Carol Gray’s Blog

Read Past the Headline

Wed, 26 May 2010 16:03:31 -0700

I regularly read medical journal abstracts about research pertaining to mothers and babies. Sometimes I only read the title of an article and continue down the list.

For example, in today’s Medscape Ob/Gyn & Women's Health MedPulse I read, “Breast-Feeding Linked to Lower Incidence of Fever After Immunizations”. Duh, I say. No need to read past that headline. Next I read, “Infants Delivered By Cesarean May Be More Likely to Develop Celiac Disease”. I’m not surprised enough to need more details about this one, either.

Then I read, “New Research Suggests That Mode of Delivery Does Not Affect Neonatal Outcomes”. WHAT? REALLY? How can this be? What new load of garbage is ACOG trying to jam down our throats now? How are they going to back this up? What do they mean by, “suggests”?

It turns out that this particular (small) study looked at 126 VERY PREMATURE (23-30 weeks gestational age) infants. Some of whom were vaginally delivered and some of whom were cesarean delivered. Their outcomes were similar. The results: These babies were so small and immature that it didn’t much matter, in terms of their mortality and morbidity, how they were born.

If I hadn’t looked beyond the headline on this one I might have begun to believe that - just like the headline says - mode of delivery does not affect neonatal outcomes - NOT TRUE.
Nice try.

Every Day is a Nestle-Free Day at My House

Mon, 29 Mar 2010 22:18:29 -0700

The current surge of Nestle boycotting (Nestle-Free Easter) is in part about Nestle chopping down rainforest land and destroying orangutan habitat to plant palm oil plantations.

I am excited that Greenpeace and other protesters have commandeered Nestle’s Facebook fan page in order to speak the truth - and sling mud - about Nestle.

For 33 years I have boycotted Nestle products (an ever growing number) due to their aggressive infant formula marketing practices in developing countries and the resulting infant deaths. These practices include women dressed as nurses giving out free samples and promoting the “benefits” of formula feeding to some of the poorest new mothers on the planet.

The women who are the targets of this sleazy promotion have little understood that feeding formula will dry up their milk. They don’t always understand in advance how much it really costs over the weeks and months to formula feed. By the time they realize they don’t have the money to continue paying for formula their own milk has dried up. And they don’t necessarily have access to safe water with which to mix the powdered formula which then becomes a thin solution of formula, water and harmful microorganisms. Their babies die of malnourishment and dehydration caused by the diarrhea that surely follows mixing powdered formula with unclean water.

Here’s what you boycott when you boycott Nestle:
 Candy and Chocolate: Baby Ruth Bit-O-Honey Butterfinger Carlos V (”the authentic Mexican chocolate bar”) Chunky Gobstoppers Goobers Laffy Taffy Lik-M-Aid Fun Dip Nerds Nestle Abuelita chocolate Nestle Crunch Nips Oh Henry! Oompas Pixy Stix Raisinets Runts Sno-Caps Spree Sweettarts Wonka 100 Grand
Frozen Foods: Lean Cuisine (frozen meals) Lean Pockets (sandwiches) Hot Pockets (sandwiches) Stouffer’s (frozen meals)
Baking: La Lechera (sweetened condensed milk) Libby’s Pumpkin Nestle Tollhouse Morsels and baking ingredients
Ice Cream: Dreyer’s (ice creams, frozen yogurts, frozen fruit bars, sherbets) Edy’s (ice creams, frozen yogurts and sherbets) Häagen-Dazs (ice cream, frozen yogurt, sorbet, bars) Nestle Delicias Nestle Drumstick Nestle Push-Ups The Skinny Cow (ice cream treats)
Pet food: Alpo Beneful Cat Chow Dog Chow Fancy Feast Felix Friskies Frosty Paws (dog ice cream treats) Gourmet One Pro Plan  Beverages: Coffee-Mate Jamba (bottled smoothies and juices) Milo Powdered Beverage and Ready-to-Drink Nescafé Nescafé Café con Leche Nescafe Clasico (soluble coffees from Mexico) Nescafe Dolce Gusto Nesquik Nestea Nestle Juicy Juice 100% fruit juices Nestle Carnation Malted Milk Nestle Carnation Milks (instant breakfast) Nestle Hot Cocoa Mix Nestle Milk Chocolate Nestle Nido (powdered milk for kids) Taster’s Choice Instant Coffee  Specialty items: Buitoni (pasta, sauce, shredded cheeses) Maggi Seasonings Maggi Taste of Asia
Infant Formula: Nestle Good Start Gerber Pure Water (for mixing with formula)
Baby Foods: Cerelac Gerber (cereals, juice, 1st Foods, 2nd Foods, 3rd Foods, etc.) Gerber Graduates (snacks, meal options, side dishes, beverages, Preschooler meals/snacks, etc.) Mucilon NaturNes Nestum
Accessories: Gerber - cups, diaper pins, pacifiers, bowls, spoons, outlet plugs, thermometers, tooth and gum cleanser, bottles (all of these are made by Gerber)
Breastfeeding supplies: Gerber Seal ‘N Go breast milk storage bags, bottles, nipples, nursing pads, Breast Therapy warm or cool relief packs, Breast Therapy gentle moisturizing balm (all of these are made by Gerber)
Bottled Water: Arrowhead Deer Park Gerber Pure Water Perrier Poland Spring Pure Life S. Pellegrino Vittel
Breakfast Cereals: see joint ventures below
Performance Nutrition: PowerBar Boost
Miscellaneous: Jenny Craig
Joint Ventures (in which Nestle is partnered with another company): Nestlé SA has several joint ventures. These are some of the larger ones:
Beverage Partners Worldwide, formed in 2001, is a joint venture between the Coca-Cola Company and Nestlé S.A. It concentrates on tapping markets in the beverage sectors, particularly ready-to-drink coffee and teas, such as Nestea.
Cereal Partners Worldwide is a joint venture between Nestlé and General Mills. From what I understand, in the USA, the cereals are made by General Mills. In the UK, they are made by Nestle.
Laboratories Innéov is a joint venture between Nestlé and L’Oréal, formed in 2002. Cosmetics included in are: L’Oreal Maybelline Garnier Lancome
Dairy Partners Americas is a 50/50 partnership between New Zealand dairy multinational, Fonterra and Nestlé and was established in January 2003. The alliance now operates joint ventures in Argentina, Brazil, Venezuela, Ecuador and Colombia.

Good Question

Thu, 14 May 2009 19:24:06 -0700

Q: Do you ever advocate shushing, bouncing, putting a pacifier in a crying baby's mouth?

A: I don't ever actively promote these things, but I'm not openly critical of them either. It all depends on the parents, the situation, the reason for the crying and the temperament of the baby. Crying is a distress call, a form of expression and a pain coping practice. It is irritating to parents for a reason: It insures that the parents know the baby is in pain or has an unmet need and causes them to take appropriate action.

Example: The hungry baby cries. We pick up the baby and offer milk. The baby nurses and stops crying.

Babies who cry a lot and whose needs are more mysterious are at increased risk for shaking or other harm at the hands of distressed parents. So, if the parents are close to the edge and they use a pacifier or bouncing to quiet a frequently screaming baby, would you tell them to stop?

If this bouncing/shushing/sucking (you forgot swaddling - the baby straight jacket) is deeply entrenched behavior, my intervention would be to acknowledge that this particular baby cries more than most and that his needs are mysterious at times. I would then introduce the idea that if all the known needs are met and reasonable solutions offered (dry/fed/warm/held, etc.), it is OK to hold a crying baby without the intention of stopping the crying. Distressed, sleep deprived parents might not be able hear this at first, though.

There is something disrespectful about stuffing something (a pacifier) into the mouth of a crying baby. To me it's like saying the "s" word = shut-up. Although, there is a difference between stuffing a pacifier into the mouth of a wailing baby and simply offering it.

Babies are better able to organize themselves neurologically if they are sucking. Sucking is a major survival skill for a baby. It makes sense that it would be intensely pleasurable for the baby to suck. I know that if we are presented with two kinds of stimulation - one pleasurable and one painful - we are actually hard-wired to pay more attention to the pleasurable stimulation and thus feel less pain. That's why soaking in water helps with the pain of labor. When a woman is feeling pleasurable sensations on her skin from the water, the pain gets a smaller slice of her awareness pie.

What if the baby uses crying as a pain coping practice? How many women vocalize in labor? Allowing the baby to cry and offering her support while she does it would be helpful, right? What if bouncing is also a pain coping practice for the baby? Who's to say that one is "better" than the other? If laboring women use vocalization sometimes and movement at other times to cope with the pain, babies can, too, in my book.

Some babies will stop crying if offered pacifiers, swaddled, shushed or bounced. I think it's important for parents to define the goal. If the goal is to stop the crying before the parents go crazy and hurt the baby then I say bounce away. If the goal is to stop the baby from crying because the parents think that a crying baby is a sign of bad parenting then the strategy could use some revision.

I think it all comes down to intention. We want our babies to be safe. We want to be sure we are meeting our babies needs. We want our babies to be able to freely express their emotions - even the ones that are expressed by crying.

The Lead Garden

Sat, 2 May 2009 09:38:13 -0700

I read an article in the Portland Tribune about the hazard of backyard chickens eating lead-based paint fragments in the soil. The lead tastes sweet. After the chickens eat the lead they lay lead-laced eggs which are eaten by their unsuspecting green-leaning owners.

Lead in the soil is a hazard not only for egg raisers and eaters, but also vegetable gardeners and eaters. I wince when I see so many home vegetable gardens snugged up against older (pre 1978) houses.

While chickens eat the lead directly, plants also absorb lead from the soil. The mineral content of plants is variable depending on the soil in which the plants are grown. Minerals in the soil, including lead, end up in the plants we eat. Lead concentrations are usually highest in roots. Next comes leaves, then fruits and last seeds (usually).

Lead concentrations in the soil near a house (that has been painted with lead-based paint) are usually highest about three feet away from the building. It makes sense that most of the scrapings between paint jobs would land there.

* Note: Lead contaminates soils along highways due to our long love affair with leaded automobile fuels.

Plants that are high in calcium (like spinach and broccoli) end up with the highest lead concentrations. The lead binds tightly with calcium. That’s why lead settles in our bones after we ingest it.

In theory, we could eventually get the lead out by planting successive crops of spinach and then pulling and sending the mature plants to the landfill - year after year. Don’t eat or compost these lead-bombs. This is called “cropping out”.

A better solution would be to brick over the area near the building and then build raised beds with clean soil over the bricks. The idea is to keep the roots of our food plants away from the contaminated soil.

Another option is to remove a significant amount of soil and replace it with clean soil. Determining the depth and concentration of the lead wold require testing. More testing would be required to determine if replacing the soil resolves the problem.

One we have decontaminated the soil in the garden area, we must be vigilant about preventing recontamination from flaking, pressure-washed, sanded or scraped paint.

The easiest solution is to not plant your garden near the house or garage.

Eat

Sat, 25 Apr 2009 15:10:15 -0700

Parents ask me about introduction of solid foods all the time. Here’s my take on it.

Babies store iron in their livers while they gestate. Milk has next to no iron in it. At some point after birth, babies’ iron stores begin to diminish. This is often when they show signs of interest in iron rich solid food. Hopefully, this occurs around the time they are developmentally ready in other ways. Unfortunately, some babies have their cords cut soon after birth and don’t get all of their own blood - some of which remains in the placenta or umbilical cord. I think this leads to anemia or a premature necessity for solids or supplements before the baby is otherwise ready.

What are the readiness signs? If we sat on the floor and ate with our hands the readiness signs would be obvious. A ready baby would simply join in the family fare. The baby would be able to sit stably. She would probably (but not always) have some teeth. She would be interested in eating food. The interest thing is most important. We need to trust babies to know when they are ready. The ready baby would pick up pieces of food, put them in her mouth, gum, chew or mash them up and swallow them. I believe that when babies can do this they are ready.

When my kids were babies the standard practice was to formula feed and then begin solids in the form of rice cereal at six weeks. Then we were supposed to feed pureed bananas, pears and the like. The idea was that formula was deficient in certain nutrients and early supplementation with solids would somehow make up for it. The myth that babies on solids would sleep better or longer was rampant (and persists today).

For some reason I never followed that template. I must have read some radical article about the “late” introduction of solids and stuck with it. I breastfed my children, but hardly anyone else did in those days. I tried feeding my oldest son at age six months with a spoon, but he wanted to feed himself so I let him.

My middle son didn’t eat any solid food until around his first birthday. When he could sit on his own, we dutifully placed him in a high chair at the table with the rest of us during mealtimes. We offered him little pieces of food which he fed to the dog. His first solid food ended up being guacamole. He ate quite a lot. After that he ate everything we ate. It all happened at once. That was it.

I am against poking rice cereal or other pureed concoctions into babies’ mouths with little spoons. Normal babies don’t really need “baby food”. We don’t need to buy it and we don’t need to make it. Babies can eat what we eat. We might need to mash it up with a fork or cut it into pieces, but if they are really ready that’s all we need to do.

Babies will show interest in spoons and other utensils when they are ready. My philosophy is that if the baby wants a spoon the baby gets a spoon. Sometimes babies want certain utensils before they are ready. One of my granddaughters has been especially interested in using a knife since before age two. Luckily, she lives with adults who can safely cut her food for her.

I do think it makes sense to introduce new foods singly and, in some cases, in a particular order, especially if there are food allergies in the family. That way we know which food is the culprit if the baby has a reaction. Sometimes that doesn’t always go according to plan. One of my granddaughters got the food urge on vacation in Europe at age five months. She grabbed and tried to eat everything she could snag off our plates. She had many multi-ingredient new foods that were not necessarily on her parents’ list of what to introduce first.

Self feeding can be a bit messy. Use a bib. Put plastic under the baby’s chair. Get over the idea of white carpeting in the dining room until the kids are grown. Kids spill. We always employed dogs as part of the self feeding team. The floor can stay pretty clean with the right dog on duty.

Last, self feeding eliminates what I think is the weirdest part of spoon feeding. When we spoon feed our babies they have to eat in order to please us. I would rather my kids eat for healthier reasons.