Handling the Holiday Stress

It is amazing how the holidays kind of sneak up on us every year. It is that time again, the calendar is starting to fill up with holiday activities and family gatherings. This is a beautiful and exciting time of year, but it can also be stressful. There is so much pressure that we put on ourselves to bake ALL the Christmas cookies, send out Christmas cards, purchase gifts for ALL the people in our lives, participate in ALL the festive happenings around the city and of course see every family member that you don’t see the rest of the year.

All of this stress that we put on ourselves can leave this joyful time of year, feeling somewhat depressing and just plain overwhelming. That is why I think there are some easy tips for you to remember through the next month to help you feel less stressed and consumed in all of the hustle/bustle of the holidays.

De-Stressing Your Holiday Season

• Prioritize your time. This is huge. All of us want to be able to do ALL this things this time of year, but that isn’t always realistic. Make a list of things that you want to do and then go through that list again and prioritize what the most important things are to do for this year. Maybe going to see Santa, doesn’t make the cut this year or maybe it is focusing on doing an activity with a close family member who will actually be in town on a specific day. If you aren’t able to do all the things that you would love to do this holiday, that is ok. Make sure you prioritize and make time for the really important things/memories.

• You can say “No.” Sometimes family obligations are intense this time of year. Lots of families want to get together and spend time together, but some times that isn’t feasible. Especially if you have work obligations or small children, it is hard to get time to spend with all those family members. You don’t have to feel like a terrible person, if you have to say “no.” That is alright and your family will understand. That is the beauty of family, is that they might be temporarily frustrated or disappointed, but they will always love you and there will be opportunities to see them and get to spend time with them in the future. Don’t put additional stress on yourself if you can’t make a family obligation fit into your schedule. Go easy on yourself and give yourself some grace and the power to say “no.”

• Make activities family affairs. If you do have a list of things you want to do this holiday season (decorate the house, make cookies, wrap gifts, volunteer somewhere, etc) make those activities family affairs. Include your children, your spouse, your extended family and do those activities together. I know sometimes cooking with children takes more time and is messier, but that way you are getting some quality time together while doing things that you would be trying to do on your own. So much of what we like to do over the holidays is centered around others, why not spend some of that time actually doing those activities with those people we care about.

• Make time for you. I know this is a crazy concept, but take some time each day for you. It can be something simple, like sitting in peace and quiet for 15-20 minutes on the sofa with no expectations for yourself. Give yourself some grace and love. It can be take an extra warm shower or getting a new mask to use and try it out afterwards. This time is important to help handle stress and give you a chance to reset.

Enjoy the holiday season and find ways to help you feel less stressed. It is a wonderful time of year, but stress can often make seen overwhelming and less fun. Hopefully some of these tips and tricks will help you enjoy the holiday festivities more!

Wrapping Up 2nd Trimester of Pregnancy #2

It is hard to believe that I am almost to the end of the 2nd trimester with Baby Busenburg #2. Time has just flown by and I am pretty sure that is due to being busy and chasing an almost 2 year old around. I have been so thankful to feel good and be healthy during this second pregnancy so that is a huge blessing.

I am currently 28 weeks along with Baby Busenburg #2. So that means we have another 12 weeks to go before getting to meet this little guy. That is just crazy, because I am not sure I am ready to embrace the life of motherhood with two children.

This little one has a had a little bit of a hiccup when it comes to causing us to worry. At my 26 week appointment we heard some PACs (premature atrial contractions) when the OB was listening to the heart rate. This means the heart beat was off and there were some irregular beats happening. This is typically due to the heart being premature and that electric pulse running though the heart, not being fully developed. We are now going in weekly for heart rate checks and had another ultrasound. The ultrasound showed everything was anatomically fine so that is good news. This is an issue that normally resolves naturally and isn’t a huge cause for alarm. At my 28 week check, the PACs were less frequent, so that is a blessing. We just continue to pray that this little’s one heart continues to mature and his heart beats normally.

Thankfully the lab work and glucose tolerance test were all good and those values were within normal limits. That was great news and that has been a huge blessing.

Last 12 Weeks of Pregnancy

• I want to savor and enjoy all the moments with my boys (my husband, William and our dog, Einstein). I know when this second kiddo arrives, life is going to get crazy and I want to enjoy and appreciate our routine right now.

• I am going to work to figure out where we want to store this little’s clothes and diapers. He is going to share a room with William so I need to think through how I want to store his stuff so they can share that space. We are also going to try to figure out what type of toddler bed we want for William and what space will allow for in their room. We plan to keep him in his crib for awhile longer, but needed to kind of figure out what might work best for that space in the months to come.

• I will need to wash and pull out the newborn clothes and get those ready for this little guy.

• I need to read through the Bradley Method workbook from when I was pregnant with William I want to remind myself about the stages of labor and work to get ready for hopefully an uneventful, unmedicated 2nd birth process.

• We have a bassinet for this little guy, which is exciting, and I will just need to figure out where to put it in our room and where to set up a diaper changing station in there as well.

• Wrapping up projects at work. I will plan to work up until the day I have this baby, but I still want to work to get things organized and ready for my maternity leave.

• I plan to cook several dishes and get them in the freezer so that we can use them during my maternity leave and I don’t have to cook every day.

• Organize the two closets. I know that seems like a strange thing, but I find organizing things quite relaxing. I want to organize the hallway closet and William’s closet in his room before the baby comes. I would also like to do the same thing with the office closet. This is totally part of my nesting phase here at the end.

• I am planning on continuing to run/going to the gym these last weeks of pregnancy. That is something I did with William. I was running/doing yoga and using the elliptical more days a week with William, but I am just so much busier with having one child already I am doing good to get to the gym twice a week and then doing yoga at home weekly.

I am so thankful for coming to the end of another trimester, only one left to go through and then we will have two little boys in our life to take care of. It is crazy and exciting. I know these last couple of months will continue to fly by.

Thanksgiving and the Kick Off to the Holiday Season

This week is Thanksgiving and you know what that means … lots of delicious food and time with family and friends. I love the holidays and the next month is filled with fun activities, birthdays and celebrations. Thanksgiving is a great time to kick off this festive time of year and enjoy some amazing food along the way.

I have posted in previous years about tips and tricks to help make healthier choices this holiday season. Last year’s post was focused around an article that I read in the New York Post about Thanksgiving favorites. The year before that I read a handout from MyPlate and put together some Healthier Holiday Options blog post. It did a similar topic in 2015 as well and enjoyed providing some recommendations on how to stay on track on Thanksgiving. So if any of those topics sound interesting check out those previous posts!

Lots of years I feel like the mantra around the holidays and trying to be healthy is negative. Lots of time I feel like we hear what to avoid and what not to do. I don’t love that message. I think that we should focus on what Thanksgiving is about - being grateful for what we have and getting to celebrate those blessings with our loved ones.

A Grateful Look at Eating Healthy this Thanksgiving

• So much food! This is often what people find the most overwhelming and as the main stumbling block starting here in November with Thanksgiving …. there is so much food that we love to eat. I say we celebrate that fact. We have lots of food. That is such a blessing. Lots of people all over the world and even in our country struggle with food insecurity. They don’t know where their next meal will come from. On this day, we sit down to a huge table, filled with food and we celebrate having plenty. This tradition has been passed down from the pilgrims. This one day we take what we have and we share it and we enjoy it. I think we focus on the fact that we enjoy this day and all that comes with it. This isn’t to say that you stuck yourself to bursting, but enjoy your holiday favorites. If you really enjoy pumpkin pie or homemade mash potatoes, then get a serving of those favorite foods and savor every, single bite. The other amazing part to Thanksgiving is the left overs. This is another opportunity to share the bounty that we all have with others. If you know of a family or individual who would benefit from a home cooked meal, take some of those left overs to them. That is a great way to get to show others some love and demonstrate the mantra of the holiday.

• Mandatory family time. Some times the pressure to see family and friends or the disappointment of missing that opportunity is stressful for people. Instead of focusing on how much of an inconvenience it is to see family or travel to a different city, take this chance to appreciate the fact that you have loved ones who want to see you and spend time with you. There are lots of people who don’t have those special people in their lives and having this expectation to see family and friends should be celebrated and looked at as a positive thing. Yes, it means giving up something, traveling and taking time away from what you might want to do, but it is means so much to see those people who you love and care for.

• Chance to give back. I love working to give back during the holidays and it all starts with Thanksgiving. There are so many different ways to volunteer at a food pantry, serve a Thanksgiving meal, participate in a run/walk event where the proceeds goes to a food pantry or homeless shelter. There are countless ways to share some of the blessings you have with others. I think we sometimes question if there is still good people wanting to help one another in the world and I think the answer if yes. Take this Thanksgiving as an opportunity to show others how you care and want to help and support your community. We have so much and being able to share a small piece or part of that with others is a great experience. One of the traditions that my family has done for the last 5 years is participating in the Broad Ripple Drumstick Dash. My parents and I have been going and we love being able to exercise in the morning and then encourage our feast later in the day. We have enjoyed being able to involve our other family members (my husband, our son, my cousin and other friends). This is a great way to exercise, be active and then support a local food pantry.

Enjoy your Thanksgiving and the start to the holiday season. Try not to stress about all the food, but embrace the day and enjoy, in moderation these amazing foods. Find some ways to give back to your community and show love to your neighbor. Being thankful for all the the blessings of the season.

Cooking With Your Child

I have talked about including your child with cooking before on my Facebook page and blog, but it can definitely be a tough thing to do. It takes WAY longer to include your child in the cooking process and it honestly can make a much bigger mess, when all is said and done. I still want you to encourage you to give it a try! I am not asking you to include your child with every meal, every day, but make an intentional effort several times a week to cook with your child. If you want your child to grow up and be independent and enjoy the cooking process, that love for cooking starts now.

Tips for Cooking with Children

• Embrace the Mess. When cooking with children, whether toddlers or older school age children, messes happen. It is inevitable that things will get spilled and your kitchen will end up being twice as messy compared to it your children weren’t “helping” you. Working to embrace that mess and be ok with that “disaster” is important. We would all love a neat and tidy work space, but teaching children and having them learn things can be a messy process. Along with the mess that will happen, take them time to work with your child and have them help you clean up. That is just as important of a skill as learning how to cook is how to clean up. Being able to take the time to involve them in the measuring, the mixing, the cutting (as they get older) and the stirring helps teach them to follow directions and create something. Having your child help with the dishes, load/unload the dishwasher, dry the dishes and put them away are useful skills to teach following directions and seeing a task through to completion.

• Be Patient. As you cook with your children, you will quickly learn that it takes LOTS of patience on your part. It is way more stressful for you to slowly walk through the instructions and slowly measure/mix the ingredients. Your child will want to be independent and try to do that task on their own. That is great, but will require an extra dose of patience when they spill the ingredient on the counter/the floor. It will take extra patience as you work with your child to unload the dishwasher as they slowly place the silverware in the drawer, one piece at a time. Teaching your children these skill is a slow process. Try to keep your cool and embrace the fact that you will need to be patient, but they are learning and that is worth the effort.

• Assign Specific Tasks. As you are working with your child, give them specific jobs to do. Explain to them what you want them to do. For example, have them stir ingredients on the pot on the stove. Give them a spatula and tell them that their task will be stirring the ingredients. Talk through how the pot and the stove are hot and they need to be careful. Give them affirmation that they are doing a great job following your directions and they are a big helper. This specific instruction is helpful for children to know what is clearly expected from them and then gives them a sense of accomplishment.

• Be Flexible. Nothing will go quite as you planned it. You probably anticipated being able to prepare that food item in less than 30 minutes, but working with your children can length that task out by at least an additional 10-20 minutes. Sometimes you will have an expectation of what roles they will help with and how they will be involved, but your child might have different ideas. That is ok! Be willing to be flexible and let them help you in ways that they are interested in and make the experience positive. If you are cooking a meal like pizza with different topping options, be willing to let your child pick whatever they want on their own pizza. Be willing to hand over that responsibility to the child and let them take ownership of that. If you assign your child a job task, like sweeping the floor after they finish cooking, let them do that however works best for them. Be flexible with empowering them to take ownership of a task.

• View this Experience as a Teaching Moment. Our main job as a parent is to teach our children. Taking the time to involve them in cooking and preparing food in the kitchen is a great way to teach them the art of cooking/baking, but also following directions, helping other people, functioning as part of the family unit and creating something to share with people. These are all amazing skills and using cooking as an avenue to work on these skills and instill these qualities in our children is a great goal. Talk through each step you are doing so your child learns what all goes into making a meal for the family. Your child will get better and faster at these tasks as you work with them over time, but enjoy the learning process and embrace the teaching moments.

Enjoy working with and getting to know your child better in the kitchen. This is a fun time to work with your children and help teach them skills that they will be able to use in the years to come. It can be stressful, but work to keep the environment positive, listen and dance to music as you cook and enjoy these little moments cooking with your child.

Jump In and Go For It!

I feel like this is becoming a common theme in my life. I have been blessed with amazing opportunities growing up through 4-H, opportunities to visit other countries on mission trips, the chance to learn an instrument, attend an amazing college, serve on various boards/committees throughout college, land an amazing first job, move into a specialty area and get another amazing job, etc. All of these opportunities have been blessings. I strongly believe that, but I also believe that I have “jumped in and taken a chance” when opportunities presented themselves. I very easily could have just avoided the opportunity and not applied for a board position or a chance to do something that pushed my comfort zone.

When it comes to advice, I am a strong believer in “jumping in and going for it.” Whatever that opportunity is! If you see a chance to take a leap, push yourself, advance your career, learn a new skill … then take that leap! This made me think of the Purdue 150th Anniversary Celebration. As you know, I am a proud Purdue Alum, but I love the theme for this year and this celebration - “Take Giant Leaps.” I think this fits perfectly into my mantra for life … “Go for it!” In order to continue to learn and became better and whatever you decide to do, you have push yourself and take risks at times.

The whole reason I decided to make a blog post on this topic was, because I had an opportunity that presented itself this last week. I was sent an email encouraging me to pursue an application for a national board position within the Academy of Nutrition & Dietetics. Is it a long shot that my application would even get chosen and then if I would even get elected to that position …. yes! It is a huge long shot. Did that stop me from throwing my hat in the ring? No! I was asked by a colleague what made me want to apply? I said, “because I can.” I didn’t need another reason. I had an opportunity come my way. I had a chance to take a leap and try something I have never done before. I decided to try to make that dream a reality and I am going for it. Who knows what will happen. Probably nothing. I gave it a go, but I am not afraid of failing and not being chosen. It is fine. I am busy with lots of things and if this opportunity doesn’t work out this time, that is fine. I can always apply again in the future and see where that door leads.

Basically I wanted to share these thoughts with you to encourage you to push yourself, take those giant leaps and don’t be afraid to say “yes” to an opportunity that comes your way. Putting yourself out there is the best way to move forward and to learn! So jump in and go for it!

Halloween Tricks and Treats

Something about fall and the cool crisp air makes me love Halloween. It is kind of the start to the holiday season and of course you doesn’t love a cute kid wearing an adorable costume. Halloween means delicious candy will find its way into your house, if it hasn’t already. Lots of times we think that those “fun sized” candy bars are perfectly size … and they are if you only eat 2 not 15. Every year I feel like the fun-sucker when it comes to Halloween candy. I love a small amount of candy, but it is definitely a treat that can be over done. There are lots of neat food items that you can pass out that aren’t candy - pretzels, popcorn, crackers, fruit cups, etc.

I enjoy reminding people of ways to provide trick-or-treaters with goodies that aren’t always food related. There are amazing little goodies that you can find at your local dollar store that are inexpensive and the kids will love them!

Non-Food Related Goodies

• Whistles, kazoos, or noisemakers

• Bouncy balls

• Finger puppets or novelty toys

• Bubbles

• Spider rings or mini slinkies

• Vampire fangs or other Halloween themed goodies

• Mini notepads or coloring books

• Playing cards

• Bookmarks, stickers and stencils

• Crayons, markers or other writing utensils

• Glow sticks (bracelets, necklaces or rings)

Why would you want to go through the trouble to pass out non-food related goodies? Well lots of kiddos will end up with tons of candy by the end of Halloween. Most of those goodies will get eaten by themselves or their families. Some candy is fine, but most of us don’t need ALL that candy. Some children have food allergies or intolerances and that means that they can’t eat a lot of that candy that they get. That is definitely less exciting for a child who can’t eat what you give them and makes their parent’s worry that they might accidentally eat something they are allergic to. Offering non-food treats is helpful because ALL of the kids that you pass those items out to will be able to enjoy them.

The Teal Pumpkin Project - I have talked about this initiative over the years, but I wanted to bring it up again. This is a movement to provide safe, non-food related treats for children. Putting a teal pumpkin on your doorstep means you have non-food treats available, such as glow sticks or small toys. This simple act promotes inclusion for trick-or-treaters with food allergies or other conditions.

1. Provide non-food treats for trick-or-treaters.

2. Place a teal pumpkin in front of your home to indicate to passersby that you have non-food treats available.

3. Add your home to the Teal Pumpkin Project map.

4. Spread the word! Share the Teal Pumpkin Project with your friends and family.

I encourage you all to become a supporter of the Teal Pumpkin Project and work to help provide healthy and safe treats for children this Halloween!

Healthy Benefits of Fall Themed Foods

Well fall has officially arrived in Indiana this week. Monday the weather was mid-80 degrees outside and then by Wednesday the weather shifted and by Thursday the high was mid-50 degrees. It was a big shift and needless to say it finally feels like a cool, crisp autumn day outside.

With this shift to cooler temperatures there are variety of fall-themed food items that start making their appearance in grocery stores this time of year. I love the pumpkin flavoring and of course baked apples. I wanted to talk about some of these fall flavors and tease out what some potential health benefits would be for these food items.

Fall Flavors

• Pumpkin - You can find so many different types of pumpkin flavored food items, from bagels, to cream cheese and even your coffee can have pumpkin flavoring. Most of these pumpkin flavored food items are not any healthier than their regular food alternative. The health benefit that is gained from pumpkin is from eating fresh pumpkin puree and putting that in food items. The deep orange color that you commonly see in pumpkins signifies a large amount of carotenoids. Caroteniods act as antioxidants and can be converted to Vitamin A. The Vitamin A is helpful for eye sight and prevent the growth of cancerous cells. Antioxidants are helpful in decreasing inflammation in the body and protect from free radicals throughout the body as well.

• Cinnamon - This spice comes from tree bark and is very fragrant and this smell is due to the oily part of the bark that releases that smell. This spice is loaded with antioxidants to help protect from free radical damage in the body and can act as a natural preservative. There have also been some studies showing that cinnamon could help with cholesterol levels and reducing high blood pressure or helping with blood glucose control (need to consume 2 teaspoons/day). From the initial research, you have to consume a large amount of cinnamon (120mg/day) and I am not sure that is realistic for the average person. Some cinnamon can definitely make whatever you are making taste good, but I am not sure I would bank on a large antioxidant intake from what you sprinkle on your coffee.

• Cranberry - These deep red colored berries are commonly seen around the grocery store this time of year. This little berries are packed full of Vitamins C, A and K and are low in calories. They are also rich in proanthocyanidins, which are an antioxidant that help to fight off diseases. Cranberries can help with treatment of kidney/urinary tract infections or other issues. When it comes to dental wellness, the proanthocyanidins help prevent bacteria from attaching to your teeth. These berries are not super sweet so often people add lots of sugar. This is often where the additional calories come from. So try to enjoy your cranberries with limited added sugar.

• Squash - This is food is technically a fruit and not officially a vegetable. Squash contains high amounts of Vitamin C, Magnesium and antioxidants. This is such a versatile food that can be used as a side dish or a main entree. You can serve certain types of squash cold or warm. This can be a diabetic friendly food, because it has a low glycemic index and isn’t as starching as a potato or pasta. The antioxidants help to boost the body’s immune system and helps with glucose regulation and insulin release. Folate is found in high levels in squash and this nutrient is important for pregnant women to prevent neural tube defects. The potassium amounts in squash are high enough to help with vasodilation and help with blood flow throughout the body and overall blood pressure.

• Ginger - This spice is popular to add flavor to various dishes and recipes. This spice can be helpful for nausea and helping with morning sickness for pregnant women. Daily consumption of ginger (2g/day) can help with muscle soreness. This isn’t an immediate affect, but can help with soreness over time.It is hypothesized that ginger, like cinnamon, would help with blood sugar control (2g/day) and could be a helpful supplement for diabetics. If you experience indigestion often, ginger could help with this problem. Some further research is needed, but these are interesting findings and might be helpful for some people.

These are just a few of the common fall flavors that you might see at restaurants or at the grocery store. Hopefully this information is helpful as you consider any of these food items and their health benefits.

The 2nd Pregnancy

I feel like with this blog I haven’t written as much as I did the first time I was pregnant. I think I was so focused on learning about the process and how things change. Writing about that process was helpful for me personally. All those posts are totally still up on the blog and you are welcome to read back through them. This post was focused on the 2nd trimester and that is where I find myself once again. 

I wanted to talk about how things are different this second time around. I feel like I have less time to just think about being pregnant, because I am just trying to keep up with the rest of life.

Differences the Second Time Around

• I had tracked all the calories that I ate the first time I was pregnant. I used My Fitness Pal and I love that app. It worked great for me. I found that tracking calories was super helpful. This pregnancy, I haven’t tracked anything. I have been trying to monitor weight gain, but I don’t feel like I am overeating. I think because I am busier than I was the first time around, I have less time to eat and even at meals I don’t feel like I eat as much as maybe I use to. I need to replace the batteries in my scale and continue to track weights to help ensure that I don’t over indulge too often.

• I did prenatal yoga weekly with my first pregnancy. I had that as major priority and it was easy to get to classes. I happily spent the money and I loved it. This time around it is harder with a little one at home to take care of him and then also fit in classes. Plus they are an added expense and we are trying really hard to save money to help support having a second kid. That has made me not really want to spend that money. I do want to get back in the habit of trying to go maybe once every 3 weeks.

• I exercised almost daily with my first pregnancy. Again I wasn’t having to look after anyone else and so that was easier. I am still working out about 3 times a week, but then I do walk the dog and try to get in a long walk daily. That has been tough though because by the end of the day my energy levels are wipe. Between the job, cooking, cleaning, trying to exercise and then getting ready for the next day it is a lot to manage. So I am doing really well if I can get in an aerobic work out 3 times a week. 

• I use to have more relaxation time. I actually had time at the end of the day to sit, watch TV and just relax. That doesn’t happen any more. From the cleaning after dinner, packing lunches, laundry, dog walking, etc there is no time to sit down between 8-10pm. It is go, go and go. When I do sit down, I fall asleep and just put myself in bed. So I kind of miss some of that self-care. I know that when this second child arrives, I have will to set aside some specific time for self care, because otherwise it will not happen.

• I am not as stressed throughout this pregnancy about being pregnant and the time is just flying by. I can’t believe that I am already at 21 weeks and we are over half way there. We have seen the baby on ultrasound and the baby is doing great. I feel like in the craziness of life … this pregnancy is going by quickly, which is nice, but also surprising to me.

• I love not having to worry about purchasing lots of pregnancy clothes. I had a bunch of friends let me borrow clothes when I was pregnant last time. That was awesome. I bought some other clothes, but it was really nice, not to have to worry about what to wear. I have all the things I like and that is a nice feeling.

• We took the Bradley Method classes during my first pregnancy. This time we aren’t planning on taking any formal classes, but I do want to pull out my Bradley Method book and work on some of the exercises and read through the notes from the class. I also have our birth plan and then packing list for the hospital all saved and I will need to pull that up and have that on hand.

• The main thing that I am worried about it just financial concerns with two children. Cost of two children with “daycare” and just the stress of caring for two children. That is the overwhelming part, but it is manageable and I am working on keeping a level head about those things.

This pregnancy is definitely different than my first one, but I think that has to do with our different my life is now. We live in a different place, we have another child, my husband has a different job and we are a few years older (maybe wiser). It is a blessing to be able to be in this position again and we are praying for a healthy and happy baby!

We had our Gender Reveal party this past week and were excited to learn Baby Busenburg #2 is a going to be a boy!

Book Review - Real Food for Pregnancy

I had the opportunity to write up a book review on Lily Nichols newest book, entitled Real Food for Pregnancy. This is an excellent book! Can I just tell you that I have never read a nutrition pregnancy book like this before. I was so excited to read a book filled with useful information and practical guidelines for practitioners and also for the general public. Lily did an an amazing job talking about nutrition recommendations for this important time in lots of a woman’s life. I also really appreciated the push for real food and using full fat food items made me happy. I love good food and often during pregnancy it is hard to eat and so having something nutritionally rich and delicious is a huge win!

Disclaimer: I was given this book for free in return for writing a review. I was dedicated to writing what my thoughts and professional opinion was as a Registered Dietitian, despite getting this book for free. All the information and feedback provided below are my true feelings and recommendations regarding the information written in this book.

Favorite Highlights from the Book

• To start off the book, Lily answers the question of why real food? I love that because most women get so many mixed messages about nutrition, I love that she just answers why eating whole food matters.

• She discusses what real food looks like during pregnancy and the different food groups. She talks about mindful eating and meal timing and how to choose those healthy options. Since that is the title of the book, I love that she covered that in chapter 2.

• Chapter 3 dives into foods that build a healthy baby. I love these recommendations, because they aren’t ways discussed with your OB or midwife. Foods that she highlights are eggs, liver, meat on the bone, leafy green, seafood, full fat diary and why vegetarianism is very challenging when pregnant. So I have admit that because of this chapter I have been eating 1 egg every morning throughout my entire pregnancy. I recognized that I wasn’t getting enough protein in my diet in the morning and that helped with my nausea, plus eggs are a source of choline. “Egg yolks and liver have, by far, the highest concentrations of choline compared with any other foods.” - p.30. Choline is helping your baby’s brain to develop appropriately and most women do not get near enough choline from their diet.

• On the flip side there is a whole chapter devoted to foods that don’t build a healthy baby in chapter 4. I thought this was a refreshing way to look at the commonly forbidden food items and consider eating on the “safe side’ versus risking nutrient deficiencies.

• Who doesn’t love a chapter of meal plans. Chapter 5 goes through meal plan ideas and 7 days worth of real food meal plans for you.

• There is a whole chapter devoted to supplements. In chapter 6, Lily covers everything from prenatal vitamins to chia seed, probiotics and gelatin. I learned so much from this section and just understanding why my own diet would be insufficient and how my prenatal vitamin might be less than perfect as well.

• What pregnancy book could be complete without a chapter on common complaints from nausea to heart burn and weight gain. These topics are covered and recommendations given on how to deal with common issues for pregnant women.

• Another topic near and dear to my heart is exercise. Chapter 8 discusses physical activity and pelvic floor strength. I am so glad that Lily discusses the importance of exercise throughout pregnancy and how that looks as the weeks and months go by.

• Throughout pregnancy women end up with lots of lab work that is drawn. Lily provides a breakdown on what lab tests are normally run and what speciality labs you might want to ask your health care provider about.

• Chapter 10 and Lily’s discussion about toxins was very eye opening for me. I ditched my plastic containers in my kitchen and switched to all glassware. After reading this chapter I knew that I had to make some chances and now (being pregnant) was as good a time as any to really clean up our house and change some of our habits.

• The next chapter was short and focused on stress and mental health. This was a good reminder that this phase can be stressful, before, during and after pregnancy and being mindful of that increased stress is important.

• The final chapter was about the fourth trimester. I am a strong believer in this last part of pregnancy and it is commonly the area that is overlooked and not focused on. This time after baby arrives is quite the transition period for you physically, emotionally and mentally. Know how to cope during this time and then setting realistic expectations will help to set you up for success.

Why I love this for ALL women!

I wanted to focus on why this book is a must read for any woman who is thinking about being pregnant or wanting to have children in the future. This is a great and easy read. The information provided by Lily is extremely easy to understand and then if you have follow up questions about the research that she presents, all the citations are at the end of each chapter. There is SO much information in this book and I would say most of it is very eye opening. I love her philosophy to encourage women to eat real foods and not to try to follow some unrealistic “diet.” Her recommended eating habits should be part of normal routines if we are pregnant or not.

Why I love this ALL Registered Dietitians!

Of course I had to share my love for my fellow RDs and encourage you all to read this book as well. If you happen to work with women and/or especially pregnant women then this is a MUST read for you. The research that went into writing this book is amazing and all the references are right there for you. You can easily share this with any OBs that you work with or other primary care physicians to help educate them on why a real food, healthy diet is important for all women, especially those who are pregnant. This is an easy read, even with all the research that is cited, and it touches on all the key nutrients that go into having a healthy pregnancy.

This is a MUST read!

This book is filled with so many amazing recommendations and backed with evidence-based research. It is a resource that should be used throughout healthcare to help provide women with the best tools to have a successful pregnancy. I work in a NICU and I see sick women having sick babies all the time. Healthy women tend to have healthy babies and that is better for all involved. We can’t keep all of these babies out of the NICU, but following the recommendations in this book definitely sets women up to be more successful and help care for their unborn babies to best of their ability.

Purchase this book HERE.

Check out Lily Nichols, RDN, CDE’s webpage HERE.

Get Rid of the Plastic

I have been debating this idea of getting rid of all the plastic food containers in our kitchen for awhile now. I have been going back and forth and how feasible this would be and if it is really necessary. Some of the containers that we have are from 2012. We got them when we got married and now it is 2018. That seems like WAY too long to keep plastic containers that are storing food items. I wash them, but they are looking a little rough. With that in mind, I was reading Real Food for Pregnancy and there is an entire chapter devoted to toxins. That was the chapter that really made me stop and decide to order more glassware. I am going to write up a whole review on this book, once I am finished reading it. I am almost done and I have to say it is such a great book for anyone who is expecting, planning on having children or counseling pregnant women. It is a must read! There is a blog post that Lily wrote up on this topic as well that I thought I would share. The big take away so questioning storing foods in plastic and reusing them over time. That is practice has not been shown to be healthy for pregnant women, but also can affect just healthy individuals as well.

I think this information applies to pregnant women obviously, but also all people. Those toxins are in these products and will have an affect on us whether we are pregnancy or not. I started to also think about all the times I am using plastic throughout the day. The cream cheese I got is in a plastic container, the bagel is stored in a plastic bag, my reusable water bottle is plastic, and then I am putting all of our left-over food in plastic containers in the refrigerator. I work hard to limit our consumption of certain products and we recycle the plastic that we do use. But I think there are always ways that we can do more. How many times are you coming in contact with plastic throughout the day? 

I took all the plastic containers out of the cabinets and started to put them out on the counter. It was amazing how many containers I had accumulated over the years. Some of these containers are older than others and I don't feel like they are suppose to last as long as they do. I have had some of this Rubbermaid since 2012 or before. That is over 6 years and I feel like heating and cooling plastic for that long and eating food out of it isn’t the best of ideas. I decided to go with glassware instead. Glassware can last for 6 years and hopefully more and you don’t have those same concerns as with plastic. I purchased a set of Pyrex glassware with plastic lids. The lids are replaceable and you can get new ones if needed. I ordered this set off of Amazon and then got some small 1 cup containers as well for packing lunches for work. I don’t have all the plastic and glassware in the picture below, but it is the majority of what we have. I have been slowly getting rid of the plastic and replacing containers with glass instead.

I encourage you to take a look at all the plastic that you encounter throughout the day. Are there ways that you can reduce your plastic consumption? Can you reuse or recycle some of those items? Do you have to use plastic as all? What if you looked to get rid of that plastic and replace it with another product like stainless steel or glass? This isn’t suppose to a post to scare you, but instead make you think and find ways to be healthier and help our environment along the way!

Running during pregnancy

When it comes to exercising during pregnancy there are lots of types of activity that you can do. Any type of exercise can be good. Obviously, contact sports are discouraged, but other activities like running, swimming, aerobics, etc are all great options. I specifically wanted to focus on running when pregnant. I should also say that any type of activity you were doing prior to being pregnant you can continue while you are pregnant. If you never ran before in your life, maybe don’t start running right away while you are pregnant. Ease into that and start with walking or using the elliptical at the gym first and work up to that more strenuous activity. If you run in the past, that is totally something that you can continue while you are pregnant. Being active during your pregnancy is good for you as the mom and good for baby. Exercise has also been shown to help with blood sugar control and blood pressure control as well. Both as wins during pregnancy because you do not want to develop gestational diabetes or pre-eclampsia.

What does running look like when you are pregnant? Well every time you lace up your shoes and head out will be a different adventure. That is the thing about being pregnant, your body changes every day and that makes any activity different and more challenging as the months go by. With my first child, I ran all the way up through about 37 weeks gestation. I got too uncomfortable at the very end to try to run. I went to the gym and used the elliptical and that worked out well. I still got in some aerobic activity, but didn’t have stress on my belly and joints that comes from running. I would encourage you to keep running if you did that prior to becoming pregnant, if you weren't a runner, then I would recommend start with something like walking before you start running. 

What does running look like with a 1 1/2 year old? Well I would say running with one child is a lot different than running with no children while pregnant. I have always taken William running with me and now that I am pregnant for the second time that isn't changing. He does well in the stroller and I think it is good for him to be out and about. Now I just push a stroller in front of me while running. This is a definitely a work out. It builds arm strength to be out there pushing a stroller with a 27 pound child in it, but it is good exercise. I am definitely not breaking any speed records, but getting out and working hard is definitely important. 

I really enjoy having this time and ability to work out and maintain my health and the health of my future child. Any form of exercise while pregnant is so important to help with blood sugar control, fluid management and weight control. It has definitely been proven to be make for a better labor process and of course health outcomes for mother and baby. Finding some form of activity is key. I also really enjoyed prenatal yoga when I was pregnant the first time round. Cost is definitely more of a factor this time and I haven't been able to go on a weekly basis. I need to work hard to do some of the stretches and poses at home, but we know how tough that can be to actually follow through with at home. Finding different forms of physical activity can help ensure that you stay healthy throughout this entire pregnancy process.

Tricks to keep running through your pregnancy:

1. Go at your own pace. Don't try to set any speed records. Your body is already working hard carrying yourself and a baby.
2. Don't push yourself super hard. Ease into the run and work up on intensity based on how you feel.
3. Stay hydrated and plan potty breaks. It is key to keep fluids handy when exercising and then also know where close restrooms are, because those might be needed more too as time goes on. 
4. Keep your energy up by eating before and after. Throughout pregnancy good nutrition is key and having a small snack before and after you exercise can be helpful. Again make this a healthy option and include some protein to help with recovery after you finish your work out.

Baby Announcement!

Well I have an announcement to share with you all ... We are expecting another baby next year in February! You might remember back in 2016 we shared with you some exciting news about our first child. It is kind of crazy to think that next year we will have baby #2 here and we will be parents to two little ones and one dog. It has definitely been an adventure being pregnant again and with one child running around, but it has been good. I am at 16 weeks and really appreciating the 2nd trimester. That surge in energy and lack of nausea has been a relief. Being pregnant for the second time has been smoother than the first go round. Obviously, knowing what to expect makes it easier. It is going quickly and hard to believe that we are already in that 2nd trimester and this little one will be arriving in no time after the craziness of the holidays. 

I am trying to get back into my exercise routine now that I have energy to devote to working out. I am also trying to work in some prenatal yoga classes. I don't have the time or money to go to a class every week, but I am going to try to go two times a month. I really enjoyed and benefited from prenatal yoga when I was pregnant the first time with William. Food is also less repulsive now so I am trying to get back in the habit of making better meals at home.

I am excited to share this journey with you all like I did the last time. It is a little different since this isn't all new to me, but it neat to get to experience this amazing process for a second time. If you have any pregnancy related questions or topics you would like me to address on the blog, let me know! 

Excited to welcome this second little one around February 16th, 2018. 

Probiotics

I had a special request to write up a blog post about probiotics. I thought this was a great idea. I hadn't written about probiotics specifically before. I had discussed gut flora and keeping your GI tract healthy, but not specifically through the use of adding a probiotic to your diet.

So I thought I would start with a definition of a probiotic. A probiotic is a substance that stimulates the growth of microorganisms, especially those with beneficial properties in the intestinal flora. Probiotics are live bacteria and yeast that are good for your digestive help. Our body is full of bacteria (good and bad). You can find probiotics in foods and also you can take supplements. There are lots of different types of probiotics with different health benefits. 

• Lactobacillus is a common probiotics that you commonly find in yogurt and fermented food items. This strain can help treat diarrhea and also help people who are lactose intolerant. 
• Bifidobacterium can be found in some dairy products. If can help to ease symptoms of irritable bowel syndrome. 
• Saccharomyces boulardii is a yeast probiotic and it can help fight diarrhea and other GI issues. 

Probiotics are helpful for your GI tract. Your intestinal tract is often known as a "forgotten organ." Your gut needs to stay balanced and prevent a leaky gut (where your intestine doesn't absorb nutrients appropriately). This leaky gut can leave your GI tract vulnerable to other infections or illnesses. These probiotics containing foods include yogurt, kefir, sauerkraut, Tempeh, Kimchi and others. I love this list that I found on Health.com outlining a list of foods that are good sources of probiotics. I like the idea of getting probiotics from food sources. I think that your body can use and metabolize them better compared with a supplement. Plus supplements are not regulated the same way as food. Often with a supplement you are only getting one type of probiotic, compared with eating the food item you are eating multiple types of probiotics. Also just keep in mind that probiotics are not the same things as prebiotics which are dietary fibers that serve as the food for friendly bacteria that are already in the gut. 

The list of ailments that probiotics can help treat are long. Everything from skin eczema to Crohn's disease. Everyone's experience is going to vary and the type of probiotic that you take could help with a different issue. I believe that working to keep your intestintal tract functioning optimally will help you stay healthier and feel better. There was a guide which outlined various strains of probiotics and which strain helped with which issues. You can find that article if you CLICK HERE. I am not going to rewrite all of those recommendations, but know that resource is available if you need it or would like to look over it. 

Some other things to consider when it comes to intestinal health is fluid intake and exercise. Your GI tract benefits from physical activity just like your heart, lungs and brain benefit. Exercise helps your body to move through food you have eaten and absorb what is needs from that food and then excrete the waste in a timely manner. If you have had issues with constipation or just being irregular with bowel movements, work to add in some physical activity (even walking) into your day and that can help keep your GI tract moving appropriately. Fluid intake can also have a big role to play on how well your intestines work. Staying hydrated and focusing on drinking enough water is helpful. 

Your intestinal tract flora is able to change based on your environment and what you eat. If you had an illness and had to take antibiotics, that medicine probably wiped out that good bacteria that had colonized in your gut. Often a doctor may prescribe a probiotic at the same time as a antibiotic to help lessen that breakdown of the gut flora. What you eat can have an impact as well on helping your gut to re-colonize with healthy bacteria. There have been studies showing the gut flora in a healthy weight adult who regularly exercises compared with an overweight adult who never exercises and they have different microorganisms living in their GI tract. What you regularly eat has a role on your gut health. Aim for a healthy diet - filled with fruits, vegetables, lean protein, dairy and whole grains. Those healthy foods will help fuel to healthy bacteria to grow in your intestinal tract. Do I think you need to take a special probiotic supplement to help with your gut health? No, I don't think you HAVE to take one, especially if you are eating this probiotic containing foods and an overall healthy diet. If you have noticed GI issues and try some of these probiotic containing foods and if that doesn't help, you can try some of the supplements and see if that helps with your symptoms. I think it is important to talk about gut health and helping people know that there are ways to aleviate some of these uncomfortable symptoms.

Hopefully that is helpful to provide you some insight into what probiotics are and how they can help your body. If you have any other questions or ideas for topics you would like me to cover on the blog, let me know! 

References 

1. https://www.webmd.com/digestive-disorders/what-are-probiotics#1 
2. https://www.healthline.com/nutrition/probiotics-101#section1
3. https://www.health.com/health/gallery/0,,20918991,00.html#kombucha-tea--0
4. https://www.health.harvard.edu/vitamins-and-supplements/health-benefits-of-taking-probiotics
5. https://www.humnutrition.com/blog/the-guide-to-choosing-the-best-probiotic-for-you/
6. http://pilatesnutritionist.com/5-fermented-foods-boost-intake-probiotics/

Exciting Opportunity for RD Anna

I wanted share with you all who follow along with RD Anna about some exciting new opportunities. I have had some new endeavors that I am getting involved with this fall. Some of your may remember that I did some outpatient pediatric nutrition counseling at my last job. I really enjoyed working with a feeding clinic and doing some weight loss classes up in Lafayette, IN. I haven't had the opportunity to do any of that in the last several years. I am continuing to work my full time job as a NICU dietitian as well. I wanted to make that abundantly clear as well. This is going to be a fun, side job that I am excited for and have been eagerly anticipating for the past 6 months. 

There was the opportunity to create a partnership with a business in Carmel, IN and I had to say yes! I use to work with Megan, Mini Minds business owner, at St. Vincent. She left her job at St Vincent as a social worker to launch her own private practice as a therapist/counselor. I have really admired her journey and I am so excited to learn from her about owning her own business. Mini Minds has grown and expanded into an amazing therapy office servicing the Indianapolis area. Make sure you check out their website and all the amazing services that they offer. Of course, the newest line of services including nutrition therapy and education options. 

As you may remember I made RD Anna a LLC this past year and then I also worked to get my NPI so that I could start charging insurance companies for nutrition counseling services. This has been a big step for me, because I have never owned my own business before or offered nutrition services for payment before. I am really excited to partner and work with Mini Minds and get to provide nutrition education/counseling for those clients and their families. We are getting started with a workshop class this upcoming weekend on Back To School: Putting Together Healthy Snacks for Your Family. That should be a fun session trying new snacks, talking about healthy options and then even making some delicious recipes. I also have plans for launching a 3 week cooking class series in October focused on shopping and cooking healthy family meals with your children. There are lots of neat things that I am hoping to do in the fall with this opportunity. So stay tuned for those exciting announcements about RD Anna! 

Realities of Life

Being a Mom is hard. It is a full time job and it is definitely the most rewarding thing I have done, but it takes a lot of energy. If you pair that with working another job full time it leaves you not that much time to pause and think about things. I love my day job and I love my child. I couldn't imagine now life without either occupation. 

I have also being working on a variety of side projects and to be honest I now feel that I am very overwhelmed with everything. I think I said "yes" to several opportunities and now life has shifted a little and that has made for a crazy next couple of months. I am determined to do all these projects to the best of my ability, but I think I might be maxed out when it comes to taking on anything else at the moment. I have decided that I need to devote some serious time to a few of these side projects so that I really focus on getting some quality writing done. I have do some editing on a chapter of a book that I co-authored as well as writing an article for a pediatric nutrition publication. These are all neat things, but I really need some creative time to focus on them. 

I decided to finally take my Mom up on an offer my son, William over night. I know that might not seem like a lot, but we have never spent a night apart and he is 1.5 years old. This is just reality of life. With so much going on I really need some help and that involves giving me a day to work on side projects. I was hoping to use that day to do writing, but I realized that I am going to be teaching a workshop that day instead, which is still a great thing to do and I am excited for the opportunity to do more with RD Anna, LLC. 

Some times with the realities of life you need help. Raising a child or children takes a village, especially if you want to continue to stay engaged with your career and continue to to be the best Mom you can be. I just wanted to encourage you that it is ok to ask for help and that doesn't make you any less of a Mom. 

Meal Prep For Your Week

All of us tend to be busy. We are often running around trying to make to work on time, picking up children from day care, trying to find something healthy for dinner and then getting the children to bed at a decent hour. Lots of us barely have time to get all those things done in a day. When it comes to meal preparation for the week, this can get overlooked and not made a priority. I am guilty of this as well. Grocery shopping and preparing meals can get so old, because you have to do it week after week and something it is just not well thought out. 

I am hoping to encourage you to make the time meal prep for your week so that you can set yourself and your family up for success. First step is to make sure you sit down and make out a grocery list for the week. The items that you need to prepare a list of recipes that you want to make throughout the week. Then head out to the grocery and stick to that list. When you bring those food items home, set aside about a hour to cut up and get that food ready to cook with for the week. This is often the part that gets overlook. Taking the time to wash all your produce, chop it up and put it in containers will drastically increase your cooking time throughout the week. This will help you so much when it comes to making quick and easy meals at home for your family. You can even cook up some meat as well if that ends up being helpful for lunches throughout the week. I would encourage you to start with simply washing, cutting up and putting your produce in containers so that it is more easily usable throughout the week. 

Making Breakfast Ahead of Time 

I wanted to share a couple of recipes with you for some great ideas on how to make a healthy breakfast ahead of time so that you are starting your day off on the right foot. 

Overnight Oats 

I love this recipe because it is super easy and delicious. Simply mix together rolled oats, yogurt, milk and some chia seeds. This can be put in small containers and kept in your refrigerator. Then you can throw some berries or other fruit on top and take this fiber-filled oatmeal dish with you to work. 

Microwave Breakfast Scrambles 

I found this recipe from the website Budget Bytes and I love this idea that I just had to share it with you. You can place chopped up vegetables, cooked sausage or hash-browns in a wide neck ceramic dish. This can be stored in the refrigerator and then you add a raw egg on top and microwave for 15 second increments, stirring in between to carefully cook that egg and create a breakfast scramble. There are lots of creative recipes that you could follow. You could combine bacon, hash-browns, cheese or you could make a veggie themed scramble with spinach, tomatoes and feta cheese. 

Packing a Healthy Lunch 

Obviously each meal that you eat makes a difference in your overall health and eating a healthy lunch is just as important as a healthy breakfast. With work and school it can be rough to have time to pack something ahead of time and take it with you. There are a couple of ideas here that I think would be easy to pack ahead of time and take with you. 

Pasta and Sautéed Vegetables 

This can be a easy dish to put in a container, because it could look different each week depending on what leftover pasta options you might have in your refrigerator. You could do a spaghetti with a red meat sauce and pair that with some roasted squash (zucchini and yellow squash). You can top with fresh basil and then simply heat this up for your lunch time meal. If you happen to have a left over salad, you could bring that as well. 

Burrito Bowl

I love burritos and all the ingredients you can pack in that tortilla, but sometimes things can just get messy. That is why I really like this idea of a burrito bowl You can put together in one container all the ingredients you love from a burrito and then heat it up and enjoy with a few less carbohydrates sans tortilla. You can line up your meat or black beans for protein, some shredded cheese, grilled vegetables (like peppers, onions or zucchini), salsa, corn and top with green onions. You can pack some lettuce, avocado or sour cream separately. 

Cobb Salad 

For this dish you will need two Tupperware or glassware containers. One will be for the lettuce/salad mixture and the other will be for the toppings. You can put your favorite cobb salad toppings together - chickpeas, cubed cheese, chicken slices, bacon, tomatoes, hard boiled egg and then pack your favorite dressing on the side. If you do choose to purchase bagged lettuce, make sure you recognize that something this goes bad faster then whole lettuce leaves. Just plan ahead when it comes to your meal prepping so that you don't create more food waste. 

Quick and Easy Dinners 

Dinner time is often a stumbling block for a lot of people. This is why doing some meal preparation can be super helpful for dinner. The key to being success in making healthy, quick dinner at home is to not spend your whole evening in the kitchen. If you can prepare items ahead of time, cutting, chopping, cooking, etc then you are able to save that time in the evening. You can even cook meals ahead of time and then simply reheat them for dinner. That works as well. Using left-overs is a great way to save time and money as well. If you make a large pot of soup that be easily stored in the refrigerator and reheated at another time will be helpful. You can use that chili, for example, as a stand alone soup or as a topping for baked potatoes. 

There are so many recipes that you can find online with ideas for quick and easy meals. Once you find a recipe that you like, save it and print it off. That way you can keep your favorites and prepare them again in a couple of weeks. 

When it comes to meal prepping, the key is to plan ahead and then do a little of that work ahead of time to save you time later. The hardest part to spending the initial time shopping and preparing the food items. Hopefully some of these tips and recipes help inspire you to do some meal planning this next week! 

Writing a Nutrition Care Note

So I totally understand that this blog post may not be super interesting to a lot of people. I know most of the people who read this blog are not necessarily clinical dietitians, but this has been something that has been on my mind. I never thought that I would feel passionately about how you should write a nutrition note for a medical record, but now after being a dietitian for 7 years I have opinions. I didn't want to go into clinical nutrition initially, but after working in a hospital for the past 7 years, I definitely feel strongly about a well documented nutrition note. 

I am not going to go through the whole note writing process, because that is boring to most people, but I do want to touch on the last section - The Nutrition Intervention. This is where you get to write what you did to intervene in the nutrition care of the patient, what goals you have moving forward, what you want to monitor and how you plan on evaluating what you monitor (like your professional opinion on the situation). This section I feel strongly about because it is the one place in your nutrition note, where you get to put on display your nutrition knowledge. It is where you outline how you plan to treat this patient and what you anticipate might transpire in the future. It is where your professional opinion is able to be shared. Lots of times I feel that some RDs just put the minimum information in this section. They just put that the goals are met and what they might like changed. They tend to leave out the part about their professional opinion, they might omit details that better description the nutrition problem listed earlier or they might not share what they anticipate might happen during the next week. That is what I feel like detracts from a well writing nutrition note. 

Example - (1) Diuresis has been as anticipated. Weight was down 1.9% from birth weight. Weight gain goals are ~19g/day.  (2) Infant is on TPN support and we are aiming for 92kcal/kg/day, 4g PRO/kg/day and GIR Of 4-6mg/kg/min. Currently the lipids have been turned off as we work up on enteral nutrition. (3) Infant has been having issues with bilious emesis. Infant does have Gastroesophageal Reflux and will have an upper GI done. Slowly working up on enteral nutrition. Feedings are running continuously to help with tolerance. We are using maternal breastmilk. Encourage and support Mom with pumping. Infant may also get donor breastmilk and this is appropriate as a back up plan through 34 weeks gestation/1500g. Total fluid goals are 130-150mL/kg/day and currently tolerating 142mL/kg/day. Monitor tolerance with feedings and working up on volumes and down on TPN support.

Now if you are not a dietitian, this may not directly apply to you, but this idea about sharing your professional expertise is important for anyone. If there is an avenue through which you can share your career expertise in a specific way in your day to day activities ... you should always take advantage of that chance. Taking the time to thoroughly share that knowledge helps to justify your job and show how you are an important member of the team. I know as a dietitian, I want to be respected and valued as a member of the nutrition care team and how I write my notes plays into that. I know there are similar examples for other jobs. When talking to my husband about writing code for data pipelines that he works with that is something that he can do in a neat and well organized fashion. Taking the time to write "clean code" shows his skills has a computer scientists and shows that he cares about the "product" or code that he creates. 

After going through 4 years of school, a year long unpaid internship and now working for 7 years, you better believe that I am going to highlight my nutrition knowledge in that Intervention section of each and every nutrition note I write! Hopefully this encourages you to find ways to highlight your expertise at your job and take pride in the work that you do! 

Breast Milk Versus Formula

I decided to delve into this controversial debate about breast milk versus baby formula. I thought this might be an interesting blog post for a couple of reason. First of all it had been in the media quite frequently after President Trump tweeted "The failing NY Times Fake News story today about breast feeding must be called out. The U.S. strongly supports breast feeding but we don’t believe women should be denied access to formula. Many women need this option because of malnutrition and poverty." 

So if you are wondering about this article that President Trump said was Fake News you can find it HERE.  I would encourage you to read through it and see what your thought are. The main accusation against the United States is the reported situation as follows ... "American officials sought to water down the resolution by removing language that called on governments to “protect, promote and support breast-feeding” and another passage that called on policymakers to restrict the promotion of food products that many experts say can have deleterious effects on young children." That might not have been that big of an issue, but when other countries didn't come to back the United States' proposed changes then things got more heated. "When that failed, they turned to threats, according to diplomats and government officials who took part in the discussions. Ecuador, which had planned to introduce the measure, was the first to find itself in the cross hairs. The Americans were blunt: If Ecuador refused to drop the resolution, Washington would unleash punishing trade measures and withdraw crucial military aid. The Ecuadorean government quickly acquiesced." That is the part that bothered me. I don't think we should go threatening countries to get policy changes. That is something that I think is wrong and seems to be behaving kind of like a bully. 

So that was kind of a crazy response to something like breast feeding. I honestly was quite surprised to read that article. Then there started to be more articles and other opinions written. and I wanted to make sure to share those with you too. I really liked this article by VOX because I thought it did a good job at outlining the main issue that was being debated by the United States and other countries. "The UN group responsible for setting the standards on how countries should regulate food products, the Codex Alimentarius, hasn’t yet decided whether follow-up formulas should be treated like infant formulas — as “breastmilk substitutes.” Calling them a substitute for mother’s milk would mean heavier scrutiny and regulation — something public health advocates want. The US wants to call it a food, not a breast milk substitute,” said Elizabeth Zehner, project director for Helen Keller International’s child feeding project, who was present at the Codex negotiations. “That will leave the door open for all countries to call these products as non-breast milk substitutes, so they will get advertised on TV — and they look just like the infant formula.” 

So that is the main part of the debate ... how to categorize this formula products. I know it seems like a simple issue, but it can have big ramifications. Food is a complicated thing and when it is regulated different can lead to a large variance in products. The supplement industry is that perfect example. That is the under the Food and Drug Administration and anything classified as a supplement doesn't meet the same scrutinized criteria as other actual food items. So companies can put whatever health claims on those products and they aren't held to the same regulations as the food industry. I would say most of the time that can be ok, but I understand the concern voiced in the VOX article about how toddler formulas are regulated, because if they are labeled as "breastmilk substitutes" that would change their nutrition make up and how they are marketed to families. 

There was another story published on NPR on this topic and I wanted to make sure you had access to that as well, CLICK HERE. I think that this debate is not other and the formula industry does have a lot more money to lobby with compared with advocates for breast feeding. They are pushing a product and want to make money. That being said I believe in a baby being fed and healthy and that can be accomplished through either breast milk or baby formula. The debate here isn't necessarily which is better nutritionally, the debate comes down to money and how these formulas are categorized. That will then have a big influence on the products that are manufactured and then marketed to families. I would say our country has come a long way in encouraging mothers to breast feed and educating families on why that is the best thing for your baby. I think like any basic mothering skill, there are so much emotion that gets ties into this topic and can lead to guilt and regret. That is another blog post, but I wanted to make sure that you got some information on this debate and maybe some more insight as to why the President cared if women were breast feeding or using formula. 

Saving Money and Sticking To A Budget

So this post is late. Normally I post on Mondays and I get that up in the morning or at least by the end of day. Well Monday came and went and I wasn't feel super inspired to write a post. There wasn't anything rolling around in my brain that I thought was super exciting to share with you. 

Well inspiration finally struck today. I figured I wanted to share some honest struggles with you about sticking with a budget and saving money. That is the most exciting things that I have been trying to work on recently. 

Our family has both myself and husband working full time. We make an "ok" salary between the two of us (especially compared to people in other countries we are very blessed). We also have our far share of loans. Between my husband's car and then his school loans we also have a decent chunk of our income going to pay for those things. When it comes to money we have save for retirement, but we needed to do a better job at saving our the rest of our income. The retirement is easy, because it gets deducted from your paycheck and you never see that money, but the money that you actually bring home is tougher to save. I try really hard to cook meals at home, but we do eat out occasionally. But I never thought we spent tons of money, but after some serious self-reflection we are working hard to try to change some habits and actually save more money. 

I have to admit, working at saving money is probably one of the most changing things I have done. I have done lots of hard things, but this has to be the slowest, and the hardest to stick with. We have really ambitious goals for our much money we want to save and to get there we needed to make some adjustments. We have cut out all extra spending. So we will still purchase things if they are needed, but nothing else extra. For example, on Amazon Prime Day we ended purchasing a bowel for William to learn how to use, dog treats for Einstein and a bike rake for Chas' bike so he can bike to work. Nothing extra, nothing that wasn't something we would already plan to purchase. 

Things I have learned ... 

• It is hard. When you try so hard to save and then you don't see that much more money in your account it is depressing. 
• You realize all the little things add up. That cup of coffee, plus that bottle wine or that time you went out to eat can easily add up to $50 without you noticing. 
• You have more free time. When you spend less money, you spend less time at stores and you have more free time. That is always a win. 
• Trying to find things to do that we can do for "free." We have memberships to a couple of museums and we can totally go enjoy those activities because they are already paid for. That is a great way to do something fun, but not spending more money. 
• Hang out with other people who are saving money. That always helps. There is nothing worse than hearing about someone's trip somewhere and you realizing you can't take a trip right now because you are trying to save money. So find some like minded friends and spend time with them! 
• Find ways to make enjoying at home fun. I have been trying to find cheap, healthy ways to prepare food at home and not miss eating out as much. For example, we made homemade Udon soup last weekend and it was amazing and way cheaper than eating out. 

Hopefully this post helps encourage you that if you are interested in working to set a goal, saving money or something else .... that you stick with that goal and moving toward that end goal. It is small steps that hopefully add up over time to big changes. But until then ... we will be hanging out at home, eating popcorn on our couch and watching Netflix and trying not to spend extra money. 

Healthy Holiday Picnic

I have been loving this summer weather. We are done with June and offically into July. That means lots of fun summer time activities and celebrating with cookouts and picnics. It is easy to some times think that there are not ways to include healthy foods at your next cookout. That is what I wanted to share with you today ... some creative ways to include healthy foods for your next picnic or cookout. 

Fresh Produce. The summer time means there are lots of fresh produce items that are in season. Your local Farmer’s Market or even the grocery store will be filled with healthy, fresh produce options that are all starting to be in season. From the berries to watermelon, tomatoes and lettuce all of these items are now coming into season. That means that you can purchase these fresh items more locally. They will be fresher and even more delicious. I would encourage your to include all of these fresh produce items into your cookout menu. They can be raw with a fun dip or you can throw these veggies or fruit on the grill to bring out different flavors. You can make a salad and combine a variety of different produce items with a delicious dressing. Lots of these fresh produce items are easy to pack up and take with you to an event. If you are looking for some good recipes - CLICK HERE for a great list from Clean Eating Magazine.

Temperature Danger Zone. When you pack up your food to take it on a picnic or when cooking out make sure that you keep your cold food cold and your hot food hot. It has been easy for cold food to start to warm up and get in that temperature danger zone. Try to keep your food outside the range of 40-140 degrees F. When your food is within this temperature range it can become a petrie dish for bacteria to grow and potentially cause food poisoning. When you pack cold food items, use ice or ice packs and keep them in a cooler. If you are bringing hot foods or preparing hot foods on a grill, make sure that you eat them right away and don’t leave them out so they fall within that temperature zone. 

Wash Your Hands. One more food safety tip, bring hand santizer. I know that sounds simplicist, but it is important to practice safe food handling, even when you are eating out at a picnic or cook out. If you are handling raw meat, ideally, use water and soap and wash your hands. Hand santizer is a good alternative, if you don’t have water and soap available. Keep your hands clean when you are preparing foods and when you are also eating food. 

Stay Hydrated. If you are spending an extended time outside, make sure that you bring plenty of drinks. With this warmer weather outside now, staying hydrated is very important. If you enjoy an alcoholic drink, that is fine, but remember that may lead you to getting dehydrated faster. Bring plenty of water or other healthy beverages. Watch out for sugary drinks, because those are often filled with unneccessary calories. 

Enjoy the summer and this chance to get outside and grill out. Try some new recipes and remember to keep your food at safe temperature to avoid any unwanted foodborne illness issues.