Peanut Allergy continued…


Peanut allergy is on the rise…it can cause a severe reaction which is life threatening.

Unexpected sources of peanuts:

  • sauces, chili sauce, hot sauce, pesto, gravy, mole sauce, and salad dressing
  • sweets like puddings, cookies, and hot chocolate
  • egg rolls
  • potato pancakes
  • pet foods (reactions may occur after being licked by a pet that has consumed peanut)
  • specialty pizzas
  • Asian and Mexican dishes
  • Some vegetarian food products, especially those advertised as mean substitutes
  • foods that contain extruded, cold pressed peanut oil, which may contain peanut protein
  • glazes and marinades
  • salads and salad dressings
  • barbecue sauce
  • breading for chicken
  • pancakes
  • meat-free burgers
  • pasta
  • honey
  • fish dishes
  • pie crust
  • mortadella (may contain pistachios)

Things to keep in mind:

  • Alternative nut butters may be processed on equipment shared with peanuts…contact manufacturer about these products.
  • Discuss with allergist whether to avoid tree nuts…cross contamination with peanuts is always a risk.
  • Ice cream served in ice cream parlors should be avoided due to cross contamination…always tell the manager that you have a nut allergy.
  • Sometimes foods that contain other nuts also contain peanuts.
  • Peanuts go by other names, such as beer nuts, ground nuts or monkey nuts.
  • Ask your doctor if you should avoid peanut oils.
  • Peanuts can be found in many foods and candies, especially chocolate. Check all labels carefully and contact the manufacturer with your questions.
  • Peanuts can cause severe allergic reactions. If prescribed, carry epinephrine at all times- lean more about anaphylaxis.

Some children actually can outgrow a peanut allergy…check with your doctor.

via: DuPage Medical Group- Asthma and Allergy Center, 1801 South Highland Avenue, Lombard, IL 60148 – 630 545 7833 


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Oregon Plans Ban on C-Sections …

Banning early C-sections is a very interesting headline…I am not sure how hospitals in Oregon are going to actually enforce this hard line control on early, elective Cesarean sections.

Having a c-section for other than true medical necessity is never a good idea…the baby is still developing during the last weeks of pregnancy. Certainly it is not a great thing for a newborn to be shuttled off to the NICU for respiratory problems due to an early elective c-section…not to mention the added cost of the NICU care.

  • After delivery if a baby is in the NICU the bonding that is so important is difficult because mom is dealing with her own post-op pain and restrictions.
  • Breast feeding then becomes more difficult as well and cannot be established as early in the postpartum period as it generally is after a vaginal delivery.

It will be very interesting to watch how all this ‘plays out’ in Oregon and how it influences what is happening in other states as well.

Starting next week, many hospitals in Oregon will be taking a stand against early and elective Cesarean sections, reports. C-sections have become commonplace, and federal statistics now show that surgical deliveries account for more than 30 percent of all U.S. deliveries.

However, Oregon officials are now working toward the goal of giving “babies more time for important development and to reduce costly complications after birth,” MSNBC reports.

Seventeen Oregon hospitals (including all nine birthing hospitals in the Portland area) are implementing a “hard stop” on these elective procedures, says the March of Dimes’ Oregon chapter, as quoted in the MSNBC report. According to a 2009 study published in the New England Journal of Medicine, about 1 in 3 C-sections is performed before 39 weeks (37 to 41 weeks is considered full term).

via Oregon Plans Ban on C-Sections – Parenting on Shine.

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Congenital heart disease screening for newborns….


There is a new recommendation from the American Academy of Pediatrics and the American College of Cardiology Foundation and the American Heart Association which calls for screening of all newborns for congenital heart defects.

Before newborns leave the hospital, they should receive a simple, pain-free test to check for signs of congenital heart disease, one of the most common types of birth defects, according to a recommendation by a federal advisory panel.

via Congenital heart disease screening recommended for newborns –

A congenital heart defect can be detected early but often goes undetected because newborns can appear normal in the first few days after delivery. The reason these newborns look normal is that fetal circulation may still be functioning somewhat and thus they do not turn ‘blue’ or have a signs of distress until after they are at home.

This is pretty scary stuff for parents. A simple pulse oximetry test can look at the oxygen in the baby blood. It is non-invasive and requires putting an electrode on the newborn’s toe. Although there may be many false positives with this test it can give an indication of whether the newborn is in any kind of distress which is not evident by listening to his/her heart sounds or by looking at his appearance which may indeed be pink and healthy looking.

The question here is what to do if the pulse oximetry is positive indicating that there may be a problem. This has not yet been worked out thoroughly. The newborns that have a positive pulse oximetry may be sent for further testing such as a cardiac ultrasound. Not all hospitals are capable of newborn follow-up so the baby may have to be sent to another hospital for these tests. Parents will be upset and anxious until the results are in…but it is a small price to pay to avoid a possible life threatening cardiac event in the newborn period.

I am not sure what the protocol will be concerning these new recommendations but each hospital will more than likely develop their own response.

Parents need to be aware of these recommendations and the reasons for them so that they can advocate for their newborns and make sure that their precious little ones get checked out thoroughly.

‘Let them eat cake’…

I came upon this beautiful birthday cake and it was love at first site  sight.

Yesterday, I made a practice sample of the cake itself…it was surprisingly easy and the gel colors make the cake brilliant!

The cake is superbly moist and the hint of lemon in the frosting is delicious…I wasn’t quite sure about lemon but it really is tasty.

Later this week, I am actually going to put this entire cake together with the Meringue Icing and the Fondant topping.

The birthday girl will hopefully be able to doodle on it with her little friend and make this a very unique cake experience.

Kids and Allergies…



Allergies are serious and especially so in children.

The vast majority of allergic reactions to foods affect the skin in one way or another. The severity of symptoms can change quickly and there is always potential for a severe, possibly life-threatening reaction.

This week I had a crash course in allergies and children. The fact that ingesting a food such as a peanut could be life threatening is truly  a scary situation.

There are ways to minimize the potential risk and prevent accidental exposure to the foods that cause an allergic reaction.

Here are some of the family’s responsibilities when they have a child with a food allergy:

  • Notify the school of the child’s allergies
  • Work with the school team to develop a plan that accommodates the child’s needs throughout the school including in the classroom, in the cafeteria, in after-care programs during school sponsored activities and on the school bus as well as a Food Allergy Action Plan.
  • Provide written medical documentation, instructions, ad medications as directed by a physician using the Food Allergy Action Plan as a guide. Include a photo of the child on written form.
  • Provide properly labeled medications and replace medications after use or upon expiration.
  • Educate the child in the self-management of their food allergy including:
  1. safe and unsafe foods
  2. strategies for avoiding exposure to unsafe foods
  3. symptoms of allergic reaction
  4. how and when to tell an adult they may be having an allergy-related problem
  5. how to read food labels (age appropriate)

– Review policies/procedures with the school staff, the child’s physician, and the child (if age appropriate) after a reaction has occurred.

– Provide emergency contact information.

excerpts: from DuPage Medical Group – Asthma & Allergy Center

NEXT:  School’s responsibility

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A Shift in Strategy to Get More Mothers to Breast-Feed


As a follow-up to a recent post of mine I would like to comment on the article in the Wall Street Journal that is quoted below.

Hospitals can definitely play a significant role in the success of breastfeeding especially if they follow what Georgetown University Hospital is doing to actively encourage women and their infants to bond and breast feed soon after delivery.

I am not surprised that this example is from a teaching hospital in a major metropolitan area. Patients can be selective and demanding about where they deliver and these teaching hospitals want to offer all they can to provide what is recommended best for moms and babies. I am in no way putting down other hospitals but in my experience the teaching institutions will get on board with recommendations faster than other hospitals. The reasons are many  but in today’s healthcare environment economics is a very motivating factor.

On the topic of economics…obstetrics traditionally is not a money maker for hospitals the way cardiovascular surgery is…that being said hospitals are businesses and pouring money and time into obstetrical services is not something that is done without serious financial considerations.

In my practice, I have had moms say that nurses and lactation consultants have been “Nazis” when it comes to breast feeding immediately after delivery and they have not liked the attitude that is has been conveyed to them in the hospital.

My question about the shift in breastfeeding strategy is ,when are we going to learn to be gentle with new moms and be encouraging with kindness? New moms are often scared and unsure of themselves and sometimes they are even afraid of their newborns and afraid of all the body changes that they are experiencing immediately after delivery.

New moms need to be catered to while in the hospital…they will be home soon enough dealing with a whole new world now that their baby is finally here.

Hospitals can be encouraged to shift their strategies ….that is all well and good but until they have the  nurses and lactations consultants with a gentle touch, who are not overworked…but who are devoted to “helping” the new mom with her new baby without being judgmental, breastfeeding will still be much more of a challenge for mom and baby than it needs to be.

It is my belief that much more emphasis should be placed on the approach that is used with the new mom in combination with the strategies of early breastfeeding and bonding.

Maybe we need to revisit “Reva Rubin”s Postpartum Theory” to understand what the mom is emotionally experiencing in the first hours and days after delivery and use Reva’s observations to guide us in the care of the mother and newborn.

a. Taking-In Phase. During this phase the mother is oriented primarily to her own needs. She primary focuses on sleeping and eating. She may be quite passive and dependent. The mother is reacting to the intense, physical effort expended during delivery and the intense, emotional effort required of her during labor. The mother does not usually initiate contact with the infant. This is not out of disinterest. It may result from her own immediate dependency. Nevertheless, she is taking-in information that helps her to identify the infant. She may use her finger-tip to touch her infant. This serves as one of the first steps in the identification process. She holds the baby facing her so they can explore each other’s face (in the face position). The mother relives the delivery experience which allows her to integrate it fully with reality, fully realized her baby is born, and to identify her infant as being outside and separate from her. This phase, taking-in phase, may last for a day or two. The nurse should plan activities so that the patient can rest as much as possible because failure to allow the patient to receive the necessary and earned rest may yield a “sleep hunger” which may be manifested by irritability, fatigue, and general interference with the normal restorative process. The father’s role is primarily being supportive of his wife and his family.

b. Taking-Hold Phase. During this phase the mother strives for independence and autonomy, she becomes the “initiator.” She is concerned about her ability to control her bodily functions (that is, bowels, bladder, and if breast-feeding, concerned about adequate amount and quality of milk). She takes an active part in trying to control these functions. She is concerned about her ability to take care of her newborn. This phase is associated with a great deal of anxiety (especially by a new mother). She may have several mood swings. The mother might be involved in a lot of activity trying to accomplish tasks. Fatigue and exhaustion may occur if the mother is not helped to set realist expectations and limits for herself. The nurse is responsible to allow the mother to actually perform infant care tasks, reinforce all positive actions (do not impose yourself), and provide guidance, instruction, and demonstration, as necessary. Reassurance and explanation about infant care are especially needed in this phase. This phase lasts for about ten days (most of this phase is accomplished at home).

c. Letting-Go Phase. Generally, this phase occurs when the mother returns home. The mother must accomplish two separations during this phase. The separations are to realize and accept the physical separation from the baby and to relinquish her former role of a childless person. The mother must adjust her life to the relative dependency and helplessness of her child. If she quits work, she must adapt (even if only temporarily) to less freedom, less autonomy, and less social stimulation. If she continues to work, she must handle the additional strain of finding sitters and meeting additional workload. The mother may experience a let-down feeling, which is called postpartal, or baby, “blues.” This is a form of depression that is usually temporary and may occur in the hospital.

via Psychological Needs of the Postpartal Patient.

Reva Rubin believed that a mother needed time to absorb and integrate her labor and delivery. This takes place in the first couple of days postpartum while the mom is trying to get to know her newborn and begin the awesome task of taking care of him/her, changing diapers, bathing and feeding. The new mom probably does not pass through the “taking-in phase” before she is discharged home from the hospital.

Over the years postpartum hospital stays have gotten shorter and shorter so mom has had to condense her “taking-in” experience into hours rather than days. She has to get comfy with diapers, bathing, swaddling, and of course feeding…breast or bottle. Postpartum nurses have had to adjust their care to give mom a “crash” course in newborn care…this is a tall order and in my opinion it takes a skilled educated nurse to accomplish this effectively with a new mom.

To encourage breast-feeding, Georgetown University Hospital staff place the newborn on the mother as soon as possible, usually within a half hour after birth. The hospital, in Washington, D.C., delays weighing and measuring the baby until after this skin-to-skin bonding takes place, says Carol Ryan, who manages Georgetown’s lactation team. For women who had caesarean sections, healthy babies are brought to the mother as soon as possible and touch the mothers’ face if they can’t be placed on her, says Ms. Ryan. Infants also are roomed with the mother 24 hours a day, rather than being taken to the nursery.

The U.S. government’s goal for the end of the decade is for about 60% of women to be breast-feeding at least part of the time for the first six months, according to the government’s 2020 Healthy People objectives.

via A Shift in Strategy to Get More Mothers to Breast-Feed –

We need more than strategies from hospitals…we need human kindness and a much more gentler approach to mother and baby in the hospital followed by a gentle approach at home while this dyad begins to take on the tasks before them. There needs to be a real effort made to make breastfeeding a “socially” acceptable thing. Education of the general public would greatly help in this area.

Then maybe we will begin to see a serious increase in breastfeeding success.

related posts:

Top 50 Pregnancy Blogs

Top 50 Pregnancy Blogs

Pregnancy can be quite a trip. From the first fluttering in your belly to the endless parade of minor (and major) discomforts, your mind is opened to a whole new world of bodily functions. As your body changes, your brain tries to catch up. Is this normal? What will birth be like? What’s a “boppy pillow”? And do I need one? Read More ↓

via Top 50 Pregnancy Blogs-Pregnant Chicken.

World Breastfeeding Week — You Can Still Be A Great Mother, Even If You Can’t Breastfeed

Although World Breastfeeding Week is over this post is so worth reading. Enjoy.

After trying for many years I had my first child at age 40. I was determined to do everything right. High on that list was breastfeeding. I was prepared for it to be challenging, but it turned out that my son and I were the perfect nursing pair. He did a great job of latching on and sucking, and I did a great job of producing “liquid gold.”

When my son was eight months old I developed a breast infection. Many nursing women have them — they are painful, but no big deal. I felt a lump that seemed like a clogged milk duct. But when the infection went away, the lump stayed so I scheduled an appointment with my physician.

via Cheryl Greene: World Breastfeeding Week — You Can Still Be A Great Mother, Even If You Can’t Breastfeed.

World Breastfeeding Week…

This is “World Breastfeeding Week”…we know that breastfeeding is “Best for Babes” but not every mother feels that she can adequately breast feed and not every woman wants to breast feed. This being said there are many ways we can encourage women to breast feed and do so successfully.

The following article talks about ways that hospitals can encourage a new mother to breast feed. Many good points are made here…but ultimately the mom will be taking her newborn home after a very short stay in the hospital and the home atmosphere and home support will be the true test of success.

What we need is a “doula” of breastfeeding…a compassionate, educated, non-judgemental mom who is willing to help mother and baby get established in their breastfeeding routine together. This is not an easy task. There is no room for a fanatical breast feeding “doula” who imparts her successful breastfeeding stories and inadvertently guilt to the new breastfeeding mom. This relationship in my opinion can make or break a breastfeeding experience.

Hospitals can only do so much and since hospital experiences are so short  for the new mom in many cases, it is my belief  that for many reasons  hospitals will never provide the support that is needed  for success in breastfeeding.

A new mother’s ability to continue  breastfeeding is influenced by what she  experiences and how much support she receives during the first hours and days after birth. Breast milk is “the perfect nutrition,” says Frieden. It provides antibodies to help newborns ward off illness until the immune system can produce their own, which doesn’t happen until the infant is 6 months old.  Mom’s milk also provides important hormones that help baby regulate how much it needs to eat. Plus, studies have shown that breastfeeding reduces diarrhea, ear infections and bacterial meningitis, as well as cutting the risk of sudden infant death syndrome, diabetes and asthma, according to the American Academy of Pediatrics.

The CDC report says breastfeeding for nine months reduces a baby’s odds of becoming overweight by more than 30%. For babies to get all of these benefits, the AAP recommends that infants should be fed only breast milk for the first six months of life and moms should continue to nurse while they start introducing solid foods until the baby is at least a year old, longer if mom and baby still want to.

In response to this report, the American Hospital Association tells CNN: “Breastfeeding is a personal choice and hospitals will follow the wishes of the mother, be it to breastfeed or bottle feed. There are numerous reaso

ns for the results and those include that hospitals can’t always accommodate a single room for maternity care and some mothers choose to send their babies to the nursery.”

There are of course other ways to help mothers continue to breastfeed. One came earlier this week, when the Department of Health and Human Services adopted recommendations from the Institute of Medicine, which will require insurance companies to pay for breastfeeding support, supplies and counseling, without any cost to the insured (aside from her regular insurance premiums of course), starting in August 2012.

via Hospitals need to do more to help moms breastfeed – The Chart – Blogs.

“Best for Babes” is a wonderful organization which is totally on the right track in trying to assist the breastfeeding mom and baby. We need more involvement like this in order to promote successful breastfeeding. Here is the mission of “Best for Babes” for those of you who are not familiar with this organization.

The amazing health, economic and environmental benefits of exclusive breastfeeding for six months or more are well-established.  Moms know this — they want to breastfeed. But sadly, very few of those who start or plan to start make it past the first few days — they struggle and suffer unnecessarily and give up, understandably, long before they intended to.  Too often, it’s not their fault!  They are being set up to fail by the very people and places that are supposed to help them — by the Booby Traps– the many cultural and institutional barriers that prevent them from achieving their personal feeding goals.

BFB’s mission is to help turn this situation around by bringing the power and influence of a consumer-driven, celebrity and corporate-backed, mainstream independent nonprofit –the Mother of All Causes –to bear on this issue;  to help create permanent  culture change that embraces, celebrates and supports breastfeeding and moms!  As a nonprofit foundation, we serve and complement the heroic, long-term efforts of the existing breastfeeding community and we lend added value by being able to harness and leverage the collective power of celebrities, corporations, foundations, the public sector, advertising, the medical community and the media.