Mary Lou Hulseman, MD

August 2024

The incidence of autism and other developmental difficulties has been increasing since the 1980’s.  Data suggests that this increase is likely due to environmental toxins and some nutritional issues affecting both parents.  The quality of sperm has deteriorated over this time.  Infertility has increased, as has preterm delivery.  The developing fetus is exposed to the toxins from the mother and does not have effective ways to eliminate them.  Therefore, addressing toxic exposures and adding specific nutrients well before becoming pregnant likely will reduce infertility and optimize childhood outcomes.

Both parents should compulsively avoid toxins and detoxify their bodies, ideally starting months before considering conception.  Continue avoiding toxins indefinitely.  Below are logical steps to take:

1. Eat pesticide, chemical and antibiotic free foods.  Avoid aspartame and other artificial sweeteners, MSG, and preservatives.  Avoid storing or heating foods in plastic.  Avoid bottled water for this reason. 
2.  Never eat GMO foods (especially corn syrup, sugar and soy).  These foods are full of glyphosate (Roundup), which is known to cause cancer in rats and is associated with risk of autism.  Use the app from www.ewg.org called Dirty Dozen to avoid the most toxic vegetables.
3. Avoid the following fish:  Shark, Swordfish, King Mackerel, Tuna, Tilefish from the Gulf of Mexico.  The Environmental working group also has extensive lists of fish to avoid.
4. Decrease chemicals of all types in your home.  Clean with baking soda, vinegar and “environmentally friendly” products.  Use only no VOC paint in the home.  Avoid replacing carpets within several months of conception.  Do not use pesticides in or around the house.  Use only organic products on the lawn (as opposed to chemical fertilizers and weed killers).
5. Use fewer chemicals on your skin.  Avoid or decrease use of make up, perfume and lotions.  Use coconut oil on your skin for a lotion. 
6. Consider a medical grade HEPA filter to clean the air in your home.
7. Get a medical grade or high grade carbon filter for the cabin of your car.  Keep your windows rolled up while driving in heavy traffic to decrease inhaling air pollution.
8. Do not travel to heavily polluted cities for months prior to conception.
9. Unless your water is known to be of high quality, consider a whole house carbon filter or reverse osmosis filter for drinking water.  (this is a must in Indiana)
10. Remember that EMF (electromagnetic fields) from wireless devices are a form of toxin.  Studies show that EMF can adversely affect development in animals.  Keep your computers and other devices wired where possible.  Turn off routers at night (especially when pregnant).  Fathers should keep their laptops off their lap! (EMF affects sperm quality and production).  Keep cell phones away from your abdomen, especially when pregnant or keep the phone in a heavily shielded cell phone case.  (www.theemfguy.com for more info).  Continue to keep electronic devices away from young children.  Due to the addictive nature of electronic devices, consider no smart phones until your child is 16 years or older.
11. Stop smoking, if you smoke.  Avoid alcohol for 3 months prior to conception. Avoid drugs and medications as much as possible.  Do take medications as prescribed but be sure to let providers know that you are pregnant.  Do not take Tylenol while pregnant.  (may increase the risk of ADHD and autism)
12.  Consider possible pollution from your work environment.  If there could be chemicals that get onto your clothing at work, dad should change his clothes before coming home (and ideally shower immediately at work, or as soon as he arrives home).  Put the clothing immediately in the laundry away from the bedroom.  Pregnant women should not work with chemicals, or if absolutely necessary, then take extensive precautions, including wearing N95 masks at work.
13.  Avoid insect repellants on your skin (okay to use non-toxic varieties).  For a few months prior to pregnancy, avoid lots of time spent in areas where insect transmitted disease is common (to avoid exposure to zika virus and Lyme disease, for example)
14. Moms should avoid cat litter and horse manure while pregnant (unless she has blood work documenting she is immune to toxoplasmosis—a parasite carried by those animals).
15. When possible, avoid taking antibiotics and if you do, take probiotics, especially saccharomyces boulardi, during and at least 2 weeks after taking them

In addition to avoiding toxins and healthy diet, attend to the following medical and nutritional issues:

1. Both parents should have their doctor check their vitamin D level and if below 50, take an additional 5000 IU/day of vitamin D3, or get sunshine (no sunscreen) for 30 minutes a day or more.  
2. Future moms should have blood work for thyroid functions and ferritin (a sensitive test for iron) done several months prior to conception and correct abnormalities. 
3. Mom should have vaccine immunity titers done for chicken pox and Rubella and be immunized well before conceiving, if needed.
4. Unless done within the last 3 years, get a tetanus-pertussis vaccine 2 to 3 months before getting pregnant (to protect the newborn from whooping cough).  Have any adults who will be around the baby also get immunized.  If possible, avoid flu, COVID and other vaccines when pregnant, especially in the first 12 weeks of pregnancy.  If mom is not clearly immune to COVID, she should be immunized several weeks or longer prior to conception. 
5. Both parents should take high quality multivitamins with methylfolate 1000 mcg a day and vitamin D 1000 IU/day starting several months before conception.  (I recommend Orthomolecular Mitocore for dad and Healthynest Prenatal vitamin for mom.  Moms may want to consult the app Prenatal Rater).
6. Both parents should also take high quality fish oil, 2 to 4 grams twice a day.  Fish is contaminated, so purchase from a high quality vendor who has removed the pollutants.  Prescription Lovaza is good, as are products from Nordic Naturals, Thorne Research and Orthomolecular.  
7. Moms should continue these supplements at least through pregnancy and nursing.  
8. Mom’s diet during pregnancy should be high in fiber, dairy free (especially if a previous child had autism), low in gluten and sugar.  Squeeze ½ lemon into water taken with meals to improve digestion.  Avoid soda of all kinds (aspartame in pregnancy has been linked to autism)
9. Plan to breastfeed exclusively for 6 months and continue breastfeeding for at least a year, ideally two.  Continue supplement and nutritional rules while breastfeeding.  If formula is needed for supplementing breastfeeding, use organic formulas only.  If your baby has reflux, colic or constipation, consider probiotics for the baby and elimination diet for breast feeding moms. (that is, avoid foods that you suspect could cause a problem–especially dairy, wheat, corn and soy– for your child for at least 10 days, then restart and watch for symptoms to recur)
10. Consider giving newborns the probiotic L rheuteri for the first month or more of life, especially if delivery is by C-section or if antibiotics were given during labor and delivery
11. Introduce cultured food such as sauerkraut and yogurt in the first year of life, before fruit, so the child will accept these healthful foods.

Detoxification occurs with good nutrition, avoiding toxins as above and sweating.   Most known toxins are removed thru the sweat.  At least one study showed that it did not matter whether one sweats with an infra-red sauna, steam sauna or exercise.  Try to sweat for at least 30 minutes daily prior to conception. Pregnant women should stop sauna use and intensive exercise (to the point of sweating) while pregnant, so as not to mobilize toxins into a developing fetus.  Exercising at a moderate level is good during pregnancy, however. 

After conception occurs, consider a mid-wife or family practitioner to be the prenatal provider.  Consider a doula (labor coach) for assistance in labor.  Unless there is a medical emergency, avoid induction of labor.  Work to understand reasons why a need for C-sections might occur and what you can do to avoid them.  C-sections do not allow the normal exposure of the infant to mom’s bacteria, leading to numerous effects on health and development. Ways to decrease C-section risk include moderate exercise while pregnant, avoiding excessive weight gain, avoiding inducing labor, being allowed to move about during labor, having a doula, avoiding medications and avoiding early use of epidural.

Unless mom is Hepatitis B positive (all pregnant women are checked for this), do not give your baby the Hepatitis B vaccine until they are much older (ideally as teens, if at all).  They are not at risk of getting Hepatitis B, as it is transmitted sexually and through blood products.  Read about vaccines and space them out as much as possible.  Ideally do not let your baby have more than 1 injection every 6 weeks and never allow an immunization if the baby is ill.  Consider delaying vaccines for the first 1 to 2 years of life (discuss with your doctor). Never give Tylenol with vaccines (it decreases the effectiveness and response to the vaccine).