I have been convinced that fish would be a perfect blog topic ever since I returned from a recent trip to San Francisco. Let me assure you that my newfound determination to focus your attention on fish was not triggered by my proximity to Fisherman’s Wharf, but rather by what was discussed in the city by the bay at a meeting of pregnancy and newborn nutrition experts. The topic, which warranted a full day of discussion, was the fact that pregnant and breastfeeding women should be eating more fish.

That’s right – I didn’t say less fish. I said most pregnant and breastfeeding women should be eating more fish. And this recommendation not only comes from an esteemed group of experts in perinatal nutrition, but from the Food and Drug Administration (FDA). Now this recommendation in and of itself wouldn’t necessarily warrant a blog post, except for the fact that just about everyone seems to believe that pregnant women should avoid eating fish altogether because of the risk of mercury exposure. More than an isolated few also (mistakenly) believe that everyone should significantly limit their fish consumption. And therein lies the problem.

You see, back in 2004, the FDA released guidelines clearly stating that “fish and shellfish are an important part of a healthy diet. Fish and shellfish contain high-quality protein and other essential nutrients, are low in saturated fat, and contain omega-3 fatty acids. A well balanced diet that includes a variety of fish can contribute to heart health and children’s proper growth and development. So, women and young children in particular should include fish or shellfish in their diets due to the many nutritional benefits.” At the same, however, the FDA also offered some cautionary advice about how to limit the risk of mercury exposure from eating fish by simply recommending that pregnant and breastfeeding women consume no more than 12 ounces of fish per week. While the American public seemed to have no problem digesting the information that fish may contain methylmercury, far too many completely missed the part about the benefits of eating fish –for pregnant and breastfeeding women, for their babies, and for all of us.

And that brings us to what has been referred to as “the fish paradox.” Once known as brain food because of its high levels of omega-3 fatty acids and other nutrients, fish has suffered an undeserved fall from grace. It is for this reason that I am committed to clarifying what we know about fish, its benefits, the issue of mercury, and what current dietary guidelines recommend when it comes to fish consumption. While you probably have heard of the mercury risk associated with eating seafood, I want to make sure to leave all of you – but especially those of you who are new or expectant moms – with a very healthy respect for the risks of not eating seafood and the following fish-food for thought.

Let them eat fish! Compelling evidence tells us that eating fish during pregnancy and while breastfeeding can improve brain development in babies, and even potentially decrease a woman’s risk of preterm labor and post-partum depression.

Simply avoid four types of fish. Instead of struggling to remember which fish contain less mercury, just make it a point to remember that there are only four higher-containing fish to avoid: Tilefish, Shark, Swordfish and King Mackerel.

Make fish a part of your weekly diet. The 2011 Dietary Guidelines reinforce the recommendation that pregnant and breastfeeding women should make an effort to eat 8 to 12 ounces of seafood a week – an amount currently being consumed by fewer than 20 percent of new and expectant mothers.

Fear not the fish. Unless you are pregnant, planning on becoming pregnant, or breastfeeding, then you should also know that the recommendation to limit seafood consumption doesn’t apply to you. What does apply to you is the fact that the 2011 Dietary Guidelines recommend we could all benefit nutritionally by increasing the amount of fish in our diets!

Originally posted on Omaha World Herald’s Live Well Nebraska

Coughs, Kids & Vaccines: Why parents are the key to silencing the sounds of pertussis!

You really don’t have to listen very hard to hear the sounds of the season – the rustling of fall leaves, the weekend cheers of husker fans, and lawnmowers out for one last run before being swapped out for snow blowers. But if you ask me, the most noticeable sounds this time of year are all of the coughs, sniffles and sneezes that predictably make their annual show of force during cold and flu season. For parents and pediatricians alike, these are familiar sounds that we learn to live with and treat as needed. This year, however, we are hearing a lot more than usual about another sound – a sound for which we should all be listening carefully: the sound of pertussis.

Perhaps you’ve heard of pertussis – also commonly referred to as whooping cough – from your pediatrician. Some of you may remember reading about it each time you received the standard set of vaccine information sheets describing each of your child’s scheduled immunizations, since the DTaP (the “P” part referring to pertussis) vaccine is routinely given.

Chances are that if you’ve been following the national news lately, however, you may have also heard that there’s a pertussis outbreak in California. In the world of infectious diseases, let me assure you that California isn’t very far away from Nebraska, and this outbreak is not just another news story about an isolated incident hundreds of miles away. The spread of pertussis in California is, in fact, proving to be the worst outbreak in 60 years, having already claimed the lives of 10 infants under the age of 3 months. If that’s not a reason to stop and take notice, I don’t know what is.

The fact of the matter is that pertussis is caused by one of the most contagious bacteria we know. The infection can start out seeming like a common cold, but over the course of a couple of weeks manifests itself as an escalating cough which then turns into coughing episodes sometimes severe enough to result in vomiting or the characteristic “whoop” sound that represents the dramatic effort to draw air back into the lungs.

While adults typically experience weeks (if not months) of a cough that just won’t go away, they don’t often “whoop” like kids do. Neither do babies under 6 months of age – a fact that increases their risk of life-threatening illness or death at a time when they can’t yet be vaccinated (under 2 months) or haven’t developed full immunity (under 6 months of age). Unable to draw air back into their lungs, babies may gasp, gag, or simply stop breathing altogether – making them the most vulnerable at a time when they are also the most at risk.

As someone committed to helping insure the health and well-being of all children, I’ve therefore pulled together some very important facts about whooping cough, who is at risk, and what each of us can do to prevent the spread of pertussis in hopes that we protect all of Nebraska’s children and adults against a sound you never want to hear at any time of the year….the sound of a young child with pertussis.

Make sure your child is up to date on his/her shots. DTap is recommended at 2, 4, 6 and 15-18 months, and again at 4-6 years. The best time to get your child protected against pertussis is the first day your child becomes eligible for each recommended immunization.

Get your adult tetanus booster. Immunity to whooping cough doesn’t last forever. Any adult (or teen) who doesn’t remember getting a pertussis booster shot, or hasn’t had one since they were immunized as a child needs to get vaccinated. The fact of the matter is that babies too young to be protected by the vaccine rely solely on all of us to not expose them. Sadly, an estimated 3 out of every 4 babies with life-threatening pertussis infection got it from a loved one. Prevent this from happening by rolling up your own sleeves, getting an adult booster shot, and doing your part to limit the spread of pertussis.

Be on the lookout for pertussis and contact your doctor or your child’s pediatrician with any concerns. It’s all too easy to mistake pertussis for the common cold at the outset of the infection, and while people are contagious for up to a month, antibiotics are of little benefit after the first week or so. Half of babies with whooping cough end up needing to be hospitalized.

Listen to the sound of pertussis. If my blog hasn’t already convinced you, or you simply want more information, watch my recent pertussis-focused CNN interview with Kiran Chetry on American Morning, go to www.soundsofpertussis.com and let Jeff Gordon of NASCAR fame convince you, or simply listen to what a baby with pertussis sounds like .

Now let’s all commit to doing everything we possibly can to silence the sounds of pertussis.

Originally posted on Omaha World Herald’s Live Well Nebraska