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

The Benefits of Breastfeeding

There sure has been a lot of discussion about breastfeeding in Nebraska lately, and for that I’m glad. But I have to cringe every time it’s brought to my attention that Nebraska is one of only two states without legal protection for “the practice” of breast-feeding. To put it bluntly, as a pediatrician I find this quite embarrassing. Even more than embarrassing, I find it completely baffling. As much as I try to understand the opposition to LB 197 and the right to breast-feed in public, I simply can’t.

After all, you can’t convince me it’s based on concerns about over-exposed breasts. Not in this day in age. Not when Katy Perry flaunts her assets on Sesame Street, Lady Gaga’s outfits leave little to the imagination, and everything from billboards to Superbowl ads bombard us (and worse yet, our children) with nearly bare-all images of women’s breasts. Let me also point out that there’s a huge difference between the pervasive and highly sexualized imagery our society has discouragingly come to tolerate, and breast-feeding. Quite frankly, breast-feeding shouldn’t even be discussed in the same breath. Sure, it involves the breasts, but that’s as far as the connection goes.

I also think that anyone who opposes protecting the rights of women to breast-feed in public is missing the hugely important fact that promoting breast-feeding is one of the single best ways we know to improve the health and well-being of babies (and their mothers). It’s no coincidence that the U.S. Surgeon General, Dr. Regina Benjamin, recently  launched a nationwide campaign to encourage breastfeeding by removing barriers that discourage it. I applaud well-respected pediatricians Dr. Laura Wilwerding (the American Academy of Pediatrics’ breast feeding coordinator for Nebraska) and Dr. Tom Tonniges (former Associate Director at the American Academy of Pediatrics and now Medical Director at Boys Town) for their recent and ongoing efforts to insure that Nebraskans don’t lose sight of just how important breastfeeding is.

I join them in closely watching what’s happening with LB 197 and hoping Nebraska will soon catch up with the rest of the country in better supporting every new mom’s noble efforts to successfully breast-feed her baby –in the hospital, at home, and yes…even in public.

On that note, I figured it would be most compelling to leave you with a few simple but powerful reminders of just why breast-feeding and LB 197 are so important.

  • Breast milk contains infection-fighting antibodies that provide babies with protection against everything from diarrhea and the common cold to ear infections and pneumonia
  • Breastfed babies are less likely to have asthma
  • Babies who are breastfed for at least six months are less likely to become obese
  • Breastfeeding reduces the risk of Sudden Infant Death Syndrome (SIDS)
  • Moms who breastfeed not only return to their pre-pregnancy weight faster, but experience less postpartum bleeding and are at reduced risk of breast and ovarian cancer.

Obstacles such as lack of support, instruction, and accommodation to breastfeed at work and in public all contribute to the fact that while 75% of moms in the U.S. start breastfeeding, only 43% are still doing so at the end of six months (and only 13% exclusively, as recommended by the American Academy of Pediatrics).

Originally posted on Omaha World Herald’s Live Well Nebraska

An alternative to Valentine’s Day chocolate: reasons to dance your heart out!

Valentine’s Day is undeniably all about love and sweethearts. It’s also defined by the heartfelt gifts of chocolates, sweets and (candy) hearts so plentiful this time of year. Now it’s not that I think we need to do away with all of these sweet gifts in lieu of a more heart-healthy approach to Valentine’s Day. But it has occurred to me that this holiday could mean so much more when it comes to finding ways for our loved ones to have happy hearts.

To get you one step closer to achieving this goal, I’d like to suggest that you, your kids, and your sweetheart all get up and dance. That’s right…dance! There are several reasons why you and your family should put your best foot forward and get up and start dancing.

It’s Fun. Regardless of age, who doesn’t like putting on some music and just letting loose? The good news is that regular physical activity throughout the day (which could easily include dancing), improves sleep, reduces stress, and overall makes people feel better about themselves. So just break out those dancing shoes (and your toddler’s skid-free socks and tutus) and start dancing. For some added fun – grab your video camera and capture the moment(s). No rules, just fun.

It’s Exercise. I imagine you don’t need me to tell you that we’re in the middle of a nationwide childhood (and adult) obesity epidemic. The beauty of dancing is that it’s not work, it doesn’t require committing to regular trips to the gym, and it doesn’t cost a thing to break a sweat. Yet don’t let this lack of requirements deceive you into thinking it’s not exercise. In fact, First Lady Michelle Obama’s national Let’s Move! Campaign actively promotes the need for kids to get 60 minutes of moderate to vigorous active play every day. After all, when they (and you) simply get moving (or dancing!), it all adds up to building and keeping healthy bones, muscles and joints and achieving a healthy body weight.

It’s Quality Family Time. Whether you opt for a daddy-daughter dance, a dance contest, or a more freestyle approach to your family’s dancing, it all adds up to the potential for quality family time. With the hectic pace of parenthood and often over-scheduled childhood that defines the times, I would argue that protected quality time with the family – at the dinner table, during conversations with your child in the car, and when sharing fun family activities like dancing together – is invaluable.

And now for my timely and heart-warming news. As many of you may already know, in addition to being a pediatrician, I also own an educational childcare center – Primrose School of Legacy – located in West Omaha. As one of over 200 franchised centers across the country, I am particularly proud to share with you that from February 1st through March 19th, all your heart-felt family dancing can be for a very worthy cause! That’s because Primrose Schools is hosting the 2nd Annual National Family Dance-off Contest. This fun family-oriented dance-contest is open to all families and benefits the Children’s Miracle Network Hospitals. By simply uploading a 30-second video of your family’s most creative, unique, or amusing dance moves at www.FamilyDanceoff.com and/or making sure that you and everyone you know votes each day for your favorite Omaha video, you could be one of 14 weekly contest winners who receive a flip video camera and up to $5000, while also winning Children’s Hospital and Medical Center a chance at receiving a $15,000, $20,000, or even $30,000 donation from Primrose Schools!

Simply put, I want to see Omaha families and children getting healthy by eating healthier, getting up and moving, and dancing. And through March 19th, I more specifically hope you all will be dancing to win, not only for yourselves, but for Omaha’s Children’s Hospital and Medical Center. I guarantee you it will do your body, your family, and your heart some good!

Originally posted on Omaha World Herald’s Live Well Nebraska

An Alternative to Valentine’s Day Chocolate: Reasons to Dance Your Heart Out

Valentine’s Day is undeniably all about love and sweethearts. It’s also defined by the heartfelt gifts of chocolates, sweets and (candy) hearts so plentiful this time of year. Now it’s not that I think we need to do away with all of these sweet gifts in lieu of a more heart-healthy approach to Valentine’s Day. But it has occurred to me that this holiday could mean so much more when it comes to finding ways for our loved ones to have happy hearts. To get you one step closer to achieving this goal, I’d like to suggest that you, your kids, and your sweetheart all get up and dance. That’s right…dance! Continue reading “An Alternative to Valentine’s Day Chocolate: Reasons to Dance Your Heart Out”