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Thursday, November 14, 2013

Rethinking Rice Cereal with Babies














Rethinking Rice Cereal







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Got Breast Milk?


by Deborah Pike Olsen
November 09, 2013

When it’s time for babies to eat food other than breast milk or formula, many parents reach for baby cereal—particularly rice cereal. For years, pediatricians have recommended that babies’ first food be iron-fortified cereal, particularly rice, which has a low risk for allergic reaction.

Recently, concerns have been raised about the levels of arsenic in rice and rice-based products, including baby cereal. New research on the topic from the U.S. Food and Drug Administration (FDA) has led that agency and others, including the American Academy of Pediatrics (AAP), to take a closer look at rice cereal and offer more recommendations on introducing solids to your baby.

What is arsenic?
Arsenic is a chemical element in the earth’s crust, present all around us, in both organic (naturally occurring) and inorganic forms. Both forms can be found in water, air, soil, and foods. Organic forms are released from volcanoes and through erosion of mineral deposits; inorganic arsenic, the more toxic form, is added to the environment through human activities such as burning coal, oil, gasoline, and wood, mining, and the use of arsenic-containing compounds in pesticides, herbicides, and wood preservatives.

The Environmental Protection Agency (EPA) describes inorganic arsenic as a carcinogenic (cancer-causing) agent. Several studies have linked inorganic arsenic with increased risk of skin cancer, as well as cancer of the prostate, liver, bladder, kidney, nasal passages, and lungs. For children, long-term exposure may cause lower IQ scores; exposure in utero and early childhood may increase mortality risk in young adults. Low level exposure can cause nausea, vomiting, stomach pain, circulatory problems, damage to blood vessels, a “pins and needles” feeling in the hands and feet, and redness and swelling of the skin.

Experts currently don’t know what level of arsenic is dangerous to public health. Since 2011, the FDA has analyzed samples of rice and rice products. As FDA Commissioner Margaret A. Hamburg, MD explains, the agency is “committed to ensuring that we understand the extent to which contaminants such as arsenic are present in our foods, what risks they may pose, whether those risks can be minimized, and to sharing what we know.”

Research
The FDA has monitored arsenic levels in food for nearly two decades, with the latest analysis being its most ambitious and far-reaching effort to date. The report provides data on 1,300 samples of rice products, 200 first reported in 2012 and an additional 1,100 tested in 2013. Products included in the analysis ranged from over-the-counter cookies and rice snacks to infant formula and baby cereal, ready-to-eat and hot cereals, rice “milks,” and more.

The FDA measured levels of inorganic arsenic and total arsenic for each product type. The FDA focused on rice because, unlike other crops, rice readily absorbs arsenic from the environment.



Results
FDA researchers found that arsenic levels varied widely from sample to sample within the same product. For the various products, levels ranged from 0.1 to 7.2 micrograms of inorganic arsenic per serving. However, serving sizes also varied.

In the absence of dietary limits, it is hard to know how to interpret these results, but the full text is available online. Readers can consider the relative risks of such products as rice cakes, rice milks, brown rice, and more. (Note that brand details about samples are not provided.)



Recommendations
The Illinois attorney general’s office conducted similar testing in 2012 in conjunction with Consumer Reports. Based on the “troubling” results, Consumer Reports and Illinois Attorney General Lisa Madigan have called on the FDA to set federal maximum levels for arsenic in food, especially baby food, and to caution the public about eating large amounts of rice and feeding it to small children. In fact, the next step in the FDA’s process will be risk assessment.



In the meantime, parents can take the following steps to minimize the risk of arsenic exposure for themselves and their children:
•Choose a different first food for babies. Former chair of the AAP’s nutrition committee Dr. Frank Greer notes that the group has “been trying to move people away from the use of rice cereal for the first weaning food … because it does not really provide that much nutrition.” Some experts suggest starting with meat, poultry, or tofu, which are iron-rich foods. Currently, the AAP’s position on introducing solids is that there is not sufficient evidence to show that introducing solids in any particular order is beneficial. Instead, the organization suggests babies should be offered a wide variety of nutrient-rich foods, including a variety of grains, within the first year to reduce exposure to arsenic from rice. Other good first-food options include sweet potatoes, squash, carrots, avocado, apples, pears, bananas, and peaches.
•For babies with gastroesophageal reflux (GERD) tendencies, consult a pediatrician. While rice cereal has traditionally been recommended as a thickener for these infants, the FDA notes that “wheat, barley and other grain-based infant cereals also readily absorb liquid and are similarly effective for infants with esophageal reflex tendencies.” Parents should talk with their child’s doctor.
•Avoid rice milk for children younger than age 5. Some of the highest levels of arsenic were found in products marketed as “rice milk.”
•Eat a balanced diet, with a variety of grains. Everyone should consume a varied diet. For nutrition guidance, the ChooseMyPlate website can be a good place to start.
•Limit rice consumption. Consumer Reports provides specific recommendations of servings per week for children and adults, noting, “for infants, children, and pregnant women, risks may be heightened.”

Sunday, October 20, 2013

Your new baby and visitors


Bringing Baby Home: Four Ways to Manage Visitors

March 19, 2013

Bringing Baby Home: Four Ways to Manage Visitors
Bringing your new baby home for the first time can be one of the most exciting moments in your life! Before you ease into the calm and comfort of your home sweet home, prepare to be greeted by supportive friends and family. At times, it’s lovely to have visitors, but let’s be honest, it can also be exhausting. Blogger Amy Morrison recently shared a post on managing guests after birth. Here are some tips to help you relax and get support needed to ease into motherhood.

1.) Ask For Help
It’s easy to be overwhelmed by all the new responsibilities of being a mom. Don’t hesitate to ask guests for help. They’ll be thrilled to lend a hand and help you and your bundle of joy get comfortable in your new home.

2.) Make the Visit
Every family has one (or five) people who tend to visit for just a bit longer than most might prefer. If you’re not up for a marathon chat, offer to make the trip to see that person yourself (with your little one, of course). This way, you can choose to keep the visit short and sweet, or linger little longer if you’d like.

3.) Spread Out Guests
It’s okay to space out your visitors (and we don’t mean a few hours apart). Feel free to take a few weeks to get the hang of being a mom, and limit the amount of guests you have during this time. You’re a new mom whose life has just taken an exciting turn. Take some time to simply enjoy the giggles, smiles, and incredible little being you have by your side.

4.) Place Your Order
After diaper changes, breastfeeding, cleaning, playing, giggling and cuddling, it’s easy to lose track of your own mealtime. Remember, eating well and staying hydrated is one of the best ways to maintain breastmilk supply. So, say “yes” when visitors offer to bring over food. Moms deserve little treats too!

Wednesday, October 9, 2013

Read this before visiting a new Mom & Baby


Going to Visit Family or Friends Who Have a New Baby? Follow These Tips!

Posted on September 30, 2013


Baby in Hat

Your friend or family member has a new baby. You want to visit. You want to help. You want to meet that amazing new little person! Before you go, read this primer on how to be a good visitor to a family with a newborn in the house — the kind of visitor who will make the family feel loved, supported, and forever grateful!

Included are guidelines that apply to all visitors, plus tips specifically for close friends and family, long-term visitors, and friends and family who live far away but would like to help nonetheless.

In the United States, we shower attention on families during pregnancy, but not during the postpartum period — when in fact the postpartum period is the time when families need the support of their communities the most! Be a gentle, considerate visitor who puts the family’s needs first. Your thoughtfulness will be remembered and appreciated for years to come!

WHEN AND HOW LONG TO VISIT
◾Always call/message in advance to schedule the visit. Do not drop in unannounced. Be on time.
◾Front-porch meal drop-offs or short (10-15-minute) visits are good in the first several weeks, when families are overtired and commonly not feeling up to hosting company.
◾Longer visits (30+ minutes) are good in the later weeks/months, when long-term helpers (grandparents, etc.) have left; other visitors have stopped coming; and spouses have gone back to work. Mothers often report feeling isolated after 1-2-3 months at home with a newborn (and any other children), and welcome longer visits in the later weeks/months.
◾Very close friends/family may be invited to come for longer or more frequent visits to help in the early weeks, but should always ask the mother what type of visit — short or long — would be most helpful to her.
◾If the mother will be home alone with the baby most of the time (single parent, spouse deployed or working long hours), she may wish for visitors to stay longer. Ask.

PREPARING FOR THE VISIT
◾If you are ill in any way — even the tail end of a cold — stay home. Visit when you are well.
◾Do not wear perfume, scented body lotions, or aftershave. These linger for hours or days after your visit and are often overpowering for baby and mother, who have heightened senses of smell.
◾Leave your pets at home.
◾Leave your children at home. This is especially important in the early weeks, when the family is likely to want quiet, rest, and minimal outside germs. One exception is bringing your children over for a playdate or outing with the family’s older children, outside or away from the family’s house, which you plan to supervise.
◾Bring food. See “Bringing Food” below.
◾Bring small gifts for any siblings in the house, if you can. Gifts that do not make noise are best. Special food treats are a nice, inexpensive option.

DURING THE VISIT
◾Remember that the purpose of the visit is for you to help the family, not for you to spend time with the baby. Now is the time for you – not the family — to prepare food and clean up any messes made during the visit.
◾Do not expect or ask to hold the baby. (Yes, this can be difficult — new babies are so snuggle-able!) Wait for the mother to offer. Many won’t. One big exception is offering to hold the baby after a feeding so the mother can take a shower or a nap.
◾Wash your hands when you arrive, and let the mother know that you have washed them before touching her baby.
◾Greet any siblings enthusiastically. Give a big hello and lots of love to the older children before fussing over the baby — it will make them feel special during a time when the baby is the focus of most adults’ attention.
◾Do a chore. Do it without asking. Or say, “It would make me so happy if I could [do chore XYZ]. Will you indulge me?” (Saying something like this helps ease discomfort the family might feel about having someone clean for them.) Load the dishwasher. Wash the dishes in the sink. Wipe down a counter. Sweep the kitchen floor. Fold that basket of laundry you see sitting there. Take out the trash. Excuse yourself to the restroom and scrub the toilet or wipe down the counters.
◾Or, watch the older siblings, or take them out of the house on an outing.
◾Or, offer to take dogs for a walk, if you’re a dog person. Adjusting to a new baby can be hard for pets, too. They need a little extra love at this time, as well!
◾Give advice only if the parents specifically ask for it. Do not criticize.
◾Follow the mother’s cues about how long a visit she’d like. Remember that it can be very difficult for her to ask you to leave once you are there, even if she truly needs privacy to nurse or pump or perform postpartum self-care.
◾If the family has a premature baby in the NICU, they still need support — lots of it! Tell them “Congratulations!” (they do want their new little one to be acknowledged and celebrated). Ask them how they and the baby are doing, and then really listen. Give them gift cards to restaurants near the NICU; gas cards; or a care package of healthy snacks and drinks that do not need refrigeration (dried nuts/fruit/veggies, trail mix, homemade muffins, snack/granola bars, seltzer water, etc.). If they are staying near the hospital, away from home, offer to pick up mail, water plants, care for siblings or pets, or bring needed things from home to the hospital.

BRINGING FOOD

◾Most families welcome food anytime, but it is often especially welcome at these times: after any other long-term helpers (visiting family, etc.) have left; after the first several weeks when other visitors have stopped bringing food; and when the spouse goes back to work or is away on a business trip.
◾Ask whether the family has set up an online meal-delivery calendar, such as Meal Train or Take Them a Meal. If they have not, organizing one is is a great job for a close friend or family member (see below).
◾Check the family’s Meal Train page (or check with the family) for information about food preferences, sensitivities, and allergies, as well as any other preferences (food delivery times, locations, dates). Respect that information.
◾Bonus points: bring a complete meal (main dish, salad/veggie side, and dessert) and/or meals containing ingredients that promote breastmilk production, such as oatmeal (oatmeal lactation cookies are one option), whole grains, dark leafy greens, beans, vegetables, and nuts/seeds.
◾Avoid bringing foods containing large quantities of those herbs which are known to reduce breastmilk production, such as peppermint and sage.
◾If you do not cook, consider bringing a healthy store-bought ready-to-eat meal (such as rotisserie chicken or a complete dinner from the supermarket) or a collection of healthy snacks that the mother can grab and eat one-handed during the day or while nursing, such as nuts or trail mix (unsalted), dried fruit/veggies, healthy snack bars, precut fruits/vegetables, cheese, hummus, and whole-grain crackers. Trader Joe’s and Costco are great places to buy these things inexpensively.
◾Bring the food in disposable containers or in inexpensive reusable Rubbermaid or thrift store dishes that need not be returned.
◾Consider attaching a note to the meal specifying that the dish does not need to be returned and that no thank-you note is necessary.

IF YOU ARE A CLOSE FRIEND OR CLOSE IN-TOWN FAMILY MEMBER

◾Run an errand. School drop-off, grocery store, Target. For example, call and say, “I am going to the grocery store. What can I get you? I will drop it by on my way home.” Note that it is “What can I get you?” not “Can I get you anything?”
◾Be the one to organize a group of friends/family to deliver meals in the first three weeks (or longer). Use an online organizing service like Meal Train or Take Them A Meal. Be sure to include information about food preferences, sensitivities, and allergies. If the meal-receiving family is not large, have meals delivered every other day so that the backlog of leftovers does not overwhelm the refrigerator before the family can get to them. Spread word of the Meal Train throughout the family’s social circle.
◾Help the family write a Chore/Helper List. This is a list of tasks that other visitors can help with, so that when visitors ask what they can do, the family has immediate answers. Place it in a prominent place, like the refrigerator.
◾Help the family research the baby/parenting information they need, if they would like. With a new baby in the house, it can be hard to find time and energy to research lactation consultants, breastfeeding or postpartum support group meeting information, etc. A list of local maternity and parenting resources can be found here.
◾Lend an ear. Ask the mother how she is feeling, then follow her signals. Do not pry. If she wants to talk about her experiences, she will.
◾Observe the mother for signs that she may be developing postpartum depression (PPD) or anxiety (at least 1 in 5 new moms in the United States do). Know the difference between normal new mom stress and a postpartum mood disorder. Be gentle and compassionate with the mother. Ask her what kind of support would help her feel better. If she wants peer or professional assistance, this page has a list of local and national postpartum support organizations. To better understand what a mother with PPD is experiencing, her friends/family may find it helpful to read Brooke Shields’ memoir, Down Came the Rain: My Journey Through Postpartum Depression.
◾Watch the father for signs of anxiety or depression as well. Postpartum anxiety and depression occur in fathers, too. Like mothers, fathers need sleep, good nutrition, exercise, and alone time to stay well. This page has a great list of resources both for fathers experiencing postpartum depression themselves, and for partners of women experiencing PPD. Additionally, Postpartum Men Online Forum is an online community that these men may find helpful.

IF YOU ARE A FAMILY MEMBER VISITING FOR AN EXTENDED PERIOD
◾Come for an extended visit only if the family has invited you to do so. Never invite yourself.
◾Ask if the family would prefer that you stay in a hotel during your visit. Be gracious if they say yes.
◾Offer nighttime help. Offer to stay up late with baby while they catch a few early-evening hours of sleep. Offer to burp/walk/bounce a fussy baby after a midnight nursing/feeding so that the parents can sleep. Nighttime is often a time when help is scarce but dearly needed.
◾Be their personal assistant. Do whatever they indicate they need. Drive them to appointments or support meetings. Run errands. Grocery shop. Pick up prescriptions. Babysit siblings. Cook. Clean. Do laundry. See “During the Visit” above.
◾Encourage them. Tell them that they are doing a wonderful job. Tell them that you are proud of them. Especially for a nursing mother struggling with breastfeeding, the words, “You are doing a great job,” are magical.
◾If you are a generation older, understand that parenting techniques likely have changed since you last cared for babies. Ask the parents about their parenting philosophies. Follow any specific baby-care instructions they provide. Reading (and following) the same baby-care books that the parents are can be helpful.

IF YOU LIVE FAR AWAY BUT WOULD LIKE TO HELP
◾Pay for the services of someone who can help in person: a postpartum doula, a house cleaner, a diaper service, a grocery delivery service. A list of such local resources is available here.
◾Be part of the family’s virtual support team. Let the mother know that you are a friendly, supportive ear that she can call or Skype at any time, day or night.

IF YOUR SPOUSE OR CHILDREN WANT TO HELP, TOO

As stated above, having a crowd of visitors in the house — or running in and out of the house — can be overwhelming for a family with a new baby. But having a work crew tackle the work literally piling up outdoors? Such a help. If you can bring your own tools (for example, rakes and leaf bags for raking leaves) so you have no need to ask where to find supplies, it’s all the more helpful.
◾Pet care. Walk the dogs. Poop-scoop the yard. Change the litter box or the hamster cage.
◾Yardwork. Mow the lawn. Rake the leaves. Shovel the snow off the driveway and sidewalk. Snow and leaf blowers can be grating on the nerves — avoid them.
◾Garden work. Weed. Pick veggies. Especially good for parents of babies born during harvest season!

FURTHER READING
◾Why Are America’s Postpartum Practices So Rough on New Mothers? (The Daily Beast)
◾A Letter to Grandparents by Penny Simkin
◾After the Birth, What a Family Needs (Gloria Lemay)
◾How To Be the Best Post Partum Visitor in 15 Minutes or Less (There Are No Ordinary Moments)
◾The Answer Is Always “YES!” (Or, How To Help a Struggling New Mom) (Dou-la-la)
◾For Parents: Visitors After the Baby? 10 Tips for New Parents (Huffington Post)
◾For Parents: Is DAD the Ideal Postpartum Doula? (The Birthing Site)
◾For Parents: DONA International’s Postpartum Plan (DONA)

This post has been several years in the making. Sincere gratitude to the many mothers who have contributed, both directly and indirectly, the ideas, suggestions, and wisdom reflected within it!

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