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Your Baby

Eating During Labor May Speed Up Delivery

1:45

In many hospitals, when a woman is in labor, all she is allowed to eat are a few ice chips. That rule may need updating, according to a new study that finds women who were allowed to eat before delivery had a slightly shorter labor than those who were restricted to ice chips or sips of water - although the study can't prove that eating caused deliveries to happen sooner.

The practice of limiting food during labor goes back a study in the 1940s in which women who delivered under general anesthesia were at risk of inhaling their stomach contents and choking in it, writes senior author, Dr. Vincenzo Berghella, of Thomas Jefferson University in Philadelphia, and his colleagues in Obstetrics and Gynecology.

“We really don’t know how much if anything people can eat or drink in labor," said Berghella,.

Whether women can have more than water or ice chips as they labor to give birth is a common discussion among healthcare providers, he told Reuters Health.

General anesthesia is not commonly used during delivery these days, but the old guidelines are still in use.

For the new study, the researchers compiled data from randomized controlled trials that compared the labor outcomes of women who were allowed to eat only ice chips or water and those who were allowed to eat or drink a bit more.

For example, one study allowed women to drink a mixture of honey and date syrup. Another study allowed all types of food and drinks. A few others allowed women to drink liquids with carbohydrates.

Overall, the researchers analyzed 10 trials that included 3,982 women in labor. All were only delivering one child - not twins or triplets - and were not at risk for cesarean delivery.

The women with the less restrictive diets were not at increased risk for other complications, including vomiting or choking, during the use of general anesthesia.

And women who were allowed to eat and drink more than the traditional ice chips and water had labors that were shorter, by an average of 16 minutes, compared to women with the more restrictive diets.

Speaking from experience, 16 minutes less of labor pains is a real bonus. How does adding more liquid or food during delivery help reduce the time before delivery? The researchers presented some ideas.

"If we’re well hydrated and have adequate carbohydrate in our body, our muscles work better," said Berghella. A woman's uterus is largely made of muscle.

Another of his studies, which found women who received more fluid than normal delivered faster than other women, reinforces the finding.

Berghella said it's still common practice for women with uncomplicated births to be restricted to water or ice chips during labor.

"The evidence from well-done studies is they can have more than that," he said.

Do women really want to eat much during labor? Probably not, there’s a lot going on in the body as labor progresses.  But more liquids and some light carbohydrates during the early part of labor may be welcomed – especially if they shorten the time between labor and when baby enters the world.

Story source: Andrew M. Seaman, http://www.reuters.com/article/us-health-pregnancy-labor-food-idUSKBN15O2ZR

 

Daily Dose

Fit Foods for a Healthy Lifestyle

1:15 to read

Wherever you are on your healthy lifestyle journey, you are not alone.  I tell my patients that the key to being healthy is being disciplined in eating the right foods, staying active and getting enough sleep...and that’s for both you and your kids.

Committing to your overall health and wellness should start early on.  When you’re pregnant, it doesn’t always mean you’re eating for two. A growing baby needs nourishment from their mother’s diet throughout the day but experts say nutrition during pregnancy should be about adding extra nutrients and not extra meals. Moms to be need to be eating foods that are good for them and their baby.  You just need to choose the right ones.

Avocados are a power food loaded with critical vitamins and minerals pregnant moms need to pass along to their unborn baby.  Nutrients like folate which helps prevent birth defects of your baby’s brain and spinal cord. Avocados contain powerful antioxidants like lutein an ingredient found in breast milk which is known to protect important cells in a baby’s eye. 

It’s so important for pregnant moms to consume a host vitamins and minerals and avocados are a great resource.  You might say avocados are a very similar to a prenatal vitamin!  And avocados may even help reduce morning sickness!

And the health benefits of avocados don’t stop once your baby is born.  If you’re breastfeeding…avocados are high in monounsaturated fats which are good fats and are important for a baby’s weight gain, growth and brain development. 

Avocados are the perfect first food for your baby.   Between 4 and 6 months you can introduce avocados into your child’s diet.  They work perfectly because they are easily mashed and slightly sweet.  This is a good time to introduce new food textures as well.

What’s the foolproof way to know that your family’s favorite fruit is ripe?  Push lightly near the neck and feel for a gentle yield.  If you’re still not sure it’s ready to eat? Pop the stem button.  If the stem button pops off easily, then the fruit is ready to eat.

Moms and dads…we always put our children first…so don’t forget about yourselves.  Avocados are a fit food fruit.  Studies show avocados may reduce total cholesterol levels while they lower bad cholesterol and increase good cholesterol.

Avocados are also loaded with dietary fiber which may help you lose weight and reduce blood sugar spikes.

The next time you’re grocery shopping, make sure you add a few avocados to your cart.  They’re nutritious, heart healthy and taste delicious.  They’re good for you and everyone in your family! What more could you ask for in a fruit?

For more information, visit worldsfinestavocados.com.

 

 

 

 

 

 

 

 

Daily Dose

Why Vitamin D is Important!

1:30 to read

As a follow up to the blog last week on children, calcium and vitamin D needs, a recent article in a Canadian Medical Journal reports that children who drink non-cow’s milk, such as soy, rice, almond and goat’s milk have lower serum vitamin D levels than those who are drinking vitamin D fortified cow’s milk.

This study looked at 2800 children between 1-6 year olds, and their consumption of either cow’s milk which is all vitamin D fortified and those who drank non-cow’s milk, in which case fortification is voluntary.  The researchers then looked at blood samples to measure vitamin D levels.

The researchers found that children who drank non-cow’s milk had nearly three times the risk for having low vitamin D levels.

So...bottom line...when I am discussing milk and dairy intake with families I am going to reiterate the need to drink cow’s milk, or children may need to continue vitamin D supplementation  and for most parents, including myself, it is hard to remember to give a vitamin or mineral supplement every day for a child’s entire life!).  A glass of vitamin D fortified milk at meals seems an easier choice in most cases.

Daily Dose

Marketing Healthy Foods to Kids

1:15 to read

The marketing of foods to children continues to be a hot topic.  As any parent knows…by the time your child is 3, 4 or 5 years old…they can often point to the box of sugary cereal with their favorite cartoon character on it, or identify a sign (McDonalds, Chic-Fil-A, Pizza) although they are not yet reading.  Companies are very clever when it comes to marketing…especially to children who drive a lot of consumer choices.

But, a recent article in Pediatrics shows how marketing may also drive healthy food choices. The study entitled, “Marketing Vegetable in Elementary School Cafeterias to Increase Uptake”, looked at the number of students who chose fresh vegetables from the salad bar at 10 elementary school cafeterias in a large school district over a six-week period.

The study included four different groups. In the first group the schools displayed vinyl banners with branded cartoon vegetable characters. These banners were then wrapped around the salad bar bases. The characters displayed “super human” strength related to eating vegetables (the Popeye of my generation - with his spinach).  The second group of schools showed short television segments which had vegetable characters delivering healthy nutritional advice. In the third group of schools both the salad bar banners and TV segments were used to promote healthy nutrition and food choices.  The fourth group was the control group and received no intervention.  The intervention schools also had decals with the vegetable characters placed on the floor which directed the children to the salad bars.

The results?  Nearly twice as many students ate vegetables from the salad bar when they were exposed to the banners.  More than 3 times as many students who were exposed to both banners and TV segments went to the salad bar (more girls than boys ). Interestingly, the marketing campaign also increased the number of students who chose a vegetable serving in the regular lunch line as well. 

So, it seems that branded marketing strategies may be used in a positive way to promote healthier food choices among young children.  Now we just have to get the advertisers to change some of their branded messaging aimed at young children from the “junk” to the healthy foods, as we have data to show that kids will choose good foods…especially if their super heroes like it too!

Daily Dose

Food Textures

1:30 to read

If you have a baby between the ages of 8-9 months and have already been offering them pureed baby foods it may be time to start some textures as well.  Many parents are a bit “wary” of offering any food that hasn’t been totally pureed, but it is important that your baby starts to experiment with foods that have different consistencies. 

Of course this does not mean you hand your baby anything that they could choke on like a grape, or piece of meat etc. But instead of totally pureeing carrots, why not cook them well, chop them up a bit and put them on the high chair tray. It is fun to watch how they touch and feel the carrots, before they “smoosh and moosh” them and get them to their mouths.   

There are so many foods that are easily offered to a baby to get them used to feeling different textures.  This is the very beginning of experimenting with finger foods, and this doesn’t just mean puffs or cheerios either. I like to encourage babies to feel cold, gooey, warm, sticky, all sorts of different textures which will ultimately help them become better and more adventuresome eaters as they get older.  

Unfortunately, I see far too many little ones (and not so little ones too) continuing to eat totally pureed foods and then becoming adverse to textures as they did not get the experience at an early enough age. 

It is also fun to watch your child as they begin to pick up foods that have been chopped and diced into small soft pieces. In the early stages they have to scoop and lick the food from their fingers and hands, but very quickly their pincer grasp takes over and suddenly they can pick up that well cooked green bean or pea!!  Such a feat and worthy of a home video to send to the grandparents for sure. 

So, put out some mushy food and let them play - I know it is messy but that is what being a kid is often about!

Parenting

Vegetarian Diet Is Good For the Whole Family

1:456

Has your teen or little one brought up the idea of going vegetarian? In the current age of online videos and social media groups, a lot of kids are seeing and learning about animal product processing and are experimenting with the idea of changing what they eat. While it may seem like a silly idea at first, you might want to give it further consideration.

For years, some people have thought that vegetarian and vegan diets may not be healthy enough for children.

A new study published by the Journal of the Academy of Nutrition and Dietetics (AND), says not to worry, vegetarian and vegan diets can be safe and healthy for people of any age.

In fact, several studies show that vegetarians generally have lower risks of obesity and chronic diseases such as type 2 diabetes, heart disease and certain cancers, according to the AND. That includes vegans -- who avoid not only meat and fish, but also all animal products, including dairy.

"No one should doubt that vegetarian diets are safe at all life stages, including infancy, childhood and adolescence," says Susan Levin, one of the report authors and director of nutrition education at the nonprofit Physicians Committee for Responsible Medicine in Washington, D.C.

Levin also noted that studies show children on vegetarian diets eat more fruits and vegetables, and fewer sweets and salty snack foods. They're also less likely to be overweight or obese.

The academy also noted that vegetarian and vegan diets can be safe during pregnancy and lactation. These diets can also be fine for athletes and the elderly, the report said.

While all this information sounds promising, what you include in your vegetarian diet is the key to staying healthy. If you subsist on white rice, Levin pointed out, that might be technically vegetarian, but not nutritious.

So it's important to eat a variety of foods, including a range of whole grains, beans, fruits and vegetables, and nuts and seeds.

Vegetarians and vegan diets do lack one important nutrient found in animal products– vitamin B-12.

According to the AND report, vegans should take supplemental vitamin B12. Vegetarians usually need supplements or B12-fortified foods, too, the group said -- since their dairy intake may not supply enough of the nutrient.

But, Levin said, B12 is the only supplement vegans need. They can get all of their other nutrient needs from food.

Getting enough protein, calcium and iron has been another concern about vegetarian diets and particularly vegan diets. That shouldn’t be a problem, Levin says, as long as you make wise food choices.

The report noted, it's imperative to make wise food choices: Calcium from vegetables like kale, turnip greens and bok-choy is much better absorbed than calcium from high-oxalate vegetables such as spinach and Swiss chard, for example.

As for the potential health benefits, studies have found that vegetarians and vegans tend to weigh less and have lower cholesterol levels than omnivores do. They also tend to have lower risks of high blood pressure, heart disease, type 2 diabetes and certain cancers, such as cancers of the prostate and gastrointestinal tract.

"If there were a pill that did all of that," Levin said, "everyone would be taking it."

Lots of families aren’t necessarily willing to give up all animal products, but would like to cut down on their meat consumption. Vegetarian and vegan recipes can help fill the void on meatless lunch and dinners while offering a nutritious substitute.

The AND report also notes that vegetarian diets are kinder to the environment.

It takes far fewer resources -- land, water, fuel and fertilizer -- to produce a pound of kidney beans than a pound of beef, for example.

"Vegetarian diets leave a lighter carbon footprint," said Levin.

The ADA suggests that families interested in going completely vegetarian or vegan should seek assistance from a registered dietician to help them learn about the various sources of protein and other vital nutrients. Vegetarian cookbooks and classes are also available for families thinking of making a dietary switch. There are also very good informational resources online.

Story source: Amy Norton, https://consumer.healthday.com/vitamins-and-nutrition-information-27/food-and-nutrition-news-316/vegetarian-diets-benefit-people-and-the-planet-717307.html

Your Baby

Fish Oil During Pregnancy May Reduce Baby’s Asthma Risk

2:00

A Danish study’s results suggests pregnant women that take a fish oil supplement during the final 3 months of pregnancy may reduce their baby’s risk of developing asthma or persistent wheezing.

The study involved 736 pregnant women, in their third trimester. Half the women took a placebo containing olive oil and the other group was given 2.4 grams of fish oil. The women took the supplements until one week after birth.

Among children whose mothers took fish-oil capsules, 16.9 percent had asthma by age 3, compared with 23.7 percent whose mothers were given placebos. The difference, nearly 7 percentage points, translates to a risk reduction of about 31 percent.

In the study, the researchers noted that they are not ready to recommend that pregnant women routinely take fish oil. Although the results of the study were positive, several experts have noted that more research needs to be done before higher doses of fish oil supplements are recommended over eating more fish.

Researchers found no adverse effects in the mothers or babies, the doses were high, 2.4 grams per day is 15 to 20 times what most Americans consume from foods.

One in five young children are affected by asthma and wheezing disorders. In recent decades, the rate has more than doubled in Western countries. Previous research has shown that those conditions are more prevalent among babies whose mothers have low levels of fish oil in their bodies. The new large-scale test, reported in The New England Journal of Medicine, is the first to see if supplements can actually lower the risk.

Before doctors can make any recommendations, the study should be replicated, and fish oil should be tested earlier in pregnancy and at different doses, Dr. Hans Bisgaard, the leading author of the study, said in an email to the New York Times. He is a professor of pediatrics at the University of Copenhagen and the head of research at the Copenhagen Prospective Studies on Asthma in Childhood, an independent research unit.

Dr. Bisgaard said it was not possible to tell from the study whether pregnant women could benefit from simply eating more fish. Pregnant women are generally advised to limit their consumption of certain types of fish like swordfish and tuna because they contain mercury. But many other types are considered safe, especially smaller fish like sardines that are not at the top of the food chain and therefore not likely to accumulate mercury and other contaminants from eating other fish.

“It is possible that a lower dose would have sufficed," the Bisgaard team said.

The supplements didn't seem to affect the odds of a baby or toddler developing the skin condition eczema, or an allergy such as a reaction to milk or egg products, or a severe asthma attack.

An editorial in the same journal by an expert who was not part of the study praised the research, saying it was well designed and carefully performed. The author of that editorial, Dr. Christopher E. Ramsden, from the National Institutes of Health, said the findings would help doctors develop a “precision medicine” approach in which fish-oil treatment could be tailored to women who are most likely to benefit.

If the findings are confirmed in other populations, doctors could test to see who would mostly likely benefit from fish oil supplements. "The health care system is currently not geared for such," Bisgaard said. "But clearly this would be the future."

If you are considering taking fish oil supplements during pregnancy, be sure and check with your OB/GYN for a recommended dose.

All fish oils are not the same. Some brands of fish oil are of higher quality than others. A reputable fish oil manufacturer should be able to provide documentation of third-party lab results that show the purity levels of their fish oil, down to the particles per trillion level. Also, if the supplements smell or taste fishy, they shouldn’t. High quality fish oil supplements don’t. Avoid fish oils that have really strong or artificial flavors added to them because they are most likely trying to hide the fishy flavor of rancid oil.

Story sources: Denise Grady, http://www.nytimes.com/2016/12/28/health/fish-oil-asthma-pregnancy.html?WT.mc_id=SmartBriefs-Newsletter&WT.mc_ev=click&ad-keywords=smartbriefsnl

Gene Emery, http://www.reuters.com/article/us-health-asthma-fish-oil-idUSKBN14H1T3

http://americanpregnancy.org/pregnancy-health/omega-3-fish-oil/

 

Daily Dose

Your Child's Lunch

1:15 to read

I have been interested in the recent news article about a mother who had packed Oreo cookies in her child’s lunchbox. It seems that although she had also packed other lunch items, the school her child attended deemed the lunch “unhealthy” and not only did not allow her to eat the cookies, they  sent her mother a note encouraging her to “pack a nutritious lunch”.

WHAT??  Are schools and daycare centers now deciding what a parent may put in a child’s lunchbox?  I understand the need for nutritious lunches for our children. I talk about this everyday in my practice. But are there not bigger issues facing our schools than policing every child’s lunch. This mother did not “just” pack Oreos, her child had a sandwich and string cheese as well. Her mother stated that, “she was out of fruits and vegetables that day”, so she added some cookies.  

Schools are in the throes of changing menus in an effort to help our children make good choices at lunch. But, even without serving fried foods or soft drinks, they do still offer dessert during school lunch.  They have ice cream, frozen yogurt, pies, cookies....and unfortunately many children probably eat more than one.  

I once headed a committee at our sons’ school to change the school cafeteria’s policy to have a “soda fountain”.   I realized that even if I talked to my children about nutrition and health, and did not have soft drinks in our home, if they were offered a choice between soft drinks and milk I knew  that they would sometimes choose a soft drink (with free refills I might add). 

After about a year of discussions and some very unhappy parents and students our school did stop serving soft drinks. As I pointed out even then, this was for children who were buying school lunch and drinks....we were not telling parents what they could and could not send or have in their own homes.

At the minimum I think this poor 4 year old should not have been put in the middle of this discussion. Would it not have been more appropriate to send the mother a note asking her not to send cookies for lunch again?  Was there a notice of acceptable lunch items that had been posted at the beginning of school?  Is there a “zero tolerance” for cookies rule?

I guess schools will be sending sandwiches home that have white bread or bologna, or who knows what else. While I am a huge advocate for healthy eating habits and making changes in all of our homes...let’s not take it out on a 4 year old.

 

Daily Dose

HELP! My Child Does Not Like Milk!

A mom's dilemma: my child will not drink milk.Dear Dr. Sue: my 13 month old baby boy doesn’t like milk! With my other two children, I stopped bottles/formula cold turkey. But my baby boy loves his formula.  What should I do?”

Rhonda, I think you have answered your own question. You said that you stopped formula and bottle with your other two children.  Provide your son with healthy meals and if you stop the bottle and formula and ONLY give him milk in his cup, he will eventually drink his milk. Not only does he have good role models in his older siblings, if you don’t “cave” and give him his formula or even juice or water he will drink his milk, as he is thirsty. Not only does he no longer need formula after he is 1 year, he needs to get the majority of his calories from food rather than from formula. You also know that this is the easiest time to get rid of the bottle before he becomes “attached’ to it. He may be your “strong willed” third child (all children seem to have this title at some time) on this issue. I also agree with you that he needs to be a milk drinker and this is the time to establish this. I have found that if you don’t get children to start drinking milk at this age, then for the majority of children, they will not drink milk later on in their childhood and adolescent years.  Although you can give him other dairy products to help him meet his calcium and vitamin D needs, it is hard to meet those daily requirements without drinking some milk. So, I would just go with your previous habit and stop the formula and give it some time. He will drink his milk; he just has to get thirsty enough (that means that his sibs cannot give him other fluids either!) Anyone else go “cold turkey”? How did it go? Love to hear from you.

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