Wednesday, April 16, 2014

The Breastfeeding Chronicles: Prologue

I think the most important thing to give a baby is love. Whether you breastfeed or not, your baby will be OK. I was formula fed as a baby and I turned out great, right?
I didn’t know a lot about breastfeeding before getting my original job as nutrition coordinator at the state Department of Health. For those who don’t know, breastfeeding has benefits for both baby and mama. Baby has less risk for asthma, allergies, ear infections, respiratory infections, and other diseases. For mom, the risk for certain cancers including breast and ovarian cancer, type 2 diabetes, and postpartum depression is lowered. Some research has shown that breastfeeding can help mom lose weight more quickly and prevent obesity in older kids. Breastfeeding also has a lower environmental impact since you don’t have to use all the formula packaging.

Thanks to my job, I knew all this when I got pregnant with my first child, and made a strong commitment to breastfeeding. Having this commitment and a wicked stubborn streak helped me out when all did not go as planned. My son latched on right away, so I didn’t think that was a problem. The delivery room nurses were great – they brought him up to nurse very soon after delivery, and showed me how to do it. But then, my milk did not come in right away. I felt like a complete failure! The two nights I spent in the hospital are hazy, but I remember that the night nurse kept trying to feed him some kind of sugar supplement and I was like Luke fighting the Dark Side and would not let her. He was crying a lot (poor little guy), which was tough on me and my husband. So, we ended up giving him a pacifier before my milk supply was established. Hospital policy didn’t allow pacifiers; however, the nurse had a hidden supply that we were thrilled with at the time.

A lot of different factors affect whether and how long a woman will breastfeed, and if she will follow the American Pediatrics Association's guideline to provide only breast milk for about the first 6 months. Individual knowledge, cultural background, physical ability, and support from her family, birthing hospital, primary care provider, child care provider, and employers all factor into a woman’s success with nursing. In future “Breastfeeding Chronicles” posts, I will write about my family’s quest to breastfeed, and the internal and external forces that shaped our journey.

May the force be with you!

Friday, April 4, 2014

Kind of Like a Melon

Only three weeks late (yay Amy!), I brought my son in for his four year wellness check. Imagine my surprise when our doctor said that he was in the overweight category based on his body mass index (BMI). If you’re wondering what BMI is and what category you or your child fits in, there's good info online. Anyway, my son has chubby cheeks and is what you'd call a sturdy kid—kind of like a melon that weighs more than you think it will. But I would not have thought he was overweight. My husband didn’t think it was a big deal, but (being a health professional specializing in nutrition, physical activity and obesity prevention) I thought it was important to address. The kid already eats a good amount of veggies, whole grains, and fruit (as long as none of it touches…). The doctor suggested reducing snacks and making sure he gets enough physical activity. We live about fifteen minutes from the in-home daycare the kids go to, and my husband gives him a snack on the way home from daycare. Then, since I don’t get home until six most nights, the kiddo gets another snack while dad fixes dinner and watches the baby. So he's getting three snacks after lunch—definitely too many eating opportunities. You would think I would’ve picked up on this since I have been trained in dietetics!
Since that doctor’s appointment, here are some of the things we’ve been working on:
  • Giving him carrots or smaller portions of the snack on the way home, and then no snack right when they get home. My son is not thrilled about either of these changes, and is sure to express his emotions. It’s tough, but worth it to set up healthy eating habits for a lifetime.
  • Making sure he gets some good wiggle time every evening (well, almost), which he likes much more than the dietary changes. Kids should get 60 minutes of physical activity each day. Some of his favorite indoor activities are imaginary races with various friends; dancing to his favorite music—his current is the soundtrack to a certain blue train #1; kid-friendly yoga that I get at the library; pretend ice skating; Simon Says that includes jumping jacks and other active things (good for a parental giggle); counting to see how many jumps in a row he can do or how many times he can run up and down the hall; and running down the hallway and jumping on a bunch of pillows. The last one makes me cringe a bit, but we have a strict red light (stop)/green light (go) rule so he avoids collisions with his sister and the dog.
  • Working with daycare to avoid giving him a lot of sweets—when my daughter was born we switched from a center-based facility to an in-home daycare. More on that in another blog post!
Our best statistics, which aren’t perfect, say that about 25 percent of preschoolers are overweight or obese in Washington. By the time they are adults, about 61 percent are obese or overweight, and 27 percent are obese. A recent study published in the New England Journal of Medicine that followed kids throughout their early years showed that kids who were overweight by age five were much more likely to be obese by age eight. It is hard to believe my son is in one of these categories. We’re talking about a kid who considers fruit leather to be a really special treat, and asked what soda pop was the other day. I’m so thankful my doctor pointed it out early. If she wasn't reimbursed for counseling on BMI, I wonder if we would have even caught it. Your doctor can now be reimbursed for providing counseling on overweight and obesity because of the Affordable Care Act, so make sure you make your well-visit appointments and ask about BMI at your next appointment.

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