My Top 10 Avoidable Physical Dangers for Kids

As a naturopathic doctor, I don't see a lot of emergency cases. Parents tend to know when they need to go to the ER, so I generally see kids for their follow-up care. But, as a mom who is also a doctor, I ponder questions such as: what do I worry most about for my child? Here are the physical dangers I worry about most for my baby, his buddies, and my patients, that are preventable, or at least whose damage can be mitigated.

1. Drowning
2. Accidental Gun Shots
3. Unrecognized Respiratory Distress
4. Accidental Marijuana Ingestion
5. Alcohol Poisoning
6. Accidental Over the Counter Medication Overdose
7. Falls From a Window
8. Obesity
9. Car Accidents
10. Vaccine Preventable Illness

Here are some suggestions for avoiding these, or mitigating their damage.

Drowning: a far too common cause of death and disability in children. Since it is entirely preventable, the onus is on us to beware the water. Remember, drowning does not only occur with swimming; it can occur in a few inches of water if the child is too young to move his head. Always supervise swimming and bath time. Do not leave buckets of water unattended around young children.  Keep toddlers away from the toilet unless they are supervised, or install a lock on it. Talk to your teenagers about drinking and swimming. Help them understand that drinking or doing drugs and swimming (especially cliff diving!), are not a good combination. Be aware of "dry" or "secondary" drowning.  If your child chokes on water, or has any sort of "near drowning" event," he is vulnerable to drowning at a later time.  Watch for coughing, trouble breathing, chest pain, changes in behavior, or fatigue.  If you notice anything unusual, even hours after the event, call your doctor or 911, or go to the Emergency Room.  If you do not already know CPR, take a class. You could be the one to save your own child's life, or someone else's. 

Photo by Lotzman Katzman; downloaded from Flickr without amendments

Accidental Gun Shots: if you decide to have a gun in your home, keep it locked in a safe, preferably unloaded. Ensure that the safe will not be accidentally opened by someone who does not know the gun is there. Hiding a gun is not sufficient to protect children. They are curious, persistent, and know no boundaries. There is no reason to think that your child, your child's friends, or your child's caregiver won't stumble upon it at some point. No matter your view on gun control, make 100% sure that your child and his friends are 100% safe.

When your child begins visiting other people's houses, especially if he will be there without you, ask the parents if there is a gun in the home. If there is, ask where it's kept and if it's loaded.

Unrecognized Respiratory Distress: respiratory distress is not always as obvious as you might think. Whether it's a viral infection in a baby, asthma developing in your older child, or a child with an inhaled foreign body, you could potentially miss it. Here's what to look for:

• fast breathing
• abdominal breathing: either the space where the ribs meet the belly or the V where the ribs, top of the belly, and xyphoid process all meet is sucking in with each breath
• retractions: the muscles in between the ribs are contracting with each breath, or the spaces just above the sternum or clavicles suck in with each breath
• nasal flaring: nostrils flare with each breath
• shoulder shrugging: the shoulders move up and down with each breath
• wheezing: this is generally only audible with a stethoscope, but you might hear it on the outbreath
• leaning forward, open mouth breathing, drooling
• unable to talk or walk normally
• cyanosis: blue lips or fingertips 

Image and more information on respiratory distress available here

If you notice any of these signs, call 911 or your doctor immediately. For more information, read this article.

Accidental Marijuana Ingestion: recreational marijuana is licensed in Washington State and Colorado now. I would expect more states to follow suit. This means that marijuana is more widely available. People who never would have used it or possessed it before, now do. Which means that when you go to a party, you need to find out exactly what's in the cookies. And the brownies. And the lasagne. It brings a whole new meaning to the question, "Mommy may I have a cookie?" Be sure to speak with your child's friends parents about this one too: find out if they have it, and if it's kept away from the children at all times.

Alcohol Poisoning: people have different ideas about how to raise children with a healthy respect for and a reasonable relationship with alcohol. I won't get into that here. But I do want to make sure that your child, whether a toddler or an adolescent, never gets alcohol poisoning. For toddlers this may be as easy as keeping it out of reach. Until of course they can reach it, which will come sooner than you expect - on the day they learn to move a chair over and climb on it. Also when your child starts going to other people's houses for play dates, find out where their alcohol is.

Obviously this may be easier said than done for adolescents, but think about it, research the options, discuss it with the family, choose a strategy, and most importantly, address it. Do NOT think that because your child hasn't brought it up with you that she's not being faced with it at school. And do NOT think that because your child is: obedient, an athlete, a straight A student, etc; that she is not thinking about using alcohol. For more guidance, here's a good place to start.

Photo by Daniel Lee; downloaded from Flickr without amendments

Accidental Over the Counter Medication Overdose: kids are curious. They will get into medications, supplements, essential oils, you name it. Iron is a big offender here. Ensure that all of your medications are stored in their original child-proof containers. Supplements and essential oils can be harder to deal with as they usually do not have child-proof caps. Store them out of reach and periodically ensure that your child has not gained the height or skills necessary to reach them.

Adolescents and child care providers may get into these substances too, very much on purpose. Have an idea of how many pills you have in any given bottle. Keep especially attractive / addictive medications like pain killers locked in a safe. If you have left-over medications, especially pain killers, take them to a drug take back location; do not save them for "next time."

Falls From a Window: this may sound crazy, but it does happen. If a child can get to the window, he can climb out of it. So leave them either closed and locked or open only enough that he can't fit through (as long as you're sure he can't open it further). Remember to think and act like a child. It might not be obvious that he can get to it, but if he climbs that and scoots under this, he's there. Be especially careful of windows that are elevated, but remember that even if he doesn't hurt himself going out the window, he's still now on the loose without you knowing it. Finally, know that kids have flown out of windows after bouncing on the bed, or rough housing in some way.

Photo by storebukkebruse; downloaded from Flickr without amendments

Obesity: all too common these days, and not necessarily because parents are overweight. It's an epidemic; one with terrible consequences. And despite the fact that we know how bad it is, how rampant it is, and what contributes to it, we as a country do not change our practices. So it's up to us as parents to bring our children up in a way that fosters healthy weight and healthy body image. Here's what to do:

• Avoid juice and sugary drinks (and artifically sweetened drinks - more on these in a future post).
• Avoid sugar except for occasional treats.
• Limit processed food, junk food, and white flour.
• Encourage fruits, veggies, and whole foods.
• Encourage physical activity. I don't use the word exercise with kids for 2 reasons: they naturally love to run and play outside in a very physical way; I think this wording encourages them to embrace that. I also think using the word "exercise" too much can make it sound like a boring adult activity being forced on them.
• Promote outside time - because fresh air is important for physical health, for mental / psychological development, and because if you're outside, there's a good chance you're moving your body.
• Foster good sleep. Poor sleep is an independent risk factor for obesity, so practice good sleep habits with your children.
• Limit total screen time. Do not allow screen time within an hour of bed; do not allow any screen in the bedroom. 

Car Accidents: can be hard to avoid. I'm sure you already do everything you can to decrease your risk (avoid alcohol and drugs, don't drive tired, no fiddling with the radio, no talking on the phone or texting). But since accidents happen, consider how to mitigate the damage. Wear your seat belt and make all of your passengers wear theirs too. Every time. Place your child in his car seat and lock the harness. Every time. Ensure your car seat fits in your car properly and that your child fits in the seat properly. Ensure that you are using your car seat properly.

Photo by Bradley Gordon / bradleygee; uploaded from Flickr without amendments

Vaccine Preventable Illness: I have many posts coming soon that address vaccines in detail. But for now I'll just make this plea: if you decide not to vaccinate, or to delay vaccines, be completely sure you understand the diseases your child is at risk for. I don't want any child coming down with meningitis or tetanus induced respiratory depression because of a lack of information. Be sure you are familiar with the course of the disease, the complications, and how it's contracted. Be sure you understand the risk you are taking by not vaccinating before you make your final decision.

Remember in medicine, the best policy is usually prevention.

I have no affiliations to disclose and no financial interest. This post does not constitute medical advice. If you have medical questions or concerns, call 911 or speak with your doctor.

Healthy Eating for Kids - Meals

I went to a diner this weekend whose kids menu included a sandwich, cheetos and a soda.  Why do restaurants all seem to have the same concept of kids food: peanut butter and jelly, grilled cheese, (fried) chicken fingers with french fries, macaroni and cheese and juice or soda?

At what point did we give up on kids eating nutritious food?  As I asked in a previous post, why do we swap pureed good-for-them baby foods for salty, not good-for-them, kid foods?

Photo by Rupert Ganzer; downloaded without amendments from Flickr

Yes, I am aware that kids go through a picky phase.  But you can minimize the impact of this phase.  You can continue to offer nutritious foods after your kids are finished with baby food and until you are no longer feeding them.  If they never know foods like mac and cheese and french fries, or if they are largely unfamiliar with them and know them only as treats, then they won't fight you (or they'll fight you less) on the roasted chicken with green beans and potatoes.  

Of course, kids, like adults, have their likes and dislikes, and some kids just don't like green beans.  For those kids I say, don't offer green beans (provided of course you've offered them 10 times in a nonchalant, no-pressure way as I mentioned in a previous post.)  And for the kids whose list of dislikes is more extensive, here are some suggestions: 

Photo by Luis Tamayo; downloaded from Flickr without amendments

Tips for Picky Eaters

1. Persistence:  Continue to offer the foods they don't currently like on an occasional basis in a nonchalant, no-pressure way.
2. Creativity:  Expand your own food horizons by offering them vegetables and other healthy foods that you are not in the habit of cooking, and that are not on their list of dislikes.  Use variety in spices and cooking methods.  Some kids just want variety (as do most adults). 
3. Emotion-free eating:  Remember everything I mentioned in "Growing Healthy Eaters." Release your emotional attachment to their eating.  Keep providing varied healthy food, in a non-attached, nonemotional way. One day, they will surprise you. 
4. Rules:  Don't be a short order cook.  Set the expectation that the whole family eats the same meal.
5. Reliability:  Make sure the family meal includes some foods they do like and will reliably eat.

Also, yes, I have met the child who can go for days surviving on one bite of peanut butter toast and an orange.  I've heard them called air-etarians, or air-ivores.  It can be very stressful for parents to feel that their child is not eating enough.  But trust me, kids will eat when they need to.  Of course, there are exceptions to every rule, and if you have a child who has any sort of special circumstance or need, or if your gut tells you something is wrong, then please, make an appointment with your child's provider for an evaluation.  Otherwise, here are some suggestions for the child who just doesn't eat:

Photo by Patrick Feller; downloaded from Flickr without amendments

Tips for Food Avoiders

1. Persistence:  Continue to host meals at the table, at routine times, away from the TV.  Have as many family members as possible at the table for meals.  The more the family all eats together, the better.  I don't believe a child should feel tortured by having to sit at the table, so make it engaging for them.  Talk about how everyone's days went, and include her in the conversation.  Talk about the food you're eating and where it came from.  Talk about gardening, farming, ranching, and the culture and history of the food you're eating.  (Note: for older children, doing a little research before dinner into these subjects can trigger interest and more fruitful conversations).  You'll have to find the balance that works for your family as far as how long your child should sit if she's not hungry, and how far to go to make it engaging for her.  I do not advise bringing books or toys to the table.  Keep it about food and family.
   
   Photo by US Dept of Agriculture; downloaded from Flickr without amendment
2. Nutritious Snacking:  Snacks are an important part of a growing child's life, but they can blossom out of control.  Make snacks part of the daily routine.  Once or twice a day, sit down with your child at the table (or at the picnic table if you're at the park), and have a nutritious snack.  Do not let your child wander around or play while snacking.  Minimize snacks eaten in the car or otherwise on the go.  Do not fill her with empty calories.
3. Swapping Meals For Snacks:  In regards to #1 and #2, if your child is consistently jumping up from the table at meal time claiming she's not hungry, only to come back 45 minutes later for a snack, then some trouble-shooting needs to occur.  She needs to eat that meal rather than that snack, so start by altering the schedule.
4. Reliability:  At meals and snacks, offer foods you know she likes (as well as some she doesn't, as mentioned in the previous set of suggestions).  Be creative to maximize variety.  New spices, new foods, and new cooking methods can be very helpful.
5. Involvement:  Continue to involve her in food shopping, food preparation, and food culture (see below).

Photo by Jaro Larnos; downloaded from Flickr without amendments

Ways To Involve Your Child In Food

1.  Food shopping:

• Set yourself up for success:  go at a time of day when you both are at your best, not tired, and not in a rush
• Make shopping fun: go to a farmer's market, a produce stand, or a store you don't always go to
• Ask your child what he wants to buy (while you're in the produce section, not the candy section!)
• Give your child a choice: e.g. "We need a vegetable for tonight, would you like to pick it out?"

2.  Food preparation:

• Have your child sit down with you on Sunday and plan the week's meals together; then make the grocery list together
• Place your child in charge of clipping coupons, or looking online (supervised of course!) for good deals of the week
• While cooking, have your child stir, dump foods from a bowl into the pan, tear lettuce, cut soft foods with a plastic knife, operate the salad spinner, etc.
• Garden with your child (even if it's just growing basil in a pot in the window) 
• Make it fun: make your own pizza night, pasta bar, etc - prep everything together in the kitchen, and bring it all out for everyone to assemble as they like (don't forget to include veggies!)
  
  Photo by Coqui the Chef; downloaded from Flickr without amendments

3.  Food culture:

• Go to food events like the Bite of Seattle or the Herb and Food Fair at Bastyr University
• Go to Farmer's Markets, the Pike Place Market, You-Pick Farms, Pea Patches or other community gardens (sometimes they have fun events at the gardens) 
• Discuss and celebrate the culture of origin of your dinner (afternoon project: research the culture and find a fun fact)
• Wear sombreros at taco night, wear saris for Indian night 

Sneaking Nutrients In
Sometimes you may want to experiment with stealthily boosting your child's nutrition. Most kids will reliably eat marinara or pizza sauce, so puree some vegetables and add them in.  Find other sauces you know they will eat and do the same.  Make zucchini bread instead of banana bread.  Add raw greens to a smoothie (as long as they will tolerate a green smoothie!)  There's a book called Deceptively Delicious that you might want to sneak a peek at.  

Most importantly, breathe.  Take my suggestions, but make changes slowly; don't stress yourself or your family out.  There's enough stress in life; I do not want to add to yours.  But I would be so happy to see restaurants change their kids menus to include healthy choices because consumers start demanding it!

I have no affiliations or financial interests to disclose.

The Principles of Naturopathic Medicine, or How Red Sorrel Taught Me What I Already Know

I was recently diagnosed with a serious problem: red sorrel in my yard.  I knew it was there; I watched it spread from the parking area last summer to my yard this spring.  I saw those blades of beautiful red flowers waving in the breeze all over my yard.  But I had no idea that I had a problem.  When my neighbor came over and gave me the diagnosis, I tried not to panic.  I did what any good patient does - I got on the Internet.  I found some optimistic and cheery sights touting its great culinary and medicinal uses.  But mostly I found sites that were frightfully useless.  They were all about the same: a description of the weed and a picture (thanks, but I got that part), a description of where it likes to grow (anywhere and everywhere), and an explanation of how to manage it (you can't - just forget it; give up before you even try).  These web sites always mentioned that you could try this or that weed killer, but only in spot treatments.  I'm not certain what constitutes a "spot," but I'm pretty sure it's smaller than half my yard.  You could probably guess that I'm vehemently anti-weed killer, but these guys are telling me that even if I were up for using it, I can't because it's only a spot treatment?  So do I have any options?  Should I sell my house?  Rip up the top 2 feet of yard and start over?

Red Sorrel: Photo by Jacob Enos; downloaded from Flickr without amendments

Alas, I have not found a miracle cure to rid my yard of the dreaded red sorrel. But, being certain that I didn't want this noxious, invasive weed taking over the rest of my yard and the strawberries I just planted, I decided I had to maintain hope.  Why am I telling you this story?  Because this terrible weed is reminding me of valuable lessons I already know about life and medicine.

Again, like any great patient would, I looked deeper into the Internet. (Do you hear the sarcasm in my voice?  Maybe soon I'll write a post about Dr. Google and its followers).  I hit the jackpot: two different blog posts outlining attempts to kill red sorrel organically.  One says the only thing she did was add nitrogen to her soil and the following spring, problem (almost entirely) solved.  The other says she's about to try adding sawdust and manure mulch, which she has heard can work.  Sadly, this one gave no follow up posts, and has not replied to my inquiries.  No matter; I will believe.  I will continue my quest with vigor.  I will dig out the sorrel, replenish the soil, plant native plants, and start nurturing my yard (something that has not happened in at least 2 years since I've been busy with other parts of my life).  I will believe that I can get past the sorrel fiasco, even if the Internet tells me otherwise. 

This story of restoring land health is strikingly similar to that of restoring human health.  It follows the principles of naturopathic medicine and the therapeutic order of healing so well that I just had to write about it. 

Photo by Sean Mason; downloaded from Flickr without amendments

Principles of Naturopathic Medicine

The Healing Power of Nature
Naturopathic medicine believes that nature, and the human body, have an innate healing power.  Given the proper foundations of health, and the appropriate support, the human body has the ability to heal itself of illness.  Someone who is ill and eats a diet of strictly processed foods, drinks nothing but diet soda, and lives with an abusive spouse may not experience this power.  But if that same person begins to eat fresh vegetables, drink clean water, and amend emotional health, nature may now be uncovered and allowed to work toward healing.  I believe that once I provide my lawn with the foundation of health (water and nitrogen) and the appropriate support (strong native plants), that it will heal itself of the red sorrel. 

Western Trillium:  Photo from Mount Rainier National Park's photostream; downloaded from Flickr without amendments

Identify and Treat the Cause
We NDs don't just say "well you've got constipation, here's a prescription for a laxative."  We dig into the root cause of the constipation - why is your body responding this way?  Is it diet?  Is it emotional? Is it a genetic syndrome?  Is it an anatomical malformation? 

Why do I have a sorrel infestation?  Because I wasn't paying attention.  I let it grow without finding out what it was.  I was focused on everything in my life other than my front yard.  I was putting it off for later, when I had time.  My yard was not watered once last summer.  It was about half grass half dandelions and moss at the time the sorrel came to town.  I planned to dig it out and replace it with native plants one day.  But in the mean time, I was completely ignoring it.  Just as we so often ignore our health.  We know one day we will start exercising, increase our veggie intake, or start making time for ourselves.  But when does that day ever come?  Often it comes when there's a major problem.

First Do No Harm
Drugs?  This is a question I ask a lot when I see patients.  Will they help?  Will they harm?  Are they immediately necessary or can we try something else first?  Sometimes, drugs are immediately necessary; often they are not.  Drugs, as well as any intervention, can cause harm.  The question should always be, do the benefits outweigh the potential harm? 

Weed killer?  My 2 year old plays in this yard, digs in the dirt, rubs it on his face, breathes the air that comes off of it, and sticks his fingers in his mouth before we can get inside to wash them.  Do I really want residue of something designed to kill left on this lawn?  And what about the watershed?  Weed killer runs off our lawns and straight into our rivers and streams.  This is not an insignificant problem (see links below).

Photo by Fletcherjcm; downloaded from Flickr without amendments

Doctor as Teacher
You better believe I have become the greatest anti-invasive plant evangelist there ever was.  Sometimes I think I just might have the time and energy to pursue a side career in landscaping specializing in native plant restoration. 

Treat the Whole Person (Yard)
Rather than seeing a patient with symptom X and prescribing drug Y, we NDs like to get a list of all the symptoms, determine why the body is expressing these symptoms, and address the root cause of these symptoms with natural interventions.  So, for constipation in a child, I don't jump to prescribe a laxative.  I find out what the child eats and drinks; I ask about emotions and emotional support - is this a child who can't let go of anything, or who can't use a public bathroom?  I ask about other symptoms.  I might prescribe increased water consumption and diet improvements.  I might prescribe counseling.  I might uncover emotional stress at school and prescribe cooperating with teachers to address it.  The prescription will be individualized and address the child as a whole person.  What I've found with the dreaded sorrel is no different.  I can't solve this problem with a single solitary action.  I'm going to have to remove the offending agent, nourish the health of the soil, add strong native plants that can fight off the sorrel (probiotics?) and continue to promote health in the future. 

Prevention and Wellness 
Generally, the best way to prevent illness is to promote wellness.  A well fed, well watered, happy, emotionally attached, cared for human who exercises, gets lots of fresh air, and relaxes and sleeps well, will typically be healthier than one who does not, and will often be sick less often, less severely, for less time.  Apparently, the same is true for my lawn.  A lawn that goes an entire summer and then some without water, that is growing in soil that has never been nourished, seems to be a bull's eye for a hostile take-over.

Photo by Lindsey Turner; downloaded from Flickr without amendment

The Therapeutic Order

NDs prefer to use the lowest intervention possible for each patient's treatment plan.  Here is the order: 

• Determinants of Health - Are the following needs being met for the patient: adequate clean water, fresh air, exercise, adequate nutritious food, emotional and mental health?
• The Healing Power of Nature - Is something preventing the body from healing itself?
• Tonify Healing Systems - E.g. series of structured sweats, hydration, and increased exposure to fresh air.
• Correct Structural Integrity - E.g. is the gut lining damaged by years of exposure to a poorly tolerated food?
• Symptom Based Naturopathic Treatment - A specific natural product that treats a specific symptom of illness without addressing the root cause; e.g. licorice for heart burn or calendula for mouth sores.
• Symptom Based Pharmaceutical Treatment - A specific pharmaceutical that treats a specific symptom of illness without addressing the root cause; e.g. Ibuprofen for headaches.
• High Force Interventions (e.g. surgery)

Echinacea: Photo by Nomadic Lass; downloaded from Flickr without amendments

With each patient, we choose where we need to come in on the Therapeutic Order, based largely on the extent of the illness at hand, but also on the patient's abilities and desires.  

With my red sorrel, I considered, for about a half a second, coming in at symptom based pharmaceutical treatment: weed killer.  But, I learned it wasn't an option, and I would have been unwilling to do it in the end anyway.  So, I'm coming in at determinants of health, the healing power of nature, and correct structural integrity. 

Sadly, you can't always cure a disease.  Some patients will die of their diseases, and some will live with them chronically.  But you can always help a patient, if you seek the opportunity.  At this moment, I have to believe that I will cure the disease, that I will beat the sorrel, that I won't still be battling it in 5 years.  But I may be.  And at least, the patients (me and the lawn) have been helped.  I think it's obvious how my lawn has been helped (sparkly new plants!)  As for this patient, I've seen how the idea of foundational health applies to the earth.  And I've been reminded of the tantamount importance of these foundations of health for the wellness of my family, my friends and their families, and the globe.  Okay sorrel, lesson learned.  Thank you, you may go away now!


Resources:
Roundup linked to health problems
Roundup's inert ingredients kill human cells
Weed killers in our water
Pesticides as Water Pollutants

I have no affiliations or financial interests to disclose.

Healthy Eating for Kids - Snack Food

Why is it that when I walk into a day care snack time, I see kids eating pretzels, goldfish, crackers, or other variety of simple carb loaded with salt and almost void of nutrition?  Why, when kids gain the ability to feed themselves, do we swap their pureed veggies, fruits, meat, and grains, for crunchy, salty, refined white flour products in a plastic bag?  

Sure, I know that it's easier.  But is it even a conscious choice anymore?  Or have we all been lulled into forgetting the wise old adage that we are what we eat?  

Please don't misunderstand me: I'm all for the occasional treat, and for enjoying food in a relaxed manner.  However, I firmly believe that our children should be snacking to nourish, not just to fill their bellies.  Snacks should provide protein, vitamins and minerals.  To be fair, the bagged crunchy treats do provide vitamins and minerals - they are artificially inserted after processing removes the nutrients which nature provided.

Photo by Linda Aslund; downloaded from Flickr without amendments

There are folks who will argue that nutrients are nutrients, whether they occur naturally in your food or are added as part of the processing.  I do not agree; I believe it's incredibly important to obtain nutrients from whole foods, the way nature intended. But that argument is beyond the scope of today's blog.  There is no argument that whole foods contain certain nutrients that are not available in processed foods (the polyphenols in berries is one example).

Protein performs a variety of vital jobs in our bodies, and therefore must be eaten in adequate amounts throughout the day.  Most adults in the US eat too much meat, and therefore too much protein.  However, many kids in the US do not get enough protein at a given meal and do not eat protein frequently enough.  This is due in part to taste (many kids only like certain protein foods served in particular ways) and in part to what's offered to them.  One of protein's most important jobs in a child's life (and the adults who care for that child) is to balance blood sugar, thereby preventing emotional melt-downs.  But it's also important for growth and development of the body and brain, for proper immune system functioning, for clear thinking, and for physical energy, as well as for many other bodily functions. 

Photo by James Emery; downloaded from Flickr without amendments

All this is to say, let's make better choices when it comes to finger and snack foods for our kids.  Let's call out salty crunchy white flour products for what they are - treats.  Let's take this opportunity to boost immune systems, lower obesity risk, flatten emotional roller coasters, and promote a love of healthy food. And parents, don't just do this at home - talk to your child care providers about improving food choices at their establishments too. 

My top 5 nourishing, non-protein snack foods:

1. grapes (watch out for choking in the younger crowd)
2. berries
3. roasted yam bites (this is a recipe I use all the time, however, I don't cook on aluminum; I use cast iron.  Look for more on this in a future blog post.)
4. baked oatmeal bites
5. baby carrots (steamed if you're feeding a younger child)

My top 5 protein-rich snack foods:

1. peas
2. roasted chick peas
3. cheese - sliced, cubed, or sticks
4. cubed deli meat
5. hummus 

For a well-rounded, protein-balanced snack, choose at least one from each list to offer at each snack.  These foods made my top 5 based on their nutrient density, appeal to kids, ease of prep, and lack of mess when eaten.  You'll notice I've left nuts out of the discussion here, as many day cares and schools are nut-free facilities due to allergies.  If nuts are available to you, they are an easy, nutrient-dense, protein-rich snack.

Photo by Jonny Hunter; downloaded from Flickr without amendments

Juice - I have 3 uses for juice: a young, sick, dehydrated child who might otherwise require an IV for fluid replacement; a constipated child; a mixer for my adult beverage.  As far as I'm concerned, it should never be used for anything else.  Except maybe as a dessert, but when I'm having dessert I want ooey-gooey chocolate, not juice.  There is as much sugar in juice as there is in soda.  Although 100% juice has the same nutrients found in the original fruit (as long as they haven't been processed out), the huge amount of sugar, and the total lack of fiber, make it an unhealthy choice.  Kids should drink water, milk, or herbal tea (alternative milks can be low in protein and high in sugar, so be careful with them).
 
Parents are often concerned about their children overeating.  In our world full of obesity, diabetes, and heart disease, it's an understandable concern.  But kids won't overeat (unless we push them to - see my blog post "Growing Healthy Eaters").  What they will do is eat what we offer them.  If we offer them empty calories on a daily basis, they will grow accustomed to eating this way, putting them at risk for innumerable health concerns.  If we offer them nutrient-dense food on a daily basis, and reserve empty calories for special occasions, we prevent a myriad of health problems, and foster adventurous eating.

Resources (Recipes):

Parents.com - I disagree with some of their choices, but there are a lot of great creative ideas here

100 days of real food

Vegetarian protein snacks

Weelicious.com - more simple carb and sugary recipes than I prefer here, but there are also lots of really nourishing and creative recipes.  Also, she's lowered the sugar content of the sweet treats.

Photo by the US Dept of Agriculture; downloaded from Flickr without amendments

Happy eating!!

I have no affiliations or financial interests to disclose.




 

A Little Love

I just couldn't let this article "What a Little Love Means to a Little One," go by without bringing some extra attention to it.  
 
It was posted on ABCnews.com on Sunday.  I missed it until a good friend and colleague posted it on her Facebook page.  If you haven't already had a chance to read it, I encourage you to do so now.

In a world full of children who struggle to connect emotionally, I can't help  wondering how much of it is due to what this article addresses - a lack of appropriate love and affection given by the parents in infancy.  

Photo by Tostadophoto.com; downloaded from Flickr without amendments


The authors present some numbers that to me are truly shocking: 4 out of 10 US born infants do not form a strong bond with either parent and 40% of US infants live in fear or distrust of their parents.

I understand some of the barriers to giving attention to babies:  we are busy with other children; we are distracted by the perpetual voice in our heads ticking off all the things we need to do that day; some of us are stressed about trying to get the bills paid and put enough food on the table; some of us have babies who cry all the time; some of us have undiagnosed or untreated Post Partum Depression.

If being busy with other children is your barrier, I have a simple solution: wear your baby.  I know it's hard to carve out time to snuggle baby when you're chasing after a toddler.  And sure, babies still cry sometimes even when they are being worn.  But this way, they are getting that physical attention they need.  And I'm pretty sure if they could speak, they'd say "Mama, I much prefer to cry in your arms than to cry alone in my car seat!"  Is it a perfect and complete solution?  Of course not, but I think it goes a long way.

Photo by Jasleen Kaur; downloaded from Flickr without amendments


The authors mention that poverty is a contributing factor.  And clearly, when money is so tight that you have to decide between food and health insurance, you're going to be over-stressed and less emotionally available to your screaming baby.  For those who are that poor, we need to find a way to help you.  Here are a couple of links to places that serve moms in poverty (if you don't need this kind of help, please consider volunteering your time or making a donation): 

A Wider Circle
King County MOMs Plus Program

For those who are not financially destitute, we need to, with all due respect, get a grip.  Whatever we are struggling with should pale in comparison to the needs of this tiny human we've just brought into the world. It might even be time to sit down, snuggle with your baby, put your feet up, and think about how you can re-prioritize your life.  How can you change things so that you have more time with your baby, and maybe even more time for yourself?  Are you a perfectionist who can't have a messy house?  Are you an over-achiever who can never say no?  Are you avidly against ever eating take-out?  Are you working when you don't really have to?  For most of us, there are small steps we can take to reduce stress and have a little more free time.  Personally, I had to let go of four things:  exercising for as long and as often as I prefer; keeping my house as clean as I like it; advancing my career as quickly as I intended; and always eating homemade food.

Photo by Andrew Dawes; downloaded from Flickr without amendments



For parents of babies who cry all the time, life can certainly be tough.  Sometimes, you really do need to put baby down and walk away.  Naturopathic Medicine has a lot to offer to babies who have colic.  If you think your baby is abnormally fussy or has colic, schedule an appointment with your ND.  And here are some resources for help with colic:

http://www.cooperhouse.org/fussybaby/index.html
http://www.healthychildren.org/English/ages-stages/baby/crying-colic/Pages/Colic.aspx
http://www.askdrsears.com/topics/health-concerns/fussy-baby/coping-with-colic (NOTE:  I recommend against altering your diet without the input and participation of a health care provider.)

Finally, if you think you may have Post Partum Depression, address it now, before it gets any worse.  There are pharmaceuticals, vitamins, nutrients, and herbs that can help relatively quickly.  They can make you feel like yourself again.  They can take you and your baby out of harm's way.  But you have to take the first step: go see your doctor.

I know there are barriers I'm not aware of.  And I know there are barriers that may seem to have no solution.  I think we can all agree on the goal:  more babies loved and tended to properly more of the time.  I wrote this piece hoping to encourage moms, dads, aunts, uncles, friends, and caregivers to join me in reaching out to whomever you can whenever you can to try to attain this goal.  People can put up a powerful facade when things are not going well, so please remember to go out of your way to lend a helping hand whenever possible.

Will I ever drink again: Alcohol and Nursing

The baby has arrived, you are home and beginning to think you may have settled a little in to this new parent thing.  You may even dare to think you are developing a bit of a routine.  Your body is healing and your baby is thriving.  Adult beverages have begun to sound appealing again.  But how does drinking affect nursing? Does it show up in breast milk?  What does it do to baby? What does it do to your supply? What problems might arise from drinking and nursing? 

Does alcohol transfer into the breast milk? 

Yes.  If there is alcohol in mom’s blood stream, then there is alcohol in the breast milk.  If baby drinks breast milk with alcohol in it, his liver has to process it, and his body will be affected by it.  Babies’ livers are immature, therefore their ability to process alcohol and other toxins is diminished.  (Their brains, nervous systems, and kidneys are all immature; therefore they are generally more susceptible to all toxins.)

Photo by Janet McKnight; downloaded from Flickr without amendments

Does alcohol affect baby?

Baby will have the same issues we do, but with a much lower amount of alcohol.  So even a small amount of alcohol in breast milk can cause problems such as poor sleeping and poor eating (babies have been shown to get less milk from a feeding occurring within 4 hours of mom having a drink)[1]. Alcohol in breast milk may also lead to motor delay, although the research on this is conflicting.  Prolonged or heavy use of alcohol in a breastfeeding mother would lead to much more severe health issues in a nursing baby. 

If you can’t resist the urge to drink, or feel you may be drinking too much, please consult your health care provider.  You may need help, and you may need to provide formula or donor milk instead of breastfeeding.

Does alcohol affect breast milk supply?

Contrary to popular belief, beer does not increase breast milk production (not even dark beer).  In fact, alcohol ingestion may decrease supply.  And as mentioned above, a baby nursing within 4 hours of mom having a drink may get less milk.  (If you need help increasing your supply, see your health care provider.  Supply can often be increased with the help of a lactation educator or consultant, and by taking certain herbs, foods, or pharmaceuticals.)

 Photo by Kimery Davis; downloaded from Flickr without amendments

So what’s the bottom line?

Most experts agree that it is okay to have an occasional drink while nursing. But what is occasional?  Is it okay to drink every day?  Is it okay to drink more than one drink at a time?  The details of this are not known with certainty.  It’s difficult to study. 

Some say limit drinking to special occasions, and some say no more than 1 or 2 times per week.  Some say one small drink, and some say up to 2 glasses of wine or beer or one shot.  Some say to wait until baby is 3 months of age.  To further complicate the issue, there are additional variables: the age and metabolism of your baby, your own metabolism and ability to process alcohol and how much you have eaten with your beverage.

So what’s the bottom line?  It’s probably okay to have one or two drinks on special occasions, or less than 2 times a week.  

Ensure that you avoid breastfeeding your baby until you are sure you no longer feel affected by the alcohol.  This may mean you have to provide formula or breastmilk you pumped before drinking.  If you want more specifics, be sure to contact your health care provider.

Photo by Eivind Barstad Waaler; downloaded from Flicker without amendments

Co-sleepers:  Remember that you should never co-sleep after drinking alcohol.

A note on SIDS:  People often sleep more soundly after alcohol ingestion, so you may not wake as quickly or as easily to baby’s noises.

I’m having a drink – how should I do it?

Have your drink just after you nurse or pump, then nurse or pump again once the alcohol is out of your blood stream. For one drink, it generally takes about 2 to 4 hours for alcohol to dissipate from your milk, BUT everyone is different.  If you feel the effects of the alcohol, it is too early to feed (this is an argument for limiting yourself to 2 drinks at the most.)  If baby is hungry before you feel ready to feed, give previously pumped milk or formula.  Also, remember that alcohol and breastfeeding are dehydrating, so be sure you drink extra water to compensate.

Photo by Mahalie Stackpole; downloaded from Flickr without amendments

Should I pump and dump?

Do NOT pump and dump.  There is no need.  Once alcohol is out of your blood, it is out of your milk.  Pumping and dumping does not speed that process up. If you need to pump to relieve engorgement until the next feed, do dispose of that milk.  But do not pump to try to get rid of alcohol.

Some words from the nostalgic mom

Remember that you will not breastfeed forever.  You will also not be the parent of a baby forever.  Before you know it you will have the time and freedom to drink and go out as you please.  So try to savor the here and now, even when it means you are covered in spit up and drinking lactation tea.  It will be gone before you know it.

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[1] Mennella & Beauchamp 1991, 1993; Mennella 1997, 1999

More resources:

• For a comprehensive review of the available science, see this article from the NIH's National Institute on Alcohol Abuse and Alcoholism.
• http://www.babycenter.com/0_alcohol-and-nursing-moms_3547.bc
• http://www.lalecheleague.org/faq/alcohol.html