The Gut To Brain Connection. What’s Its Role in Development?

You are what you eat. How many times have you heard that? As adults, we certainly have considered this when it comes to our own food intake, but what about our children? As a Physical Therapist, I have a mental checklist of things to consider when traditional interventions aren’t progressing a child’s motor development:

• Could they have residual fluid in their ears from chronic ear infections?
• Could there be a leg length discrepancy?
• Are there sensory integration challenges interrupting independent movement?
• Is their vision typical?

Nutrition was never high on that mental checklist. I never considered it beyond, “Is it adequate to support motor development?” That was before I met Finn.

Meet Finn

I worked with Finn for 2 years as his early intervention physical therapist. Shortly after his birth, his parents – Jennifer and Alex – noticed how often Finn was fussy. His first pediatrician thought it was simply colic, but as Finn grew older, his parents’ concerns also grew. Finn spit up more frequently than other babies, had frequent thought-to-be eczema patches, was fussy more than he was content and couldn’t self-soothe or be soothed by his parents. Finn seemed spaced out and had significant delays in social, language, and motor skills, which became more noticeable as he grew older.

The most alarming observation was head banging. It started at night when Finn would bang his head against his crib to fall asleep but progressed to banging throughout the night, and then even during the day, while playing. Finn would find the corner of the wall and bang his head until a bald spot eventually appeared, and he didn’t seem concerned by the discomfort. These behaviors and symptoms seemed to further enhance a growing global developmental delay.

What’s Wrong With Finn?

Jennifer and Alex believed these symptoms were more than eczema or colic and began a search for what was going on with Finn. Finn started taking medication for acid reflux, which helped with spitting up, but not with other symptoms. Because he had a history of reoccurring ear infections, he had tubes placed in his ears. Shortly after the procedure, he started to walk, but the communication and social skills continued to lag behind and the head banging intensified.

Finn’s early intervention team (speech, physical, and occupational therapists) offered strategies from sensory integration and balance activities to basic imitation skills in play as a basis for eventual language development. A developmental specialist observed and worked with Finn on self-soothing and deterring techniques for the head banging. After the sensory strategies failed, a head MRI and a detailed autism screening revealed no concerns, the team called on a registered dietician through the West Virginia Birth To Three Program.

A gastroenterologist ruled out eosinophilic esophagitis (EE) – an allergic inflammatory condition of the esophagus – and Finn was finally referred to a pediatric allergist. Blood testing and 3 days of extended patch testing revealed that Finn was allergic to soy, wheat, dairy, oats, and intolerant to phenol, a chemical compound found in many natural foods and artificial preservatives.

New Diet

New diet With larger fears put to rest, Jennifer and Alex had a whole new world to learn about. It was no easy task to find foods that were safe for Finn and that he would actually eat while maintaining the required calories and nutrients for his age. Jennifer shared, “To be completely honest, I wasn’t sure that I believed all the diet changes would help. I prayed that they would, but deep down I was skeptical. To think a handful of goldfish crackers or a couple grapes could cause him to struggle for days and completely alter the course of our entire family is something I would have never thought possible, had I not lived it!”

After 2 weeks of the new diet, Finn’s demeanor and development changed dramatically. His mother recalls, “We had food journals and had to document everything he ate, all his skin reactions, behaviors, and try to make sense of all the parallels. About 2 weeks after we had changed his diet, he went from having about 5 words to over 70 words, and eventually no longer needed weekly speech therapy!”

Within 5 months, Finn has made over a year worth of progress with development. Now he’s walking, running, climbing, talking in complete sentences, initiating social greetings, and, most importantly, he’s a happy 3½ year old. Affectionate and silly, he’s quite the charmer to his 3 older sisters.

Gut to Brain Connection

Finn isn’t alone in his diagnosis of food allergies. According to a study by the Center for Disease Control, food allergies increased 50% from 1997-2011. Although more and more people have food allergies, there’s no clear answer as to why. While many “traditional” allergic symptoms, such as facial swelling and hives, are well-recognized, others – such as the ones Finn experienced – are often misdiagnosed.

Georgeann Freimuth, MS, RD, LDN – the Registered Dietitian who solved Finn’s puzzle – sees more and more children suffer behavioral and developmental consequences as a result of what they eat. When people question the relationship between the two, Freimuth jokes, “Think there’s not a gut to brain connection? Come have a glass of wine with me!” In all seriousness, the effects of nutrition on the body shouldn’t be ignored. Freimuth says, “The gut to brain connection should not be overlooked when dealing with a child who is sensitive to emotion, anger, anxiety, or who has behavioral concerns. This is important because the brain and the gastrointestinal system are intimately connected. Certain foods and food intolerances or allergies can adversely affect a child’s behavior and attentiveness, while certain nutritional deficiencies can cause aggressiveness disorders and behavioral disorders as well as subtle and occasionally dramatic effects on the child’s behavior.”

She continues, “Food allergies or food intolerances can affect the nervous system by altering brain chemistry, which then can affect a child’s behavior. Understanding if a child has food allergies and/or food intolerances along with nutritional imbalances could be helpful when trying to help a child’s behavior or development.” Eliminating aversive foods can be helpful in some cases; increasing nutrients and minerals that are below typical is necessary in others. For example, increasing zinc intake can improve symptoms associated with ADHD.

Freimuth advises, “Intolerances to foods, food additives or looking into food allergies may have a crucial role in a child’s behavior. Behavior and cognition in children and adolescents can be influenced by what they eat and their nutritional statuses.”

Although nutrition isn’t the culprit for all developmental or behavioral concerns, it certainly is a possibility. As a practicing therapist, I will never rule it out again. It has a permanent spot on my mental checklist.

Roadblocks

The more we – my business partner Lacy Morise, MS, CCC, SLP, and I – work with children and families, the more we start to recognize patterns. We often discuss roadblocks in the way of a child’s development: some are created by caregivers or the environment, and others, like Finn’s nutritional concerns, are biological. Often, these roadblocks could be changed or at least managed if recognized.