Work, Life Balance

I had someone mention to me the other day ... "I don't know how you do it all?" I am sure from the outside it can easily look like I have it all together. Social media has a way of only showing the highlights of life. None of us just post our boring weekday evenings, washing the dishes or folding laundry. It is easy to compare ourselves to one another. We look at other working Moms and wonder how they find time to take their kids on a walk and then also cook dinner that evening. Often I feel like working mothers feel this constant pull in so many different directions. I know that I will see stay at home moms on social media and I am often jealous that they don't have to fit a traditional work schedule into their routines. 

This comparison is not healthy. Social media is just a quick snap shot into people's lives and never shows the whole picture. I thought it would be a good idea to just touch on work, life balance and maybe share some recommendations to help you. I do not claim to have everything in order and all of this figured out. I am just a working mom who is going through life, doing her thing and then using this blog platform to tell you about my experiences. 

Time Management 

I think any mother would tell you that time management is part of motherhood. As soon as you become responsible for another little human, you have to start managing your own time. To help with my own work, life balance I have accepted the fact that I do the same things over and over again. Each day I get up at 6am. I get ready before William wakes up. Then I load the car with the bags that I packed the night before. I go to work. Then after work I have about 30-45 minutes that I can fit in some physical activity before picking up William. Then the night time routine starts when we get home: make dinner, clean up after dinner, bath for William, put William down, pack lunches, and get myself ready for bed by 10-11pm. Then this cycle repeats each day. Managing my time each day is the only way that "everything" gets done. Taking the time to figure out what your schedule looks like and then account for each hour of each day will help you prioritize what needs to get done. If I have any tasks left undone and it is already 11pm then I just call it a day and head to bed. I need that 7-8 hours of sleep a night and that is a priority for me! 

Support System 

To maintain whatever schedule you create for yourself and your family, you need help! You need the support of your friends and family. There will be days that things don't go right and the schedule get totally messed up. There will be times you will be asked to help with something that you didn't anticipate. Being able to call on those friends and family members at those times will keep you sane. For example, there was a week day when I decided we needed to go see a family member. I had to make a few extra stops after work and I called up our amazing nanny. She helped me by assisting William with making a card. I didn't have the time to do that with him, but with her help and support we were able to get that done. Having those support people in your life to help you is so important. Even if it is someone you can complain to at the end of the day. Just having a shoulder to cry on is important. 

"Relax Days" 

Having a schedule and sticking to that routine throughout the week is great, but we all need some down time. When we can relax and just wear our pajamas all day and don't care. That is the weekend for me. I try to not set an alarm on Saturdays so that I can just sleep until William gets up. That is so liberating. After the hustle and bustle during the week, that quiet, care free start to the weekend is a must. It provides some time to help re-charge those batteries and gear up for the upcoming week. This past weekend, I came down with a cold. I let myself take a nap on Saturday and Sunday! When William slept I took a 2 hour nap with him. It was the best thing ever. I knew that I need to slow down and take that time for myself. Those "relax days" are an important part to the whole work, life balance dance. Without them, you can easily get burnt out and then be left feeling so overwhelmed. 

Taking Back Your Kitchen

The holidays are over and we are now well into 2018. In fact we are half way through the month of January. I am not sure what your resolutions were for the New Year, but odds are that you have already ditched those resolutions. I am not sure if "cooking more at home" was one of your resolutions, but I want to help encourage you to take back your kitchen. All of us are busy and we have so much competing for our time. Finding time to cook is often difficult. 

What are some obstacles that keep you from preparing meals in your kitchen? For me, it often involves lack of time and if I don't plan ahead, there is no way I will be able to make dinners at home. Identify whatever obstacles that are keeping you out of your kitchen. Then let's work on overcoming those challenges. 

Take Back Your Kitchen 

• Meal Prep - Taking the time to make out a list of what you want to prepare at home for the week is a must. Think through what food items you love to cook or you have time to prepare and get those recipes. Make out your shopping list using those recipes. That will help ensure that you purchase only the food you need to cook those meals. Making out a list ahead of time can also help to save money when you go to the grocery store. Once you go to the store and purchase your food items, when you get home, take the time to prep some of those foods. Taking the time to cut and prepare your fruit and vegetables can be helpful during the week. Sometimes that cleaning and prep work takes too much time during the week. Doing it on the weekends can help ensure you are able to cook these meals at home. 
• Realistic Recipes - When you pull recipes for the week, make sure that they are realistic. If a recipe will take you 2 hours to cook then that might not be a recipe to make during the week. If you work or have evening plans the sticking with 30 minute recipes will help ensure you are successful in cooking foods at home. Also during the week, make sure that ingredients are also easy to get. Some times if you forgot an ingredient and if you can't easily pick it up during the week, you might not prepare that recipe during the week.
• Clean Up - Whenever you cook there is often a mess. Lots of dishes and clean up afterwards. Taking the time to tidy up your kitchen at the end of the day is helpful for the next day. I hate cooking in a dirty kitchen. Each night I try to take the time to clean up from dinner and from putting together lunches for the next day. I like walking into a clean kitchen in the morning and then preparing dinner the following night in a clean kitchen. Is that is something that is an obstacle for you cooking at home, find ways to remove that obstacle. If your spouse enjoys dishes or is able to help with one part of the cooking/cleaning that teamwork is great! 
• Use the Left-overs - Don't throw out the food that you took the time to cook. You can save these left-overs and use them for lunch the next day. If you have enough left, you can even use it for another dinner that week. If you have taken all that time to prepare the meal, it would be a shame to throw out that food and some what wasteful. 

Think about what stands in your way from cooking in your kitchen. Do you want to take back your kitchen and start preparing more meals at home? Hopefully some of these tips and tricks will help you be successful and accomplish this goal! 

The End of a Pumping Journey

It has been a little while since I have written about my breast feeding experience with William. We have reached the year mark. That had always been my goal to breast feed William through his 1st birthday. That goal has been accomplished! Such a big milestone and I am so excited and proud of both of us. 

Photo credit: Karre Ann Photography from William's 12 month photo session.

I started pumping when my milk came in (so the first week of life with William). I know that my lactation consultant that I met with in the hospital said I didn't need to do that, but I was so uncomfortable. When my milk came it the only thing that helped was pumping. Then I would just pump randomly 1-2 times a day over maternity leave to comfort. I would freeze the milk and plan to use that for when I went back to work. 

I ended up having an over supply of breastmilk, but honestly, I was fine with that. I really wanted William to only have breastmilk so that was a "problem" that I was fine with. If you haven't read through my first breast feeding post - CLICK HERE and check it out. I wrote about breast feeding as being a choice and a gift that I wanted to give my child. I am not here to judge, you as a mother, if you breast feed or not. Each mother and child has to decide what will work for them. For myself and William, I wanted to breast feed and that meant also pumping. 

Lots of mothers that I have spoken with hate pumping. They loathe it and it is something they dislike. I tried really hard to look at it has a choice and again, something that I was doing for my child. I wanted to give my child that gift of my breastmilk and when going back to work I knew that meant having to pump. 

At the beginning, I went back to work when William was just turning 8 weeks old. I pumped 3 times during the work day. I also had a 45 minute drive to/from work. Then I would breast feed him throughout the night, in the morning before going to daycare, he would go with 3 bottles and then I would breast feeding twice before bed. William also would get up to eat throughout the night until 6-7 months of age. I was pumping/breastfeeding 8 times a day for about 6 months. Then I started pumping only 2 times at work and continued to do that until William was 12 months old. I wanted to make sure to keep up my supply. Again, I probably didn't have to do that, but I had more than enough milk and it was something I was happy to do. 

Well now I have reached the end of my pumping at work journey. This week I stopped pumping at work. I had decreased pumping at work to only once a day after William turned one. Then after talking with one of our MD/Lactation Consultants I understood that I needed to let that go. There was no NEED to keep pumping at work. I am still breast feeding William in the morning and at night before bed. He enjoys that and it works for us. 

This week I stopped carrying my pump to work. I have a beautiful Sarah Wells Pumping bag that I love and served me well for the last year. It is hard to believe that this part is finally over. I never loved pumping, but I didn't hate it. It was something that I knew I had to do and I made the best of it. Now that it is done, it is bittersweet. I love being able to wear clothes to where I don't have to think about being able to get to my boobs. Today I wore a cute dress and it was awesome. I haven't been able to do that in a year. But at the same time, this change means my baby is no longer a baby, but a toddler. 

I know that I will be able to continue to breast feed for as long as William is interested. That is a blessing and I am fine with that. I just wanted to share about my pumping/breast feeding journey. I know that lots of times you just hear the terrifying stories or people complaining. I wanted to share with you a positive story that came to a happy end. 

If you want any more information about breast feeding and why breastmilk is the best thing for your baby, check out this blog post on The Powers of Breastmilk that I put together earlier in 2017. If you have any other questions, feel free to message me and I would love to help you out or put you in touch with someone who can answer your question.

Being a NICU RD

Being a NICU Registered Dietitian is a very unique job. Lots of people don't fully understand what this job entails. Other RDs often have no idea what all goes into working in a NICU with preterm infants. As of 2013 there were 983 NICUs in the United States (reference). Out of those NICUs not all of them have Registered Dietitians. All Level IV NICUs are required to have a RD involved to help provide nutrition care for those infants. I wasn't able to find a number of Level IV NICUs in the United States, but there are not that many (maybe ~100). I spoken with multiple RDs across the country who are working in NICUs and not sure how to provide the best nutrition care to their units. Often, RDs are asked to step into this role with limited experience.  

I just wanted to highlight what NICU RDs do and what they offer to the Multi-Disciplinary Team in the NICU. There is a misconception out there that just because babies in the NICU can't talk that somehow the care we provide as a RD is not as valuable or doesn't require communication skills?! Well that is just not the case. We work very closely with the neonatologists, the bedside nurses, the case managers, the social worker, the pharmacist, the therapists and the parents. Being able to communicate with everyone who is in involved in patient care is extremely important.

Job Tasks

• Attend Multi-Disciplinary Rounds on a weekly basis to provide recommendations on nutrition changes for each patient. 
• Sit up in the physician work room to serve as a resource for the MDs and the other NICU staff for nutrition recommendations. 
• Weekly see all the NICU patients and assess growth and if nutrition plan is best meeting assessed nutrition needs. 
• Keep track of complex GI patients to spreadsheets to monitor ostomy outputs and to micromanage those complicated patients. 
• Put together discharge feedings plans for tube feeding and TPN home discharges. 
• Fill out WIC scripts for families being discharged. 
• Help to oversee and run the Formula Mixing room. Provide education staffing for those formula mixing technicians. We are working hard this year to start using a breastmilk scanning system called Timeless in our unit. Help with hiring staff and making sure they have the tools they need to do their job well. 
• Sit on several committees and run a neonatal nutrition committee with various leaders of the multi-disciplinary team in the NICU.
• Serve as a resource for other NICU RDs to help provide support and answer questions, because it can be a tough job and something you just need to run something past another RD. 

This is a great job because you get to work with such small patients who grow and change so quickly. I think that is one of my favorite parts of the NICU. When you make a change or adjust feedings you see changes right away.  It is a fast paced environment and things are always changing. There is nothing more satisfying than seeing a little 24 week infant who is < 1000g grow, reach full term age and then get to be discharged home. That is an amazing journey to get to be a part of! 

New Year, New You!

Setting goals for the New Year is always a tradition. You look at your life, decide what you want to work on in the new year and then come February you are find yourself back in your old habits. Nothing ends up changing and maybe you are wondering if you should even make resolutions this year. 

Well I have some tips for you as you plan for setting goals for 2018. I think you should set goals for yourself. What do you want to accomplish this year? Where do you want to be at the end of 2018? Hopefully this suggestions will set you up for success and help you reach those personal goals! 

Writing Goals for 2018

1. Write down your goals.
   • May sound so simple, but posting your goals and looking at them frequently will help keep you focused on what you want to accomplish.
   •  Some people make “vision boards” and what I love about these is that it shows pictures of your goals. Either write down your goals or create a vision board with what you want to accomplish and post this in a post where you will see it on a routine basis.
2. Set SMART goals. 
   • Specific - Avoid anything too broad. Write your goal to clearly state your goal. “I want to increase the number of days a week that I exercise.”
   •  Measurable - After you decide on your specific goal, you need a time frame associated with that goal. “I want to go to the gym 3 days during the work week.”
   •  Attainable – Whatever goal you set for yourself, make it something realistic. If exercising 3 days during the week isn’t possible, adjust that goal and set it at 2 days a week. Start with something realistic that you know you can accomplish.
   •  Relevant – Make this goal for yourself that is something you really want to accomplish. If a goal about fitness isn’t really important for you, then set your New Year’s Resolutions around things that you feel passionate about.
   •  Time-based – Give yourself time limits for your goals. “I want to go to the gym 3 days during the week for the next month.” That way at the end of the month you can evaluate if you met your goal or not. If not, then change around your goal and try again.
3. Hold yourself accountable.
   • In this say of social media, it is totally possible to post about your goals and that can serve as a way to help hold you accountable.
   • Have a support group that can follow up with you and help keep you on track. Going to the gym with a friend or planning on running a race with a friend can help keep you focused on your goals.
4. List out your obstacles/challenges. 
   • Just like you write out your goals with what you want to accomplish, write out what challenges you might face.
   •  If you know what might keep you from accomplishing your goals that will help you in successfully meeting your goals.
5. Plan a time to re-evaluate.
   • Lots of times people make goals in January and totally forget about them in February. Put a reminder in your phone/calendar to look back through your goals and see if you accomplished.
   • Take this time in February to revamp your goals to help set yourself up to be successful going into the rest of the year.
   •  Plan to check back in each month to see how you are doing and if you are meeting those goals you set for yourself.

2017 Year In Review

It has been a wonderful 2017. It has been a BIG year for RDAnna. Got use to life as a parent, came back to my full time job after maternity leave, my husband graduated with his Master's, he landed his first job out of graduate school, we moved and you all have gotten to be apart of it. I have been able to share lots of posts with you over the year and here are some of the fun 2017 recaps and highlights. 

Blog Statistics 

• Published 48 blog posts in the last year. 
• The most people on the website were in February of 2017 when 238 people were checking out my website. 
• 51% of people viewing RD Anna are doing so on their phones. 
• 55% of people are getting RD Anna from social media links. 
• There were more people (2000 page visits) in the last year visiting RD Anna compared to the previous year. 

Favorite Blog Posts

• The Birth Story

• Hitting the Pavement Again

• Postpartum Body

• Baby Lead Weaning

• Donating Breastmilk

Media Segments 

• Had to chance to work with FOX59 throughout the year last year to do several nutrition -related segments. 
• Also got to do a New Year's story with RTV6 which was a great way to end 2017 and looking forward to 2018! 

Goals for 2018 

• I am excited to be able to continue to bring you guys a weekly blog post each week. I love blogging about nutrition topics that I run into in my personal life. If there are topics that you want me to address or look up, let me know. 
• I am hoping to continue to work with local news outlets to serve as that nutrition resource for St Vincent in mass media. 
• I am excited to be working on writing a chapter in a Nutrition Communication book that will be published in 2019 with the Academy of Nutrition and Dietetics. Hopefully I can share about that experience here on the blog as well. 
• I will be to writing test questions for a national board exam (CSPCC - Certified Specialist in Pediatrics in Critical Care) and I will definitely share that experience with you as well. 

Merry Christmas!

I just wanted to share our Christmas card with you for 2017. I wanted to wish you all a very Merry Christmas and thank you for taking time over the last year to read my blog. I have really enjoyed having a place to share nutrition advice and wellness information with you all. It is so great to have a platform to share from and I am glad that you all take the time to read what I write. It is amazing to see how this blog has changed over the years and I am eager to see what the future holds.

Hope you have had a wonderful holiday season and a very blessed New Year! Looking forward to a great 2018! 

Healthier Holiday Baking

I am a sucker for a good Christmas cookie. I love baking around the Holiday Season and having an excuse to eat a delicious little Christmas cookie is just what I want to do while sipping hot tea on the sofa. Have you thought about what you are putting in those yummy little treats that you make each year. There is normally quite a bit of sugar and fat that is goes into making a yummy, Christmas cookie. There are some ways that you could make some healthy substitutes and work on making your holiday treats a little bit healthier. I found some of these recommendations from Eating Well Magazine.

1. Add Some Fiber
   • Lots of times people don't think about adding a little bit of additional fiber to increase the "bulk" of the cookie. This an easy way to work up on your fiber intake and this can benefit your heart health. You can replace some or all of your flour with whole wheat flour. This is a simple substitute that would make your breads or cookies even healthier. If you make that switch you add get 4 times the amount of fiber compared with the all-purpose flour.
   • If you don't like whole-wheat flour or are gluten free, you could try rolled oat flour as well. This would increase your fiber intake and also could be gluten free.
   • They other thing you could add could be flaxseed or chia seeds. Obviously, both of these options could change the texture of the cookies or bread, but if you add a little you could give a little boost to your fiber intake per cookie. 
2. Cut Down on Added Sugar
   • Any type cookie or quick breast, typically calls for lots of added sugar. Cut down on the total amount of sugar you add into the recipe and try to replace with some extra flavor enhancers (almond, vanilla, orange or lemon extract).
   • Play with the recipe to try cut down the sugar a little bit at a time. You could also use "natural" sweeteners like agave, honey or molasses. That is still treated as sugar, but is a natural source that you could use. 
3. Add a Vitamin Boost
   • Flaxseeds are a great source of omega-3 fatty acids and fiber. This is a great additional to a cookie that has texture, like oatmeal or a highly flavored cookies (gingersnaps or something with molasses). That will help to hide the texture and the flavor from the flaxseeds. You could also use flaxmeal for a smoother texture. These omega-3 fatty acids are great for heart health and can help with cholesterol levels. 
   • You could also work to decrease your use of processed trans fats by using canola or olive oil. These also have more heart healthy fats.

There are lots of way to tweak and change your favorite holiday recipes around to make them a little healthier. Obviously, if you want to keep your recipe the same and enjoy it this one time a year, that is fine too. I don't want to be a Scrooge about it, but I also want you to know that there are ways to make small changes that can have big impacts on your overall health. 

First Birthday Party

It is hard to believe that we are now celebrating William's first birthday. It has been awhile since I have posted about William. I did several pregnancy posts throughout my pregnancy and then some breastfeeding and baby lead weaning posts over the last year. I wanted to take a moment and put together a fun post highlighting William's First Birthday. William was born on 12/23 and yes it is SUPER close to Christmas. We wanted him to have a separate birthday celebration and so we officially celebrated his birthday on 12/16. 

This party was mainly for use (William's parents), family and friends. William won't remember this party, but I know he will lose seeing the pictures when he is older. I wanted to do something fun and have this get together as a "thank you" for all the support from our amazing friends and family. 

Photo was from William's 12 month photo shoot we did with Karre Ann Photography in Noblesville, IN. 

So here are the party details. The theme - Dr Seuss! It kind of started with Cat in the Hat and expanded to include all Dr Seuss characters. We held the party at our house and there able to get some cupcakes made that we super cute. Shout out to Abby's Cakes for her amazing work. The menu included deviled eggs (green eggs/ham), cheese sticks (with the cat in the hat on them), relish tray, fruit salad, cheese ball. 

For the decorations we put up a wall decal of the Cat in the Hat that my Mom had used at a baby shower she hosted previously. It was great to have that to use again. I also got Dr Seuss books that we used on the table as decoration. I painted the letters "ONE" for some other decorations. We got a little Cat in the Hat plush toy to serve as a decoration. I also made the Christmas tree Dr Seuss themed. I had the ornaments all red, white and blue and then made some fabric embroidery hoops with Dr Seuss fabric on the inside.  

I put together a few goody bags for the 3 kids that were able to come to party. I used blue bags with a hat on the front of them and filled them with some goodies (Dr Seuss pencils, stickers, playdough and snacks). It was an easy and fun way to send the kids home with some treats. 

It was such a great day to get together with family and friends and we have been so appreciative of everyone's love and support. It is so special to get to have William in our lives and get to celebrate him on this special first birthday. 

Managing The Holiday Stress

This was a very timely topic for me this week. I wasn't able to sleep the other night, because I was thinking through everything that I needed to do. Working full time outside the home and then coming home, there is SO much to do. Having the time to get things done is tough. With limited time that means that often stress levels can go up and even more so around the holiday season, because we like to try to "special" things like bake cookies, put up special decorations or spend more time with family. All of these "special" things are great, but can increase your stress level. 

So what can you do to help manage your stress around the holiday season? Here are some helpful tips and tricks that you will hopefully find helpful. 

• Make a "To Do" List
  • This is such an important and simple things to help clear your mind and decrease worrying about all that you have to do. Simply taking the time to put your thoughts onto a piece of paper helps you take those concerns and set them aside. You don't have to worry about forget anything, because you wrote that "To Do" List down and you can come back to it when you have time. When you are able to come back to that list and start accomplishing things, check off what you have gotten done so you can experience that sense of accomplishment. 
• Prioritize Your Activities
  • This is easiest to do, after you put together your "To Do" List, take a look at what you need to accomplish and then rank them in order of what NEEDS to happen first. There are always something on that list that takes priority compared to other items. For example, I had to get leaves raked in my yard and the lawn mowed one last night by the weekend. That was a task I wasn't wanting to do, but NEEDED to do before the weekend. So I needed to take time and do that activity before I go out Christmas decorations. I would have much preferred decorating for Christmas, but in terms of priority levels, decorating fell below the leaf raking. 
• Embrace the Mess
  • In the craziness of life, things gets messy. Sometimes your house is a disaster and some times that needs to be ok. If you have made out your "To Do" List and you have other things that NEED to happen first, then do those things and bump cleaning down on the list. Or if you have the ability to get help with cleaning through someone coming into your house or even have your spouse help you. Sometimes delegating this task is helpful. For example, I have embraced the fact that when William is up and wake the house will have toys everywhere. Then at the end of night, we walk around pick up toys and that is when things get cleaned up. So embrace the craziness and then try not to stress too much about it. 
• People First
  • This is a life motto that will always make you happy. Put people in your life first. Relationships with people you work with, people in your family, and your friends are important and that will bring you more happiness then anything else. When you make time for people, that is always the right choice. Taking the time to go out of your way to see that friend (you only see a hand full of times a year), that friend who lost their mother, your aging grandparent or a friend who might be lonely .... that always is the most important thing. 

With the craziness of the holidays, remember that you are not perfect and things won't go perfectly and that is OK! The main things are taking time for those people you love and everything else will get done and it will be a fantastic end to the year! Now excuse me while I go tackle my "To Do" List - first up, Christmas decorations.

It Takes A Village

Do you ever have one of those weeks where you look at your schedule and you aren't quite sure how everything gets done? Or maybe you look at your schedule and you realize that some things definitely didn't get done? That is how my life feels all the time since becoming a mother. I felt like prior to William's arrival (about 10 1/2 months ago) I was fairly on top of things. I could get to meetings/appointments early, I was able to get all my grocery shopping done on one day, I could run errands to like 5 different stores, I was able to exercise every day, the list could keep going. Since becoming a mother, my life has really changed. Being responsible for another human, like completely responsible, takes a lot of time and brain power. As a working, full time Mom, I know that I wouldn't be able to do what I do on a daily basis without my village. I always heard that "it takes a village to raise a child," but I never really understood what that means until I had my own child. I am so thankful for all those people in my life who have helped me to do my job, and help us with William.

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Say Thank You! When I think about all of the people that help and support us with our jobs and family I think saying "thank you" more often is important. Taking a moment to pause and thank those people on a regular basis helps to keep those relationships strong. 

It's Not All About Me. With the craziness of life I feel like I am always count up in what is happening to me and my little family. I sometimes don't the best job about stopping and thinking about other people. To stop and ask them how they are doing. Then remembering to not bring up my own stuff, but to focus on them and really listen to how their day is going. Slowly down, asking and listening are important steps that I need to keep practicing. 

Helping Others. I feel that I end up getting help with my people around me and I like to remember to try to help others when I can. At this stage of life I know that I am limited in what I can do, but when I see a chance to help others, that is something that I always need to do. I have tried to make sure that I take the time to help co-workers who have feeding related questions, support charities through financial contributions or giving of my limited time. We packed shoe boxes for Operation Christmas Child and that is a fun yearly tradition. 

So for all of you who are reading this ... you have been helpful and supportive to myself and my family. Thank you for taking the time to read and follow my blog. I have loved being able to provide nutrition/wellness advice via RDAnna. Thank you for all your support with William as well. He is such a great kid and I am so lucky to be his mama. 

Healthy Thanksgiving Favorites

It is the time of year ... Thanksgiving is THIS week. Can you believe it?! I know I kept having to look at the calendar twice because I couldn't believe that we are already starting the holiday season. 

I came across the article and I thought it was hilarious in the New York Post. I felt like I could relate to this, because I always feel like people think I am just slap their favorite foods out of their hand. That is not the case. I love delicious food and I don't want to be known as a "health freak who is ruining Thanksgiving."  I totally agree with having tempeh instead of turkey if you are doing it because of dietary restrictions (vegetarian or vegan), but if you are doing it because you think there is something magical about tempeh compared with turkey then unfortunately that is not quite true. I love tempeh, but I also enjoy turkey and on this Thanksgiving I am planning on cooking a turkey and serving that at our luncheon. 

Image used from the New York Post Living Article.

Lean protein source - Turkey is a healthy, lean meat. The white, breast meat is particularly lean and has less fat compared with the darker, more fatty meat. But overall turkey is a lean bird and is a healthy protein source. The turkey itself is a great protein item, where the additional calories come from is often what we put on top of the slice of meat. The additional gravy or cranberry sauce is where the additional calories are hiding. Now that doesn't mean you need to eat your turkey without a tasty topping, but work to make sure that you topping it with a moderate serving of gravy. 

Colorful veggies - Thanksgiving just like any other meal where you should be aiming to fill 1/2 your plate with lots of colorful vegetables. There are lots of traditional Thanksgiving foods that can be healthy - sweet potatoes, pumpkins, green beans, and collard greens. One of the easiest way to prepare all of these veggies is to throw them in the oven or in a pan and roast them. Add some salt, pepper and if you want a special kick add some cumin. If you prefer raw veggies, put together a colorful salad and then serve that alongside your turkey and sweet potato casserole. 

Mix in Whole Grains - We all love our bread at our Thanksgiving feast. From the stuffing, to the rolls, to the chicken with noodles. There are lots of sources of grains at Thanksgiving. Why not try to substitute some of those with whole grains. Make whole grain muffins/rolls or add in some whole wheat bread to the stuffing recipe. This is helpful for diabetics and to help with fiber intake. 

Sweet Treats - I really enjoy all of the delicious pies for Thanksgiving. I think that in moderation these can be a great way to celebrate the holiday. I love cutting pies into 12 pieces compared with 8 pieces, because you can enjoy a smaller slice of pie and still enjoy the flavor. Or if you want to sample multiple types of pie, try a 1/12th of a pie and this will equate to 1/8th of a pie if you end up with 2 pieces. There are also ways to make your pie healthier, but more often than not, I find that moderation of your serving size is the most realistic way to stick with following a healthy lifestyle.

Move your feet - There are lots of Thanksgiving Day races available. That is such a fun way to fit in a work out and then enjoy a delicious meal. There are so many races in every town around the country. If you are worried about burning calories and the holidays that is a great way to get more steps in on Thanksgiving. 

Races

Confession time ... I haven't run in an official race since before William was born. It has been 10 1/2 months. I know ... that is crazy. I love running and I have been running since I got the all clear from my OB back in February, but I haven't run in an official, timed race from Thanksgiving of 2016. Whoa! Crazy right?! Believe me, I had high hopes. I wanted to run a half marathon in the spring, but that didn't happen because I couldn't find the time to train and I didn't feel like I was back to myself 100%. After getting from pelvic floor therapy, I feel like I am back to my pre-baby self and I thought about a fall half marathon. Will that time has come and gone. I wasn't able to get in enough mileage to run 13.1 miles in a healthy way. So here we are in November and it is almost time for Thanksgiving and the Drumstick Dash again. I have actually three races that I am signed up for in the next month. None of them are half marathons, but it is a start. They will be official races that are timed and needless to say ... I am so excited! 

1. SCOUTStrong 5K - November 11th at Camp Belzer in Indianapolis. I have been on the planning committee for this 5K for the past 2 years. Last year I ran in it pregnant. William did a great job (tagging along with me). It was a fun, beautiful fall course. Ran through the woods and this year it will go into Fort Benjamin Harrison. 
2. Drumstick Dash - November 21st in Broad Ripple. This is one of my favorite races every year. I have done this with my Mom for the past 4 years and this year will be #5! It is such a fun tradition and I love to feeling of being at the start line with SO many people. We have got to "move our feet, so others can eat!" Each year we have family do this with us and this year there will be 7 of us (William included). 
3. Hot Cider 5K - December 6th in downtown Indianapolis. I signed up to run this with a girlfriend, because there was going to be a fun thermal shirt and hot cider. Yes, please! I have done several races around the canal area downtown and it is fun. 

Goals for 2018 include running another half marathon. I think this upcoming year, I will bite the bullet and run the Indianapolis Mini Marathon. I know ... insert gasp here ... I have run LOTS of half marathons, but never the Indy Mini. I am thinking what better way to get back in the half marathon running habit then starting off with the biggest half marathon race in the country! I will have to start training in January of 2018. Should be a fun journey! 

My Experience at FNCE 2017

I had to the chance to go to FNCE this year in Chicago for a day. For those of you that don't know FNCE is the Food and Nutrition Conference and Expo. It is the annual national conference hosted by the Academy of Nutrition and Dietetics. I haven't been since I was an intern back in 2010 when it was in Boston. I was very excited to attend this year, because it was in Chicago (3 hours north of Indianapolis). Even with having a small (10 month old) child, I wanted to try to go. Shout out to my amazing mother, who came up with me and watched William for the day. That was such a huge blessing and really made it possible for me to go.

I was actually given a scholarship to attend FNCE this year. The local Dietetics Association that I belong to - CIAND (Central Indiana Academy of Nutrition and Dietetics) gave out a $250 scholarship. I thought I would apply and I was so excited that I was chosen. With this scholarship I took a day off work and headed up to Chicago for the conference. 

If you haven't had the chance to attend FNCE, then mark the upcoming dates on  your calendar, save some money and try to go! It is worth the time and money. It is such a HUGE conference and there are so many neat speakers. You have the chance to earn SO many continuing education units and network with amazing dietitians.

I wanted to share with you some of the highlights from my 24 hours at FNCE. 

Purdue Alumni Reception 

I was able to get up to Chicago on Sunday evening and attend the Purdue Alumni Reception. I was so glad that this event was sponsored by the Department of Food and Nutrition and by the Alumni Board. There was a great turn out and such a fun chance to see old classmates and professors. I was able to bring my Mom and baby with me so that was neat to show off my little guy and have some help watching him. 

Networking Luncheon

On Monday there was a luncheon at a hotel near the conference for the authors of a book that Barb Mayfield is leading. It was so great to have a chance to network with some other amazing dietitians. This nutrition communication book will be such a great resource for dietitians and I am excited to see it come together and so thankful to be included on this project.

Educational Sessions

I love being able to go to continuing education sessions and I wish I could have attended more of these. I had fun though attending three of them during the day on Monday. My favorite had to be the main speaker on that day, which was Kimbal Musk. He is such an interesting person and it was so neat to hear him talk about his philosophy with food. Plus his mom is a RD! Another interesting session was one on Type 1 Diabetes in Africa. Very neat and made me want to go on a medical mission trip. 

If you haven't been to FNCE before,  mark your calendar and try to go next year. Some other fun parts to FNCE is the Expo Hall, the awesome networking events with the DPGs and of course the main speakers. It is such a neat conference and I am so thankful for being able to go this year! 

Halloween Goodies

Crunchy leaves, spooky decorations and lots of sweet treats. That basically sums up this time of year. Halloween is just around the corner. With a little 10 month old running around our house, Halloween is even more exciting. We have a great family costume planned - it includes a farmer, a pig, a spider and a spider web. Any guesses ............... if you were thinking Charlotte's Web you would be right! 

When it comes to Halloween goodies we tend to reach for lots and lots of candy. In fact, Americans will end up purchasing 600 million pounds of candy on Halloween. For those trick-or-treaters that come to your door, their number one choice for Halloween treats is chocolate. About 157 million people participate in Halloween and 141 million purchase Halloween candy. That equates to 45% of the US population handing out candy to trick-or-treaters (source). So it is obvious that lots of people are purchasing candy, the kids that are trick-or-treating love it and we are eating lots of extra calories around this time of year. 

Have you ever wondered how many calories are in some of your favorite candy bars? Want to know more - CLICK HERE for the article. 

• Reese's Cup (110 calories) - You would need to run 7 minutes (at 10 minute per mile pace) 
• Butterfinger (85 calories) - You would need to do 10 minutes of Zumba
• Regular M&Ms (67 calories) - You would need to do 9 minutes of jumping jacks 
• York Peppermint patty (60 calories) - You would need to do 25 minutes of yoga
• 3 Muskateers Bar (63 calories) - You would need to do 26 minutes of pilates 

Do you have to hand out sugary treats? No, there are lots of options for things that you can pass out at your house. I love highlighting the Teal Pumpkin project every year, because for lots of families Halloween ends up being stressful. For families who have food allergies or food intolerances this is tough to have to sort through all the candy and pick the "unsafe" treats. The Teal Pumpkin Project has some great resources in terms of signage for your house, ideas for non-food related treats and spreading the word about food allergies. Last year I put together a great blog post with more treat ideas and a video about the Teal Pumpking Project - CLICK HERE to check it out. I loved this infographic and just had to share it with you. 

If you think the Teal Pumpkin Project is a neat idea, but you also want to hand out candy, that works too. That is what I do every year. I have a bowl of goodies filled with non-food related treats and then another bowel with candy goodies. That way I have options for everyone and I feel better about the large amount of candy that all these kids are eating on Halloween. 

Personal Goals

It is that time of year for annual self evaluations at my work. That is not my favorite thing to fill out, but it got me thinking about personal goals. I am a strong believer in always having goals for yourself. No matter the area of your life, having a goal and working towards something is important. I like to have personal goals for my job, for my finances at home, for my fitness and for my marriage. If you can't tell, I really like having a list of goals and then accomplishing them. 

http://tinyurl.com/ydgvaj3j

I wanted to focus on personal job goals. I have had some conversations with students (in college) and colleagues at work about setting out goals for your job each year. What do you want to accomplish through your work and how do you plan on pushing yourself. 

This year I started off the year with some goals and now I am noticing that those goals are shifting/changing. For example, I have been working towards becoming a IBCLC (lactation consultant) and I wanted to try to get my exam scheduled by the end of 2017. Well we are now just about at the end of 2017 and I am still needing to log 45 education hours before I can sit for that test. Life happened throughout this year and that kept pushing back my ability to do self-study materials to log those 45 hours. There have been several new projects/opportunities that have come up and I needed to focus on. 

Goals for 2017 

• Nominating Chair for the Indiana Academy of Nutrition and Dietetics (IAND).  
• Work on self study materials for IBCLC Exam. 
• Schedule IBCLC Exam. 
• Re-launch NICU Nutrition Committee.  

When you write down goals for yourself, then you can go back and see how those goals need to change. Being flexible is so important. Life never goes as you think it will, but the beauty for setting goals is having the power to change and adjust them. That is what I have had to do here in the last month. I have had several new opportunities come my way and I have had to change my goals for myself to allow me to work towards those new goals. 

Updated Goals for 2017

• Continue to serve as the Nominating Chair for IAND. 
• Scheduled Neonatal Nutrition Committee and put together agenda in our NICU. 
• Started to work on a nutrition communication book through Academy of Nutrition and Dietetics (AND) as a co-author. 
• Chosen to work on a committee with AND for creating a pediatric critical care board exam. 
• Re-designing our formula room to use breastmilk scanners in our NICU. 
• Look at continuing education for IBCLC Exam.

I really believe that creating a list of goals for the year is so important. I always work towards doing my "daily work" and then working on side projects. I enjoy being a NICU RD, but all of the charting get a little old so adding in additional projects makes my daily routine more fun and engaging. Again, I wanted to share my personal work goals with you, but I believe that as a professional you should have your own goals. What do those look like for you? What do you want to accomplish in the next year, professionally? Are there things you have always wanted to do? Author a book? Create questions for a national board exam? Teach a class? Whatever goals you have for yourself, write them down and then work towards accomplishing them! 

http://tinyurl.com/ycop5dkc

The Benefits of SNAP

I came across this news story about a new research article that was in JAMA and I just had to share this information with you all. I don't like to get political on this blog and that is not my goal. I simply want to share this research with you and you can make whatever decision about it. I think that part of being a good American is understanding how Government agencies work and being informed. 

http://tinyurl.com/y8qffxon

So let's just jump in. There was a research study in JAMA that was published in 2017. The title of the study is Supplemental Nutrition Assistance Program (SNAP) Participation and Health Care Expenditures Among Low-Income Adults. This is one of the first studies that I have seen really looking at a large sample size of low income individuals and looking at their overall health. This retrospective cohort study of 4447 adults (whose income was below 200% of the federal poverty threshold) participated in a NHIS (National Health Interview Survey) in 2011. Out of these participants 1889 were SNAP participants and 2558 were not involved with the program. The study found that those who were involved with SNAP had lower estimated annual health care expenditures (a savings of $1409). This is significantly lower estimated expenditures compared with the non-SNAP participants. That is a HUGE amount of savings! For the 1889 participants that equates to $2,661,601 estimated health care expenditure savings. If you look at all the SNAP participants who are adults (40% of those on SNAP) that could create a huge potential savings. Lots of these SNAP participants are also on Medicaid. 

Long story short that means that this could be an avenue to help decrease health care costs. We know that more and more Americans are struggling with obesity, heart disease, and diabetes. With this increase in chronic diseases that leads to an increase in health care costs/dollars. To combat this diseases, it is most effective to change lifestyle habits - eat healthier and exercise more. Making those changes can have big impacts on overall health. That is why this study is so interesting. Looking at SNAP recipients and seeing that this government program is providing food dollars to Americans is helpful in supporting a healthier lifestyle. According to the SNAP program, there are 20.5 million households stretch their budgets to purchase food. That is a lot of people that could use help and support with affording food. With the proposed budget cuts there is a potential cut of $193 billion dollars over ten years = cut of 25%. That is a big decrease and could have a big impact on lots of Americans. (TIME had a great article - CLICK HERE to read it for more information). In that article, there was another statistic that stood out to me .... in 2013 when SNAP funding had been decreased there was a rise in hospital admissions for diabetics with hypoglycemia (low blood sugars) due to food insecurity. Paying for an ER bill is much more expensive compared with offering SNAP benefits. Just an interesting finding that I think it worth thinking about.

I think when we talk about decreasing money to SNAP we need to know what impact that has long term. We need to understand what this program does and how it benefits people. Then after looking at that information, if the budget still needs to be cut, then we need to figure out how we help and support the people that have been utilizing this program. 

I don't want this to be political or be an argument over the proposed budget cutting initiatives being put forth from the White House. I just wanted to highlight the fact that there was a study done looking at how a government program (SNAP) was working to help make their participants healthier and saving money in the long run. That is very exciting and honestly I wish there were more studies out there looking at SNAP and WIC because having that data and talking about it could help to show the importance of these programs.

Update on Donating Breastmilk and Breast Pumps

I wanted to do a quick write up about donating breastmilk to the Indiana Milk Bank. I was able to drop off some of my extra milk to the Milk Bank and I was very excited and wanted to share about that experience. I was able to go through the approval process to become a donor. Then I went ahead and donated 687oz of frozen breastmilk. My mother had this milk in her deep freezer and she helped me drop it off at Columbus Regional Hospital. I was so excited to be able to give some of my milk to the Milk Bank to sell to hospital to use for preterm babies. 

If you are a breastfeeding mother and have extra breastmilk, you should consider becoming a breastmilk donor. Check out my first post about this - CLICK HERE. 

I also donated some breastmilk to a random stranger on Facebook .... gasp! I know right? I was torn about it. But here is why I did it ... I had some breastmilk that had been in a refrigerator/freezer for > 6months and I wasn't able to donate it to the Milk Bank. There standards can < 6months in a refrigerator/freezer. This was milk that I didn't need and I wanted it to go to someone that could use it. There was a lady on a Swap Group I belong to on Facebook who was needing donor breastmilk for her little one and she hadn't been able to find anyone with extra milk. I really felt like I could and should help her. I felt like I wanted her to get good, safe milk and I let her know that I was an approved donor through the Milk Bank. I was able to give her over 200 oz of breastmilk. Normally I am not a fan of just giving away your breastmilk to a stranger, but I felt like if you think about it and do what you feel comfortable with that can be the write call. 

I also wanted to touch on breast pumps. I have had several people ask me about my breast pump. I went ahead and purchased a Medela Symphony. This pump is a hospital grade pump and it is what you would use while in the hospital or if your baby was in the NICU. This is a great pump, but is very expensive to purchase on your own. Insurance won't purchase it for you. I was very torn about what type of pump to purchase. I really liked Medela, but there are so many different options and I kept hearing such mixed messages about all of them. I was really stressing about it and that is when my husband suggested we look online for a used Symphony. We found one on Ebay that was ~$600 and it has ~75 hours on the machine. This was a great deal when retail value is ~$1000. I knew that this pump would work well and I wouldn't stress about it. If I had rented the same pump through the hospital it is $60 a month and over the course of 12 months that costs $720. So I knew that I would get my money worth out of that pump if I purchased it on my own. I just wanted to share that story with you, because I don't think people realize that you can purchase a used Symphony pump. Now, please be smart about it when you shop on Ebay. But if you really want that hospital grade pump there are ways to obtain one for less than the retail price of $1000. 

If you are looking at getting a breastmilk pump through your insurance .... do your research, look online and talk to your friends. Try to figure out what pumps have good reviews and evaluate what would work for you. This is a big decision and you need to make sure that you are making the best choice for you and your little one. 

Eating Healthy While Eating Out

Did you know that the average American eats out 4-5 times a week. That equates to about 18 meals per month that are consumed outside the home. Those meals are, on average, $12.75 per person and that totals ~$232 per month on restaurant meals. If you look at fast food meal consumption, about 20% of Americans are eating meals in their cars. The average American spends $1,200 a year at fast food restaurants. So why do we love eating away from home? Well it is convenient and it is normally something we do to socialize. So obviously we all know that we will be eating out at restaurants so let's talk about ways to do that in a healthy way. 

Navigating a Restaurant Menu

• Avoid portion distortion. 
  • Meals often are large. More often than not you are getting way too much. Ask for a doggie bag and save what is left over for lunch the next day.
  • Try to avoid going to the restaurant hungry. Most of us all over eat when we are already starving. So avoid going to the restaurant when super hungry.
  • Skip the sides or substitute a healthier option. Try to make healthier choices in the sides that you order. Skip the fries and instead order a salad.
• Be sauce savvy. 
  • Watch out for high calories sauces and dressings and try to get the sauce on the side. When you put these toppings on the side that is an easy way to decrease calories and limit your consumption of these calorie rich toppings.
  • Add flavor to foods. This is easy to do by asking for extra mustard, salsa, peppers, onions or other flavorful toppings. Skimping on the on the dressing doesn't mean you have to eat less flavorful food.
• Say no to fried.
  • When you pick fried food items you are adding extra calories. Watch out for words on the menu like breaded or crunchy.
  • Food can still taste delicious and can be grilled, broiled or baked. 
• Sip smart.
  • Soda may sound refreshing, but if it isn't diet, then it can contain extra calories. If you drink too much diet soda it can  make you feel hungry and tend to over eat. 
  • Get water, unsweetened ice tea or low fat milk. Plus water will save you money on your restaurant bill.
• Be prepared and have a plan.
  • Look at the menu ahead of time and come up with a plan. Figure out what food items are healthier and lower in calories. 
  • All of the menus are available online and you can use a nutrition app to look up nutrition information.

There is a great video that I found on YouTube about navigating fast food in a healthy way. Sometimes trying to find healthy choices at these restaurants may seem impossible, but it can be done! 

Hopefully some of these tips and tricks will be helpful when you head out to a restaurant this week. I know that some times it can feel overwhelming, but focus on 1 meal at a time and all of those good choices will add up! 

Peanuts and FDA Health Claim

Food allergies are on the rise amongst children. This is a common issue that lots of families struggle with. Peanut allergies are one of the most common food allergies out there. In fact, in the US the incidence of food allergies has increased 400% from 2007 until 2016. The incidence of peanut allergies has increased 450% in that 9 year span. This is an alarming increase in the percentages of food allergies and specifically peanut allergies. Researchers have been looking at ways to combat this alarming trend. For lots of children they tend to out grow their food allergies, but for some it is an issue they struggle with their entire life. 

There was a research study that was done in the UK in 600 infants looking at the exposure to peanut protein powder and their incidence of peanut allergies by 5 years of age. These infants were labeled as "high risk" because they has eczema and issues with eggs. The cohort was between the ages of 4-11 months when they were started in this study and they were followed through 5 years of age. This group of 600 infants were divided into two groups: 1) avoid peanut protein completely and 2) were given 6g peanut protein powder weekly. The research findings showed that there was a reduction in the incidence of peanut allergies by 81% in the group that was exposed to peanut protein. Out of that group only 1.9% ended up with a peanut allergy compared with 13.7% of the children in the complete avoidance group.  This is very interesting research because it definitely leads us towards the idea that early exposure could potentially help to decrease the incidence of peanut allergies. 

Currently the AAP says that you can give peanut/peanut products to children when you start solid foods if there is no family history of peanut allergies. If there is a family history of food allergies then have a discussion with your pediatrician first. With careful monitoring from a pediatrician and a dermatologist, you can still give your child some peanut protein and that small dose, over time could help reduce the incidence of an allergy in the future. There is a product on the market called Hello Peanut. This product is very interesting because it could help serve as a tool for health professional to exposure children to a small amount of peanut protein and with close monitoring could help prevent peanut allergies. The way the product works is you start with the introduction packets and use it for 7 days. Each day you give one packet of the peanut protein and each day the amount of peanut protein in the packet increases in volume. It is kind of like a peanut challenge. If your child is able to tolerate the increasing dose over that week then you can move up to the maintenance packets. One issue with the research study that I mentioned above, is that there is no set length of time that is associated with how long you need to continue this exposure to peanut protein to prevent an allergic response. They are doing a follow up study to look at having those 5 year old, not consume peanuts for a year and see if they are exposed to peanuts after that year, if they elicit an allergic response. 

This is all a neat idea to potentially decrease people's risk of developing a food allergy by giving them some exposure to this protein and letting their bodies adapt to that protein and not elicit an allergic response. 

There was a great write up in the New York Times about the Hello Peanut product and how it can be used. Again, this is best used under the supervision of a health professional to ensure the safety of the child taking this product. If you child already has a diagnosed peanut allergy this is not a fix for that condition. There is no cure of peanut allergies. 

The other really interesting thing about this research study is it prompted the FDA to look at this research and put forth a "Qualified health claim" that says that consuming foods with peanuts could potentially help prevent future allergies. This is the first time that the FDA has made a statement like this in regards to a food allergy. The whole claim is as follows "for most infants with severe eczema and/or egg allergy who are already eating solid foods, introducing foods containing ground peanuts between 4-10 months of age and continuing consumption may reduce the risk of developing peanut allergy by 5 years of age."  Now there needs to be further research in this area and the FDA does knowledge that, but this is a huge step forward for food allergy research and could have a big impact on those of children and their lives in the future.

If you missed the FOX59 segment talking about this research study that aired in Indianapolis, click this link!