The Gift of Breastfeeding

So I am officially a breastfeeding mama. It has been quite the adventure let me tell you. I have worked with Moms and breastfeeding with my job a Registered Dietitian and on a feeding team, but this is my first time actually doing this myself. I wanted to make sure that I talk about on this blog the reality of breastfeeding. Sometimes I think Moms aren't exactly sure what they are in for and sometimes it can be very overwhelming. 

Here are some statistics for you about breastfeeding that came from an article that was released just a few days ago: 

• In 2012, estimated 80% of mothers started breastfeeding their infants. By 6 months of age, an estimated 51.4% continued to breastfeed and by 12 months of age that number fell to 29.2% of mothers still breastfeeding. 
• Goals for Healthy People 2020 are for these rates at birth to be at 81.9%, by 6 months keeping 66.6% of mother breastfeeding and by 12 months of age having 34.1% of mothers continuing to breastfeed.
• Breastfeeding support programs are effective in helping to encourage and support mothers of all ages to continue to breastfeed.
• Breastfeeding has several maternal benefits including - lower risk of breast and ovarian cancers, less visceral adiposity, reduced rates of diabetes and cardiovascular disease in the mothers.

I wanted to make sure that I shared with you some of my experiences with breastfeeding. I have only been doing this a few weeks, but I think it is an important thing to talk about and prompt discussion.

The initial latch - Can we talk about how when your baby latches for the first time it hurts? It is very uncomfortable. I was really concerned at the beginning that William wasn't latching correctly and that was causing some pain, but after speaking with a lactation consultant in the hospital, he was doing a great job and had a great suck. It took about 2-3 days for the initial "pain" with the sucking to go away. Lanonlin was my best friend. That helped so much to help relieve some of that pain and keep my nipples from cracking and bleeding. I would apply it after each time breast feeding. 

Milk coming in - Oh my goodness this was a surprise. My milk came in on day #3 after having William and WOW! I was so overwhelmed. It was painful to have super huge boobs and have them filled with milk. I didn't know this was going to happen so quickly. I had a ton of milk immediately and I didn't know what to do with it all. Originally, I was not going to pump for the first month, but when my milk came in I had to pump. I had to relieve that pressure. So I started pumping twice a day and I have been sticking with that regime since that first day home. 

Engorgement - I didn't know how to handle this side effect of breastfeeding either. I wasn't prepared for the engorgement feeling and again because my milk came in so quick I was so overwhelmed. It was such a crazy experience to be solely responsible for feeding your child. I have been thankful that I have a good milk supply. I know that lots of women struggle to increase their supply. Breastfeeding is tough and takes lots of time. 

It is a gift - In the midst of feeling overwhelmed and learning how to breastfeed I had a wonderful chat with my husband, Chas. He was so encouraging and helped to remind me that I didn't have to breastfeed. If there was any point that I felt like I didn't want to breastfeed, I didn't have to. There are other ways that we could feed William. He reminded me that he would support me in whatever I decided to do. He also said that if I continue to breastfeed that is a special gift that I am able to give William. It is something that I can choose to give him. Taking that perspective has been so helpful for me. Viewing breastfeeding and pumping as a gift for my son really hit home for me. I thought this perspective was worth sharing. If you are a breastfeeding Mom and feeling discouraged, remember what you are doing 6-12 times per day is a gift. All of the hard work is something special that you can give your child. 

I will keep you posted on how breastfeeding is going. We are now 3 weeks into this adventure and it is going well. William loves to eat and is growing quickly. Our next big challenge will be next month when William goes to daycare and I head back to work. Until then, we will continue to breastfeed, practice with a bottle 1-2 times a day and pumping ~3 times a day. Keep up the hard work if you are currently breastfeeding and if you know someone who is breastfeeding give them a pat on the back. 

The Birth Story

If you have been following my blog, you would know that I have been pregnant and writing up some blog posts about my experience. Trying to debunk some pregnancy nutrition/health myths along the way. A lot of people aren't familiar with what happens during pregnancy and so I was eager to share what I was learning with you all. Well my pregnancy finally came to an end on December 23rd. You may have seen on Instagram, we welcomed our first little baby into the world and his name is William. His birth story is rather boring, which is fantastic, because that is exactly what we wanted. 

If you want all the details on William's arrival into this world, let me know (some people might want to know more and I don't want to bore you) ... I will share the highlights with you here. Labor started around 6am in the morning. I was having some pre-labor contractions (they ramped up to 3 minutes apart and 1 minute in length) immediately. They lasted until about 730am and started to die down in intensity and lengthened out. But then by about 8am or 830am the contractions had increased again in intensity and were getting slightly stronger. I was scheduled to have an appointment with my OB that morning at 11am, but Chas called the office for me and they had me come in early. Chas was awesome at working to keep me calm. I sat in our bed this whole time, just trying to relax and ride the wave of each contraction. The more relaxed I was the less painful the contractions were. Chas finally got me in the car and we had all of stuff loaded in the car already. We then started the trek to the OB office and arrived there around 930am. My OB took a quick look and confirmed that I was dilated to 6cm and 60% effaced. She sent us directly over the hospital were I was a direct admit to the Labor and Delivery Unit.

It was a wonderful experience being at St. Vincent Women's Hospital. Our birth plan was very simple ... a very hands off approach with minimal interventions as possible. I wanted to go through labor without any medicine (no epidural or other pain medication). I felt like this was something that I could do and would give my baby the best chance at a healthy delivery. I didn't want any IV fluids either. I worked out throughout labor to continue to drink water so that I wouldn't be dehydrated. I had an IV placed (per hospital protocol), but thankfully it never had to be used. I also wanted to make sure that at the end, once William arrived, if possible I wouldn't need any picotin. Thankfully, it all went well and I didn't need any IV pitocin administered. I also wanted the wireless fetal monitor, but unfortunately it broke the day before we arrived. I was able to go on intermittent monitoring - meaning I was on the monitor for 20 minutes of every hour. The nurses were great about only coming into the room to hook up and take off the monitor and check my vital signs. 

Labor was long. I knew it was going on for awhile, but thankfully I didn't have a good concept of time. Chas did a great job at protecting me from that. The total length of time that I was laboring was 20 hours. I have been told that is fairly common for your first child, but it was quite the marathon. Thankfully that was the biggest challenge. Towards the end of labor, we learned that there was meconium staining, which means the bag of water had meconium in it. If William would have aspirated any of this then that could have caused an infection and required intervention (respiratory or medication). Thankfully he came out crying, the NICU team was there was quickly assessed him and he didn't need any type of intervention. He did great and maintained a perfect heart rate throughout the 20 hour labor process. He welcomed a healthy, strong boy into the world at 1020pm that night on 12/23. It was wonderful to see him finally come out and that long, marathon of labor start to come to an end. 

We can't thank everyone who helped us throughout this pregnancy and during the labor/delivery enough. We had a wonderful experience at St Vincent Women's Hospital and were so impressed with the amazing care and support we received. We were so thankful for going through the Bradley Childbirth Classes to help feel more prepared for the long labor process. I am also thankful for keeping fit throughout the 9 months of carrying William so I was able to go through labor, exactly how I wanted. It was great to have done prenatal yoga through the entire pregnancy and I felt physically as prepared as I could be to bring a baby into the world. If you have any questions or want more details ... feel free to get in touch with me. I wanted to just provide a nice close to my pregnancy journey. Now I have embarked on my next adventure ... being a breastfeeding Mom. Don't worry there will be a few blog posts about that as well! 

Healthy Dinner Ideas: Homemade Soup

This is the time of the year when the weather is chilly outside and it is often cold and gray. Nothing warms you up at the end of a long day like a delicious, bowl of homemade soup. I love cooking soups at home during the week, because more often than not, they are quick, make a complete meal and there are left overs to take to work for lunches. 

Perks To Preparing Soup From Scratch: 

• Healthier - I love that you can find just about any type of recipe online and you can make a traditional soup recipe even healthier. There are so many substitutes you can make to any recipe that you find. For example, if you need to watch the amount of sodium in your diet then you can consider using fresh tomatoes or no salt added canned tomatoes. You can make your own broth or use a lower sodium broth option. You can choose fresh or frozen vegetables compared with their salter, canned counterparts. There are so many easy ways to tweak and make recipes even healthier. If you need to increase the amount of fiber in your soup and your overall vegetable intake, consider adding kale or spinach to the recipe. This is also a great source of Vitamin K and antioxidants. 
• More Cost Effective - Preparing your own soup from scratch will end up saving you more money compared with purchased an already prepared canned soup option or even a dried soup packet option from the store. There is obviously more prep work involved to make the soup from scratch, but you will get a larger volume of soup and you can use it for left-overs later in the week. This larger quantity is a perk if you have a large family to feed as well. You can pair other sides with the soup as well to make it a complete meal - have bread on the side with another fruit or vegetable offering. 
• Customization - When you take the time to put together a recipe from scratch there is a lot of areas where you can change the recipe to fit what you or your family likes. If someone in your family really dislikes corn, then in your minestrone soup recipe, make sure that you avoid adding corn and instead use another vegetable like squash or lima beans. If you have a family member with a food allergy, then preparing your own soup from scratch can allow you to accommodate their specific diet needs. 

My Favorite Soup Recipe - White Bean and Sausage Soup

Ingredients

• 1 cup baby carrots, cut in half 

• 1 cup onion, chopped 

• 2 garlic cloves, minced 

• 7oz turkey sausage/keilbasa, cut into 1/2 inch pieces 

• 4 cups chicken broth, fat free and reduced sodium 

• 1/2 teaspoon Italian seasoning 

• 1/2 teaspoon black pepper 

• 2 cans Great Northern beans, drained and rinsed (15.8oz cans) 

• 1 bag of spinach, fresh (6oz) 

Cooking Directions

1. Heat a saucepan, coat with cooking spray over medium-high heat. Add the carrots and cook until tender. Add the onion, garlic and the sausage. Saute the vegetables for 3 minutes and stir occasionally. Reduce the heat to medium and cook for 5 minutes. Add the chicken broth, Italian seasoning, pepper and the beans. Bring to a boil, reduce the heat and simmer for 5 minutes. 
2. Place 2 cups of the soup in the food processor or blender and mix until smooth. Return the pureed mixture to the pan. Simmer for an additional 5 minutes. Remove soup from the heat. Add the spinach, stirring until spinach wilts. 
3. Substitutions - You can substitute the spinach for kale if you would prefer. 

This is a great recipe, because you can easily make this in about 30 minutes. I enjoy having dinner together within 30 minutes during the week, because after working all day, walking the dog, and exercising, I hate spending way too much time in the kitchen cooking/cleaning. Cooking Light has a great assortment of soup recipes that you will have to check out! 

Welcoming in the New Year

The New Year is upon us. 2017 is just about here! That means time to think about your goals for the New Year. What are you wanting to accomplish in 2017? What did you struggle with in 2016 and want to work to improve? 

To set yourself up for success it is helpful to make sure that the goals you have for yourself are able to be accomplished. Being able to take the time for write "SMART" goals can help ensure that you are successful. 

SMART Goals 

• Specific - Set a goal that is specific. Avoid something vague or too broad. How else will you be able to tell if you have accomplished your goal, unless it is specific? For example, if you want to work on being more active then make your goal specific by saying what type of activity you want to do. "I want to be increase the number of days per week that I run." 
• Measurable - After you have determined your specific goal, then plan a time line. Take a moment to figure out over what duration in time you want to work on accomplishing this goal. For example, determine the time you want to meet this goal. "I want to plan on running for 3 days each week for the next 3 months." 
• Attainable  - Whatever goal you have in mind, make sure that is able to be accomplished. Don't set too lofty of a goal or you won't be able to accomplish it. For example, make sure that you are able to meet your goal parameters. Running for 3 days a week is possible for me, because I have done this before, but if I had never run before this might be too much. "I will plan on running 3 days a week for the next 3 months." 
• Relevant  - Make whatever goal you are aiming for to be relevant to what you want to accomplish. This may seem like a no brainer, but if you don't care about your goal, then you will for sure not accomplish it. My goal is about running, now if I didn't like running, then I would make sure that my fitness goal was about something else. That goal should be relevant to what you are interested in and care about. "I will plan on running (outside or at the gym) 3 days a week for the next 3 months."
• Time-Based - Make sure that your goal is time-bound. This means that you are able to put a start/stop time on the goal and that will be allow you to re-evaluate your goal and see if was accomplished. For my example the end of the goal is at 3 months from when the goal was set. That gives me 3 months to try to accomplish this goal and then if at the end of the 3 months, I can re-evaluate and determine if I met the goal.  "I will plan on running (outside or at the gym) 3 days a week for the next 3 months."

Hopefully some of these tips and tricks are helpful to you as you look forward to the New Year and set some goals for yourself. I am not the biggest fan of New Year's Resolutions, because most of the time they don't stick, but that is often due to the fact they are not SMART goals.

What goals do you have for yourself? How do you want to change and be more healthy this next year? 

Healthy Habits

This is the time of year when healthy habits seem to fly out the window. The weather is cold, it is dark early in the evening and we are all busy running around getting ready for Christmas. Amongst all of this craziness it is important to try to keep up with some of those healthy habits that will keep you feel better about yourself. 

Prioritize Your Fitness:

This is what I wanted to focus on and encourage you ... stick with a fitness routine. Don't let this lapse. There will be days due to travel or family obligations that you may not be able to do your normal workout routine, but make a point the day before or after to be active. There are lots of fun runs that happen around this time of year. Sign up for one near you and get out and move! If you enjoy the gym and haven't been in awhile, pack up your gym bag and head over after work today. If you have exercise equipment in our house, then change your clothes and go use it. The perk to being active during the holidays is that it allows you to consume additional calories and then will help to prevent extra weight gain during this time of year. You will feel better about yourself as well and this is worth it. All of us need to feel good about how we look and feel and simply taking some time to be active can help in your confidence level. 

Navigate the "Holiday Treats" in Moderation: 

I think the most challenging part of making healthy food choices over the holidays is the food. There is so much of it and a lot of it is "special" and not what we normally consume. I am not saying that you can't have some of your holiday favorites, but watch the portion and space those cookies out. If you find having these treats in your house is too tempting, make sure to keep them in a storage space, which is off the counter. Try to get these tempting goodies out of your house as soon as possible. Give them away and then you will not have to deal with the on going temptation from now until Christmas. If you feel adventurous you can work to make some "healthier" swaps in those recipes. This may take some practice, but could make your favorite treats a little more friendly for your waist line. 

Make the Holiday about the People: 

This time of year, is about giving back and the people we interact with. This is the main focus. I know it can be easy to get caught up in the hustle and bustle and forget about time with family and friends. Enjoy this time with your loved ones and make this the main focus. Try not to stress about the decorations, the cleaning, the cooking or the gifts. Decreasing your own stress level is good in terms of helping to keep you healthy. 

Enjoy this festive time of year and hopefully the end of year will come to a close on a positive note! 

Merry Christmas and Happy Holidays

I wanted to make sure that I shared a post on Christmas to wish everyone, who takes the time to read this blog, a very Merry Christmas and hope you have a wonderful holiday season! I know I appreciate everyone who follows along and reads what I have to share on RD Anna. It means so much and I hope that you find the information helpful/insightful. 

I had to share our Christmas card this year with you all! Our little chihuahua did a great job during our maternity photo shoot back in October. 

Working In A Formula Room

It has been awhile since I have spoken about my day job here on the blog. As you may recall, I work in a Neonatal Intensive Care Unit (NICU) and I am a pediatric dietitian. I work with newborn babies and I calculate their nutrition needs to help them grow appropriately since most of our patients are born early. Another part of the job, is helping to oversee our Formula Rooms. This is the part of the NICU where all of the feedings are put together/made for our patients in 24 hour batches. We help to schedule, oversee and hire the Formula Room Technicians that work in those mixing rooms. Sometimes the dietitians fill in those shifts as well if we don't have enough techs to fill the spots on a particular weekend. 

This last week I have had the opportunity to work in our Formula Rooms a couple of times. I am always impressed with our system and how we so accurately get all of our babies fed ~ 8 times a day. It is truly a well oiled machine and is so neat to be a part of that. 

I thought it might be neat to address some of the Frequently Asked Questions that I get about our Formula Room/NICU and how nutrition plays a role in that environment. Most people are surprised to learn that there are dietitians in the NICU and that we have a mixing room for feedings. 

Frequently Asked Questions

1. What does a dietitian do in a NICU?
   • This is a great question. The role of a dietitian in a NICU varies, but the main role is to help provide nutrition care to this specialty population. The RD serves as the nutrition expert on the medical team and provides guidance/advice to the neonatologist about  the best feeding recipe for each patient. Each week the RD sees every patient in the NICU and writes up a nutrition note about their plan of care that week. The RD would suggestion what feeding option might be best for that patient, the avenue of administering the feeding, when start vitamins, how feedings might change based on lab values and monitor growth velocity and tweak the nutrition plan as needed. 
2. Do you just mix formula in the Formula Room?
   • No. In our Formula Room we prepare ALL of the feedings for ALL of our patients and they are stored in a refrigerator in that room. The RN will come in and out of the Formula Room to get the feedings and take that aliquot to the bedside and feed the baby. Each patient has their own bin in the refrigerator and their feeding is in that bin for the RN to grab anywhere from 6-8 times per day.
3. How do you feed your patients?
   • In the NICU, since our patients are normally premature, our most common form of administering nutrition is via a feeding tube or via TPN. We prefer to use the GI tract and will try to give feedings via the feeding tube and we work to wean TPN support as soon as possible due to line infection risk and liver damage. Infants do not have their swallow/feeding reflex developed until ~34 weeks gestation and so that would be the point that with cues, we might start some bottle feedings. 
4. Do you feed your patients breast milk? 
   • Yes. Our goal is to use maternal breastmilk whenever possible. That is the gold standard for all of our babies, because it has so many protective properties. Some times there are medical diagnoses that prevent the use of breastmilk, but those cases are limited. Premature babies also need higher calories, more fat and more protein. They are born early and their nutrition needs are higher compared with a term infant. This means that unfortified breastmilk won't meet their nutrition needs so in the NICU we use different formula/fortifier to add to the breastmilk to increase the calories, protein, fat and other vitamins the infant is receiving. We have recipes that we use to mix these feedings and that is the primary role of our formula room technicians. They are the ones that will mix up these recipes for each baby in 24 hours batches and those feedings will be used throughout the day by the nursing staff.
5. How much do you prepare each day in the Formula Room?
   • Our technicians make 24 hour batches for all the babies that we are mixing for that day. Our NICU holds 90 babies and our nursery unit holds an additional 10 babies. There is the potential that we could mix for all 100 babies, but that is normally not the case. It is inevitable that there is a baby or two who are NPO (nothing by mouth). Our average census is ~70-80 patients at a time. 
6. Why do you have technicians mixing feedings compared with nursing staff? 
   • Nursing staff in some hospitals do mix feedings and they have at our hospital in the past. With this creation of a Formula Room space it is more conducive to having one person mixing up feedings compared with each RN mixing their feedings. It decreases the number of people in the room and would decrease risk of errors/infection risk. We work hard to make sure that our technicians are trained well and mix the feedings appropriately. This helps give the RNs more time at the bedside to do what they do best, provide that direct care for our babies. 

Hopefully this has given you a little better idea about what we do in the NICU and how we provide top-notch nutrition care to our patients. We have some of the sickest babies in the state at our hospital and I am so proud of our medical staff for the level of care that we provide each and every day! 

Food Safety Tips for the Holidays

All of us, enjoy all the food that is associated with the Holiday Season - everything from the cookies to the turkey. It is so much fun to gather with family and friends, celebrate another year and eat delicious food. For all of the time that goes into making a gorgeous holiday spread, you want to make sure that your meal or appetizers do not end up making your loved ones sick. That is why food safety is so important, especially this time of year. There are some great handouts and information available from the CDC and FDA. Food borne illnesses are a serious issue in the United States causing ~76 million people to become sick each year. The most common food borne diseases associated with meat, poultry and fish are Salmonella, Campylobacter and E coli. Pregnant women, older adults, infants, young children and those with a weakened immune systems are at higher risk for severe infections. 

4 Steps to Food Safety

1. Clean - Always wash your hands with warm water and soap for 20 seconds before touching or preparing any food. This is the best way to prevent the spread of food borne illnesses. This also applies to all your kitchen equipment and utensils - clean them with warm water and soap, especially in between working with meat and produce.
2. Separate - Keep your meat and produce items separate. Use a separate cutting board for raw meat, poultry and seafood and then use a different one for fresh produce. This helps to prevent cross-contamination. Remember to keep the juices of these fresh meat items away from any already prepared foods as well. 
3. Cook - When you are cooking your meat and poultry items make sure that you are getting the internal temperature of those food items to a safe level. This will ensure that all the microorganisms are killed. Use your food thermometer and make sure that you insert the thermometer correctly into the food item. The AND has a great page on how to properly calibrate your thermometer and use it correctly! 
   • Turkey, stuffing, casseroles and leftovers to 165F 
   • Beef, veal, lamb roasts to 145F 
   • Fully cooked ham to 140F 
   • Fresh ham, pork and egg dishes to 160F 
   • All leftovers should be cooked to 165F 
4. Chill - Once your meal is over, getting your food put away and properly cooled is important. Your refrigerator should be kept at 40F or below to prevent bacteria growth. Any type of egg dish always needs to be kept in the refrigerator. Get your leftovers in the frig within 2 hours of them being out on the table and never defrost your food at room temperature.

Entering the Home Stretch

• It is almost time for our little guy to arrive. It is hard to believe as I am writing this that we are quickly coming to the end of this pregnancy. It feels like not that long ago, I was putting an announcement up on this blog. For all of you who have followed me on social media - Facebook, Twitter and Instagram you have most likely seen a variety of things about my pregnancy over the last 9 months. 

I wanted to take the time and just write up a little summary of my experience being pregnant and looking back over the last 9 months. 

First Trimester 

• Issues with Nausea - This was huge initial struggle for me. I am never sick and I really had issues with a lack of appetite, increased ability to smell things and some issues then with vomiting a few times. I tried a variety of things to help diminish these symptoms. I used Sea bands and they helped a little. I also made sure that I was eating something small every 3 hours (even over night). I would wake up and eat applesauce or crackers overnight. I found that I liked cold food items better than hot items. I also really struggled to eat vegetables so I didn't push myself to eat them. I also took a combination of Vitamin B6 and Unisom to help take the edge off of the nausea. This helped the most and really helped me be able to start eating again and be around food. 
• Extreme Tiredness  - I was amazed at how tired I was during these first weeks of being pregnant. I was wiped at the end of every day and I would get home and just sit or sleep. I was thoughtful for the chance to take it easy and just rest when I needed to, which helped a lot.  
• Sacroiliac Pain - This started for me right away. I noticed pain in my hip/back when I would stand on one leg in the shower or when I was putting on pants. I started doing some research online and found a variety of exercises that would help. I also made sure that I had good posture to help prevent the pain from getting worse. I think getting on this problem before it got worse really helped me throughout the past 9 months.
• Started Prenatal Yoga - This was one of the best things I did throughout my pregnancy - every Tuesday night I did prenatal yoga. I absolutely loved it! In fact, I am going to really miss it when I am no longer pregnant. It helped my sacroiliac pain and helped just to move/stretch. I think it also helped maintain some strength, balance and flexibility which is important in labor. 
• Totally Overwhelmed - This was a very overwhelming time and I am so thankful for a supportive and encouraging husband. Without him, I am not sure I would have had such a positive pregnancy overall and for that I have to make sure he receives all the credit that he is due! 

Second Trimester 

• Return of Energy and Normal Activities - Getting into this second trimester was wonderful. I felt "normal" and like my regular self again. I had my energy back and I could do all the things that I would normally do - work, exercise, fit in errands after work, cook dinner and clean the house. I am the type of person that is always moving and doing something. I didn't exercise as much during the first trimester, because I was so tired, but I got back into my normal routine of exercising for about 30-45 minutes every day. 
• Have the Chance to Travel - Since I was feeling better, it was great to take the time and travel some during this time frame. We went to Fort Wayne over the summer for a baseball game, got to travel to Ransburg for a couple of weekends and made a big trip out to the East Coast for a wedding. We enjoyed being able to see some family and friends. 
• Labor and Baby Preparation - We took this time to make sure that we got as much done as we could prior to our little guy arriving. We put together our baby registry, re-organized our house to accommodate baby things, took our Bradley Method child birthing classes, and started to purchase some items for the baby/his space. We also took time for the two of us, myself and my husband. We wanted to appreciate and cherish all of this time that we had left with just the two of us.
• Monitoring Weight Gain/Counting Calories - This was very important to me to make sure that I was eating enough, but not over doing it. During the first trimester, I didn't gain or lose weight. I just maintained my normal and that was perfect. During this second trimester, I wanted to make sure that I didn't gain too much weight too quickly. To help provide myself with reassurance, I started counting my calories. This has been such a helpful tool to keep my weight gain appropriate. 

Third Trimester 

• Continue to do most normal activities - As I moved into the third trimester, not much changed. I noticed that starting around 30 weeks gestation, I started to show a lot more and started to feel more pregnant. I have been able to still do most of all the things that I want to do. I still run, but the time has slowed and it has gotten harder. I ran two 5Ks during this trimester and I was so excited to be able to do that. I didn't win my age group, by any means, but I didn't come in last! To balance out my slower running pace and the increased toll on my body, I made a normal routine out of going to the gym and using the elliptical. This has been easier on my joints and still allowed me to be active. 
• Started to slow down a little bit - In these last final weeks before Baby Busenburg's arrival, I have started to notice myself slowing down. I am bigger and he is growing well and I just take a little longer to move around. I notice that I get more winded when I go up the stairs and if I sit in one position too long, it is uncomfortable. These have really been the worst of my complaints. I have been so thankful for an uncomplicated and boring pregnancy. 
• Eager Anticipation - I think both Chas and myself are getting more and more ready for Baby Busenburg to make his arrival. We are both as ready as we will be to start this parenthood journey and I know that I will be happy to have my body back. It will be lovely to finally see our baby's face, not be kicked randomly throughout the day and be able to sleep on my belly again. I know we will have lots of other new challenges to face, but I have an amazing husband who is going to be right there by myself the whole way! 

Holidays, Moderation and Stress

Now that Halloween is over and we are into November, the holiday season has officially started.  This means lots of gatherings with friends and family and of course food! Celebrating holidays is very tightly associated with delicious meals and sweet treats. It can be challenging to always navigate this time of year in a healthy way. In addition, to the tasty food temptations, we normally are under additional stress to plan a Pinterest perfect party or give that one of a kind gift to our family members. Being able to balance the stress of the holiday season in a healthy way in terms of our minds and body is very important. Hopefully some of this information will help give you some peace of mind.

Tips for Handling Stress in a Healthy Way –

• Stick to a budget. We all love to spend money during the holidays from clothes, to gifts, to food and travel expenses. It can be an expensive time of year. Take some time now to plan what you can realistically afford in terms of gifts this year. Think about your travel expenses and make sure that you set aside some money for those additional costs. Having a plan will help ensure that you are successful in sticking with it. There are ways to give gifts to co-workers or family members that are more cost effective, like baking goodies to give out or putting together fun gift baskets with items from thrift shops or the dollar store. The goal is to determine your budget ahead of time and then stick with that goal. This will help decrease that stress about money and stretching yourself too thin financially.
• Plan ahead. This ties in to the previous point about putting together a budget. Figure out how you want to structure your time during the holiday season. What goals/traditions do you really want to do and then what things are not necessary to accomplish? If you are able to take time off, how are you planning on spending that vacation time? Have a plan in place so you know what to expect and that helps you feel less stressed. Have conversions with family ahead of the holidays to determine what days you will get together and mark that on your calendar. By looking at your schedule ahead of time, you can work hard to not over book yourself and still enjoy the holidays with lower amounts of added stress.
• Don’t abandon your health. This can be challenging during the holidays to not totally throw healthy habits out the window. Take time to work in some physical activity into your vacation time from work. Go on a walk with your family or play in the back yard with your grandkids. If you have a pet, take the dog for a walk or head to your local park. Even, shopping at the mall could be made into some extra physical activity by walking some extra laps in the mall or parking really far from the mall entrance. Try to break up your sitting intervals, even when you are traveling by stretching, getting up and moving around. In addition to exercise, try to set yourself up for success through what foods you are eating. Before you head to the holiday neighborhood party, grab a healthy snack: a cheese stick and an apple, so that you aren’t famished and don’t over indulge on the holiday cookies.  If you are going on a road trip to see family, pack a healthier lunch with you so that you aren’t tempted to stop at the drive through to grab a bite to eat. Taking a little bit of time to plan through how you can stay active and make healthy choices, will go a long way this holiday season in helping you feel better about yourself.
• Take a moment for you. More often than not, the holidays have us rushing around to see family and friends and not taking time for ourselves. There are some holiday traditions or fun things that you probably love about this time of year and making sure that you pause, and enjoy that moment is important. If you love to watch Christmas movies while drinking hot chocolate, plan one night where you sit on the couch and watch the whole movie, while sipping on your hot chocolate and you enjoy that little tradition. Finding time to take a moment will help you to feel grounded and enjoy the holiday season amongst all the hustle and bustle. 

This time of year is so special and being able to manage your health and stress levels in a healthy way will help to ensure that you finish 2016 off right and greet 2017 on a positive note. Hopefully some of these tips will be helpful as we gear up for the holiday festivities. Remember, stick to your budget, plan ahead, don’t abandon your health and take a moment for yourself over the next month and half. By utilizing some of these recommendations, you will feel better and enjoy this wonderful time of year! 

Packing A Healthy Lunch

I had the opportunity this past week to give a Lunch and Learn presentation to a local Indianapolis business. It was for National Healthy Lunch Day and it was on behalf of the American Diabetes Association of Indianapolis. I have done a variety of things along side the ADA here in Indy over the past couple of years. They are a great resource in the greater Indianapolis area and I was happy to put together a presentation about Packing a Healthy Lunch. This is a topic that affects everyone, because all of us have to eat and all of us should be eating something for lunch. The goal is to make that food we put in our mouths, a healthy choice. 

Goals for Packing a Healthy Lunch
Include at least 3 food groups …
•Fruit (sliced apple, fruit salad, banana)
•Vegetable (salad, cut raw veggies, steamed veggies)
•Protein (meat, nuts, peanut butter)
•Grain (pasta, bread, pizza, etc)
•Dairy (slice of cheese, yogurt) 

Plan a snack
•Include one of the food groups you didn’t have at lunch.
•Pair protein with a carbohydrate
•Peanut butter and an apple
•Greek yogurt with granola

•Prepare enough at dinner for left-overs and portion out the left-overs for lunches.
•Make a large batch of lunches on Sunday: Cut and bag all of your fresh veggies/fruit for the week. Portion out the chili for the week into individual lunch portions.
•Keep healthy staples on hand. Always have some lunch meat, lettuce and tomato in your refrigerator for a sandwich, if needed.
•Pack what you like - Don’t force yourself to eat something you hate.

Taking the extra time to pack something healthy for lunch can really have a big impact on your health. If you are bringing healthy food to work, you are most likely going to eat it and consume healthier food choices. You will also save money, because eating out for lunch on a regular basis is more expensive. There is a little time in preparing those meals, but it is worth it! 
 

The Bradley Method

In lieu of Baby Busenburg's anticipated arrival at the end of December, my husband and I decided we needed to take some birthing classes. We are first time parents and obviously have never done this whole baby, birthing thing before. We wanted to find some birthing classes that were in depth and really outlined what we needed know and how the whole labor process works. 

St. Vincent Hospital offers birthing/baby classes, but unfortunately, that wasn't quite what we were looking for in terms of in depth knowledge. I have heard great things about the classes, but we really wanted to know all the details. This lead us to the Bradley Method. I had a co-worker that went through this class series back > 20 years ago and she found it extremely beneficial. I was able to locate an instructor on the northside of Indianapolis. This class series is normally 12 weeks long and it teaches you in depth information about pregnancy, the birthing process and even after delivery. The main goal of the Bradley Method is to deliver a baby naturally, without the aide of medications. This is a little different class compared with Lamaze classes (which focuses on just breathing techniques), because the Bradley Method emphasizes physical fitness and healthy diet to help support a healthy pregnancy and natural birth. This was in line with our goals with this pregnancy and hopes for delivery. The other main emphasis of the Bradley Method, is the husband assisted coaching. Both the Mom and Dad are involved in the classes and have roles. The Mom is obviously going to labor and birth the baby, but that whole time the Dad serves as the coach and provide encouragement for the mother. This was another key thing, we wanted from our birthing classes, support/encouragement for the Dad and not have the classes be only about the Mom.

I just wanted to discuss this birthing method, because I think it is great and has been such a positive experience for us and lots of women out there are unaware of this birthing technique. I went ahead and compiled some information from The Bradley Method website summing up the process and how this technique is helpful to woman preparing for birth.

• This birthing method, teaches woman and their partners how to stay a low risk pregnancy. Obviously, there are things outside of our control, but there are a variety of techniques that can help set your pregnancy for success and to keep you as a low risk pregnant woman. 
• Relaxation is a key component in this birthing method. Staying relaxed helps your labor to progress naturally and helps you, as the laboring mother, feel more confident in knowing what to expect and anticipate. 
• This method also utilizes a birthing coach as well. This is a very important role and is normally filled by the husband or partner. This coach is there is to help support the mother and help protect her during this labor process.  We liked this aspect of the classes, because we wanted both of us to be involved and it be a team effort. This birthing method encourages that idea of teamwork. 

I wanted to just share our birthing classes with you, because I think more people need to be aware of the different ways to give birth. It does not have to be a painful experience or something that you don't feel/remember. If you are a low risk pregnancy and want to have your baby naturally there are great resources out there to help you accomplish that goal. I believe that this is the best way to have a baby for the mom and for the baby. I really appreciated finding a birthing method that encouraged woman to be strong and encouraged their husbands to have a key role in the birthing process. If you have any other specific questions about the classes, feel free to let me know. We are wrapping up our class series next month and are so thankful for the time we took to attend the classes, do the homework and hope that come December, all the prep will pay off when Baby Busenburg arrives. 

Holiday Food Makeover

It is the time of year. The holidays are under way. Halloween has just wrapped up and now November has started. That means that Thanksgiving is coming at the end of the month and then Christmas next month. I love the holidays and all the festivities that come with the holidays (the food, the family get togethers, the travel, etc). One of the big ways that Americans celebrate is with food. That means that most get-togethers include food and normally the options aren’t the healthiest. This can be overwhelming for people to know how to navigate that holiday spread and know how to make smart choices. 

If you have the opportunity to cook food for your Thanksgiving or Christmas holiday get together then consider making some healthy swaps to those recipes. 

1. Tweak the sweets – This incorporates making healthy options available for desserts. You can definitely include your traditional pumpkin pie, but also put together a fruit salad, which is a healthier option. This is going to have less added sugar compared with the pie and will have more fiber from the fruit, making a much friendlier diabetic choice. 
2. Cheers to good health – Make sure to watch out for added sugars and calories in festive holiday drinks. This includes regular soda, sweet tea/lemonade, and alcoholic drinks. There can be a lot of added calories hiding in these beverages. Make sure to space out your drinks with glasses of water. Set a goal to make every other glass, a glass of water versus only drinking sweet tea or that delicious mixed drink.
3. Bake healthier – If you are in charge of cooking food for your next holiday party then consider some healthy swaps you can make when baking. You can substitute applesauce or bananas for the fat source (like the butter or oil) in various dessert recipes. You can also use greek yogurt in place of sour cream. These simple substitutions can help to decrease the overall calories in the dish you are putting together. 
4. Spice it up - Lots of us love to use salt to enhance the flavor of the food that we are preparing. This isn’t always the best thing for our heart health. Consider using over spices to add flavor that don’t contain salt, like sage, garlic, pepper, Italian seasoning or cumin.  
5. Brighten your meal – As you load up your plate, make sure to fill your plate with ½ fruits and vegetables. Your plate should be colorful and not just filled with starches like white potatoes, yellow corn and a white roll. Brighten up that plate with over colors from the rainbow such as orange carrots, green salad, red cranberries and yellow squash.  
6. Skim the fat – When your recipe calls for a full fat item like heavy cream, butter or whole milk, consider using skim milk, low fat cheese or margarine instead. This will help to decrease the overall fat being added to the dish and cut the overall calories. If you feel like the flavor would be jeopardized with this change, then add in some extra spices that are not just salt. 
7. Swap the grains – If you just have to have your dinner roll with your holiday meal, consider using a whole grain roll in place of just a white roll option. This is more diabetic friendly, because the whole grains will break down to simple sugars slower and this will help prevent a sharp blood sugar spike. This can be applied to crust of pies even. You could use half the flour in your pie crust as whole grains and then the other half white flour. This might change the texture of the pie, but might be a fun, new way to make a traditional recipe a little healthier. 
8. Go easy on the gravy – When you ask for the gravy to be passed over to you, make sure that you don’t send your turkey swimming in it. Use the gravy in moderation. If the meat or potatoes have good flavor, they might not even require gravy poured over them. This is just an extra calorie source and not always necessary if you are trying to make healthier choices.

Food & Nutrition Magazine Article - The Stone Soup

I was excited to share this with you all, because I thought it was neat. I have been asked to write up/share some blog posts that I had up on RDAnna.com. There is a magazine that is run through The Academy of Nutrition & Dietetics called Food & Nutrition Magazine. This is a lovely print magazine and I absolutely love reading through it whenever it arrives at my house. They have a blog called The Stone Soup, which is a great compilation of posts from RDs all over the country. I had been talking with them for awhile about posting something, but it took me forever to get around to it. 

Well I submitted a couple of options for them about various nutrition topics and they chose one about endurance nutrition/running. I just had to share this with you! I was so excited to have this wonderful opportunity. If you want to read my article on the Food & Nutrition website then CLICK HERE.

I also had a great shout out on Twitter from @foodnutrimag and I was excited about that as well. Any time something that I write or share has the chance to reach a wider audience, I can't help but get excited! 

Scary Halloween Facts

Today is Halloween! October 31st! That means if you haven't already, you will have little ghosts, goblins and princesses showing up to your door and asking for treats and goodies. I hope you were able to read the post from last week about the Teal Pumpkin Project and possibly put together some allergy-free treats for your trick-or-treaters. 

I also wanted to share with you some scary Halloween nutrition facts, because it is fun and ends up being eye opening. These statistics are brought to you by Daily Burn. 

• Americans spend ~$7.4 billion dollars on Halloween candy, costumes and decorations each year. 
• Americans purchase 90 million pounds of chocolate during the week of Halloween. 
• There are 41 million potential trick-or-treaters between the ages of 5-14 years old in America.
• Each year, 35 million pounds of candy corn is produced for the Halloween/Fall season. 
• If you ate an apple cider donut, you would have to do 54 push-ups to burn it off (~330kcal). 
• Do you love the Starbucks Pumpkin Spice Latte? If you drink a tall (~380kcal) you need walk for 134 minutes to burn off those calories. 
• Did you know there are 10.5g of sugar in a Reese's Peanut Butter Cup and this happens to be American's favorite Halloween candy.
• You would have to do 17 minutes of burpees to burn of 1 bite-sized Snickers bar (~160kcal).
• Wondering how much your pillowcase can hold in terms of candy - 1,690 pieces of candy to be exact. 
• On Halloween, children collect any where from 3,500-7,000kcal worth of Halloween candy in their pumpkin pails. 

I don't want you to know that I don't love Halloween, the treats, goodies and decorations. I love celebrating holidays, but I think it is important to remember that you or your child do not need ALL the Halloween candy. Trying to keep moderation at the fore front of your mind is the main message. Enjoy your time trick-or-treating, taking pictures and dressing up. Just try to be active, burn off those extra calories and make sure you have a healthy dinner before you head out. Have a safe and wonderful Halloween! 

Navigating Food Allergies on Halloween

This is a topic that is near and dear to my heart. Every year I try to take some time and make sure I talk about the Teal Pumpkin Project. This program is sponsored by the Food Allergy Research & Education group and its main focus is to provide all kids safe treats this Halloween. This campaign was launched back in 2014 nationally and has gained lots of traction over the last 2 years. 

For kids with food allergies, it is not safe for them to eat candy, because often these sweet treats contain dangerous allergens. This project wants to encourage people to provide non-food treats for trick-or-treaters so that they can still participate in the Halloween traditions, but not have to worry about their food allergies. To participate in the Teal Pumpkin Project follow these simple steps: 

1. Have non-food treats available for kids to pick up. It is easy to find Halloween themed goodies at your local grocery store, party store or craft store. Plus, these are great goodies to hand out to all the children, because they are going to get plenty of sugary treats.
   • Bubbles 
   • Pens/pencils 
   • Glow sticks/necklaces/bracelets 
   • Vampire fangs 
   • Stickers 
   • Bouncy balls 
   • If you don't have time to run to the store to find these goodies - go ahead and purchase the Essentials Kit from FARE Teal Pumpkin Project and get it shipped directly to you! 
2. Put out a teal pumpkin in front of your home, on your porch/in your entry way. Incorporate your family and paint your teal pumpkin today! 
3. Display the FARE Teal Pumpkin Project sign  explaining what the teal pumpkin means.

Pregnancy Glucose Test ... What this means?!

So if you have ever had a baby or know someone who has had a baby, you have probably heard about the pregnancy glucose tolerance test. This is a test that is done between 24-28 weeks gestation to determine if you body is properly utilizing glucose. If your pancreas is struggling to produce enough insulin to uptake the glucose in your blood stream from the food you have eaten, then you would be diagnosed with gestational diabetes. If you have already been diagnosed with diabetes prior to pregnancy, then you will not have to complete this test. 

What exactly in the glucose tolerance test? The test begins with you consuming a sugary, liquid solution that contains 50 grams of glucose. You have to consume all of this liquid within 5 minutes. Then you wait for 1 hour and you have your blood drawn to test your blood sugar (or the amount of glucose circulating in your blood stream). If this number comes back elevated, then you will have to repeat the study with a 3 hour tests, where you take the solution and have your blood drawn at the 3 hour mark to see what your blood sugar is and if it is elevated then you have gestational diabetes. 

Your fasting blood sugar should be < 95mg/dL 

Your blood sugar 1 hour after taking the solution should be < 180mg/dL 

Your blood sugar 2 hours after taking the solution should be < 155mg/dL 

Your blood sugar 3 hours after taking the solution should be < 140mg/dL 

So now that I have established what the glucose tolerance test is, I wanted to discuss briefly about what this test shows. As a dietitian at a Women's Hospital, we see a lot of women with gestational diabetes and some women that just missed the mark for being diagnosed, but they failed the 1 or 2 hour blood sugar checks. As a Registered Dietitian, who works with these babies in the NICU, I think that we need to do a better job at educating our mothers about a healthy diet/lifestyle even if they just barely passed their glucose tolerance test. Often, if you pass it, then you physician doesn't really focus on diet or exercise and lots of Moms just assume they can continuing eating whatever and it won't have an affect on their baby. There was an article that I came across from Health Day talking about how diabetes during pregnancy can produce negative outcomes for your baby. This research was released at the European Association for the Study of Diabetes in Germany this week, I thought this was a well timed article and good for mothers to be informed. Your health, as the mother, has a huge impact on your child's birth and health outcomes. This is important for us to remind pregnant woman, that your health matters and making the effort to watch what you eat not only is helpful to you, but also your unborn baby. 

Hopefully some of this information is helpful and you can share it with a pregnant friend or family member. I am had the chance to participate in my very own glucose tolerance test this past week and thankfully I passed with flying colors. All my blood work came back great and that was a huge relief. It is nice to be reassured that things are going well! 

Being An Adventurous Food Traveler

We had the chance to travel out to Maryland this past week for a wedding. We took the opportunity to turn this trip into a little "babymoon." We hadn't gone on a big summer vacation or anything this year, because we have been saving money for the upcoming arrival of our newest addition at the end of December. So with this wedding out in Maryland, we decided to make a long weekend trip out to the east coast and were able to see Salisbury and Baltimore Maryland and ventured up to Philadelphia, Pennsylvania. 

One thing we love to do when we travel is make an effort to only eat at local restaurants. There is too much good food in the world, to eat at a chain restaurant when on vacation. This trip was no exemption to that rule. 

Eastern Shore, MD - 

• Rise Up Roasted Coffee - This was a super hip and cool coffee shop in the middle of Easton, MD. This shop actually was where the coffee roasting happened for the coffee that this store sold. They had a delicious smoked salmon bagel, a very smooth latte and a fantastic atmosphere to just hang out in for a little bit. We ended up just hanging out at this shop for a good 1.5 hours. It was neat to watch the employees roast the coffee beans that they sell. We picked up a package of their fall seasonal roast and are excited to have use it for our coffee at home. 

• The Atlantic Hotel - We ventured over the Berlin, MD from Easton and checked out a historic hotel that had a cute, little restaurant attached. The town of Berlin is near the coast of Maryland. The lunch we got was yummy. I had a crab chowder and Chas got a crab roll sandwich. We were able to sit outside on an enclosed porch and enjoyed a quick walk around the downtown area after our luncheon. 

• Specific Gravity Pizzeria - For dinner we checked out this pizza place in Salisbury, MD on the recommendation of a our friend, Lee. This is supposedly the best kept secret in Salisbury. We had a pizza with chorizo, manchego cheese and fried shrimp. It was absolutely amazing! One of the best pizzas I have had. The crust was thin and the manchego cheese was delicious. Then we also got DOUGHnuts for dessert and that just ended the meal on a high note. I definitely recommend it if you find yourself in Salisbury, MD.  

• The Barlett Pear Inn - The wedding that we traveled all this way to attend, we held at this adorable inn. Immediately following the ceremony there was a reception with amazing hors d'oeuvres. It was such a nice venue and they had a beautiful spread for us to snack on.

• The Red Roost - This local establishment is kind of in the middle of nowhere in the country. It was such a neat restaurant. I am so glad that we got to go and eat blue crab that were caught right there in the Chesapeake Bay area. I have to admit at first I really struggled, but it was a great experience and so much fun! 

Philadelphia, PA - 

• Famous 4th Street Delicatessen - This restaurant ended up being our 2nd option for our brunch date in Philly with my sister, but it was so worth the walk. The restaurant was so beautiful and the food options were so diverse. The portions were huge and it tasted delicious. I got Challah french toast and Chas had an amazing Reuben sandwich. 

• Jasmine Rice - This local Thai spot has a couple of locations in Philadelphia. We got to meet the owner, and he was extremely nice. I had some friend jasmine rice with vegetables and tofu and it was delicious. It is was light and full of flavor. Chas had some wonderful Tom Yum soup. 
• Menagerie Coffee - This local coffee shop is where my sister use to work. I was excited to be able to go and see it. It was super cute and the cold brew coffee we had was quite good. It had a great atmosphere and I would see it being a great place to hang out at, drink delicious coffee and work on things.

Baltimore, MD - 

• Cafe Jovial - This little cafe was right down the street from the townhouse that we stayed at in Baltimore. It got good reviews online and we walked down there for lunch. The owner was nice and the hot sandwiches that we ordered were quite tasty.
• Sabatino's Italian Restaurant - As our last stop, we walked over to Little Italy in Baltimore and checked out some of the local restaurants. We ended up stopping at this local place and enjoying some traditional Italian food before heading to the airport. Chas ordered a shrimp alfredo and I had some gnocchi. The pasta portions were quite large. It was all very good and a fun place to stop before we headed out of town.

I am not sure if you have heard of or watch my YouTube, but Sorted Food is a great channel with some fun guys who do a great job at promoting new foods. They had a great blog post up on their website about being an adventurous eater and trying new things - CLICK HERE to read the post. Here were a few of my favorite comments that they made ... "every meal is exciting, and you have the best stories to tell," These are two of the best parts of eating out and trying new things in my opinion. 

I would encourage you when you plan your next trip to scope out some of the potential eating establishments in the area and try to find some local food to eat. Now I also like to try to make sure that there are some "healthier" options available as well. Even though it is vacation, it is important to try to remember the importance of a balanced diet. 

Not All Formula Is Created Equal

I decided to put together this blog post because I work in a NICU (Neonatal Intensive Care Unit) and we work with a lot of breastmilk and baby formula to feed our patients. This is my area of expertise and I had the pleasure of recently attending lunch with a formula rep and talking about formula. This luncheon, brought this topic to the fore front of my mind - Not all formula is created equal. I don't want this post favor one brand over another. I just want to bring some facts to light that you might find helpful. My perspective is that for all babies, breastmilk is best and is a very unique substance. We have worked for years and years to try to create a formula that mimics breastmilk. For some of our babies in the NICU, we have to add things to the breastmilk to increase nutrients because our patients are born early and breastmilk isn't designed to meet their unique nutrition needs. 

That being said ... I wanted to discuss all the different types of formula and how there are various brands. In the US, we have Similac, Enfamil, Gerber and Store brand options. All of these companies abide by rulings set out by Congress in the 1980s, referred to as The Formula Act. This piece of legislation has been around for awhile and unfortunately hasn't been totally updated since then. There have been guidances given for the formula industry and an example in includes the health claims made by formula companies (September 2016).  Baby formula always ends up being a controversial topic. Thankfully all of these companies continue to create and work on new research in the area of baby formula even though the standards they have (required by law to follow) are now ~35 years old.  There are lots of different types of formula options within each brand and some times the options can be overwhelming for parents. The main focus that I wanted to bring to your attention is that the brand name formulas may cost more, but there is more research being done in those products and they are up to date with the best nutrition compared with the generic products. Just so you are aware, the generic version of the formulas are the older recipes from the brand name companies. This means they may not contain some of the important nutrients that we have discovered and are now able to add to formula. This means that as the consumer you are getting a product that is based on older research and may not be as helpful for their baby's growth and development. This is the one time in your baby's life when they are eating 1 food item to get all the nutrients that they need to grow and develop. Whether it is breastmilk or formula this is a very unique time for your child (the 1st 12 months of their life). 

For example, we have learned that DHA (docosahexaenoic acid or omega-3 fatty acids) and ARA (arachidonic aicd or omega-6 fatty acid) are very important for brain development in infants. These fatty acids have been around awhile and most of the generic formulas that I looked at had at least DHA in them. Another important phytonutrient that is now being added to formula is Lutein. It helps with eye health and is a carotenoid that has an important role to play in brain function/development. We didn't necessarily have this information back when the Formula Act was put together so if you read the label for a generic baby formula and make sure that these formulas have these nutrients added. Most of the ones that I glanced at, did have these nutrients added, which was reassuring. These nutrients are naturally found in breastmilk and has we do more research they are being added to infant formulas as well. 

I wanted to also just touch on the different types of baby formula so that you know what you are looking at when you go to the baby aisle of the grocery store. There are lots of options and often the challenging is just determine, which product is appropriate for your baby.

Different Types of Baby Formula - 

• Cow milk protein-based formulas. Most infant formula is made with cow's milk that's been altered to resemble breast milk. This gives the formula the right balance of nutrients — and makes the formula easier to digest. Most babies do well on cow's milk formula. Some babies, however — such as those allergic to the proteins in cow's milk — need other types of infant formula.
• Soy-based formulas. Soy-based formulas can be useful if you want to exclude animal proteins from your child's diet. Soy-based infant formulas might also be an option for babies who are intolerant or allergic to cow's milk formula or to lactose, a carbohydrate naturally found in cow's milk. However, babies who are allergic to cow's milk might also be allergic to soy milk.
• Protein hydrolysate formulas. These types of formulas contain protein that's been broken down (hydrolyzed) — partially or extensively — into smaller sizes than are those in cow's milk and soy-based formulas. Protein hydrolysate formulas are meant for babies who don't tolerate cow's milk or soy-based formulas. Extensively hydrolyzed formulas are an option for babies who have a protein allergy.

*In addition, specialized formulas are available for premature infants and babies who have specific medical conditions.

My intent with this blog post is not to make you hate formula or purchase only a certain type of formula. I just wanted to make sure that you knew how much research goes into infant formula and how it is always being updated and our knowledge base is growing. Breastmilk is an amazing substance that women's body can produce and we have spent lots of time and money trying to find ways to create a formula that mimics what nature can create. I am a huge proponent of additional research and I am always excited to hear what companies have learned and are able to add to their formula products. 

If you end up with questions about formula, please don't hesitate to get in touch with me and I would be happy to talk with you more about this fascinating topic of infant nutrition! 

Fall Has Arrived ... Everything Pumpkin!!!

Fall has officially begun as of September 22nd; however, at least here in Indiana the weather is still behaving much like summer. Fall happens to be my favorite time of the year. The cooler weather, crisp breezes, cute clothes, warm drinks and fun activities like apple picking, trick or treating and Thanksgiving have me all excited. This is also the time of year that pumpkins have exploded onto the food scene. You can find everything pumpkin flavored now ... from your coffee to your cereal. Have you ever wondered, besides the delicious flavor of the pumpkin, cinnamon, nutmeg and cloves, is there a health benefit to pumpkin? 

The beauty of the pumpkin is that it is a simple food item. It doesn't have an overly strong flavor so using spices blends can create delicious and unique dishes quite easily. You can make pumpkin sweet or savory and there are tons of recipes online that can help you incorporate this festive gourd into your weekly menu. 

Health Benefits of Pumpkin

1. Helps with your eyesight. Pumpkin contains over 200% of your daily value of Vitamin A and this fat-soluble vitamin is important to help your eyes work appropriately. They contain beta-carotene which is a carotenoid - this creates the orange color and produces Vitamin A in the body. 
2. Helps with meeting weight loss goals. Pumpkins contain a lot of fiber and this helps you to feel full and eat less with meals. There are 3 grams of fiber found in 1 cup of pumpkin puree for only 49 calories. Produce tends to be high in fiber and that is helpful in weight management. 
3. Heart healthy seeds. The pumpkin seeds contain heart healthy fats, which can be helpful reducing your risk of cardiovascular disease. These seeds do contain more calories compared with the puree due this fat, but in small amounts this can easily fit into a healthy diet. 
4. Improve your mood. Besides containing healthy fat, these pumpkin seeds also contain tryptophan. This amino acid breaks down to another amino acid product called, serotonin, which is helpful for sleeping and this can help your mood. This can help you rest and taking that time for you, can help to improve your outlook on life. 
5. Loaded up with potassium. There is a lot of potassium found in 1 cup of pumpkin puree (564mg) and this is more than what you would find in a banana. This is an electrolyte that your body replaces after working out to help keep your hydration status in balance and feeling good. If you have a tough work out in the heat and sweat a lot, consider some pumpkin puree to help replenish your potassium stores.
6. Boost your immune system. There are lots of vitamins and minerals found in pumpkin, another vitamin is Vitamin C that is found in high quantities. This Vitamin C is helpful in boosting your immune system and helping your body ward off disease. One cup of cooked pumpkin puree contains 11mg of Vitamin C or 20% of your daily value (if you are a woman). 
7. Skin protection. The carotenoids that we mentioned earlier, help to keep your skin healthy, smooth and strong. This is a great added bonus as we head into the fall and drier weather and we all want to protect our skin from the elements. 

So as you reach for your pumpkin flavored whatever ... consider picking up some pumpkin puree and using it in a new recipe this week. Unfortunately all of these health benefits can only be achieved through consuming the pumpkin puree itself and just the pumpkin flavoring that is often added to food items. Go ahead and Google/Pinterest some pumpkin recipes and try to incorporate some of this amazing fall superfood into your next meal!