This One is for Moms

Is Restricting Really Normal?
By Christie Caggiani, RDN, LDN, CEDRD

 

“We don’t keep bread in the house.”  “One serving is enough – kids don’t need seconds.”  “We just have protein and veggies at dinner.”  “Why is my child sneaking food and snacking all the time?!”

 

Hmmm – at first glance, these may seem like separate, unrelated statements.  There is, however, a common thread and a chain reaction that is in play throughout the scenarios…and it all starts with restriction.   If you consider the unrelenting headlines that tell us obesity is an “epidemic”, that individual foods will either kill or save us, and the sneaking messages that lead us to think we’ll only be happy if we are a certain size, then it makes some sense that people are grabbing at the latest food rule (aka, restriction), to take control of their or their kids’ lives.   Yet the more we reach for restriction, the more out of control we become.

 

Let’s keep it straightforward.  There are some basic side effects of over-controlled under-eating:

  • It confuses body chemistry, triggering it to more readily lose muscle and regain weight as fat
  • It causes feelings of deprivation and depression that often rebound to overeating
  • It creates a lowered self-esteem, and disconnects individuals from their emotions and sense of well-being
  • It creates irritability, decreases concentration and memory, (especially if carbs are limited) and can cause tension in relationships
  • It can disrupt a female’s menstrual cycles
  • It makes exercise ineffective, because there isn’t enough fuel to run your body’s basic processes

 

So when you feel the need to snack on cookies and chips after the kids have gone to bed, notice if you’ve eaten enough during the day or pulled carbs out of the meal prior.  We can’t function effectively if we are depriving ourselves of enough fuel – and we are destined to swing the pendulum the other direction to try to create balance.

 

And the next time you feel the emotional tug to try the latest fad diet, label carbs as evil or tell your kids to stop eating, take a deep breath and remember:

Eating is Normal. Restricting is Counterproductive.   

 

 

Raising Children With Different Nutrition Needs

By Laura Cipullo, RD, CDE, CEDRD, CDN with Elyse Falk, MS, RD, CDN

A Real Mom’s Question

How should a parent handle instances when one child has a HUGE sweet tooth, and is underweight but the other kids in the same family are a normal weight or overweight?  For example, at dessert time, all the kids want ice cream – maybe one child shouldn’t have a ton and the other really could use it.  How does a parent deal with this situation in a way that doesn’t create food issues?

Two Real Moms’ Answers

Focus on Equality

First and foremost, everyone should be treated equally at the dinner table. In order to prevent any type of discord between the kids, you’re far better off teaching them the importance of nutrition and their health in a more neutral setting.

Regardless of weight, children need to focus on eating balanced meals and snacks. Sweets, like cake, cookies, and candy, are what we like to call “sometimes foods,” because they are foods that are okay to eat some of the time.

The child with the huge sweet tooth has to learn to eat an array of flavors – not just those made mostly of sugar – otherwise they may develop nutrient deficiencies or simply close their mind to the idea of fruits, vegetables, lean meats, nuts, eggs and low-fat dairy. Even an underweight child should not make sweets his or her primary source of nourishment. Instead, teach them to focus on increasing the amount of nutrient-dense foods they consume throughout the day. Young children need to learn to eat the kind of food that’s necessary for their bodies, and observe healthy role models who guide them, so that they can grow into confident eaters.

Reassess

Did your family’s pediatrician recommend that your child gain weight, or are you assuming this? Do your children’s height and weight fall into in the same percentiles on the growth chart? If so, it is probably safe to assume that both of your children are at appropriate weights. In general, the focus should not necessarily be on gaining weight. Instead, it should be on eating enough nutritious food on a daily basis. Consider seeking counseling with a registered dietitian.

If your child’s weight is truly beneath their height on the growth curve, your child has not grown in a year, or if a physician prescribed weight gain, then you’ll need to focus on increasing the quantity of food your child is consuming while simultaneously looking for ways to add nutrient-dense foods to their intake (this refers to a small serving of food that is high in calories). As Mommy Faulk reminds, children have smaller stomachs than adults and often can’t consume large amounts of food at a time. Because of this, they may need to eat smaller, nutrient-dense meals more often.

You may also want to ask yourself: Is my child a picky eater? Don’t forget that, just because school sets aside time for lunch doesn’t mean your child is eating. Perhaps something happened at school that is causing them not to eat, or maybe they don’t have enough time to eat. This may be the problem, especially if your child has lost a significant amount of weight in the past 2 months (>/= 2%) and could possibly put them at risk of developing an eating disorder. In other words, in order to remedy the situation, it’s essential to first determine why your child is not meeting their nutrition needs.

Quick Tips to Increase Intake Without Increasing Quantity

  • Add 1-2 tbsp of wheat germ to yogurt, meatloaf, cereal, muffins, etc.
  • Add an extra slice of cheese to their sandwich.
    • Add granola to low fat yogurt or allow them to eat it plain.
    • Put peanut butter on their muffin.
    • Make smoothies with protein powder and lots of berries.
    • Add a morning snack of raisins or nuts at around 10 a.m.
    • Provide a snack of crackers and a spread like hummus before bed.
    • Encourage healthy fats such as avocado, olives, olive oil, nuts, and nut butters.
    • Have all-natural nutrition bars and packaged low-fat milk available on the go.
    • Let them have a mini-meal when they get home from school, like a sandwich, grapes, low-fat cheese, hearty soup, homemade English muffin pizza, etc.
    • Add olive oil to whole-grain pasta and veggies; let child dip whole-grain bread into olive oil with their meal.

Behaviors to Implement

  • Talk to the school to help your child to remember to eat.
  • Help your child relax before meals and decrease anxiety to prevent emotional fullness.
  • Encourage your child to help choose the menu.
  • Do not discuss food issues and/or weight at the table.
  • Focus on your child’s behaviors around food and commend them for trying new foods or practicing self-care.
  • Make meals an enjoyable time so they are not rushing to finish and leave the table.
  • If the pediatrician is concerned, have them talk to the child with a parent in the room and explain why they need to get more nutrition.

To Breastfeed or Not To Breastfeed?

In honor of World Breastfeeding Week, we wanted to share a previous post from a guest blogger, Allison:

 

Guest Blog: Breastfeeding versus Bottle-feeding
By Allison Brooks

Photo Credit: nettsu via Compfight cc

Moms may differ in their opinions and or choice to breastfeed or bottle-feed. I personally think it should be the woman’s right to choose. Breastfeeding and bottle-feeding both have pros and cons. We hear the many pros of breastfeeding such as less illness, possible greater intelligence of the child and so on. Many organizations including the Academy of Nutrition and Dietetics (formerly known as the American Dietetic Association) promote breast-feeding here in the USA and abroad. However, I question whether this is always appropriate especially if the mother is deficient in micronutrients, deficient in essentially fatty acids, malnourished, stressed, had multiple births in a short period of time or perhaps is not the right choice for the mother. I was breast fed for 3 months and choose to bottle feed my children.

Below, guest blogger Allison Brooks shares her point of view at an international level. Allison studies biomedicalization in Bolivia. Here she presents an example of biomedicalization on breastfeeding versus bottle-feeding in third world countries. Allison shared with me that she too was bottle-fed.  Feel free to comment and share your opinions as well. All are welcome.

Biomedicalization of BreastFeeding: What is healthy here, might not be healthy for all

Biomedicalization is a term used to describe the way in which natural life processes, human conditions and problems are defined and treated as medical conditions. Aging, childbirth and breastfeeding are good examples of normal life processes which have come under the authority of doctors. Biomedicalization may bring benefits, but there are also costs. Philosopher Ivan Illich was one of the first to use the term “medicalization,” which he argued actually caused an increase in social and medical problems as a result of medical intervention. One example is the drive by manufacturers of baby formulas to supplant breastfeeding with formula.

When a mother dies in childbirth or cannot breastfeed for some reason, infant formula may be the only choice. However, in the underdeveloped nations of the world, breastfeeding serves a number of critical purposes. Breastfeeding protects babies from infection, provides them with near-perfect nutrition and acts as a natural birth control for the breastfeeding mother. Breastfed babies are less likely to develop diarrhea, bacterial meningitis, ear infections and respiratory infections than infants who are fed formula. Breastfeeding also triggers beneficial hormone secretion in the mother, and the milk changes in amount and constituents to meet the needs of the individual infant.

The Nestle baby formula promotion of the 1970s urged mothers in less-developed countries to forgo breastfeeding in favor of formula, stressing convenience and nutrition. Nestle used strategies such as sending a new mother home with free samples; once the samples ran out, the child was habituated to formula and the mother’s milk had dried up, so the family had to buy formula.

Problems with this sort of infant nutrition quickly became apparent. Formula must be mixed with water and water in poor countries is often contaminated. Mothers could not read the instructions on water sterilization, or did not have the means to boil the water. Formula-fed babies were much more likely to die of diarrhea or pneumonia as a result of infections. Poor mothers would often mix inadequate amounts of formula for each feeding to make the expensive formula last longer, resulting in malnourished babies.

Nestlé’s marketing activities were considered so unethical that a boycott was launched by a group called the Infant Formula Action Coalition. In 1981 the World health assembly adopted Resolution WHA34.22, which bans the promotions of breast milk substitutes. Although Nestle agreed to accept the code, in 1988, formula companies were accused of repeating the unethical tactics and the boycott, which was still in force as of 2011, was launched. Other companies such as BordenSimilac and Wyeth have come under similar criticism for marketing methods that imply formula and breast milk are nutritionally equal. Most physicians and international organizations such as WHO and UNICEF recommend now breast milk exclusively for the first six months of life.

But the effects of biomedicalization do go way beyond the idea of breastfeeding. Pharmaceutical companies push new rules on societies regardless of their cultures, everyday. This is easy to see in America, because we are the only country that allows pharmaceutical companies to run ads and develop an image for people to follow. Without regards to the culture, the environment and so on, sometimes these “better” medications/therapies can actually be harmful for the people. With new drugs entering the system to promote beauty or health, or a better life-expectancy for cancer, traditional practices are be dropped by the wayside, and people and cultures are being negatively affected.

 

About Guest Blogger Allison Brooks:

Allison says “I was bottle-fed too, that’s why I say what is healthy to you might not be healthy to others (cultural relativism). Thats why I don’t push my beliefs onto people, I state what I know and allow you to do what you please, with no judgment.”

Allie went to the University of Mississippi. She earned her degree in biomedical anthropology and  is now studying in the field to finish an ethnography on the effects of biomedicalization on Bolivian cultures, but as it relates on other societies as well. She loves to guest blog on her time off to past time and spread the word. When she is not at her computer, Allie enjoys riding her  horse, Lilly and playing with her ducks, Alvin and Shirley.

One Mom's Story on Breastfeeding

In honor of World Breastfeeding Week, we wanted to share a post from a guest blogger, Rachel:

Breastfeeding May Be “Natural,” but That Doesn’t Make It Easy
By Rachel Lipson

Like so many other pregnant woman, I spent the months leading up to my son’s arrival planning, reading, decorating the nursery, and educating myself about childbirth, breastfeeding, and raising a newborn. I took classes, read books, talked to lots of moms and moms to be to get more tips. Everyone told me that breastfeeding would be difficult, but I couldn’t believe it would be difficult for me. I couldn’t imagine that a practice passed down over so many generations, a practice that nourished newborns since the beginning of time, could be all that challenging. The pain of unmedicated childbirth should have given me a clue that just because something has been done countless times before doesn’t mean it’s easy. I took breastfeeding classes, read books, talked to anyone who would give me tips, and prepared myself for any issue that could come up with nursing.

 

When my son came out last November, rooting and ready to latch, it still seemed like the most natural, carefree experience a mom and baby could share. How amazing that he came out knowing just what to do! Then he latched on and I was in excruciating pain! I was breathing through every suckle like it was another contraction. The nurse told me to toughen up (ironic since this was following a thirty-hour labor, an unmedicated birth, and two very severe post-partum hemorrhages that led to massive medical interventions and two blood transfusions). I had just been through quite a lot but was feeling stronger and more capable than ever. So, I persevered. The nurses at the hospital fancied themselves lactation consultants but dished out the worst advice. It turned out, following a visit to the pediatrician after we got home, that my son was tongue-tied. I thought that sounded like a figure of speech and not a diagnosis, but as it turned out, his tongue was too attached to the bottom of his mouth and that’s what caused the painful latch. We were referred to an ENT and had it corrected when Max was five days old. We were told he would cry for a moment and then nurse painlessly immediately after. He did only cry for a few moments, but when he tried to latch, he couldn’t figure out what to do with his tongue! After two visits with a lactation consultant, we were partially able to nurse with a nipple shield. Then, at the next doctor’s visit, it turned out Max was losing too much weight. We were advised to supplement with formula, but instead I supplemented with my own pumped milk in bottles after every feed.  Max’s latch was still incorrect, and it turned out he wasn’t efficiently nursing. I continued to nurse and pump and bottle feed…I was exhausted!

 

All of that pumping helped him to return to his birth weight but led to a massive oversupply of breast milk. Max would drink for a few moments and pop off screaming as milk squirted into his mouth. This was just getting harder and harder. I should say here that I’m the type of person who is extra motivated and somewhat of a perfectionist. It’s harder for me to give up than it is to persevere. Still, I thought about giving up, and when Max became colicky at three weeks old, I was ready to throw in the towel. I was exhausted, the latch problems were still there, and the nursing, pumping, and bottle-feeding took up way too much time and energy. That’s when things really got tricky. Max’s colic got worse and worse. He would cry and fuss from 7:00 p.m. or so until 2:00 a.m. every single night. My husband and I were losing our minds. The doctor suggested giving up dairy in my diet to see if it helped his colic. She gave us a can of hypoallergenic formula to try as well in case we wanted to see results even faster. Within just a few days, Max was a different baby. He no longer seemed to be in such intense discomfort, and the crying at night subsided. It turned out that Max had a milk protein intolerance. Problem solved!  But wait! A few days later, his reflux started. He was spitting up left and right and crying out in discomfort. The doctor suggested giving up soy as well. I gave up soy, and his reflux started to improve to some extent. The hypoallergenic formula made his reflux much worse. We tried multiple other hypoallergenic formulas (to supplement), and every single one made him absolutely miserable and unable to keep any food down.

 

From that moment on, I knew that all I had done to continue to breastfeed my son had been worth it. I had a child who couldn’t tolerate any food other than my breast milk (as long as it was milk and soy free). We had all sorts of other ups and downs, Reynaud’s phenomenon, mastitis, etc. I constantly wished I could stop, but I knew that this wasn’t an issue of what I felt was best for my son…there was nothing else for him to eat! What would we have done if I hadn’t kept it up all those weeks before? By six months, he was thriving and loving life. The reflux started to subside, and with the help of the amazing Brooke from Sleepy on Hudson, Max started sleeping through the night. I tried every hypoallergenic formula out there once again and found that there was one ready-to-feed version (one that had failed us miserably early on) that he was able to drink and keep down. When he was seven months old, he had given up nursing (his choice) for the most part and was exclusively bottle-fed (still mostly breast milk). I knew I had given him what he really needed…food and sustenance during a time when he couldn’t tolerate anything else. I was ready to eat dairy and soy again, ready to stop pumping 4–6 times a day, and completely weaned him by the time he was eight months old. Now he’s nine months old and as happy and healthy as can be.

 

Pregnancy was challenging at times, childbirth was excruciatingly painful beyond words, but breastfeeding was hands down the hardest thing I’d ever done in my life. It wasn’t always the amazing bonding experience I had envisioned, but I am grateful that I had the willpower and perseverance to stick with it when my son really needed me the most. I can’t believe I thought it would be easy! Of course, I’m sure it couldn’t be that hard the second time around…right?

 

About Guest Blogger Rachel Lipson:

Rachel Lipson is the founder and director of Blue Balloon Songwriting for Small People in Brooklyn, NY.

Breastmilk or Bust

Does the Rocking Chair Look Good Next to the Deep Freezer?
By Amanda Mellowspring, MS, RD, CEDRD, LD/N

Eat from the Earth Nutrition Counseling, LLC
www.eatfromtheearth.com

We all hear stories about “the crazy things” that mothers will do to care for and protect their children. I, along with many of you, also thought I was immune to such craziness despite my big heart…until I actually became a mom myself! Oh yes!

First, I will declare that “crazy” is not the right word for what I will share below, nor for most of the decisions we make as parents. While others may have their own views on our choices, the decisions that feel right in your family do not require approval from others. So, here’s a portion of my story…

In 2012, my husband and I welcomed a baby boy into our lives through adoption. What a powerful experience (which is an entirely separate story)!

As with any parents, our discussions had thoroughly covered a million topics on how we would care for this child. We reached out to only a few family and friends before his birth to avoid spreading the word in such a delicate situation (again another story altogether). One topic that arose as we spoke with another family that had recently adopted a child was feeding. Now, I certainly think most families have some discussion about feeding, so I don’t think being a dietitian really impacted me all that much. My friend shared with me the idea of breastmilk donation. I was immediately in LOVE and curiously asked a million questions about safety, quantity, storage, resources, and networks and then we were off! We eagerly met with pediatricians in our area to find a good fit before the big day and asked for their feelings about our decision to pursue breastmilk donation, at least as much as possible. We purchased a deep freezer for our milk storage & pre-purchased breastmilk bags to trade these amazing mommas who would offer us milk. We nervously contacted our local midwife to explain our situation and ask if she knew any mothers who may like to donate. Interestingly, this was the only thing, aside from one sweet handmade teddy bear that my husband made, that we allowed ourselves to do to prepare for his birth. Again, side story, adoption is amazing and amazingly scary. Everyone approaches this in their own right way.

The dietitian in me did step in the picture at times. We had an open adoption process, and knew that our birthmother was a beautiful gift in our life, but she also refused anything aside from soda and pizza throughout the pregnancy. Now I am not out to bash a good pizza and soda now and again, but talk about checking my work at the door! And, don’t worry I hold onto my own mom/RD guilt about not trying to induce lactation (yes, you can do this & yes, it is super cool), but there were a million reasons that it wasn’t possible in my life at that time. I have always been a strong advocate for breastfeeding, but prior to hearing about breastmilk donation, I had already adjusted my personal feelings about using formula as I had anticipated it to be my only reasonable option. Yes, formula is formulated to resemble breastmilk and provides adequate nutrition, and bonding really comes from love and not from boobs, so I was okaying myself with this. In learning more about milk donation, I also knew that I would most likely supplement with breastmilk donations and primarily feed formula and it would be fine, more than fine. I mean, how would I actually get enough breastmilk from other women to feed him only that!?! So, my dietitian part obviously loved the idea of the nutrition that breastmilk would provide, but I was most excited surprisingly about two other aspects of this endeavor – introducing milk would allow for flavor variation which would assist with food introduction and the development of his flavor palate & I would meet other moms! When you adopt, you don’t generally build the community that you may get from birthing classes etc, so meeting mommas was on my radar!

Beautifully and perfectly, our little guy was born on 9/12/12 and came home with us just a few days later. Over the next 9 months, I fully engaged in my “crazy” & my amazing husband went there with me! I linked up to every milk sharing network that I could find and began driving all over the state (& even other states when we travelled) to meet moms to trade breastmilk for milk bags and fresh foods from our garden. (The Friday evening car rides that took 3-4hrs round trip to pick up donations, the parking lot meetings at Babies R Us, & the coolers that constantly resided in the back of our car may be the “crazy” that I speak of!) Most of the moms didn’t want anything in trade (although milk bags are expensive and I would have bought a million of them if someone had wanted). Just the joy of knowing that they were offering a priceless gift satisfied these amazing women. (It is illegal to pay for breastmilk in the US just so you know, & I never met a mother that would have ever considered it either.) Amazingly, we were able to provide him with ONLY breastmilk from donation for 9 months – and talk about flavor profile with cultural influences from all over Latin America, Asia, Australia, France, & throughout the US! I will just take a moment here to say that the amount of breastmilk that a woman can produce is AMAZING! Seeing all of the milk that my son took in just by standing over a deep freezer packed, labeled, and organized always left me in awe (& usually tears again…a theme in motherhood I am pretty sure.) We pulled back from the search a bit as he started to eat more solids, because we knew that there were more new little ones out there that could benefit from this precious gift. Our little guy had never even had a diaper rash in this time period, so we wanted other babies to benefit from this nutritional gold mine too.

The idea of breastmilk donation dates back, way back, all the way back! Historically women have always been known to wet-nurse or nurse babies that were not their own. It’s just a love thing. But, even still, my protective mom self and my RD part considered what questions to ask women about their lifestyle, their diet, their health, etc. ‘To each her own’ on this topic, I say. I think everyone should be responsible for asking the questions that fit for them. We did not use formal hospital-based milk banks (which do exist) because those generally are reserved for sick children or children with special nutritional needs & there was not one in our area. For me, I can say that I have hugged every woman that provided for my child in this way & that, amongst a few questions here and there, felt right for me. Mind you, that almost all of these women came to me to offer to donate via midwives, other mommas, & friends. I went to their homes, met their babies, and even shared tears for babies that made the gift possible but didn’t live to see the gifts of their mothers in this way. Many women consider the birth children of their milky moms’ to be “milk brothers/sisters”. All of the sudden, I wasn’t just making momma connections; our family was literally growing with every milky mom we met! Thankfully, somewhere in the craziness of the adoption process and becoming a mother, I had the clarity to ask each woman to pose for a photo with our little one. In total, over 30 heart-touching, heart-wrenching photos of love and gratitude have compiled my little guy’s “Moms Book”. His book includes photos of his birthmother, several women (& a man) who were integral to his adoption, over 30 milky moms, & me. Quite a book. And, we are really loving picture books right now anyhow. We look at it together, and I suppose that one day he will ask why I always cry when we do.