IAND Spring Meeting

I had the opportunity this last week to attend the Indiana Academy of Nutrition and Dietetics (IAND) Spring Meeting. Not only did I get the chance to attend for one of the two days, I also got be a presenter. I was asked to talk about being a Neonatal dietitian and what my role is in the Neonatal Intensive Care Unit (NICU). I was honored be to asked to speak and was excited to share about my job. I think I have a really neat job and having the chance to talk about nutrition in newborn, preterm babies is like a dream come true. #nerdalert 

The day of conference speakers was fantastic. I really appreciate having the chance to network with my fellow RDs around the state and also have the chance to learn more about nutrition. I thought I would share some of the highlights from my presentation and some of the highlights from the conference as well. 

Below you will find some of my favorite slides from my presentation. I talked about the history of the NICU and how nutrition plays an important role in the development of these preterm babies. I discussed the various types of formula available and how our goal is to use maternal breastmilk for feedings. I also talked about assessing growth in newborns and how we run our Formula Rooms to prepare feedings for our patients. 

The entire day at the IAND Spring Meeting as fantastic there were several speakers who discussed some very interesting topics. 

• Sharon Palmer, RDN spoke about eating a Plant Based Diet and finding ways to incorporate more fruits and vegetables in your daily meal routine. She did a great job and at highlighting the importance of eating more plant based and how it can taste good. I liked how she didn't put down meat in a negative way, but instead encouraged using meat as a seasoning and less of the main course. 
• Kate Byers, MS, RDN spoke about everything coconut. Kate is a fellow Purdue Alum and we have gotten to know one another on the College of Health and Human Sciences Alumni Board. She had a great presentation talking about coconut - how it is grown, how it can be used, what to look for on labels and some research about how healthy it really is or is not. 
• Sandi Morris, RDN also spoke about Order Writing Privileges for RDs in the state of Indiana. That was a great topic to discuss, because that can change how RDs operate in the hospital setting. 

It was a great day and I was so excited for the chance to attend and have the opportunity to speak! 

The Reality of Being a Parent

I know that this is a blog about nutrition, exercise and wellness. I however, feel that being parent overlaps with my nutrition, exercise and wellness so that is how I am tying this into my normal theme on this blog. I would also argue that being parent is having an impact on my nutrition, exercise and overall wellness. The balance of work, family life and staying healthy is quite the challenge when you add a small child into the equation. This small, tiny human now demands all of your attention and limits your ability to stay late at work to hit up the gym or may drive up your alcohol consumption due to his needless crying in the evenings. Of course, you also have to factor in the lack of sleep. When breast feeding at night, you have to wake up every 3-4 hours, change the baby and then feed him. All of this totally throws off your own sleep schedule. All of these factors have an influence on your overall health. 

I didn't want this to be a total complaining session about how tough it is to be a parent, but I wanted to discuss the challenges and maybe some ways to help you be successful in overcoming them. I have quickly learned that I need to take time for myself. That is use to always be going for a run, doing yoga or walking the dog. Now with a baby this has had to change and shift a little bit. I honestly haven't been able to run as much as I would like. By the time I get home from work, make something for dinner, feed the baby, and get the dog walked, the sun is setting and I have lost daylight for a run. I am excited with the lengthening spring evenings that I will be able to fit in more week night runs with William. But even if I can't fit in as many runs as I would like, I try to take time each night for myself. Last night it was a shower. Simple, I know, but after being frustrated by a fussy baby and needy dog I just wanted to do something for myself and nice warm shower fit the bill before crawling into bed. 

• Take time for you.  I am working on this and I am still figuring it out. It looks different each day, but taking this time for me helps me to be a better mother, wife and employee. 

• Don't sweat the small stuff.  I have to admit this is a huge challenge for me. I am a Type A, control freak and learning to let go has been tough. I like to do things my way and learning to delegate is necessary. I also have had to learn to be ok with things not always getting done, like cleaning the bathrooms or doing ALL the dishes every night. 

• Enjoy the little moments.  There are some great moments in being a parent. Those smiles that I get after feeding William or taking a moment to snuggle with my husband on the couch after William has fallen asleep. Those little moments are wonderful. Stopping from rush of life and embracing those moments has been another thing that I have been trying to do.

Hopefully you have found this post encouraging. You are NOT alone in your parenting journey and it is tough. That balance between your role as a parent, your job, and your family is something that is always changing. Keeping working hard at it and enjoying every moment. 

Motivational Monday

I wanted to write a blog post about motivation and try to encourage you to get up, get moving and meet your goals. What do you want to accomplish this week? How are you going to meet those goals you have set for yourself? 

1. Put together a list of the things you need to get done this week. Each week I make out a list of the things I need to get done at work and in my personal life. These things are items that I need to get done and it serves as a reminder to me of what my priorities are. It is so easy to get off track and lose focus. My husband had to remind me to this last week and encourage me to stay on task and get my work done quickly and well so when I come home I am not stressing about work.
2. Re-evaluate that list on Wednesday. Taking some time to look at how you are doing on your task list part way through the week can be helpful. You might find that you ahead of schedule or behind. Then after your re-evaluate your progress you can decide if you need to buckle down or maybe you do something fun and take a break for a moment to reward yourself.
3. Once you have accomplished the tasks on your list, celebrate! At the end of week, take a look at how well you did with your task list. Is everything done? Did you meet your goals for the week? If so, then great! Do something special for yourself. Last week after charting on ALL of my patients by Friday, I took the time to leave work a little early and I stopped by Target on my way home. It is a nice treat to do something fun as a reward for all the long hours I had put in earlier in the week. If you haven't met all the goals on your list then take a moment and see what needs to get done right away and maybe some of those things can get push to next week. 

The Powers of Breastmilk

I had the opportunity for the past week to attend an amazing 5 day long conference about breast feeding. I know for some people that might not be an exciting topic, but I thought it was fascinating. St Vincent hosted the event and brought in two wonderful speakers to teach us for the 5 day course. The name of the course was Foundations for Best Practice for Lactation Care and the instructors were from Evergreen Hospital in Seattle, WA. Molly Pessl was one of the instructors and she has been a nurse for over 50 years. She has been working with lactating mothers for the majority of that time and is such a wealth of knowledge on the topic. 

I hope that over the next year or so I can work towards completing the course work to become a IBCLC or an International Board Certified Lactation Consultant. I first was exposure to working with women and breast feeding at WIC during my dietetic internship. I really enjoyed that part of the rotation, but didn't think much more about it, until now. I work in a NICU and we are always wanting and needing maternal breastmilk for our little babies. I thought that this would be a great time to start working towards that credential. Then this 5 day course was offered by St Vincent and I had to do it. 

I just thought I would share with you some of the amazing things that I learn during this coursework. I have never attended a lactation conference before so everything that was shared was new to me. We talked about the changes/development that happens for Mom and the baby during pregnancy, delivery and into the 4th trimester. It is amazing how the woman's body is designed to sustain life in the womb and afterwards. We talked about how the mammary glands work and how the hormone changes creates breastmilk for the infant. We talked about child development from in utero through 12 months of life. It was neat to discuss case studies as a group and have this chance to learn from the experience of people in the class. Of course at the end of the 5 days, I was so excited about everything that I have learned. I obviously think breast feeding is an amazing thing and something that every woman should be encouraged to do. It is worth all the hard work and effort to provide this unique food to your baby for a few days to a few years. 

I hope this post helps to normalize breastfeeding. This has been the way babies have been fed for thousands of years. I know that baby formula can help and save lives for lots of children, especially those who are premature, but their own mother's breastmilk helps even those tiny babies. I hope you are encouraged by this post and have a desire to show support and love to those mothers who are out there breastfeeding their babies and giving that gift to their children.

National Nutrition Month

March has arrive and that means it is National Nutrition Month! This is the month where all of us in the dietetics field celebrate eating healthy and encourage people to put their Best Fork Forward! 

So I really like the theme this year ... Put your Best Fork Forward. I think that this hits home the message and we need to select healthy foods to put in our mouths. It starts with each bite that we take. I am guilty to totally choosing to eat too much cereal and not enough vegetables. When life is crazy (and it is now) it is way easier at times to grab the cereal box, versus grabbing some carrots out of the refrigerator. I have been trying to balance the hecticness of life and planning ahead to have healthy meals during the week.

• Aim for a variety of foods in your diet. Variety is defined as a diverse assortment of foods and beverages across and within all food groups. These foods should be selected to fulfill the recommended nutrients you need each day without exceeding the limits for calories and other dietary components. So this means that all foods are far game, but we want you to select healthy foods most of the time. Definitely balance with a sweet treat or beverage every once in awhile, but everything in moderation.
  • Plan meals that include different colored vegetables through the week. 
  • Experiement with different vegetables when preparing healthy soups or salad. 
  • Choose vegetables that are in season, whenever possible.
  • Pack of variety of different colored fruit as snakcs. 
  • Enjoy fruit in place of sweets for dessert.
  • Try choosing whole grain options - such as brown rice in place of white rice. 
  • Look for cereals and snacks that use whole grain flours. 
  • Substitute plant-based proteins in new recipes. 
  • Experiment with seafood by grilling and baking fish in place of other protein options for dinner 1-2 nights/week. 
  • Give sweetened plain, low fat yogurt a try with different fruits/whole grain cereals. 
  • Make smoothies with fruit and yogurt. 
• Watch out for the sodium hidden in foods. This can be challenging, especially if you are eating out a lot. Take the time and try to prepare some meals at home and use less salt. Making some small changes can have a huge impact on your heart health.
  • Use the nutrition label to look at the sodium in food and compare with other options. 
  • Try purchasing lower sodium versions of food items.
  • Flavor foods with other spices in place of just adding salt.

Enjoy this month and take the time to think about what you are putting on your plate and ultimately on your fork!

via GIPHY

Your Gut Microbiome

This past weekend the stomach flu went through our household. Let me tell you, that was an awful experience. It had been several years since I have had the flu and I had forgotten how terrible it is to be sick. I had to day time off of work, because I didn't want to spread the illness to the medical staff or babies in the hospital. It was the best choice to stay home and rest up. 

This recent illness had me thinking about overall health and how your health impacts your body overcoming an acute illness. More and more research is being done on our GI tract microbiome that is showing how our health really impacts our quality of life. The food that you eat each day has an impact on the types of bacteria that live and grow in your GI tract. They have found that depending on your diet (healthy vs unhealthy) will prompt the growth of certain types of bacteria. These bacteria living in your GI tract are known as your gut microbiome. This bacteria helps to digest the food you eat. Sometimes our guts get colonized with a "bad bug" like a with the flu virus and that can lead to unattractive side effects (vomiting, diarrhea, gas, etc). Often if you get put on an antibiotic, these drugs kill/destroy the bacteria (good and bad) in your gut and it can take awhile to repopulate that good bacteria. After having an illness, like the stomach flu, making sure that you consume healthy foods will help to promote the grow of the "good" bacteria in your gut. We don't want to promote the growth of "bad" bacteria that will not help boost your immune system in the future. 

What are good foods for gut health? 

• Choosing foods that are high in fiber is great for gut health. These fibrous foods also serve as great food for the "good" bacteria living in your GI tract. Aim for more fruits, vegetables, beans, lentils, whole grains, nuts and seeds. 
• Fermented foods can survive your GI tract and serve as food for the "good" bacteria. Eating foods like yogurt contain live/active bacteria cultures that can help repopulate your GI tract after an illness. There are some other foods out there that are gaining popularity - like Kefir (fermented yogurt drink), kombucha (fermented) tea, tempeh (fermented soybean cake) and fermented vegetables (like sauerkraut and pickles).
• Gut diversity. It is important to make sure that you are eating a variety of foods and this will help ensure that the microbiome in your gut is balanced. Reaching for colorful produce, whole grains and various forms of protein will help build a healthy GI tract.

Hopefully you have avoid getting any stomach bugs and have a healthy winter this year. Remember to take care of your gut and eating a healthy, varied diet will help accomplish that! I am excited that spring is arriving and hopefully we will all be healthy and back to normal here soon!

How Much Water Do You Really Need?

I am sure that you have heard that you need to drink 8 glasses of water a day. But is that true?! Is there is something special about 8 glasses? Not 6 or 9 glasses a day, but 8. Who came up with that recommendation anyway?

That is what I want to talk about today ... what your body actually needs to keep you hydrated. Your body is made up of ~60% water. For babies, their body composition is about 75% water and decreases to 65% by their first birth day. Your body relies on this water and it is necessary for your survival.

Water does lots of things for you ... 

• Utilized by the brain to manufacture hormones and neurotransmitters. 
• Forms saliva to help you digest your food.
• Keeps your mucousal membranes moist (eyes, nose, throat).
• Helps to regulate your body temperature through your breathing and sweating.
• Helps to rid your body of waste, through your urine. 
• Lubricates your joints.
• Helps deliver oxygen all over your body.

This list can keep going. As you can see this element is vital to your body working appropriately. Did you know that women actually have less water in their bodies compared with men. People who have more fatty tissue have less water in their bodies compared to their less fat counter parts. Now does this mean that we need differing amounts of water per day? YES! It does ... unfortunately we do not all need the same amount of water per day. 

Sadly there is no straight forward recommendation about how much water we each need every day. Instead,  you will have to do a little self-reflection. Do you feel thirsty? If so, that is a great indicator that your body is in need of water. I know it sounds simple, but making sure that you always drink water when you feel thirsty will be an easy way to make sure that you stay hydrated. Now if you are wondering if you are getting enough water, then take a moment and observe the color of your urine. Again, not glamorous, but it is effective. There is a great chart (CLICK HERE) to compare the color of your urine to your hydration status. Another easy way to know if you are drinking enough, is to track how often you use the restroom. Most well-hydrated people use the restroom 7-8 times per day that is about every 3 hours. Sometimes that can increase to 10 times per day or be as low as 4 times per day.  That is why noticing what color your urine is will help evaluate if you are appropriately hydrated. The handout mentioned previously, also includes some signs/symptoms of dehydration. One way to prevent dehydration, is carrying water with you where ever you go. Find a water bottle that you love and take it with you. You can fill it up with water, lemonade, tea, whatever is your favorite beverage and make sure it goes with you when you leave the house. This will help ensure that when you feel thirsty you will have a way to easily quench that thirst and avoid dehydration. 

As you can see, that 8 glasses of water per day recommendation may not hold true for everyone. It is a great goal to make sure that you are carrying around a water bottle and staying hydrated throughout the day. Make sure that you are using the bathroom on a regular  basis and taking note of your urine color. I know it is not glamorous, but it is worth it to make sure that your body's fluid needs are being met. This allows your body to function at its top potential. Now grab a glass of your favorite drink and bottoms up! 

Hitting the Pavement Again

I am back running! I couldn't be more excited. I got the go ahead from my OB that I could resume my regular exercise routine. It had been 6 weeks since I had been able out for a run and let me tell you it was kind of an adjustment getting back out there. I headed out on a Saturday morning run ... my favorite time to run! I love it because it is normal peaceful outside and I can come home and make a nice warm breakfast. This past Saturday was kind of cold and I thought about not going out, but then I saw a lady run past my house with her dog ... I was like "if she is out there running, I can too!" So I laced up my shoes and headed out. It was glorious.

It was also hard to get back out there, literally I was sore afterwards. My abs have been through quite a bit - having a baby, being pulled apart to make room for said baby and then the whole trying to go back to the way they were after baby was born. So being out there and running ended up being quite the ab work out. My hamstring was quite tight as well. I didn't realize that those ~3 miles would feel so long, but I did it and I was proud of myself. 

The weather ended up being kind of nice this past week and headed out again for another run, but this time brought William with me in the BOB jogging stroller. It was fun to get to bring him along and he did great in the stroller. I absolutely loved the BOB stroller as well. It worked great and I could easily control it as I ran. It did end up making the run a little harder. I found that it turned into a work out for my upper and lower body. I am sure that William and I will log lots of miles on that stroller. 

Besides just sharing with you my experience at hitting the pavement again after having a baby, I wanted to encourage you get out there, set a goal for yourself and make it happen. What are obstacles that are standing in your way of accomplishing your goal? Is it something like time, lack of self confidence or putting your family's needs above your own? It is important to take a look at what obstacles are keeping you from your goal. Take those obstacles and come up with ways to move them. If the obstacle is time, then schedule time to work out and meet your goal. If it is self confidence, then find a gym or park where you can exercise and feel comfortable without a lot of people around. If it family obligations, then talk to your loved ones and schedule "you" time where you can focus on what you want to accomplishment. For me, I want to go to the gym 2-3 times per week and lift weights, use the elliptical and treadmill. If the weather is nice, I want to get outside and run on weekends and maybe one night a week. I also want to go through and do the 31 days of Yoga with Adriene on YouTube. I love yoga and I want to be able to do that in the evenings after work and before bed.

Well good luck to you as you set your fitness goals and work on accomplishing them. I will keep you posted on how my return to running is going and how well I accomplishing my own goals. 

LOVE Your Heart

Well February is upon us and that means it is time to think about your heart health. Even if heart disease doesn't run in your family, taking the time and making you are making heart healthy choices can improve the quality of your life. 

What is a heart healthy diet? A heart healthy diet is one that is low in animal fats and high in plant based fats. This also includes consuming fish on a regular basis. The omega-3 and omega-6 fatty acids found in fish have been associated with lower risks of heart disease. Consuming more a more plant based diet as also been found to help heart healthy and improve your body composition. People who were of normal body weight had less instance of heart-related medical complications and lived healthier lives overall. The Academy of Nutrition and Dietetics has put together a great list of cooking changes that you can makes for your heart health. Make sure that you are limiting your saturated fats (from animal sources) and trans fats (man made fats, found in some margarine products). When cooking animal meats, make sure to drain off extra fat or grill the meat so that the fat falls away from the meat when cooking. If you consume high amounts of saturated (animal) fats this type of fat can build up in your arteries and this can lead to a blockage/heart attack. That is why a lower fat, more plant based diet is recommended. 

Put down that salt shaker. In addition to watching the amount of fat in your diet, keeping an eye out for the amount of sodium in foods will go a long way in blood pressure control. If you have a history of hypertension, or if it runs in your family, then taking the time to watch your sodium intake can help keep your heart beating strong. Lots of fast food or pre-made, frozen entrees have a fair amount of added salt to help with the favor and preservation of the food. That is why when you can prepare meals at home, from scratch, that will go a long way in limiting the amount of added salt you consume each day. Make sure that you are not adding salt to your meals after they have been cooked. That is why moving the salt shaker off the table and into the spice cabinet can limit your added salt intake. If possible, purchase lower salt food items - low salt diced tomato or chicken stock, low salt lunch meat or sliced deli cheese. These little changes can help with your blood pressure control. 

Move more. You can never under estimate the benefit of being physically active. Exercising helps your heart by having it beat harder and grow stronger. Your heart is a muscle and for it is stay strong it needs to be worked out. That means scheduling time to be physically active will help your heart to stay strong and continue to beat for a long time to come. Exercise can look different for different people. Find something that you enjoy and do that activity on a regular basis. If you enjoy exercise classes, find a gym and attend classes that you enjoy. 

Hopefully you can take some of these tips and recommendations and put them into use this month to help show your heart some love! 

The Art of Cooking with a Baby

Can I just tell you that finding a way to juggle holding a baby and preparing dinner is one of the toughest things I have done. It takes special talent to figure out how to get dinner prepared and then balance that the eating schedule of a newborn. Of course, the baby wants to be held during the time when dinner needs to be prepared. I have been working on acquiring my skills of balancing this act of motherhood and the need to make food to feed myself and Chas. 

Things I have learned and skills I am cultivating: 

• Do what you can while they are sleeping. As soon as William falls asleep I take advantage of that time to figure out what I need to get done. I have also learned that I need to prioritize my to do list. For example, being able to eat something for lunch should always trump working on the computer or some times even showering. Maslow's Hierarchy of Needs is in full affect. If I am not trying to feed myself I am normally trying to prepare food for the next meal. 
• I am learning to operate within a 2-3 hour time window. So if I have to run errands I know that if I feed William I have a solid 2 hours and possibly 3 hours before he is hungry again and needs to be fed. This means that I am left prioritize where I need to go and what I need to do so I can get home before his next feeding. This is a total change of pace for me, but I am learning and getting better at it each day. Often that means only 1-2 stops while I am out at a time. Gone are the days and being out to ALL the errands done at one time.
• I have learned that crock pots, bread makers, etc are amazing devices ... use them! I have fell in love with my crock pot again. Being able to chop up ingredients or get the meal prepared ahead of time and tossing it into the crock pot = the best thing ever. That way it is done and can be ready to be eaten whenever. 
• I have embraced the fact that as soon as I think I can get something done, like chopping the veggies to go with the roast, the baby starts to wake up and crying. I have walked away from all the veggies that I have pulled out and gotten them ready to cut up, to feed the baby. I have just left this mess to come back to it when I have a moment to finish that task at hand. 
• Master the one arm hold. I have been practicing and I have become much better at being able to carry William around in one arm and then do things with that other arm. I have been able to make some coffee, toast bread or stir soup. I have been proud of myself and I know that this skill will continue to improve with increased practice. 
• Cook with the baby. I have brought William into the kitchen and put him in his Bumbo seat and let him watch me cook. It is normally content for a little bit to hear all the noises and stare at the lights. This way I can be reassured that he is fine and I can work on actually doing some productive things, like get a meal prepared. If having in next me to isn't making him happy enough the next thing I have learned to try to to attach him to me. He likes to be carried around in a wrap and that allows him to feel comforted and me to use both of my hands to get things done. 
• I have discovered online grocery store ordering via Kroger. This is quite exciting that I can place my order online and then drive to store and pick up the things that I need. How neat is that! I am excited to use this and I think this will be become something that I do quite frequently in the months ahead! 

Vitamin D and Your Child

When you have a newborn baby you have probably heard your pediatrician talk about Vitamin D. They have probably asked you if you are giving a Vitamin D supplement to your child. Now you might be wondering why this is necessary and how important is it really? Well that is what I wanted to share with you is the importance of Vitamin D for your growing baby.  

Vitamin D is a an essential vitamin that your need to get through sunlight exposure and your diet. The challenge for all of us, especially in the winter, is getting enough sunlight exposure. This holds true for adults and children. If you are breastfeeding your infant, your breastmilk doesn't pass along very much Vitamin D. If that is solely what your infant is getting for nutrition and it is the middle of winter, your child really needs a Vitamin D supplement.  There was an article that was released this past week that prompted me wanting to write this post - CLICK HERE for a link to that write up. 

Why is Vitamin D important? Vitamin D helps with bone development and if your child isn't getting enough in their diet, sun exposure or via a supplement they can develop rickets. This occurs when the bones are weak, they bend and children have issues walking. This can be prevented through simply making sure your child is getting a minimum of 400 IU (international units) of Vitamin D each day. If your child is taking breastmilk or formula, supplementing with Vitamin D is necessary. There is an estimated 1 IU of Vitamin D in 1 fluid ounce of breastmilk. This is surprising for a lot of parents, but most people hear that breastmilk is the perfect food for your infant. That is true for most nutrients and for all of the antibodies that are passed via breastmilk. The one area where breastmilk falls short for term infants is the amount of Vitamin D available. Fortified baby formula contains 15 IU of Vitamin D in 1 fluid ounce of formula. Again, this surprises a lot of parents, but formula is designed to be nutritionally completely, but it like breastmilk is inadequate in the amount of Vitamin D it provides. As you can see, when the recommendation daily for infant is 400 IU per day, both breastmilk and formula fall short of meeting this goal. That is why providing your infant with a supplement is needed. 

Supplements - Now that we have established that your child, whether breastfeed or formula fed needs additional Vitamin D what are you going to purchase? There are lots of different brands of Vitamin D that are available. The main thing you want to make sure is that when you purchase a supplement you are giving 400 IU per day to meet the recommendations set out by the American Academy of Pediatrics. Most supplements will provide 400 IU in about 1mL of a liquid supplement that you would squirt in your infant's mouth daily. There is a product out there that provides the 400 IU of Vitamin D in 1 drop of this liquid, which can be placed on the mother's breast. This would mean the child would ingest it when they go to breast. This product is called Baby Ddrops. There are a variety of products out there and finding what works for you and your child is important. 

The main take away from this post is to help encourage you to give your infant their daily dose (400 IU) of Vitamin D each day. It is necessary for proper bone growth and development. When possible, make sure you take your child outside and get some sun exposure as well. Being outside for 15 minutes at midday with full sunshine would provide an adult with 10,000 IU of Vitamin D. So being outside for a less than 15 minutes as a child will help to meet their daily Vitamin D goals.  

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!