Monday, September 26, 2011

Information about milk substitutes

From Yahoo:

Cow-free milk is no passing trend: The milk-alternatives market grew 12.5 percent last year, according to the Beverage Marketing Corporation. "While cow's milk contains nutrients such as calcium, vitamin D, and protein, people are turning to nondairy varieties because of allergies, lactose intolerance, and concerns about hormones and antibiotics," says Elisa Zied, R.D., author of Nutrition at Your Fingertips. Some faux milks are more beneficial than good old moo juice and clock in at fewer calories (skim has 90 per eight-ounce glass), while others lack nutritional value or harbor hidden calories and sugar, particularly the vanilla-and chocolate-flavored ones. Consult this guide before you drink up.

Almond Milk

Almond Breeze Original, Per cup: 60 cal, 2.5 g fat (0 g sat), 8 g carbs (7 g sugars), 150 mg sodium, 1 g fiber, 1 g protein
Taste: Creamy, rich, and slightly nutty with a hint of sweetness

Pros: The least caloric of the bunch, it's fortified with vitamin E, a powerful antioxidant that fights UV damage, as well as calcium and vitamins A and D

Cons: While almonds themselves are a good source of fiber and protein, the milk contains skimpy amounts of these nutrients (that's because the milk is made by grinding the nuts and mixing with water). Almond milk is also higher in sodium than other alternatives.

Best in: Smoothies, coffee, and cereal

Hemp Milk

Tempt Original, Per cup: 100 cal, 6 g fat (0.5 g sat), 9 g carbs (6 g sugars), 110 mg sodium, 0 g fiber, 2 g protein

Taste: Nutty and earthy

Pros: It's naturally rich in omega-3 fatty acids—wonder nutrients for your heart, brain, and mood. Hemp milk is made with cannabis seeds, but it won't get you high, because it lacks significant THC (the psychoactive ingredient in marijuana). 

Cons: Depending on the brand, you may gulp only 10 percent of your daily calcium needs. It's not a great source of protein either.

Best in: Mashed potatoes, muffins, and quick breads. Unobtrusive in flavor, it's a good stand-in for cow's milk in baked foods.

Coconut Milk

So Delicious Coconut Milk Beverage Original, Per cup: 80 cal, 5 g fat (5 g sat), 7 g carbs (6 g sugars), 15 mg sodium, 0 g fiber, 1 g protein
Taste: Thick, creamy, and, well, coconut-y

Pros: It has the least amount of sodium and can be fairly low-cal—even some flavored kinds will cost you only 90 calories per serving. Plus, most brands are fortified with half a day's worth of vitamin B12, a brain-boosting nutrient. 

Cons: "The majority of fat is saturated," says Lauren Slayton, R.D., founder of Foodtrainers in New York City. But at five grams per serving, it constitutes less than 8 percent of your total daily value for fat.

Best in: Coffee, tea, pudding, smoothies, and oatmeal—it's a go-to thickener.

Rice Milk

Rice Dream Enriched Original, Per cup: 120 cal, 2.5 g fat (0 g sat), 23 g carbs (10 g sugars), 100 mg sodium, 0 g fiber, 1 g protein
Taste: Light, watery, and sweet

Pros: The carbs. "Have a glass before or after a workout—it offers carbs to fuel and fluid to hydrate, and like a sports drink, it's a good source of electrolytes," says Nancy Clark, R.D., author of Nancy Clark's Sports Nutrition Guidebook.

Cons: The carbs. If you're trying to drop a few pounds, it's best to eat whole-grain carbs, which contain filling fiber; rice milk has zero.

Best in: Desserts, baked goods, pancakes, and French toast. Its natural sweetness complements indulgent foods.

Soy Milk

Silk Original, Per cup: 100 cal, 4 g fat (0.5 g sat), 8 g carbs (6 g sugars), 120 mg sodium, 1 g fiber, 6 g protein
Taste: Faintly sweet. Some varieties have a slight tofu flavor.

Pros: It has almost as much protein as cow's milk, plus plant chemicals that may help inhibit absorption of cholesterol. It's often fortified, so shake the carton well—added calcium tends to settle at the bottom, says Zied. 

Cons: Some studies suggest that overconsuming soy promotes breast cancer. "A good guideline is about 25 grams of soy protein per day," says Zied. 

Best in: Creamy soups and salad dressings, sauces, casseroles, and other savory dishes. Vanilla-flavored varieties are great in coffee or tea (or by the glass!).


Friday, September 23, 2011

First Foods!

So- my little man turned 6 months old! Seems crazy how fast time flies by. Per current guidelines, he was exclusively breastfed until 6 months and then I started introducing solids, following the 4 day wait rule.

We decided to pick avocados as his first food. (We did the same with my older son- so it was an easy choice). I took half of the avocado and mashed it up and gave it to him on a spoon and left the other half in large slices for him to feed himself.

He loved it! He liked the taste and did not even make weird faces. He mostly played and explored- just as he should.

We also introduced bananas this week. I did the same- mashed some, left some whole. I also froze part of the banana and put it into a mesh feeder because the poor guy is teething something awful and he loved the cold on his gums.

Overall- it was a great experience and although I am sad that I am no longer his only food source, I am excited to introduce him to so many great new flavors and foods!

Friday, September 16, 2011

Role of Breastfeeding and Bacteria

Here is an amazing article on how breastmilk introduces good bacteria into the stomachs of newborns, thus developing and shaping their immune systems.


Good bacteria, the role of breastmilk in immune system development and that "one" bottle by Lakeshore Medical Breastfeeding Medicine Clinic

In a perfect world, a term, healthy newborn comes into the world vaginally.  Again, I want to talk about normal.  I know the process doesn't go normally all the time. (And I've talked about this here.)

The delivery of that baby close to the anus is critical for immune system development.  The healthy, term newborn's gut is sterile (without bacteria) and the bacteria that get into that pristine gut are truly important.  During a vaginal delivery, the largely harmless bacteria around the mother's anus are the bacteria getting into the newborn gut.  They increase in number, compete for food and space and help coordinate efforts to create a healthy gut for that baby.  With the exception of our skin, the gut is the largest immune system organ in our body.

Because breastfeeding is normal, what happens to healthy, term newborns who are breastfed is normal.  The newborn has a delay in their immune response to bacteria.  A delay?  To a bacteria?  Yup.  Normal.  After delivery, that newborn gut has many challenges from invaders that may not be friendly.  Doesn't seem too smart not to fight back.

We all have mechanisms in our body to fight infection.  In the gut it's called Gut Associated Lymphoid Tissue (GALT) and it's ready to roll at 19 weeks of gestation.  All of the things that make up the GALT are waiting for a specific series of events to occur after delivery, when, if it proceeds normally, will result in a functioning immune system. 

The sequence of those events is important.  For example, after the good (commensal) bacteria has set up shop in the newborn gut, something called an "isolated lymphoid follicle" in the intestine of that baby develops.  It's activated by substances in colostrum and helps with T cell development and function.

T cells are part of what is called the "innate" system.  They mature in the thymus, an immune system structure found in the neck and chest of newborns.  Human milk activates resting thymus cells, helping to shape the immune function of these cells.  Breastfed kids have a larger thymus than those that are not breastfed; the thymus of the breastfed child is up to twice the size of a child not breastfed.  The innate immune system contains cells that kill bacteria but they do it by also causing inflammation and tissue damage.

The innate immune system is different from the "adaptive" immune system, which is very specific to certain invaders.  (Never being very good at immunology, but being really great at American football, I see the innate system as the offensive line, generally protecting from guys coming at the quarterback.  The adaptive immune system is more like the wide receiver or cornerback- a player with a more specific job)

The cells of the adaptive immune system, antibodies, come in several flavors: Immunoglobulin M (IgM), which is the first type of antibody produced and isn't very specific; IgG which is transferred across the placenta and is the only immunoglobulin that the baby gets from mom and has at birth (the newborn, with only IgG is essentially immuno-compromised); IgE which isn't too relevant here; and IgA which rocks.  IgA is a "sticky" immunoglobulin that protects surface areas from infection.  A special type of IgA, secretory IgA, is found in huge numbers in human milk and protects the airway, gut and other mucous membranes from infection. Secretory IgA is special because the "secretory" part is an addition to the IgA  and importantly,  is resistant to being broken down  by the baby' stomach and GI tract.

So, we have a new baby, exposed immediately to bacteria...why no inflammation?  Well, the activity of the T-cells is delayed for about 10 days (remember, T-cells cause inflammation and tissue damage.) Well... secretory IgA helps.  It's made by mom in response to infections in her environment and passed to the baby through breastfeeding.  Moms and babies should stay together.  This is one good reason: mom can't make antibodies to things that the baby is exposed to if the baby isn't with her.

Human milk also contains special sugars, oligosaccharides, which help feed good bacteria.  In fact, they are necessary for that good bacteria to grow.  Plus, they are a type of prebiotic- something can block bad bacteria before they ever get to the surface of the gut.  They let the probiotics, the good bacteria, stay in the gut.  And because they never let the bad bacteria get to the gut surface, no innate immune system is needed, and we get no inflammation or tissue damage.  Oligosaccharides also work with certain receptors (called Toll Like Receptors).  These receptors work in the first 5 days (when are our kids getting supplemented?) and are controlled tightly, like hour by hour. 

In the time that the immune system is delayed, oligosaccharides, toll like receptors and good bacteria protect against bad bacteria and avoid the need for an inflammatory response.  Any alteration in human milk or addition of formula interferes with toll like receptor function, changes the bacteria that the baby's gut gets exposed to and can then lead to inflammation and tissue damage, the result we were trying so hard to avoid.

Just one bottle.

The lesson?  Let's make sure we know why we are supplementing. 

(I suppose that's another soap box- check out the "3b's"  birth weight, blood sugar and bilirubin)

Jenny Thomas, MD, IBCLC, FAAP, FABM

More info?  A very nice book from Dr. Lars Hanson on Breastfeeding and Human Milk.

Tuesday, September 13, 2011

Recipe of the Day- Carrot Cake Agave Muffins!

 Carrot Cake Agave Muffins: – Makes 36 muffins

1 cup Organic Amber Agave Nectar
4 large eggs
1 cup canola oil
3 cups shredded fresh carrots
2 1/4 cups whole wheat flour
1 tsp baking soda
1 tsp baking powder
2 tsp cinnamon
1/2 tsp salt

Preheat oven to 350 F.
Prepare 3 – 12 cup muffin pans with liners. In a large bowl, combine agave, eggs, and oil, beat well. Stir in carrots. In a separate bowl, combine dry ingredients. Blend in batter. Fill cups only half-way for proper baking. Bake 22 to 25 minutes until the center of a muffin springs back when lightly touched.


Wednesday, September 7, 2011

Introducing Solids to Your Preemie

Check out this great article about introducing solid to preemies from Wholesome Baby Food:

This article has some really important information to be sure your preemie gets the proper nutrition!

Saturday, September 3, 2011

Recipe of the Day- Grilled Veggies!

A GREAT idea for babies, toddlers, kids and adults! Everyone will love the selection and the sweetness added by the balsamic vinegar. Check out this great recipe from Giada and the Food Network- or come up with your own variation. Labor Day is the perfect time to grill with the family.

Grilled Vegetables


  • 3 red bell peppers, seeded and halved
  • 3 yellow squash (about 1 pound total), sliced lengthwise into 1/2-inch-thick rectangles
  • 3 zucchini (about 12 ounces total), sliced lengthwise into 1/2-inch-thick rectangles
  • 3 Japanese eggplant (12 ounces total), sliced lengthwise into 1/2-inch-thick rectangles
  • 12 cremini mushrooms
  • 1 bunch (1-pound) asparagus, trimmed
  • 12 green onions, roots cut off
  • 1/4 cup plus 2 tablespoons olive oil
  • Salt and freshly ground black pepper
  • 3 tablespoons balsamic vinegar
  • 2 garlic cloves, minced
  • 1 teaspoon chopped fresh Italian parsley leaves
  • 1 teaspoon chopped fresh basil leaves
  • 1/2 teaspoon finely chopped fresh rosemary leaves


Place a grill pan over medium-high heat or prepare the barbecue (medium-high heat). Brush the vegetables with 1/4 cup of the oil to coat lightly. Sprinkle the vegetables with salt and pepper. Working in batches, grill the vegetables until tender and lightly charred all over, about 8 to 10 minutes for the bell peppers; 7 minutes for the yellow squash, zucchini, eggplant, and mushrooms; 4 minutes for the asparagus and green onions. Arrange the vegetables on a platter. The key to getting those great grill marks is to not shift the vegetables too frequently once they've been placed on the hot grill.
Meanwhile, whisk the remaining 2 tablespoons of oil, balsamic vinegar, garlic, parsley, basil, and rosemary in a small bowl to blend. Add salt and pepper to taste. Drizzle the herb mixture over the vegetables. Serve the vegetables, warm or at room temperature.