‘Tis the season

Happy holidays! Hope you enjoyed many delicious holiday meals and did not deprive yourself too much. If you’re like me, you enjoyed some candy canes and cookies, but you’re also looking forward to getting back to your regular healthy routine.

This holiday season I was talking with someone and she mentioned how, back when she was younger, holiday meals were typical fare, but that nowadays you can buy just about anything all year-round. Sure enough, this houseguest purchased blueberries from my local grocery store (my daughter and I both love blueberries). These lovely little blue fruits bursting with phytonutrients came to us by way of Chile, where it’s summertime now.

Sustainability and carbon-footprint arguments notwithstanding, I typically don’t buy fresh food that’s out of season, for many reasons:

1. It’s expensive. A teeny 6-oz. container of blueberries was $2.99 (that’s $7.97/pound, if my math is correct). Meanwhile, locally-grown apples were on sale for $1.89/pound.
2. It lacks magic. There’s something fun about seeing a favorite fruit or vegetable suddenly appear at the farmer’s market or grocery store. The overflowing bin of fresh corn is a sign of summer and barbecues to come, and stacks of pumpkins mean fall is just around the corner (and yummy pumpkin pie and bread!)
3. It doesn’t taste very good. Sorry, but in my experience a fresh strawberry that tastes like it was rolled in sugar or plucked fresh from the garden can only be found in the summertime. Same with a juicy, fragrant peach and a ripe watermelon. No offense to my Chilean comrades, but when I bit into a mouthful of the blueberries all I tasted was “meh.” That locally-grown red delicious apple was, well, delicious!

So what’s a person to do when, come February we’re faced with the umpteenth squash or root vegetable? Well, I buy frozen.

Frozen fruits and vegetables are picked at their peak and flash frozen to seal in freshness. They keep for months and taste absolutely delicious when thawed (or not, depending on how you’re preparing them). One sign that summertime is coming to an end is when I buy my last package of fresh strawberries and begin stocking up on the mixed berry bag my local Costco carries. Each morning I thaw a half-cup of these delicious berries and sprinkle them on my cereal or oatmeal. No sugar needed (and none added when they are frozen – check the ingredient list when you’re buying frozen fruits and veggies to make sure it’s simply the fruit or veggie – no added sugar, salt or preservatives).

Note: 100% juice also gives you the taste of fresh fruit year-round. And canned food is another way to enjoy foods out of season – just watch for added salt and/or syrup.

Yes, we are so lucky to be living in a time when we can enjoy our favorite foods when we want them. But for the most bang for your buck (taste and otherwise), only buy fresh produce when it’s in season.

My formula for successful breastfeeding

Well hello again! I’ve been quite busy lately, with life and work and my two little kids – guess my blog got a little neglected. If only I could post the blogs I’ve been writing in my head! There has been so much going on in the news lately, a bunch of things I’ve wanted to blog about, but somehow hadn’t found the time. Sometimes it was just easier to tweet (follow me @elanaRD), but I’m back to blogging. Nice to see you!

One major news item that caught my eye recently was the announcement by Kaiser Permanente and its commitment to breastfeeding support. Among the action steps all KP hospitals will take is that no longer will formula be given to new moms upon discharge.

Now, I’m a huge proponent of breastfeeding. I gave breastmilk to my daughter from birth to 13 months, including the last 6 or 7 months of exclusive pumping. My son is nearly 7 months old now and still breastfeeding. I haven’t decided how long we’ll go – maybe a year, maybe longer – we’ll see.

But I’d be lying if I told you that neither of my kids ever had formula. With my daughter, she was about 6 months old before I finally broke down and fed her some Similac. My milk supply was scant, thanks to an out-of-whack thyroid, stress related to a cross-country move, a new job, and general new-mom anxiety. I felt defeated when I popped the vacuum seal on the can and shook a 4-oz bottle. But she gobbled it up and happily went back to breastmilk once my supply rebounded.

With my son, introducing formula happened earlier and occurs more often. I still hate it, but try as I might I simply can’t pump enough to keep him satisfied while he’s at daycare. As if my working mom angst needed additional guilt – “First you pawn off your child to daycare and now you can’t even FEED him?” (no, no one actually said that to me, but working/nursing moms know how I feel!)

Now did I give my son formula earlier because I was given 2-oz premixed bottles of Similac as a parting gift from my hospital stay? Doubt it. Even though my daughter was born at a Kaiser Permanente Baby-Friendly-Designated hospital in Colorado (my son was born in Virginia, at a hospital without the baby-friendly designation), the formula companies still sent me free canisters and unsolicied coupons for formula (probably got my mailing address from my baby registry).

Let’s face it, formula isn’t hard to get, whether it comes home from the hospital with you or is a quick trip to the drugstore down the street. Even the most well-meaning grandparents and husbands (and breastfeeding moms!) may purchase a can or bottle “just in case.”

The difference between a baby-friendly hospital and one without that designation is not just about whether you get the “gift” of formula or not. The Baby-Friendly Hospital Inititative has at least 10 criteria that BFHI hospitals must comply with in order to be labeled as such. Not one works in isolation to ensure breastfeeding success. I can tell you what worked for me:

• Breastfeeding support groups: By far I felt these groups offered me the greatest support for my decision to initiate – and continue – to breastfeed. In Boulder where I lived, most of the hospitals with birthing centers offered weekly breastfeeding support groups in which moms and their babies could come in, nurse their babies, weigh them, talk to a lactation consultant (or several of them) hosting the group. But perhaps most importantly, it gave me a reason to get out of my house, maybe put on some makeup if I really had energy, and meet some other moms. Those early infant-caring days are wonderful but can also be lonely…especially for moms battling with post-partum baby blues or worse. My daughter was a little peanut, and I always worried that I wasn’t producing enough milk for her. Going to these groups, doing a pre-feeding weight and a post-feeding weight to find out how much milk she drank, helped keep my confidence up. I actually went to two different hospitals each week. OK, I was a little obsessed about my daughter’s weight.
• Access to lactation consultants (LC) 7 days/week: At the Boulder hospital where I delivered my daughter, the lactation consultant came to my room no less than twice during my stay (I was there for only 36 hours – my choice). I was also given the number for the LC support line, available 7 days/week (except holidays) during normal business hours. Just leave a message and the LC on staff called me back within 2 hours (often much quicker than that!). There was no charge for the service, and the LCs were always more than happy to answer my questions. And I asked a LOT of questions!
• In-home post-partum well-check: KP isn’t just a medical center, it’s an insurance plan. I don’t know if this was a service of the hospital or of my insurance, but a few days after my baby and I came home, a nurse came to MY house to do the mom and baby wellness checkup. She weighed my daughter, observed my breastfeeding, checked my uterus and answered all our questions. Those of you with kids know that the first few days of having a newborn at home are a blur: days and nights are mixed up, hormones are a mess… Keeping track of time, bundling a newborn baby and all the accoutrements said baby needs (my husband declared that the size of the baby is inversely proportional to the amount of stuff you need!) – getting out of the house can be exhausting! Also, something as private and sensitive as nursing I think is better dealt with in the privacy of one’s home than in a clinical setting.

I’m glad I had the experience I did with my daughter first, as nourishing her for a full 13 months gave me the confidence I needed to get me through nursing my second child. I can easily see how a new mom’s confidence would be shot if she had difficulty nursing and had to navigate a complicated system to help her get answers. The pressure to breastfeed – and particularly to continue breastfeeding – can be tough, and it’s of little wonder why most moms choose to wean well before the recommended 1 year mark. I strongly believe that keeping formula in the house isn’t what derails most people - it’s the lack of support.

Wasa new-a in my pantry

Growing up, it wasn’t unusual for someone in my house to decide to be on a diet. There were clues to when these times came around: certain foods would be off limits to us kids, like when the pantry was stocked with NutriSystem foods or the freezer had diet fudgsicles. You also knew it was diet time when the only crackers you could find in the house were these thick, plywood-like, flavorless sheets that came in a cardboard box wrapped in paper…Wasa crackers. 

This was back when “diet food” tasted terrible, but as dieters you’d feel virtuous eating it. If it tasted good, it must be bad for you, right? Wasa crackers to me were the epitome of diet food.

As I’ve mentioned before, a perk of being a dietitian is that I sometimes get food samples to try out.  So when a few packages of Wasa crackers arrived, I was curious. These were not the Wasa crackers of my youth, but new thin and crispy flatbread crackers.

I should say right off the bat, I love flatbread crackers. I could eat them plain or topped with cheese. But the brand best known for making quarter-inch-thick bricks of crackers is now making flatbread thins? This I had to try.

There were three flavors to sample: original, sesame and rosemary. I tried the rosemary first, since I love pretty much anything seasoned with rosemary. These did not disappoint. For a thin little crisp, it was quite a burst of flavor. There was a perfect mix of rosemary and sea salt, which gave the cracker a rustic taste. I could eat these by themselves…and I did. At 70 calories per two flatbread crisps, eating a couple of these is great when you’re craving potato chips or something crispy and salty.

Next I tried the sesame. I was a little dismayed that these crackers didn’t have whole sesame seeds sprinkled on top, but the flavor was really good. Again, there was a hint of salt and rosemary, but not as strong as the rosemary crackers. These were also good by themselves or with a topping (I used different kinds of cheeses).

Last I tried the original. It was bland, which was a bit of a letdown at first but actually worked out well as a basis for strong cheese or hummus.

Nutrition-wise these crackers are pretty good. As I mentioned before, two crackers supply 70 calories and contain 8 grams of whole grains (half a serving), and whole wheat flour is listed as the first ingredient. I was a little surprised that you only get 1 gram of fiber for every two crackers, but then again, it’d be hard to boost the fiber and still keep the cracker thin and light. Besides, if you’re itching for more fiber, just top a flatbread with some hummus or guacamole. Easy…and delicious!

Cooking with Children: A Recipe for Kitchen Safety & Fun

Today I’m pleased to bring you a guest post provided by Dan Gilbert on behalf of Primrose Schools. For over 25 years, Primrose Schools have helped individuals achieve higher levels of success by providing them with an AdvancED® accredited, early child care services and education.  Through an accelerated Balanced Learning® curriculum, Primrose Schools students are exposed to a widely diverse range of subject matter giving them a much greater opportunity to develop mentally, physically and socially. Dan has written a number of articles on topics varying from bilingual learning to teaching the importance of volunteering.

How much time do you spend in the kitchen? Does this take away from the time you could be spending with your child? Dr. Mary Zurn, Vice President of Education for Primrose Schools, offers a new perspective on cooking; using it as quality time to spend with your child while helping them practice basic skills and learn new ones. “The kitchen is often the most popular place in the house for families to gather. It’s a place for learning and sharing, where the family can enjoy quality time. Children can also develop a sense of responsibility by participating in daily tasks,” said Dr. Zurn. Basic skills such as, sharing, following instructions and responsibility are easy to teach while you are cooking or baking with your child. Also, since you are around food it could be a wonderful opportunity to sprinkle some knowledge on your child about healthy eating habits. 

These four steps make up a simple recipe that when followed will keep children safe in the kitchen while they learn something new:

1. Set some ground rules.
2. Engage your child meaningfully.
3. Build up skills step-by-step.
4. Keep it FUN.

1.) Ground rules should be set before children spend any time in the kitchen since it can be such a dangerous place. The hazards however, can easily be avoided with the ground rules and some adult supervision. Teach children to wash their hands before and after handling food to avoid spreading germs. Discuss on a regular basis what’s safe to touch and what’s not. Make sure the handles of pots and pans are turned inward on the stovetop so you and older children don’t accidentally bump them and spill hot liquids or food.

2.) Engaging your child in a meaningful way is very important no matter how old the child is. To entertain toddlers just give them some pots, pans and wooden spoons so they can pretend to cook with you or use them for music making. The tuneful accompaniment will let you know they’re safely engaged and give them a way to feel like they’re helping too. For older children, there are a variety of tasks they can accomplish independently. Simple jobs such as stirring, mixing, measuring and pouring can boost a child’s self-confidence and give them a sense of accomplishment. Tearing lettuce, adding sprinkles to sweets and rolling dough into balls are also safe, satisfying tasks children can easily accomplish.

3.) Children can develop many essential skills in the kitchen, such as counting, following instructions and learning measurements. For more advanced skills however, start slowly and have your child master easy tasks before attempting harder ones.  Older children can gradually be taught to use a knife. Start them off with a dull spreader, cutting softer items first such as cheese or dough. As your child’s coordination develops, they can move on to slicing or sawing vegetables and fruit with a plastic knife.

4.) Most importantly, make sure you always keep it fun! We all know cooking can be messy, even when the children aren’t around! Instead of stressing over the “oops” moments offer guidance and let your child try again. If the cookie batter ends up on the floor instead of the baking sheet, oh well! Cleaning up is another important lesson to learn, and it can be just as fun!

After everything is finished, sit down and enjoy your meal with your little sous chef. Offer them the first bite and see what they think! Discuss what they might like to make next time, perhaps some dessert instead of an appetizer? Until then, bon appétit!

Type 1 Diabetes – let’s find a cure

Kids are adorable, especially the ones related to me.

Over the weekend, I got an e-mail from my nephew. As a dutiful aunt, I’ve collected box tops, flipped through catalogs and ordered kitchenware I didn’t really need, all in the name of raising money for something or other. But his request this time was a little different.

My nephew’s friend Jack was recently diagnosed with Type 1 diabetes. Jack is organizing a team in the Juvenile Diabetes Research Foundation (JDRF) Walk to Cure Diabetes this October. My nephew, Jonah, will be walking with him and is raising money for the team. I should mention, these kids are 7 years old.

What touched my heart was the little-kid honesty and simplicity in each of the letters the kids wrote on his personal donation page. Here’s Jonah’s request:

We really need you to donate money for us because we need money to find a cure for diabetes so nobody gets it.  My friend Jack has diabetes and I want to find a cure for him.

And Jack’s here, with his brutal honesty:

Type 1, or juvenile diabetes, is a devastating disease that affects millions of people, a large and growing percentage of them children. AND IT SUCKS!!!

Yes, Jack – type 1 diabetes does suck. It’s an autoimmune disease in which the body attacks its own cells, destroying the insulin-producing beta cells of the pancreas. Insulin is needed to remove glucose (sugar) from the bloodstream, so that means in type 1 diabetics, the body doesn’t have an efficient way to absorb and use the sugars in the blood. So, they need to be vigilant about what they eat, inject insulin every day, and be mindful of their blood sugar levels when being physically active.

While Type 1 diabetes isn’t typically a deadly disease, it is one that must be managed for the rest of one’s life. And when you’re 7 years old, that’s a long, long time.

Also, a diagnosis of type 1 diabetes affects more than just the patient. For the child, suddenly he needs to learn self-control and self-awareness, and things like birthday parties, Halloween and special events take on new meaning. For most kids, the worst that can happen when they eat too much ice cream is brain freeze – for type 1 diabetics, it’s diabetic coma. Parents find themselves taking a crash course in metabolism and become label-reading experts. School nurses are required to administer the insulin. Coaches need to be aware if the diabetic kid is pushed too hard or doesn’t have his glucose tablets or juice nearby, in case of emergency.

There is no vaccine, no cure for type 1 diabetes, just lifelong, daily treatment. Perhaps more maddening than not having a cure is that we also don’t exactly know who is most at risk for the disease. According the CDC, risk factors for type 1 diabetes can be genetic or environmental – or simply autoimmune, which means the body attacks itself with no known explanation. In other words, anyone is susceptible.

Please support Jack, Jonah and all the other kids walking this fall to cure type 1 diabetes. For Jonah’s donation page, click here.

Breastfeeding on the road

It’s no secret that I’m a huge proponent of breastfeeding. I gave my first child breast milk for the first 13 months of her life, despite a wildly fluctuating milk supply (thanks to an out-of-whack thyroid plus stress related to moving across the country and starting a new job). Making life more complicated was the fact that after 7 months, my daughter refused to nurse directly, so for 6 months I exclusively pumped and fed her from bottles.

Luckily, I have a job that allows me to work from home, so pumping during the work day isn’t as big a deal to me as it is to most working women. However, when I’m out of my element – such as traveling or even going out for an extended period of time – I truly feel the pain of my fellow working women and other mothers who face major hurdles as they strive to keep their babies well-nourished with breast milk.

One major downside of my chosen career is that there’s no such thing as paid time off. That includes maternity leave. So when my second child was born two months ago, I resumed work after just two weeks. Granted, my hours are flexible and I’m able to work in my pajamas, unshowered and without makeup, without anyone knowing the difference. And with temporary live-in childcare that allows me to keep my son at home for the first three months (thanks, Mom and in-laws!), I can easily grab a chunk of time to nurse throughout the day. However, with my child not even one month old, I found myself squeezing my postpartum body into business clothes, applying makeup and gathering all 8 AA batteries needed to power my breast pump. Yep – I had a business trip.

A few people think I was crazy for resuming work and traveling so soon after having a child. But my circumstances are unique and I’m glad we found a way to make this happen. Still, it required a fair amount of planning ahead and commitment, not just on my own behalf but also my mom’s, who was the one watching my son during that trip, and my husband’s. Luckily we made it through (despite a luggage snafu, but that’s a story for another day…)

Since that trip, I’ve done a fair amount of breastfeeding-on-the-go. It’s not my favorite thing to do, lugging a breast pump on a trip, even just into the city for an afternoon meeting. But it’s so worth it in the end when you can bring home that liquid gold and feed it to your little one.

Here are my tips for making breastmilk pumping a success:

• If you plan to pump more than once in any given outing, invest in an electric, dual pump breast pump. Also, buy one of those hands-free bra-like things so you can multitask (as working moms, we’re masters of multitasking!)
• Pack extra batteries. At least one more complete set. And bring your power cord, too. It doesn’t take up much extra space so when available, plug in rather than run your pump off battery power.
• Rent a refrigerator for your hotel room. The minibar often isn’t cool enough for properly storing breast milk, so call ahead to have a mini-fridge put into your room upon check-in so it’s cold and ready when you arrive.
• Bring a cooler bag with a frozen ice pack. My business trip was a quick 24-hour jaunt, so I really didn’t want to check my bag. I know that TSA rules seem to vary from person to person, but even when traveling alone and with an empty cooler bag with just a frozen pack inside on my flight out, the TSA agent allowed it through since the pack was still solid.
• When you get to your hotel, put the frozen pack into your mini-fridge’s freezer. If you don’t have a freezer compartment, ask the front desk if they’ll store it for you. My freezer pack came from the freebies the hospital gave us when my son was born, so it had Similac logos all over it. No one was going to steal that! At the very least, put your name and check-out date on it (perhaps room number, too), to reduce the chances that it’ll get misplaced.
• Get a nursing cover. Yes, even for pumping. I was lucky enough to be on a flight that still had empty seats. I found an entire row (the last row on the plane) without any passengers and took a window seat there. As soon as we were allowed to use our electronic devices, I pulled out my pump, strapped on my “hooter-hider,” even put my laptop up on the middle seat tray to do some work, and pumped away. No one had any idea.
• Store pumped milk into bags made for freezing breast milk. This is something I discovered after so many times bringing all my supplies and realizing I forgot to pack caps for my bottles. Doh! Just pump and dump into those bags, which also fit really well into coolers and don’t take up any extra space. You can add fresh pumped milk to previously chilled milk, so fill it with two or more pumpings. Just don’t freeze your milk, because once it’s thawed you have to use it within 24 hours.

 For information about how long to store pumped milk, click here.

Getting reacquainted with an old childhood friend: cottage cheese

One of the perks of being a registered dietitian is the food samples. Recently, I was the lucky recipient of some Daisy brand cottage cheese, delivered cold right to my door. I’m not a big cottage cheese-eater – it’s a food item I often forget about even though it’s fairly nutritious – so I was pleased with the opportunity to try some again.

Perhaps my all-time favorite cottage cheese was something served in a local restaurant where I grew up. Instead of bringing over a bread plate for patrons to nibble on while we glanced over the menu, the servers dropped off dishes of herbed cottage cheese (I think with chives) along with an assortment of breadsticks and crackers. We used to devour this free appetizer and sometimes asked for seconds. I’ve yet to replicate the consistency and flavor of this cottage cheese, and the restaurant is long-since closed, replaced by a strip mall, so the recipe is probably gone forever.

Now, it’s very likely that this cottage cheese from my youth was full-fat and mixed with who-knows-what to give it that spreadable, thick consistency. The 2% fat Daisy brand I now have in my fridge is a pretty good substitute, in that it’s thick enough to be eaten with a fork rather than a spoon. And at 90 calories per ½-cup serving, it’s a low-calorie, lowfat way to get high-quality protein and some calcium (10% Daily Value). Milk, yogurt and even most regular cheeses are better sources of calcium, usually providing 20% Daily Value or more. Also as with all cheeses, cottage cheese is not a good source of vitamin D and provides a fair amount of sodium. Still, you’re getting a pretty nutritious bang for your calorie buck.

One of the reasons cottage cheese isn’t among my go-to foods is because I find it a little sour. It’s just not a food I could eat on its own – I need to mix it with something sweet, such as chopped fruit, or put it into a pita pocket with crisp lettuce and cucumbers. One great idea I recently heard is to top a baked potato with cottage cheese and chives instead of sour cream – what a nutritious, balanced meal! For other ideas on how to serve cottage cheese, check out some of the tips on the Daisy website.

Despite my own preferences and biases, I would recommend reduced-fat cottage cheese to most relatively healthy clients looking for a quality, vegetarian protein without too much fat and calories. Now, time to make a cottage cheese sandwich!

Note: As with everything on my blog, all views expressed in this post are my own. I did not receive compensation for this post, nor did Daisy ask me to post a review.