Melatonin, Probiotics, & Vitamins: The Pediatrician Mom Answers All of Your Questions

An interview with The Pediatrician Mom, Dr. Krupa Playforth, on the research behind common supplements for children

Source: Anna Shvets/Pexels

You can listen to this interview in your podcast player below:

For this week’s Parenting Translator podcast/newsletter, I was so excited to interview Dr. Krupa Playforth. Dr. Playforth, who you might know as The Pediatrician Mom, is a board-certified pediatrician and mother to three young children. She specializes in communicating evidence-based medical information to parents through her social media account and website. In today’s interview, we discuss many of the burning questions you may have about supplements and vitamins for children including:

• Is it okay to use Melatonin to help your child to sleep?

• Should we be giving our children probiotics and multi-vitamins?

• Does Elderberry, Vitamin C, and other supplements really improve immune function?

• Do Omega-3 supplements really help children’s brain function?

• What about supplements for neurodiverse children?

You can read the full transcript of the interview below:

Dr. Cara Goodwin: Hi everyone. Welcome to the Parenting Translator newsletter and podcast. I'm Dr. Cara Goodwin and I'm so thrilled today to be here with Dr. Krupa Playforth. Dr. Kupa Playforth is known as “The Pediatrician Mom”. We are Instagram colleagues because we both share the mission of getting research-backed information into the hands of parents. Her information as a pediatrician is more based on medical advice, so she's here today to talk about the questions I have about supplements and vitamins such as melatonin and probiotics. I can't wait to dig into it. Thank you, Dr. Playforth, for being here today. Dr. Playforth, could you please introduce yourself? I would love to learn a little bit more about you and what inspired you to become a pediatrician.

Dr. Krupa Playforth: I'm a Board-Certified Pediatrician and a mom of three in Northern Virginia. My kids are eight, five, and almost two. I'm in the trenches with what a lot of parents are going through, particularly with the whole pandemic parenting thing.  When I started medical school, I went in thinking that I was going to become a psychiatrist. I had done psych research on kids, which sounds a lot creepier than it really is, in college. I worked in a baby lab and I thought, oh, obviously it's psychology. I'm going to be a psychiatrist, this will make sense, it all fits together. Then I did my pediatric rotation and I realized I think the factor that brings it all together is not the psych, it's the kids. Because taking care of kids and taking care of families is just such a wondrous, fulfilling thing. I haven't looked back. It's been a really rewarding career.

Dr. Cara Goodwin: Amazing. So as a psychologist with three children, I know I thought a lot of what I thought about clinical and research issues changed after becoming a mom. How did your pediatric practice change for you after becoming a mom?

Dr. Krupa Playfort: It completely changed. I think that most people change at a deep level when they become parents in terms of how they approach problems and the level of empathy that they have for other parents. I think before you experience some of these things, it's really hard to know how gut-wrenching it is when your child won't sleep or if they're really upset and you can't soothe them. I know that I was a pediatrician for several years before I started having children and I definitely was a little bit of a by-the-book, follow-the-rules type of pediatrician. When I think back to some of the advice I gave parents back then, nothing was unsafe, but it was just not always as nuanced as I think the reality of parenting is. 

Then I had my kids. My oldest was a reflux baby who was failing to thrive. I was struggling with breastfeeding and I put them to sleep drowsy but awake. All of the things that I would say to parents suddenly just didn't fully make sense. When your kid is sick and you're scared that something is deeply wrong with them. I had the pediatric knowledge to be able to analyze that situation objectively. It still floors me when my kid is sick, I am no different really, than any other parent. I can try and take a step back and look at it objectively. Sometimes if my husband says to me, “What would you tell a parent in this situation?” That will help. But a lot of times I am just in that very primal emotional brain space that a lot of parents are when their kid is sick. I think that what's changed in terms of my practice is I just have a whole new level of empathy and kindness and compassion for what the experience of what parenting can be like. Especially in a world where we are being barraged with tons of information and misinformation. Sometimes you don't know who to believe and where to find evidence.

Dr. Cara Goodwin: Yes, that is so true. I feel the same way as a psychologist. Before I had kids, it all felt so simple. It was like, this is what the research says so why would you not just follow the research? It's simple. This is easy stuff. Then of course, literally within a week of having my first, I felt like, wow, this is a lot harder than I thought!

Dr. Krupa Playforth: Do you feel like now that you have multiple children, that what also keeps you on your toes, is that sometimes what works for one kid really isn't what works for another, and you have to constantly be adjusting the way you're doing things?

Dr. Cara Goodwin: So true. I'm pregnant with my fourth child and you would think I've got it figured out now. But I feel like every day my husband and I have a moment of– how do we handle this? And I feel like sometimes I have no idea what I'm doing. 

So I have so many questions for you. I'd love to get into some of the research on supplements and vitamins and probiotics. So first I want to start off with what should parents think about in general when we're considering supplements and vitamins, which by that I mean non-medical treatments or what you can buy off the shelf of a drugstore? What should parents know about supplements in general?

Dr. Krupa Playforth: I think that parents should be aware that the marketing industry is very smart and very manipulative and takes advantage of our innate anxieties. As parents, every parent wants to do the best thing for their child. We want our children to thrive, to be healthy, to have healthy immune systems, and we all want to make sure that we are doing right by our kids. And sometimes, especially during a time of high anxiety, for example, going through an unprecedented pandemic, I think that the marketing industry capitalizes on the fact that we suddenly are not sure what the right thing to do is as a parent. 

If you are given information about supplements, the bottom line is be suspicious. Think about who's giving you that information, why they might be giving you that information, what qualifications they have to give you advice about whatever it is that they're talking about, and what they're getting out of moving you towards a behavior where maybe you buy a supplement or not. Are they selling the supplements? Are they getting a commission? Be suspicious. It seems harsh to think about it that way, but anyone can put anything on the Internet. There are a lot of claims that are not founded in evidence and that make a whole lot of sense.

Dr. Cara Goodwin: That is so helpful to know. So really be aware that people are making a lot of money off of parents with this marketing. Is it true that supplements are not really very well regulated?

Dr. Krupa Playforth: Supplements are not regulated. The FDA does not regulate supplements. When you look at Consumer Lab and Consumer Reports and when they're analyzing what is on the supplement bottles and what is inside the supplement bottles, what the labels say is not always what the pills contain. There's no nationwide standard that these supplement companies have to adhere to in terms of the claims that they're making, in terms of the doses that they're putting in, in terms of saying they are research-backed. But is that research actually peer reviewed? Is it truly rigorous research? None of it is well regulated. Now this doesn’t mean that there are certainly companies out there that are trying to do a good job, but it's really hard to determine which companies are being scrupulous and which ones are not.

Dr. Cara Goodwin: Wow, that's very scary, knowing that there's very little regulation on these things that we could potentially be giving to our kids every day. So I'm very curious to know what your thoughts are and what your understanding is of the research on melatonin. I've struggled with the decision to give my own kids melatonin. One of my kids struggles a lot with sleep and I eventually gave in and gave her melatonin because I figured she was staying up way too late, not getting enough sleep.There's also negative side effects of not getting enough sleep for her. I felt very conflicted as a parent. So I'd love to hear, what are your thoughts on melatonin? Is this safe? Is it effective? How do we make these decisions as a parent?

Dr. Krupa Playforth: Let's talk about what melatonin is first of all. Melatonin is a hormone. It's important to remember that you are giving your child a hormone, but it is a hormone that is produced in our brains in response to various environmental signals that tell us it is time to sleep. It is normal for our bodies to produce this as a trigger for sleep. The circadian rhythm, your day-to-day rhythm, determines how much and when it is produced. It's tuned into each individual person's sleep wake cycle when you take it exogenously. When you take a pill that contains melatonin, you are giving your body a hormone to help induce that trigger to sleep. Now, this isn't to say that it is completely unsafe. I think that the research on melatonin is still up and coming, especially in the pediatric population. 

What we don't know very rigorously right now is what dosages are right for what ages. Most pediatric medications are dosed based on weight. If you look at Tylenol or Ibuprofen, it will tell you the dose by age on the bottle as a general guideline. But really we are dosing based on milligrams per kilogram of weight. 

When these studies are done on many of these supplements, they're A) done in adults and then B) they make some assumptions about the way children's bodies process different medications, different supplements that are not always the case. Children are not small adults and assuming that a child's body is going to process a medication the same way as an adult's body is not always the right assumption to make. Thinking about something like Aspirin is really helpful when you think about this. Aspirin, especially baby aspirin, is something that adults take a lot.  We give it to pregnant women now with the new data, but it's widely considered to be safe. But in children, we do not give them any Aspirin-containing product because it increases the risk of a rare syndrome called Reye's syndrome, which can be fatal. So children are not small adults, their bodies do not necessarily process things in the same way. For some things they probably do, but we don't always know and without studying it, we can't tell. 

Now, getting back to your specific question about melatonin, there is data in adults that shows that melatonin supplements can be really helpful for things like jet lag. If you have a wrecked sleep schedule because your kid's been sick or you are doing shift work. It 's not the best long term solution to be giving your body that exogenous hormone. But as a temporary measure, while you work on some of the other things that might be going on that may be contributing to a difficulty with sleeping, it can certainly be a really helpful tool to use. 

I like to think of most medications as just tools in your toolbox, but not necessarily the solution. Because ultimately what you want to do is work towards getting your body to be producing the right amount of that hormone at the right time, long term. Because obviously sleep is something that your body is going to need for the rest of your life. In terms of pediatrics, we do use melatonin in certain populations, in neurodivergent populations, and it is considered to be safe as a way to help some of those children obtain good, high quality, consistent sleep. And like you said, sleep and sleep deprivation also has serious consequences. 

So when I think about a supplement for myself and for my kids, I always think about it in sort of one big frame, and that is to look at risks and to look at benefits. Just because research hasn't been done yet on something doesn't mean it's necessarily risky. You have to weigh what benefit it's going to be giving you against what risk you're potentially taking on by giving your child or taking that supplement yourself. In a population that is neurodivergent, that has issues with circadian rhythm disturbances, the benefit of melatonin may well outweigh the risk. In an otherwise healthy child that is struggling long term with sleep, it may be helpful over a short term period of time, and the risk over a short term period of time is probably quite low. But you also want to be thinking about what else may be contributing to that child struggling to sleep. Does that make sense?

Dr. Cara Goodwin: Yes, that is so helpful. If you need it to get you through a rough patch, it can be helpful, but also think about what else you can do. I would assume that would be like, bedtime routine, making sure that the child has sufficient time to calm down, reducing screen time at night?

Dr. Krupa Playforth: Exactly. Sometimes it may be that your child's on ADHD medication and you may need to adjust the time that you're giving it or to adjust to something that's a little bit shorter acting if you're finding that it's impacting their sleep. A lot of older kids need to take a little boost of an ADHD medication, like a shorter acting medication after school to help with after school activities and homework and things like that. But maybe you change the dose or you change the timing if you can, so that it then also doesn't interfere with sleep, particularly for that population. I mean, sleep deprivation can lead to symptoms that look a lot like hyperactivity and attention deficit. 

You want to make sure that you are optimizing everything else as well as taking whatever medications you need to optimize your child's health. 

I think we can't really talk about melatonin without also talking about the recent safety reports on it because there have been overdoses. Melatonin often comes in a formulation that is a gummy, which is obviously very tempting for children.  I think because something like melatonin is more easily available for a parent, it's easy to think of it as safe just because it is so easily available. But it is certainly possible to overdose and those overdoses can be quite serious, especially if a child gets a hold of a bottle. So you still want to treat it like any other medication. But also we don't have optimal dosing information for children.

Dr. Cara Goodwin: That is such an important fact that we don't know which dose is actually appropriate based on the child's weight. Also you can see how tempting it is for a child if they have this gummy thing beside their bed and they think, “Well, I'm just going to eat all of them.” So remembering that even though it is available on the drugstore shelf, you should still be careful. You should store it in a place that's safe.

Dr. Krupa Playforth: A lot of melatonin supplements actually have cannabinoids CBD in it too. Children should not be taking CBD. There's absolutely no safety data. There's really no reason that they should be on it. If you have combination gummies or inadvertently have purchased a combination gummy that has melatonin and CBD in it and your child gets a hold of that, that has consequences.

Dr. Cara Goodwin:  I've seen those news reports, and that's very scary because we have no research on CBD in young children.

Dr. Krupa Playforth: I also want to make clear that this is not an attempt to guilt a parent that is giving their child melatonin. I think it's really important to be very intentional and thoughtful about anything you're giving your child and to think about what your off ramp is going to be for that supplement. Try and make a plan for an off ramp. It doesn't mean that it won't be beneficial for them in the short term, but talk to your pediatrician and make a plan for what is my long term goal here and how am I going to achieve that goal and get my child off any additional medications they do not need. That's the way to think about it.

Dr. Cara Goodwin: That is so helpful. So what about other supplements? I know when I was little I took a Flintstone multivitamin and now it seems like that has fallen out of favor. So what do you think about giving a child multivitamin? Is there any situation when you would advise that?

Dr. Krupa Playforth: Vitamins are a hot topic because many of us grew up on vitamins. I took Flintstones as well. I know some people have this sentimental feeling about that chalky taste, but I despised it. But I grew up in the middle of Africa and Flintstones were even available there, which says a lot, right?

Dr. Cara Goodwin: That really does.

Dr. Krupa Playforth: But vitamins are an example where the idea makes so much sense, right? Children are picky eaters and you think, “I know that they need this balanced diet of fruits and vegetables to be healthy.” That is something that we know for a fact. So you immediately assume that if your child is not getting that every single day that maybe the best way to make sure that they're still getting those nutrients for their bodies to function optimally is to give them a supplement. The trouble is, the data doesn't support that giving your child those supplements, if they are not actually legitimately deficient, makes any difference. Vitamins can be quite expensive. Most of the time all they're doing is causing your child to make very expensive pee. I don't know if I'm allowed to say pee. It's expensive urine. In a child that is legitimately deficient, then yes, absolutely. There is a benefit to giving them the specific vitamin that they might be deficient in. Now there are certain populations where that is something we do see. 

One example is a vegetarian or a vegan child. Vitamin B12 is something that you can really only get through animal products. And so if you are a plant-based eater, your child is a plant-based eater, or has food allergies that lead them to be missing an entire food group, then for those children there is a reason to be thinking about giving them some specific vitamins like a B - 12. My children are vegetarian and they do okay with other, non-meat animal products. But when I was breastfeeding my youngest, he had a milk protein allergy, which meant that egg was suddenly the only animal product that I was able to consume. I'm vegetarian and there's only so many eggs that you can eat.I ended up deficient in B12 and I was symptomatic from it and had to give myself B12 shots every month. So that is a situation where the B12 makes a huge difference.

Iron is another one where a lot of kids may have some degree of iron deficiency. It's something we track as pediatricians. We routinely will check for anemia in younger children, but for the majority of other vitamins, even a picky child will still be getting what they need. A child does not have to eat the right balance of fruits and vegetables every single day. My children are picky. My children eat like normal children. And no matter what I do or say about it, there are some things you just can't fight. And that is the reality of parenting. But I try to look at it over a week rather than on a day to day basis. And over a week their eating kind of tends to even itself out. It also means that I am less anxious about everything they have consumed every single day. So that's the way to think about it. But if your child is not consuming an entire food group because of a food allergy, that is something you want to talk to your pediatrician about. But even a picky child, even a picky toddler, otherwise should not really or does not really get any benefit out of taking a vitamin.

Dr. Cara Goodwin: That is so interesting. So you should ask your pediatrician whether your child has any deficiencies. And if there are no deficiencies, you just shouldn't worry about the multivitamin.

Dr. Krupa Playforth: Now, the obvious next question is should I have my pediatrician check for defiiciencies? If your child is otherwise growing, well, thriving doesn't seem like they're having any clinical issues, then I think it is more traumatic to try to get the blood draw than not. I'm not sure that there's necessarily any benefit if your child is thriving. 

Another category of children that might benefit from a vitamin supplement would be a child who has a malabsorption or a chronic illness. That means that they're not getting as much of some nutrients as they need. And so for those children, your pediatrician should be on it, your specialists should be on it.

If you're not sure and you just kind of want somebody to look at your child's diet and really give you a little bit of peace of mind, nutritionists and dietitians are massively underutilized as resources. But especially now, one of the benefits of the internet and of the pandemic, it's a silver lining of the pandemic, is that a lot of these resources are accessible online. A lot of registered dietitians moved to providing online services, and so these resources are more easily accessible than they were even five years ago. I think parents should seek that out if they're a little bit concerned about it, and hopefully that will give them the peace of mind they need.

Dr. Cara Goodwin: That is so helpful. I don't think a lot of parents think about seeing a nutritionist for a child, so that's very helpful advice. So what about probiotics? I've heard a lot in the news media about probiotics recently, questioning how valuable they are. So what's your take on probiotics?

Dr. Krupa Playfort: The data on probiotics is not as robust as the probiotic companies would have you believe. The idea of this gut microbiome is such a hot topic of research right now that my gut instinct, no pun intended there, is that we will find in time that there are benefits to taking probiotics. Now the question then becomes which probiotics and how much gives you the benefit? And that's the question that we don't have a great answer to right now.

In certain populations, if you think about your standard colicky baby, we have data that probiotics can decrease the duration of crying in children who are diagnosed with colic, which is a little bit of sort of a waste basket diagnosis. It's defined, but a lot of different things can look like colic in a baby because they're just crying. There's data that supports the use of lactobacillus reuteri in that population, and some parents find it helpful. Again, you still want to talk to your pediatrician about whether or not to use it.  You want to make sure that any product that you purchase is coming from a reputable company that you trust, that you feel like has scrupulous business practices and cares about making sure that what is on the label matches what is inside the bottle. 

But the other area where we do have some research in the pediatric population when it comes to probiotics is in gastroenteritis, so infectious diarrhea. And there's a little bit of data that suggests that supplementing with a probiotic during that type of diarrheal illness can decrease the duration of the illness, but it's only by a few hours. And so then you sort of get back to this question of risks versus benefits. If it's really only going to decrease their symptoms by a few hours, is it actually worth the risk of giving them something that isn't that well regulated? Little bit of a judgment call there. 

But for other things, a lot of people will say, oh, I give my child probiotics for their behavior. I give them for sleep. Social media is rife with these kinds of claims. I wish desperately that we had a supplement that could help with some of those things. But unfortunately, I think that at the end of the day, what helps with a lot of these issues is harder than giving a supplement. It takes more work than just giving your child a pill. 

Dr. Cara Goodwin: Yes, but how nice would it be if we could just give our kids a pill that changed their behavior?

Dr. Krupa Playforth: It would be so great. Or if you give your child a pill that's really just going to help them feel better. If you're struggling with some kind of issue, I mean, we all want our kids to feel better. It is tempting to believe the claims of these companies because we do want our kids to feel better, to thrive. It makes sense. I understand why it's tempting. I really do.

Dr. Cara Goodwin: So speaking of supplements that might impact mood, what do you think about Omega-3 supplementation? Would you ever recommend that?

Dr. Krupa Playforth: I think the data on Omega-3 is still in its infancy. We know that  Omega-3 fatty acids are important substances that the body needs for a range of different things, and that includes things like cognition, neurologic functioning. There are some studies that show that maybe there's an impact on certain types of neurodivergent behaviors, but I'm not fully convinced by the data we have because I think that there are other studies that show that Omega-3 supplementation does not have that impact. You still run into the same issue of how much do you give and where do you get it from.

I think if you can try to incorporate dietary sources of Omega-3 fatty acids, fatty fish, shellfish, some nuts and seeds and vegetables do have some Omega-3  fatty acids, but they're not quite as bioavailable as they are from other dietary sources like fish. I think if you can get it through the diet, that’s probably worth doing. But I also wouldn't stress about it over time. If there is more data, obviously I will share it. You will share it and then maybe the recommendations will change. I don't know. What do you think? You've looked at this data.

Dr. Cara Goodwin: I'm not fully convinced by the data myself. There's part of me that thinks like that  it doesn't hurt, but I agree. I'm not fully convinced that this will have a major impact. I've seen a lot of formulas and milk that are supplemented with Omega-3 . Would you say that extends to that as well?

Dr. Krupa Playforth: I think if it's there, I agree with you, it's probably not going to be harmful to your child. Do I think that you should pay exorbitantly more money for it? Maybe not. I'm not sure I'm convinced enough for that. But if it's there and if it's something you're purchasing anyway and it also has a little bit of the Omega-3s, I mean, it probably isn't harmful.

Dr. Cara Goodwin: Yes, it’s not going to hurt. So what about elderberry, vitamin C, other sorts of immune support? I know this podcast is coming out in the summer and a lot of us are traveling and we're thinking, how do I make sure my child doesn't catch every terrible thing on the plane? So what do you think about those kind of supplements? Is it worth it?

Dr. Krupa Playforth: Let's talk about what immune-boosting is, first of all, and if it's really a thing because it's become such a hot topic through the pandemic, especially this year when your kids are just endlessly sick. I mean, my kids have been sick probably every two to three weeks, sometimes more frequently than that. It is exhausting and it takes so much out of me as a parent because I catch it all and not to mention then the other kids catch it. It's just hard. It has been a really rough winter and so it's sort of the same concept. If there was a pill, if there was something I could give my kids that I knew would help decrease this burden on us as a family, I mean, it's very tempting.

But immune systems, our immune systems are a lot smarter than we give them credit for. And then a lot of the supplement companies would have you believe they can be boosted but they are designed to function optimally and you don't want to boost them beyond that. That's what an autoimmune condition is, right? It is an immune system that is overactive and starting to blindly attack things it shouldn't. Does a supplement cause that level of boost? Probably not, but I'm not sure that it really helps either. We do have some information and some data that supports supplement use in adult populations. Elderberry is one of these that has been shown to have some beneficial effects when it comes to recurrent illness in adults. But we get back to the same issue of do children process it the same way? Is the dosing the same? How can you figure out what the dose is for a two-year-old versus a ten-year-old? What is the right dosing for each population? Because you don't want to be giving something that isn't going to give you the effect that you're seeking. 

When it comes to immunity, it's important to remember that these recurrent illnesses are not a sign that the immune system is not working. They're actually a sign that our kids’ immune systems are doing exactly what they're designed to do, which is to recognize illness, to fight the illness, to develop a blueprint for the future when they're exposed to this illness again. It's not like we're dealing with a world full of immune-deficient children. We're dealing with a world full of children whose immune systems are doing exactly what they're supposed to do. It's just really taxing on us.

Dr. Cara Goodwin: It would be so great to reduce the number of illnesses. If there was an easy way to do it, I would definitely choose that way out.

Dr. Krupa Playforth: The best way to do it is the simple stuff. You wash hands, you keep your kid home when they're sick. I mean, I know that's not that easy to do if they're sick endlessly. You also are a parent that has to function and do other things. You wash hands, you minimize exposure to sick people. You try your best to keep them physically active, to give them nutrients, to offer them nutritious food. We have evidence about vaccination. That is one of the most important things you can do to optimize your child's immune system. Giving them the blueprint to then fight some of these illnesses. All the preventative health stuff that we talk about, it's not sexy. None of that stuff is sexy to think about or talk about.  But it's the stuff that actually has data that shows that it works.

Dr. Cara Goodwin: Yes, that's true. Not sexy, not exciting, but it actually works. So what about supplements for neurodiverse children? We've touched on this a little bit, but are there any supplements that are shown to have a positive effect for neurodiverse children, like children with ADHD or autism that parents should consider?

Dr. Krupa Playforth: I think what's tricky about the category of neurodiverse children is that there is so much diversity within that category. It's really easy to just assume that one child who has ADHD is the same as another child who has ADHD. And one child who is on the spectrum is the same as any other child. But any parent who has experienced this will tell you that their child is unique. And that's actually true of neurotypical children as well. Every child is unique for certain types of conditions. 

We know that something like, for example, melatonin in a child that is struggling to sleep because of their underlying issues, melatonin can help them sleep. And then sleep then has the domino effect of helping across a myriad of different body functions, behavioral functions. So I do sometimes recommend melatonin in that situation. The benefits outweigh the risks, but it's something we always talk about because a parent really needs to have all that information to be able to make that judgment call, because they're the ones that know their kid the best. I think it's really tempting for a parent whose child is struggling with any kind of issue to really seek some solution that's just going to fix the problem. 

Oftentimes the solution is just more complicated than that. Focusing on behavioral resources, focusing on therapy, focusing on making sure that they're getting other medications that are going to help them thrive. Doing all of those other things is probably the most important thing that will help your child. And then any supplement that you do may be a little bit of gravy on top, but I don't think it's going to be the defining thing that's going to change your child's experience or yours as a parent. I don't know, what do you think?

Dr. Cara Goodwin: What I always say to parents is that the research on supplements is mixed. But the research on behavioral therapy and some medications, it depends on what the child's diagnosis is– that research is very robust and consistent. If you have the time and the energy to also do these supplements and there are no negative side effects, that's great. But put your eggs into the basket of what we know works. If you only have so much time and energy, which we all do, invest in behavioral therapy because we know that does work.

Dr. Krupa Playforth: There's a natural fallacy to this. It's so tempting to think that just because something is natural, it's better, and that's true for all kinds of supplements, but it's not always the case. I like what you said about putting your eggs in the basket that we know is going to yield the most result.

Dr. Cara Goodwin: Yes, I think that's such an important point you make about these supplements being natural, because I think that's a term that these supplements use in their marketing is it's all natural, but what does that really mean?

Dr. Krupa Playforth: Organic even can mean so many different things like arsenic and cyanide are natural. It doesn't mean they're healthy.

Dr. Cara Goodwin: Natural does not necessarily mean that it's harmless. So the major takeaway that I'm getting from you is that it's pretty complicated, it's nuanced, and that there isn't exactly a pill that's going to be a cure for all the problems you're having. But there may be some supplements that are helpful and you always have to think of the risks and the benefits. And this nuanced message that I'm getting from you is not what I typically see on social media and on the Internet. 

I'm so curious, how can we as parents navigate when there's so much out there. We don't always have access to our pediatrician, but we always have access to social media and the internet. What advice do you have for parents on finding medical advice that is actually legitimate when it's the middle of the night and you're having these problems and you don't know what to do? How do parents know what to trust and what not to trust?

Dr. Krupa Playforth: Credibility is important, and frequently credibility comes with qualifications. Parents embraced social media way before physicians did. And unfortunately what that meant is that there was a vacuum of information and a lot of people without appropriate qualifications jumped in and started creating content and making themselves seem like good resources. If you took a step back and you looked at things objectively, those people didn't necessarily have the qualifications. 

The other thing to know about social media, again, it's the same message of be suspicious of social media. It is easier to grow on social media if you are black-and-white, not nuanced and you're saying controversial things. Those are the people that are going to grow the most and potentially have the biggest following, which is unfortunate because then those are the people that social media platforms will show parents. 

I think more and more physicians are starting to recognize that if social media is where parents are getting information, then it is our responsibility to provide credible evidence-based information that has nuance. I think a lot of physicians and other qualified healthcare professionals like yourself don't necessarily get the same benefit of being clickability and therefore being shown to larger audiences because what we're saying is not always sexy and it's certainly not always controversial. It's harder for parents to find us, but it doesn't mean that those resources are not out there if it is the middle of the night. 

The reason I created my website and my entire platform was because I wanted to combat that middle of the night Google search that most parents have experienced, including myself, if I'm honest. When it's the middle of the night and your child has a fever or it's Friday night, because of course they're always going to get sick on a Friday night. And you're like, okay, they have a fever. Like, what do I do now? Do I panic? Do I need to go to urgent care? Do I need to go to the ER? How high? What if the fever is like 105? Do I need to panic? Now? That feeling, if you go onto the mom's group or the Internet, you are going to find people that are like, well, of course you should panic. It's 105. My kid had a seizure when they were 105. You're going to find that selection of information and it's not going to help. It's all fear-mongering. 

What you want to do is seek out resources from people who have credibility and qualifications and really aren't always saying the sexy thing, people who are more committed to saying the evidence-based thing than the sexy thing and focus on getting your information from those resources. I think that your platform is actually one of my favorites for this reason, because I think sometimes you say things that are really not what social media or the status quo believes, and I'm sure you get a lot of pushback from people about it.

Dr. Cara Goodwin: I do.

Dr. Krupa Playforth:I find that when I talk about COVID for example, I get a lot of pushback and there have been moments in my social media career where I've been very tempted to just stop because it can be very demoralizing to be out there putting out that information and having people attack you. But I just really strongly believe that it is the responsibility of qualified healthcare professionals to provide parents with information. I think that sometimes, like you said, you don't always have access to your pediatrician. Not everyone has great access to their pediatrician, or even when they do, those interactions are rushed and sometimes they feel dismissed. They don't feel like they have the space to ask all the questions that they have or that they don't feel like the healthcare provider has the bandwidth to answer all of the questions that the parent has. And sometimes I think that some healthcare providers really don't seem to make the assumption that parents are smart. I think that they just feel like they shouldn't be questioned. But that balance is shifting and I'm seeing more and more, especially pediatricians, that are recognizing that parents are smart. They just care deeply and they want to do the right thing. So you want to find resources that help you do that.

Dr. Cara Goodwin: That is such helpful advice. I think that's really helpful to know. Who can I trust? Who can I not? Your account and your website is such a great example of somebody who has the credentials and also puts the power back in the hands of parents saying, “I understand you're smart and capable. Here's what we do know ti make your own decision." Thank you so much for all this advice. It's been so incredibly helpful. Where can parents find you if they want more information?

Dr. Krupa Playforth: I'm on Instagram and Facebook at @thepediatricianmom and also my website is www.thepediatricianmom.com. For parents who are in the DC, Maryland and Virginia area. I am opening a pediatric practice, hopefully later this year. I'm going to keep it very small and intimate so that I can make sure that I am providing care to the standard that I expect for my own kids and so that we're not creating this environment where parents are feeling dismissed and rushed and not heard. That’s the goal.

Dr. Cara Goodwin: That sounds really amazing. Because it's not always the case with pediatricians, unfortunately.

Dr. Krupa Playforth: No. It's a shame. I think most pediatricians want to do it, I'll be honest. They just aren't in a system that allows for that, which is tragic.

Dr. Cara Goodwin: It is very unfortunate. Well, thank you so much for coming on and answering all the questions about supplements. This is so incredibly helpful and I know it'll be helpful to other parents, so I can't thank you enough.

Dr. Krupa Playforth: I know we talked about elderberry and vitamin C. I actually have free resources on my website that go through all the data on elderberry, especially in kids. I have a free download on immunity, and I go through the data on the main immune supplements that are available and really what does the data actually show. All of that information is free. Everything on my website is free.

Dr. Cara Goodwin: Amazing. It was so good to have you here. It was so helpful. I know I will be digging into those resources later as well. Thank you again. This has been so helpful. And thank you everybody, for tuning in to the Parenting Translator newsletter and podcast. Listen next week for more research-backed tips for parents.

Dr. Krupa Playforth: Thank you.

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Welcome to the Parenting Translator newsletter! I am Dr. Cara Goodwin, a licensed psychologist with a PhD in child psychology and mother to three children (currently an almost 3-year-old, 5-year-old, and 7-year-old). I specialize in taking all of the research that is out there related to parenting and child development and turning it into information that is accurate, relevant, and useful for parents! I recently turned these efforts into a non-profit organization since I believe that all parents deserve access to unbiased and free information. This means that I am only here to help YOU as a parent so please send along any feedback, topic suggestions, or questions that you have! You can also find me on Instagram @parentingtranslator, on TikTok @parentingtranslator, and my website (www.parentingtranslator.com).

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