Archive for July, 2012

It’s 4:00 am and today we are making our first big trip with the baby… I have the typical new Mom feeling about traveling… I hope my baby doesn’t cry! I have organized this trip like I am producing a segment for a show! HA.. Talk about type A personality!!! I am going to Blog Her which is a mommy blogging conference and it gives me a good excuse to see all of my amazing friends in NY. They are all dying to meet our little munchkin…

Here we come NYC!!!

I’m trying out my Zoo Jumperoo. I can’t quit reach things though, so I guess I’ll just wobble around and bounce for now.

You may not have heard of choline.  Researchers are just beginning to realize it’s significance, especially during pregnancy.

Choline is an essential nutrient which has a complex role in all the cells of the body.  It is needed for messages sent between the nerves and muscles of the body, for making neurotransmitters (important in the brain), as well as having a role in forming one of the essential amino acids.  It’s mid boggling that more attention has not been put on the importance of Choline.

What is Choline’s role in pregnancy?  Choline is required for growth of the placenta in early pregnancy, for preventing preeclampsia (high blood pressure during pregnancy), neural tube defects, and low birth weights.

Researchers at Cornell University found that Choline supplementation in the third trimester was linked with lower levels of cortisol (the stress hormone) in utero which could set the tone for less risk of hypertension, diabetes, etc. for the baby’s entire life.

“This study provides compelling evidence that maternal choline intake during the third trimester of human pregnancy can modify global and site-specific epigenetic marks in fetal-derived tissues,” the researchers wrote in the study.

Choline is not normally found in most prenatal vitamins so how much do you need and  what foods are high in choline?

Recommended amounts for pregnant women are 450 mg/day and 550 mg/day for lactating women.  The highest source of choline is eggs at 125 mg. (the whole egg since egg yolks have the highest concentration).  Here are other foods high in choline:

Food                                  Amount of Choline

3 oz beef:                             111 mg.

3 ounce trout/salmon:       102 mg.

1 cup tomatoes:                   100 mg.

1 cup peas/kidney beans    99 mg.

1 cup broccoli:                       62 mg.

1 cup milk:                              43 mg.

1 oz almonds                         15 mg.

Take home message:  Include high choline foods in your diet and if you question whether you are getting enough consider a small supplement of choline while you are pregnant and/or breastfeeding.  It could set a better tone for the course of your child’s life.

No doubt about it, Miles passes gas. Frequently. And loudly. He’s never been much of a burper, so I guess the air needs to come out somewhere.

In the bath once he farted so loud he startled himself.

Definitely one of the more uncomfortable problems that can be exacerbated during pregnancy, constipation is a common complaint.  Between the hormonal effects of progesterone slowing down the motility of your intestines, the iron and calcium in prenatal vitamins, the displacement of the intestines by a growing uterus and the changes in our diets during pregnancy all lead to a disruption in bowel function.  Some have bowel changes consistent with a softer and more frequent stool, others have hard “rabbit” pellets and many others have bowel movements every 2-5 days.

Constipation during pregnancy can be prevented with the following lifestyle changes:

Drink plenty of fluids. Water is the best choice and I would recommend drinking at least 8-10, 8 ounce glasses a day. Fruit juice, especially prune juice, will help regulate your constipation.  Drinking warm liquids in the morning is also effective.

Physical activity and exercise should be a part of your daily routine.  Daily walks, lasting 30-45 minutes, and other aerobic activities can help prevent pregnancy constipation.  Exercising regularly aids in our digestion and makes you feel physically and emotional stronger and more energetic.

Include more dietary fiber in your diet. Choose high-fiber foods, such as fruits, vegetables, beans and whole grains.  Fiber helps bring water into the intestines, softening the stool and allowing it easier to pass.  With your health care provider’s OK, consider a fiber supplement, such as Metamucil, Citrucel and Miralax.
Stool softeners, such as Colace, moistens the stool allowing easier passage. I encourage most of my patients to take 50mg to 100mg of Colace two times a day throughout the duration of the pregnancy.

Bulk forming laxatives such as fiber supplements are the gentlest on your body and safe to use during pregnancy.  Metamucil, Citrucel and Miralax are examples of this and are recommended throughout pregnancy.  Stimulant laxatives, such as Ex-Lax and Senokot are the hardest on your intestines and should not be used during pregnancy.

There are remedies and solutions for this serious and uncomfortable side effect of pregnancy.  As always consult with your health care provider

Last night Miles flipped on this tummy in the middle of the night, SWADDLED! Needless to say Ian heard a muffled cry and we turned him over… very scary. Miles little legs are so strong that he kicks them up and moves all over the co-sleeper. He is also becoming a little Houdini and escaping from the swaddle.. Not sure how much longer he is going to be able to stay in it!

Since NY is a walking city (unlike LA), I need to be able to be light on my feet with Miles. I tried the Ergo Baby Carrier and he seemed to take to it well. Ready to hit the streets with the munchkin.

I can’t wait to walk! Dad still has to help me up, but I’m ready to run and check everything out!

Well it’s started.. Miles teeth are on the way! He is drooling and jamming his little hand in his mouth all the time. I am dreading the thought of when those teeth come in and what he is going to do to my breast. Just when I have finally got a handle on breastfeeding! HA!

I really like the frog by Bebe Dubon Water Filled Teether, and of course he loves Vulli Sophie the Giraffe Teether.

At Grandma and Grandpa’s condo.

Miles can stand hold up his own body weight on his legs, as exhibited here. No bad for a baby a week shy of 4 months.

He needs help to stay balanced, but he can stay upright on his own power. Perhaps he could end up walking before he crawls. We still give him tummy time, but he much prefers being on his feet.

I was nursing Miles last week and he popped off my breast and turned his head to look at me, he continued feeding then popped off again, looked at my breast and broke out with the biggest smile on his face. It was like he made the connection that my Mom is feeding me. It just melted my heart. Ian just happened to be over my shoulder looking at him so we were able to share this amazing moment as a family. Now he does it all the time and talks! I think he likes taking a break to say what is on his mind… HA! So much fun!

My cousins came for a visit, so I got to hang out with them. This is me with mom and Kathy.

We can talk to my relatives through skype in front of the computer with mom and dad. It’s fun, because I can see myself too!

Grandpa is reading cards to me in Spanish. Being in SoCal makes knowing some Spanish a good idea. I’m still learning English of course, but I like hearing all the different sounds!

In case you haven’t noticed most prenatal vitamins have less than the RDA for Vitamin A in the natural form also known as beta-carotene.

What’s the reason for this?

Research shows that too much Vitamin A and in the form called  retinol can cause birth defects.

Most pregnant women take prenatal vitamin so what’s the issue?  The issue is whether you are consuming other foods that are fortified with vitamin A such as cereals, protein bars, etc.

If you are consuming something in a package please check the label.  If the food has more than 20-30% of the RDA for vitamin A consider limiting  that food and only get your vitamin A from natural sources such as fruits and vegetables, which are completely safe and recommended for health.

In addition, check to make sure your prenatal has less than the 5000 IU RDA for Vitamin A (most have 4000 IU in the beta-carotene form).  This will help contribute to a healthy, happy pregnancy.

Look at me lifting my head all the way up! I’m practicing to crawl. Still trying to get all my arms and legs to coordinate though.

It’s taken awhile for Miles to get use to the Baby K’tan Baby Carrier and the Moby Wrap, I am still not sure he is completely sold on either! He seems to like this position because he can see everything I do. We shall see how it goes, it certainly makes it easier for us to do things around the house.

Here I am hanging out here on the My Brest Friend. I just enjoyed a nice milk session with mom, now I’m just chillin.

This is what I look like each night at 9:30PM, and again between 12:30-2:00AM. He goes to sleep between 6:30PM and 7:00PM (depending on how long it takes to put him town), then we wake him up for his 9:30PM feed, then let him sleep until he wakes up for his middle of the night feed. During the middle of the night feed I feel like a walking zombie.

Miles has been wanting to walk since he was 12 weeks old and we have encouraged that. My girlfriend came over and she said that if you continue he could be bowlegged. So I talk to our Dr. about it and she said all babies are born bow legged because of their folded position in the uterus and that is an old wise tale. The infant’s bowed legs begin to straighten once the child starts to walk and the legs begin to bear weight. Thank goodness because our little munchkin loves to walk!

What is all the hype about Vitamin D?

Vitamin D is critically important to women’s health.  The main source of Vitamin D is from sunlight, food and supplements. We produce it ourselves, in our skin, as long as we get enough exposure to the sun.  This is how it became known as the “sunshine vitamin”. There are 5 forms of vitamin D, of which Vitamin D3, is the more effective form used by humans

Studies show that as many as 3 out of 4 Americans suffer from Vitamin D deficiency.   It’s thought to be the most common medical condition in the world, affecting over 1 billion people.  In the United States, 51 million children were found to have Vitamin D insufficiency. Many none-too-shocking factors contribute to what scientists perceive as an “epidemic” of vitamin D deficiency; our indoor-oriented lifestyles, limited sun exposure during cold-weather months, and frequent sunscreen use.

Can we get vitamin D from food? While obtaining nutrients from food is generally the best route, dietary sources of substantial vitamin D are few and far between. Limited amounts of vitamin D can be found in fortified dairy products and cereals, as well as sardines, cod liver oil, salmon, and eggs yolks.

The sun is your best source of Vitamin D. If you go outside, remove your clothing, defy recommendations to use sunscreen, and stand outside soaking up UV rays for about 15 to 20 minutes, you will satisfy your Vitamin D daily requirements.

Vitamin D is essential to good health, helps build strong bones and teeth, prevents diabetes, and helps fight off infectious diseases.  Observation studies also support reproductive health and preparation for pregnancy.  In studies related to pregnancy, Vitamin D3 2,000 IU greatly reduced the risk of pregnancy associated complications, including gestational diabetes, preterm birth, pregnancy induced hypertension, and infection.  Additionally, women who took the higher doses of Vitamin D during pregnancy were the least likely to have deficient or insufficient blood levels of the Vitamin, as were their newborn babies.

Overall benefits of Vitamin D:

o   Protects against heart disease, high blood pressure and strokes
o   Helps with neuromuscular function and immune system strength
o   Reduces complications associated with pregnancy such as hypertension, gestational diabetes, preterm labor
o   Supports reproductive health and prepares you for pregnancy
o   Osteoporosis prevention
o   Higher levels of Vitamin D have an “anti-cancer” effect with breast, colon, and prostate cancers
o   Contributes to bone and teeth health
o   Promotes healthy cell development
o   Protects against chronic diseases

Prenatal vitamins contain the RDA (Recommended Daily Allowance) of Vitamin D which is 600 IU’s.  It is extremely important for your health care provider check your Vitamin D level to know how much you should be taken during pregnancy, lactation and beyond.   Normal range of Vitamin D 25-OH is between 30-100ng/ml.  Studies show a level of 40ng/ml is required to receive the maximum benefits of Vitamin D.

How much vitamin D do we need from supplements? Factors such as age, obesity, and skin color all influence our vitamin D requirements. Supplementing 1,000 IU of calcium D3 (cholecalciferol) is generally considered safe. The recommended upper limit for vitamin D is 2,000 IU per day especially if you are pregnant.  Although toxicity is rare, vitamin D is fat-soluble, therefore can be stored in the body for long periods. So before you start supplementing, consult your doctor. My best advice is get your Vitamin D 25-OH levels checked so you know where you stand in the Vitamin D deficiency epidemic.

The hype surrounding Vitamin D is ongoing and controversial.  Physicians and researchers have varying recommendations based on the ongoing studies taking place around the world.  What we do know is that there are valid studies showing that there is a true Vitamin D deficiency occurring worldwide and Vitamin D has a profound impact on our health.

This article my brother sent me is about research showing dogs and cats could be helpful to a baby’s immune system. The theory is that dogs and cats will expose babies to more things, which is ultimately helpful for in the long run.

Our pediatrician did say that for the first couple months one should still limit what an infant is exposed to, because they are so vulnerable at that time. We’ve been diligent about cleaning up the cat hair and keeping Izzy off of Miles’ stuff, but it doesn’t seem as much a concern now, and in fact could be helping him.

What are some good options for maintaining a healthy pregnancy and staying cool through the summer months?  Besides eating a balance of protein, carbohydrate and fat here’s a few ideas to keep you cool and healthy:

• High protein smoothie:

Need an afternoon snack?  Research shows that having more protein in the afternoon can help with keeping your appetite under control.  For a balanced refreshing drink try blending up a combination of organic milk or unsweetened vanilla almond milk, plain yogurt, frozen berries, and a little vanilla or cinnamon to taste.  You can even pour the smoothie in Popsicle containers and freeze for a refreshing snack.

• Make your own lemonade:

Squeeze a few lemons into water and add a teaspoon of honey, some fresh ginger, water (or seltzer water) and ice and you’re good to go.

• Make your own Frozen Greek Yogurt

Mix frozen berries or fruit compote into your favorite plain Greek yogurt and freeze – amazing taste and high in protein, probiotics and flavor.

Miles sleeps with 2 Lovies (Angel Dear (Frog) Blankie, Angel Dear (Robot) Blankie)
The frog has my scent on it and the robot has Ian’s scent on it. The Dr. said to introduce Miles to them now by rubbing his cheek with them. She said you want babies to be able to self sooth and having a lovie is a good way for them to do just that!

Is it easier to care for the circumcised penis or uncircumcised penis?
 
The circumcised penis is generally easier to keep clean. An uncircumcised boy should be taught to clean his penis with care. Cleaning of the penis is done by gently, not forcibly, retracting the foreskin. The foreskin should be retracted only to the point where resistance is met. Full retraction of the foreskin may not be possible until the boy is 3 years old or older.

What is the relationship between circumcision and urinary tract infections?
 
The incidence of urinary tract infections in male infants appears to be lower when circumcision is done in the newborn period. It was first reported in 1982 that urinary tract infections (UTIs) are more common among infant males than they are in infant females (this switches later on in life). In this study, it was revealed that about 95% of the infected infant boys had not been circumcised. This risk is especially significant in infants less than 1 year of age. Many studies have shown that uncircumcised infants have a tenfold increased risk of developing a UTI than circumcised infants.

His head is still a bit wobbly, but he’s starting to get the hang of sitting upright.

Sophie the Giraffe is the first thing Miles actually grabbed today. I have put all sorts of things in front of him and wrapped his little finger around toys, stuffed animals and rattles but today he grabbed this little teether without my help and held it for awhile… YAY Miles! One day I am going to hate that he is grabbing everything but now, I couldn’t be prouder!

6:00 am… another night terror. Miles eyes were wide open and he was screaming at the top of his lungs. I am finding out more about night terrors. They are relatively rare — they happen in only 3-6% of kids, while almost every child will have a nightmare occasionally. They seem to be a little more common among boys. Night terrors are caused by over-arousal of the central nervous system (CNS) during sleep. This may happen because the CNS (which regulates sleep and waking brain activity) is still maturing. Some kids may inherit a tendency for this over-arousal — about 80% who have night terrors have a family member who also experienced them or sleepwalking (a similar type of sleep disturbance). We are going to the pediatrician on Wed. for a scheduled visit and of course will discuss with her.

Ian and I have woken up several times to Miles screaming in his sleep. It’s disturbing and gut retching. He is sound asleep and screaming at the top of his lungs. What could he possibly be dreaming about that would be so traumatic?

I researched on line and found quite a bit of information. “A night terror, also called confusional arousal or sleep terror, is not a dream. It is a state, how a baby or child feels and reacts when waking up from a deep sleep. This makes it very different from a nightmare.” Toddlers can experience night terrors but it’s not as common in babies yet our baby is having them.  He has had about 3 or 4 of them and what they say is to make sure your baby is not overtired, apparently fatigue is a trigger. If it continues then figure out the times he has them and wake him up before it occurs. This will change their pattern of sleep.

To Circ or Not to Circ, that is the question!

Routine circumcision remains a constant topic of controversy and confusion when you find out you are having a boy.  According to the most recent policy on the male circumcision policy from the American Academy of Pediatrics there is “insufficient information to recommend routine circumcision.” Most major medical societies have taken an “impartial” view of the procedure, neither recommending nor renouncing the practice.

What is a circumcision? Boys are born with a covering over the head of the penis called the glans. This covering is also called the foreskin. During circumcision, the foreskin is surgically removed, exposing the glans of the penis.

Neonatal circumcision is one of the most commonly performed procedures in the United States. Religious and cultural circumcision is commonly performed.  In the Jewish and Islam religions circumcision is widely practiced within days of the birth of a son.

Infant circumcision was recognized in the United States around 1900.  The United Kingdom was one of the first countries to critically look at neonatal circumcision. In 1949, the United Kingdom’s National Health Service removed infant circumcision from its list of covered services, and circumcision has since been an out-of pocket expense to parents.

Circumcision statistics in the United States are difficult to gather because of the many locations in which circumcisions are performed. Different sources provide varying rates, and circumcision frequency varies from year to year. In the late 1940s and early 1950s, 76% of boys were circumcised, of which, approximately 80% were Caucasian and 45% were African American.

The American Urological Association (AUA) believes that neonatal circumcision has potential medical benefits and advantages as well as disadvantages and risks. AUA also notes that when circumcision is being discussed with parents and informed consent is obtained, medical benefits and risks, as well as ethnic, cultural, religious, and individual preferences, should be considered. The risks and disadvantages of circumcision are encountered early, whereas advantages and benefits are prospective.

The World Health Organization (WHO) takes a more pro-active stance toward circumcision in certain populations, stating that male circumcision should be considered an effective intervention for human immunodeficiency virus (HIV) prevention in countries and regions with heterosexual epidemics, high HIV, and low male circumcision prevalence.  Recently, however, several large studies revealed a 60% decrease in HIV transmission in circumcised males compared to uncircumcised males.

Complications associated with circumcision in male neonates, infants, and children, are rare. However, complications were seen, especially when circumcision was undertaken at older ages, by inexperienced providers, or in non-sterile conditions.  Complications included bleeding, hematoma, urethral laceration, removal of too little tissue or an incomplete circumcision, infection and injury to the glans and frenulum.  Advantages to having a circumcision include a protective role against penile cancer, HIV, HPV and other STD’s in the higher risk populations.

The procedure can take from 5 to 20 minutes and will usually be performed before leaving the hospital. Your baby will be placed in a padded restraint chair and usually be given anesthesia, either topical lidocaine cream or a lidocaine injection. Since there are several different types of possible procedures, you should ask your health care provider to explain the type they will be using. Procedures include the Plastibell, the Gomco clamp or Mogen clamp which all require the use of a scalpel. These procedures first separate the foreskin from the glans with a device followed by surgery with the scalpel to remove the foreskin.

On the simplest level, some parents will base their decision to circumcise their male infant based on if the father is circumcised.  Keeping all the males in the home “looking the same” helps minimize future questions regarding differences in the male anatomy.

Neonatal/infant circumcision rates in the U.S. vary geographically and have fluctuated in accordance with guidelines set forth by various medical groups, including American Academy of Pediatrics. Over the years, there has been a trend in favor of a decreasing prevalence of circumcision. When counseling parents regarding the pros and cons of circumcision, it is important to discuss the potential impact of circumcision on HIV and STD risks, particularly as they apply to higher risk populations.

Not bad. Pretty comfortable. Memory foam pad is a plus. I could use a little more space though.

There’s a very interesting baby in the mirror, and I need to get closer to check him out.

These past weeks have been a bit hard to post everyday, Ian was away and the baby has needed more attention than usual, but I had to post that Miles is awake! He is now 3 months old and he has become a baby. Miles is no longer a small infant! He is holding his head up, smiling, cooing, giggling, standing, walking (with us holding his arms), and lots of chatting! Everyday there is a new discovery for him. Just the other day he looked up at me when I was breast feeding him and smiled… Talk about melting my heart… It was like he was saying “Hey… there is my Mom.”

This dress by RVCA is a great option on America’s holidays. The empire waist will sit right above your growing little one, while the pattern will flatter your ever-changing waistline.