Dr. M's Women and Children First Podcast

Welcome to Dr. M’s Women and Children First Podcast, where we explore the science, stories, and ideas that are changing how we understand the health of women and children—with a particular focus on how the earliest environments of life can shape health for decades to come.

Today we are going deep into one of those earliest environments: the immune conversation between a mother and her developing baby.

My guest is Dr. Judy Van de Water, an internationally recognized immunologist whose work has helped reshape our understanding of the relationship between maternal immune function, pregnancy, and neurodevelopment.

Dr. Van de Water received her Bachelor of Science in Biological Sciences from the University of California, Davis, in 1978, followed by her PhD in Immunology from UC Davis in 1988. She went on to build her career in clinical immunology and immunopathology and joined the UC Davis Department of Internal Medicine faculty in 1999. She subsequently became part of the newly established UC Davis MIND Institute, where her research increasingly focused on the immunobiology of autism and other neurodevelopmental disorders.

Her laboratory has spent decades investigating a fascinating question:

What happens when the maternal immune system interacts differently with the developing fetal brain?

That work has included the study of maternal cytokines and chemokines, immune dysregulation during pregnancy, environmental influences on immune function, and—perhaps most notably—the discovery and characterization of specific maternal autoantibodies that recognize proteins important to fetal brain development.

This research ultimately helped define what is now known as Maternal Autoantibody-Related Autism, or MAR autism—a biologically defined subtype of autism associated with specific patterns of maternal autoantibodies.

And I think her work raises a much larger question.

What if autism is not one biological condition at all?

What if the behavioral diagnosis we call autism represents a final common pathway reached through multiple biological routes—genetic, metabolic, environmental, inflammatory, immunologic, or some combination of them?

If that is true, identifying those biological subtypes becomes incredibly important.

Because once we understand mechanism, we can begin asking better questions about risk, prediction, prevention, and ultimately more precise care.

Today we’ll talk about how these maternal autoantibodies were discovered, why they develop in some women, what the animal and human studies tell us about causality, the science behind MAR autism and MARAbio, and perhaps the biggest question of all:

If we can identify a biological risk pathway before a child is born, what do we do with that information?

Enjoy,

Dr. M

Today’s guest is Dr. Doug Thompson,  a 27 year veteran of dentistry since he graduated from the University of Michigan School of Dentistry in 1996. Dr. Thompson is a teacher, researcher and trail blazer in the field of modern dentistry. Today we travel down paths that lead to explanations as to why oral health is so important to systemic and truly whole human health.

We look back in time and follow a timeline to the present-day research that says that we have scientific knowledge through laboratory study that the oral microbiome, the bacteria that reside with the oral cavity, as well as the oral system’s function has far reaching effects on the heart, the intestines, pregnancy and general metabolic health. Over the decades, Dr. Thompson realized that the science needed a portal to the masses and other dental professionals.

Usher in the project called the Wellness Dentistry network circa 2015 which is an internet-based community of dentists with a keen awareness of how oral conditions affect whole-body health. It is a forum for Dr. Thompson and colleagues to use research to develop advanced practice ideas to thwart systemic health concerns that may arise from oral health dysfunction.

On his website, Integrative Oral Medicine, Dr. Thompson states that he believes in an interdisciplinary treatment model that coordinates dental care with other medical practitioners for total body health care for his patients. He employs advanced DNA bacterial testing methods and other leading-edge dental science to enable early risk assessment and personalized treatment planning. To me this remains the future of all healthcare disciplines, collaboration, cooperation and patient centered.

Let us dive into the oral cavity with Doug Thompson.

 

Enjoy,

Dr. M

The Story We Cannot See

For those that have not read Theo of Golden, do so. Quite an incredible read.

There is a moment in Theo of Golden when Allen Levi introduces us more deeply to Ellen, a woman whose circumstances make it easy for the world to place her into a category. Homeless. Poor. Troubled. Someone living at the margins.

But then we learn her story.

And suddenly that category becomes inadequate. Worse, inappropriate.

That is one of the quiet gifts of a beautifully told story. It forces us to remain with another human being long enough for our first judgment to become uncomfortable. For it to turn against us. For us to recoil against our prejudices.

I have experienced versions of this countless times in the newborn nursery.

A baby is born, and somewhere in the medical record is the story we have constructed about the mother. No permanent address. Limited prenatal care. Substance use. Domestic instability. Unemployed. Teenager. Medicaid. Social work involved.

These things matter. As physicians, we need to know them. They may tell us something important about the risks facing a newborn.

But they tell us remarkably little about love. Or lack there of.

I have walked into rooms where a mother's life outside the hospital was extraordinarily difficult, yet there she sat holding her newborn with the same wonder I have seen in mothers surrounded by every imaginable advantage.

She studies the baby's face.

Counts the fingers.

Asks whether the baby is eating enough.

Worries about a rash.

Pulls the blanket a little higher.

And sometimes, sitting beside that bassinet, the distinction between the woman with everything and the woman with almost nothing disappears..... and a literature review.

Dr. M

"Last week someone asked why I prefer books. My immediate answer was that I love their quiet, non-commercial nature. No ads. No hype. Just quiet wisdom with deep rewards for a focused mind.

But today I realized something more profound: Each of my biggest life-changing moments came from a single sentence deep inside a book." (Sivers D. 2026)

I still prefer to hold a book in my hands, the weight of it, the rough-hewn pages beneath my fingers, the quiet ritual of turning one page after another.

Reading, for me, has never been simply about absorbing information. It is the privilege of living for a while through another person’s eyes. We borrow their world, their memories, their fears and joys, and somehow return to our own lives seeing them a little differently.

And then there are the words themselves. Sometimes I stop not because of what happened in the story, but because of the way someone chose to say it. A sentence can be so beautiful that it deserves to be read twice.

Perhaps that is what I love most about books.

For a little while, the world gets quiet, someone else begins to speak, and I get to simply be in love with words.

For me, the changes are not as profound as Derek noted in his response. (hit the link below to read his life altering passages) For me, most passages were more in line with philosophy and health.

and more....

Dr. M

My guest today is Nicholas Kelly, a registered dietitian, speaker, and someone who has spent essentially his entire life navigating medicine from the other side of the exam table.

Nicholas was diagnosed with cystic fibrosis in infancy. That diagnosis meant growing up with a chronic disease that required constant attention: medications, treatments, nutrition, hospitalizations, and an intimate relationship with a healthcare system that most children never experience.

But what makes Nicholas’s story so compelling is what he has done with that experience, a story that has inspired me.

He ultimately became a healthcare professional himself, giving him the unusual perspective of being both clinician and lifelong patient. And through his TEDx talk, Healing Through the Human Experience, and his broader work, he has challenged clinicians to think more deeply about something that can easily get lost in modern medicine:

What does healthcare actually feel like to the person receiving it?

Our conversation moves well beyond cystic fibrosis.

We talk about resilience, identity, nutrition, the evolution of CF treatment, the patient-clinician relationship, and the moments when healthcare gets that relationship right and when it gets it very wrong.

We also explore what happens when a child who has spent his life being defined, at least partly, by a serious disease grows into an adult and begins to decide for himself what that disease will, and will not, mean for his life.

Nicholas’s story is ultimately about much more than living with cystic fibrosis.

There is an amazing story within the story about his mother. Listen and find out what she did for him.

Beautiful.

It is about living fully in the presence of uncertainty, finding purpose through adversity, and reminding those of us who practice medicine that treating disease and caring for a human being are not always the same thing.

This is my conversation with Nicholas Kelly.

 

Enjoy,

Dr. M

The Story Your Brain Decides to Tell

Two people walk into the same room.

One has been told that she is there to make new friends. The other has been told that she is there to determine whether the people in the room can be trusted.

Same room. Same people. Same conversations.

But perhaps not the same experience.

That is the fascinating implication of emerging neuroscience exploring how the brain constructs the story of our lives. We tend to imagine that our senses work something like cameras. Light enters the eyes. Sound enters the ears. Information travels to the brain. Reality comes in, and we experience it.

Except that isn't really what happens.

The brain is constantly deciding what matters.

Our goals, expectations, memories and beliefs create a frame through which incoming information is interpreted. This month's Scientific American article by Ingrid Wickelgren describes research suggesting that when people approach the same experience with different goals, their brains organize that experience differently.

Their neural activity begins to reflect the narrative they are constructing.

In other words, we don't simply experience reality.

We edit it.

This is even more complex because we all show up with epigenetic fingerprints of past experiences.

Think about walking through an airport.

If you are hungry, you suddenly notice restaurants.

If you are late, you notice clocks.

If you are angry, you notice people's energy and anger.

If have a history of trauma, you notice similarities of past experience.

If you have lost your child for thirty terrifying seconds, you notice every small person wearing a similar shirt.

The airport hasn't changed.

Your brain's response and perception has.

Your orientation and current frame/goal determines which pieces of an impossibly complicated environment rise into conscious awareness.

Neuroscientists have been circling this concept for decades. Marvin Minsky described mental "frames" as structures we bring to new situations. Rather than building our understanding of the world from scratch every second, the brain pulls up a model based upon previous experience and asks, essentially: What kind of situation is this? What should I expect? What matters here?..... And a section on maternal story and the default mode network.

Dr. M

Today’s conversation sits right at the intersection of childhood development, technology, and a question that is becoming harder for parents to ignore: What might our children need to develop before we hand them a screen?

My guest today is Dr. Kari Stubbs, who holds a PhD in education and has spent her career in K–12 education technology. And that makes her current work particularly interesting. She isn’t approaching this conversation as someone who is anti-technology. Quite the opposite. She understands technology, has worked within it for years, and sees very clearly where the world is headed.

But she also spends her weeks talking with early-childhood leaders and school-district directors, hearing firsthand that children are showing up at school differently than they did a generation ago.

Kari raised her own two children using what she describes as a brain-based approach to movement and development, during a time when screens still largely stayed attached to walls and desks. Today, she argues for something that sounds almost countercultural coming from an education technologist: protecting significant screen-free time during the first five years of life.

Her argument isn’t that technology is bad. It’s that timing matters.

Those first five years are when children are building many of the foundational human capacities they will carry into school, relationships, and eventually the workplace—things like curiosity, adaptability, creativity, self-regulation, and collaboration. And ironically, as artificial intelligence becomes increasingly capable, these deeply human aptitudes may become more valuable, not less.

Kari writes about these ideas in her Substack, The First Five: Before Screens, and today we’re going to explore what the developing brain actually needs from movement, play, relationships, and the physical world—and what may be lost when screens arrive too early or occupy too much of childhood.

Enjoy,

Dr. M

Back To School Thoughts

As summer winds down and the school year starts, our attention naturally turns to backpacks, school supplies, new clothes, sports schedules, and carpools. But getting ready for school is about much more than checking items off a list. It is about helping our children return to the classroom with the physical, mental, and emotional foundation they need to thrive.

A few simple changes now can make the transition much easier.

1) Start With Sleep

Summer has a way of pushing bedtimes later and later. Often 1 to 3 hours beyond when a school child should wind down. Begin moving bedtime and wake-up time toward the school schedule a week or two before the first day.

Sleep is not simply downtime. It is when the brain consolidates learning, regulates emotions, restores energy, and prepares for the next day. Deep sleep is critical for cleaning the brain of disruptive chemicals. Younger school-aged children generally need 9–12 hours of sleep, while teenagers need 8–10 hours. A consistent bedtime routine and getting phones and other screens out of the bedroom can make an enormous difference.

2) Feed The Brain

Children cannot consistently perform their best when they are running on highly processed foods, sugar, and caffeine. Build meals around real food: vegetables and fruits, whole grains, beans, nuts and seeds, healthy fats, and quality proteins such as fish, poultry, and meat. Breakfast does not need to be elaborate, but including protein, fiber, and healthy fat can provide much steadier energy than starting the day with a sugary cereal or pastry.

And remember the simplest nutrient of all: water. Send children to school well hydrated and encourage them to carry a water bottle when possible..... and back to school recipes.

Dr. M

The Hardest Part of Medicine Isn't Making the Diagnosis

Last week I wrote that one of the most healing words in the English language may be "no." I believed it when I wrote it.

After today, I believe it even more.

Today was one of the hardest days I've experienced in medicine in a long time.

I drove home with a heaviness that is difficult to describe. Not because a child died. Not because I faced an impossible diagnosis. Not because science failed me. Not because of the many reasons medicine offers for struggle.

I drove home grieving.

Grieving for children who have no idea what is quietly happening inside their own bodies.

Grieving for my own pain at being unable to convince certain parents to see this problem.

Grieving because I can already see a future they cannot.

Today marked the one-year follow-up for many of the children enrolled in our asthma pilot program. We built this program around hope. We invested time that most medical practices simply don't have. We spent hours educating families. We provided healthy food. We offered gift cards to encourage participation. We discussed sleep, movement, nutrition, inflammation, insulin resistance, and the remarkable ability of the human body to heal when given the right environment..... and a literature review.

Enjoy,

Dr. M

In this podcast repost, we rediscover the work of Pediatric Gastroenterologist Dr. Alessio Fasano from the Massachusettes General Hospital Department of Pediatric Gastroenterology. In this conversation, we discussed the research on Intestinal Permeability, Microbiomes and MIS, Multi Inflammatory Syndrome in Children .

Dr. Fasano also directs the Mucosal Immunology and Biology Research Center and is associate chief for Basic, Clinical and Translational Research. Under his leadership, investigators are studying the molecular mechanisms of autoimmune disorders including celiac disease, and other-gluten-related disorders. He has been named visiting professor of pediatrics at Harvard Medical School. He authored the groundbreaking study in 2003 that established the rate of celiac disease at one in 133 Americans. Widely sought after by national and international media, Dr. Fasano has been featured in hundreds of interviews including outlets such as The New York Times, The Wall Street Journal; National Public Radio; CNN; Bloomberg News, and others.

He recently co authored an excellent book with Susie Flaherty called Gut Feelings. I highly recommend you purchase and read this book. It is an encyclopedia of information regarding gut health, the microbiome and much more.

Enjoy my conversation with Dr. Fasano,

Dr. M