The New Pediatric Pathology: Allergies, Asthma, Atopy (eczema, hives), and Autoimmune Disorders…The 4 A’s

With chronic health conditions at an all time high it is imperative we identify its causes so we can make changes to improve our health and our children’s health. Learn more about the 4 A’s – Allergy, Asthma, Atopy and Autoimmune in this article by nutritionist Amy Carlson…

By Amy Carlson, Nutritionist – Environmental toxins, genetically and chemically modified foods, and gut dysbiosis are creating health issues in our children.  Our detoxification systems and immune systems are on over-drive reacting to constant triggers both inside and outside the body.  Infectious diseases may be at an all-time low, but chronic conditions that are inflammatory and immune based are at an all-time high.

The conditions affecting our children from an early age, even at birth, are called the 4 A’s – Allergy, Asthma, Atopy and Autoimmune – and they include:

  • Food allergies (1 out of 12 kids) and food intolerances (1 out of 3 kids)
  • Environmental allergies (2/3 kids)
  • Asthma (1/8 kids)
  • Eczema (1/5)  ( in industrialized cities it is actually found to be 2/5 )
  • Autoimmune disorders: type 1 diabetes, rheumatoid arthritis, celiac disease, etc.  (1/30)

With these issues increasing at an alarming rate over the last three decades, research has taken precedence on these exact issues.  Most research on the 4 A’s in children point to three main causes of immune dysregulation.  They are:

  1. An inflammatory diet that is high in processed and packaged foods but low in nutrients and antioxidants
  2. Exposure to environmental toxins and pollutants with compromised natural detoxification
  3. Intestinal lining damage and microbiome imbalances (dysbiosis)

Since we know what is causing these issues in our children, we need to change what we are doing and prioritize our children’s health.  One of the best places to start is with the food that is being served at the table and at schools.

Our food issues run deep in this country. 

We have become so industrialized that our food system has taken a major hit in the nutrients and antioxidants.  Food out of a package or food that has been engineered in some form is responsible for almost 70% of the standard American diet (also known as the SAD diet).  That leaves little fresh, whole foods to be found on children’s plates and in their lunchboxes.  If you weren’t aware of how dangerous lab created food can be, here are a few other bits of information that you want to be made aware of:

  • Genetically modified and altered foods- changing structure of DNA; unrecognized protein structure changes how our body interprets the food molecule; become intestinal irritants, signals immune response = chronic inflammation and dysbiosis
  • Preservatives / dyes / colorings/ food chemicals- these cause huge changes in mood and behavior in children; excitatory/stimulant because body can’t recognize what it is and it is seen as toxin = inflammation and neurotransmitter dysregulation (think ADD/ADHD, anxiety, and asthma)
  • Herbicides and pesticides- toxins, irritants, poison in the body; gut lining irritants, breaks down the tight junctions = leaky gut which allows toxins to enter blood stream leading to slowed detoxification and immune response

The function of your digestion tract is vast. 

When function is optimal then digestion, absorption, and elimination happen smoothly.  But when your child’s diet consists of eating foods that are processed, created in a lab with preservatives, food dyes and other chemicals, there is a good chance that he or she will start to show signs and symptoms of dysfunction.  Constipation, diarrhea, acid reflux, frequent tummy aches, headaches, nutrient deficiencies and skin conditions will become noticeable.  These foods can’t give the body what it needs to function well.  They are irritants and affect the detoxification system and wreak havoc on your child’s microbiome.

Gut flora, the good bacteria that live in everyone’s gut

Gut flora – collectively called your microbiome – are responsible for keeping each of us alive.  You or your child would not be living if it weren’t for these bacteria! Nutrient extraction is a main role gut flora plays, which affects how nourished your children are, as well as production of certain nutrients (certain B vitamins, K, iron).  Good bacteria are also part of the detoxification of internally produced chemicals.   Body cells make waste products from the individual functions they perform, and certain species of bacteria help to eliminate that waste.

A strong and diverse microbiome maintains the gut barrier which protects immune regulation and reactions- certain species of bacteria stand like guards along the intestinal wall, making sure that toxins don’t enter the blood stream.  A healthy functioning gut with a strong microbiome is also responsible for the production of neurotransmitters which affect your child’s behavior, mood, as well as hormone regulation- like that of melatonin, a hormone which regulates sleep.

Not only can a lack of whole, unprocessed foods disrupt our gut and microbiome function but antibiotics are the major culprits of dysbiosis- an imbalance of good bacteria.  Antibiotics are much more powerful than they were just a decade ago.  They use to be made to target specific bacteria.  However, because we have created bacteria-resistant strands of illness, the antibiotics of today are much more comprehensive, targeting many species of bacteria.

Probiotics for Immune Health
Supplementing with quality Probiotics are essential to prevent or reverse the 4 A’s ! Ask your physician to recommend a probiotic blend best suited for your condition.

As of 2015 the average America child had received 20 rounds of antibiotics by the time they turned 18 (Aviva Romm, MD).

Most prescriptions were given for ear infections, forms of strep throat, bronchitis, and rhinitis (sinus “infections”).  However, 1 out of 3 of these diagnoses were wrong (studies found that health care providers did not wait for cultures to come back- the prescription was just given at time of visit) and the culture result showed the illness to be viral based.  Therefore, the antibiotics were used as “preventative measures” which depleted the gut flora.  Depleting the microbiome without replacing it afterward weakens the immune system, which causes intestinal distress and inflammation because it breaks down the intestinal lining.  Since 2017 it has become more of a focus for the health care industry to avoid unnecessary antibiotics.  This is central to preventing allergies, eczema, asthma, food intolerances, and autoimmune disorders.

Symptoms of dysbiosis in your baby and child:

  • acid reflux
  • gas
  • bloating
  • colic (infants)
  • frequent loose stools or constipation
  • eczema
  • hives
  • allergies
  • asthma
  • autoimmune disorders
  • hyper-sensitivity to environment
  • low immune function (always getting sick)

Dysbiosis – or a shift in gut flora – happens all the time. 

Your child’s gut and microbiome are always adapting to what is coming in and passing through.  But certain major changes directly impact functions of body and that of the microbiome.  These include the type of birth a baby goes through, if and how long a baby is breastfed, stress in any form during major developmental stages, a serious infection or illness at a young age, poor nutrition, strong household cleaners and antibacterial soaps and medications to name a few.

It is most optimal for a baby to be born vaginally.  At the time of birth, the vaginal canal is full of specific bacteria that are significant to the health of your baby.  It is like the baby’s first inoculation of good bacteria; it’s the beginning of the “non-self” protectors of the immune system.  Cesareans, although it may be needed, do not supply the baby of those bacteria.  New precautions are being practiced by some practitioners; other strategies done by mothers are being practiced, in particular one called vaginal seeding.  Research is still being conducted to see if this practice is safe and beneficial.

Unless an infant’s mother has a serious health condition, there is no better food for the baby than breast milk.  It is like liquid gold.  Not only are nutrients and micronutrients present in breast milk, but many factors are contained in breast milk that not only protect the baby, but build his microbiome and develop his immune system.  Recent research has shown that babies who are exclusively breastfed for 9 months or more have stronger and more developed gut flora and better adapted immune systems, limiting their chance of developing one of the 4 A’s.

Stress, especially trauma of any kind, can disrupt the function of the gut and microbiome.  Many neurotransmitters are made right in the gut.  Stress and traumatic events can affect how food is assimilated and absorbed and can disrupt the right levels of neurotransmitters.

A serious infection or illness in a child’s early years can have serious repercussions on their gut health and their immune system.  Many times, parents report that a serious infection- bacterial or viral- is what seemed to prompt their child’s allergy or skin condition.  This could be from medications given in response to the infection.  It may also be a possibility that the type of stress from a serious illness can turn certain genes on and off, as well as affect the developing immune system.  More research is being done involving the 4 A’s and epigenetics.

A poor diet, one lacking in any macro or micronutrient as well as fiber and antioxidants will lead to an underdeveloped microbiome and weakened immune system.  It cannot be stated enough that our children need to eat fresh fruits and vegetables, multiple servings, daily.  Getting fruits and vegetables from fruit juices or vegetable gummies is not enough.  “Kids foods” are heavily marketed and their packaging is much more appealing than that of a head of broccoli, but offering and encouraging your children to eat a variety of fresh foods at every meal is imperative to their health.

Medications like antidepressants, anti-anxiety, sleep aides, NSAIDS- Tylenol, ibuprofen, etc, and proton pump inhibitors like Nexium all have a negative effect on the gut and microbiome.  They can be useful for some purposes, but in general, these medications should be used with caution and lifestyle modifications should be assessed to see why these medications are needed.

Antibiotics were already discussed, but even antibacterial soaps and strong household cleaners can be disruptive to the immune system and microbiota.  Other home items like certain chemically treated fabrics and materials like carpets and floorings are triggers for children, especially those with mucosal membrane damage (like those lining the gut, lungs, and sinuses).

The immune system is highly developed and like a spider web, highly responsive and reactive.  One trigger can send a cascade of responses that may take days for the body to get under control.  The immune system’s main job is to protect the self.  It targets invaders and handles them as quickly as possible.  80% of your child’s immune system is in the gut, so if the gut is impaired your child’s immune system is impaired.   Toxins, especially in the amount we experience today, dampen immune function and the ability to filter toxins sufficiently is impaired when the body becomes overloaded.

Diet and nutrition to prevent and reverse disease
One of the keys to building a strong immune system and avoid chronic disease is focusing on nutrition. You and your children need to have the majority of your diet to be from real food: fruits, veggies, healthy fats, and proteins!

So what can you do to help build a strong gut and effective immune system in your child?

  • Go outside as a family and play in the dirt! Coming in contact with other kids and animals has shown to increase the integrity of the immune system and create a diverse microbiome.
  • Avoid anything that is labeled “antibacterial”. This includes soaps, body products, sprays, laundry soaps, etc. Using these sparingly isn’t an issue.  But everyday or often use has a negative effect on the immune system.  Look for natural products that can do the same thing.
  • Environmental / food chemistry: there are 80,000 registered chemicals in our bank, some of which have not been tested for long term side effects. Eight have been banned in the USA and only 32 have had full studies done about them (which led to 8 being banned; although first they were used in food industry). These chemicals are stressful on the body and always a trigger to the immune system in some way. (EPA.org, NRDC.org)
  • Nutrition: your children need to have the majority of their diet to be from real food: fruits, veggies, healthy fats, and proteins. Food will influence epigenetics either for the better or for the worse… there is not a sometimes. Please read food labels if you are purchasing food that comes in a box or package.  Cook at home or go to restaurants where you know food is “real”.  Try to always buy animal products organic and fed a species-appropriate diet, and fruits and vegetables non-GMO and organic when possible.  This may seem to bring an increase in your grocery bill, but spending money on your health is better than spending money on steroid creams, steroid inhalers, and medications that are affecting your child’s health.  There are plenty of helpful articles in how to shop for healthy food while keeping your spending low.  Review the EWG’s Clean 15 and Dirty Dozen to become familiar with what needs to be purchased organic/conventional.
  • With the help of your provider or a knowledgeable professional, you may find that probiotics can help any of the 4 A’s. Specific strands may be needed for specific issues, and following up for a few weeks with probiotics after a round of antibiotics is found to be quite beneficial to your child’s microbiome. If you are looking for your infant, please specifically look for infant probiotics (Gut-Pro is highly recommended).
  • You may need to start with whole food based supplements for your child, especially if she is a picky eater and you are having trouble transitioning away from processed foods. Vitamins A, C, D, Zinc, antioxidants, omega 3s, and fiber are common nutrients that are lacking in the standard American child’s diet (Nordic Naturals, Yummi Bears, and Smarty Pants are recommended brands).
  • There are some herbs that have shown to be helpful to children when it comes to the chronic inflammatory responses and soothing the gut and immune system. Chamomile, quercitin, nettle, ginger root, fennel, marshmallow root, and turmeric. Look for formulas that are specifically made for children like Gaia Kids and Herb Pharm Kids.

If you are a household that experiences any of the 4 A’s, ask your health care provider if an elimination diet is right for your family.  You may be surprised to find that common foods may be part of the problem when it comes to your child’s allergies.  One of the most recent research articles published on February 20, 2019 by the National Institute of Allergy and Infectious Diseases found evidence that there are subsets of eczema linked directly to food allergies.  Common culprits include: dairy, wheat and gluten, food dyes/additives/preservatives, sugar (too much, too many forms), eggs, and nuts.  It is not hard to adjust to if you are prepared.  You can work with a professional to help you find recipes and make menus that would fit your family’s lifestyle and routine.  It is a bit of a change, but it’s very motivating to put in the effort when the eczema flares decrease and your child has less asthma attacks.

Amy Carlson Holistic Functional NutritionistAmy Carlson is a Holistic Nutritionist who practices a whole-foods based approach in helping the body to heal and thrive.  She has a strong interest in sharing what she has learned so that everyone has the opportunity to live in a healthy body.  “Each body has the ability to heal if it is given what it needs and the understanding of why it is hurting is discovered and nurtured as well.” Learn more about her approach to wellness by visiting her website

Contact The Acupuncturists, Dr. Robert Herbst and Dr. Landon Agoado, for a free consultation to learn more on how we incorporate functional nutritional practices into our acupuncture treatment plans.

References: Environmental Protection Agency, Aviva Romm, Weston Price