8 Amazing Benefits of Breastfeeding for Babies [Infographic]

In honor of World Breastfeeding Week, I thought I'd share a special infographic with you highlighting only a few of the amazing benefits of breastfeeding for babies.  I'm definitely an advocate for breastfeeding and want to do my part in bringing awareness to this natural, healthy feeding practice for infants.  If interested, please check out my previous posts on this topic:  Breastfeeding: A Moral Decision?, Breastfeeding: What are the Benefits for Baby?,  Breastfeeding: How Does it Benefit Mom?, and Breastfeeding: Sticking with it.   Without further adieu, here's the infographic. Please feel free to share with proper credit.

How do you bring awareness to and support breastfeeding?  

Amazing Benefits of Breastfeeding for Babies - Copyright 2014 - Michelle Loy, MPH, MS, RDN, CSSD

Amazing Benefits of Breastfeeding for Babies by Michelle Loy, MPH, MS, RDN, CSSD is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Based on a work at nutritionandwellnessbytes.blogspot.com.

10 Interesting Facts About Registered Dietitian Nutritionists [Infographic]

Happy Registered Dietitian Nutritionist Day 2014!  In honor of all of the hard-working RDN's out there, please enjoy this infographic of 10 Interesting Facts About Registered Dietitian Nutritionists.

Feel free to copy, distribute, and reprint unaltered versions for non-commercial/educational purposes with proper credit.

Thank you and Enjoy!

10 Interesting Facts About Registered Dietitian Nutritionists [Infographic]

10 Interesting Facts about Registered Dietitian Nutritrionists [Infographic] by Michelle Loy, Go Wellness is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Based on a work at www.gowellnessco.com.
Permissions beyond the scope of this license may be available at nutritionandwellnessbytes.blogspot.com.

Watch Out For These Kids' Food Marketing Gimmicks

Photo credit: Mykl Roventine (Flickr)

Would you be surprised to learn that the food industry spends over $1.6 billion each year marketing to our American youth?  If you've ever spent a half hour watching The Disney Channel or Nickelodeon, you've probably seen plenty of examples of the types of foods that are marketed to kids.  They are typically calorie dense, nutrient poor processed foods, like sugary cereals, sweetened beverages, and convenience foods.  Not only are companies marketing to children on the silver screen, but they're also marketing to kids on the Internet, through mobile phones, in video games, and in schools.  They continue to find sneaky creative ways to reach America's youth.  There's a good reason that companies spend so much marketing to kids. It works.  Not only do children develop a preference for the advertised foods, but the advertisements are also linked with greater consumption of and requests for these foods, higher total calorie intake, and more snacking. Unfortunately, children under 8 years old don't really grasp that they are being marketed to.  While there has been a call for food marketers to voluntarily change marketing strategies for kids' foods, the progress has been minimal, in my opinion.  The good news is that parents don't have to wait for these marketing practices to change. With the division of responsibility in feeding, parents are in charge of what children eat.  However, because of the many inventive advertising strategies of food marketers, sometimes parents' best efforts are sidetracked.  Here's a list of 6 common marketing gimmicks to watch out for when it comes to foods for kids.

• Spokes-characters, celebrities, and cartoon characters:  Be leery of anything with these on the packaging or in advertisements.  These are the products for which many parents experience "pester power" from their kiddos, and they're also usually some of the least nutritious foods.  You could use this strategy to your advantage by packing your own nutritious snacks with some DIY sticker marketing.

• Toys and Games:  This is actually a hot button issue right now as Nebraska is currently proposing a bill that would ban toys in fast food kids' meals.  I definitely know these strategies work as I fell for them as a kid.  As you're standing your ground, keep in mind that these toys and games are often cheap and quickly forgettable.

• Nutrient, Health, or Other Claims:  I see a lot of these claims plastered on some of the least nutritious foods for kids: "High in Vitamin C", "Good Source of Calcium and Vitamin D", "Gluten Free", "Organic", or "Natural".  Beware!  These are often big distractors.  I saw a terrific example of this just the other day in the store.  A package of Kool Aid Jammers boldly claimed "100% Daily Value of Vitamin C".  I would recommend whole foods, like oranges or strawberries, that also contain many other valuable nutrients before I'd recommend Kool-Aid as an excellent source of vitamin C.  While "Gluten Free" and "Organic" foods are hot right now, that doesn't mean they're nutritious.  "Made with Real Milk" or "Made with Real Fruit"?  What else are they made with?  Read the labels, especially the ingredient list.  Are there a lot of ingredients?  Are there numerous sources of added sugar?  Is it high in sodium?  Does it contain trans fat partially hydrogenated oils?

• Coupons or Promotions: Coupons and promos can definitely offer great ways to save money, if used wisely.  The truth is that these are proven marketing tools.  They're frequently offered on new food products to get consumers to try them in hopes of creating repeat users. I've seen these coupons, and believe me, they're not always for the most nutritious foods.  So think twice before clipping all of those coupons or jumping into the promos.

• Rewards or Sweepstakes:  These programs are very enticing.  Earn rewards points when purchasing participating food items, and use those points to "buy" things like movie tickets, magazine subscriptions, or restaurant gift cards.  Or earn your chance at an amazing prize in a sweepstakes contest with just one purchase.  If it's prizes you're after, then it might be health-wise to go about getting them the old-fashioned way.  Buy them directly or save up for them.  Otherwise, consider being very picky when it comes to participating in these programs.  

• Supporting Good Causes:  While programs, like Box Tops For Education, support good causes, they could still be luring you in to buying foods that aren't very nutritious.  Many of the participating food products for the Box Tops program are low nutrition quality, processed foods, like sugary, refined cereals and snacks.  If you want to support the cause, consider donating directly, select more nutritious food items, or opt for non-food items instead.

As a parent, I understand that we've really got quite the challenge on our hands since we can't just put our kids in a bubble and feed them nutritious foods all day long.  The littlest ones may throw a temper tantrum when we choose not to purchase less nutritious foods with the spokes-characters on them.  The older ones may get the food when they're out with friends.  Remember, you still have a significant impact on what your children eat regardless of those struggles.  You have an amazing opportunity to leave your children with a legacy of health and well-being, so remember that amidst the challenges.  If you'd like more info on how to best guide your family through all the food marketing, you may want to check out this tip sheet from the Yale Rudd Center for Food Policy & Obesity.

What kids' food marketing gimmicks do you struggle with most?  How do you manage them?  

My Funny Valentine

Photo credit: Michelle Loy. Copyright 2011. All rights reserved.

My daughter's preschool class celebrates Valentine's Day today with a Valentine's Exchange.  I knew that I wanted to share an extra little treat along with her Valentine's Card, but it wasn't going to be candy or sweets.  When it comes to holiday celebrations for the little ones, I always try to think outside of the "sugary goodie" box for treats.  I'm working on setting a new trend that teaches kids that holidays aren't about food (even if it might just be my kids that get this message).  They're more about family, friends, and fun!  Many times I don't include food at all with holiday or party treats. I stick with non-food goodies, like stickers, pencils, crayons, erasers, balls, or temporary tattoos.  That's what I opted for today:  a miniature can of Playdoh, mini-deck of Crazy 8 cards, and mini-bubbles.  To get ideas, I just had to get into the mindset of a 3 year old.  What would a 3 year old like?  Another option is to include more nutritious goodies, like dried fruit, fruit leathers, or trail mix.  In fact, I saw another child bring clementine oranges along with a card for each kiddo today.  That was nutritiously cool, in my opinion!  

So, parents, how do you handle holiday treat-giving?  What non-food or more nutritious goodies do you include in your child's party packs?  

13 popular foods for kids that are sources of trans fat

Photo credit: YGX (Flickr)

Lately, I've been finding that frankenfats keep showing up in some unexpected places in children's diets.  Given all of the evidence of the potentially harmful effects of industrially produced trans fat in the diet, I'm surprised that we're still finding it lurking in the food supply, especially in foods that children commonly consume.  Don't be fooled by labels that suggest a food is trans-fat free.  If a food contains less than 0.5 g of trans fat per serving, it can be labeled as trans-fat free.  While a food may contain little trans fat, there really is no need for trans fat in the diet, and there are plenty of high quality, nutritious alternatives to these foods.  Also, don't be distracted by claims that a food is "High in Vitamin C" or "Excellent Source of Calcium" or "Low-Fat".  It may still contain trans fat.  Always read the food label's ingredient list, and look for  "partially hydrogenated" oils as these are sources of trans fat.  Here's my list of popular kids' foods that contain trans fat.

Fruit snacks:  Fruit By The Foot, Fruit Roll-ups, and Fruit Gushers all contain "partially hydrogenated oil".  Look for options that do not contain trans fat, or make your own fruit leather at home.
    
Toaster pastries:  You may want to think twice about letting your little ones pop toaster pastries, like Pop Tarts and Toaster Strudels, into their little mouths.  These may be convenient breakfast options, but they  contain trans fat and added sugar.  A more well-rounded breakfast that includes a high quality source of whole grain and protein along with a vegetable or fruit will provide your child with a better balance of nutrients to fuel his day.

Yogurt-covered snacks:  The yogurt coating on snacks, such as raisins, pretzels, or Yogo Bits, is a source of trans fat.  Dried fruit, such as cherries or raisins, are perfectly nutritious snacks for children; however, I draw the line when they're wrapped in trans fat.

Cinnamon rolls:  Refrigerated cinnamon rolls, like Pillsbury Grands Cinnamon Rolls, are certainly a grand source of trans fat, containing as much as 2.5 g per serving.  There are plenty of other nutritious, convenient, and tasty breakfast options available.  Try these.   

Sandwich crackers or cookies:  Although a popular portable snack option, sandwich crackers and cookies are a significant source of trans fat. Keebler's Sandwich Crackers offers 2 g of trans fat per serving.  You're better off making your own mini-sandwiches to take along.


Cookies:  Beware of those Girl Scout Cookies because four varieties contain trans fat.  Refrigerated cookie doughs are even more significant sources of trans fat. In fact, one serving of Pillsbury's Read to Bake Sugar Cookies contains 2.5 g trans fat.  Other popular kids' cookies are also sources of trans fat, too, so read the labels!

Pudding snacks: Sometimes parents rely on pudding snacks as a source of calcium for their children.  While these snacks may contain calcium, they also contain trans fat as well as added sugar.  Yogurt sweetened with real fruit would be a more nutritious option for calcium, potassium, and protein.

Hot cocoa mix:  It can be fun and comforting on a cold, wintry day to warm up with a cup of hot cocoa.  However, hot cocoa mixes also contain trans fat.  It's usually listed within the first three ingredients.  You'd be better off making your own homemade version instead.

Microwave popcorn:  What's family movie night without a little microwave popcorn, right?  Well, unfortunately, microwave popcorn often contains partially hydrogenated oils.  Be sure to read the labels carefully, or better yet, make your own at home so that you can control what goes on it.
  
Pancake and waffle mixes:  Aunt Jemima might have made breakfast-prep a lot easier, but unfortunately, she, along with Hungry Jack and others, didn't leave out the trans fat.  Homemade pancakes and waffles are really not that time consuming, so give it a shot.

Graham cracker snacks:  No, not Teddy Grahams.  They're so cute!  Yes, and they can also contain trans fat.  There are some graham snacks that do not contain trans fats, so those would be better options.

Vanilla wafers:  Often introduced to babies and toddlers, vanilla wafers can be high in trans fat.  Keebler Vanilla Wafers contain 2.5 g of trans fat per serving.  It's better to help those little ones develop preferences for more nutritious options, like vegetables and fruits.

Animal crackers:  Yes, these seemingly innocent snacks can contain trans fat and few other high quality nutrients.  Scan those labels to avoid trans fats or find more nutrient-dense alternatives.

Do any of these surprise you? If so, which ones?

Loving our children through nutrition and positive feeding

Photo credit: Michelle Loy (top) and Kristin Eldridge (bottom).  Copyright 2011. All rights reserved. 

As I contemplated a topic or theme for my blog this month, I could only think of one - love.  How cliche, right?  Love for February?  Well, I thought I would focus on love for our littlest sweethearts, our children.  I have two little angels of my own, and I love them to pieces.  If I've learned anything about love since having my little ones, it is that I am capable of loving a lot more than I ever imagined I could!  In the last few years, I've also learned that love is more than a feeling.  It's also an action and a choice, and that's what brings me to this post today.  We have a lot of ways to to act on that love: spending time with them at home, showing up at their special events, giving them lots of affection, or showering them with gifts. I'm going to suggest that we also choose to love our children by nourishing them well and fostering a healthful relationship with food, eating, and their bodies.  As parents, family, friends, caregivers, teachers, or just someone involved in a child's life, you have the power to significantly and positively influence what children eat, how children eat, and how they relate to their bodies.

Even before a child is conceived, parents have the opportunity to nourish their own bodies well in order to support a more healthful pregnancy and baby.  Optimal nutrition and health during pregnancy also impact the growth and development of the baby. In fact, a growing body of evidence suggests that many chronic diseases and illnesses may be linked to an infant's experiences in the womb.

Once baby is born, there is the decision about whether or not to breastfeed. Some health professionals propose that food preferences and eating behaviors may be impacted by this.  Breastfeeding is definitely linked with positive health outcomes from infancy through adulthood.

From childhood to adolescence, parents and caregivers are responsible for determining what, when, and where children eat.  Also, what we eat, how we eat, and how we relate to food and our bodies also strongly impacts our children.  If children see us skipping breakfast, then they are likely to develop that habit, too.  If they see us consuming nutrient poor foods on a regular basis, then they will likely develop preferences for those foods, too.  If they see us in a constant cycle of "dieting", then they are more likely to fall into those patterns, too.  If they hear us criticizing our bodies, they are likely to do the same.

I believe that we have an extraordinary opportunity before us to leave our children with a wonderful legacy of health and well-being.  In addition to lavishing them with kisses and hugs, let's also provide them with a variety of high quality, nutritious foods.  As we cheer them on at their soccer games, let's also nurture positive eating behaviors and attitudes about food, eating, and their bodies.  Let's choose to love our children in these ways because they deserve it!

What steps will you or do you take to love your children in these ways?

10 nutritious finger foods for older babies

Photo credit: Michelle Loy. Copyright 2010. All rights reserved.

Beyond pureed baby food, I've found that many parents seem stumped about what to feed their older babies (9-12 months of age).  When parents begin to experiment with finger-feeding, I often find that they start with some of the typical foods, such as Cheerios or puffs.  While these choices provide a developmentally-appropriate and convenient start, there is a host of other nutritious and safe finger foods that parents can offer to their little ones.  I thought I'd share my top 10 list of nutritious finger foods for older babies for a little inspiration.  Keep in mind that this is not a complete list of possibilities. For more ideas, put yourself in your baby's booties.  If you had no to minimal teeth and were still developing your chewing and swallowing ability, what could you eat?    

Black beans: Jam-packed with fiber, black beans can help ward off constipation, which can sometimes trouble infants during the transition from pureed foods to table foods.  Black beans also offer a significant plant-based source of protein, an essential building block for proper growth.  These velvety-textured beans are also an excellent plant-based source of iron, which is necessary to support their rapid growth.   

Green peas:  Green peas are loaded with vitamin K and manganese, two vital nutrients for proper bone formation.  You've heard of carrots for vision, but what about green peas?  Yep, they are a good source of the carotenoids, lutein and zeaxanthin, which support eye health, especially the retina.  Look to these for a fiber boost as well.

Egg Yolk: Egg yolk offers a significant source of choline, a nutrient that is essential for brain and memory development in infants.  It also supplies lutein and zeaxanthin for eye health. 

Blueberries:  Blueberries are rich in vitamin C, which promotes a healthy immune system, enhances iron absorption, and helps form collagen that is needed for healthy bones and skin.  They're also a good source of manganese and fiber.

Salmon: Salmon is a high quality, easily digestible source of protein, which is helpful for those maturing little digestive tracts.  Salmon also boasts a high omega-3 fatty acid content, specifically EPA and DHA, which promotes proper brain and vision development.  Finally, salmon is a fantastic source of vitamin D, a must-have for calcium absorption and bone building.

Avocado:  Avocados supply healthful monounsaturated fats, which help infants meet their high energy needs for rapid growth.  These fats also form part of every cell in the body and are needed for proper brain development.  Avocados are also a source of folate, which helps form and maintain new cells during periods of rapid growth.

Cheese:  Cheese is an excellent source of high quality, easily digestible protein and bone-building calcium.  But you knew that, didn't you?  Here's what you may not know...cheese may help combat those acids that are responsible for tooth decay.  So a little cheese may actually help promote the health of your babies new chompers!  Cheese is also a good source of the sleep-inducing amino acid, tryptophan.

Sweet potato: Sweet potatoes provide an excellent source of vitamin A, which promotes a healthy immune system and plays a vital role in bone growth.  The sweet potato also serves up a nice helping of vitamin B6, which supports immune function.  Would you be surprised to know that these are also a good source of vitamin C? My little guy (pictured above) loves oven baked or steamed sweet potatoes!   

Whole wheat pasta: Whole wheat pasta provides a quality source of complex carbohydrates, which promote growth and serve as a major energy source for your infant's brain.  Including adequate carbohydrate in your infant's diet also allows protein to be used to build new tissue rather than for energy. Whole wheat pasta is also a source of magnesium and zinc, which both support immune function. We also can't forget that fiber!

Butternut squash:  This winter squash is packed with nutrients, including fiber, potassium, manganese, magnesium, vitamin C and A to name just a few.  Pair baked diced squash and apples and sprinkle with cinnamon for a nutritious and flavorful feast for your little one.

What nutritious finger foods do you enjoy sharing with your baby?

5 Kids' Snacks That Might Be Less Nutritious Than You Thought

As I cruise through the grocery store, I often find myself on the prowl for the latest snack foods available for kids. Lately, I've noticed that when I pick up the product and take a closer look at the Nutrition Facts Panel and read the ingredient list that I am quite surprised by what I find upon closer investigation. I thought I'd share my insight on 5 kids' snacks that may be less nutritious than you thought. 

• Fruit Snacks: These are the "fruit" snacks that look like gummy bears.  They seem to be popular with parents because they're handy, and having the word fruit in the name must mean that they're nutritious, right? The first three ingredients for most of these snacks are basically sources of sugar. In fact, one serving of many of these products I've reviewed provide around 13 grams or 3 tsp of added sugar! Some say "Made with Real Fruit" right on the label. So, what's the problem?  The first two ingredients before the source of fruit (apple puree concentrate) are corn syrup (= added sugar) and sugar.  While it might be "made with real fruit", just how much real fruit?  Not enough to make it equally or more nutritious than the real "real fruit"! The products also often claim to "high in Vitamin C". Wow, that's great, right?  Even though it might be high in vitamin C, what other nutrients is it high in?  Not many other than sugar.  And although the one of first three ingredients is a blend of fruit juice or fruit puree concentrates, fresh fruits will still be better sources of vitamins, minerals, and fiber and will likely have more between-meal staying power.  
• Yogurt or yogurt smoothies for kids: These snacks do contain yogurt, which is a high quality source of protein and other nutrients, such as potassium, calcium, and Vitamin D. They are also a source of probiotics (aka, friendly bacteria). However, even though the name of the yogurt (eg, Strawberry Explosion) might suggest that it contains fruit, there is often no actual fruit involved. For instance, the label on one yogurt smoothie product targeted towards children states "Strawberry Explosion contains no fruit juice". A look at the ingredient list also shows that this food contains added sugar. A 3.1 ounce serving contains 14 g of sugar, some of which most likely comes from the naturally-occurring milk sugar; however, the rest is added sugar. You might be better off mixing or blending whole fresh or frozen fruit with plain yogurt for a more nutritious homemade version. 
  
• Squeezable, freezable fruit: I checked out a few of these products and found that two of the first five ingredients are fruit purees and two of the first five ingredients are also sources of added sugar. I'm not sure how much of the 26 g of sugar per 1 cup is added sugar, but I am sure that the little ones might be better off with a homemade version for which you can control the sugar content.
• Yogurt-covered snacks: Take a look at the ingredient list of these yogurt-covered and you'll find that these are less yogurt and more added sugar. First ingredient = sugar! Second ingredient = coating, which is composed mostly of sugar and partially hydrogenated palm and palm kernel oil, which are sources of trans fat. In fact, one serving provides 13 grams or ~3 tsp of added sugar! It does contain 60% of the Daily Value for Vitamin C; however, it's pretty scant on other nutrients, such as vitamin A or iron. Plus, I can think of plenty of other foods that would be better sources of vitamin C as well as other vitamins, minerals, and fiber. 
• Organic snacks: They're organic, so they're more nutritious right? Granted, organically-produced foods may be better for children; however, organic and healthy are not synonymous. After reviewing an organic fruit snack product, I found that, although organic, 4 of the first 5 ingredients are sources of added sugar, and with 10 grams or 2 1/2 tsp of sugar per pouch, it can really add up. 

So am I saying hands off to these kids' snack foods? Not necessarily.  I'd definitely recommend practicing moderation with these foods.  Maybe you offer these foods sometimes but not everyday.  And when offering these foods, maybe you could balance out your child's nutrition by also offering other more nutritious foods throughout the day, too.  It's best not to take kids' snacks at face value.  Look beyond the front label to scope out that Nutrition Facts Panel and the Ingredients List for more information.  

Toddler and Child Nutrition: Food jags

The mother of a 2 1/2 year old girl recently told me that her daughter only wants to drink milk and will not eat much else.  Clearly frustrated, she requested my advice.  If you've ever cared for a toddler, this is probably familiar territory.  Well, the RD is in, and I would diagnose this as a food jag.  Food jags occur when a child prefers to eat only a few favored foods over the course of several days, and it's actually quite normal for a young child to experience them on occasion.  What parents need to realize first is that children around this age are developing their independence, and this is really just a sign of that.  This could shed some light on one of the toddler's favorite words - NO! And it also helps explain their constant testing of limits, which is a true patience-builder if you ask me!  Preferring to only drink milk does not necessarily mean that this little one only likes milk nor does it mean that she won't eat anything else.  So, what do we do with these food jags?

When a child experiences a food jag, instead of rewarding the behavior with negative attention, it is best to relax.  Focusing on the food jag may only serve to intensify and extend it.  Remember that you're the parent, and the parent's job is to feed while it's the child's job to eat.  I always rely on Ellyn Satter's division of responsibility in feeding:  1) Parents are responsible for what, when, and where children eat and 2) Children are responsible for whether and how much.  This means that it is up to the parent to purchase, prepare, and serve a variety of healthful foods to the child and to trust her to eat the right amount that she needs. It's alright to continue offering the favored food along with a variety of other foods at meal and snack time.  If the child chooses to eat only the favored foods for a week, breathe easy as the reality is that your child will not develop malnutrition from a temporary food jag.  Food jags can be harmless depending on how we respond to them. I do suggest that you remain observant of lingering food jags as sometimes it can be a sign of something more concerning, such as a food allergy or intolerance that evolves into a fear of eating a wide variety of foods.

For more advice on feeding children, I suggest these resources.

My previous posts:

• The WHAT and WHEN of feeding a toddler 
  
• The WHERE of feeding a toddler or young child
• Picky, Picky
• Juice: A four letter word?
  

Books:

• Child of Mine: Feeding with Love and Good Sense
• Secrets of Feeding a Healthy Family: Orchestrating and Enjoying the Family Meal

Breastfeeding: Sticking with it

Back in January 2000, the U.S. Department of Health and Human Services released the Healthy People 2010, which involves over 450 health objectives for our nation. Here were the objectives set for the area of breastfeeding at that time:

• Increase the proportion of mothers who breastfeed in the early postpartum period from 64% to 75%.
• Increase the proportion of mothers who breastfeed at six months from 29% to 50%.
• Increase the proportion of mothers who breastfeed at one year from 16% to 25%.

Fast forward to September 2009. How are we doing? Well, based on the most recent data, U.S. mothers are not quite hitting these targets. Of those surveyed:

• 70.9% of mothers breastfed in the early postpartum period.
• 36.4% breastfed for six months.
• 17.7% breastfed for one year.

At least we're heading in the right direction, but we're not quite there yet. So, what's the problem? Knowing doesn't equal doing! Many women may know about the benefits of breastfeeding over formula feeding, as we can see by breastfeeding initiation rates (approaching the goal of 75%!). However, it does not mean that mothers have the knowledge, tools, and {most of all} the support to stick with the decision. While it was easy for me to choose to breastfeed initially, once my first child had arrived and I actually started breastfeeding, there were times that I seriously felt like giving up. Thankfully, I had (and have) a few tricks up my sleeve to keep me from doing just that, and that's what I'd like to talk about -- the strategies that worked for me and for other moms I've known.

• Arm yourself with information about the challenges and solutions before baby arrives. I did a lot to accomplish this as I was strongly committed to my decision to breastfeed, and I believe that getting a head start in gaining the knowledge and skills needed for a positive breastfeeding experience before starting the process was priceless!
  
• Attend a lactation education class (or classes) offered through a hospital or birthing center. My husband and I both attended a lactation education class taught by a Registered Nurse and Certified Lactation Consultant. The class was an excellent investment of our time. Not only did I learn a lot about the how-to's associated with breastfeeding, but it also allowed my husband to be a HUGE support during the process by learning about everything along with me. When I ran into a challenge, he'd recall something he learned in the class and helped me through it.
  
• Talk to family members, friends, and others who have breastfed or are currently breastfeeding. After having my first child, I remember referring to my sister for many of my questions as she was breastfeeding her son at the time (7 months older than my daughter). She had a lot of practical tips and tools to offer, and she played a major role in helping me stay on track during that first few weeks. I also joined online groups of pregnant and nursing moms for additional support. I can't even begin to tell you how valuable that online connection was! Sources I've liked are kellymom.com and La Leche League.
• Obtain professional guidance from a Certified Lactation Consultant or Certified Lactation Educator. Fortunately, I have a colleague and friend who is an International Board Certified Lactation Consultant and Registered Dietitian, and I was able to refer to her several times throughout the experience with my first child and prior to having my second child for knowledge and guidance. If your hospital or birthing center offers access to a lactation consultant or educator, I suggest that you take advantage of their expertise. Thankfully, the hospital in which I delivered my children had lactation consultants available on a daily basis to provide one-on-one help with breastfeeding during my stay. I believe that this truly enhanced my early post-partum breastfeeding experience.
  
• Read, read, read! One great source of information before getting started was the book, The Nursing Mother's Companion. This super tool covered a wide range of information from proper latch-on to bra-fitting. You may also want to bone up on nutrition for lactation. I'd recommend Expect the Best: Your Guide to Healthy Eating Before, During, and After Pregnancy by Registered Dietitian Elizabeth Ward.
• Find a hospital, birthing center, and pediatrician who support breastfeeding. When searching for a pediatrician, I made it a priority to find one that encouraged my decision to breastfeed, and believe me, it was a tremendous help through that first year. You can also search for a hospital or birth center that has implemented the UNICEF/WHO Baby Friendly Hospital Initiative.
  
• If you plan on returning to work after having your baby, make sure to inform your employer of your decision to breastfeed. Make arrangements regarding the timing and location needed for pumping and storage of breastmilk.
• Join a support group for nursing moms. You can find local support groups through the La Leche League or you may want to ask your hospital or birthing center, your pediatrician or OB, or a lactation consultant/educator to recommend one.
  
• Invest in essential tools. You may need to seek advice from family, friends, peers, or lactation professionals on what tools might be "necessary". Do you need nursing tops or bras? A nursing pillow? A nursing cover? Nursing pads? A breast pump, storage containers, and bottles?
• Remember your reason. It's always good to remind yourself about why you chose to breastfeed your child in the first place. Doing this can often get you through the tough times. Based on my experience and that of other mothers I know, there may be some tough spots through the process, especially at first, but armed with the right knowledge, skills, and support, you really will get through it and the experience will be positive and rewarding.

Well, this ends the four part blog series on breastfeeding. I hope that it has enhanced or solidified your knowledge about breastfeeding as the optimal source of nutrition for infants, and I also hope that it has helped you consider ways in which you can commit to your decision to breastfeed and/or serve as a source of support for someone else in your life who is or will be breastfeeding her child. The experience is valuable in so many ways, and you and your child are worth it!

Breastfeeding: How does it benefit mom?

How does breastfeeding benefit mom?

It often seems that when we talk about breastfeeding we most often focus on the benefits for baby; however, there are numerous advantages for Mom (and even Dad) as well. So, let's dig in to how breastfeeding benefits mom.

How does breastfeeding benefit Mom?

• Breastfeeding promotes quicker shrinking of the uterus (aka, uterine involution). Oxytocin, the "let down hormone, levels increase during breastfeeding to stimulate the ejection of milk. Oxytocin also causes the uterus to contract and return to pre-pregnancy size much faster. A big plus for moms who've only had an expanding belly over the previous 9 months.
• Breastfeeding decreases post-partum blood loss. This is also due to the oxytocin stimulating the uterine contractions that help control bleeding after a woman gives birth.
• Breastfeeding delays resumption of menses. Exclusive breastfeeding for the first six months after childbirth postpones the return of menstruation, and while not 100% fail-safe, can provide a natural form of birth control and spacing between pregnancies.
• Breastfeeding enhances mother-infant bonding. Some studies have detected a relationship between higher maternal levels of oxytocin and an enhanced mother-infant bonding experience, possibly creating greater feelings of love and euphoria in breastfeeding mothers.
• Breastfeeding promotes psychological well-being. Researchers have indicated a possible role of oxytocin in mitigating the effects of stress in the post-partum period. Prolactin is the milk-producing hormone secreted during pregnancy to generate breastmilk. Prolactin has been associated with elevation of mood and buffering the effects of stress in breastfeeding mothers. In fact, researchers have proposed that women who've had more than one pregnancy reduce the risk of depression with breastfeeding.
• Breastfeeding is associated with lower risk for breast and ovarian cancers. A large-scale systematic review of 47 studies conducted in 30 countries estimated a 4.3% lower risk of breast cancer for every 12 months of breastfeeding. Essentially, the longer a woman breastfeeds throughout her lifespan, the lower her risk for breast cancer. Another large, prospective trial suggests that women who'd breastfed for 18 or more months over their lifespan had a significant reduction in risk of ovarian cancer in comparison to those who had never breastfed.
• Breastfeeding may offer protection against osteoporosis. Studies have suggested a positive relationship between duration of breastfeeding and bone mass of the hip and lower risk of hip fracture in older women.
• Breastfeeding provides a convenient, safe source of nutrition for baby. Since it comes straight from the "tap", there's no need to worry about water safety or proper mixing and warming. And as new mom, I personally appreciate not having to get up in the middle of the night to prepare a bottle.
• Breastfeeding is less expensive than formula feeding. According to the American Academy of Pediatrics, families can save an estimated $400 in the first year of breastfeeding compared to formula feeding!

So, there you have it. Now we know that even moms stand to benefit from breastfeeding. Great! However, many will admit that the experience is easier said than done. So stay tuned for the next blog in which I'll discuss how to stick with the decision to breastfeed.

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Breastfeeding: What are the benefits for baby?

Breastfeeding: What's in it for baby? Copyright 2009 - Michelle Loy, MPH, MS, RD - Go Wellness

I must admit that I used to look at breastfeeding advocates and think to myself, "Oh, she's one of those people." You know, those people who are just fanatical over breastfeeding. However, once I really learned about the host of health benefits resulting from breastfeeding, I could no longer deny the advocate in me! I do hope that once you read about some of these benefits, that you, too, will see where I'm (and they're) coming from. In continuation of my series on the what, why, and how of breastfeeding, today's blog post is dedicated to the first of two posts on the why.

How does baby benefit from breastfeeding?

• Human milk provides superior nutrition. Since it's made for humans by humans, how could one go wrong? The nutrient composition of breast milk is almost perfectly tailored for an infant with the exception of a few nutrients, such as Vitamin D and fluoride. In addition, breast milk contains other factors that also enhance the digestion and absorption of nutrients, such as calcium, iron, and zinc! And I can't stop there. The other remarkable thing about human milk production is that the composition of the milk actually changes according to baby's needs across the feeding, across the day, and across the infant's lifespan! Amazing! So how does it work? During an actual feeding, the initial milk ejected, the foremilk, contains a higher concentration of protein and water and less fat. This helps satisfy a baby's fluid and protein needs earlier on in the feeding. Then about 1/3 of the way through the feeding the milk contains a higher percentage of fat, which enhances satiety and helps meet energy needs. The composition changes across the day by consisting of a higher percentage of foremilk in the morning while containing a higher percentage of hind milk in the afternoon and evening. It's speculated that this helps the infant stay more alert earlier in the day while helping the infant rest better in the evening due to the nutrient content of the two types of milk. Finally, the milk changes across the lifespan to meet the infant's different nutrient needs at different stages of growth. And this process cannot be duplicated by any human milk substitute!
• Human milk contains factors that provide immunological protection. You could call it baby's first immunization! In approximately the first two weeks of life, almost everything the mother has developed an immunity to is passed on to the baby through maternal antibodies. Human milk also contains a multitude of other factors that weaken or destroy harmful bacteria or help generate antibodies. And it's these very factors that have not been duplicated in formula to this day. On the other hand, there are also compounds called bifidus factors that actually promote the growth of friendly bacteria in the infant's GI tract, which, in turn, prevents more harmful bacteria from establishing there.
• Breastfeeding decreases the risk for allergies, especially among those with a family history of allergies. First of all, when an infant is exclusively breastfed for the first 6 months of life, there is a delay in the introduction of other foods that helps reduce exposure to potential food allergens, such as cow's milk or soy protein from formula. In addition, the colostrum helps coat and protect the infant's GI tract from penetration by allergens and other foreign bodies that contribute to allergies.
• Breastfeeding lowers the risk of childhood obesity. The choice between breast milk or formula affects the baby's earliest sensory experiences with food. Infants fed breast milk are exposed to a greater variety of food flavors via the maternal diet whereas those who consume formula are exposed to one flavor. This could affect an infant's acceptance of new foods, like vegetables, later on down the road. So this could mean having a less picky eater as a result of breastfeeding. It is also theorized that breastfeeding helps the infant stay in tune with his/her hunger and satiety cues better. It is conceived that the breastfed infant is better able to control the flow of milk from the breast whereas a bottle-fed infant receives formula more quickly and easily, which could lead to overfeeding. Therefore, the bottle-fed baby gets used to a greater feeling of fullness and begins to more easily override satiety cues. While our understanding of how it is that breastfeeding helps reduce the risk of childhood obesity is still unclear, there is still plenty of research supporting the fact that breastfed infants are less likely to experience childhood obesity than their formula-fed counterparts.
• Breastfeeding improves cognitive development. Many studies support an association between breastfeeding and improved cognitive development through early childhood; however, it's still unclear if there are factors other than the actual breast milk contributing to this relationship (i.e., genetics, environment). Breast milk is naturally rich in the essential fatty acids DHA and arachidonic acid, which help promote brain development, and researchers suspect that these fatty acids could play a pivotal role in the link between breastfeeding and cognitive function. The effect may be even more pronounced in pre-term infants since large amounts of these fatty acids accumulate in the brain during the last trimester, and because premature infants are born early, they miss out on the full transfer of these vital nutrients.
• Breastfeeding reduces the risk for sudden infant death syndrome (SIDS). SIDS is the leading cause of death for infants during the first year of life, and several studies suggest that exclusive or partial breastfeeding reduces the risk for SIDS. In fact, a recent case-control study detected a 50% reduction in risk of SIDS for breastfed infants.
• Breastfeeding may lessen the risk for diabetes later in life. In comparison to formula-fed infants, breastfed infants tend to have a lower risk for developing both type 1 and type 2 diabetes later in life, especially those infants at higher risk of developing the diseases. It appears that infants who are breastfed for a longer period of time and those who are exclusively breastfed have lower risk than infants who are not breast fed at all, experience shorter duration of breastfeeding, and/or encounter early introduction of formula or cow's milk. Due to some study limitations, such as parent recall of breastfeeding practices and other potentially confounding factors, more research needs to be conducted in this area.
• Breastfeeding may decrease the risk for cardiovascular disease later in life. Several studies suggest a protective effect of breastfeeding on certain cardiovascular risk factors, such as atherosclerosis, blood pressure, cholesterol profile, along with other cardiovascular risk factors. Again, there are limitations to the results of such studies due to parental recall of breastfeeding practices and other potentially confounding factors.

Preliminary studies suggest a large number of other health benefits related to breastfeeding, but I hope that this helps increase your understanding of some of the health-related benefits of breastfeeding for the infant.  Stay tuned for my next post regarding the advantages of breastfeeding for mom!

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Breastfeeding - A moral decision?

At 8 1/2 months pregnant with my second child, I am in the last stretch of preparations before our little guy's arrival. With this being my second pregnancy, I am thankful that there are not as many critical decisions for me to make -- What car seat? What stroller? What nursery theme? The list goes on and on, especially for new parents. However, I believe one of the most important decisions a parent makes regarding a new baby relates to how to feed the baby. Human breast milk or human milk substitute (aka, formula)? As a Registered Dietitian and someone who is well aware of the multitude of benefits of breastfeeding for both baby and mom, the decision was easy for me. Yes, yes, yes -- breast is the best!

Yes, you got that right. I am quite gung ho for breastfeeding. At the same time, I also realize that making the decision is not a moral issue -- at least it shouldn't be. You are not a good parent if you do and a bad parent if you don't! However, to me, it is a health issue and I realize that for many parents the decision is not so easy. I can understand why as there are still so many sociocultural and environmental factors that seem to easily persuade parents to choose formula over breastfeeding. Let's first take a look at our environment. I see the plethora of very persuasive marketing by the formula industry to moms-to-be and new moms. During the first pregnancy, I was inundated with a new fantastic coupon deal for formula at nearly every OB visit, diaper bags provided by several formula companies, free samples, and even materials provided by the formula companies that would appear to support breastfeeding (i.e., ice packs for storage, etc.) -- don't even get me started on this. It is influences such as these that seem to easily sway parents to choose formula over breastfeeding or to simply give up on breastfeeding altogether. In terms of sociocultural influences, I believe that there are very subtle ways in which sociocultural factors can influence a woman's choice to breastfeed. I was reading a new book to my daughter the other day called "I'm a Big Sister". I noticed something in the story that others might not. The story presents a situation in which the big sister gets to help bottle feed the baby. Now, the reader can fill in the blanks and assume that the bottle is filled with formula or breast milk. It did not say. However, I just found this scenario interesting as I believe that our minds can be influenced in the most subtle ways when it comes to nutrition. Why not have the father and the little girl assist the mother while she's nursing the new baby rather than insinuating that in order for father and big sister to help s/he must participate in bottle feeding? Another example...the other day I was presented several questions from a reporter for a local university newspaper. One of the questions posed was "What can a parent feed a child who's allergic to cow's milk and soy?" Initially, I thought about how I'd actually like to educate and encourage the parent to feed a new baby breast milk first and foremost -- before any formula.

I get it...the decision is not easy, initiating the process is not always easy, and there are a lot of factors still working against the successful lactation experience. However, I will tell you, the rewards are well worth it. As a public health professional and advocate, I'm feeling a personal duty to spend the next few blogs writing about the what, why, and how of this very important issue in the hopes that if you're a parent-to-be, a new parent, or someone who knows someone about to make this important decision, you'll strengthen your decision for breastfeeding or at least consider this option more strongly. So, let's start with the what.

What is the recommendation regarding breastfeeding?

• The American Academy of Pediatrics, American Dietetic Association, and U.S. Department of Health and Human Services recommends exclusive breastfeeding during the first six months of life (with some exceptions that you will find here). These organizations also suggest continuing breastfeeding along with appropriate introduction of solid foods for at least the first year of life.
• The World Health Organization recommends breastfeeding through at least the first two years of life with the proper addition of complementary foods.
• The national Healthy People 2010 goals include objectives targeting breastfeeding rates in the U.S. 1) Increase the rate of mothers initiating breastfeeding in the early postpartum period to 75%. 2) Increase the rate of mothers continuing breastfeeding to at least six months to 50%. and 3) Increase the rate of mothers continuing breastfeeding to at least one year to 25%.

Stay tuned for the why's of breastfeeding. How will it benefit baby?

My take on baby food

So, it's been asked...what are my thoughts on baby food...Make your own? Commercial? Organic? Let me tackle these one by one.

I personally decided to make my own baby food. What I enjoyed about this is that I knew exactly what was going in it. I also felt like it allowed Gabriella to really taste the food at its freshest. (I've tasted commercial baby food and it's sometimes not that scrumptious to me.) I also loved that I was actually making her food. I just found pleasure in that process. It was fun to explore different vegetables and fruits to try. I felt that I was able to offer a lot of variety in that way. I also think that my homemade baby food offered a lot more variety in textures than that smooth commercial baby food. Lastly, I see this as an opportunity to also prepare your infant to eat with the family by eating what the family is eating. Oh yeah, and it's actually cheaper to make your own.

While my personal preference was to make and offer homemade baby food, it does not mean that commercial baby foods are not safe or nutritious. I think there are advantages to each. Commercial baby foods can offer some convenience over homemade foods, especially when feeding an infant away from home. If you check out the ingredient list for many commercial baby foods, you will find them to be quite simple...the vegetable or fruit and then water. However, combination foods, which combine grains or vegetables with meat, etc. may contain additional ingredients such as sugar or sodium, which infants don't need in large quantities and can produced learned preferences for these tastes. Again, my personal opinion is that it is best to modify foods that the family is already eating so that the infant learns to eat what the family eats anyway.

As far as whether or not to go organic, you may want to check out my blog post about organically produced foods. If you have the funds to do so, I suggest going with at least "The Dirty Dozen". These are the top 12 vegetables/fruits that are most likely to be contaminated with detectable levels of pesticide residue. I say this because the little ones are at greatest risk from the potentially harmful effects of pesticides since they are smaller in size and their organs are still developing. If money is no object, you may want to consider going organic with other items such as bread, cereals, or pastas. If budget is a concern, then I suggest these tips to reduce exposure:

• Locally grown produce (fewer pesticides or other residues used)
• Peel or wash produce with tap water and scrub with a brush, if appropriate
  
• Offer a variety of foods