You Can’t Collaborate With an Anxious Brain

Acid blockers and food allergy, SPACE with Robyn Isman, and a wild three-year-old

New format this week: one study, one conversation, one listener question. Tell me in the comments if it works.

Sponsor: Novaferrum. Use code NFIG10 for 10% off

Comment On This Episode

Is my baby’s reflux medicine a problem? (01:20)

* What acid suppression changes about the gut, and why the gut is where the immune system gets built

* The numbers from a 2025 database study: PPIs in the first year linked to roughly five to six times the rate of food allergy diagnosis, with antibiotics showing a dose-dependent pattern

* The stepwise approach I run before I write a prescription: feeding position, milk supply, dairy or soy removal, two weeks at a time

* When antibiotics are non-negotiable, and when a one-sided ear infection can safely wait

Why isn’t my kid’s anxiety getting better? (09:35)Therapist Robyn Isman built her practice around SPACE, the Yale protocol that treats child anxiety by working only with parents.

* What accommodation actually is

* Unilateral parental action: you decide, then you tell your child... you don’t ask how they feel about it first

* The announcement, and exactly what it sounds like when you change bedtime

* Delaying, disengaging, distancing: three ways to hold the line when your kid escalates

* Validation plus confidence, and the wording that keeps it from sliding into reassurance: not “I know you can do it,” but “I know you can do it while you’re scared”

* Why reminding an anxious kid of past successes usually backfires

* Where school avoidance, permissive parenting, and the phone in your kid’s pocket all collided

Is my wild three-year-old ADHD? (56:20)A mom asks about her impulsive, intense, transition-hating three-and-a-half-year-old.

* Why I don’t diagnose ADHD at this age, and what I look for instead

* The sensory-seeking behaviors that get read as defiance: crashing, jumping, oversized hugs, shutting down in noise

* Sleep first. Snoring, mouth breathing, restless nights, wired but tired

* The short list of labs I’d actually consider, and why I’d call an OT first

Our pediatric practice is open to those in Nebraska, Florida, Texas, Illinois, Kansas, and Iowa. We are now in-network with most insurance plans for these types of visits. If you’re looking for a whole-picture evaluation of your child (we obviously do these virtually if you’re not in our neck of the woods!), learn more and schedule at —> https://clinics.frontierpediatric.care

Links

* Sponsor: Novaferrum. Use code NFIG10 for 10% off

* The study: Chaaban MR, Tanzo JT, Thatte S, Kabalan M, Kaelber DC. “Association of Acid-Suppressive Medication and Antimicrobial Use in Infancy with Food Allergy and Anaphylaxis.” Journal of Clinical Medicine, 2025. Free full text: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12155881/

* Robyn Isman: https://www.theanxiouschild.com

* Instagram: https://www.instagram.com/parentingtheanxiouschild/

* Do Less Parenting podcast:

* SPACE (Supportive Parenting for Anxious Childhood Emotions), developed by Dr. Eli Lebowitz at the Yale Child Study Center:

* Sensory processing episode with Dr. Kristen Pfeil, OTD, OTR/L: https://dearparents.substack.com/p/dear-parents-episode-004-sensory

* NovaFerrum: iron drops and chewables kids will actually take. Use code NFIG10 for 10% off using this link —> Novaferrum

* Have a question for the show? https://drphilboucher.com/ask

dear parents,

Today I get to talk about the history of homeschooling and how it has exploded in the past decade…super interesting conversation around the history of homeschooling and what it looks like nowadays.

Dixie Dillon Lane holds a PhD in history from Notre Dame, homeschools her own kids, and just wrote Skipping School: A History of American Homeschooling and How It Went Mainstream (I had to steal back this book from my wife’s nightstand so I could prep for this interview!)

We talk about how homeschooling evolved from a counter-cultural, keep-it-under-the-radar movement in the ‘80s and ‘90s into a normal educational choice that families move in and out of year to year. We dig into what the research actually says about socialization and safety, why religious instruction is no longer the top reason families homeschool, and how parents can be deliberate about preparing homeschooled kids for adult life.

And one stat that shocked me: there are now more homeschooled kids in America than kids in parochial schools

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Links:

Get Dixie’s book: https://amzn.to/4fRwrOg

Checkout the WSJ review of Skipping School

Have a parenting question? Ask at https://drphilboucher.com/ask

Thanks for reading dear parents! This post is public so feel free to share it.

I love teaching authoritative parenting.

Above is a very real response from a dad to my lesson on the handling window between getting home from school/work and dinnertime.

Watch the lesson on after school meltdowns this question came from: https://apsg.drphilboucher.com/apsg-demo-22

Authoritative parenting is both high in warmth and high in boundaries. It has by far the best research on short-term outcomes, such as getting through difficult day-to-day moments and seasons, as well as long-term outcomes related to our children’s development and our relationship with them as they grow.

Authoritative parenting is not as easy as authoritarian and permissive parenting.

Authoritarian and permissive parenting are really based on avoiding discomfort.

In authoritarian parenting, you use your big voice and threats and coercion and guilt and shame to get compliance. In doing so, parents try to avoid the discomfort that we face when our children don’t do as they prefer immediately. It is high in demands and low in warmth/connection.

In permissive parenting, warmth is present, but limits and boundaries are lacking. Permissive parenting is a response aimed at avoiding the discomfort the child might face if a parent sets a boundary or expectation. It is high in warmth but low in boundaries and limits.

Authoritative parenting, by contrast, takes the good side of both…. it is high in warmth and connection and also high in boundaries and expectations.

Read more about authoritative parenting:

https://dearparents.substack.com/t/authoritative

Your Toddler’s Sleep Didn’t Break. She’s Just Missing You.

Read/watch/listen to the full post https://dearparents.substack.com

Ask your question: https://drphilboucher.com/ask

This week’s episode is an Ask Me Anything from a mom named Emily, and it’s one so many of you are living right now:

Hi, Phil. My name is Emily, and our daughter Remy turns three in about three weeks, and recently has really regressed with her sleeping over the last two weeks. Particularly at nighttime, she lays in her bed until we leave, and then immediately goes to the door and screams for about an hour, bangs on the door crying, hits her toys against the door, and it just really goes on from there.

It’s also happening at nap time at home, even though she’s napping great at daycare. I think it’s some sort of separation anxiety. Not entirely sure what triggered it. We did start swim lessons a couple weeks ago that she had a lot of separation anxiety with, but she’s gotten a lot better. Her daycare class has also been a lot more chaotic than usual, and we notice that when things are a little up and down at school, she tends to regress.

So just curious if this is a phase. We’ve been letting her cry it out. We did try laying in there till she fell asleep. Within the minute she woke up and realized we weren’t there, pattern starts all over again. Tried leaving the door open with a barrier to say, “Hey, stay in there.” But that didn’t work. She kept coming out and then wanted us to sleep in there with her. So right now we’re just kinda letting her scream. And we have an infant at home that can wake up when she does scream. So anyway, just curious what you think. It’s happening at night and at nap time when we’re at home. And really don’t wanna get into a co-sleeping situation, ‘cause the last time we brought her into our big bed when she regressed, it was really hard to break her of that.

She usually loves her bed and sleeps really great. So curious what you think. Thanks.

My response:

First, the co-sleeping trap is real, and you can avoid it

This is one of the most common issues parents bring to me, and it very often leads to co-sleeping, because we’re all exhausted, there’s a new baby at home, and it’s so easy to fall into “just get in bed with me,” or to not even realize they climbed in because you were too tired to notice.

Avoiding co-sleeping is possible. It just takes some intentionality. We have six kids and never fell into it Emily clearly wants a peaceful bedtime and an end to the nightly door battle, and we can get her both.

This is not a melatonin problem

Before we go further: a lot of well-meaning friends will hear this and say, “Oh, just give her some melatonin.” Please don’t.

This is not a melatonin deficiency. This is a habit, separation anxiety, and busyness-of-life situation that we fix with new practices, not with something that chemically knocks a kid out. Melatonin might work temporarily, but it won’t fix the real issue. And I don’t love putting young kids on it for any stretch of time. Remember, melatonin is a hormone, not a vitamin. It has effects all over the body, and when it isn’t indicated, I’d much rather skip it.

The big picture: this is separation anxiety, not broken sleep

I honestly don’t even think of this as a “sleep regression.” People talk about regressions like a child hits a magic age and their sleep just detonates. There are windows where it’s more common, sure. You’ve heard about the four-month one, the eight-month, the nine-month. It’s tough to keep them straight because you can find a blog post about the 6.4-month regression if you look hard enough. It just happens across babyhood and toddlerhood.

Here’s what tells me this is typical separation anxiety specifically:

Most kids with type 1 diabetes are diagnosed in crisis: thirsty, exhausted, losing weight…they end up in the hospital and often the ICU. In this deep dive, I make the case that it no longer has to start that way. Type 1 is an autoimmune condition that shows up in the blood years before the first symptom, and we finally have the science to catch it early.

What you’ll take away:

* Why type 1 is an immune system problem, not a blood sugar problem, and why a normal finger-stick can falsely reassure

* The old rule that misses most kids: 90% of those diagnosed have no family history

* The three stages, and why stage three (the ER, the DKA) is the end of a process that began years earlier

* The new JAMA study (Winkler et al., May 2026): 200,000 kids screened at well checks, DKA at diagnosis dropping from 40 to 60% down under 10%

* When to screen, what the antibody panel involves, and why knowing early lowers anxiety rather than raising it

Screening at Frontier Pediatrics:

We are now offering this screening even if your child isn’t our patient! These are virtual visits and we don’t need to see the kid(s), just parent! We can do one visit and order screening for all the kids. Available as a virtual visit in Nebraska, Iowa, Kansas, Illinois, Texas, and Florida. Most insurance plans cover the testing and we can also help find low-cost or free alternatives like the research sites.

Click here to learn more and book.

Have a question? Ask yours here https://drphilboucher.com/ask

Curious about my ADHD Compass?

Find out where your child falls across all 4 domains of ADHD (hyperactivity, inattention, emotional regulation, executive function) and get a custom-tailored report based on their age, stage, and current strengths & challenges ($19)

https://drphilboucher.com/adhdcompass

This week I’m talking with Lauren Picasso, founder and CEO of Cure Hydration, about something that comes up constantly in my practice: how do I actually keep my kid hydrated?

We get into when water alone isn’t always enough, how oral rehydration solution works (the WHO formula that’s been around over 50 years), and why kids dehydrate faster than adults... smaller bodies, developing kidneys, and the toddler who can’t tell you they’re thirsty until they’re already behind.

We also cover:

* The difference between rehydrating and just loading up on sugar (some sports drinks pack nearly 40g per serving)

* When to reach for electrolytes instead of plain water: fever, vomiting, diarrhea, heat, sports, and even air travel

* Why I keep these packets in the parent kits we hand out

* What Cure built specifically for kids

* Hydration in pregnancy, including Lauren’s take!

If you’ve ever stood in the pharmacy aisle at 2am with a vomiting kid, this one’s for you!!

More at dearparents.substack.comCure Hydration: www.curehydration.com

Feeding kids has never felt harder, and today we chew on how much of that difficulty is manufactured. Jennifer Anderson, MSPH, RDN, founder of Kids Eat in Color, joins me to cut through the conflicting six-second advice and hand parents something better: a way to make their own calls. You are the expert on your own child. If a strategy is making things worse in your house, that’s reason enough to drop it.

What you’ll take away:

Why a consistent meal and snack routine is the best place to start when feeding feels like chaos

What grazing does to hunger and fullness cues, and why fewer, fuller meals usually serve kids better

Why “good food, bad food” language backfires, and what to say instead: different foods do different things in your body

Why dessert as a reward teaches the opposite of what you want

Where food dyes actually rank against what matters most: calories, protein, water, and fiber

The line between typical picky eating and ARFID, and a simple screener to tell the difference

Please please please:

Pre-order Jennifer’s book Feed Them Well

PSA Eat screener for ARFID and extreme picky eating

Ultra-Processed Foods and Kids’ Behavior: What the New JAMA Study Means for Your Family

A new JAMA study followed over 2,000 preschoolers and found that higher ultra-processed food intake at age three predicted worse behavior at age five: more anxiety, withdrawal, aggression, and hyperactivity. At age three, UPFs already made up 45.5% of these kids’ daily calories.

The good news: researchers modeled what happens when you swap just 10% of UPF calories for real food, and behavior scores improved across every domain. Small and intentional beats dramatic and unsustainable.

In this episode, I walk through two quick rules of thumb for spotting a UPF, why “organic” and added-vitamin labels give parents a false sense of security, and how to actually reduce UPFs at home using the authoritative approach.

Study: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2845768Later this month, I’m launching the Authoritative Approach Study Group: a daily text message with one small parenting nugget, plus a weekly Zoom call for live coaching, cases, and Q&A. No course logins, no homework piling up. One registration covers two adults, so both parents (or you and a co-caregiver) can learn together and stay on the same page. Seats are super limited.

Authoritative Approach Study Group

Quick video on how to save yourself a lot of headaches and time when your child wants to watch a show but you don’t have 47 minutes to flip through 3 different streaming services to find what they want to watch.

Also, if you are interested in learning and actually implementing authoritative parenting, I have an upcoming authoritative parenting study group starting on May 19th. It will be a really cool experience (I think) for parents to learn authoritative principles and approaches to make parenting more enjoyable from toddlers through teens. Daily lessons delivered straight to you over text message so you don’t have to do any digging to keep learning & growing paired with weekly live learning for cases and Q&A time! Click this button to learn more ⤵️