that on social media, you said there was a huge outpour of therapists who reached out and were like, Hey, let's, you know, let's talk about this a little bit. Um, So let's, let's talk about it. Let's, let's have a conversation. I mean, what are your thoughts on, on crawling? Your open, honest thoughts.

Joel Warsh, MD: 29:13

Yeah, no, no, great, great question. So this, I think it's such an interesting topic because going back to our training, right, in, in med school, we, we learned about the developmental milestones. And, and the biggies, you know, would probably be sitting, crawling, walking, talking, those kinds of things. So we definitely learned about it. Now, did we learn that crawling was essential? We did not. We definitely did not. I, I think that most, uh, Doctors and pediatricians in general would say that crawling is, you know, on that pathway. But, you know, if a kid went from just moving around to straight walking, I guess that's fine. Because we're really aiming for walking anyways, and that's really all that I was ever taught, and that's kind of how I thought of things so if a parent was like, oh, they're not really crawling, but they started walking, is that an issue? It never really crossed my mind. Thought of it as one. And then, then the American Academy of Pediatrics changed the guidelines, and they, they, they took crawling out, or you know, they, they didn't really say it as being essential anymore. Um, and so people asked me about that, and I said, okay, well, you know, same thing, like, it's probably not essential. I still think it's important, so I think it's something that, You know, we can still continue to be mindful of. But if they're not crawling, I wouldn't be super concerned about. But then it was really interesting after I said that, because a lot of therapists who work with a lot more kids than I do on, you know, sensory and emotion said, no, they really do think it is actually vital. It's really important for the brain, really important for development, really important for, you know, cross training the brain and things like that. And so that was really interesting to me. Because it's not something that I ever considered and certainly I don't work with kids in that way. And so to me, that that really shifted my perception to a place where I still think it's very important. I'm not sure that I would, if a kid was delayed in terms of their crawling, I'd be extraordinarily concerned as long as everything else is moving. But I definitely did change my recommendations of a kid not crawling to tell parents to continue to work on it, even if they are walking, so that way they can do both. But I'm curious where you guys lie on that and if that's similar or different, because it's interesting. I never, never think of it as a contentious topic, but you know, I guess in the therapy world it is.

Rachel: 31:10

Yeah, you know, especially to now that, I mean, it was always important to us. But after, you know, the recommendations were changed, it was a little bit more like eye opening. That, you know, the, the people, the big people in charge are like, this isn't important and for all of us, little people, all of us therapists.

Jessica: 31:29

Who actually work in the field.

Rachel: 31:31

Yeah, we see clinically the kids coming into us. You know, elementary school age, for one example, who didn't crawl, skipped crawling, didn't crawl, they bum scooted, they didn't crawl properly, and they can't hold a pencil, they can't read, they can't write. I'm saying can't, like, you know, they might struggle with one area or the other. But we see a big connection between these academic skills and upper body strength, being able to sit in a chair. Who knows if it's all related to crawling, but generally, when we're going through and talking to our clients about their their development a lot of these kiddos who are struggling are ones who didn't crawl or didn't crawl very long or who are skipping it. And we can go back through and work on these, these underlying crawling skills. And like you mentioned, bring both sides of the brain together, increase the hand strength, improve sensory processing, visual processing, the primitive reflex integration. So I don't know. Do you want to add anything?

Jessica: 32:33

No, I think that was great.

Rachel: 32:34

It's just something we're very passionate about and we want, we want parents, we want professionals to recognize that it is really important. And yeah, that's, that's our thoughts.

Joel Warsh, MD: 32:45

Yeah, well and the other thing that, that you remind me of when you were kind of talking there was I am always frustrated at how arrogant medicine is sometimes. It's like there's, there's no reason and I try to look at from what I could tell they did not, you know, consult therapists for their, their guidelines and it's, you know, it's ridiculous to not I think when you're trying to make guidelines for movement that you wouldn't have some people, you know, occupational therapist, physical therapist, whatever it may be on the team when you're making guidelines like that. And I couldn't find that. That was true. I can't say for sure because I was not a part of it. But from what I read, it was not. You know, they were not consulted, and I, some therapists have said that, so I'm assuming that's true. Um, but it's, it's very arrogant not to include therapists in these things. Because again, it's like, we're all on the same team, and for whatever reason, it's like, okay, well, here are the guidelines, and it's like, we're all working with the same guidelines, and then if you're like, oh, well, you know, crawling's not that important. I mean, it was very obvious from one post, but it is very important to you guys. So it would be very obvious to me that if that was presented to your community, then you would have had something to say, and maybe they would have modified it or said, well, you know, maybe it's not essential, but it's really important. So we should be looking at this age for this and this reason. Like, you know, it's all in the wording too. Sometimes it doesn't have to be essential to be important.

Rachel: 34:01

Yeah. And, you know, usually there's an underlying reason as to why a child is skipping crawling or not crawling as well. So being able to, to look at that, are they really tight? Do they have retained primitive reflexes? Are they, you know, struggling from a gross motor, core strength? You know, there's usually. There's usually a reason and we want to, to try to get behind it, but those reasons can often get missed and then a child's in school and they can't copy from the board because they've got reflexes or they can't sit they're falling out of their chairs because they don't have the core strength. So there's just there's so many moving parts to it. But it's nice to chat with someone who is open to hearing our side of it. You know, our first pediatrician, I asked him, I was like, what are your thoughts on crawling? Do you think it's important? He's like, no, not really and I'm just like, and we're done here. I was like, I'll let myself out, you know, for someone who's just not open to seeing a different perspective too is tough.

Joel Warsh, MD: 35:01

Yeah, and I mean that that is one of the big problems with social media these days, right? It's like a lot of yelling, a lot of division, not a lot of discussion. I mean the media in general It's not it's not very open to discussions because I I feel like if you presented this to a bunch of pediatricians and they could just spend like 15 minutes with it, then most doctors of that would be like, Oh, yeah, okay, fine. Like, it's not one of those, like, I'm so against this. How could you say this? No, it's like, I think just most doctors don't know. I didn't know and I just didn't think like, okay, it's important that we walk. So it's not super important than older kid crawls. But if you connect it to well, it's connected to these other things and we noticed a lot of this with these other things. So that's why it's important. And I think a lot of people would would change their mind. But you need those discussions first and you need debate and you need to be open to not yelling at each other. But just like listening to other people's opinions. You don't have to agree, but at least you can kind of go back and forth on it and debate. And that will get you to a better place. And we don't have nearly enough of that these days on, on basically any topic. Um, and even, you know, and that kind of circles back a little bit to the book, because a lot of what I do in the book actually is do a lot of this is kind of talking about these two sides of a lot of these topics, because I have found this very thing. It's like, you know, it's very divisive, divisive on a lot of these topics like potty training or how to start your kids feeding, like baby led weaning versus purees. And when you look on social media or wherever, it's like, this is the only way and if you don't do this way, your kids are gonna have this, this and this problem. And the reality of most things in parenting is there are many ways to do it and we want to bring that all together. Bring the different ideas together, and then you do what's best for your family. And with feeding, you know, baby led weaning versus purees, a lot of people that do baby weight weaning is like, it's the only way you can do it and they're not going to feed well and, and the reality is that just stresses parents out so much and then they're very anxious when they're feeding and there's no reason you can't do both. And then I try to remind people, what's the real problem in the world? Some kids don't have food, right? So baby weight weaning versus purees, does it really matter? Not really, you know, or just do both. So like, it's those kind of ways of thinking of things that I try to bring, bring in and bring both sides. Because in the social media world, it's very much like, yeah. This is the one way to do it. And that's not true for parenting. Uh.

Rachel: 37:13

And true, like bringing, bringing that awareness to parents of like, here are two different options. Every child is unique. You don't have to do one way or the other, you know, your child best, and you need to advocate for them. If you don't feel comfortable giving them, you know, an entire slab of meat to chew on, then they're going to be okay, you know. Feeding themselves purees or picking things up on their own. Like, I feel like there is so much of that out there. Like you do it this way or you do it that way, but there's no in the middle. And I mean, I can tell you, I did both. It was fine, like you do what's comfortable for you and what works best for the baby.

Jessica: 37:49

I think too, the challenges with social media. A lot of times is that it takes away our intuition as parents because we see all these conflicting opinions and then we suddenly don't know what to do. And instead of just putting the phone away and getting on the floor and playing with our child and letting them lead. And us doing it more intuitively and kind of going with our guts, I think that that's also a problem.

Joel Warsh, MD: 38:16

Yeah, no, I agree. I think that we know what's best for our kids and it's really amazing to see that parents have kind of forgotten that. Like there's this, we don't parents don't trust themselves. I think they're comparing themselves more and more because of social media. And a lot of times we just don't have that that, um, the grandparent around the other people to bounce things off. We are bouncing things off of what we see online and most of what we see online isn't even true. It's not real. It's not based in reality at all and it's, it's just unfortunate to see that. And another good example that I, I mentioned in the book that I think is helpful for parents is like, you know, because of where I am, I take care of a lot of, you know, Um, prominent people and just being in Los Angeles and, you know, models, celebrities, whatever it is that have big followings and I'll see them, let's say, at the one month old visit and nobody looks great at their visit, you know. Everyone's got, um, you know, sweatpants on and they got spit up all over them and they're not in their best place and maybe they're not the happiest or whatever it is. Because they haven't been sleeping for a month and they could leave my office crying, but I might see on their social media like an hour later. Take care. The most perfect picture that was, you know, taking very different clothes, perfect nursery, holding the baby, hashtag blessed, so excited to be a parent. Everything's perfect, love being a mom, love being dad, you know, whatever it is. It's like, I just saw you 20 minutes ago and you were miserable. Uh, you know, but it's like, and that's fine, but the social media is just not real, right? It's not always real. People portray a certain image that isn't necessarily the reality. And if you're comparing yourself to that, if you're a one month old, Uh, you know, a parent who has a one month old and you're like, why isn't my nursery look like that? Why is my house look like that? Why don't I have this perfect picture? Well, that person had a makeup team and a photographer and, you know, behind that on the other room, it's all messy, but like they're not showing that. So that's just the kind of things where if you're comparing yourself to those things, it might not be true.

Rachel: 40:06

Well, and one thing I like about your book, one thing, there's a lot of things, but one thing I like about it is it's like a guide, you know. It's a really simple. Here's your guide, the first three years, you know, here's some more information that maybe your pediatrician can't give you in the 10 minutes or 15 minutes they're seeing you, you know. Here's just some step by step things for you to think about and look into and just have that little guide in your back pocket, you know.

Joel Warsh, MD: 40:33

Yeah, I mean, that kind of, that sums it up pretty well. I mean, I really tried to talk about the things I talk about often. But even, you know, here, it's hard sometimes to spend all that time discussing every one of these, these topics and these are just the things that we talk about so often. And, and again, it's not, it's not about me telling people what to do. I mean, I say that specifically, medicine has moved way too far into the world of telling people what to do; instead of teaching them. I mean, the word doctor comes from dosair, which means teach. So really, that's what medicine was based on in the beginning was teaching. But now it seems like it's telling people what to do, which is not the way that it's really meant to be. It's supposed to be a partnership. And we're supposed to, you know, obviously, if you work with a doctor, hopefully you like them and you listen to their advice, but it's not about. Telling them what to do. It's about helping people to make decisions by providing them information within the realm of what's reasonable and safe and then letting people make the decision that's best for their family. But we're not doing that anymore. It's much less. I think it's like really a lot of telling people what to do and we have to move back to teaching. And so again, the book is more of that. It's like, here's the options and help you make a decision that's right for your family.

Rachel: 41:41

I love that. I love that.

Jessica: 41:43

Um, because your book covers the first three years, are you planning on writing another book that covers

Rachel: 41:51

three and beyond?

Jessica: 41:52

Yeah.

Joel Warsh, MD: 41:53

Yeah, those are those will be in the next the next steps. I think the next book I'm going to work on. It'll be for that. But. Maybe more along the environmental toxins and foods and that kind of thing. That's what I'm really thinking to get into. So it'll be useful for, for every age, but maybe diving into like having a healthy home and all the things, things to look into. And it's, it's, it's hard because I try to balance what is out there versus what's not out there. And then what's, what's, my unique area, and the therapists do a good job with the older kids. I feel like, in terms of a lot of those books, and it's less, less medical, unless you want to do like a, how to handle a cough, um, kind of thing. It's more, I think, so I think that, that, we'll see, I'll probably will do one of those too, but I think the next book will be like a toxins book.

Rachel: 42:34

I like that. Okay, good to know. So how can everyone get your book and read it and check it out?

Joel Warsh, MD: 42:43

Sure. So you can go to anywhere that books are sold. I mean, the usual answer, right? Amazon, Barnes and Noble, whatever that may be. You can also go to the website for the book. So parentingAtYourChild'sPace.Com. And all the links are through there. If you do pre order the book and you email me, which the email's on the website, then I'll send the introduction chapter. So you can get it before the book, a bonus chapter, and then a free one month subscription to my VIP membership. So that's like a natural parenting community with a bunch of parents. We all chat and people ask questions and I try to help answer. So it's like a way to extend if you have questions from what you read or anything else. So that's all available through the website if you email me.

Jessica: 43:22

When does the book launch?

Joel Warsh, MD: 43:23

The book launches on August 6th.

Rachel: 43:26

Awesome, I love that. Well, if you can leave our listeners, parents, therapists, teachers, and everyone in between, with one piece of golden advice, what would it be?

Joel Warsh, MD: 43:38

One piece of golden advice? I think if I was leaving with a golden advice, it's that you know how to do more than you think. We can do it. Um, people have been parents for forever and we have a lot more information than they ever had and it can be overwhelming if you take in too much information. But the information can be very helpful. So it's actually probably the least stressful time to actually be a parent. We have more information than ever, especially if you're in the Western world, then you have access to things. We are generally living longer than we used to, right, many years ago. So there's a lot, a lot of great things. Like we didn't used to have, we used to have lead in things. We used to have mercury in things. We used to, um, you know, cocaine in, in, in food and it's like, you know, that was like a normal medicine that people were given. So we know a lot more, we have seatbelts, right? We have a lot of things that actually keep us safer. So it's, it's actually not the most scary time to be a parent, but there's just more information than ever. So we can do this and, and trust in your, your parenting instincts.

Rachel: 44:37

I love that.

Jessica: 44:38

Yes. That's great.

Rachel: 44:39

Well, thank you so much. We will link everything, all of your resources, your social media, your book, your website, all the things in the show notes for everyone to check out.

Joel Warsh, MD: 44:49

Thanks for having me on.

Jessica: 44:50

Yeah, thank you so much.

Rachel: 44:52

What a fantastic interview once again. I always am learning something from Dr. Joel and if you aren't already following him on social media, I definitely recommend checking him out, following his account, and we will link everything in the show notes for you. If you aren't already adding his book to your cart, if you aren't already following him, if you don't mind leaving a review on iTunes or Spotify. Especially when we have guests on, it is so helpful to hear your feedback and kind of give them a shout out as well. We really appreciate that and with that, we will plan on chatting with you next week. Thank you for being here and listening to us. It's jibber jabber in your ear. We appreciate you. Thank you so much for listening to all things sensory by Harkla.

Jessica: 45:45

If you want more information on anything mentioned in the show, head over to Harkla.co/podcast to get the show notes.

Rachel: 45:54

If you have any follow up questions, the best place to ask those is in the comments on the show notes or message us on our Instagram account, which is at Harkla_family or at All Things Sensory Podcast. If you just search Harkla, you'll find us there.

Jessica: 46:10

Like we mentioned before, our podcast listeners get 10 percent off their first order at Harkla. Whether it's for one of our digital courses or one of our sensory swings, the discount code sensory will get you 10 percent off. That's S E N S O R Y.

Rachel: 46:28

Head to Harkla.co/sensory to use that discount code right now.

Jessica: 46:34

We are so excited to work together to help create confident kids all over the world. While we make every effort to share correct information, we're still learning.

Rachel: 46:43

We will double check all of our facts, but realize that medicine is a constantly changing science and art.

Jessica: 46:49

One doctor or therapist may have a different way of doing things from another.

Rachel: 46:52

We are simply presenting our views and opinions on how to address common sensory challenges, health related difficulties, and what we have found to be beneficial that will be as evidence based as possible.

Jessica: 47:04

By listening to this podcast, you agree not to use this podcast as medical advice to treat any medical condition. In either yourself or your child.

Rachel: 47:13

Consult your child's pediatrician or therapist for any medical issues that he or she may be having.

Jessica: 47:18

This entire disclaimer also applies to any guests or contributors to the podcast.

Rachel: 47:23

Thanks so much for listening.