Sunday, October 27, 2013

Running with a Jogging Stroller: My Top 10 tips

It's official- I have signed my son and I up for our first 5k together!

I have participated in other 5k runs for charity in the past, but since having my son and moving to a town that hosts very few events we can attend together, this will be a first for the two of us.

Before I had my son I loved working out- I would work out on my treadmill and Total Gym sometimes 3 or 4 times a day. When I got pregnant I switched to doing yoga once or twice a day. About 8 weeks after my son was born I tried to get in a work out on my treadmill and was met with a decreased milk supply and an infant that hated the taste of the lactic acid my work out pumped into my breast milk, so my days of working out went out the window. I resigned to eating healthy and burning calories by chasing my son around all day.


Recently my mother came out to visit. While here she urged me to go on a run with her at a local nearby park. While it was a short run, I immediately felt the familiar high of working out and decided it was time to get back into the swing of things. With my son now 12 months old, my milk supply fully established and finding myself going stir crazy being at home for most of my day I have added at least a half hour work out to each morning.

I have started out mostly running at home on the treadmill. While I figure it is a great way to get my body used to the motions and stresses of running that it has been missing for the last (almost) 2 years, it is becoming a deadly game of hopscotch. My son has always been terrified of loud or mechanical noises from things he doesn't understand- he cries hysterically every time I vacuum. I knew the first time he saw me use the treadmill would cause a similar reaction so I turned it on the lowest setting and let him explore it... Bad idea. He loved it. He wanted to walk and walk and walk and never get off. When I was able to convince him to let me give it a try he then began throwing toys and objects at my feet to watch me step on them and then see them fly off the back. I tried the barricade maneuver to block off an area around the treadmill, which tragically bombed. I even had to carry him while I speed walked one morning, just so I could get my mile in without him crying for me. I resigned to setting him up in his room across the hall with a billion toys to play with while I ran- with one hand on the baby monitor.

Now that I am getting a little of my strength back and my legs are a little more use to the motions again I have started to take my son with me to the park for my jog/run in the mornings.

With the 5k looming over my head I have a need to get to know my jogging stroller a little more intimately. With that in mind I began to seek advice, so I can be as prepared as I can in the next 3 weeks. So here are my 10 tips and tricks to running (or jogging) with a jogging stroller:

1. Get a Good Jogging Stroller- 4 wheel strollers are just not safe at fast speeds. If the stroller wasn't made to do it, then why risk it?

2. Use the Safety Features- Lock the front wheel so you don't risk the stroller turning suddenly and crashing. Wear the wrist strap that links you to the handlebars- don't risk the stroller getting away from you, especially with your child in it. If you stop, put on a wheel break or two.

3. Age Range- It is recommended that you not take your baby out on a jog with you until they are around 8 months old. They must be able to hold their own head up. If you hit a bump or a dip it could pose a risk for an infants neck. Despite some companies saying it is okay to jog with your baby at 6 months of age if they are in a stroller with a car seat adapter and the infant is in the car seat and thus has neck support, I don't think this would help too much in terms of big bumps or sudden dips.

4. Maintain Your Stroller- Check the tires, for loose screws, etc. before every run. There is nothing fun about a wheel coming off and having to lug your broken stroller AND your child back home or to your car.

5. Think of Your Child First- Dress them appropriately for the elements, bring water and a snack (if you're going to be out a while), and most importantly strap your child in with the full harness.

6. Have Realistic Expectations- Pushing a stroller while jogging adds a great amount of weight that also requires upper body use. You will not be able to weave through people or handle going downhill the way you can while running alone. You won't be able to run the pace you are used to while running alone, so if you're running against the clock, know that your times will be slower by usually one minute per mile.

7. Remember Your Running Form- Make sure when running downhill you keep your chest up to combat some of the force the heavy stroller and gravity will put on you. You should be pushing with your legs, not your arms. Keep your arms close, if you find them stretched in front of you pushing the stroller you are likely hunched. And don't go faster than or on a course that you may not be able to control or stop your stroller.

8. Swing Your Arms- If you are pushing a double stroller you will probably need to keep both hands on the handlebar, but if you use a single and like to pump and arm, make sure to alternate your pushing a pumping arms.

9. Plan Your Run- It's probably best not to go on a jog with your little one right before or during a meal time. If your little one tends to fall asleep in the stroller, perhaps going during a nap time is best. Be prepared to occasionally have to mix things up though. If your little one decides they want out of the stroller, you may have to stop to let them run around for a bit. Also, nursing moms may want to nurse before a run to avoid discomfort (and if you baby is picky about not nursing after a work out due to lactic acid, like mine is, then this is a great idea).

10. Don't Get Discouraged- Running with a stroller is hard. It is uncomfortable and difficult to get used to at first. Once you get into the swing of things, it really is wonderful being able to exercise while introducing new scenery to your little one.

Infant Reflexes and Apgar Score

Before I had my son I was aware of there being two reflexes that a child is born with: The rooting reflex and the startle reaction (Moro reflex). It wasn't until I started my research for this article that I discovered there are a handful more reflexes that I did not realize babies were known to display, or rather that were even considered 'reflexes'. I could cover them all, but there are some that need no explanation, like the cough reflex, the gag reflex and the blinking reflex.

Soon after birth your child is given an Apgar score. APGAR stands for Appearance, Pulse, Grimace, Activity, and Respiration. Babies tend to undergo this test 1 minute and 5 minutes after birth (and occasionally again at 10 minutes after birth). In each of the 5 categories your baby is scored on a 0-2 scale (0 meaning absent or non-existent, 2 meaning active and normal). Appearance tests skin coloration, Pulse tests heart rate, Grimace tests reflexes, Activity tests muscle tone and Respiration tests the rate and effort of breathing.

While most categories in the Apgar scoring system are obvious (color: pink skin, pulse: over 100 bpm, etc.) the Grimace or reflex irritability category could potentially test any number of things. What doctors and nurses are testing for is the babies reaction to a stimulus- like a mild pinch. This could also be tested by suctioning the infants airways and noting their reaction- do they cough, pull away and/or sneeze? Essentially they are trying to irritate the child to see how they respond. Their response is based upon their reflex reactions.

Some of the reflexes a person is born with include:
-Moro reflex (startle reaction)                          -Truncal Incurvation (Galant reflex)
-Sucking reflex                                               -Rooting reflex
-Step reflex                                                    -Parachute reflex
-Tonic Neck reflex                                         - Blinking, cough, sneeze, yawn and gag reflexes
-Grasp reflex (Palmer)                                     -Plantar reflex
-Swimming reflex                                           -Babkin reflex



Reflexes are protective reactions involving the spinal cord. When a receptor picks up a stimulus an impulse starts. A reflex sensory reaction occurs when it first travels through sensory neurons, then interneurons in the brain and spinal cord and then the motor neurons in muscles. 

It is hard to understand the reasoning behind some reflex's and what their purpose is in the survival of an infant, for instance tonic neck and the Babinski reflexes appear to serve little to no purpose. The Moro reflex, however may have played a part in our evolutionary history. Much like the primates of today we carried our young all day long, and if an infant lost its balance the Moro reflex is believed to have caused the child to grasp onto the mother to regain its hold. The rooting reflex is a reflex that still greatly assists an infant in learning to breastfeed. Research suggests that after continuously being breastfed for 3 weeks starting from birth an infant no longer relies on the reflex and is instead drawn to the nipple from habit. What is important to note is that no matter if a reflex appears to serve no purpose now, they often still have a functional significance that allows a child to reach developmental milestones, ie. the body righting reaction will help a child roll over when they are later capable.

Many of the primitive reflexes disappear after a very short time. Most, in fact, disappear before the age of one. If a reflex persists for an extended period of time it may suggest there is something wrong neurologically with the infant. At birth, and at at least the first few months of check ups the pediatrician will test some of an infants reflexes as a way of checking for any issues with either this persistence or utter lack of a reflex. For example, if there is asymmetry while checking the reaction of the Moro reflex, it could indicate a brain injury or lesion or perhaps a peripheral nerve problem to the upper extremity or if there is persistence of the Galants reflex beyond 2 months could suggest atheltoid cerebral palsy.  



Tuesday, October 22, 2013

Breastfeeding and Alcohol


I've never been much of a drinker. I can honestly say I have been legally drunk no more than 5 times in my life. Heck, it's been almost 2 full years since I've even had a glass of wine and I can't say that I really miss it. That being said there are a lot of women in forums, at my La Leche League meeting and some acquaintances of mine that have wondered if they could have an occasional drink while breastfeeding and what the effects would be in their milk supply and their baby. Personally I do not condone drinking while breastfeeding, nor do I think it's 'OK' to get 'hammered' while you have an infant to look after due to it being a safety hazard. While below are some general guidelines and information I have compiled in regards to alcohol and breast milk, I ask that you please exercise caution and use your best judgement if you do decide to drink. 
 
The amount of alcohol that makes it to your bloodstream is similar to the amount that makes it to your breast milk. While a single glass of wine or one beer may seem like a small amount it’s important to keep in mind that your baby is small and has a tiny immature liver. Obviously with a small liver your infant does not process alcohol the same as you- infants under 3 months process alcohol at about half the rate of adults.




Some side effects for the infant from a mother that has consumed one alcoholic drink 4 hours prior to nursing include consumption of about 20 % less milk and drowsiness (while also sleeping for a shorter length of time).  Over time it may also hinder an infants’ development. No one knows all the effects that alcohol has on a breastfed infant, and for good reason- I know I’d never sign up to put my child at risk to test the outcomes in a study, so it is best to abstain at least for the first three months of your child’s life.

The best advice I have found in my research is on Baby Center. These 6 tips are great to keep in mind if you decide to have a drink while breastfeeding: 
Wait at least two hours after you finish a drink before nursing your baby to give your body a chance to clear the alcohol.
Your blood alcohol level (and the level of alcohol in your milk) is generally highest 30 to 90 minutes after you have a drink, although that time – and the length of time it takes the alcohol to leave your body – varies from person to person.
You can time your drink so that your baby won't be nursing for a few hours afterward by having it right after a feeding, for example, or during one of your baby's longer stretches of sleep.
Or you can pump and store your milk before having a drink, then feed your baby expressed milk from a bottle. (Pumping after you drink won't clear alcohol from your system any faster – it will still take at least two hours.)
Another option is to feed your baby formula in the hours following your alcohol consumption.
To ward off dehydration, down a glass of water in addition to the alcoholic drink. It's also a good idea to eat beforehand or when you're having your drink. This helps lower the amount of alcohol in your blood and your milk.

There is an old wives tail that says drinking one dark beer a day will increase your milk supply. This is entirely false. In fact, alcohol dehydrates your body, which can cause a drop in milk production. It has also been proven that alcohol makes milk producing hormones behave erratically. When alcohol is ingested oxytocin levels decrease while prolactin levels increase significantly causing a drop in milk supply. Many women have heard of taking an herbal supplement called 'brewers yeast' in order to increase their milk production. While this supplement may sound like the yeast used to brew beer it is actually a by product of the brewing process which is removed. Brewers yeast is full of B vitamins and protein, and has been known to be effective in helping women increase their milk production. (I will caution you though that it can cause stomach upset in yourself and your infant, which is never a good thing, so use with caution.)

There is also a wives tale that is very widely believed that states if you drink you need to 'pump and dump' your breast milk. Here's the thing- if you are drinking and your breasts become engorged I can see this as being a very viable option to relieve your discomfort. 'Pumping and dumping' however, does not help to remove the toxins from your milk. Once the alcohol is out of your blood stream the alcohol is also out of your breast milk. It does not collect in your breast, just like it does not collect in your blood. Your best bet is to wait to nurse until the alcohol is out of your system (likely two hours after your last drink). There is even a product out now with test strips that can test alcohol levels in breast milk. (Target $15) 

Again, I caution that if you do decide to have a drink or two while your child is still breastfeeding that you use your best judgement when it comes to nursing after drinking, as well as not becoming intoxicated to a point that you cannot safely care for your child. In the grand scheme of things, is nursing your child for a year or two and going without a glass of wine really an issue for you?

Thursday, October 3, 2013

Things They Don't Teach New Moms: Baby and Toddler Poop

I hope you haven't just finished your dinner, because I'm going to talk about poop now.

I breastfeed my son, and plan to do so until he weans himself (hopefully not past 2 years though, as that's my personal limit). When you breast feed your child's stool is different from one receiving formula, right from the get go. So for all intents and purposes this post will touch mostly on breastfed babies as it is what I am experienced with.

Breast milk goes through changes, starting out as colostrum, then breast milk and changes for your child's needs and age. Similarly your babies stool changes from meconium to a lighter and thinner stool to even some with partially digested food in it. There are many colors, consistencies and smells that can all mean your child is healthy and normal.

I received lots of advice, and guidance when my son was young from the local La Leche League as well as my local Baby Cafe. I came home with pamphlets, informational sheets and books on everything from babies eating schedules, sleeping patterns and yes, poop. As a first time mom it struck me as odd that there would be a need to explain such a thing to anyone- food goes in and well, you know what comes out. That was until my sons bowels changed and I was desperately wracking my brain trying to remember where I put the pamphlet with the poop chart on it.

The hard thing is finding information on children that are eating solids as well as breastfeeding or consuming formula. After all, babies are supposed to get the majority of their nutrients from these sources as opposed to foods for the first year. Through research I have been able to compile some answers to put my mind at ease that may also benefit some moms out there for babies of all ages.

In the first 5 days after a child is born their bowels change daily, in color, consistency and frequency. This chart explains the changes:
This chart shows the likely colors of the child's
 bowels before solid foods are introduced: 


Color: Stool is made up of 3 different things, bile, bacteria and cells from the intestines. Bile aids in digestion of foods and makes up the majority of the color of the stool. The reason for the color changes is in part due to the digestive tract being introduced to new bacteria. As the stool moves through the intestines it collects different colors and smells from digestive juices, bile and bacteria. Babies that are exclusively breastfeed receive different proteins depending on what the mother consumes which can cause color variations. Formula fed babies, while they get fed the same food daily, may have color changes in their poop due to new bacteria. When a baby starts eating solids their poop changes immensely. Their stool may appear the color of whatever foods they have recently eaten, and fiber rich foods like raisins may pass through seemingly undigested. As a child gets older their bodies are more adept to digesting these foods, and their stools will become smellier, thicker and darker.

Consistency: If nutrients move slowly through the digestive tract the water has more time to be absorbed into the body causing constipation. On the other hand, if things move quickly through the tract more water is retained in the stool resulting in diarrhea. Breast milk poop tends to be softer, more yellow, and seedy. Formula fed babies stool is often more of a brown-yellow color and bulkier, like toothpaste. When introduced to solids some foods may come out whole. If a baby drinks too much water their stools can become loose, if they do not drink enough liquids their stools may become too hard. I swear by the BRAT diet when my son has diarrhea and prunes and water when he is constipated. Breastfed babies are less likely to develop diarrhea or constipation. 


Odor: Generally breast milk poop does not stink, whereas formula fed poop can be slightly odorous. The longer feces sits in the bacteria of the intestines the more it will collect a smell, however if a baby passes stool that smells more foul than normal, before solids are introduced there may be an allergy or intolerance. Once solids are introduced prepare for an array of horrid smells.
Frequency: Newborns may pass up to 10 bowel movements a day, but as long as they have one they are A-OK. As a child gets older they may pass them less frequently. After the age of 6 months 4 a day is really the most they should be passing stool. As long as when they child goes they are not straining and the stool is soft when it does pass then there is really no worry in regards to frequency. 

What to look for:
'Normal' poop can be a whole array of colors: yellow, green, brown, orange, dark green/almost black of on an iron supplement and may contain partially digested foods once solids are started. 
If the poop can roll, it is too hard.
If a baby's stools are looser and passing more frequently it could be diarrhea.
If the stool is bloody, black like tar after the first 3 days after birth or pale see your child's pediatrician.
If the baby's stools have a strong, unusual odor before they begin solids ask the pediatrician if it's anything to worry about.

This site has a great visual guide to color and consistency: Baby Centre's Poo Gallery


Wednesday, October 2, 2013

Holiday Tradtions

Now that the first day of fall has come and gone and the cold weather is starting to creep up on us I have gone head first into the festivities that make up my favorite time of the year. According to surveys and polls fall is the most favored season- and for good reason. I have always been a sucker for weather that allows me to wear fuzzy socks, consume anything pumpkin spice, create elaborate pumpkin carvings and snuggle on the couch watching holiday themed movies. And that's just the beginning of it! I love the foods that are in season, the change in colors in the leafs and carrying out family traditions.


My son was born in mid October last year. Since he was still so new, and I was adjusting to motherhood it was hard to carry on with some of our family traditions. I was not able to carve pumpkins that year, but I still made Thanksgiving dinner for our friends and family, sent out our yearly Christmas cards and took my son out in the snow. This year will be the first year that my son will be able to partake in a lot of the traditions and festivities as he is now capable of interacting to some degree. Watching him in the snow will be a whole lot more entertaining, and I will be able to chase him around the pumpkin patch for his first time. I look forward to letting him squish the goo from the inside of our pumpkins, letting him paint his pumpkin(safer than carving by a long shot), sharing a turkey dinner with him at Thanksgiving, dancing together to Christmas music and watching him tear the paper off his presents on Christmas morning.

Growing up my family had a million traditions for the holidays- most seem over the top now that I am older, but some are traditions I keep up with yearly. Every year my family used meet for a Christmas family reunion. These reunions were either in Hawaii, Florida, Canada or Chicago. While together we would have an elaborate Christmas dinner complete with caterers, an obscene amount of decorations and fancy ball gowns. These yearly reunions are quite impossible now with everyone's busy schedules, and my minuscule budget, but they certainly gave me amazing memories and some smaller, more do-able, traditions within them to uphold. My favorites were listening to Mickey's Christmas Carol's from the late '80's-early '90's, taking turns with my sister opening the advent calendar each day, and leaving cookies for Santa and carrots for Rudolf. Our traditions earlier in the season that I loved were carving pumpkins in the backyard, eating home made Chex mix and cracking the wish bone from the Thanksgiving turkey and crying when my sister won the bigger half.

Of all the holiday traditions from my childhood and my husband's, we have decided on a few that we hope our children will someday carry on as well. For Halloween I will continue to decorate pumpkins and dress up in costume. Thanksgiving will never be complete without cinnamon pears, as per my Grandmother's recipe accompanied by a sit down dinner with loved ones. Christmas comes with the longest list: Pictures with Santa is a must, leaving cookies and carrots out on Christmas eve, as well. Christmas lights, decorations and a REAL tree are mandatory. Sending out Christmas cards to those we love, and having dinner with those near us is imperative. My favorite traditions are, first and foremost, playing in the snow, even if it requires a drive to some mountains somewhere, the whole family wearing matching pajamas to bed on Christmas eve to make great pictures the next morning, and under no circumstances will children see the tree or touch a present without Mom and Dad being there first to watch (and take pictures) of the excitement that is Christmas morning.


This year, now that my son is a little older, I hope to start a couple new traditions. Last year while looking for gift ideas for friends and family I came across the story of the Elf on the Shelf. I loved the story behind it, and think it will make for some great memories with my son. My son is not quite old enough to write a letter to Santa as of yet, but I hope we can make this a tradition starting next year. Looking back at the few letters I wrote to Santa when I was little is a blast and are just some of the little things I cherish today. The one activity I will be starting this year and hoping to make a consistent tradition as long as I am able is to make donations to a charity around the holidays. Family members have made donations on my behalf numerous times, which I think is a wonderful gift now that I am older and am not wanting gifts of 'stuff'and I am aware there are so many charities in need. This year I will be making more donations to Goodwill, as well as a donation to the Wounded Warrior Project.
The fall and winter seasons will always be my favorites. The most important thing I hope to instill in my children in regards to the holidays is the concept of family togetherness. This is the key, and the reason I look forward to and thoroughly enjoy this time of the year.

Well, that and the fuzzy socks...