December 2005 Feeding Kids Newsletter

News & Views on Child Nutrition
For Parents, Educators, and Health Professionals
by Connie Evers, MS, RD
Issue 57, December 2005

Seven Steps to Successful Breastfeeding

While many women start out with good intentions to breastfeed, many give up in the early weeks due to sore nipples and feeding difficulties. A just-released study (1) finds that many new moms would benefit from the support of lactation-savvy health professionals and family members. Findings From the Pregnancy Risk Assessment and Monitoring System found that 32% of women did not attempt breastfeeding at all, 4% started but stopped within the first week, 13% stopped within the first month, and only 51% continued for more than 4 weeks.

While the American Academy of Pediatrics recommends that infants breastfeed for at least one year, statistics from the Centers for Disease Control and Prevention (CDC) show that only 17.2 % of infants were breastfeeding at 1 year of age.

The numbers don't tell the whole story, though. Just because breastfeeding is natural doesn't mean it is easy! I still have vivid memories of the pain and difficulty I encountered when I tried to nurse my daughter (now a 19 year-old college freshman!) Not until I received advice from an experienced lactation counselor, did our difficulties (and my pain) resolve.

Steps to Successful breastfeeding

Early in your pregnancy, make a commitment to breastfeed. Take classes, read books, and identify local resources before your baby is born. You will feel more prepared and confident.

Develop a plan for lactation management in the hospital. Communicate to the doctor, nurses and hospital staff that you prefer 24-hour rooming in, feeding on demand and oppose the use of sterilized water, sugar water, formula or artificial nipples.

To prevent nipple confusion, avoid the use of pacifiers and bottles until nursing is well-established, a process which normally takes a month to several weeks.

Watch for signs that your baby is receiving adequate nutrition, i.e infant latches on with an open mouth, there are audible swallowing sounds during nursing, the baby wets and stools frequently (at least six wet diapers and three yellow stools in 24 hours) and there is adequate growth and weight gain at doctor or clinic visits. Newborns should be seen by a healthcare provider two to three days after discharge and again in two weeks for an assessment and weight check.

Consult a knowledgeable lactation specialist at the first sign of a problem. Often, difficulties with sucking, positioning, and scheduling can be easily remedied if caught in the early stages. Check with your doctor or hospital for referral to a board-certified lactation consultant.

Planning and problem-solving are prerequisites for combining work and breastfeeding. Women should address the issue beforehand with their employer, detailing what their needs will be (e.g. a private place for milk expression, use of scheduled lunch and/or breaks for pumping, refrigeration, etc). Even the most difficult work situations can be adapted to accommodate milk expression. For those who work in open or semi-private cubicle areas, one solution is to find a private area in their workplace. A borrowed office, storeroom with a lock, an empty conference room, or a private lounge area can all be adapted for breast pumping. If refrigeration is a problem, milk can be stored in a small cooler with refreezable ice packs.

A support network is one of the most important factors contributing to longterm success at breastfeeding. Become involved in groups such as La Leche League International or Nursing Mothers Counsel (check your local area to see there is a chapter nearby).

Reference:
1. Indu B. Ahluwalia, Brian Morrow, and Jason Hsia. Why Do Women Stop Breastfeeding? Findings From the Pregnancy Risk Assessment and Monitoring System. Pediatrics 2005; 116: 1408-1412. Abstract available online at http://pediatrics.aappublications.org/cgi/content/abstract/116/6/1408

Talk about an all around winner! Breastfeeding has so many advantages, including health, economic and even environmental! Here's a few:

FOR BABY:

Breast milk provides superior nutrition matched precisely to a growing baby's needs. Studies show that the omega-3 fatty acids found in breast milk play an important role in infant brain development. Additionally, researchers have identified hormones, enzymes, and other growth factors in human milk that make subtle, yet important contributions to growth and development.

Breast milk contains antibodies that protect infants from disease. Breastfed babies have fewer allergies, less diarrhea, and a lower risk of serious bowel disorders.

Babies who are breastfed have reduced ear infections and respiratory illnesses, and fewer doctor and hospital visits than infants who are formula fed.

Breastfed babies have a lower risk of Sudden Infant Death Syndrome (SIDS).

Breastfeeding may convey a lifetime advantage in terms of cancer risk. One study showed a lowered risk of breast cancer in later life for women who were breastfed as infants. Another report documented a reduced risk of childhood cancer among those youngsters who were breastfed.

Babies who are breastfed have a lower risk of developing insulin-dependent diabetes in childhood.

Production of breastmilk uses around 200-500 calories each day, which aids new moms in losing excess pregnancy weight. (It's like walking an extra 2-5 miles each day!)

Women also regain their shape faster because of the hormones associated with lactation. The uterine contractions women feel in the early weeks of breastfeeding signal that the uterus is contracting back into shape.

Lactation may be a protective factor against breast cancer and ovarian cancer, particularly in premenopausal women. It appears that women who lactate the longest have the most protection.

Breastfeeding women who return to outside employment miss fewer days of work attending to an ill infant.

Breastfeeding is more convenient and economical -- there's nothing to buy, mix, or store!

Breastfeeding is a relaxing and enjoyable chance for mother and baby togetherness. When feeding time comes, schedules, deadlines, and other activities become secondary. The hormones produced during lactation contribute to relaxation and stress relief.

3 medium sweetpotatoes (or 2 large)
1 large Granny Smith apple, washed and thinly sliced
1/3 cup packed brown sugar
1/3 cup water
1/2 cup raisins
1/2 teaspoon cinnamon
2 T. soft margarine (trans-fat free)
nonstick cooking spray

DIRECTIONS:
1. Scrub the sweetpotatoes and put them in a saucepan. Cover with water and bring to a boil. Cover and boil gently for 20-30 minutes or until easily pierced with a fork. Drain, cool slightly, peel and slice into 1/4 inch thick pieces.
2 .Preheat oven to 350 degrees F. Lightly spray a 1 1/2 quart baking dish with nonstick spray.
3. In a small saucepan, mix together brown sugar, water, raisins, cinnamon and margarine. Cook over medium heat for approximately 5-7 minutes, stirring often.
4. In the baking dish, layer sliced sweet potatoes with sliced apples. Pour the sauce mixture over the top.
5. Bake covered for 15 minutes. Uncover and continue baking for 15-20 more minutes until the sweetpotatoes and apples are tender.
Makes 6-8 servings

Connie Evers, MS, RD, is the author of How to Teach Nutrition to Kids, the companion LEADER/ACTIVITY guide and a number of additional resources located at http://nutritionforkids.com.

For an order form that you can print and mail or fax to us, click here.

To order online, please visit our secure shopping cart.
Did you know that Connie is a frequent and popular speaker at state and national conferences on child nutrition topics? Email her at connie@nutritionforkids.com to discuss.

	Breastfeeding Basics Seven Steps to Successful Breastfeeding While many women start out with good intentions to breastfeed, many give up in the early weeks due to sore nipples and feeding difficulties. A just-released study (1) finds that many new moms would benefit from the support of lactation-savvy health professionals and family members. Findings From the Pregnancy Risk Assessment and Monitoring System found that 32% of women did not attempt breastfeeding at all, 4% started but stopped within the first week, 13% stopped within the first month, and only 51% continued for more than 4 weeks. While the American Academy of Pediatrics recommends that infants breastfeed for at least one year, statistics from the Centers for Disease Control and Prevention (CDC) show that only 17.2 % of infants were breastfeeding at 1 year of age. The numbers don't tell the whole story, though. Just because breastfeeding is natural doesn't mean it is easy! I still have vivid memories of the pain and difficulty I encountered when I tried to nurse my daughter (now a 19 year-old college freshman!) Not until I received advice from an experienced lactation counselor, did our difficulties (and my pain) resolve. Steps to Successful breastfeeding Early in your pregnancy, make a commitment to breastfeed. Take classes, read books, and identify local resources before your baby is born. You will feel more prepared and confident. Develop a plan for lactation management in the hospital. Communicate to the doctor, nurses and hospital staff that you prefer 24-hour rooming in, feeding on demand and oppose the use of sterilized water, sugar water, formula or artificial nipples. To prevent nipple confusion, avoid the use of pacifiers and bottles until nursing is well-established, a process which normally takes a month to several weeks. Watch for signs that your baby is receiving adequate nutrition, i.e infant latches on with an open mouth, there are audible swallowing sounds during nursing, the baby wets and stools frequently (at least six wet diapers and three yellow stools in 24 hours) and there is adequate growth and weight gain at doctor or clinic visits. Newborns should be seen by a healthcare provider two to three days after discharge and again in two weeks for an assessment and weight check. Consult a knowledgeable lactation specialist at the first sign of a problem. Often, difficulties with sucking, positioning, and scheduling can be easily remedied if caught in the early stages. Check with your doctor or hospital for referral to a board-certified lactation consultant. Planning and problem-solving are prerequisites for combining work and breastfeeding. Women should address the issue beforehand with their employer, detailing what their needs will be (e.g. a private place for milk expression, use of scheduled lunch and/or breaks for pumping, refrigeration, etc). Even the most difficult work situations can be adapted to accommodate milk expression. For those who work in open or semi-private cubicle areas, one solution is to find a private area in their workplace. A borrowed office, storeroom with a lock, an empty conference room, or a private lounge area can all be adapted for breast pumping. If refrigeration is a problem, milk can be stored in a small cooler with refreezable ice packs. A support network is one of the most important factors contributing to longterm success at breastfeeding. Become involved in groups such as La Leche League International or Nursing Mothers Counsel (check your local area to see there is a chapter nearby). Reference: 1. Indu B. Ahluwalia, Brian Morrow, and Jason Hsia. Why Do Women Stop Breastfeeding? Findings From the Pregnancy Risk Assessment and Monitoring System. Pediatrics 2005; 116: 1408-1412. Abstract available online at http://pediatrics.aappublications.org/cgi/content/abstract/116/6/1408

	Benefits for Both Baby and Mom! Talk about an all around winner! Breastfeeding has so many advantages, including health, economic and even environmental! Here's a few: FOR BABY: Breast milk provides superior nutrition matched precisely to a growing baby's needs. Studies show that the omega-3 fatty acids found in breast milk play an important role in infant brain development. Additionally, researchers have identified hormones, enzymes, and other growth factors in human milk that make subtle, yet important contributions to growth and development. Breast milk contains antibodies that protect infants from disease. Breastfed babies have fewer allergies, less diarrhea, and a lower risk of serious bowel disorders. Babies who are breastfed have reduced ear infections and respiratory illnesses, and fewer doctor and hospital visits than infants who are formula fed. Breastfed babies have a lower risk of Sudden Infant Death Syndrome (SIDS). Breastfeeding may convey a lifetime advantage in terms of cancer risk. One study showed a lowered risk of breast cancer in later life for women who were breastfed as infants. Another report documented a reduced risk of childhood cancer among those youngsters who were breastfed. Babies who are breastfed have a lower risk of developing insulin-dependent diabetes in childhood. FOR MOM: Production of breastmilk uses around 200-500 calories each day, which aids new moms in losing excess pregnancy weight. (It's like walking an extra 2-5 miles each day!) Women also regain their shape faster because of the hormones associated with lactation. The uterine contractions women feel in the early weeks of breastfeeding signal that the uterus is contracting back into shape. Lactation may be a protective factor against breast cancer and ovarian cancer, particularly in premenopausal women. It appears that women who lactate the longest have the most protection. Breastfeeding women who return to outside employment miss fewer days of work attending to an ill infant. Breastfeeding is more convenient and economical -- there's nothing to buy, mix, or store! FOR BOTH: Breastfeeding is a relaxing and enjoyable chance for mother and baby togetherness. When feeding time comes, schedules, deadlines, and other activities become secondary. The hormones produced during lactation contribute to relaxation and stress relief.
	Updates from Connie 2005 has seen a lot of changes in the field of nutrition! Here are some of the highlights from projects I've been involved with this year: - How to Teach Nutrition to Kids is being revised to reflect the 2005 Dietary Guidelines and MyPyramid. - In the meantime, I am dropping the price of How to Teach Nutrition to Kids (2003 edition) to $12.95! That's a savings of $7.00 which will be in effect until December 31st. To take advantage of this offer, you must order online through the 24 Carrot Press shopping cart. No exceptions. - The Leader/Activity Guide will be completely overhauled and it will have a new title (ideas anyone?). The guide will remain a tool with plenty of reproducible activities and handouts. The feedback I receive is that you like this format a lot! In case you can't wait, I do still have around 30 copies of the 1998 version in stock. - My most exciting news is that I finished work on a new children's book that will be published by Disney! This 48 page book/game will be highly interactive, colorful and engaging. I can hardly wait to see the Disney characters getting into the act of promoting good food and activity for kids! It is to be published late spring/early summer of 2006 and is targeted for elementary-aged children. More to come...
	RECIPE:Sweet Granny Potatoes The Dietary Guidelines for Americans 2005 and MyPyramid recommend we "Vary our Veggies" and even list sweetpotato as a specific example. Little wonder, since sweetpotato is an absolute nutritional powerhouse. One medium sweet potato, with a mere 103 calories, is good source (>10% daily value) of fiber, vitamin B6 and potassium, and a very good source (> 20% daily value) of vitamin A, vitamin C and manganese. Too often though, sweetpotatoes conjure up images of buttery, marshmallow swamped orange mushy stuff served only at holiday time. But sweetpotato is a delicious vegetable all on it's own! Even my 13 year-old son enjoys a plain boiled sweetpotato, dabbed with a bit of soft margarine (I buy the trans-fat free varieties). The following recipe was a big hit with my kids at Thanksgiving. Upon request, I made another batch the following week. Enjoy! 3 medium sweetpotatoes (or 2 large) 1 large Granny Smith apple, washed and thinly sliced 1/3 cup packed brown sugar 1/3 cup water 1/2 cup raisins 1/2 teaspoon cinnamon 2 T. soft margarine (trans-fat free) nonstick cooking spray DIRECTIONS: 1. Scrub the sweetpotatoes and put them in a saucepan. Cover with water and bring to a boil. Cover and boil gently for 20-30 minutes or until easily pierced with a fork. Drain, cool slightly, peel and slice into 1/4 inch thick pieces. 2 .Preheat oven to 350 degrees F. Lightly spray a 1 1/2 quart baking dish with nonstick spray. 3. In a small saucepan, mix together brown sugar, water, raisins, cinnamon and margarine. Cook over medium heat for approximately 5-7 minutes, stirring often. 4. In the baking dish, layer sliced sweet potatoes with sliced apples. Pour the sauce mixture over the top. 5. Bake covered for 15 minutes. Uncover and continue baking for 15-20 more minutes until the sweetpotatoes and apples are tender. Makes 6-8 servings

	News in Brief Food Marketing Aimed at Kids Influences Poor Nutritional Choices What many of us suspected all along about food marketing to kids has been confirmed. Food and beverage marketing targeted to children ages 12 and under leads them to request and consume high-calorie, low-nutrient products, says a new report from the Institute of Medicine. The report offers the most comprehensive review to date of the scientific evidence on the influence of food marketing on diets of children and youth. Click here to view the news release. School District Develops "Virtual Cafeteria" Students in the Carrollton-Farmers Branch Independent School District in Carrollton, Texas have all the information they need to make healthful and informed food choices at school. On the "Virtual Cafeteria" web site, students can plan ahead for breakfast or lunch by building a virtual meal, which gives detailed nutrition information and price. The website also includes the Texas Nutrition Policy, menu nutrient content, healthy recipes, and a nutrition bulletin board. The site is located at http://studentnutrition.cfbisd.edu Do More, Watch Less! The California Obesity Prevention Initiative has released *Do More, Watch Less!,* a TV reduction tool targeted towards 10 to 14-year-olds in after school programs and other youth-serving organizations. The sessions aim to help youth incorporate more screen-free activities into their day while reducing the time they spend on screen-based activities such as watching TV, surfing the internet, and playing video games. Download the complete 36 page guide here.
The information contained in this newsletter is not intended as a substitute for medical and/or nutrition advice. See your physician and/or registered dietitian for individual health and/or dietary concerns.	©2005, by Connie Evers, All Rights Reserved. There is a modest reprint fee for reproducing the material in this newsletter in either print or electronic publications. Please send an email to reprint@nutritionforkids.com for details and rates. The FEEDING KIDS NEWSLETTER is published bimonthly by 24 CARROT PRESS . To subscribe, click here.

Breastfeeding Basics

Updates from Connie

RECIPE:Sweet Granny Potatoes

News in Brief

Connie Evers, MS, RD, is the author of How to Teach Nutrition to Kids, the companion LEADER/ACTIVITY guide and a number of additional resources located at http://nutritionforkids.com.

For an order form that you can print and mail or fax to us, click here.

To order online, please visit our secure shopping cart.

Did you know that Connie is a frequent and popular speaker at state and national conferences on child nutrition topics? Email her at connie@nutritionforkids.com to discuss.