The Sleepover: From a dad, a doctor, and child abuse advocate

One of my daughter’s had her first sleepover. She was invited to a play date and as the day went on the play date turned into a sleepover. The decision to let her spend the night at someone’s house was easy for me. I have wonderful memories from those days and wanted her to have the same. Besides she was super excited at the idea.

Many parents are on the fence about the need for a sleepover. Will my child be better off for going? Will they be deprived if they don’t go? Obviously, I am in favor of them. Maybe naively so but I trust people.

I trust people because I see the worse of what happens to children as the medical director of the Collier County Child Abuse Team. The overwhelming majority of people are trustworthy. Given the number of sleepovers that happen every weekend night and the number of abuse-related cases that end up in my clinic, sleepovers are hardly a concern. Of course, every parent should do their due diligence before allowing their child to sleep away from home.

Here are several good reasons to say yes to sleepovers:

  1. Your kids will get a chance to practice the manners you teach and you will glow when you hear how well they behaved.
  2. Your kids will get to do and try different things – food, games, travel, etc. they may not otherwise, which is all part of making it a treat.
  3. Your kids will make new friends, and so will you.
  4. Your kids will get to learn social boundaries and custom – how to behave in someone else’s house, car, etc. is different than behaving at home.
  5. You and your kids will have a chance to unwind and relax, away from the constant attention of each other.
  6. You and your kids will be on the path of mutual trust.
  7. Your kids will have meaningful connections and happy experiences to look back on and this is what it is all about.


O Xbox, Xbox, Wherefore Art Thou, Xbox?

“How much gaming screen time should be allowed?” is an oft-asked question by parents, my kids and my friends. “But I am a good kid, I make good grades, I play two sports, and rarely get in trouble,” is the reply I often hear as the debate unfolds in my house, at the office, and likely your house.

Regardless of a child or teen’s stated qualifications, TV time, gaming time, or general screen time for more than two hours a day, every day, without a decompression period outside and time for ordinary family interaction is detrimental.

Make no mistake this is a minefield that ought to be carefully navigated because your child may be seeking recognition for their effort as well as arguing for a dopamine hit.  

Inevitably you will be hit with, “But why?”  This is a great question and one your teen should ask. Remember your child is looking for acceptance, mastery and independence. Saying ‘no’ to your child is a poor man’s way of saying, “I love you and need you to learn other skills too. This is also unhealthy.”

Here is reasoning to support more eloquent ‘No’s’:

1. Sitting in front of a screen down-regulates the number of dopamine receptors in the brain’s reward processing area. As a result, the ability to feel pleasure is decreased so more and more stimulation is sought.

2. Heavy use of screen time results in an imbalance of activities of daily living, such as sleep, learning how to empathically communicate, and take on new hobbies.

3. Malcolm Gladwell famously surmised that it takes 10,000 hours to be world class in any field.  That would take 13.69 years spending 2-3 hours a day to become world class. Now that could be spent on social media, games, or in that same time, you could learn how to play guitar, improve grades, train to be a better athlete, serve your community, become an artist, learn to cook, and gain emotional resilience. 2-3 hours a day can solve almost any problem.

4. Even the most cleverly designed games are limited in creativity and offer only the illusion of choice.  Would your child rather work towards someone else’s goals bound by their limitations and rules or create their own goals and lay down their own rules? Your child’s brain has unlimited possibilities when playing without restrictions.

5.  Some games are rich in narrative and layered with Shakespeare-worthy metaphors.  In rare instances, games can be seen through the lens of artistic expression, but those that are worthy of being labeled art are few and far between.  Most games are designed with addictive behaviors in mind and are singularly focused on turning a profit.  For example,
loot boxes are a controversial monetization scheme employed by gaming companies which is no more than a thinly veiled gambling system effectively marketed to children.  

At the end of the day, we are not trying to take anything away from our children and we need to be certain that message comes across.  We are giving them our attention, our love, and encouragement to pursue their interests.  One of the most successful strategies to reach someone is to go to them in their interests and needs.   Commit some time in their space doing their interests with them first.  Turn the game or media into a talking point and a teachable moment, but keep it a two-way conversation.

If all else fails you may need to put your foot down, remove the screens, set boundaries, and suffer some lashing out.  Remember that social media and games hit all the same pathways as substance abuse and there will be some withdrawal.  Have sympathy and sit with them in their pain as you remind yourself in silence that you are their parent and not their friend. 

Good luck. Teaching your children is the best game played.

Probiotics: beneficial or spore taste?

Written by Special Contributor, Jennifer Barrell, MS, CNS, LDN

Spore probiotics are spore forming bacteria or soil-based organisms (SBO’s) that come from Mother Nature. Synergistic in nature, they come from the soil and are found in animals as well. Spores are like tiny seeds that blossom in the warm, humid climate of our intestines. It is generally believed that in modern day we have lost touch with the earth (literally) and therefore we could be lacking in these beneficial bacteria that may offer a wide array of benefits. The most widely studied spore species may arguably be Bacillus subtilis, however there are MANY more!

B subtilis is a spore commonly found in the soil around the root and grass level. It is known as one of the most resistant gram-positive bacteria. B subtilis started its journey as a supplement in 1958 when an Italian company began using it as a treatment for Small Intestine Bacterial Overgrowth, or SIBO. SIBO is a condition where bacteria start to grow in an unwanted territory- the small intestines. Risk factors for SIBO include chronic constipation, low stomach acid, multiple rounds of antibiotics, Crohn’s disease, Celiac disease, or prior bowel surgery. Symptoms include abdominal pain, bloating, distension, constipation, diarrhea, gas/belching and malnutrition.

Spore probiotics’ biggest claim to fame is their durability: they are heat stable and can survive a low pH. There is also much science indicating they can resporulate.  All of this means they transport well in supplement form (no fridge needed!), they have a better chance of making to the intestines and they may actually re-inoculate the gut with their beneficial selves.  However, repopulation may not always be the end goal. SBO’s have been known to induce gas and other unfavorable GI symptoms. They may also stimulate the immune system, which could be beneficial for some, but not others.

Regular probiotics are native to the human body; be it in the gut, skin, nose, mouth, etc. Most effective probiotics list a genus, family and strain. A common example would be Lactobacillus (genus) rhamnosus (family) GG (strain). Probiotics with good science behind them almost always list the strains. Specific probiotics are good for specific symptoms, and the strain is what helps indicate what that particular one will do. Unfortunately probiotics are delicate bugs, so they have the highest chance of survival if taken first thing on an empty stomach, preferably with something like yogurt (for powders or open capsules).

Their delicacy brings up the point of refrigeration. Is it necessary? Why do some survive a box on the shelf and others don’t? It really just depends on the strain. Some are more delicate and require certain climates to remain stable; making it imperative to follow the manufacturer’s instructions. Probiotics are also transient, and they do not repopulate. This does not take away from their strength of action. When specific strains of probiotics are correctly matched to the appropriate symptom for enough time, their effects can be seen far and wide. 

The take away here is that they are both beneficial, it just depends on what outcome you are looking for. Research (and experience) indicates certain spore forming probiotics can helpful for patients with IBS or allergies, and taken concurrently with antibiotics. Taking them for 3 months to one year may suffice.


More about the author:

Jennifer Barrell, MS, CNS, LDN, is a wife, mother of two perfect little ones, and a functional/clinical nutritionist currently living and helping people navigate their way to health in Naples, FL. 

When Mom has the Flu?

You do not want to give up snuggle time but you also do not want to be Typhoid Mama either. So what is a dedicated mom to do…


You want to generously dole out affection but not germs.


#1 Wash your hands.  Everyone wash your hands with soap and water.  There would be far less infection in the world if everyone washed their hands more frequently.


#2 Keep your distance.  Maintain at least a 3 foot bubble from all loved ones unless you have recently washed your hands and have not sneezed all over yourself.


#3 Wear a mask.  Not just any disposable mask, but a N95 mask that blocks 95% of  particles that are 0.3 microns.


#4 Continue to nurse. New mommies may consider maintaining space from infants, but should continue expressing breastmilk because nothing is as nutritious and helpful to a baby’s immune system as breastmilk.  Mommy should wash her hands and wear a mask when expressing milk while a healthy family member handles feedings if possible.


#5 Disposable tissues. This will help reduce the spread of germs often associated with sneezing and coughing into the air, clothes, or hands.  Flu germs can stay airborne for about 3 minutes, so anyone who walks into the that once empty space you sneezed in may get sick.


Remember illness usually has a lower severity when the virus enters a healthier terrain. Eat well, sleep well, exercise well, hydrate well, relationship well – daily. 

Vaccines: History, Culture, and Countermeasures


This will be a full length three-part lecture on the topic of vaccines beginning in the origins of vaccines, then taking us to current state of social discontent, and concluding with a discussion on the measures you can take a concerned parent.  We are currently seeking an appropriate Naples based venue for the event.  Please RSVP early, or ask to be kept informed about the event by calling us and giving us your contact information.  We will be collecting ticket revenue for this event to offset the costs of the venue with extra revenue being donated to a local children’s based charity.  We look forward to hearing from you and seeing you at the lecture.