Wednesday, December 12, 2012

Happy 12/12/12!

I decided to save my one-hundredth post for 12/12/12.  It is such a cool date.  I wore the number 12 when I played soccer in high school so the number has always had a special meaning to me.  It is even more special considering we won't see another repetitive date until January 1, 2101.  I hope my kids will be able to see it but I know I won't so I am enjoying the day.

There has been quite a few cool things posted about today that I thought I'd share some links.  Mental Floss had been posting lists of 12 things every hour all day long.  Here are my favorite ones:
12 Terrible Pieces of Advice for Pregnant Women
12 Mind Blowing Number Systems from Other Languages
12 Fascinating Moments in Winter Clothing History
12 Star Trek Gadgets That Now Exist

Even CNN had something to say about 12/12/12.  Here is a great article about "Odd Facts about 12/12/12."

I always thought it would be cool to be born on a day like today.  There is a website that you can go to determine if your birthdate (or any day for that matter) has any sort of "pattern."  The website contains a "date pattern calculator."  It is just my luck that my birthdate has no pattern!  Oh well...

I hope you all enjoyed 12/12/12!

Thursday, November 8, 2012

Breastfeeding Doll?

I just came across an article about a breastfeeding doll.  As many of you who have taken the time to read my blog, I am very pro-breastfeeding.  I have breastfed my older son until he was 22 months old and am currently breastfeeding my 3-month old.  I have no problem breastfeeding in front of my older child because I believe that breastfeeding is a completely natural thing.  If he has any questions about it, I am happy to tell him that I am feeding the baby and that is how the baby eats.

However, I have to admit that I have mixed feelings about a doll that breastfeeds.  I don't have a daughter so this is probably not going to be something that I will be asked to buy.  If I did have a daughter, I would have no problem letting her "play" with her doll by pretending to breastfeed it by holding it up to her chest.  I find it a little uncomfortable that in this particular instance, a little girl can strap on a halter top with sensors that allows the baby to "breastfeed" complete with suckling sounds.  "The dolls, eight in all with a variety of skin tones and facial features, look like many others, until children don the little top with petal appliques at the nipples. That's where the sensors are located, setting off the suckling noise when the doll's mouth makes contact. It also burps and cries, but those sounds don't require contact at the breast."

I don't know, I think a big part of me finds this a little creepy.  I think this is taking pretending to breastfeed a little too far.  I don't think she needs to have fake "breasts" to pretend to breastfeed.  What do you think?  Would you let your daughter play with a toy that will allow her to "breastfeed?"

Monday, November 5, 2012

Yes on Proposition 37!

I hate getting political with my blog but this is one issue that you can vote on tomorrow that I believe transcends political parties and ideologies.  For voters in California, Proposition 37 is a ballot initiative that will require food to be labeled if it contains genetically modified organisms (GMO's).  "Fifty countries around the world—representing more than 40% of the world’s population---already require GMO labeling, including all of Europe, Japan, India and China."  Why aren't Americans allowed to know if their food contains GMO's?

The opposition to Proposition 37 is mainly funded by Monsanto, a Fortune 500 company that sell agricultural and vegetable seeds which have traits "developed through biotechnology."  They also manufacture "crop protection chemicals." This is rather contradictory since Monsanto has been known to support the labeling of GMO's in Britain.  Yet in the US, in opposition to Prop 37, they have been running ads indicating that this proposition will increase food costs.  Studies have been done in Europe (which requires labeling) and of the potential economic impact in the US.  These studies have shown that food prices did not increase as a result of this labeling.

This proposition will also not ban the selling of these foods.  It will just require them to be labeled as being genetically modified.  If GMO's are truly safe, why are they fighting the labeling requirement?  What are they trying to hide?  Why are they denying Californians (and by extension Americans) the right to choose what they eat ?  If this law is passed in California, it will be like a nationwide labeling requirement since manufacturers will not have separate labeling for their products sold in the state of California versus what is sold elsewhere.  If you do not live in California, contact your friends and family that do.  Passage of this law will also let you know if what you're eating contains GMOs.

I have written several blog posts about Genetically Modified Organisms (potential benefits and hazards), Monsanto and about Proposition 37.  I encourage you to read them by following this link.  The older posts are located on the bottom.  Just start from the bottom and work your way up.  As a mother who just wants to know what is in her food and make an informed decision, I urge you to vote YES ON 37!

Sunday, September 30, 2012

2 Month Update - Breastfeeding Woes

These last few weeks have been quite the circus around our home.  Adjusting to life with a toddler and a newborn along with my husband's hectic work schedule has been quite the challenge.  As the baby is getting bigger and my toddler is getting adjusted to life as a big brother, we are hoping to finally turn a corner and have more time to indulge in the little things like write a new blog entry.  Up until this point, my husband and I have had to juggle constantly holding the newborn.  Being able to type with two hands on a computer and not on my phone has been a luxury.

I would have to say that this baby has been an interesting experience when compared to my older child.  They say every baby is different and this is certainly the case for us.  With my older child, I had difficulty breastfeeding in the beginning due to a bad latch.  As a result, my milk took a while to "come in."  Since he was losing too much weight, we had to supplement him with some formula for a few days.  This baby, however, has been completely different.  Since I only stopped nursing my older child back in March (he was 22 months old and I was 20 weeks pregnant), I don't think I ever stopped producing milk.  As a result, my milk was pretty much ready for this baby from the very beginning.  At first it seemed great since I didn't suffer from the issues that typically surround the early days of nursing like sore nipples, engorgement, etc.  I had a brand new tube of Lansinoh and gel cooling pads ready to go and I didn't have to use any of it.  Since I already breastfed my older child, I didn't have any of the latch issues either.  I thought everything was going great until...

Reflux reared its ugly head.  My poor baby seemed to be getting too much milk!  After each nursing session, he would choke and appear to be drowning from my milk!  It was awful!  We couldn't lay him flat on his back as recommended because as soon as we did that, he would start to get horrible reflux.  It didn't matter if we kept him upright for an hour after nursing, he still would begin to spit up and appear to choke on his spit up.  The only way any one in our house was to get any sleep was to literally hold him upright for what appeared to be 24 hours a day.  To say that we are tired is a gross understatement.

Part of my problem after researching some of my favorite websites for information about breastfeeding was that I had a fast letdown (my milk would come out too fast) and I was over producing creating a foremilk/hindmilk imbalance.  With the fast let down, the milk literally came out of my body like a geyser.  Its the craziest thing which never happened with my older child.  I was so impressed by it, I actually took a video of it!  Since it came out so fast and hard, my baby would have to release his latch or risk choking on the milk!  I tried nursing at an incline so gravity would try to slow the flow and the baby would have to "work" at getting the milk out.  That, unfortunately, didn't work since even being flat on my back would cause the milk to shoot straight up.  Also, since I had too much milk, the baby would get full before emptying the breast.  As a result, he would get too much of the watery foremilk and not enough of the fatty hindmilk.  The poor guy had to deal with green, runny poop as a result of not getting enough of the fatty milk.  I had read that pumping before nursing would help but that left me with a catch-22 since pumping stimulates milk production which is what I didn't want to do.

I thought the best solution for everyone was to pump and then feed the baby a bottle at least once a day before bedtime so he could at least rest at night without having reflux issues.  It was a great idea until we realized the baby would not take a bottle!  It seems like if it wasn't one thing it was another.  On top of all of that, if he was going through a growth spurt, he would start cluster feeding which further stimulated my production.

Now that the baby is nine weeks old, it appears that things are beginning to get a whole lot better.  We can now put him flat on his back for at least a few hours at a time (we don't have to constantly hold him) and he is taking a bottle again at least once a night before bed.  I think the bedtime bottle has been key to helping him sleep for at least four hours at a time.   I also think that his reflux is getting better simply because he's a little older and his gastrointestinal tract is more mature and able to better handle eating.

Things are better for the most part but we are, unfortunately, still experiencing little "hiccups" along the way.  Tonight was a little strange since the baby refused the bottle from my husband.  Instead, I gave him the bottle which seemed to break the "mold" when it comes to bottle feeding a breastfed baby.  I have to admit that it was weird feeding him a bottle.  I think with my oldest, I only did that a handful of times like when we were in a car so feeding my babies from a bottle is in general a weird thing for me.

I am hoping this continues so everyone gets more sleep and I may even consider donating my breastmilk.  I had always wanted to do that but never seemed to produce enough.  Now that I seem to be producing too much, it is something that I'd like to explore.  Do you know of any good organizations that I could donate milk to?

I'd also like to share links to my favorite breastfeeding websites that provided me with invaluable information these last few weeks.  I hope that you may find these websites useful if you are experiencing difficulty with breastfeeding.  I would also like any feedback of other websites that are useful to the breastfeeding mother.
My favorite website.  I always look things up here first before exploring other websites.
Great resource for pumping questions.
A Canadian doctor's website.  He's very pro-breastfeeding and I appreciate his insight.
An Australian website with great information.

Saturday, September 8, 2012

Bottle & Pacifier "Strike?"

These last few weeks have been challenging with a newborn and toddler.  As a result, this blog and many other things in my life has been neglected.  My day to day life now consists of nursing every 2-3 hours, changing diapers, cleaning spit up (and occasional pooplosions) cooking, grocery shopping and entertaining a very active toddler.  My time spent on the Internet has been limited to whatever I can do on my cellphone while I nurse.  Typing one handed is frustrating and time consuming.  Despite all of this, I am finding a way to peck this post out of desperation.  I am presently functioning on no more than 3 consecutive hours of sleep since the baby was born 42 days ago.  To say that I am delirious is a gross understatement.  Please excuse any typos or grammatical errors since many things do not presently make sense.

My lovely baby has decided to go on a pacifier and bottle "strike."  He had taken a pacifier and bottle before.  Unfortunately, over the last week, he is refusing to take either one and only wants me to nurse him.  He is absolutely refusing to even latch onto a pacifier or bottle.  We have been trying nightly without any success.  A lot of milk has been wasted in our futile attempts.  To make matters worse, my husband has been working two weeks straight without a day off so I have been his primary caregiver.  I have turned to my favorite breastfeeding website,, for answers and despite trying many of their suggestions, the baby is still refusing to take a bottle.  We have a wedding to attend on Sunday but I am finding it less likely that I'd be able to go if this baby will not take a bottle.  I would also like to start getting more than 3 hours of sleep.  I can't do this if my husband cannot do a feeding with a bottle.  My supply is well established (which brought its own set of problems that I can write another post about) so supply being compromised is not a concern. I have plenty of expressed breastmilk ready to give to him and we do not have to use formula.  We have tried the following thus far:
  1. Feeding the baby when their cues indicate hunger, rather than on a schedule.
  2. Held in an upright position; it is especially important to avoid letting the baby drink from a bottle when lying down. Such a position is associated with bottle caries and an increased frequency of ear infections. Note also that babies should be held often at times when they are not being fed, to avoid the baby being trained to eat in order to be held.
  3. Gently, allowing the infant to draw nipple into mouth rather than pushing the nipple into the infant’s mouth, so that baby controls when the feed begins. Stroke baby’s lips from top to bottom with the nipple to illicit a rooting response of a wide open mouth, and then allow the baby to “accept” the nipple rather than poking it in
  4. Use a silicone rather than a rubber nipple to avoid an unpleasant odor or taste.
  5. Warm the nipple under running water before offering the bottle to the baby.
  6. Make sure the milk is not too warm and not too cold. If when holding the bottle in your palm, it feels warm to the touch, it is most likely too warm. If it feels cool to the touch, it is most likely not warm enough. If you can feel no difference in the temperature of the bottle and your palm, the milk is probably at the right temperature.
  7. Most babies will accept expressed breastmilk more readily than formula.
  8. Offer the bottle while holding the baby with his back to your chest so that he is facing outward, rather than trying to cradle him.
  9. Move with the baby - rock, sway, bounce, walk, walk in circles, etc. as you offer the bottle.
  10. Place the baby in a swing, bouncy seat, infant/car seat, etc. and offer the bottle. Try to distract the baby with something else as you offer the bottle.
  11. Place an article of mother's clothing up near the baby while offering the bottle, or wrap the bottle with an article of mother's clothing.
  12. Lightly tickle the baby's lower lip with the nipple and allow him to pull it in his mouth rather than trying to force the nipple in.
  13. Offer the bottle when the baby is already sleepy or just waking up (but not fully awake) or once the baby is already asleep. Many babies will instinctively suckle at these times.
  14. Try to use a bottle with a newborn or slow flow nipple no matter how old your baby is so that he always has to work hard with the bottle just as he does with the breast.
  15. Having my husband feed the baby without me in the vicinity of the bottle.
We have tried Tommee Tippee bottles and Medela bottles.  Our older baby used the Tommee Tippee, Medela and Dr. Brown's bottles without any problems.  He also used a pacifier until he was four months old and we discontinued using the pacifier.  This baby is six weeks old and I do not know if the six week "growth spurt" is the cause of our troubles.  Does anyone else have any suggestions or ideas??  I love my baby but mommy needs to get some sleep!  

Monday, August 13, 2012

3D Model of Your Fetus?

I just came across an interesting article which talks about a company that can print a 3D model of your fetus and womb using MRI imaging to create the model.  Is anyone else just a little creeped out by this?  I thought getting a 3D or 4D ultrasound was a bit much for myself but getting an actual model takes this to a whole other level.  In the video segment below, they can even make mini models for you to hang from your cellphone!  What do you even do with such a thing?  Do you show it off at family gatherings?

I think ultrasounds have been a wonderful advancement in modern technology.  It can help diagnose diseases before a baby is born and it can help practitioners monitor the health of a developing fetus.  I enjoyed seeing my twice weekly ultrasounds during my non-stress tests but they were to determine if my gestational diabetes was harming my baby.  However, is this taking things a little too far?  This is not a "medically necessary procedure."  What about the long term effects of MRI exposure on a developing fetus?  Has that even been studied?  Also, in the video, they mention CT scans.  Do they use CT scans as well to get the image?  What about the radiation exposure from CT scans?  How is that not harmful to both the mother and fetus?

Would you get a 3D model of your womb and fetus?  If so, what would you do with it?

Tuesday, August 7, 2012

Suggestions for calming a crying baby are welcome.

It seems these days, everyone has their own idea of how to calm a crying or fussy baby.  I have heard things like feeding my baby formula before bed will help him sleep longer or giving the baby some cereal in a bottle will help as well.  After researching those two suggestions, I have decided that those are things that I will not pursue.  I have to admit that for the most part, my little guy has been great.  However, like my older child, there comes a point every night where he becomes fussy.  This time has been commonly referred to as the "witching hour."  To get around this fussiness, I have been trying several methods.  Since I am breastfeeding, I start off by nursing.  I notice that beginning in the late evening to around 11PM, I feel like I am nursing constantly.  He seems to be cluster feeding at this hour and can't seem to get enough.  It has left me quite hungry and thirsty during this time.  It has also turned me into a night owl.  I have always been more of a morning person and this is not something I want to continue.

I have also been trying the methods from the book, The Happiest Baby on the Block, by Dr. Harvey Karp.  In this book, Dr. Karp uses the theory about the "fourth trimester."  He states that babies are born "before they are ready" and therefore, to calm a crying baby, you have to create a "womblike atmosphere."  He recommends the 5 S's to calm a baby.  The 5 S's are:
1. Swaddling
2. Side or Stomach Position
3. Shhhh (White Noise)
4. Swinging
5. Sucking
To accomplish the 5 S's, I have been doing a lot of babywearing with the Moby wrap and swaddling.  This method worked really well with my older son.  Unfortunately, since we're still establishing breastfeeding, we aren't using pacifiers yet.  This baby has a strong sucking need and I think until we introduce a pacifier, I will be his pacifier.  The following video demonstrates the 5 S's (notice the dad is wearing the Moby wrap).

Another method that I have been reading about is the Dunstan Baby Language.  With this method, it is believed that before the age of 3 months, babies will make 5 "sound reflexes."  These "sound reflexes" are a baby's way of communicating.  The 5 "sound reflexes" are as follows:
1. Neh - I'm hungry
2. Owh - I'm sleepy
3. Heh - I'm experiencing discomfort
4. Eairh - I have lower gas pain
5. Eh - I have (upper) gas
If you can identify the "sound reflex" you can determine what your baby needs.  The following are video clips of the 5 "sound reflexes."
As you can see, she was featured on Oprah Winfrey's Show.  A longer video of her segment can be found below:
I was intrigued by this and started paying attention to my baby's cries.  It turns out that I can recognize the "Neh" and "Eh" sounds.  The others, I'm not so sure.  I guess I'll have to try the DVD rather than rely on the YouTube videos.

Does anyone else have suggestions for calming a crying baby?  What has worked for you?

Monday, August 6, 2012

Cereal in the Bottle?

I starting hearing about parents putting cereal in their baby's bottle so they can sleep longer through the night.  I don't plan on giving the baby a bottle of anything for a few more weeks to make sure breastfeeding is firmly established.  However, since I am up every 2 hours to nurse, I decided to do a little research to determine if this has been proven to work.

The American Academy of Pediatrics does NOT recommend giving cereal in the bottle until a baby's digestive tract is ready to process solid foods at around 4-6 months of age.  At that time, they should get the cereal from a spoon and not from a bottle.

Prematurely adding cereal to the bottle can cause the baby to aspirate (inhale into their lungs) the cereal and it can also activate any allergies a baby may have.  I have also written a blog post about breastfeeding and foods to avoid which touches on the American Academy of Pediatrics position of no solids before the age of 4 months.  If you're breastfeeding, it should be done exclusively (without solids or formula) for at least 3 months to protect against wheezing early in life.  If you are using formula, then there is evidence that extensively hydrolyzed formula without cereal is best for the prevention of atopic disease (allergic disease).   Adding cereal to the bottle may cause a baby to "overfeed."  "Putting cereal in the bottle is considered by some to be a form of force-feeding that can cause babies to “overdose” on calories."

I don't believe with a lot of things Dr. Sears has to say but he does break it down in an easy to understand manner why you should not feed your baby solids before 4 months.  Aside from the issues mentioned above, he gives an excellent description of the tongue-thrust reflex.  "In the first four months the tongue thrust reflex protects the infant against choking. When any unusual substance is placed on the tongue, it automatically protrudes outward rather than back. Between four and six months this reflex gradually diminishes, giving the glob of cereal a fighting chance of making it from the tongue to the tummy."  My mom fed me solids when I was 2 months old.  She took pictures and at the time said that is what the doctor told her.  You can clearly see that my tongue-thrust reflex was in action at that age.

This is another great post from a pediatrician who advises against cereal in the bottle because of the issues with overfeeding that this may cause.  "A major study looking for the causes of obesity found that short-circuiting young children’s self-regulation of how much they eat is a major cause of later obesity."   "Cereal in the bottle does just that.  Babies that are fed this way may appear to be unaffected – but those few weeks of added convenience may result in a lifetime of struggles with weight. This common practice may have contributed to our being the most obese generation in history.  And it doesn’t even work. Scientists at the Cleveland Clinic studied the effect of cereal on sleep and found that adding the cereal did nothing at all to speed up the age of sleeping through the night. That first uninterrupted 6-hour stretch of sleep came no earlier in those who took cereal early."

After reading more about the issue, I think putting cereal in the bottle is one thing I will not be doing to my baby in the hopes of making him sleep longer during the night.

Sunday, August 5, 2012

One Week Later... An Update...

Well, we "survived" our first week of being a family of four.  This first week was not as dramatic as his entrance into the world, but I say "survive" because as any new parent will tell you, the first week after delivery can be quite an adventure.  We (including the dog) are all adjusting to the new baby.

The baby is doing well.  He was 7 pounds 1.6 ounces at birth and reached his lowest weight the following day at 6 pounds 9.6 ounces.  At his follow-up appointment on Wednesday, he was back up to 6 pounds 12.7 ounces.  He is nursing every 2 hours round the clock.  It is tiring but worth it seeing him grow.  This is quite the contrast to his older brother that had latch problems.  I am liberally using the lanolin but the pain and sores that accompanied nursing the first time did not happen this time around.  I just weaned my older baby in March and I think that I never stopped lactating.  My milk came in right away and the baby has been eating like a champ.

The baby also did not get any jaundice which may have been a possible concern since I did delay the clamping of the umbilical cord.   Part of it may also be due to my milk coming in so quickly.  It is nice knowing that my decision to delay the clamping did not result in any negative effects for the baby.  He had his first non-meconium bowel movement at the doctor's office on Wednesday and his umbilical stump fell off on Saturday.

Recovery for myself has been a little easier this time around.  I didn't have to push for 2.5 hours like the last time so I haven't had any swelling.  I only took 600mg of ibuprofen for pain relief and that was 14 hours after delivery!  I also managed to escape the entire hospital stay without an IV.  The biggest thing for myself has been trying to get enough rest and making sure I eat and drink enough.  Since I'm up every 2 hours to nurse, I have become somewhat of a night owl.  I try to sleep when baby sleeps which means I am sleeping a lot during the day.  I am also hungry all the time.  I made my first batch of lactation cookies yesterday and after the gestational diabetes, being able to eat cookies again is a welcome treat.  My blood sugar and blood pressure have both returned to normal after I had the baby.

I have also been religiously binding my belly hoping I can fit into my non-maternity clothes sooner rather than later. I did it the first time around and thought it yielded good results.  I started "binding" myself at the hospital.  I requested a support band that they typically give to mothers who have had a c-section.  I did not have a c-section so I was happy they gave me one after I asked for it.  I am also using the "belly bandit" that I bought with my first baby.

My older son is slowly coming around to the new baby.  At the hospital, he didn't want anything to do with me or the baby.  He even lost the toy that his new baby brother bought for him.  Thanks to my in-laws who replaced the toy, a crisis was averted.  In the last few days, he's become very helpful around the baby.  He's tried to tell the baby "it's OK" when he's crying in the car and even tonight tried to help give him a bath.  He's also tried to read him a book and show him pictures of family members.  He's a sweet kid and I hope this is a sign that he will be a good big brother.

The dog at first was really anxious about the new baby.  We have the baby's crib in our room since we think it would be cruel to have him share a room with his older brother at this age.  The dog has been sleeping in our room.  The first time she heard the baby crying in the crib, she freaked out and wouldn't stop barking.  We thought we might have to figure out alternate sleeping arrangements for the dog.  Luckily, she has also adjusted to this new addition and no longer barks or whines when she hears crying.

My husband has been wonderful.  He's doing the laundry and cleaning around the house.  He is off for another a week so the real test will be when he goes back to work.  In the meantime, he's been getting the toddler ready in the morning (making breakfast, changing his clothes, etc) and letting me sleep in which is nice since I'm up most of the night feeding or changing the baby.

We're slowly getting into a routine with our family.  Thank you to all who have passed on their well wishes.  I am very thankful to have a beautiful family and great friends.

Friday, August 3, 2012

Vitamin D Supplementation for Breastfed Infants

Breastmilk is touted as "nature's perfect food."  It should contain everything that a growing infant should need for at least the first six months of life.  Major organizations from the American Academy of Pediatrics to the World Health Organization recommend exclusive breastfeeding for the first six months of life.  Exclusive breastfeeding means feeding the infant only breastmilk and no other solids or liquids.  If breastmilk is "perfect," why then do we need to give breastfed infants vitamin D supplementation?

According to the Centers of Disease Control and Prevention (CDC), "Breast milk alone does not provide infants with an adequate intake of vitamin D. Most breastfed infants are able to synthesize additional vitamin D through routine sunlight exposure. However, published reports of cases of vitamin D deficiency rickets among breastfed infants in the United States caused researchers to take another look at whether all breastfed infants were getting adequate vitamin D."  "Vitamin D deficiency rickets among breastfed infants is rare, but it can occur if an infant does not receive additional vitamin D from a vitamin supplement or from adequate exposure to sunlight. A number of factors decrease the amount of vitamin D a person will synthesize from sunlight. These factors include:
- Living at high latitudes (closer to the polar regions), particularly during winter months
- Air quality conditions: high levels of air pollution
- Weather conditions: dense cloud covering
- The degree to which clothing covers the skin
- Use of sunscreen
- Skin pigmentation: darker skin types
- Furthermore, there exists a major public health effort to decrease the risk of skin cancer by encouraging people to limit their sunlight exposure"

The American Academy of Pediatrics (AAP), recommends "that all infants and children, including adolescents, have a minimum daily intake of 400 IU of vitamin D beginning soon after birth."  The "guidelines for vitamin D intake for healthy infants, children, and adolescents are based on evidence from new clinical trials and the historical precedence of safely giving 400 IU of vitamin D per day in the pediatric and adolescent population. New evidence supports a potential role for vitamin D in maintaining innate immunity and preventing diseases such as diabetes and cancer. The new data may eventually refine what constitutes vitamin D sufficiency or deficiency."

"There are 2 forms of vitamin D: D2 (ergocalciferol, synthesized by plants) and D3 (cholecalciferol, synthesized by mammals). The main source of vitamin D for humans is vitamin D3 through its synthesis in the skin" when exposed to ultraviolet light.  "Historically, the main source of vitamin D has been via synthesis in the skin from cholesterol after exposure to UV-B light. Full-body exposure during summer months for 10 to 15 minutes in an adult with lighter pigmentation will generate between 10000 and 20000 IU of vitamin D3 within 24 hours; individuals with darker pigmentation require 5 to 10 times more exposure to generate similar amounts of vitamin D3."  Vitamin D3 which is derived from fish "has greater efficacy in raising" vitamin D levels.  It is the supplement of choice over vitamin D2.

"In a lactating mother supplemented with 400 IU/day of vitamin D, the vitamin D content of her milk ranges from <25 to 78 IU/L."  Even if a mother takes a vitamin D supplement and her infant drinks a liter of breastmilk a day, this is far less than the 400IU recommended daily for infants.   For a woman to produce the recommended amount of vitamin D in her breastmilk, she will have to consume 6400 IU/day of vitamin D supplements.  "Although vitamin D concentrations can be increased in milk of lactating women by using large vitamin D supplements, such high-dose supplementation studies in lactating women must be validated and demonstrated to be safe in larger, more representative populations of women across the United States. Recommendations to universally supplement breastfeeding mothers with high-dose vitamin D cannot be made at this time. Therefore, supplements given to the infant are necessary."

Vitamin D supplementation is recommended because "in adults, new evidence suggests that vitamin D plays a vital role in maintaining innate immunity and has been implicated in the prevention of certain disease states including infection, autoimmune diseases (multiple sclerosis, rheumatoid arthritis), some forms of cancer (breast, ovarian, colorectal, prostate), and type 2 diabetes mellitus.  Results from prospective observational studies also suggest that vitamin D supplements in infancy and early childhood may decrease the incidence of type 1 diabetes mellitus."

Despite the recommendations by the AAP, a study published in the journal Pediatrics, titled, "Adherence to Vitamin D Recommendations Among US Infants," found that "most US infants are not consuming adequate amounts of vitamin D according to the 2008 AAP recommendation. Pediatricians and health care providers should encourage parents of infants who are either breastfed or consuming <1 L/day of infant formula to give their infants an oral vitamin D supplement."  I don't find this particularly surprising since many message boards that I have been reading have threads full of mothers saying that their Pediatricians have told them that it "wasn't necessary."

I plan on supplementing my baby with vitamin D especially since I will not be exposing him to much sunlight during his first six months of life.  I remember that with my first baby, it was difficult in the beginning to get him to take his vitamin drop and I wasn't always that consistent with it.  After researching this topic, I am going to have to make sure that I am more diligent with the vitamins and also be more diligent with myself getting enough calcium and vitamin D.

Thursday, August 2, 2012

Happy World Breastfeeding Week!

Did you know that August 1-7, 2012 is World Breastfeeding Week?  "20 years ago, the World Alliance for Breastfeeding Action (WABA) launched its first World BreastfeedingWeek (WBW) campaign with the theme: "Baby-Friendly Hospital Initiative."  It is celebrated every year from August 1-7 in more than 170 countries to "encourage breastfeeding and improve the health of babies around the world. It commemorates the Innocenti Declaration made by WHO and UNICEF policy-makers in August 1990 to protect, promote and support breastfeeding."

There are many celebrations around the world and country commemorating this week.  The La Leche League of the United States has information on their website regarding events in the United States. One of the big events scheduled this year is the "Big Latch On."  There are a number of sites around the country that will have women breastfeeding their babies at the same time (10:30AM) on either Friday, August 3 or Saturday, August 4, 2012.  You can check the following website to determine if there is a site near you participating in the "Big Latch On."

The Big Latch On is hoping to:
  • "Support for communities to identify and grow opportunities to provide ongoing breastfeeding support and promotion.
  • Raise awareness of breastfeeding support and knowledge available in communities.
  • Help communities positively support breastfeeding in public places.
  • Make breastfeeding a normal part of the day-to-day life at a local community level.
  • Increase support for women who breastfeed - women are supported by their partners, family and the breastfeeding knowledge that is embedded in their communities.
  • Communities have the resources to advocate for coordinated appropriate and accessible breastfeeding support services." 

As you all probably know, I am a big proponent of breastfeeding.  Unfortunately, this year, my baby is a little too young to go out in public.  I may not be able to be "officially" counted at an event but I am going to be latching my baby at 10:30 on Friday and Saturday in support of all of the mother's participating in the "Big Latch On."  Is anyone going to join me?

Tuesday, July 31, 2012

Circle of Life

After recently having my second child, I find myself thinking about the "circle of life."  As the old saying goes, "nothing is certain in life except death and taxes."

My oldest child was born exactly 100 years to the day after his great grandfather (my grandfather).  I remember thinking the day before that this coincidence was not going to happen.  However, at 3AM, at 39 weeks and 1 day, my water bag spontaneously ruptured.  I waited in the hospital for several hours with no contractions until they started a pitocin drip (to get contractions going) and eventually an epidural.  As the day progressed, I kept thinking that this baby better come before the end of the day.  After two and a half hours of pushing, my little guy entered the world a little before 10PM on what would have been his great-grandfather's 100th birthday.

My second baby was born the day after his great grandfather (my husband's grandfather) unexpectedly passed away.  We got a phone call late in the evening on Thursday night saying that his grandfather was rushed to the hospital.  My husband reluctantly left me (heavily pregnant and contracting off and on) at home with our older child to see his grandfather before he passed away.  He was at his bedside along with other family members when he passed away early on Friday morning.  It was sad especially since he had appeared healthy and still had his sharp mind.  One of the last times that we saw him was at my older child's birthday a couple of months before.  I am fortunate to have taken many pictures that day of my toddler and his great-grandfather happily smiling for the camera.

Despite the sadness of losing a family member, there was still the excitement at the impending birth of the newest family member.  I had been contracting off and on for more than a week before the baby was born.  I did not have any consistent or overly painful contractions but they would be noticeable.  I had also been doing my non-stress tests twice a week which showed contractions but nothing major or consistent.  I was definitely uncomfortable and ready to "get the show on the road."  If I did not deliver naturally, I had a scheduled induction at 40 weeks, 1 day.

I lost my mucous plug at around 10:22 on Saturday morning.  I was 39 weeks and 4 days along.  I went about my day as usual.  I did notice more frequent urination as the day progressed but no consistent or overly painful contractions.  I made spaghetti for dinner and settled down for an evening of watching the olympics.  I watched the Michael Phelps vs. Ryan Lochte 400m IM race at the olympics.  After the race, I went to the bathroom.  I sat down on my bed (which my husband wisely made me cover with a chux pad) and watched Michael Phelps' interview about his reaction to missing a medal with a fourth place finish.  As soon as that interview finished, I felt pressure and then a trickle of fluid ran down my left leg.  It was 9:45PM and I knew that my water had broken.  I rushed to the bathroom and sat on the toilet.  My husband asked me if he should call my parents.  I told him to call his parents because they had to drive 44 miles (which takes 45 minutes to an hour) to get to our house to get our older son.  I called labor and delivery at 9:48PM and was placed on hold for 8 minutes!  They were apparently busy and told me that it would be a while before a nurse could talk to me.  I had no contractions at that point and since it took 18 hours from when my water broke to when my first baby was born, we all thought we had plenty of time to get to the hospital.  They wanted to make sure it was amniotic fluid and not urine.  Since I had just urinated right before my water broke and the fluid resembled coconut water (the closest thing I could think of), I was pretty sure it was amniotic fluid.  I got off the phone with L&D at 9:59PM.

My husband brought me a bowl of spaghetti and water despite having had a small bowl of homemade strawberry ice cream (which I made the day before) about 30 minutes before.  I shouldn't have had ice cream with my gestational diabetes but this late in pregnancy, I figured, why not?  With my first child, they also told me to eat something before coming in since they would not let me eat once I got there.  I was famished during labor with my first that I wanted something substantial in my stomach.  I know its gross to eat while seated on the toilet but I sat on the toilet for a few minutes so as not to get amniotic fluid all over the house.  I then realized that I should be ready when his parents got to our house.  While I was getting ready, my husband loaded our bags into the car.  That was when the contractions started.  The contractions started around 10:15PM.  I had my husband start timing them since my phone was getting one last recharge.  They were initially 10 minutes apart.  By the time we left for the hospital at 10:44PM after my in-laws arrived, they were five minutes apart.  I sat in the car with no seatbelt (my pain was intensifying) and I told my husband to not get into an accident since I could not buckle my seatbelt.

My husband dropped me off at the emergency room entrance at 10:50PM (luckily we live very close to the hospital) while he went to park the car.  When I arrived at the security counter, I was having painful contractions and had difficulty walking.  They let me sit in a wheelchair and wheeled me right to the check-in counter.  They checked me in at 10:52PM.  My contractions were painful so they immediately took me to labor and delivery triage.  I arrived at labor and delivery triage at 10:55PM.  They made me stand while they checked me in.  At that point my pain was getting worse so they directed me to a bed to sit in.  My husband arrived at that moment.  Of course, he forgot the bags in the car but at that point, the pain was so bad, he could not leave me.  He had to help me change into a gown and help me get a urine sample.  They hooked me up to the monitors and my contractions were right on top of each other. They asked me what number baby this was for me and I told them that it was my second child.  They immediately called for a doctor.  The nurse told me that two other mothers had come in earlier that night who had delivered their second child very "precipitously."  As we were waiting for the doctor, the nurse tried to test the fluid to make sure it was amniotic fluid.  When the doctor arrived, she told me that I was already 8cm!!!!!!  I was shocked!  I was only 2 cm at my doctor's appointment only 5 days before and I did not have contractions until about a few minutes before.  I begged for an epidural and she said that I may not be able to make it in time for one.  They asked me if I felt the urge to push and at that moment, I did not.  The nurse told me that some people get stuck at 8cm and are able to get an epidural. I would just need to be able to sit very still.  If the pain prohibited me from sitting still, I would not be able to get one.  The nurse and doctor exchanged a few words and at that moment, they decided to rush me into a delivery room.  All of the rooms were occupied so I got stuck in a tiny "back-up" room that I remember seeing during our hospital tour with our first child.  It was something like out of a television drama.  They were literally running down the hall with me on a bed and all of these people scrambling to the room.

Once in the delivery room, they started yelling for a warmer for the baby and had me try to move to another bed.  I was in so much pain at that point I had difficulty moving to another bed.  After crawling to the bed, I began to try to process what was going on.  We had just gotten to the hospital and they were preparing me to deliver a baby!  I wanted my epidural or at least something for the pain!!  They told me that I had no time to wait for an epidural or an IV for pain medication.  The doctor told me that I would be able to say that I had a "natural birth."  I DID NOT want a natural birth but at that point, I guess I had no choice.  I was not mentally prepared to do it without medication and it was quite intimidating to me.

The pain at that point was intense.  I remember hugging the railing on the left side of the bed and saying that I was "going to puke."  The thought of that bowl of spaghetti was beginning to haunt me.  They scrambled to get me an emesis basin.  My husband held it in front of me.  At that moment, the doctor asked me if I had the urge to push.  I DID and they immediately told me to get on my back and scoot my bottom toward her at the edge of the bed and put my legs in the stirrups.  This of course was impossible since the pain was intense.  My husband then grabbed one leg and the nurse grabbed another and they told me to start pushing.  I gave one push.  I looked at the time and it was around 11:20PM.  I started getting a tingling sensation in my extremities.  Everyone told me that was because I was hyperventilating and screaming.  Things were so crazy that the nurse had to even hold the fetal monitor against my body because it would not stay in place with my writhing in agony.  It's crazy what the most intense pain that you've ever felt would do to you.  I seriously thought about yelling at them to just cut this kid out of me since that surely would be less painful then the waves of contractions that were happening.  I also thought that I was going to pass out from the pain.  Yes, it was that bad!  They told me that I need to redirect my energy away from hyperventilating and screaming to pushing.  It was like a lightbulb went off in my head.  I remember that from my first birth and decided to "take the bull by the horns" and use my energy to push.  I asked my husband if he could see the baby crowning.  I pushed for 2.5 hours with my first child and I wasn't about to start pushing for that long with that kind of pain (this is why I looked at the time when I started pushing).  My husband told me that the baby was coming out.  I pushed once more, then another three pushes in a row and then felt them pulling the baby out.  Since I had an epidural the first time, I did not get to experience that sensation.  It is amazing but once the baby was pulled out, the pain stopped!  Our little baby boy was born at 11:27PM.  1 hour and 42 minutes after my water broke and 35 minutes after we arrived at the emergency room.

They immediately placed the baby on my chest and delayed the clamping of the cord as I had requested.  My husband and I had discussed previously who would get the honor of cutting the cord.  I was going to cut our first child's cord but since he was born with thick meconium, I couldn't.  Since I missed that opportunity, he let me cut the cord this time.  It was an amazing feeling after the gestational diabetes, gestational hypertension and precipitous pain-medication free delivery to finally be able to hold my baby in my arms.

Friday, July 27, 2012

Ways to Induce Labor Naturally????

Here I am, 39 weeks and almost 4 days pregnant.  I have gone further with this pregnancy than I have had with my previous pregnancy (my water broke at 39 weeks and 1 day).  While there are things that I will miss about being pregnant, I am excited to meet the baby.  I'm curious if the baby will look like me or dad, if there will be a lot of hair, if this will be a big baby, etc.  Many things to look forward to.  I feel like I am in a "holding pattern" since labor can literally happen at any moment.  Planning things in the short-term is very difficult since we have no idea when the little one will make their grand entrance. While I am not "desperate," I have been seeing things on the Internet regarding "natural" ways to induce labor.  I had to get pitocin the last time to induce labor because my water broke and I had no contractions.  I am hoping to go into labor naturally this time so I may just start exploring some of these "natural" ways to induce labor.
  1. Walking
    • Gravity and hip swaying may help the baby to naturally drop down into the pelvic area.  
    • The pressure of the baby dropping can help labor progress by priming the cervix.
  2. Sex
    • Sperm contains prostaglandins which help to ripen the cervix by thinning and dilating it. 
    • Oxytocin is released during sex which may help to trigger contractions.
  3. Evening Primrose Oil (EPO)
    • This should probably only be done under a doctor's supervision.  
    • This is an herb which can help to thin and dilate the cervix.
    • The capsules can be taken orally, the oil may be rubbed directly on the cervix or the capsules can be inserted vaginally.
  4. Castor Oil
    • Another thing that should be taken only under a doctor's supervision.
    • It is a vegetable oil that is typically used as a laxative. 
    • It causes intestinal spasms by stimulating the bowels.  Bowel stimulation can then irritate the uterus to cause it to contract.
    • Works only if you're already showing signs of labor.  Taking it without the signs of labor may just give you a bad case of diarrhea.
  5. Spicy Food
    • Another intestinal irritant which may cause your uterus to contract.
    • May cause or worsen heartburn.
  6. Acupuncture
    • Inserting needles into specific pressure points may stimulate uterine activity.
  7. Acupressure
    • Applying pressure to specific points on the body may stimulate uterine activity.
      • Applying pressure to the webbing between the thumb and index finger
      • Applying pressure to the inside of your leg about four finger-widths above the ankle bone.
  8. Nipple Stimulation
    • Massaging and twisting for a few hours a day may release oxytocin which can bring on contractions.
    • Should be done under a practitioner's care.
    • May cause long, painful contractions that can lower the heart rate of the baby.
  9. Massage
    • Massage can raise oxytocin levels which may bring on contractions. 
    • Meditation can also help to relax you and raise oxytocin levels.  This is why the majority of labor happen late at night when relaxed in bed. 
  10. Pineapples
    • Contains the enzyme bromelain which may help soften the cervix.
    • It can also aid in digestion by stimulating the bowels which can stimulate contractions.
  11. Teas
    • Should only be done under the care of a practitioner.
    • Teas containing black and blue cohosh, raspberry leaf, cumin, or evening primrose oil may help to stimulate labor.
  12. Visualization
    • Visualizing your cervix opening may actually cause your cervix to open.

Finally, for some comic relief, someone posted this video on one of the message boards that I frequent.  It pretty much sums up the things that have been said to me and how I am feeling about those things.  If only I had a crystal ball then I can tell you when "the baby is coming..."

Has anyone tried any of the "natural" methods mentioned above?  If so, what was the result? 

Thursday, July 26, 2012

Dietary Guidelines for Americans

After writing the last two posts about reading a nutrition facts label and top 10 food label tricks to avoid, I can't help but further expand on the Dietary Guidelines for Americans that I mentioned in both of those posts.

What are the Dietary Guidelines for Americans (DGA)?  The DGA "provide advice for making food choices that promote good health, advocate a healthy weight, and help prevent disease. The DGA are for healthy Americans age 2 and older."  "The advice is based on a thorough, transparent, and unbiased review of the scientific evidence. The DGA are congressionally mandated under the 1990 National Nutrition Monitoring and Related Research Act (Public Law 101-445, Section 301 [7 U.S.C. 5341], Title III). Every 5 years, the Secretary of Agriculture and the Secretary of Health and Human Services release a new set of guidelines."  The most recent guidelines were released in 2010.

The current guidelines emphasize 3 major goals for Americans:
  1. "Balance calories with physical activity to manage weight"
  2. "Consume more of certain foods and nutrients such as fruits, vegetables, whole grains, fat-free and low-fat dairy products, and seafood"
  3. "Consume fewer foods with sodium (salt), saturated fats, trans fats, cholesterol, added sugars, and refined grains"
It also "include 23 key recommendations for the general population and 6 additional key recommendations for specific population groups, such as pregnant women. The recommendations are intended to help people choose an overall healthy diet."

The entire report can be found here.  The report goes into excellent detail about all aspects of their recommendations.  I found it fascinating to read and it is something that can teach you a lot about nutrition.  I'll post the key recommendations below:

Balancing calories to Manage weight
• Prevent and/or reduce overweight and obesity through improved eating and physical activity behaviors.
• Control total calorie intake to manage body weight. For people who are overweight or obese, this will mean consuming fewer calories from foods and beverages.
• Increase physical activity and reduce time spent in sedentary behaviors.
• Maintain appropriate calorie balance during each stage of life—childhood, adolescence, adulthood, pregnancy and breastfeeding, and older age.

Foods and Food Components to Reduce
• Reduce daily sodium intake to less than 2,300 milligrams (mg) and further reduce intake to 1,500 mg among persons who are 51 and older and those of any age who are African American or have hypertension, diabetes, or chronic kidney disease. The 1,500 mg recommendation applies to about half of the U.S. population, including children, and the majority of adults.
• Consume less than 10 percent of calories from saturated fatty acids by replacing them with monounsaturated and polyunsaturated fatty acids.
• Consume less than 300 mg per day of dietary cholesterol.
• Keep trans fatty acid consumption as low as possible by limiting foods that contain synthetic sources of trans fats, such as partially hydrogenated oils, and by limiting other solid fats.
• Reduce the intake of calories from solid fats and added sugars.
• Limit the consumption of foods that contain refined grains, especially
refined grain foods that contain solid fats, added sugars, and sodium.
• If alcohol is consumed, it should be consumed in moderation—up to one drink per day for women and two drinks per day for men—and only by adults of legal drinking age.

Foods and Nutrients to Increase
Individuals should meet the following recommendations as part of a healthy eating pattern while staying within their calorie needs.
• Increase vegetable and fruit intake.
• Eat a variety of vegetables, especially dark-green
and red and orange vegetables and beans and peas.
• Consume at least half of all grains as whole grains. Increase whole-grain intake by replacing refined grains with whole grains.
• Increase intake of fat-free or low-fat milk and milk products, such as milk, yogurt, cheese, or fortified soy beverages.
• Choose a variety of protein foods, which include seafood, lean meat and poultry, eggs, beans and peas, soy products, and unsalted nuts and seeds.
• Increase the amount and variety of seafood consumed by choosing seafood in place of some meat and poultry.
• Replace protein foods that are higher in solid fats with choices that are lower in solid fats and calories and/or are sources of oils.
• Use oils to replace solid fats where possible.
• Choose foods that provide more potassium,
dietary fiber, calcium, and vitamin D, which are nutrients of concern in American diets. These foods include vegetables, fruits, whole grains, and milk and milk products.

Recommendations for specific population groups
Women capable of becoming pregnant
• Choose foods that supply heme iron, which is more readily absorbed by the body, additional iron sources, and enhancers of iron absorption such as vitamin C-rich foods.
• Consume 400 micrograms (mcg) per day of synthetic folic acid (from fortified foods and/or supplements) in addition to food forms of folate from a varied diet.

Women who are pregnant or breastfeeding
• Consume 8 to 12 ounces of seafood per week from a variety of seafood types.
• Due to their high methyl mercury content, limit white (albacore) tuna to 6 ounces per week and do not eat the following four types of fish: tilefish, shark, swordfish, and king mackerel.
• If pregnant, take an iron supplement, as recommended by an obstetrician or other health care provider.

Individuals ages 50 years and older
• Consume foods fortified with vitamin B, such 12 as fortified cereals, or dietary supplements.

Building healthy eating Patterns
• Select an eating pattern that meets nutrient needs over time at an appropriate calorie level.
• Account for all foods and beverages consumed and assess how they fit within a total healthy eating pattern.
• Follow food safety recommendations when preparing and eating foods to reduce the risk of foodborne illnesses.

All of this seems like common sense, right?  Well, apparently, a lot of manufacturers "trick" consumers through labeling that may be misleading or confusing.  Many consumers may "think" they are eating healthier when in fact, they may not be when a label is thoroughly analyzed.  Also, it is easier and cheaper to eat processed foods that may not be the "healthiest" alternative.  I think education is power and by educating ourselves about what is in the food we eat, we can make healthier choices.  I am also a firm believer in preparing your own food so you know what goes in it.  By preparing our own food and thoroughly reading labels before we purchase an item, it will go a long way in improving the diet and health of all Americans.

Wednesday, July 25, 2012

Top 10 Food Label Tricks to Avoid

When I am surfing the Internet, I get these random links to stories that catch my eye.  I came across an interesting link that I thought I'd like to write a post about.  The title of the story is "Top 10 Food Label Tricks to Avoid in 2012."  After my post yesterday about reading Nutrition Facts Labels, I thought this list was intriguing and something that I could embellish with information of my own...

  • As mentioned in my post yesterday, according to the FDA's Nutrition Labeling and Education Act (NLEA),  fat content is not required to be listed on the label "if the food contains less than 0.5 grams of total fat per serving and if no claims are made about fat or cholesterol content."
    • The bad thing about this is if you eat multiple foods that contain less than 0.5 grams of trans fat, you could be eating a "measurable" amount of trans fat over the course of the day.
  • Avoid products that have "partially hydrogenated oils" listed as an ingredient.  This usually indicates that the product has some trans fat.
  • Some may mistake this to mean "whole grain" or "whole wheat."  It does not.  This just means that the product is "made from several grains, which may be whole or refined. Labels such as "12 grain" and "made with" whole wheat can be equally deceptive. "
  • "To make sure the food is rich in whole grains, check the ingredients. The first one listed should contain the word "whole.""
  • "The FDA has no strict definition of the term, and many packaged foods claiming to be natural contain added chemicals and other substances."
  • "The USDA, which regulates meat and poultry, has a more precise definition (no artificial ingredients and minimally processed), but it still allows for some additives."
  • "In addition, it's permissible to slap a "natural" label on meat and poultry from animals raised with antibiotics or hormones."
  • "Organic products, which tend to be significantly more expensive than their conventional counterparts, can be just as high in salt, sugar or calories, low in fiber and devoid of nutrients."
  • "What's more, they may legally contain non-organic ingredients."
  • "To boost their fiber content, many packaged foods contain added fiber with names such as inulin, maltodextrin and polydextrose."
    • "While these count toward a food's fiber total, they haven't been proven to offer the same health benefits as the naturally-occurring fiber found in fruits, vegetables and whole grains."
    • "Inulin can cause gastrointestinal discomfort."
  • According to the U.S. Department of Health and Human Services' "Dietary Guidelines for Americans", "dietary fiber naturally occurs in plants, helps provide a feeling of fullness, and is important in promoting healthy laxation."
    • "These foods are consumed below recommended levels in the typical American diet."
      • Women should consume 25g daily while men should consume 38g daily.
    • "Dietary fiber that occurs naturally in foods may help reduce the risk of cardiovascular disease, obesity, and type 2 diabetes."
    • "Children and adults should consume foods naturally high in dietary fiber in order to increase nutrient density, promote healthy lipid profiles and glucose tolerance, and ensure normal gastrointestinal function."
    • They also state that "fiber is sometimes added to foods and it is unclear if added fiber provides the same health benefits as naturally occurring sources."
  • "Human studies of the sweetener high-fructose corn syrup (HFCS) have generally shown it to be no worse for our waistlines or our health than table sugar. "
    • "The two have a similar chemical makeup, and both contain about the same number of calories."
  • "Just because a product contains an alternative to HFCS -- whether sugar, fruit juice concentrate, brown rice syrup or agave nectar -- doesn't necessarily make it more healthful. "
  • "All caloric sweeteners, if consumed in excess, can contribute to obesity and related health problems."
  • " It offers no clear health advantages over table salt."
  • "By weight, both contain about the same amount of sodium, which is what poses a health risk."
  • According to the Dietary Guidelines for Americans, "Virtually all Americans consume more sodium than they need."
    • "The estimated average intake of sodium for all Americans ages 2 years and older is approximately 3,400 mg per day."
      • The recommended daily average intake of sodium for individuals aged 9-50 is 1,500mg per day.
      • The "Upper Tolerable Intake Level" is 2,300mg per day for people aged 14 and older.  
    • According to the American Heart Association, there is approximately 2,300mg of sodium per teaspoon.
      • With this calculation, you should consume only around 1/2 teaspoon of salt per day.
    • "Most sodium comes from salt added during food processing."
      • This is a good reason why you should cook your own rather than purchasing prepared foods.
    • "Some sodium-containing foods are high in sodium, but the problem of excess sodium intake also is due to frequent consumption of foods that contain lower amounts of sodium, such as yeast breads."
  • "A growing number of products imply that they can boost immunity and ward off illness."
  • "There's typically little or no evidence for such claims."
    • "This deception is permitted because of a loophole in labeling rules."
      • "By saying that a food "maintains" or "supports" normal functioning (such as a healthy immune system, blood pressure or cholesterol levels) instead of explicitly stating that it can treat or prevent a condition, manufacturers don't have to provide any proof."
  • "Studies show that fish oil is good for the heart, and many products from mayonnaise to peanut butter have added omega-3 fatty acids, the key ingredient in fish oil."
    • "But these foods typically contain a form of omega-3s known as alpha-linolenic acid (ALA), which comes from plant sources such as flaxseed and canola oil rather than fish."
    • "The health benefits of ALA are not nearly as well documented as those of fish oil."
  • "The amount we get from some products may be too low to provide any benefit."
  • "You're better off getting your omega-3s from fish such as salmon."
  • Manufacturers often list servings sizes on their nutrition labels which do not reflect what a consumer will actually eat.  
    • Consumers will often eat more than what is listed as a serving size.
    • "Especially misleading are snacks and beverages from vending machines or convenience stores that seem to be single servings."
  • Even the FDA recognizes this "problem" and warns consumers to pay attention to the nutrition facts label. 
    • "The size of the serving on the food package influences the number of calories and all the nutrient amounts listed on the top part of the label."
    • "Pay attention to the serving size, especially how many servings there are in the food package. Then ask yourself, "How many servings am I consuming"?"
After reading this article, it has made me think more about reading labels rather than blindly purchasing items.  It is amazing what manufacturers can do to "trick" us into thinking we are eating something that is healthier when in fact we are not.  This is a good example why there is an obesity epidemic and why I need to teach my children from an early age the importance of making healthy food choices.

Tuesday, July 24, 2012

How Do You Read a Nutrition Facts Label?

Since I have been diagnosed with gestational diabetes, I have become more aware of reading the nutrition labels on the food that I buy.  I have to read the labels so I do not eat more carbohydrates than I am allowed to per meal.  In the course of "reading" the labels, I discovered, that there is a lot that I do not know about the information contained on the label.  I did some research and found the United States Food and Drug Administration (FDA) has broken down the information contained on the label and what it all means.  Most of this post is based upon information from the FDA.

Who is the FDA?  The FDA "is responsible for assuring that foods sold in the United States are safe, wholesome and properly labeled. This applies to foods produced domestically, as well as foods from foreign countries. The Federal Food, Drug, and Cosmetic Act (FD&C Act) and the Fair Packaging and Labeling Act are the Federal laws governing food products under FDA's jurisdiction."  "The Nutrition Labeling and Education Act (NLEA), which amended the FD&C Act requires most foods to bear nutrition labeling and requires food labels that bear nutrient content claims and certain health messages to comply with specific requirements."

"The Nutrition Labeling and Education Act (NLEA), which amended the FD&C Act requires most foods to bear nutrition labeling and requires food labels that bear nutrient content claims and certain health messages to comply with specific requirements."  This act specifies where the nutrition label should go on the package, what font size to use and even what information is required to be placed on a package.  The following are some interesting bits of information about this act.  I have italicized the areas that were a surprise to me:
  • Serving Size - A package that is sold individually and contains less that 200% of the applicable reference amount is considered to be one serving. However, for products that have reference amounts of 100 g (or ml) of larger, manufacturers may decide whether a package that contains more than 150% but less than 200% of the reference amount is 1 or 2 servings. When a product contains 200% or more of the reference amount, the manufacturer may label the product as a single serving if the entire package can reasonably be consumed at one sitting.
  • Servings per Container - If the number of servings is between 2 and 5 servings it is rounded to the nearest .5 servings.
  • Calories - Calories must be in bold print. "Calories from Fat" must be declared unless the product contains < 0.5 g total fat. "Calories" may be followed by the optional term "Energy" in parenthesis.
  • Fat - Total fat must be in bold print and listed in grams. Saturated fat must be listed in grams, but is not required if the food contains less than 0.5 grams of total fat per serving and if no claims are made about fat or cholesterol content. 
  • Cholesterol - Is not required, if the product contains less than 2 milligrams cholesterol per serving and makes no claim about fat, saturated fat or cholesterol; and if not declared, the statement "Not a significant source of cholesterol" must be included at the bottom of the nutrient table.
  • Sodium - Foods for infants and children under 4 years of age may list the mg. amount, but may not list the % Daily Value for sodium.
  • Dietary Fiber and Sugars - "Dietary Fiber" in grams is not required if the serving contains less than 1 gram. If not declared, the statement "Not a significant source of dietary fiber" must be included at the bottom of the nutrient table.  "Sugars" is not required if a serving contains less than 1 gram of sugar and no claims are made about sweeteners, sugars, or sugar alcohol content, and if not declared, the statement "Not a significant source of sugars" must be included at the bottom of the nutrient table.
  • Protein - Declaration of % Daily Value is not required when the food is for adults or children over 4 years of age unless a protein claim is made.  However, when the food is for adults or children over 1 year of age and the protein is of poor quality, the label should state "0%" in % DV column or state "Not a significant source of protein."  The statement "Not a significant source of protein" is required if the food is purported to be for infants and has a Protein Efficiency Ratio (PER) of less than 40 percent of the reference standard (casein).
  • Declaration of Vitamins and Minerals - Nutritional information as the percent of the Reference Daily Intake (RDI) for the following nutrients is MANDATORY and must be declared in the order listed:  "Vitamin A, Vitamin C (Ascorbic Acid), Calcium, Iron"
What is a "nutrition facts label?"  The following is an example of a nutrition facts label:

The information in the main or top section (see #1-4 and #6 on the sample nutrition label below), can vary with each food product; it contains product-specific information (serving size, calories, and nutrient information). The bottom part (see #5 on the sample label below) contains a footnote with Daily Values (DVs) for 2,000 and 2,500 calorie diets. This footnote provides recommended dietary information for important nutrients, including fats, sodium and fiber. The footnote is found only on larger packages and does not change from product to product.
  1. Serving Size - The size of the serving on the food package influences the number of calories and all the nutrient amounts listed on the top part of the label. Pay attention to the serving size, especially how many servings there are in the food package. Then ask yourself, "How many servings am I consuming"? (e.g., 1/2 serving, 1 serving, or more).
  2. Calories (and Calories from Fat) - Calories provide a measure of how much energy you get from a serving of this food. Many Americans consume more calories than they need without meeting recommended intakes for a number of nutrients. The calorie section of the label can help you manage your weight (i.e., gain, lose, or maintain.) Remember: the number of servings you consume determines the number of calories you actually eat (your portion amount).
    • General Guide to Calories (Based on a 2,000 calorie diet)
      • 40 Calories is low
      • 100 Calories is moderate
      • 400 Calories or more is high
  3. The Nutrients
    • Limit these nutrients (Total fat, cholesterol, sodium)
      • The nutrients listed first are the ones Americans generally eat in adequate amounts, or even too much.
  4. The Nutrients 
    • Get enough of these (Dietary Fiber, Vitamin A, Vitamin C, Calcium and Iron)
      • Most Americans don't get enough dietary fiber, vitamin A, vitamin C, calcium, and iron in their diets. 
  5. Understanding the Footnote on the Bottom of the Nutrition Facts Label
    • Note the * used after the heading "%Daily Value" on the Nutrition Facts label. It refers to the Footnote in the lower part of the nutrition label, which tells you "%DVs are based on a 2,000 calorie diet". This statement must be on all food labels.
    • For each nutrient listed there is a DV, a %DV, and dietary advice or a goal. If you follow this dietary advice, you will stay within public health experts' recommended upper or lower limits for the nutrients listed, based on a 2,000 calorie daily diet.
  6. The Percent Daily Value (PDV)
    • The % Daily Values (%DVs) are based on the Daily Value recommendations for key nutrients but only for a 2,000 calorie daily diet--not 2,500 calories.
    • The %DV helps you determine if a serving of food is high or low in a nutrient.
    • 5%DV or less is low and 20%DV or more is high.
      • This guide tells you that 5%DV or less is low for all nutrients, those you want to limit (e.g., fat, saturated fat, cholesterol, and sodium), or for those that you want to consume in greater amounts (fiber, calcium, etc). As the Quick Guide shows, 20%DV or more is high for all nutrients.
The FDA has initiated several campaigns to get Americans to read the nutrition facts label and make healthy food choices based upon the information contained on the labels.  They have the "Spot the Block" campaign for children 9-13 and "Make Your Calories Count" to help consumers "plan a healthful diet while managing calorie intake."   They also encourage Americans to follow the "Dietary Guidelines" to help people choose an "overall healthy diet."

Until I started reading labels, I blindly chose products which looked good or I knew tasted good.  However, after reading several labels, it became clear that many of the foods that I enjoyed were too high in carbohydrates, fat or sodium.  I did not realize that many products that are packaged to appear to be a single serving actually contain several servings.  Unfortunately, that meant that all of the information on the label needed to be adjusted if I were to consume the entire package.  Do you read labels?  If not, what will it take to make you read labels more consistently?  Unfortunately, for me, it took having diabetes to read labels. 

Monday, July 23, 2012

What NOT to eat while pregnant

OK, so I just wrote a post two days ago about what can you eat while pregnant and nursing  Unfortunately, in that post, I had neglected to mention what you should definitely NOT eat while pregnant due to the potential risk to the unborn child.  The following information was put forth by the March of Dimes.  You should definitely NOT eat:
  • Unpasteurized milk or juice
    • They can carry disease-causing bacteria (such as Salmonella and E. coli), making them unsafe choices for pregnant women.
    • Pregnant women can sometimes become seriously ill from these infections. Occasionally, a pregnant woman can pass a Salmonella or E. coli infection on to her fetus, who can develop diarrhea, fever and, less frequently, meningitis after birth. 
    • The FDA requires that packaged, unpasteurized juices carry a label stating that they are not pasteurized
  • Soft cheeses, such as feta, brie, Camembert, Roquefort, blue-veined, queso blanco, queso fresco or Panela, unless the cheese is labeled as made with pasteurized milk. Hard cheeses, processed cheeses, and cream and cottage cheeses are safe.
    • Certain soft cheeses can cause a form of food poisoning called listeriosis. Listeriosis is caused by a bacterium (Listeria monocytogenes) and is especially dangerous during pregnancy. 
    • When a pregnant woman is infected with listeriosis, she may have a miscarriage, premature delivery or stillbirth, or her newborn baby may become seriously ill and may die.
  • Unheated deli meats and hot dogs
    • Ready-to-eat meats (including packaged luncheon meats and deli meats) poses the same listeriosis hazard as mentioned above.
  • Refrigerated, smoked seafood
  • Pregnant women should not eat fish that can be high in mercury, like shark, swordfish, king mackerel and tilefish
    • Pregnant women can eat up to 12 ounces a week of fish that are low in mercury, including shrimp, salmon, pollock, catfish and canned light tuna.
    • Women should eat no more than 6 ounces of albacore (white) tuna, which has more mercury than canned light tuna, in one week
    • Some omega-3 rich fish that are low in mercury include salmon, herring, anchovies, sardines and trout.
    • According to the Food and Drug Administration (FDA) and the Environmental Protection Agency (EPA), women who are pregnant or planning pregnancy should avoid eating game fish without first checking its safety with their local health department
      • Some game fish also may be contaminated by other industrial pollutants, such as PCBs (polychlorinated biphenyls). Some studies suggest that exposure to high levels of PCBs before birth may contribute to learning problems, decreased IQ and reduced birthweight
    • A pregnant woman should avoid sushi and other raw fish, especially shellfish (oysters, clams). These can be polluted by raw sewage and can contain harmful microbes that can lead to severe gastrointestinal illness. 
  • Undercooked poultry, meat or seafood
    • Pregnant women should avoid eating raw or undercooked meats, poultry and eggs because they can increase their risk of a number of food-borne illnesses (including listeriosis, E. coli and Campylobacter infections, salmonellosis and toxoplasmosis). 
    • If a pregnant woman contracts toxoplasmosis, there’s about a 50 percent chance she will pass it on to her unborn baby. Some affected babies develop vision and hearing loss, intellectual disabilities, seizures and other problems.  Toxoplasmosis can also be found in cat feces and pregnant women should not change a cat's litter box.
    • Pregnant women should use a meat thermometer to make sure that meat and poultry are thoroughly cooked. 
    • Eggs, which can be contaminated with Salmonella, should be cooked until both the yolk and white are firm. Pregnant women should avoid foods made with raw or partially cooked eggs, like egg nog and hollandaise sauce. 
What you should definitely take if you are of child bearing age (whether you're pregnant or not), is at least 400mcg of folic acid daily.  According to the March of Dimes, "An overwhelming body of evidence shows that daily consumption of folic acid is a safe and effective means of preventing neural tube defects, serious birth defects of the brain and spine."   

Sunday, July 22, 2012

Eating Nuts While Pregnant May Cause Less Allergy in Kids

I ran across an interesting article today which was written after a study was published in the Journal of Allergy and Clinical Immunology.  The study, titled, "Peanut and tree nut consumption during pregnancy and allergic disease in children—should mothers decrease their intake? Longitudinal evidence from the Danish National Birth Cohort" looked at the peanut and tree nut consumption by pregnant women and the development of allergies in their children.

The study involved 61,908 mothers who were a part of the Danish National Birth Cohort.  The mothers were questioned about the frequency of their peanut and tree nut consumption (i.e. almonds and walnuts) while pregnant.  Their babies were followed-up at 18 months and 7 years to determine if they had developed asthma and allergies.

The results of the study "do not suggest that women should decrease peanut and tree nut intake during pregnancy; instead, consumption of peanuts and tree nuts during pregnancy might even decrease the risk of allergic disease development in children."

This study further supports the policy of the American Academy of Pediatrics regarding what to eat while pregnant and nursing that I wrote about yesterday.  I am glad that more studies are being done to show that there is no risk to my unborn child of consuming peanuts or tree nuts.  Due to my gestational diabetes, I have practically been living on nuts for snacks.  They are healthy, high in protein and contain healthy omega-3 fatty acids.  The March of Dimes even states that peanuts are a good source of protein and folate.  "Folate is the form of folic acid that is found naturally in foods. Taking folic acid before and during early pregnancy helps prevent certain serious birth defects of the brain and spine. The March of Dimes recommends that all women who could become pregnant take a multivitamin containing 400 micrograms of folic acid daily, and make healthy food choices that include foods rich in folic acid. "