Article: Amazing food--Breastmilk

My little Ryan

Ryan is 24-day-old! He is drinking about 9-10 times a day 3oz each. So happy to see him growing bigger and bigger.

To all lactating mothers out there: work hard and keep it up! Breastmilk is the most wonderful gift for your newborn!

Breastfeeding Success

Breastmilk contains appropriate amounts of carbohydrate, protein, and fat. It also provides the digestive proteins, minerals, vitamins, and hormones that infants need, as well as antibodies that help the baby resist common infections which can never be found in infant formulas. Women who breastfeed also benefit:

1. Have less bleeding after childbirth
2. Return to their pre-pregnancy weight faster
3. Have fewer cancers of the ovary, uterus or breast
4. Less common to diagnose osteoporosis

Initially, BM is similar to skim milk, with a relatively low fat content. As the infant continues to suckle and a period of let down occurs, BM becomes higher in fat and calories. Encouraging baby to suck on each breast for at least 10min ensures adequate calorie consumption. Emptying time of BM from the infant’s stomach is 1.5 hours compared to 3 hours for formula-fed infantsneed to nurse every 2 hours for the first few months of life.

At the beginning of the feeding, the milk (foremilk) is bluish and contains lactose and proteins, but little fat. The end of the feeding produces hindmilk, which contains more fat, the main source of energy for your baby.

Nursing early (within the first half-hour), and frequently (on demand, or 8 - 12 times per day), allows you to nurse comfortably and efficiently. It usually takes less than 1 minute for an infant to stimulate the milk ejection reflex. You should feel little discomfort or pain when breastfeeding appropriately.

Within 6 - 8 weeks, your milk supply will adjust to your baby's needs. Before that time, your breasts may feel either too full or empty. Frequent, comfortable feedings will maintain your milk supply. Your milk supply will increase or decrease based on your baby's hunger and energetic sucking (milk demand or use). Changes in your milk supply will occur within 1 - 3 days after changes in milk demand or use.

Lactation and nutrition

In general, lactating women should get nutrients from a well-balanced, varied diet, rather than from vitamin and mineral supplements. Eat generous amounts of fruits and vegetables, whole grain breads and cereals, calcium-rich dairy products, and protein-rich foods (meats, fish, and legumes). Make sure you are getting enough calories (Pre-pregnancy energy requirement + 500kcal)

Food guide:
Milk, yogurt, and cheese -- eat at least 4 servings
Meat, poultry, fish, dry beans, eggs, and nuts -- at least 3 servings
Vegetables -- at least 3 to 5 servings
Fruits -- eat 2 to 4 servings (choose two foods high in vitamin C and folic acid, and one food high in vitamin A)
Bread, cereal, rice, and pasta -- at about 6 to 11 servings
Fats, oils, and sweets -- go easy!
Fluid -- 8oz fluid including water, soup, juice

Dos and Don'ts

Breastfeeding mothers can safely eat any foods they like. Some foods may flavor the breast milk, but babies rarely react to this. If your baby is fussy after you eat a certain food, try avoiding that food for a while, then try it again later to see if it is a problem. If you become overly concerned about foods or spices causing problems, try to remember that entire countries and cultures have diets that contain foods that are extremely spicy. In these cultures, the mothers nurse their infants without problems.

It is possible that some highly allergenic foods (strawberries, peanuts) may be passed into breast milk, increasing the risk of a later food allergy in the baby. If this is a concern, discuss food allergies with your pediatrician.

A nursing mother can safely drink moderate amounts of caffeine (equal to 1 cup of coffee per day) without causing harm to her baby. But any more caffeine than that may cause agitation and sleeping difficulties in the baby.

Since alcohol has been found in human milk and can interfere with the milk ejection reflex, avoid alcohol while breastfeeding. An occasional drink, no more than two ounces of alcohol, may be safe, but you should consult your health care provider about the associated risks.

If you are a smoker, this is a great time to quit for yourself and for your baby. Nicotine and other chemicals from cigarettes are found in breast milk. Smoking will increase the number of respiratory infections your baby develops. If you are unable to quit, try to limit the number of cigarettes as much as possible, change to a brand with low nicotine, and visit your doctor regularly.

Returning to work

Here are some tips that have worked well for many breastfeeding mothers who work fulltime outside the home:

If you plan to return to work, introduce your baby to bottle-feeding at 3 to 4 weeks of age. This allows plenty of time to establish good feeding habits. Starting bottle-feeds before 2 weeks of age often results in nipple confusion -- the baby has difficulty changing between the different sucking patterns required for the different types of feeding.

Two weeks before you return to work, buy or rent an efficient and comfortable breast pump and start building up a supply of frozen milk. If the day you return to work arrives and you don't have a freezer full of breast milk, one bottle of formula fed to your baby will be an adequate supplement. After returning to work, express milk 2 or 3 times a day, every 2 to 3 hours to continue exclusively breastfeeding. If you can only get one break a day and you are unable to pump a full day's worth in one pumping, a supplemental bottle of formula may be needed. Be aware, however, that feeding formula decreases the need for breast milk, and your milk supply will decrease accordingly.
Nurse your baby immediately before leaving in the morning and immediately upon return from work in late afternoon. Many mothers find that their babies nurse more frequently in the evenings on days they work. Feed on-demand when you are with your baby.

Info: Medline Plus

Article: Wound healing and nutrition

Wound healing, as a normal biological process in the human body, is achieved through four precisely and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. Several factors affect the rate of wound healing including oxygenation, infection, age and sex hormones, stress, diabetes, obesity, medications, alcoholism, smoking, and nutrition. One of the factors that will be discussed here is nutrition. Good nutrition facilitates wound healing particularly protein, omega 3 fatty acids, vitamin C and zinc.

Protein depletion can affect the rate and quality of wound healing. Protein requirement is approximately 20-50% higher during wound healing process. Protein is required as part of the inflammatory process, in the immune response and in the development of granulation tissue. The main protein synthesised during the healing process is collagen, and the strength of the collagen determines wound strength.

The amino acid arginine becomes essential during severe stress. It is abundant in the structure of collagen, and increases its tensile strength. Arginine metabolism is also related to the production of nitric oxide, which is bactericidal, and also aids wound healing through microvascular and haemodynamic changes.

Omega 3 fatty acids are essential fatty acids and are anti-inflammatory which aid wound healing, but it is debatable as to whether omega 3 fatty acids are beneficial to wound healing.

Vitamin C involves in collagen synthesis. Copper is also another important nutrient that stimulates collagen synthesis.

Zinc is required for protein synthesis and is also a co-factor in enzymatic reactions. During cell proliferation and protein secretion, increased demand for zinc has been shown. Zinc also has an inhibitory effect on bacterial growth, and is involved in the immune response.

Diary: Appointment

New job in June =)

Diary: Wound healed

Visited Dr. Mok today. Dressing pad is removed (a bit painful when the tapes torn off) and wound is healed, can start drinking herbal soup. Now I weigh 124lb...about 17lb to lose.

BF making me extremely hungry and thirsty all the time...and feel super hot too!

Diary: Baby Ryan

Ryan weighed 3.05kg upon discharge and gained 0.05kg on the 2nd day post discharge during doctor's FU visit.

He is somewhat quite calm and silent which is a good thing, he only cries when he needs feeds. Right now, I am feeding him every 2-3 hours BM and getting up about 3 times at nights...hope he can do better soon. I think he looks like Silas, especially when he smiles with his dimples.

My wound is more or less healed, at least not painful when I walk. It had been a nightmare on the first 2 days post-op. Contracting uterus plus the wound definitely made me cry, diarrhea, stabbing pain when urinate after off foley but very luckily, it only lasts for 2 days and with the girdle, it's even better.

New milk product for picky eater:
http://www.onelessworry.hk/PE/

diary: bb ryan is here now

birth date: may 8th
weight: 3.16kg
length: 49cm

initially the c-section was scheduled on may 10 but he was too desperate to see the world so he comes 2 days earlier than the scheduled delivery. this time, i had SA, i could feel my tummy was being pulled and stretched but couldnt feel the pain... at around 1230nn, ryan was out and crying...

he was once found to be sob, but then, the day after, his breathes return to normal, no extra O2 is required (SpO2 100). thanks god. he is still in the incubator to have his lung function monitored.

Article: 健腦食物

文：註冊營養師張志君 Michelle Cheung (registered dietitian)

腦袋有六成均屬於脂肪，脂肪參與腦部的主要功能包括學習、記憶及情緒。

脂肪有分好壞，大致上可分4大類別，飽和脂肪酸、單元不飽和脂肪酸、多元不飽和脂肪酸及反式脂肪。脂肪攝取量應佔總熱量的百分之25至30。我們常聽到奧米加3脂肪酸，是屬於多元不飽和脂肪，包括DHA、EPA及alpha-ALA。奧米加3脂肪酸有助腦部及眼部發展。

健腦食物：

1. 核桃、杏仁
維持大腦正常功能
促進中樞神經運作，避免智力下降及反應遲鈍

2. 銀杏 (又稱為白果)
有助腦部運作及增強記憶能力
保護腦細胞免受自由基的破壞
如白果薏米粥、白果腐竹糖水或香芹白果蝦仁

3. 三文魚、吞拿魚、沙甸魚
增加腦部發育和記憶力
牛肉、羊肉、豬肉、青口、蠔(含豐富鐵質)
減低精神不集中、語言學習困難、記憶力衰退和情緒不安

4. 黃豆
增強記憶能力及腦部靈活性

可惜，奧米加3脂肪酸到現時還未有研究指出對老人癡呆症有效用。

Article: 妊娠嘔吐/晨吐

妊娠嘔吐/晨吐
文：註冊營養師張志君 Michelle Cheung (registered dietitian)

妊娠嘔吐的原因? 很大機會是因為荷爾蒙(hCG或estrogen)水平的變化。
一般輕度的妊娠嘔吐不會影嚮胎兒的發展，懷孕初期，體重有輕微的下降均屬正常。但因嚴重的嘔吐而導致食慾不振，應盡快找醫生及營養師幫忙。

市面上有多種『媽媽奶粉』，一般孕婦如果飲食均衡，每日有兩至三份奶品類(脫/低脂為佳)則不需要沖飲孕婦奶粉。因為孕婦奶粉的熱量及碳水化合物較高，如體重升得過快、有糖尿病或過往曾有妊娠性糖尿病，應小心服用。但，對於食慾不振或體重有減無增的孕婦，不妨嘗試孕婦奶粉。

減輕食慾不振及晨吐飲食方法：
1. 少吃多餐
2. 流質飲品應避免在正餐時飲用，改為餐與餐之間
3. 起床前可吃梳打餅乾或烘面包等較乾身的食物
4. 維他命B6如香蕉、雞胸肉、薯仔等及薑能減少嘔吐的感覺

妊娠嘔吐與嬰兒智力有關?
2009年7月份有一項加拿大多倫多研究針對妊娠嘔吐與嬰兒智力的關係，研究對象是年齡介乎3-7歲小朋友。研究指出，如母親於懷孕初期有妊娠嘔吐的情況，日後子女均有較高智力、記憶及語文能力。研究總結，妊娠嘔吐不但沒有對懷孕期有任何的壞影嚮，長遠來說，對子女日後的心理發展反而有利。

最近有另一項研究則指出，如上一代有妊娠嘔吐的情況，下一代有百份之3的機會會遺傳妊娠嘔吐。