Subsequent research funded by ARI and other organizations revealed abnormal patterns and metabolic dysfunctions in the ASD population that include:  Gastrointestinal dysfunctions (constipation, diarrhea, reflux, increased permeability, decreased enzyme production including DPP1V, abnormal microflora etc ( 1), Neuro-inflammation (neuro-glial activation (2) decreased blood flow to certain parts of the brain, abnormal brain size), Hormonal disturbances (including increased cortisol production, disorders of serotonin and dopamine), Immune dysfunctions including a Th1 to Th2 shift and pro inflammatory cytokine production) (3),  Oxidative Stress (decreased methionine and other markers indicating decreased methylation capacity, increased  Homocysteine, lower levels of Glutationione, increased lipid peroxidation, decrease, B12 levels etc.)  and Mitochondrial Dysfunction (decreased canrnitine levels, increased lactate) (4)

As parents and clinicians work feverishly to address these abnormalities by assessing the individual issues each child presents with, and attempt to normalize or correct these various disturbances, children are improving (speech, behavior, cognition, attention, general health etc)  and in some instances they are even recovering.   But this is tremendously difficult and expensive work.  Since some of these biochemical abnormalities may be  preventable, more and more parents are working to optimize their health prior to conceiving.

I’ve been a pediatric registered nurse for 33 years during which time I’ve worked as a certified natural childbirth instructor, labor and delivery nurse and had a private practice where I provided nutritional counseling. More relevant to this discussion however is the fact that    during the ten years I coordinated the Defeat Autism Now! Conferences, I interacted with hundred of parents of children with autism.  These are the same parents who worked tirelessly to implement the biomedical approach to treating their children’s autism symptoms.    Many of them exhausted (and often broke) from instituting various treatments,  repeatedly said to me "if only I knew then, what I know now, I would have made very different choices"  Of course autism can not always be prevented and no one should harbor guilt.  We know there are genetic components.  But we also now know environmental toxicity and suboptimal nutrition play a role.   As a result of the research and parents reporting improvement in their child’s condition when they correct the various dysfunctions,  I and many other practitioners are realizing that more  has to be done to build awareness and education around the idea that autism can be prevented. 

I believe  we know enough now to encourage couples who are contemplating pregnancy, have conceived or who have an infant, to implement certain precautionary principles to minimize the risk of having their child develop autism.  These strategies involve minimizing ones exposure to environmental toxins (5), maximizing the nutrition and general health of the mother prior to conceiving, during the pregnancy and while breastfeeding, providing superior sources of nutrition for the infant and child and  careful, strategic and individualized consideration and use of vaccines. 

Of course there are no guarantees. However, with so many parents,  physicians and researchers united in their opinions  as to what  is contributing to  this condition, as well as which strategies are bringing about improvements in these children, we now have a pool of wisdom, good science and common sense from which to draw the following safe, effective and practical recommendations for preventing autism…….. and we can do it now!

Prior to conception: 
1. If a woman is considering becoming pregnant, one of the best things she can do is give herself six months to a year to improve her diet and make better lifestyle choices. She should consume organically grown grains, vegetables, fruits, nuts, and lean sources of protein  etc. (6)Laying the foundation for a healthy pregnancy by putting herself in optimal shape prior to conceiving will go a long way in minimizing the chance of miscarriage, or developing other complications of pregnancy and delivery.   

2. Because gastrointestinal problems are so common in children with autism, in addition to reducing or eliminating  the white foods: sugar, white bread, pasta, pizza, bagels, chemical preservatives and other processed foods,  some women I’ve been working with are choosing to address their own GI related conditions prior to conceiving.  If a woman has a history of candida (yeast) overgrowth for instance or digestive problems, gluten intolerance, food allergies, bloating, constipation, parasites,they are treating these conditions before becoming pregnant. Reducing sugar consumption, minimizing the use of antibiotics, taking probiotics, and using specific diets and herbs for intestinal pathogens such as yeast and parasites can all be helpful in optimizing a woman's health; all of these greatly enhance the likelihood that her child will not be prone to GI problems. 

3. Reduce or eliminate alcohol and caffeine and eliminate tobacco.  (7)

4. Begin or continue an exercise routine.

5. A 2006 report from the CDC found that the average American had 116 of the 148 synthetic compounds tested for  including the infamous dioxin, polycyclic hydrocarbons, and organochlorine pesticides. These same substances were also found in human milk, placental tissue, umbilical cord blood, and the blood and body fat of newborns(8). The average American home contains 3-10 gallons of hazardous materials, and 85 percent of the chemicals that are registered have never been tested for their impact on the human body. See the Green This! series of books by Deirdre Imus. Prior to conceiving a woman should switch to green cleaning and personal care products (e.g., shampoo, toothpaste, body lotion, facial cream).

6. If a woman’s  toxic load has been high (has taken many prescriptive or non prescriptive drugs or works or lives in a chemically-laden environment), she might want to consider a detoxification or cleansing program such as those found at www.BlessedHerbs.com.   

7. If a detox program alone does not relieve fatigue, migraines and or other symptoms associated with being toxic, she may want to consult a well trained chiropractor or medical doctor familiar with nutritional and chelation protocols for a more advanced detoxification process. Contact a MD, ND, DC or DO in your area affiliated with the American Academy of Advancement in Medicine For a list of physicians in your area: www.ACAM.com  

8.  If a woman has several mercury based amalgam dental fillings, she may want to have these removed by a dentist familiar with safe procedure for the removal of dental mercury (www.holisticdental.org)    Safely remove mercury based amalgam fillings with a dentist associated with The American Holistic Dental Association (www.holisticdental.org) at least 6 months before becoming pregnant and not while breastfeeding.15

9. Also in anticipation of conception, it makes sense to begin taking a good comprehensive multi vitamin mineral supplement.  One of the most comprehensive and easily absorbed Prenatal supplements is Opti_Natal.   Start with 1 and work up to 6 per day.  *

10. Adding a source of animal based Omega 3s is also essential for optimal health.  Krill oil is suggested by many or a mercury free source of fish oil such as Nordic Natural or OmegaBrite. 

11. Find a "green" dry cleaners (the chemical used in most dry cleaning facilities, perchlorethylene, is a known carcinogen. (9)

12. Use a stainless steel water bottle to carry and consume filtered water. Heated or not, the soft plastic bottles will release phthalates. Antimony can also be released from polyethylene terephthalate. 

13. For more information about water filters, call 1-800-673-8010 or see NSF International's Web site at www.nsf.org/Certified/DWTU and the Natural Resources Defense Council Web site at
   www.nrdc.org/water/drinking/gfilters.asp.

14. Minimize consumption of large fish (for mercury levels of fish check: www.gotmercury.org)

15.  To build beneficial microflora, take high quality probiotics (in addition to improving levels of beneficial intestinal flora, these have been shown to decrease intestinal absorption of certain chemicals by facilitating their excretion(10) and consume more fermented foods. See BodyEcologyDiet.com.

16. Improve indoor air quality by opening the windows and creating cross ventilation.

17. Test Vitamin D levels and add additional Vitamin D3 if necessary.  Many studies are supporting the use of higher levels of Vitamin D to support immune, cardio and neurological function than what was previously recommended.  (11)

18. Eating a diet rich in colorful organically grown vegetables will provide an adequate intake of antioxidants to fight off the damaging effects of free radicals.  Juicing organic vegetables is a great alternative if one can’t seem to consume the recommended 41/2 cups of veggies and fruit per day

19. If anticipating pregnancy, I would also suggest avoiding the flu shot and any other vaccine for 1 year prior to conception.

20. Computers, TV and cell phones emit Electro Magnetic Radiation (EMF’s) so should not sleep with these in bedroom.  (12)

21. Use cell phones only when necessary and keep the phone in your pocketbook as opposed to in your pocket.

22. Do what is reasonable to green your home and minimize exposure to toxins in your food, cleaning products, EMFs, water etc.   If remodeling is planned and or a new home is being constructed, try to select no VOC paints, sustainable wood as opposed to composites and resin based products, minimize exposure to building materials, allow out gasing of new materials etc. 

23. Begin regular chiropractic care with a family wellness practitioner to begin the process of optimizing nerve and immune system function and balancing pelvic muscles and ligaments with specific adjustments.

During Pregnancy:   Once a woman conceives I would suggest the following:

1. Continue a high quality organic diet that eliminates or greatly reduces sugar and other processed foods.

2. Continue to take a good comprehensive natural and easily absorbed multi vitamin with at least 1800mg of calcium and 800mcg of folic acid.  May want to consider adding 2000 IU or more of Vitamin D and continue or start a mercury free source of Omega 3s fish oil and probiotics. 

3. If possible, avoid dental work while pregnancy especially the removal or insertion of amalgam fillings.

4. If possible avoid antibiotics and other OTC and prescription medication.  There is no pharmaceutical drug on the market that has been proven safe for pregnancy.  New study showing antidepressants are especially dangerous to take during pregnancy  (13)

5. Continue an exercise program to improve circulation and stimulate peristalsis (intestinal motility slows as a result of pregnancy hormones.  So in order to continue having good bowel movements, daily exercise is essential).  In addition, take good sources of fiber like ground flax seed, pysillium husks,  bran, nuts, whole grains, seeds etc. 

6. Eat a diet that contains at least 80gms of protein per day.  Get high quality organic lean sources of protein including turkey, chicken, nuts, whey protein powder for smoothies, meat, eggs and divide up into 4-5 2oz servings.

7. Always have a protein rich snack on hand for those low blood sugar dips

8. Avoid any flu vaccine or any other immunization.  If Rhogam is needed because mom is RH negative, then ask to see the package insert to make sure there is no thimerosal in the vaccine. 

9. If sick, rest, drink lots of hot water with lemon, take extra Vitamin C and possibly use Echinacea drops (not goldenseal during pregnancy)

10. Interview midwives and or obstetricians until you find one that makes you feel comfortable and empowered.   Home birth is an option that is not right for everyone.  However, a study published in the British Medical Journal in 2005 found that natural birth at home with certified practicing midwives, is safe for low-risk mothers and their babies. The study followed 5,000 mothers in the US and Canada,  found that these home births with low risk mothers had much lower rates of  medical interventions when compared to the intervention rates for low-risk mothers giving birth in hospitals. (14)

11. Avoid unnecessary ultrasounds which may include all ultrasounds. There are no conclusive studies showing that ultrasounds are safe in pregnancy, even of more concern is that there are studies showing how prenatal ultrasound affects brain development. Even the standard, routine ultrasounds are not medically necessary and have not been shown to improve birth outcome.  Pathways magazine, issue # 22 has an informative article on the potential relationship between ultrasound and autism.

12. Minimize intrusive procedures during labor (induction with Pitocin, pain meds, epidurals, forceps, C-section, early cord clamping etc) by researching them  and discussing with your midwife or doctor which procedures you wish to avoid if possible and which ones you wish to have be part of your labor and birth experience.  Pathways issue #21 has an article that relates many of these often unnecessary procedures with an increased risk of autism.

13. Choose your birth care providers wisely. Rather than selecting a provider or place of birth because of insurance coverage, select providers who will support your philosophical core beliefs about birth. Decisions made about “necessary treatment” vary drastically between home birth midwives, birth center midwives and obstetricians.  Define your values and beliefs and then seek a provider accordingly. In this issue of Pathways there is a very informative article about choosing your provider.

14. In preparation for labor, delivery and parenthood, start childbirth classes early.  Seek classes outside of the hospital with independent groups that offer support and knowledge about natural birthing.  Additionally finding a birth support doula is essential for better birth outcome.  The perceived need for medication can be eliminated  with proper breathing and relaxation  techniques and adequate support during birth.  For additional information on natural labor and birth procedures read Pathways issue #24.

15. There is a higher risk of autism in cesarean delivered babies (15).  So although it is tempting to think of skipping labor, it is actually mother nature’s way of preparing the child for life outside the womb. The baby’s neurological function is enhanced by naturally passing through the birth canal and through cranial molding.

16. Walking during labor and being in an upright position or on all fours for pushing and delivery will greatly maximize your pelvis’ ability to open and birth with greater ease. This will then minimize the forceful use of doctor assisted pulling, forceps and vacuum extraction.
Any form of pulling and rotation to the baby’s delicate spine in labor may have a lasting affect on future nerve system function.

17. Interview several pediatricians during the pregnancy to find one who accepts your views on health and is open to discussing and giving careful consideration to invasive care with drugs and vaccines. Today, many parents are seeking providers outside of the typical allopathic model, choosing holistic practices that offer safer, more natural options to achieve health and well-being.

18. Continue with regular chiropractic care on a weekly basis throughout pregnancy with a doctor who caters to pregnant women.  This will optimize both your nerve system function and your pelvic biomechanics in preparation for an easier, safer birth.

During the newborn and infant stages: 

1. Bond with your baby as much as possible.  You will need your sleep and so you need to rest when you can.  But be sure to hold and talk to your infant as often as possible.  Co-sleeping is an option many parents are adopting to insure continued contact with their babies.

2. Breastfeeding is one of the best ways to not only provide optimal nutrition but to ensure there is a good amount of bonding time with mother and child.  While breastfeeding, keep up your excellent dietary habits of 6-9 servings of colorful antioxidant rich veggies and fruit, 80-100gms of high quality protein sources divided up into 4-5 2 oz servings per day and plenty (6-8 glasses) of filtered water per day.

3. Wear your baby as often as possible utilizing various baby carriers.  Having you baby held close allows them comfort, emotional ease, and very importantly constant motion.  These factors all contribute to strengthen and enhance neurological development in your baby.

4. Because birth is strenuous on both the mother and baby, have you and your baby checked by a qualified chiropractor shortly after birth. Spinal alignment is essential for mom’s healthy recovery and continued stamina.  Your baby’s cranial and spinal development will affect their nerve system function for the rest of their lives. Early care supports  strong nerve and immune system  function. 4. Take in extra fiber to ensure a good bowel movement each day.

5. Purchase an organic crib and or bed mattress.  Be aware of bedding and clothing with flame retardants as they contain high levels of antimony and other toxic substances.  

6 . Continue multivitamin and fish oil supplement with extra Vitamin  D if if your blood work showed level below 50,.

7. Unless a mother is positive for Hepatis B, there is no need for her newborn to receive the Hep B vaccine in the nursery or within the first few months of life. 

8. I would suggest avoiding all vaccines until the child is older and then make an informed decision based on their potential affects to your child’s immune, digestive and neurological systems.  This issue of Pathways has an outstanding article on Informed Choice by Barbara Loe Fisher, co-founder of National vaccine information Center.   

9. To minimize the possibility that your child will develop food allergies, postpone the introduction of solids until at least 6 months.    When it is time to introduce solids, only use organic vegetables (wait a few weeks, before introducing fruits), steam them and puree them in a blender.  You can make batches of these and freeze in ice cube trays.   Introduce each new food no sooner than 4 days apart to make sure there is no reaction.  Grains should not be introduced until the baby has teeth. Prior to then, they do not have the digestive enzyme to assimilate them. If you have a history of Eczema, Food Allergies, Celiac or Autism avoid dairy, soy and gluten grains (wheat, barley, oats, rye, kamut etc)

10. Continue breastfeeding for at least one year (preferably two). A child’s own immune system does not kick in until they are about 18 months of age, and your breastmilk offers the best immune system support available. Contact your local La Leche league for support and knowledge before and during breastfeeding period. 

11. Regarding vaccines. Although almost every article you read on this subject in the mainstream media states that all the studies have shown there is absolutely no link between vaccines and autism,  that is simply not true. There is good science pointing to a connection (16)  More importantly, there are thousands of parents of sick children who can tell you they had a normal child until he or she received several vaccines in one day or that their child was vaccinated despite being ill. Although more research needs to be done, these accounts by intelligent, observant parents cannot be discounted; to me, these reports are of equal or greater importance than ANY scientific study.

Parents are choosing which vaccines to give after careful consideration of the child's history and genetic background. For instance, if a child was born prematurely or has had recurrent ear infections, or if the parents have a history of autoimmune disorders or allergies, then these are indicators that the infant or toddler may not respond well to a vaccine (and certainly not when several are given at one time). I'd like to suggest discussing all of this with your pediatrician, but, unfortunately, most would not agree with the suggestion to postpone, spread out, or avoid vaccines based on a family history or current illness. As a matter of fact, I have heard several high ranking pediatricians say that a child's immune system could handle hundreds of vaccines in one day. Honestly, what are these people thinking? And where are the studies proving their theory? They don't exist!

If you do decide to give a vaccine, make sure your child has not been ill recently or is not coming down with something.  You also do not want to give a vaccine if the child has been on antibiotics or if they recently came off of antibiotics.  Ask for single dose vials and give one at a time.  There are no long term studies showing that giving multiple vaccines at once is a safe practice.  I would also suggest priming your child’s immune system with immune protective nutrients prior to vaccinating.  You can give 250mg of Vitamin C, 2 or 3 Echinacea drops and ½ tsp Cod liver oil for a few days before and after the vaccine.  For a full discussion on safer ways to vaccinate, please see HERE..

If you decide not to vaccinate, know you are a among a growing group of parents who are shifting their paradigm of health from a fear based, disease model to a vitalistic, trust base wellness model. Although you may sometimes feel isolated, know there are many parents making this shift and there is support and updated information available for you. On the Pathways website, you can find a listing of providers who are part of a new movement: Pathways Connect. They have committed their offices to be the resource for Vitalistic Family Wellness Options. There you can find information ,support and holistic care congruent with your choices.

Summary:   We don’t have all the answers.  No one does.  But let us consider the research that has already be done, the stories of improvement and recovery from parents who have traveled this difficult path and apply common sense precautionary principles as we prepare for, and enter motherhood.   If we wait for all of the research to be conclusive, or for public health policy makers to issue new edicts and catch up to what many smart and observant parents, researchers and physicians already know, how many more children will be unnecessarily affected by autism?  The time to prevent autism is NOW!

(This article will be published in the June issue of Pathways Magazine.)

Maureen McDonnell has been a registered nurse for 33 years (in the fields of: childbirth education, clinical nutrition, labor and delivery, newborn nursery, and pediatrics.) From 1998 to 2008 she coordinated the Defeat Autism Now! Conferences.  Since the late 70’s Maureen has been a vocal advocate and frequent lecturer promoting whole foods, green living and preventative health measures as the most logical and cost effective methods for minimizing complications associated with pregnancy, birth and reducing chronic illnesses in children.  In 2008 Maureen co-founded Saving Our Kids, Healing Our Planet Green Expos www.SOKHOP.com and established the blog Raising Healthy Kids Naturally at www.RaisingHealthyKidsNaturally.blogspot.com.

References:

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15. Higher rate of autism with cesarean section
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* Shaw, Petrick, et al. Aluminum hydroxide injections lead to motor deficits and motor neuron degeneration, Journal of Inorganic Biochemistry (2009)
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* Kawashisma, Y., Takekuma, K., et al.  Detection and sequencing of measles virus from peripheral mononuclear cells from patients with inflammatory bowel disease and autism.  A Dig Dis Sci. 2000;45(4):723-729.
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