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Daily Dose

Foods You Can Eat When Breast Feeding

1.30 to read

Should breast feeding moms avoid certain foods?I was making hospital rounds today and talking to all of the new moms (and dads) about their newborns.  I love talking to new parents about the importance of having healthy meals to support breast feeding! I even had a young dad asking “what foods should I avoid cooking for my wife while breast feeding?”  How cute is that! Can we clone him?!

After breast feeding my 3 children, I have decided that you can really eat whatever you want!  I know some people swear that certain foods you eat will cause a breast fed baby to have gas. But think about it, bottle fed babies and breast fed infants all have GAS!  None of the formulas contain broccoli, or cauliflower or beans or tomatoes and bottle fed babies have gas too. It is just a fact, newborn babies are gassy for the first several months as their digestive tracts mature. And yes, it is stinky too! So… I told this dad, “good for you for cooking for your wife.  Make her healthy, well balanced meals and throw in a few of her favorite foods.”  I would not change anything unless you can definitely correlate that a food ALWAYS makes your baby more uncomfortable (and that is so hard to keep track of). Eat what you want (in moderation) to be healthy and happy.  I have no data but feel certain that happier mothers must in some way have an effect on a  baby, so at least enjoy mealtime. When I had a colicky baby (previous post), I tried eating only broth and bland foods, and with me equally miserable and starving…this stressful situation only got worse. Final words, if I was going to try eliminating anything from my diet while breastfeeding to try and help “relieve “a gassy baby, it would be excessive dairy, as there has been some data on this. Remember, everything in moderation. I’m willing to bet that by the time your baby is 4 months old (the magic age) you are not even worried about what you are eating, as you are having too much fun laughing with your baby! What foods (if any) bothered your baby while breast feeding? I would love your comments.  Leave them below. That’s your daily dose for today. We’ll chat again tomorrow.

baby, breast feeding, Daily Dose, mom
Daily Dose

Happy Mother's Day!

1.00 to read

So, what if you were given a second chance as a mom? I know this is supposed to be a short blog, but I may need several pages to get this all out. 

As a mom, I know I have made many mistakes over the years while raising our three sons. They are adults now, but will always be “my baby boys”.

If I could re-play anything, I would advise moms to enjoy and embrace every stage of parenting as it all goes by too quickly. I always remember looking at other families and thinking, “when will I get to that stage?” as it always looked like the next milestone would be easier or more rewarding or more anything. But in reality, every single stage of parenting has its ups and downs and you can only realize that in retrospect. I was guilty of looking ahead too much rather than enjoying whatever present situation we were in. The old adage of “live in the moment” is never so true as while you are a parent. I say enjoy playing blocks with your baby, reading to your children every night, playing games in the yard, trips to the pool or long chats with your teens about their friends and making good choices. For each of these things goes by so quickly and cannot be replayed except as special memories in your mind. I would also remind you to take more pictures, and videos, as these are the things that will jog your memory later in life.

All of the memories that are hidden away in some remote spot in a mom's aging brain become clearer when you see a picture of an event. This was evident when I was trying to pull together our family pictures for our oldest son’s wedding. Why is it that I took pictures of everything when our oldest son was little, and by the third child, the pictures are fewer and farther between? He was no less important for sure, but the time issue just didn’t seem to allow it to happen. I should have made the time!! How long could it have taken to take a picture of kids playing together in the yard, or eating dinner at the table together or doing homework? Those are the memories I long to have, the “normal” family times. Most family pictures are of “events”, which is fine, but documenting the simple things too, for they are the most special memories.

Lastly, I asked “my boys” about a re-do, and they all said, “You should have let us wrestle more!” How funny is that! Seems like such a simple thing, but I was always breaking up those boys for fear of them hurting one another. The louder it got, the more I was sure it would only lead to trouble, so I was the “girl” in the middle pulling them off of one another. My advice to young parents, enjoy the ride and try to live in the moment that you are given. You never know what lies ahead, and some of the hardest times in parenting may actually help you appreciate the wonderful times even more. I am continuing to give myself that advice as I am learning about parenting grown sons and now a grandmother! Thankfully, parenting never ends! 

Daily Dose

Foods You Can Eat When Breast Feeding

1.30

Should breast feeding moms avoid certain foods?I was making hospital rounds today and talking to all of the new moms (and dads) about their newborns.  I love talking to new parents about the importance of having healthy meals to support breast feeding! I even had a young dad asking “what foods should I avoid cooking for my wife while breast feeding?”  How cute is that! Can we clone him?!

After breast feeding my 3 children, I have decided that you can really eat whatever you want!  I know some people swear that certain foods you eat will cause a breast fed baby to have gas. But think about it, bottle fed babies and breast fed infants all have GAS!  None of the formulas contain broccoli, or cauliflower or beans or tomatoes and bottle fed babies have gas too. It is just a fact, newborn babies are gassy for the first several months as their digestive tracts mature. And yes, it is stinky too! So… I told this dad, “good for you for cooking for your wife.  Make her healthy, well balanced meals and throw in a few of her favorite foods.”  I would not change anything unless you can definitely correlate that a food ALWAYS makes your baby more uncomfortable (and that is so hard to keep track of). Eat what you want (in moderation) to be healthy and happy.  I have no data but feel certain that happier mothers must in some way have an effect on a  baby, so at least enjoy mealtime. When I had a colicky baby (previous post), I tried eating only broth and bland foods, and with me equally miserable and starving…this stressful situation only got worse. Final words, if I was going to try eliminating anything from my diet while breastfeeding to try and help “relieve “a gassy baby, it would be excessive dairy, as there has been some data on this. Remember, everything in moderation. I’m willing to bet that by the time your baby is 4 months old (the magic age) you are not even worried about what you are eating, as you are having too much fun laughing with your baby! What foods (if any) bothered your baby while breast feeding? I would love your comments.  Leave them below. That’s your daily dose for today. We’ll chat again tomorrow.

Daily Dose

Mommy Guilt

1.15 to read

I spent part of my Mother’s Day reading the Time magazine article on attachment parenting.  The cover is obviously quite provocative and has stirred a lot of discussion in and of itself.  Even SNL spoofed it! But the greater discussion seems to me to be on how women mother and parent. What constitutes a good enough mother? (wonder if there is going to be a follow up article on fathers just in time for Father’s Day - what would that cover look like?) 

I guess my first thought about the article is that mother’s often feel like they are not good enough. I don’t think that is necessarily influenced by how long you breast feed, or if you let your child sleep in your bed, or if you ever yelled at your child. It is something about the female brain and we feel guilty about so many issues as they relate to mothering.  I have now practiced for over 25 years and the topic of maternal guilt has always been an issue for so many of the mothers I see on a daily basis, it doesn’t seem to change.  Me included! 

For some reason, the female hormones estrogen, progesterone, and prolactin that surge at the time of a baby’s delivery must also turn on some deep area of the brain related to guilt.  I often joke that “with the final push” comes enough guilt to last a mother’s lifetime. (seems to happen with a c-section as well).  The attachment to that baby is so deep that any little thing can cause maternal anxiety and it often starts with whether or not to breastfeed your baby. So let’s start with that subject. 

As a pediatrician I am a huge advocate for breast feeding, but with that being said I have also seen many a mother who is unable to breastfeed. There are any number of reasons (including breast reduction surgery and no let down, maternal medications which might affect the baby, and a mother who was diagnosed with breast cancer while pregnant who started chemo immediately after delivery.) 

There are also some mother’s who just don’t want to breastfeed. Should they be judged inadequate right out of the gate? I don’t think that is my role as a pediatrician to make that mother feel guilty. I think I need to discuss the options and the benefits of breastfeeding but at the same time realize that one size does not fit all. Is it worth having a depressed, sad and anxious mother who is unhappily breastfeeding, over a bottle fed baby with a happy mother? I think maternal well-being and feeling bonded to that newborn is what is important, whether that be with a breast or bottle. You can be attached to that baby without out actually having a latch. 

So...I digress. What about guilt and motherhood? I just don’t know how to fix it but I don’t think that the front of Time magazine really helped, but did provoke lots of conversation. 

What do you think?  I would love your thoughts! Leave them below.

Daily Dose

Pregnant? Get Your Flu Shot

1.45 to read

If you are pregnant, know someone that is pregnant, or are even thinking about becoming pregnant, you need a flu vaccine!!  (That is not to say that we all need to be thinking about flu vaccine’s right now!)

A study out of Duke University showed that of 1,600 women who delivered during the 2009-2010 flu season, those that had received a dose of flu vaccine delivered more term babies and also delivered babies who had higher birth weights. Women who received at least one flu vaccine during the season were also less likely to require a doctor’s visit for flu prior to delivery and they had lower hospitalization rates.

Another study out of Wake Forest University which was recently published in the Journal of Obstetrics and Gynecology looked at women who had received flu vaccine during their pregnancy.  This study showed that infants born to mothers who received flu vaccine while pregnant were 50% less likely to be hospitalized with flu than infants born to mothers who had not received flu vaccine. This was a study conducted over the years 2002-2009 (before H1N1) Impressive!

Flu vaccine is recommended for everyone 6 months of age and older. Infants 6 months of age and younger have the highest rate of hospitalization for flu related illness among all children.  The only reason that flu vaccine it is not given to younger infants is that the vaccine is not effective. How do we protect those babies, by protecting the mothers who are carrying the child? 

So…bottom line, pregnant women who get their flu vaccines not only protect themselves, they are protecting their newborn infants as well. A mother’s job of protecting her children is life long, but it begins even with a baby in utero. Go get that vaccine, as flu season is upon us!  

That’s your daily dose for today.  We’ll chat again tomorrow.

Daily Dose

Breastfeeding Needs Patience & Practice

It is not uncommon for many new mothers to be concerned and breastfeeding and also finding it to be a little more challenging than the books would say.Those first several days home with a newborn can be very difficult and not exactly like the Gerber your-baby on TV. I typically see a newborn in my office several days after they are discharged from the hospital, so day four to six of life. That gives parents several days to have been home alone with their your-baby and then the questions begin.

It is not uncommon for many new mothers to be concerned and breastfeeding and also finding it to be a little more challenging than the books would say. The first thing I tell them is that there is not a book that will provide the same information as on the job experience (kind of like the rest of parenting!) Breast feeding may take a bit for both your-baby and mother to get used to, new job for both, and don't let that discourage you. I found the person who was most helpful getting me comfortable with breastfeeding was a friend who had done it before and who was a cheerleader for me. The adage practice, practice, practice is important here, and you will make breast milk (trust me on this one) and your your-baby will get the hang of it, but be patient. It can bring even a CEO new mother to tears but this is not like running a business, the your-baby has their own agenda, and despite your best intellectual efforts this event is based on patience and persistence, not IQ. By day four to six a mother should have breast milk and you should see that your your-baby is having wet diapers and that their stools are changing from dark, sticky meconium to yellow, seedy stools. There are usually numerous stools and wet diapers as the your-baby picks up their nursing and "gets the hang of it". Don't be alarmed if every feeding does not go as smoothly as the next, the your-baby is just like you, eats more some times than others. The important things are to get the your-baby to the breast every two to three hours, for the nursing mother to drink lots of fluids and to eat well. Lastly, both your-baby and mother need rest, so hop back in bed between feedings. That's your daily dose, we'll chat again tomorrow.

Daily Dose

Celebrating My Son's Birthday & Motherhood!

Dr. Sue reflects on 27 years of motherhood.27 years ago today I became a mother.  At the same time, I was just finishing my pediatric residency, so I thought I was “prepared” to be a mother.

The first thing I figured out, within just a few short hours was that while being a pediatrician helped me (most of the time) recognize serious illness in my own children, it did not “prepare” me for motherhood . Being a parent is on the job training!

Looking back with joyous nostalgia about the birth of our first son, I remember how excited we were to be new parents.  The pictures of that precious 6 lb. 6 oz. baby boy, who is now 6”2” tall, show blissfully happy young parents cuddling their newborn.  But, by the time we had been home for 48 hours I had already been reduced to tears as I tried to figure out breastfeeding (that is on the job training for sure), and my precious baby boy had bruises on his ears as I tried to “push his head to my breast”, as I had been instructed. I can now laugh about how inept I was, but gradually we figured out breastfeeding, only to move on to the next hurdle. Luckily you don’t have a crystal ball to realize that there are many other hurdles and hoops to jump through during the parenting years. You just figure them out as you get there, and vow to never give up. Well, happily our precious son managed to teach us novice parents so many things along the way. We often tell him that the first child is somewhat of an “experiment” as you learn from your mistakes.  Some things you swear you will never do again, and others work well and are repeated with each subsequent child. You can’t pick your parents or your birth order, so each child has somewhat of their own experience depending on where they fall within the family. But each child is loved equally and unconditionally. One day I remember trying to instruct our second son (probably about 3 at the time) on some topic (can’t really remember what), but the older son (age 5) leaned over to tell his brother what to do.  When I pointed out to the eldest son that I was the mother and could handle it, his very quick response was, “if you were doing a better job, I wouldn’t have to help you”. I guess he had already figured out we were new at this game and he had some input that might help us out!   How did I manage to keep a straight face, as I can still laugh at that story today! As I am writing this, I continue to remember some of the best advice I ever received and continue to give today.  Parenting never ends, but while the days and nights seem endless, the years go flying by.  I know this to be true as I enter year 28 of being a mother and I am still learning! I would love to hear your first time mom stories! Don’t be shy, send me your advice!

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Daily Dose

Moms & Dads Need Vaccines Too!

Moms and dads need immunizations too!I saw a two-week-old baby the other day who is the second child for one of my many families. Their first is a precious 2 1/2 year old girl. I must admit, this is one family I really enjoy.

The mother was in and is doing well being a mother of two.  Her infant son is gaining weight well and is as cute as a button. The mom mentioned to me that they had all been sick with a cough and cold, but the baby is fine and asymptomatic.  At any rate, the evening before the baby’s visit, the Dad was not feeling well, complaining about a headache, sore muscles and feeling badly and he had also noted a scratch on his leg.  He reported to his wife that he had a temperature of 99.2 degrees. By now it was 1:00 a.m. and she was tired as she went off to nurse the baby. A few minutes later, her husband came in to talk. He told her he had figured out what was wrong with him, he thought he had tetanus (admittedly this was his internet diagnosis) due to the scratch on his leg and his symptoms of muscle aches etc.  She told me she was LOL as he walked out of the room! They were both just too tired for him to have tetanus! So, with the fear of tetanus, he made a doctor’s appointment for the next day. While I was seeing the baby and hearing this story, dad called mom to report the results of his doctor’s visit. Good news; no tetanus, and only sinusitis. The doctor put him on a round of antibiotics to treat his sinus infection. The doctor had also looked at the scrape on the dad’s leg and agreed  that the he did NOT have tetanus but because he was due for an update on his immunizations, he received a Tdap vaccine while he was there.  That was even better news!!! As you know, I have talked about the need for adults to get updated immunizations and most importantly  to vaccinate against pertussis (especially during the current pertussis outbreak). What an opportune time for this father’s internist to take the opportunity to vaccinate this father, which in turn will protect his own newborn son as well as the rest of the community. Many of my young adult parents are unaware of the need for continued immunizations and have not received a Tdap vaccine. All adults who are younger than 65 years of age,  and who have not had a recent Tetanus shot, probably in the last 5 years, need to receive a Tdap vaccine that provides protection against tetanus, diphtheria and pertussis (whooping cough). This shot is then repeated every 10 years.  In some cases new parents are receiving information about this vaccine from their Ob-Gyn. Some new mother’s report to me that they were given the option of receiving the vaccine in the hospital after having their baby, but is seems to be dependent on the OB that delivered them, rather than a standard order for all women in the post partum unit. At the same time, the hospitals are not offering the vaccine for the father of the baby, so this means that the new dad needs to find a place to get his own Tdap. It seems like we (the medical community) should make it a little easier and more consistent to get this vaccine, especially when we are having an outbreak in the U.S. and there have even been infant deaths reported in Northern California. The funny story of a father who was convinced he had tetanus ended up with a happy ending for all. Dad got his Tdap, mom had a cold which she is recovering from and the baby slept 6 hours the other night! That's your Daily Dose for today.  We'll chat again tomorrow. Send your question to Dr. Sue

Daily Dose

Breast-feeding is ‘On the Job Training’

So many of my mothers breast feed their babies and enjoy the experience. I think it is a little harder to breast feed in the early days after the your-baby is born, as your milk "comes in" and you deal with sore, full breasts as well as little sleep. Even with a well-prepared mom who has read all of the books, and practiced with dolls in different holds, real breast-feeding comes from "ON THE JOB TRAINING." But, over the next few weeks as the milk supply is established it will become much easier to breast feed and both mother and your-baby get the hang of nursing.

Saying this, it is not always possible for every mother to be successful at breast-feeding and not every mother wants to breast feed her your-baby. Although breast milk is ideal for an infant, formula works well too. The most important thing for your your-baby is for you to be a happy mother. Numerous studies have corroborated this fact, and if mother is happy, your-baby will thrive on breast milk or formula. When I discuss this with many mothers who are unhappy nursing, or are not making sufficient milk to provide enough calories for their your-baby to gain weight, there is such a sense of relief. Guilt is part of being a parent (seems especially so in us moms) but to start off your parenting feeling this way is not good for anyone. Do what is best for you and your child, and don't feel pressured by family, friends or coworkers. Lastly, there are all sorts of ways to successfully provide both breast milk and formula for your your-baby, so discuss your options with your doctor before feeling like a failure or stressing out. Just like babies, moms are all different too. That's your daily dose, we'll chat tomorrow.

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