From the Archives: Infant Feeding

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Categories Breastfeeding, Feeding, Formula, HDYDI Blog, InfantsTags , , , , , 3 Comments

Link Party Button #milkingitI wanted to take this opportunity to highlight the variety of posts here on How Do You Do It? on the subject of infant nutrition, whether breast milk, formula, or some combination. Obviously, there have been several posts over the past several days, but there’s a larger body of wisdom and experience that The HDYDI Moms have gathered here over the years.

Breastfeeding

WBW-Button-150

Expressed Breast Milk (EBM)

Breast Milk and Formula

Formula Feeding

Feeding Tube

We don’t actually have any posts on long-term NG-tube feeding on HDYDI yet, but we have a couple of post-NICU feeding tube mamas in our ranks. If you have questions, please let us know.

Weaning

Infant Feeding in General

Phew. Is anyone else emotionally worn out from the heartfelt intensity of the breastfeeding posts here and elsewhere over the last few days? I cried writing my own post and cried again reading the others. It was cathartic, but it hurt like crazy.

Feeding our infants strikes me as being representative of motherhood in general. We put every part of ourselves into being the best moms we can be, but we never feel that we’re doing quite enough. Or maybe that’s just me.

Do you have other online infant feeding resources to share? Please tell us about them in the comments.

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Foodie Friday: A Healthy Debate

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Categories Books, Feeding Older Children, Foodie Fridays, Health, Mommy Issues, PerspectiveTags , , , , 3 Comments

DDSeinfeldDo you ever cook dishes in which you hide nutritious ingredients that your family would usually refuse? Many home cooks have been doing this for decades, but Jessica Seinfeld’s book Deceptively Delicious shows how mainstream it’s become to sneak fruits and vegetables into our children’s food.

SaraBeth’s Perspective

My husband is a picky eater.  I resigned myself to the fact that I’d need to get him eating better before we had children so he could set an example.  I see “sneaking in” some standard vegetables to be a great way to make a comfort food favourite into something with a little more nutritional punch.

I bought the Deceptively Delicious book for my sister at Christmas a number of years ago for her eldest daughter who lived on a beige diet of bread, chicken fingers and milk.  I decided to adopt some of the ideas for us adults to get us into the habit of getting a little more nutrition without sacrificing the flavor.

After reading Deceptively Delicious myself I started using some of the fundamentals of the book to get us eating a little bit better.  I’d routinely add spinach to casseroles, stews, sauces, eggs, I’d add a cup or two of bananas or blueberries to my muffins or pancakes or I’d make soups that pack a lot of blended vegetables to get us eating a little more green.  I sometimes even try some desserts that focus on fruits more, but would make those anyway because they taste so good.

When the minions were born my husband and I had a big talk about integrating food in a way that would get them exposed to a variety of different dishes, spices and so on.  Luckily both of our kids are good eaters, my daughter has a bit more of an adventurous palette with a penchant for spicy hummus, dill pickles and curries.  My son is a bit more meat and potatoes guy but still regularly chooses sliced vegetables and fruits for his meals.

Sometimes we need a bit of help reaching our fruit and vegetable quota for the day, parents and children included.  I think that adding fruits and vegetables into certain dishes has become more of a healthy recipe revolution than a sneak attack.  Then again I haven’t resorted to dehydrated kale chips or mixing spinach into chocolate shakes just yet, but I know that my children and their tastes change every day, so never say never.

Sadia’s Perspective

It took becoming a parent for me to realize that I wasn’t the expert on child-rearing I had always fancied myself to be. One of my most humbling realizations is that my M is an enormously picky child when it comes to food. Despite her willingness to try all sorts of things when we was a young toddler, she is picky, picky, picky today. I walked my talk and exposed my daughters to all sorts of flavours and textures when they were younger. Still, M has turned out to be difficult to feed.

I worried about M’s nutrition. Every time she refused a meal, I pictured her sliding even farther away from the growth chart than she was already. I decided to jump on the hidden food bandwagon. I hid pureed beans in muffins to give her a protein kick. I made my own ketchup from tomato paste, Worcestershire sauce and pureed whatever-vegetable-I-had-on-hand. I hid cauliflower in macaroni and cheese only to discover one day that M suddenly hated mac and cheese, with or without cauliflower.

It was during a regular review of my parenting priorities that I began to realize that hiding nutrients wasn’t for us. My first life priority is the girls’ immediate well-being, and hiding sneaky recipes accomplished that. My second priority is their long-term well-being. I realized that by hiding the good food I was providing my daughters, I was standing in the way of their learning how to make good food decisions. I decided that teaching J and M good decision-making was more important than their food intake on any given day. For a while, I tried sneaking vegetables into the girls’ meals and also offering them what I wished they would eat. Before long, I got rid of all my sneaky recipes, and I haven’t looked back.

On occasion, J or M will refuse to eat the meal I’ve prepared. Instead of getting all flustered, I have the ungrateful picky child prepare a meal for herself. Lunch and dinner at our house must include a grain, a protein and a fruit or vegetable. A tortilla, a fistful of cashews and some apple slices? Sure. Cheerios, deli meats and carrots? Why not? Cinnamon toast, refried beans and mandarin oranges? Whatever, honey. I’m not seeking elegance, just nutrition.

The takeaway

Sneaking ingredients that your family wouldn’t eat into food that your family will eat is a great tool, but it’s not for everyone. If you’re struggling to get your children to eat a balanced diet, it may be worth a shot. Check out some ideas.

What do you think about “sneaky” recipes?

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Corn Syrup in My Babies’ Formula?

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Categories Anger, Formula, Frustration, Infants, Medical, NICU, PrematurityTags , , , , 1 Comment

I gave birth to my twins, J and M, when they reached 33 weeks gestation. They were 7 weeks shy of being a fully cooked 40 weeks along when they were born, and 2 weeks early even for my minimum goal of 35 weeks. We were incredibly fortunate that they didn’t have any serious complications, but both babies still needed special care in the NICU.

I’ve always been a parent who researches, so I was pretty well-versed on the phases of development the girls were going through at various points in my pregnancy. Still, seeing my preemies brought it home in a visceral way that no research could have done.

A very small newborn, with lots of cords and wires all over her.Both M and J were rather furry when they were born, covered with lanugo, or the in-utero hairs that usually fall off well before babies emerge from the womb. I could only distinguish this fur from their eyebrows with the help of the thin line of hairlessness that separated their foreheads from their brows.

The girls’ skin was loose on their bones. After all, they hadn’t yet reached the milestone of 35 weeks, when their baby fat would make them newborn plump. Without the natural insulation of my body or their own body fat, they had to stay in warming isolettes. They couldn’t maintain their body temperature, so the hospital staff did so artificially. On two priceless occasions, we were allowed to provide kangaroo care, placing our tiny little babies inside our shirts, against the warmth of the skin on our chests, letting them bond to us.

Infants who will be born full-term are still getting their nutrition from the umbilical tube at 33 weeks and nearly 2 months afterward. Oxygen and nutrients cross from mommy’s blood to baby’s in the placenta. Getting energy and the building blocks to grow their bodies doesn’t take any work on their part. They can focus on growing, practicing sucking and kicking and, if they’re lucky enough to share the womb with Sissy or Bro, play with their best bud.

My girls were born at 3 lbs 6 oz and 3 lbs 9 oz. They weren’t to have the easy nutrition the placenta granted them. Instead, they were going to have to gain weight with the help of calories they ingested orally. At 33 weeks, babies are usually well practiced at the art of sucking, but they’re not built to use that skill to take in all their nutrition. To help them out the nurses threaded feeding tubes up our teeny babies’ noses, directing food into their stomachs.

That food came in the form of Enfamil Lipil, a high calorie formula for preemies. M and J needed nutrition to provide not only the basics they would have received from my body, but the extra energy they needed to breathe and otherwise experience life outside the womb. Much as I was committed to breastfeeding, breast milk wouldn’t cut it. It just didn’t have enough calories.

Besides, my body was trying to figure out what was going on. Were there live babies to be fed, or was it time to get out of reproductive mode? I’ve known moms with micro-preemies whose milk never came in, their bodies interpreting the early birth as a miscarriage instead of a live birth. Despite my pumping every 3 hours started a couple of hours after the birth, it took days for my milk to come in. A full-term newborn can afford to live on colostrum for a day or two, since they have plenty of energy saved up in all that squishy baby fat. My babies weren’t squishy.

The nurses at the hospital were (with one exception) fantastic. They took every teeny tiny drop of colostrum or milk I could squeeze out. To retrieve it, they filled the doll-sized bottles I pumped into with formula to retrieve every spray of breastmilk. They split that formula in half and fed it to each of my daughters through their feeding tubes.

Lipil Ingredients. The first ingredient is corn syrup solids.I hadn’t done any research into formula before M and J’s birth, being completely committed to exclusive breastfeeding. It never occurred to me to check the ingredients on our hospital-issued formula. I thought of it as medication, something beyond my area of expertise that I should entrust to medical professionals to prescribe. Imagine my surprise, then, when years later I finally read the ingredients and discovered that my babies’ high calorie formula got its high calories from corn syrup. Corn syrup was actually the first ingredients, meaning that there was more of it in the formula than any other ingredient. The composition of the formula has since been changed, but boy, did I feel silly claiming that my daughters’ first refined sugar was the cake at their first birthday party.

Sugar is sugar, I know, but I prefer to eat and feed my family minimally processed foods. I don’t like the idea of ingesting trace amounts of stuff used in processing. Don’t get me wrong. I buy prepared foods like sliced bread, lunch meats, chocolate (lot of chocolate) and crackers. I try to steer clear of non-sugar sweeteners and high fructose corn syrup. I like ingredients to don’t force me to fight the urge to start drawing out organic molecule structures.

We live and learn. If I were to do it again, I would research everything going into my newborns’ bodies. Perhaps I would decide that that brand of high calorie formula was the way to go. Perhaps not.

I always read the ingredients now.

Sadia is raising her 7 year-old identical twin daughters, M and J, in the Austin, TX area. She is divorced and works in higher ed information technology. She is originally from the UK and Bangladesh, but has lived in the US since college.

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The Soda Culture

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Categories Feeding Older Children, Mommy Issues, Other people, School-AgeTags , , , , , , , , , , , , , 13 Comments

The first graders at my daughters’ school took a field trip to see Dr. Seuss’ The Lorax. I’m all for field trips. If this one got kids excited about Dr. Seuss and reading, so much the better.

There was one thing about the field trip announcement that bothered me, though. The movie snack pack would include popcorn, soda and a treat.

This note describes a school field trip to see The Lorax.

Am I alone in the universe in thinking that giving 5- to 7-year-old children soda to drink crosses a line? The popcorn, and even the candy, don’t bother me much. We eat both these things at home, in moderation. Adding soda to that, though, seemed like too much. All the more astonishing to me was that my girls weren’t even offered water, even though I’d jotted a note on both their permission slips requesting water for them. At lunch, too, they told me that they were only offered sodas.

J and M’s first exposure to sugary sodas was soon after we moved to El Paso. They were given it at daycare. They then stopped going to daycare, and fast. Once they’d had a taste, I didn’t think that forbidding sugary drinks would accomplish the goal of good decision-making. Instead, we struck a deal. When I drank soda, they could drink soda. This has been keeping us all honest. We limit ourselves to a sweet drink, other than juice or milk, once a month, just as we limit chocolate and other candy to once or twice a week.

Obviously, kids drinking soda is part of the culture here, but is it any surprise that we have an obesity problem? How can I encourage the kids to choose healthy options when their peers often don’t?

How do you go about bucking trends or local culture when you want your kids to choose differently?

Sadia, her husband, and their twin 5-year-old daughters, M and J, are still learning about the culture of the Borderlands, following a move to El Paso from Central Texas in August 2011.

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Ask the Moms, part 2 – Pregnancy nutrition

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This week’s question comes from Shree, who is about 20 weeks pregnant with mo/di twins. She wants to know what the moms of How Do You Do It? did with regard to nutrition during pregnancy, and whether or not we followed the guidelines in Dr. Luke’s book, When You’re Expecting Twins, Triplets or Quads. She also has the special concern of being a vegetarian, wondering about getting all she and the babies need while avoiding meat. So, here we go. Ask the moms, and we shall answer. This one’s for all the pregnant ladies in the hizzouse…

Yours Truly (Goddess in Progress) – Stats: gained 65 pounds (lots of retained water/swelling at the end), delivered at 36 weeks, baby weights were 6lb2oz and 4lb8oz.

I did read Dr. Luke’s book, and thought the recommendations were good in theory, but insane in practice. I thought I’d have to immediately quit my job so that I could eat, drink water, and sleep all day long. But I did try to make sure I was eating a fair amount, and while I did not forgo junk food altogether, I remember wanting to feel like most of the things I was consuming had at least some positive nutritional value. At work, I’d often take an early break in the morning and go to Starbucks, where I’d get one of their sausage and egg sandwiches (so tasty, plus protein – bummer that they’re discontinuing them!) and a chocolate milk (dairy!). A favorite workday lunch was stir-fry from the Thai place around the corner – lean chicken and lots of veggies. I definitely paid a lot of attention to having a source of protein at every meal. I also knew I needed extra iron, which I used as a great excuse to have cheeseburgers frequently. :-) I briefly, after reading the Dr. Luke book, created an elaborate spreadsheet to see if I was getting all of my servings every day. I don’t think it lasted 24 hours. Ah well. Oh, and then there was the water. I started the pregnancy with a minimum of two quarts a day. By the end (yay, pregnant in July), my trusty Nalgene and I made it through well over a gallon each and every day.
From the archives: Here’s what I thought when I read the book, and a wake-up call over the importance of hydration.

Cheryl – Stats: Gained 45 pounds (but lost a few before delivery), delivered at 36w5d, baby weights were 5lb14oz and 4lb14oz.

When I picked up the [Dr. Luke] book (mid-way through my pregnancy), I did feel a bit intimidated by it…my doctor assured me that I was on target weight gain-wise, so no, I decided it would be more stressful than helpful to attempt…especially with a “belated” start. Naturally dodged the recommended “avoids,” and genuinely tried to get more protein “down.” Nitrates I know are oft-verboten, but I craved gas station hot dogs (yes, the spin in the grease kind), and relented often. Since that was an a-typical craving for me in a non-pregnant state….felt it must be one those “trust your body” motivations. (Doc okayed in moderation!) Ate a lot of double cheeseburgers as well…protein intake was a primary concern nutritionwise for me. Did eat a great deal of dairy, too….always felt like the preggers Lucy Ricardo when I did! If I had to define the “diet” I followed, I’d have to say I went with the “Go With Your Gut” diet! Our kids were slightly small for their gestation, but both were breathing well and did great from the get-go, requiring no NICU time at all…nursery gen pop right away! With the benefit of time, we now know our “smaller” baby, our daughter is simply DNA destined — as opposed to prematurity/prenatally predisposed due to diet — to be small/svelte. She’s been a 3% weight curve girl and just now at age six rose to the 10%. Nuts and tofu were big satisfiers for me, as were yogurt, ice cream and homemade milkshakes and smoothies. If you are finding a craving a true craving (a palpable compulsion as opposed to “Hey, I can have 70 cookies, I’m pregnant!”), so long as it poses no danger (ask the OB-GYN), I’d go with it!

American Wife – Stats: Gained about 50 pounds, delivered at 37 weeks exactly, baby weights were 5lb7oz and 4lb14oz (no NICU!)

I don’t even know who [Dr. Luke] is! I did not avoid eating anything, unless it made me physically sick! I couldn’t drink coffee, or eat any fish that I cooked (yet I could eat cooked fish from a restaurant, as well as sushi). I tried to work in lots of Omega 3’s, so I used the Smart Balance PB, and ground flaxseed (which can go into almost anything). Also when I made mac n cheese, I used cottage cheese instead of milk for extra protein. My advice is to mix proteins and fruits! Cheddar cheese & Granny smith apples! Peaches & Fresh mozzarella with a little bit of balsamic (MY FAVORITE!). Salads with walnuts/pine nuts, fruits (mandarin oranges are good), and dark leafy lettuces/spinach with balsamic dressing. Another thing I did was to make smoothies using frozen and/or fresh fruit and either yogurt, soymilk, or sometimes tofu. I got lots of recipes from vegfamily. Here’s a decent guide to some foods that have important vitamins. A few more suggestions. Oh, also don’t eat an entire quart of Dulce De Leche by Hagen Daas in ten minutes, trust me. It tastes great going down, but coming up….
From the archives: How I got off to a really bad start.

LauraC – Stats: Gained 54lbs, delivered at 36w3d, baby weights were 6lb3oz and 6lb1oz.

Dr Luke book: YES. I read it the day after I found it was twins (18 weeks) and followed it to a T. I ate 100g+ of protein every day and 4000-5000 cals a day, as directed in the book. I avoided anything that made me vomit (eggs, soy, nuts, beans). And I generally gave in to real cravings. I was a vegetarian for 10 years before getting pregnant. Every form of vegetarian protein made me instantly vomit for the length of my pregnancy. I made the decision that the health/growth of my boys was more important than my reasons for being vegetarian and started eating meat. You CAN have a vegetarian twin pregnancy but I would recommend reading nutrition labels to get accurate protein counts. The book “Your Vegetarian Pregnancy” was helpful to me too until my m/s got so bad. The only special thing you would need to watch is your iron level. You should talk to your doctor about that.

CarrieinAK – Stats: Gained 65-70lbs, delivered at 36 weeks, baby weights were 4lb11oz and 5lb6oz

I am not sure of the nutritional guidelines in the Dr. Luke book (I didn’t read it). I just tried to aim for about 3,500 calories a day (more than likely I ate around 4,000 calories), with around 75-100 g of protein…and a helluva lot of agua. I ate a lot of homemade egg salad, bean burritos and cottage cheese. I was a vegetarian for 28 1/2 years (raised that way), until I got pregnant and started eating chicken a couple of times a month. My body craved it. I did avoid soft cheeses, etc…all the usual guidelines. And I’d never had fish before, so sushi wasn’t an issue. Kids were born at 36 weeks (exactly) and they weighed 4 lbs, 11 oz. and 5 lbs, 6 oz. Reid had been diagnosed with IUGR, but once they were “out”, their weights were way different than the ultrasound said they were.

Krissy – Stats: Gained 49lbs, delivered at 39 weeks, baby weights were 7lb12oz and 6lb12oz.

I have to say that I didn’t count calories at all, but I did try to follow the basic March of Dimes guideline (24lbs by 24 weeks gestation.) I had major adversions to most healthy foods…could barely choke down a salad, which I typically adore. I tried to eat nutritious foods, but I definitely ate more high calorie crap than I ever had in my life. I avoided the usual stuff (soft cheese, fish, etc.) and avoided most artificial sweetners.

Cynthia – Stats: Gained 40-45lbs, delivered at 34w5d, baby weights were 5lb11oz and 5lb2oz.

I read the book cover to cover and then put it away. I applied some of the general concepts to my eating/shopping/cooking routines but I did not take the book out and try to follow verbatim. I avoided the soft cheeses, sushi and (obviously) alcohol and caffeine. Although I did have the occasional glass of red wine or cup of half-caf coffee to hold off a migraine. My concern was protein (see below) but I also just tried to eat veggies at every turn. Thankfully I enjoy them so it wasn’t too hard. I was not a vegetarian by choice. However, with pregnancy I tend to develop a severe aversion to meat (gag reflex and all). Particularly chicken, but pork and beef as well. I was religious about drinking high-protein Boost shakes (chocolate, of course) 3 times per day. My twins were misdiagnosed mono-mono until 23 weeks. I had read on the monoamniotic.org website about mommies drinking Boost or Ensure so I just started. Once I found out they were mono-di, I was still worried about TTTS and knew that Dr Delia (sp?) recommended protein shakes for those diagnosed. I figured if it helped once diagnosed, perhaps it would help to do proactively. At the end I felt so big that I was struggling to get in enough of anything (good or bad) during the day and I felt like the Boost helped me with the calories in that regard. I did put them in the blender with fudge swirl ice-cream somewhere around 30 weeks. A girl’s gotta do what a girl’s gotta do, right? :-)

Rebecca – Stats: gained 38lbs, delivered at 36w2d, baby weights were 6lb6oz and 5lb15oz.

So, no, really didn’t follow the Barbara Luke book. My weight gain got quicker towards the end. I had at least 2 weeks where I gained 4 lbs a week, which I think is what the Luke book doesn’t want you to do. Don’t they think you should do the weight gain pre-20 weeks? No NICU time. Roomed in and came home with us. Oh, I also had a really easy pregnancy—no blood pressure issues or sciatica or diabetes or anything. Or preterm labor–just my water breaking. I avoided unpasturized stuff, alcohol, all but one serving of caffeine a day, sushi, undercooked meats, cold cuts. Hmm, can’t remember if there was anything else. I tried to eat more protein than usual. I’m not a real big meat eater, so I tried to get chicken on salads, eat more cereal (for milk), yogurt, even some of the South beach diet bars, which have extra protein. I was also focused on avoiding empty calories, so I cut out crackers and cookies and stuff, for the most part, after the first trimester (first trimester, goldfish crackers were my friend).

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