By Jessie Funchion, MS, RD, LDN

1)    How long is it recommended to breastfeed? 

6 months exclusive breastfeeding (according to AAP/WHO/AND), and ideally longer with complementary foods. The AAP recommends at least 1 year and the WHO recommends at least 2 years. 

2)    How long does a feeding session take? How much milk is the baby getting? 

At first, probably each feeding will likely take 30-45 minutes and should occur every 2-3 hours, or on demand. From 0-6 months, the infant will likely get around 25-30oz a day, for a total of 400-600 calories. 

3)    What are contraindications to breastfeeding? 

Mothers who..

–       Are HIV positive in the U.S.

–       Have untreated brucellosis 

–       Have Human T-cell lymphotrophic virus type I or II or use street drugs

–       Use street drugs 

Infants who have galactosemia, an inborn error of metabolism that is diagnosed first few days of life, also should not breastfeed. 

If mothers have hepatitis C or are hepatitis B surface antigen positive, have a fever or take certain medications (See LactMed) or have exposure to low level environmental chemicals, they can still breastfeed! If the baby has jaundice, they can also still breastfeed (it may even help). Occasional alcohol or cigarette use is also compatible with breastfeeding, though not encouraged. 

4)    What is breast milk composed of? 

Breast milk composition changes over the course of the baby’s life, as well as over the course of a feeding. Colostrum is rich in protein and fat soluble vitamins and produced in very small amounts (only 1  tsp/feeding). Mature milk is actually 90% water and 10% macros, and is around 20 calories per ounce. The macronutrient composition is mostly carbohydrate (lactose), low protein (7-8%) and the fat content is variable. 

Breast milk also contains a ton of ‘non-nutritive’ substances such as immune factors, appetite regulating hormones and prebiotics. 

5)    What are the benefits of breastfeeding for babies? 

Breastfed infants have lower rates of gastrointestinal and respiratory infections, ear infections, necrotizing enterocolitis and SIDS. There is also correlation between breastfeeding and lower risk of chronic disease such as type 1 diabetes, Celiac disease, obesity, asthma, dermatitis and leukemia, but more research is needed. 

6)    What are the benefits of breastfeeding for moms?

Women who breastfeed have a lower risk of hemorrhage after birth, post-partum depression and premature return of ovulation. There is correlation between nursing and body weight/weight retention, type 2 diabetes, cancer (breast/ovarian), heart disease and hypertension, but again, more research is needed. 

7)    What supplements should mom and baby take? 

It’s not a bad idea for women to continue taking a prenatal vitamin while nursing, but the biggest nutrients of concern are Calcium, Vitamin D and Iron. Exclusively breastfed babies should receive 400IU Vitamin D each day. 

8)    When should complementary foods be introduced? 

Generally 6 months of age. Some signs that infants are ready for food are…

–       sitting up on his own 

–       reaching for a spoon 

–       not spitting up food 

–       growing teeth 

It’s recommended to start with iron and zinc rich foods such as dark leafy greens, meat, fish or iron-fortified cereals. 

9)    How do I know the baby is getting enough milk? 

–       GROWTH: The infant should be progressing appropriately along his or her growth curve

–       DIAPERS: 1 dirty/1 wet on day 1 of life, 2 dirty/2 wet on day 2, etc., until infant produces around 3-4 dirty diapers each day and 5-6 wet diapers each day. 

–       BEHAVIOR: Infants should appear somewhat relaxed and satiated after a feeding 

10) What should mom include in diet? Avoid in diet? 

 Women’s diets should look pretty similar to their third trimester diets, about 400-500 extra calories a day. Focus on a well balanced diet that includes all 5 food groups. Women should drink to thirst, but aim for 3L total fluids each day. 

Limit caffeine to 300mg/day and seafood to 12oz/week. Alcohol can be enjoyed in moderation, but keep in mind alcohol in milk peaks about 30-90 minutes after consumption. 

And remember, while ‘breast is best’, we’re very lucky in this country to have formula as an excellent back up plan!  


Source: DietitianCentral.com, “Nutrition During Lactation: The First Year and Beyond” 
Resources: https://www.nutrition.gov/subject/life-stages/women/breastfeeding— 

By Elizabeth May, RDN, CSOWM, LDN

This is the time of year when many of us are focusing on our goals and getting back to meal planning, tracking and weight loss. We know that self-monitoring is the single most effective strategy for weight loss, so let’s talk about tracking!

Apps to Track

– LoseIt

– My Fitness Pal

– Calorie Counter

– SparkPeople

– See How You Eat

– Fitbit

– YouAte Food Diary

Journals to Track

  • Today is the Day:A  90 Day Food + Fitness Journal
  • Hello New Me

Other Ideas:

  • Jot down food in Notes section on phone
  • Take pictures of food and create an album on phone
  • Post your food pics on Instagram

How to Make Tracking a Habit:

  • Pick an easy to use method
  • Track immediately after a meal or snack
  • Set an alarm on your phone to remember to track each day
  • Choose favorites in your App to make tracking fast
  • Add friends to your App to keep you accountable
  • Set a goal with your Family Food dietitian to check your App at your next visit

How Does Tracking Help?

  • Keeps you accountable
  • Learn correct portion sizes
  • Creates awareness of food habits (“aha moments”)
  • Allows for a record of your improvements

By Carlie Saint-Laurent, RD,LDN

The new year brings new resolutions and like most of the US population health and weight loss are on top of the list.  Many people are looking to Complimentary Alternative medicine to rid their health condition. Apple cider vinegar (ACV) is one of those natural ancient remedies believed to aid in diabetes, high cholesterol, hypertension, digestion, and weight loss still to this day.

So what’s the truth about apple cider vinegar when it comes to weight loss?

 

One 12-week study had consisted 175 obese Japanese participants split up in to 3 groups. 1 group consumed 1 tbsp, the other group consumed 2 tbsp and group 3 consumed no ACV. The results found both groups consuming ACV had lower BMI, visceral fat, and LDL cholesterol compared to the placebo group.

 

Apple cider vinegar however maybe more effective in managing blood sugars especially in people with prediabetes. The mechanism behind this is the acetic acid in the vinegar impedes the starch enzymes from breaking down therefore ACV (along with any vinegar for that matter) is beneficial when consuming starches like bread and pasta. When the starches are not broken down the blood sugars aren’t elevated, and this in fact could control appetite as well.

 

Nutrition recommendations:

–       Consume foods that already contain vinegar like dressings, pickled foods, condiments like relish or ketchup

–       For best results consuming consistently and regularly is key

–       If going to consume ACV ensure ratio is 1 tablespoon for  8oz of water to avoid damaging teeth, throat, and stomach lining due to the acid

–       Do not exceed more than three times a day of 1-2 tablespoons per serving as it can be harmful

–       For first timers start off with 1 teaspoon to see if any adverse reactions such as nausea occur

–       If one has gastroparesis it should NOT be recommended as delayed stomach emptying can be increased

–       Consume right before the meal where it can have the most synergistic effect

 

Sources:

https://reader.elsevier.com/reader/sd/pii/S0308814616318076?token=6D9B5941533DE6B261116DBDB7B3F41EF6F0B79EE6710D50EBAA6A481B42D30719C736824DB9DFF9DBC74230ED9D83F0

https://edition.cnn.com/2017/07/19/health/apple-cider-vinegar-weight-loss/

https://www.healthline.com/nutrition/apple-cider-vinegar-weight-loss#section7