The Home Stretch

Just a few more hours to go before my "cleanse" is over and I'm really excited. Not excited so I can indulge and go back to my old ways, but because I feel great and have learned a lot about my body. It's a really wonderful feeling.

As I recap the last few days, let me remind you what the goals of my cleanse were:

• Daily Trader Joe's Total Body Cleanse supplements
• No caffeine
• No alcohol
• No refined sugar
• No gluten
• No processed or pre-packaged foods
• Try to eat at least 50% of my diet as raw foods

Day 11 - 5/8

Today was a rough emotional day for me. A little over a year ago my practice was absorbed into a larger health care system. A few (huge) benefits of this were a brand new, larger office space and the hire of my new nurse. My nurse couldn't be any more perfect of a fit for me (she loves Phish, shops at Trader Joe's and the local co-op, and is incredibly sweet to our patients) and I am so happy with my new office. The downside is dealing with layers and layers of corporate administration whenever something is wrong. Unfortunately for me, the thing that has been wrong multiple times is my pay. I discovered another error on Thursday and (as usual) was unable to reach the person I needed to talk to. I felt really powerless and frustrated. Normally an afternoon like this would end with me sitting in a pile of candy and Taco Bell wrappers hyped up on caffeine from a sweeter-than-I-usually-drink coffee from Starbucks feeling horrible. But it didn't this time. It didn't even enter my mind. Wow.

Breakfast - Smoothie (blueberries, organic whole milk yogurt, banana, chia seeds, water to blend), hard boiled egg

Lunch - Leftover Asian Salad with honey lime dressing topped with raw cashews

Snack - Pear

Dinner - Homemade steak gyros (steak, cucumbers, tomatoes) on corn tortillas with homemade tzatziki sauce and corn on the cob

Snack - herbal tea, small bite of homemade energy bars (I'll post my recipe soon!)

Day 12 - 5/9

Today was a much better day. I never got an answer to my pay question, but at least got in touch with the right person to discuss the problem. This evening was my first challenge with eating out at a restaurant. My monthly book club met at an Italian restaurant (like hardest place to find food fitting my rules!). I was hoping for an entree salad, but there wasn't anything like that on the menu so I went for the best option I could and boxed up half of the meal to bring home to my husband. It was definitely the richest meal I've eaten since starting my cleanse (and I enjoyed every bite), but I wasn't tempted to overindulge on liquor or dessert.

Breakfast - Smoothie (blueberries, organic whole milk yogurt, banana, chia seeds, water to blend), homemade energy bar (dates, cashews, and sunflower seeds)

Snack - Herbal tea, raw cashews

Lunch - Chicken breast roasted with tomatoes, green vegetables in walnut pesto (purchased from the hot food bar at the Honest Weight Co-op and elderberry Kombucha

Snack - Pear

Dinner - Garden salad with house made Italian dressing on the side (it was delicious, but as I didn't know what was in it, I only used a very small amount) and chicken picatta with roasted potatoes and green beans

I went for a short 3/4 mile jog to my in-laws house to meet my husband and the girls.

Day 13 - 5/10

Today was supposed to be rainy, but turned out gorgeous! I went for a jog in the late morning (my best effort yet) and got to enjoy some real quality time with my family

Breakfast - Two egg omelette full of veggies (spinach, red peppers, and mushrooms) topped with chopped tomato (I shared with baby bear who LOVES tomatoes and apparently cooked spinach)

Snack - Pear

Lunch - Chopped lettuce, cucumbers, cabbage, and tomatoes with leftover tzatziki sauce

Snack - Homemade energy bar

Dinner - Baby spinach salad with red cabbage, sweet potatoes, and avocado

I went for my usual 1.8 mile walk/jog talking only a short walk break and jumping right back into it. I think on my next run I might make it the whole distance! I finished up with abs and arms as usual.

Day 14 - 5/11 Mother's Day!!
Today was a fabulous day with my family. My husband got up early and put the baby bear back to bed with me and he and the bug let me sleep. Bug even had Daddy make me a hard boiled egg for breakfast because she knows I like them, how sweet! We started our day off with breakfast, pictures, and tons of play at a gorgeous town park. Then, we came home and the girls relaxed a bit while I put the finishing touches on a few dishes to share at Mother's Day dinner. We spent the rest of the day at my in-law's house with our extended family. My mom is still in Florida so we only got to see her on Facetime, but it was better than nothing!Overall, it was a very relaxing day and I didn't spend a second worrying about food.

Breakfast - Hard boiled egg, homemade energy bar, and Starbucks iced coffee (this was my mother's day "cheat" and it was totally worth it!)
Lunch - Organic "power greens" mix and leftover chicken chili with avocado/organic yogurt mashed together
Snack - Blackberries
Dinner - Grilled chicken, grilled portabellas, salad greens, curried quinoa salad, moroccan carrot salad, and fruit salad (honeydew, blueberries, blackberries, and raspberries)

Food Cleansing

I bet you expected my next post to be MORE party details, but I tricked you! Today I'm all about kick-starting my nutrition and exercise goals. I'm really using blog posting as more of a journal/motivational tool for myself, but you all can come along for the ride if you're interested.

I've been flirting with real food for awhile, but I've also been quick to stray back to old ways. I'll admit my overall diet today is still better than it was five years ago, but that really isn't saying all THAT much. In the past I relied far too heavily on fast food and processed food to get through my busy schedule. I think allowing myself to still have some of these foods on a daily basis was really sabotaging my efforts. I decided I really needed to "detox" from all the bad and give my body a chance to recover and reboot. Which brings me to...

My 14 Day Real Food/Raw Food Challenge
*This is based on so many different things I've read and watched, but does not follow one specific set of rules from any one source. This is 100% my challenge to myself - some of the ideas probably are evidence based, but I am not endorsing this in any type of medical way. This is just my journey (I hope!) to better nutrition.*

My plan is to cut out all processed foods, refined sugar, gluten, and alcohol and to cut down on dairy and animal protein. I'm intending to essentially eliminate dairy the first week and slowly introduce some back in next week. I'm also taking the Trader Joe's Total Body Cleanse vitamins to accompany my life changes.

Day 1 - 4/28
The first day was rough. I developed a horrible caffeine withdrawal headache mid-morning that continued to get worse as the day went on. By the time I got home I felt like I had a tight rubber band wrapped around my head. I also felt extremely exhausted, weak, and achy. I'm not sure if it was the change in diet, the headache, or the fact that I was so tired from bug's birthday party over the weekend but I could barely keep my eyes open driving home from work. I haven't felt that tired since residency! I went to bed before 8pm that night.

Food and Exercise Review
Breakfast - Banana and raw almonds
Snack - Red pepper slices and baby carrots with herbal tea
Lunch - Cucumber, tomato, avocado, parsley, and cilantro with lemon juice
Snack - Pear and herbal tea
Dinner - Sweet potato and avocado topped with tomato, cucumber, cilantro salsa and Chia strawberry lemon water

No exercise today! I was WAY too exhausted

Day 2 - 4/29
The second day wasn't perfect, but was much easier. I only had a mild headache during the day and didn't have any problem sticking to my food plan during the day. My first test came that evening when I picked up my very sick little bug from her grandparent's house and had to come home and cook dinner. The bug had a fever and was miserable and the little bear was her usual unruly dinnertime self (scream for food, shove as much food in her face as fast as she can, demand to get down from the table). I was very tempted to give up the attempt to cook, but took a few deep breaths, got everyone settled, and pushed through dinner prep. I was exhausted early again and started dozing off around 8:30. It was with extreme effort that I stayed up later to chat with my husband.

Food and Exercise Review
Breakfast - Green apple and raw cashews
Snack - Pear and herbal tea
Lunch - Zucchini hummus with celery and baby carrots
Snack - Herbal tea
Dinner - Cod, wilted spinach, roasted green beans, and black rice with Chia lemon water
Snack - Carrots, celery, and banana slices with organic peanut butter

No exercise again, still laying low and letting my body adjust.

Day 3 - 4/30
By the third day I was over the caffeine withdrawal headaches and the exhaustion was getting better. I slept wrong and had a searing low backache all day which made everything more frustrating, but I stuck with my plan without too much difficulty. I did get hungry in the evening and needed to eat a bigger snack. This was really the first time I felt "hungry".

Food and Exercise Review
Breakfast - Green apple and hard boiled egg
Snack - Raw cashews, herbal tea
Lunch - Kale salad with red pepper, cucumber, avocado, and lemon juice
Snack - Pear, herbal tea
Dinner - Baked sweet potato and diced avocado topped with red cabbage, red pepper, cilantro, and scallion "slaw" with apple cider vinegar dressing and Chia lemon water
Snack - Frozen blueberries and organic peanut butter

The only exercise I did was household chores - up and down the stairs about a dozen times washing and folding laundry

Day 4 - 5/1 
Today I felt great when I woke up. I was up early to sign my bug up for the before/after-school program and had to round at the hospital. Being in the hospital brought out some STRONG cravings for coffee (literally 90% of the people that walked by me had a coffee cup in their hands), but I got through it by stopping at the store for a new box of herbal tea on my way to the office.

Food and Exercise Review
Breakfast - Green apple and raw cashews
Snack - Herbal tea
Lunch - Grapefruit
Snack - Pear and cherry tomatoes
Dinner - Chicken and Quinoa Thai Salad (modified dressing to remove anything processed) with Chia lime water

I finally felt like I had enough energy today to get back into the swing of things with exercise. I went for a short 1.6 mile walk/jog outside and followed it up with an arm workout and an ab workout.

Mommy Tips: Breast-feeding basics

I skipped a week of mommy tips, but now I'm back again! Before I start a post like this I want to remind any readers that although I am a pediatrician and some of this advice inevitably comes from my medical knowledge and experience (it's impossible to separate mommy and MD when it comes to some issues), nothing you read on the internet should ever serve as a substitute to discussion with your own pediatrician! I offer these tips as mommy sharing, not medical advice.

1. If you know you want to nurse your baby, try to read up on it or meet with a lactation consultant ahead of time to give yourself some background. An easy book I read was put out by the American Academy of Pediatrics and had a lot of basic info. I also spent time with a hospital based lactation nurse learning about proper latch.
2. Let your delivery room nurse know you plan to breast feed and that you want to try to nurse your newborn as soon as possible after birth. Don't be afraid to remind them when the time comes. For both my deliveries the nurses were great advocates.
3. It will take time for your milk to come in (72 hours or more is normal!), but colostrum (early, yellow, fat amd calorie rich milk) is there right away. Keep trying to nurse every 2-3 hours to get your body stimulated to make more.
4. Make sure you drink plenty of water and eat enough food, breast-feeding places a lot of demands your body! I didn't do so well with this the first time around and my supply dropped because of it.
5. If you need to supplement formula in the beginning because of jaundice, excessive weight loss, or your baby is too hungry, it's OK. Don't beat yourself up! You can still catch up with the baby and get rid of the bottles in no time.
6. Be prepared for pain. Even if you have the perfect latch, it takes time for your nipples to "toughen up" and you will have to deal with soreness, cracking, and potentially bleeding. Have some lanolin on hand!
7. Even if you have a long maternity leave (or will be staying home), its a good idea to get the hang of breast pumping early so you have milk available if you need to be away (or want your partner to give the baby a bottle overnight so you can get a little more sleep!). I've used only Medela pumps (hospital grade, Pump in Style, and Freestyle), but hear good things about Avent brand as well. To save money, check with your local hospitals about pump rental and with your insurance company to see if a pump purchase is covered.
8. Pumping can be a lifesaver in the beginning once your milk comes in if you are becoming engorged or if you are lucky enough to have an awesome baby like mine who goes to bed at 8pm and doesn't wake up until at least 3am. I made the mistake of not pumping excess with my first, went back to work at 3 months, and ran through all of my excess milk by the time she was 5 months old. Living day to day with only what I pumped the day before was super stressful and pushed me to start solids sooner than I planned. This time I started pumping excess within the first week after birth and now have a stockpile of 40 bags (3-4oz per day) of frozen milk.
9. Use pumping to try and mimic the baby's feeding schedule to keep your supply up - if your baby nurses every 2-3 hours, pump that often too! If you have a job that makes that difficult (residency made it IMPOSSIBLE), do the best you can and try not to stress. The more you stress, the harder it will be to let down while pumping.
10. My safety tips for using pumped milk are as follows: use or freeze anything you store in the fridge within 72 hours, frozen milk is good for 3 months in a regular fridge/freezer or 6 months in a dedicated freezer, and thawed milk is only good for 24 hours.
11. When my supply dipped with my first baby (I tried the progestin birth control pills and was in residency which means I was not pumping nearly enough, was always tired, and wasn't staying well fed/hydrated), I took the herbal supplement called Fenugreek to boost my production. This stuff comes as a tea or as a capsule - I took the capsules and really thought it helped. I've also heard of drinking ONE very hoppy beer (IPAs work well) per day.
12. The best tip I can give overall is to be calm and enjoy yourself! Trust your body and your instincts about what is working for you and your baby. Breast-feeding is awesome nutrition for your baby and will definitely help you loose the baby weight and get yourself back into shape.

OK, I definitely have more tips, but I think this post is too long already. I am going to break this topic down and come back with breast-feeding tips that are more targeted (pain, pumping, weaning, supplies, etc) soon. Happy feeding for now!

Mommy Tips: Dealing with Picky Eaters

You might be one of those lucky moms like I was (in the beginning) who has an infant who seems to love trying and eating anything. I would brag all the time about how much she loved her fruits and veggies above all else, how she preferred seafood to boring "kid friendly meats" like hamburger, and that her favorite food was shrimp in coconut curry sauce. I felt like a rock star of motherhood getting my kid to eat such a wide variety of healthy foods. 

Then, in a matter of days, she changed. Some days she refused EVERYTHING and I was convinced she was going to starve. One day she would love bananas and eat three, the next she would wail at the sight of one. And the requests for junk food instead of real food started coming more and more frequently. It is from this daily (and ongoing) struggle that I present these tips to help you maintain your sanity and get that monster sweetie of yours to eat!

1. Serve your kid's food on a plate with well defined sections. For some mysterious reason one food touching another food (even if they like each food separately) can set a toddler off on a rage like you would not believe. Having sections will also prompt you to make sure you are offering a variety of foods (including a fruit and veggie) at each meal.
2. Pastas are great for making a meal "fun" because they come in so many different shapes (stars, wagon wheels, twists, shells, bow ties, etc). Your kid might refuse spaghetti and meatballs, but he/she will probably love bows from Minnie's Bowtique or Lightening McQueen's wheels from Cars - you need to be creative if you want to win this battle!
3. Become a food sculptor. This might sound crazy, but if I give my kid half a banana she will almost always refuse to eat it. If I stick a few mini chocolate chips in it for eyes and a mouth and call it a ghost or attach mini pretzel twists to either side for wings and call it a butterfly she actually eats it. Give your mind a workout and see what kind of masterpieces you can come up with.
4. Never let your kid see you cut food. For completely reasonable reasons kids want their food to be entirely intact and will FREAK OUT if you break a cereal bar in half or chop up a cheese stick in front of them. Decide before serving your kid if things need to be cut and do it out of their line of vision. If they ask, adamantly insist that it came that way.
5. When all else fails, serve it on a stick. Yup, that's right. Kids love to eat things on a stick. Either buy some lollipop sticks from a craft store or use pretzel sticks to spear items your kid might normally refuse and you will be amazed how much more they eat.
6. For the older kids, let them help you cook. My kid loves the ownership of saying she made something and will eat more of it that way. This is easy to do with crockpot meals or baked goods because you can let your kid help with the pouring and mixing.
7. As infuriating as my kid can be when it comes to meal time, she has never not yet refused vegetables. For the kids that do, get creative with hiding those veggies in unexpected ways. Interestingly, I've found a lot of great ways to do this by following Weight Watcher's recipes for myself because the veggies bulk up meals in a points free way. Two of my kid's favorite WW meals that are packed with veggies are this Turkey Veggie Meatloaf and these Sloppy Joe's.
8. Don't fall into the trap of letting your kid eat snacks whenever he/she wants because you are afraid they aren't eating enough overall. This will just backfire on you because they won't be as hungry for meals and be more apt to refuse the healthier, more substantial meals you want them to eat. Offering organic yogurt (drinkable or "tube" varieties go over especially well), low fat cheese sticks, or pre-portioned baggies of pretzels/graham crackers/cheese crackers are good for snacks. If you are super ambitious, try the homemade recipes linked above to cut out the amount of processed food your kid eats.
9. No matter how insane your kid goes on you for offering something different, try your hardest to make them stick to the one bite rule. No matter how weird something looks, they have to try just one little, teeny, tiny bite. You would not believe how often this leads to a completely shocked declaration of, "Hey! I like it!"

I probably have more tips and this might require a follow-up post some day, but I think this is a start. Good luck and happy meal planning for your own picky critics.

Addendum: Minutes after finishing this post my bug asked me to make her, "breakfast that is all different shapes." My husband started to tell her no, but I decided to follow my own advice and accepted the challenge...

Star cantaloupe and strawberries, whole wheat heart toast bites with a dab of strawberry jelly, ham and cheese omelet squares with bacon sprinkles, and turkey bacon hearts

Her response, pure glee!
And, yes she is wearing skeleton jammies in February. She's also eating off of a Thanksgiving plate. Is that a problem?

Breast Feeding News

As part of my membership to the American Academy of Pediatrics (AAP) I get daily e-mails with links to pediatric health issues in the news. I thought it might be worthwhile to repost some of them for any of the interested moms reading my blog. Here's a throwback to some of my early posts on breast feeding...

New Study: Breast Feeding Saves Lives