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Working with Children in Naturopathic Practice with Emma Sutherland and Kelly Gibson

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Working with Children in Naturopathic Practice with Emma Sutherland and Kelly Gibson

How do we engage children during consults? What does it take to build a flourishing Naturopathic Paediatric practice?

In today’s episode, Emma Sutherland and Kelly Gibson discuss their tips on how to successfully work with and treat paediatric patient, including how to engage and talk with kids, the key differences between age groups, and how to foster a child-friendly environment in your clinic. They also talk about how to build a successful and a financially viable clinical practice.

Covered in this episode

[00:54] Welcoming Kelly Gibson
[03:10] Successfully working with children
[04:25] Examples of research that informs Kelly and Emma’s practices
[06:39] optimising  a clinical environment towards children
[08:58] Logistics of zoom consults with kids
[11:13] Speaking to the adult vs the child in a consult
[13:36] Managing family dynamics
[16:44] Working with different age groups
[22:46] Working with tweens and adolescents
[28:34] Languaging: educating parents without making them feel guilty
[32:37] Discussing infantile colic and probiotics
[35:27] Getting kids to eat vegetables
[38:53] Using supplements
[40:26] Kelly’s advice for a successful and a financially viable clinical practice
[45:34] Thanking Kelly and final remarks

Resources Discussed in This Episode

Kelly's website 
Research: Administration of a probiotic with peanut oral immunotherapy: A randomized trial (Tang, et al., 2015)
Research: Evidence of exposure to chemicals and heavy metals during pregnancy in Japanese women (Maekawa, et al., 2017)
Research: Efficacy of Lactobacillus reuteri DSM 17938 for infantile colic
Systematic review with network meta-analysis (Gutiérrez-Castrellón, et al., 2017)
Government Report: Australia's Children, 2019
Facebook Group: Inner West Mums Sydney

Emma: Hi, and welcome to FX Medicine, where we bring you the latest in evidence-based integrative, functional, and complementary medicine. I'm Emma Sutherland, a Sydney-based naturopath. And joining us on the line today is Kelly Gibson, a naturopath and nutritionist who is passionate about children's health, as well as nurturing new mums and mums-to-be. She's here today to talk to us about demystifying working with kids as a natural health practitioner. 

Now, I have to say working with paediatric patients is always the highlight of my day, as they are just pure fun and joy. So, welcome to FX Medicine, Kelly. How are you?

Kelly: Hi, Emma. Thank you so much for having me on today.

Emma: Absolute pleasure. Now, I would love to know a little bit about your story. So, how did you end up specialising in paediatrics?

Kelly: Well, I think I've just always loved working with children. I was a nanny from the age of 17, actually until I completed my studies as a naturopath. So, looking after children has always been part of what I love. And it's just a pleasure to work with children and an absolute privilege as a clinician. You're not only able to change their current health situation, but you can change their future by educating and preventing diseases.

Emma: Yeah, I would 100% agree. I think that imprint that you can have on that child's life is quite profound. But you don't have to be a mum to be great at treating paediatrics. I mean, it's just like, you don't have to have IBS in order to treat IBS, but you just need to have this curious and open mind to learning, because it's really rewarding.

Kelly: Absolutely. So, I actually loved treating children long before I was a mum. And I think whilst there's a lack of paediatric postgrad education, if you want to treat children, you just have to learn and research and find a mentor that specialises in paediatrics. And that's exactly what I did.

Emma: Yeah. I think that's a really good point, find a mentor who's already doing what you're doing to help you troubleshoot and help you shortcut the learnings and working with kids. 

But how did you actually become successful at treating kids? I mean, it's one thing to work with kids, but how did you become successful at it?

Kelly: Well, kids are my kind of people. They're silly, and they're imaginative, and they're little sponges. So I just always gravitate to paediatric clients. I've been, I think, fortunate, you could say, that I've got a good rapport with kids. And to be honest, I don't think that parents would come back if I didn't. 

I also find that providing bite-sized, achievable treatment goals helps. It helps with successful treatment outcomes. So, if you've got a successful treatment outcome, then they're going to tell their family, they're going to tell their friends, their mothers' group, and that sort of recommendation is super powerful in clinic.

Emma: Yeah, it is. I mean, I have to say my clinic's located in the Inner West of Sydney, and there's the Facebook group, Inner West Mums, and we are constantly recommended on there because of people's experiences. So you're right, that word of mouth is so important in building a successful clinic and being successful at treating kids.

But looking at some research, what research papers have influenced your clinical approach when working with children? Because sometimes it's hard to find good studies in paeds. Mine was that 2015 study done by Dr Mimi Tang, showing that in kids with peanut allergy, using Lactobacillus rhamnosus alongside oral immunisation therapy produced I think it was at about an 80% rate of kids being able to actually eat peanuts. And then there was some follow-up data on those kids showing that they were still able to eat peanuts. And I found that ground-breaking because it just shows that that probiotic strain is moderating the immune response. So, what's really impacted you on that research side and bringing it to clinic?

Kelly: Yeah. Look, there was a study done in Japan which looked at prenatal exposure to environmental chemicals and they looked at the cord blood and the maternal urine, the maternal blood, and also the amniotic fluid. And the results clearly showed that the pregnant women and their foetuses had really high levels of perfluorinated compounds, phthalates, and heavy metals. 

And this study was the perfect example of Walter Crinnion, who - I don't know if you know him - but he's a man that has opened up my eyes to research at learning the effects of environmental chemicals. So, as a result, I screen all my pre-conception and pregnant clients so that they minimise their exposure, and therefore lessen the toxicity burden on their future children.

Emma: Yeah. It's a huge area, isn't it? That preconception often...that low-tox living movement. I think once people become parents, it really opens their eyes to the sea of chemicals that we are swimming in, and just what they can do to reduce their exposure. Anything from skincare products to choosing pesticide-free fruit and veggies from the local markets, but people are really impacted once they become parents. But the research absolutely backs it up. And that study sounds amazing. We will definitely put a link to that study in the show notes.

Kelly: Yeah. Great.

Emma: Yeah. I think that would be great to have that.

Kelly: Yeah.

Emma: And when you're working with kids, you've also got to be practical. So, when you do see kids face to face, what did you have to set up in your clinic so that you could work with kids? What does the clinic environment need to look like to be conducive to paediatric work?

Kelly: So, it needs to be fun. You've got to have toys there, and toys for all age groups, not just babies or toddlers. You've got to have maybe some books there for older kids as well, or puzzles. I don't think you can be precious about your clinic space.

Emma: Yeah. Agreed.

Kelly: If you've got toddlers in there, they're literally going to terrorise the place. So you've just got to be open to that and not feel anxiety of little kids running around. So you've just got to make sure that it's a fun environment. 

Emma: Agreed.

Kelly: But you've also got to make sure it's a safe environment. So, on my days off, an acupuncturist uses my room, and I've got to make sure that everything that he uses is up high, out of reach, like needles and all that sort of stuff. I've got to make sure that everything is safe for children because as I'm typing and if I'm listening to the parents or the children, you never know who's grabbing other things that they shouldn't be grabbing. So you've just got to make sure it's a safe environment.

Emma: Yeah. I couldn't agree more. And having that space where there are toys for different age groups is really fantastic. I mean, we had one family come in last week, and the siblings like to come. And they call me “the toy doctor” because we've got a playroom where kids can really just immerse in that world of imagination and play. But it's also really wonderful to observe them as they're playing.

Kelly: Absolutely. Yeah. That's so true.

Emma: Now, what other things do you need to have? So, what kind of checks do you need to have in order to work in paeds? Because there's some boxes you do need to tick that are important.

Kelly: Absolutely. So, working with children's check is the most important legal document. And it's super easy to get. You just apply for it online. I think it takes about four weeks, and it lasts for five years. So that is really important to have. And, yeah, I think just making sure that the room is child friendly.

Emma: Yeah, absolutely. But what about when you're working online with kids? What about when you're working on Zoom, like so many of us are. How do you work on Zoom with kids?

Kelly: So, look, I think at the start it was quite challenging because I see lots of children with eczema, or skin conditions, and just not being able to see that in real life, I found it quite challenging. But you've also got children, especially toddlers, that will not sit in front of you on a Zoom call for an hour.

Emma: No. They will not.

Kelly: No. So they come and go, usually, during the consult. But when they're present, I'll ask them the questions, and they're usually happy to come in and put their face up to the screen, or whatever it may be that I need to see, their tongue. But what I also do, and it's really important, is get the parent to send through photos. 

So photos of the skin, photos of the tongue, the nails, and the poo, always photos of the poo. And, I mean, most people are working online at the moment. Yeah. So I just feel like as long as you can visualise, you can see the child for a little bit, and talk to the child a little bit, then the consult is fine doing it via Zoom.

Emma: Yeah. I would agree. It's a very different experience. I find it very different compared to when I've got a little person in front of me because of how much more I can observe from them. But it's actually surprising, working on Zoom, how much you can glean from them. And I couldn't emphasise enough the fact that parents need to send you pictures. I mean, the amount of stool pics that I receive I astounding. If anyone ever found my phone and looked through the pictures, they'd think I was some crazy lady. 

But it's so critical for us to actually see these things. And I'm always saying to parents, "It doesn't matter if you think it's nothing. Just send me a pic so I can have a good look at it myself," or even a little video of the child is also helpful.

Kelly: Yeah. That's great.

Emma: But when you're working with them, you've got the child in front of you, and then you've got the parent, or the guardian, or the grandparents, or whoever's caring for that child. How do you decide who to actually speak to?

Kelly: Yeah, it's a great question. I always speak to the child first. Even little babies, when they come in, I always see the babies and give them a little hi. But, yeah, I always speak to the child first. Now, quite often, it will take a little while for kids to warm up. And especially that 1-to-3 age group, it takes a little while. So, often you're guided by the parent. And some children may not even speak to you the entire consult, but I guarantee you, at the second one, they're excited to be back, and they will see you. So, often the parents will send me an email prior to the initial consultation.

Emma: Great.

Kelly: Yeah, just to talk through things that they want to address, but may not want to talk about while the child is there, which is totally fine and really helpful. But you always address the child first.

Emma: I love that because that's also, to me, it's just respectful. It's just engaging. And when we're talking about — and we'll get into this in a bit — but when we're talking about gaining compliance and buy-in from kids, they have to feel involved. And I think, in my experience, children of all ages feel very special when you're talking to them or you get down on their level, and you're playing with the blocks with them for a minute. Or you ask them to do you a drawing and show you, which I do online as well. There's a lot of ways that you can really engage and build rapport with that child. I think that no child is too small to be spoken to.

Kelly: No.

Emma: But then you've also got to navigate the parents and the family dynamics. And it is an art, but one that you just need practice at. So if there's people out there listening that are a little bit hesitant about working in this field of paediatrics, I just urge you, don't be. Just dive in. The kids will teach you everything you need to know, essentially.

Kelly: Absolutely. You just have to be open. You've got to be open to their world.

Emma: Yes. It's a really good reframe. I like that. 

But what happens when the family dynamics start to get in the way? So, how do you deal with it? Because some families are extremely complex, and you've only just met them, or you only have known them for a short time, and we’re not always aware of the full dynamics, but you can feel it. What do you do when those family dynamics get in the way? How do you address that?

Kelly: Look, I do see this all the time. And I have found that making it really clear on their treatment notes gives the parents the ability to show the grandparents, or even the partner why they have to stick to this plan. Especially they're spending so much money on testing, and supplements, and taking the time to remove foods, or if it's an intolerance. So, yeah, it can definitely be tricky, but I just find, like, I'll say a million times it's giving really clear, bite-sized, achievable goals that the parents can stick to and the grandparents can stick to, and also painting the worst picture. Like, "If you don't do this, if you don't remove this food, this is what's going to happen."

Emma: Yeah. I have written letters to daycares. I've written letters to grandparents explaining what we're doing and why because sometimes it has to come from the third party, and that's you. And I agree with you, giving them very clear, bite-sized instructions is really important. There's nothing worse than having a very complex treatment plan in a paediatric case. It just confuses everybody and makes things a lot more arduous than they probably need to be.

Kelly: Exactly.

Emma: But most people are a little bit worried sometimes that they're going to slip up or make a mistake. I mean, how do you address those concerns?

Kelly: Look, I think slip ups are totally normal. In fact, I would say that every food intolerance child that I treat, there's always going to be slip ups. 

Emma: Yes.

Kelly: So I don't give them unattainable timeframes. And I just let the parents know that flare-ups are going to happen if your child is going to slip up, and you're going to give your child, say, dairy on weekends. I am strict with them. Yeah. I am strict, but you do have to allow for slip ups. And, also, you need to encourage the parents that it's okay because otherwise, they just feel really guilty.

Emma: Yes. Oh, my gosh. I think parents feel guilty when they haven't done anything, and parents naturally feel guilty because it's such a sense of responsibility when you have a child, but really normalising...I love that you really normalise that slip ups do happen, but you do need to move on and just say, "Well, that was then. This is now. What can we do now?"

Kelly: Exactly. Yeah. That's exactly right.

Emma: So, for you, I mean, paediatrics spans quite a number of years in a child's life. You've got the babies that are under 12 months, you've got the toddlers that are ranging from 1 to 3, then you've got kids from 4 to 8 years, and then, of course, the tweens, from 8 to 12, and then finally the adolescents, from 13 to 18. So, each of those sub-demographics are quite different. And so, what do you feel are the main differences between those subgroups of paediatrics?

Kelly: Okay. So, under 12 months, this age group is pretty much almost always treating the gut, and treatment protocols are really simple and usually given by the mum, particularly in the early months. I see lots of colic, and reflux, and cradle cap, and eczema, skin rashes. But I find that the healing timeframe is very quick. 

And then you've got the toddlers, the 1 to 3, and this is where I see lots of food intolerances.

Emma: Yeah. I would agree.

Kelly: Constipation. Yeah. Again, skin stuff, fussiness, sleep issues. But the timeframes in this age group are much longer, and I think that's because children, they're growing into their own little personalities. Their favourite words are usually "no" or "yuck." And so compliancy can be really tricky. So I definitely find that this age group is more challenging.

Emma: I would definitely agree with that. And even though this can be a challenging demographic, I actually secretly really love working with these toddlers. You know why? Because they're so defiant, and they're so absolute in their defiance. But I love it. It's like I just love to win them over and to get them on board. It's just this ultimate challenge. 

But they're also the ones, to me, that they're just...they really can make some profound changes and when you're looking at that gut health and how pliable it still is at that age, there's a lot of amazing work that we can do in those areas that you mentioned you see a lot of; the food intolerances, the constipation, the eczema, and the sleep. 

Sleep really does become a prominent issue around that timeframe, as well. And often, as we see in naturopathic medicine, you might work on the gut, but then you'll see the sleep starts to shift as well. There's all these beautiful interlays between what you can do and then what starts to improve.

Kelly: Yeah, absolutely, Em. That is exactly right. Four to 8 is also a really great age to work with. I find that's possibly the easiest age group.

Emma: Right.

Kelly: Yeah. And you got to use the correct language here. So they need to understand what is happening, and why it's happening, and how they can feel better. So I do think that language is key. And in this group, conditions tend to be more chronic, so harder to treat. You've got behavioural issues, anxiety, lots of poor immunity, which goes across all age groups at the moment, to be honest. Constipation, food intolerances. I feel like molluscum, right, every second child has molluscum in this age group at the moment. Respiratory issues, and definitely poor gut health. But, yeah, I do feel like they're the most compliant age group to work with.

Emma: Yeah. I have to agree again. And you know why I think this is is because at this age group, their imaginations are wild, and they can express themselves quite well. And if I can find out from that child what their superhero is, or what their hope is, like, what do they want? Do they want to jump like Spiderman? So that you can really use that language and those themes through your language with the child and through your treatment programs. Do you do those kinds of things? Give us some examples.

Kelly: Yeah. Pretty much every herb mix that I make for this age group, I get the child to name it. So, last week, on the weekend, I had a “unicorn cold defender.” And a little girl made that up. She chose her unicorn cold defender. And I always get, like, Spiderman. And for that younger group, I often say Bluey, or it'll be something to do with Bluey, or, "This is Bingo's eye drops," or whatever it may be. You've got to relate it back to something that they love. But I always get them involved in naming their supplement or naming their herbs. And they love it. There's this little superpower.

Emma: Yeah. Kel, that is such an amazing strategy because it gives you instant buy-in and they get instant ownership of the process by naming it. I love that strategy. That is one that everyone listening can take away and implement the next day they are in clinic. That's brilliant. Thank you.

Kelly: Actually, what I would often do, though, with this age group, in fact, with most of them, a week after the initial consult, I'll call and leave a voice message for that child, addressed to that child, and just say, "Hey, Fred, I just wanted to check how your superhero drops are going. Is it making your tummy feel better?" Or something like, "How many vegetables did you eat this week,” or “How many different vegetables did you eat this week?" And they love it. They love it. I often get little cute messages back, which is so sweet.

Emma: That is adorable. And I love that you're following up in that way. That is such a great way of bringing the child, once again, into feeling really important and special, and that you really care about them, and their situation, and how they're going.

Kelly: Yeah. Absolutely.

Emma: So, what about that tweens? What about the tweens because...how do you find this age group to work with?

Kelly: Look, I would say similar to 4 to 8, but they have more mood issues, more anxiety, a lot more anxiety I'm seeing in this age group. Lots of gut issues as well.

Emma: Yeah. I mean, the levels of anxiety in this age group in the last 12 to 18 months is much higher than I've seen in 17 years. I mean, these tweens are really impacted heavily by anxiety. I think they're more susceptible to feeling anxious. So it's something for us to keep our radars on. And if you're treating adults that have children maybe between 8 and 12, maybe you could just check in with the parent and say, "Hey, how's your child going? Do you think they're suffering anxiety? Do they need any support?" So just doing some checking in if their parents are your patients as well, and you're not currently working in paeds is an easy in as well.

Kelly: That's exactly right. And especially, obviously, children going back to school at the moment. Yeah, I would be asking all my adult clients how their children are going because it's absolutely incredible how many children are suffering from anxiety at the moment.

Emma: Yeah. There's a lot of unknowns for them, I guess, which compounds that. And then, what about the adolescents? So these are the 13 to 18-year-olds. And I love working in this space because they're like mini-adults, but often they're hostages. And what I mean by that is their parents have just booked them in, and their parents might be seeing you or might not be, and just booked them in and plunked them in front of you. And it's awkward.

Kelly: It is awkward. Look, I don't treat many teenagers, but the ones I have, yeah, the parents are obviously always there. And they don't necessarily want to talk. So the roles are reversed. The parents are doing all the talking, yet I'm trying to ascertain how they're going. But the children won't necessarily talk...sorry, teenagers. 

I always get emails from parents prior to this particular age group. And because a lot of it is for acne, and mood, hormonal issues, like, these are prepubescent and going through to puberty, and I definitely see lots of hormonal issues, lots of stress and anxiety. 

And one thing with this age group, though, is that they have their own money. So they're buying their own food, and quite often it's junk food. They're coming in with their own ideas as well. They've seen certain supplements that work for other people on social media. And so they have their own ideas as well. So it's a tricky age group to work with, I find.

Emma: Yeah, it is tricky because if they're a hostage, they're sitting there with their arms crossed, or they're not engaging at all, and the parent is talking at you at a rate of knots. But often I will in those moments...and I can see that it's just not going well, I will actually stop and say to the parent, "Do you mind stepping out while I have a chat to Sarah? Would that be okay with you?" And then 99% of the time, the parent's like, "Oh, okay." And they say, "Oh, yeah, sure. Actually, no, that's fine," and then they leave.

And then I will have a chat to said Sarah, and you'd be amazed at what comes out. And emailing the parent afterwards, and communicating via email before and after appointments with this age group is absolutely critical because there's a lot of sensitivity at this age. And it’s sensitivity about, you know, they might say something to you that their parent doesn't want to know, like, "Yes, I'm buying KitKats after school every day, and I'm telling Mum I'm not." We see that a lot with this age group. But it's that sense of independence and identity that they're trying to grapple through making their own food choices. So there's a lot of subtleties in paediatric work between the families and the child themselves.

Kelly: Absolutely. Yeah.

Emma: And so, working with all these different age groups, if you had to pick, what ones do you think you get the most success in?

Kelly: The most success? I would say the 4 to...oh, actually, I would say the babies, so under 12 months. But also the 4 to 8 group. And I think compliancy is just, babies have no choice, right? We're just syringing it in or mixing it into their yogurt. Whereas, the 4 to 8, like I said, if you are very clear with your language, and get them involved, then, yeah, I always had success treating that age group.

Emma: Yeah. That's a good clinical insight. So, for everyone listening, if you wanted to get started, maybe start with the 4-to-8 age bracket because that is one that is sort of more open and easier to work with. 

But, what about languaging? I just want to talk about languaging for a minute because I think it's so critical when you're working in paediatrics. And how do you discuss things with parents without making them feel guilty? They may be saying, "Don't eat that food, it's a bad food," but saying that may be causing some shame in their child. And, I mean, some parents are just trying to reduce conflict at the end of the day and give their kids nuggets, and other parents might be super restrictive with their kids. So, how do you navigate this with the languaging?

Kelly: Yeah, it's a good question. I mean, it's a fine line between making the parent feel guilty about food choices and educating them. I find that understanding chemicals in processed foods, it's a really good leverage for me to explain to parents why they are better off making their own chicken nuggets, or burgers, or whatever it may be. And I just think, when you have a family with, say, food issues or nutritional food intake, I always ask what their top three go-to fast foods are, or their least nutritious foods are. And I offer alternatives and recipes. So I make it really simple for them. Most often, that works really wonderfully. Sometimes it can still be a bit of a challenge.
And with the super restrictive parents, I just feel like they need reassurance that it's okay for a child to experience cake, and chocolate, unless it's something that there's a health issue and they can't have that. But I just feel like in an ideal world, we would be enjoying everything in moderation. And the food...I just explain to the parents, it's not a good or bad food, it's whether it's harming or whether it's healing. And they usually get it most of the time.

Emma: I really love that statement, "Is this food healing or harming?" So, rather than good or bad, it's just softening the edges around it there, which is really important for parents. And, I mean, what if that family's nutritional literacy is compromised? Because when you work in paediatrics, you end up changing the whole entire family meals. So, how do you work with that?

Kelly: So, in most cases, I do have to paint the worst picture, and be really, really honest. The reality is it actually is easier for the whole family to remove, say, gluten, or egg, or dairy. That way, you're only preparing one meal. And it avoids, I guess, slip ups of problematic foods. But I always offer resources. You need to offer guidelines and be specific, and make sure that you're preparing them with resources and recipes. And, yeah, if it's not a food intolerance problem, but an overall dietary improvement, then I just start with simple, achievable steps. I don't overcomplicate it, and work with them.

Emma: Yeah. I think the over-complication is where people automatically go, "Oh, it's too hard. I can't do anything."

Kelly: Yes. Absolutely. I just find providing them with...you've also got to get them to do their own research. So, rather than giving them four pages of things that is just way too much and overcomplicated, give them resources. Give them, say, three recipes, and five guidelines, and some recipes to go and do their own research.

Emma: Yeah. I think resources are one of the biggest things that I get asked for and we provide in clinic for families and parents because they do need a lot of hand-holding and a lot of reassurance. So really clear resources is imperative.

Kelly: Yeah.

Emma: Now, I wanted to dive into infantile colic, because it is so common, 30% of babies are affected by it. And due to the amount of crying a colicky baby does, it is no wonder that colic is associated with higher maternal depression scores in the literature. And the research on probiotics is absolutely compelling. So, for example, a meta-analysis on Lactobacillus reuteri DSM 17938 showed it reduced crying times at 2 and 3 weeks. And the proposed mechanism was that the probiotic had an anti-inflammatory effect on the gut lumen. Now, interestingly, research also showed the same probiotic strain reduced both parental discomfort as well as the number of visits to the paediatrician due to the infantile colic. So really compelling data that we've got. 

And I'll tell you one thing, when you have a colicky baby and you have the parents in front of you, the parents are usually either crying or highly anxious because they're so sleep-deprived and they cannot stop this insufferable crying that's happening. So, in your experience, what do you find effective for treating colic? What are some tips you can give to our listeners?

Kelly: Okay, look. I mean, I see colic babies every week. There's a real need for naturopathic treatment. Lots of babies are on protein pump inhibitors. And as a naturopath, it's really concerning because they come with their own issues and side effects, especially prolonged use of them. I would say 80% are medicated when they come in. And if you say to a parent, "Okay, we're going to take the baby off the medication," you just see the fear in their eyes because you know what they're going through. 

But I definitely use probiotics, particularly like Lactobacilli reuteri. And, obviously, there's loads of research, so you can show the parents, "This is why I'm giving this to you." Definitely, probiotics. I also use a lot of homeopathics as well, and herbs with colic babies, and slowly, slowly reduce the medication.

Emma: Yeah. So, obviously collaborating with their paediatrician, or GP, or whoever they're working with in that environment, and just going slow, and really working on the research-backed therapies that we have in our toolkit, which there's a quite a few.

Kelly: Yeah.

Emma: Now, what about this 2019 government report titled "Australia's Children" came out. And listen to these stats. Where we're talking about vegetables and kids, said the proportion of children aged 5 to 14 eating an adequate amount of vegetables in 2018 was only 1 in 25, or 4.4% of kids were eating the amount of vegetables they needed to. And this age group were eating one to two servings of vegetables a day instead of the recommended five. That's a big difference. 

So my million-dollar question is, how do we get kids to eat what they need to in order to meet their macronutrient and micronutrient requirements?

Kelly: Yeah. So, look, this is really frightening. I mean, there's definitely a lack of vegetable being consumed by our children. And I find the only way to improve that is obviously with education. 
So, we're programmed to think that we need to eat breakfast foods and cereals in the morning, but if we can shift that mindset and get children, and adults, everyone having vegetables across the entire day. So adding spinach, and zucchini, and stuff like that to their breakfast omelette, and just really increasing their vegetables throughout the entire day. In their lunchbox, ensure that they're having veggies. 

And a big one that I find is getting kids involved in either growing their own vegetables at home or joining a community garden, which are everywhere these days, and exploring the farmer's markets and choosing what foods to cook and foods to eat that week.

Also, you've got to make sure that on a child's plate, they've got their safe foods, so food that they eat, and happy, and they're comfortable, and then adding in a new vegetable. So slowly, you're adding to their taste receptors. And I just find that slowly with kids, rather than just saying, "You need to eat this vegetable. You need to eat that." So, again, language here is really key, just putting it there and seeing what happens as well. 

Now, I will say, though, that there's lots of new protein powders on the market for kids. And essentially they do provide macro and micronutrients. And some are great, but as an add-on. It should never replace their vegetable intake because children need to touch food. They need to eat it. They need to learn how to cook it and prepare it, not just by hidden taste.

Emma: Yeah. I think that there is a degree where you hide stuff, and then there's a degree where you're transparent about it. And I always say to parents, "If you want your child to eat broccoli, don't give them a whole stalk, a tree of broccoli. Put just a tiny, tiny piece of broccoli," because kids are little. You forget that there's so little, so small, small portions of foods that you're trying to introduce are going to work much more effectively.

Kelly: Yeah. Absolutely. Slowly. Don't force food on children because they will just push it away.

Emma: Yes, absolutely. Particularly in that 1-to-3-year age gap.

Kelly: Yeah. Absolutely.

Emma: And so, I guess, a question, as well, is, how do you actually get supplements into kids? How do you optimise compliance for them?

Kelly: Yeah. Look, it can be tricky, especially when you're prescribing supplements or herbs that may not taste so great. It can be tricky with compliancy, especially in the age group of, say, 2 to 4. But there's so many ways you can get them in. 

So, adding them to juices and smoothies, making icy poles and jelly vitamins. Purees are awesome for younger kids. I do use tissue salts as well, and put berries with everything. So berries seem to mask any flavour of awful-tasting supplements or herbs. I always put berries with everything. So, if you're putting herbs or supplements into a yogurt, add berries on top, mix it through, and usually it does disguise the flavour. 

And one thing I will say, though, is that if you are adding a dosage of a product to, say, for instance, a smoothie, add it to a very small amount of the liquid. And then once they've drank all that up, then top it up with more smoothie. And that way, you know that they're guaranteed to finish the dosage required...

Emma: Great idea.

Kelly: ...rather than adding it to a full pop and the child eating or drinking like a quarter of it.

Emma: Yes. That is such a good strategy because that's often what happens is half gets left behind and then the child only had half the dose that they actually need.

Kelly: Exactly.

Emma: Amazing. I love those tips. Now, what are some top recommendations you would give to other practitioners when working in this very fun area of paediatrics? What are just some top tips?

Kelly: Okay. So, first of all, you've got to create a fun space for children to feel comfortable in. That's a really important one. And then, create a good relationship with paediatricians or GPs. And sometimes this can be difficult, but I think it's really important to keep the lines of communication open with their specialist. So, I never go into too much detail in my letters to specialists. I used to, but they don't actually always read them. So you just got to keep it really simple. But having a good relationship with paediatricians is really important. And thirdly, I would say have taste testers of products, if possible.

Emma: Good idea.

Kelly: Yeah. They're spending money on products and they open it up as soon as they get home, and will call me and say, "I've just spent all this money on products that my children will not take." So, some things have strong flavours. Always get children to taste them. And I always have little taste testers there, and they can just have a little taste. And, yeah, I think that's really important.

Emma: I love those tips. So, create a fun space for kids to feel comfortable in. Always create that good relationship, keep the communication open with their paediatricians and GPS via writing succinct letters. They're busy people, we don't need to inundate them with big, long stories. And then, have some taste testers of products that you can get the kids to try before they buy, so to speak.

Kelly: Exactly. Yeah.

Emma: And so, when you first started working this space, looking back, what's that number-one piece of advice you would have told yourself with all the experience you have now? What would you look back and say?

Kelly: That's such a great question. I would say, don't overcomplicate treatment protocols. Keep it simple. And don't try to solve all their problems in the first consultation. I think that most new praccies will make this mistake. They're just really trying to please that client and make sure that they're providing every single bit of detail that they can. It's not necessary. You just need to keep it very simple.

Emma: Yeah. I think that is such a clinical pearl that we should all be reminded of is to keep it simple, especially in paeds when there's so much going on, and there's compliance, and there's emotions, and there's parental expectations. That's such a key piece of advice. 

And then, talking about the new graduate or praccies that maybe are not yet working in paediatrics, any advice for building a successful and a financially viable clinical practice? Because we need to be successful, we also need to be financially viable. So, how do we do this in this area of paeds? Any tips on your end?

Kelly: Yeah. I would say, first of all, have a mentor, someone to talk through cases with, someone to help further your education as well. You don't learn a lot about paediatrics, if at all, in your naturopathic degree, so you need to find someone that specialises in paediatrics, and pick their brains. 

Secondly, I would definitely say, understand the back-end of your business. So, don't fall behind in the admin side of things. There's lots of outsourcing that you can do here if it's something that you're not comfortable with like accounting and bookkeeping. You can get someone to develop your client handouts, someone to help with social media. There's lots of assistants out there, virtual assistants.

And make sure you've finished treatment notes and emails, etc. So this is, I think, a really big one for new praccies. Make sure that it's...sometimes you can be really overwhelmed and you can be really busy, but make sure you stay on top of finishing off those treatment protocols, finishing off your client emails. 

And stay on top of social media. I have a bit of a love-hate relationship with social media.

Emma: Yeah. I understand why. I think we all do to some degree. 

Kelly: Yeah. But it's a really effective and free way of marketing yourself. So, establish good social media platforms. 

And then, lastly, I would say, say yes. So, this is such a huge one for me, Emma, and many other new praccies, because saying yes to opportunities can be so daunting and uncomfortable. But when you get past it, it's just exciting and rewarding. So, saying yes to opportunities.

Emma: I love that. I love that. What a great closing point. Just say yes, jump in the deep end, and just give it a go.

Kelly: Yeah. Absolutely.

Emma: Amazing. Kelly, thank you so much for spending time with us today. Your work with children is certainly so inspiring, and you make it sound really easy. And I know there's practitioners out there who are hesitant to work with kids. So, hopefully, this has inspired them to just give it a try. And for those who are already working with children, you've really given us some amazing tips and areas to focus on. Thank you so much for your insights, they’re really appreciated.

Kelly: Oh, thank you, Emma. It's been fun being on your podcast today.

Emma: Well, thanks, everyone, for listening. Don't forget you can find all the show notes, transcripts, and other resources from today's podcast on the FX Medicine website. I'm Emma Sutherland, and thanks for joining us. We'll see you next time.

About Kelly Gibson

Kelly is a Qualified Naturopath living and practising on the South Coast, NSW and has been in clinical practice for 5 years. With over 15 years experience as a nanny and now a mum to two girls, Kelly’s clinic places a special focus on paediatrics. She offers a free drop-in baby clinic and a monthly Mother’s Group morning tea where she educates caregivers about children’s health.


IG: chamomile_naturopath


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