Article on supplementation

Supplementation for Children with Autism

We all love our children very much and we are prepared to do our best for them, no matter how difficult or expensive it might be. That makes us vulnerable to try anything and everything in the hope that it will help our children. I meet family after family who give their child 10, 15, 20 or more of various nutritional supplements without any idea if any of them are doing any good. Nutritional supplements are expensive and the market is full of hundreds of various brands. Many of them have questionable quality and the whole industry is not regulated very well.

I cannot emphasise enough that an appropriate diet has to be the number one intervention in successful nutritional management of an autistic child. However, some supplements can be very beneficial and some are essential, particularly in the initial stages. Here I would like to talk about supplements which, in my opinion, would make sense to be given to an autistic child.

Talking about supplements, the first thing to consider is whether those supplements get absorbed from the digestive tract. Autistic children have got damaged digestive tracts with abnormal bacterial flora. In the previous issues of "Autism File" we have discussed the roles of normal gut flora in human health. Autistic children do not have normal gut flora. For various reasons the beneficial bacteria are lacking in the digestive tract of an autistic child. As a result, digestion and absorption of foods is impaired. Autistic children do not absorb nutrients well , including supplements. So, unless we do everything possible to normalise the gut flora, a lot of expensive supplements would go right through without doing much good for the child. In order to improve the gut flora and start a healing process in the digestive tract, three measures have to be employed.

1. The essential diet for the autistic child (look in the two previous issues of "Autism File"). It is a diet designed to encourage beneficial flora and starve out pathogenic "bad" microbes, which in the absence of the "good" bacteria take over the entire gut. This diet is also designed to make the work of a child's digestive tract as easy as possible at the same time providing very rich nourishment.

2. A probiotic. Probiotics are the beneficial bacteria in a capsule. When an efficient probiotic is introduced to the gut, over time it clears out the "bad" microbes together with old putrefaction and establishes the normal flora. Once the normal flora is established, the healing process takes place and the child starts digesting and absorbing their foods appropriately, the immune system gets the right stimulation and the whole digestive tract instead of being a major source of toxicity (as is the case in autistic children) at last becomes a source of nourishment. There are lots of different probiotics on the market. Many of them are not very effective. I will explain why. They contain only a few of the traditional families of probiotic bacteria: Lactobacilli and Bifidobacteria. These bacteria are very good if they get a chance to get to the gut lining. In autistic children the gut wall is coated with mucus and putrefaction, full of abnormal microbes living in it. To clean it out and to allow the Lactobacilli and Bifidobacteria to get to the gut wall, we need soil bacteria - the Bacillus Subtilis family. These bacteria are used in waste bio-degredation. They are very effective in breaking down and clearing out that putrefactive coating from the gut walls. This process takes time and the diet is essential to support it, but with perseverance it can be done. Choose a probiotic of high concentration (10Billion/Gram or more), with as many strains of bacteria as possible, including the Bacillus Subtilis family.

3. Fish oil. Study after study is coming out showing that fish oil and cod liver oil have a strong healing effect on the gut. In fact if any healing is to be expected you have to provide fish oil. The autistic child simply can not have enough of it. The only thing you have to watch if you use Cod Liver Oil, is Vitamin A content. An overdose of Vitamin A can be liver toxic. A toxic level of Vitamin A is more than 8000mg per day for a child and more than 40 000mg per day for an adult. That translates into about 30ml of the usual Cod Liver Oil per day for a child and 140ml per day for an adult. Hardly anybody will be taking these amounts. A tea spoon full of cod liver oil twice a day will be adequate for your child. Fish oils, on the other hand, have lower amounts of Vitamin A and can be taken in larger doses.

Talking about fish oils, they are not only essential for the digestive health, but for the normal development and functioning of nervous system, immune system, sensory organs, hormonal balance and lots of other systems and organs of the body. Supplementing fish oil should be a must for any child, let alone an autistic child. I would anticipate here an obvious question: fish oil is a source or Omega-3 fatty acids. Can it be replaced with flax seed oil, which also provides Omega-3 fatty acids? I personally prefer fish oils, because they have been used by the human race much longer that flax seed oil and contain other beneficial substances. However, if the taste of the fish oil is a barrier in your child's case, then try the flax seed oil.

Apart of Omega-3 fatty acids there are Omega-6 fatty acids. These are the two major players in our eicosanoid metabolism. The subject of eicosanoids is very complex and extremely important. Here it will just suffice to say that you have to be very cautious in supplementing Omega-6 oils. I would not recommend to take it as a supplement. Provide your child with a table spoon of sunflower seeds a day and he/she will get plenty of Omega-6 oils in a natural form. Soak the sunflower seeds in water over night and sprinkle them on your child's meals. This way he/she will not only get his Omega-6 oils, but some vitamins and essential minerals as well.

So far we have discussed two essential supplements for an autistic child: the probiotic and fish oils. There is only one more supplement that I would consider essential, at least in the initial stages of the treatment. That is a balanced multi-mineral, multi-vitamin and multi-amino-acid supplement. It makes sense to provide it until your child's digestion improves enough to start deriving all the needed nutrients from his/her diet, providing that the diet is the essential diet for an autistic child. People who consume usual modern diets are deficient in lots of things because on one hand they do not get enough of essential nutrients from their food, and on the other hand they consume substances which rob the body from those essential nutrients.

Talking about minerals, it is still a grey area. Personally, I would not advise anybody to take single minerals. All minerals compete for absorption in the gut and, if an excess of one mineral is introduced, it blocks the absorption sites and causes a deficiency in other minerals. On top of that in human bio-chemistry every mineral or vitamin works in a tandem with lots of other minerals, vitamins and amino-acids. An excess of any of them introduces an imbalance. Considering that an autistic child does not absorb nutrients very well, it makes sense to provide them in a liquid form. This way a fair amount will be absorbed by the mucous membranes of the mouth, throat and oesophagus. Tests have shown that maximum absorption into the system is achieved from a liquid, and the minimum is from a tablet. Capsules are better than tablets, but not as good as liquids.

The majority of autistic children are anaemic. They look pale and pasty and, if blood tests have been done, they usually show changes typical for Iron deficiency anaemia. However, just supplementing Iron in any form is not a good idea. Iron absorption in the body is a very complicated process. It requires vitamins C, B1, B2, B12, folic acid, some minerals and number of amino-acids. It has been shown again and again in large scale studies in the 3-d world and in developed countries that Iron supplementation is ineffective in treating anaemia. On top of that Iron tablets almost invariably cause a lot of gastrointestinal upset (constipation, diarrhoea, pain, etc.), because they irritate the gut lining and feed pathogenic bacteria in the gut. The best remedy for anaemia is liver. Cook it to your liking and make sure that your child gets at least 1-2 table spoons of ground cooked liver every 2-3 days. It is not a lot and can be disguised in meat dishes, if your child does not like the taste. With the use of a good probiotic and appropriate diet the body will start taking all the necessary nutrients to remedy anaemia.

Supplementation is a very big subject. Here we talked about essentials. There are a lot of optional supplements which can be added to your child's nutritional management, depending on his/her individual needs. However, once the digestion and absorption improve with the use of the diet, probiotic and fish oil, your child will get nutrition naturally from his/her food, as it should be.

Natasha Campbell-McBride holds a Degree in Medicine and a Postgraduate Degree in Neurology. She is currently completing a second Postgraduate Degree in Human Nutrition. In her clinic in Cambridge she specialises in Nutrition for Children with Learning Disabilities, and Adults with Digestive and Immune System Disorders. Natasha is married with two sons, her eldest son having been diagnosed with Autism at the age of three. His story was published in Issue 5 of The Autism File. She can be contacted by phone on 01353 723234, or e-mail at nashcam@lineone.net

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