Book Review: Real Food for Pregnancy by Lily Nichols RDN, CDE

Pregnancy is just one chapter of a family’s story. How ever we enter this realm of life, its important to remember that there are a whole host of opinions on how to “be healthy.” Standards today don’t stem terribly far from the standards 50 years ago, and Lily Nichols RDN, CDE best selling author of, “Real Food for Gestational Diabetes” and now “Real Food for Pregnancy” has done her due diligence of sweeping study after study and finding some connections. She offers some insight on our current nutritional model for pregnancy, while shedding light on some findings that can benefit our children’s development.

Nichols changed the game with her research of gestational diabetes, and this book is no different. Admittedly I was swept up with the idea of eating up (pun intended!) every bit of information in this book, but I had to take my time to connect the dots, and I still am. She has taken into account both medical studies as well as cultural practices in prenatal diets. In addition to her highly detailed breakdown of nutrition, she utilizes the biological process of fetal development to support the statistics as well as cultural traditions.

She starts with a comprehensive look at nutrition as a whole, such as main sources of protein and how to plate your meals. It was very beneficial information as a non pregnant person, so this can have a huge affect not only on your developing baby, but also on your family as a whole. I will stress that if you are already pregnant and receiving this information it can be pretty overwhelming. That said, this book is great to have on your shelf, as it offers the ability to skim through and find clarification on the fly.

From an individual' perspective, a lot of the studies answered questions I had about my own balance of calories. This information has helped me be more mindful about the food I eat, and even how I eat it. She touches on fats and how essential they are in absorbing nutrients, as well as in the development of the fetal brain. Nichols is a saint for taking all of these incredibly extensive studies and translating them in such a cohesive text. This book is rich with information, but she offers a fluidity that nurtures your learning experience. She shows this through her insight on vegetarian and vegan diets, and how to fill any gaps in the growth and development of baby. It should be noted that a lot of the studies have shown that animal fats within the context of pregnancy and brain development are superior to plant fats. She takes the time to explain the science behind these findings, and offers practices outside of these texts for vegan or vegetarian individuals.

As a doula, I have a fair amount of discussions with my clients around nutrition. The common ones tend to be food aversions, forbidden foods, and nutrition for breastfeeding. Nichols makes a point to get down to the heart of pregnancy. It’s no surprise that the first trimester can be really tough on a pregnant person’s constitution. Some of the most common aspects are nausea, sensitivities to smells , and lack in appetite. In the words of one of my recent clients, “you get nauseous cause you haven’t eaten, but you can’t eat cause you are so nauseous.” In this circumstance, her recommendation is to just eat! You may spend some time on a starch heavy diet in the beginning, but this should let up over time offering a more nutritionally abundant diet. All aspects on growing a family requires grace, and this is no exception. I appreciate that aspect in her writing.

I would recommend this book as “THE” book in understanding the american dietary recommendations in comparison with other cultures. Topics like raw fish, soft cheese, alcohol, etc. are all covered and you’ll be happy to know that we have some more wiggle room than we thought. As a culture Americans have to vet out a lot of junk food, this certainly sets us apart from our neighboring countries. I really appreciated the clarification on these dietary choices and the strength in facts that supports them.

This book has me excited about getting pregnant, and ensures that I will continue to view my nutrition in a much brighter context and understanding. It has also opened a new avenue in which I can navigate with my clients during their pregnancies. I highly recommend this to anyone planning to be pregnant, or even just needing a change of perspective with their own body and nutrition.

Read More

Weaning Baby pt. 2 Bottle Feeding

Last week we discussed exclusive breastfeeding while working a full time job, and the challenges that can present with this style of care. What about our moms on medications unsafe for breastfeeding, or moms fed up with breastfeeding all together? Since we are eliminating the breast completely, you will no longer need to use a pump. Pumping will only encourage your body to produce more breast milk. Instead of pumping, you will want to hand express the milk until you feel more comfortable. When done as needed, this will significantly reduce the chance of engorgement, and will not cause any more milk production. Eventually you will be able to eliminate hand expressions all together. We will be addressing the two major decisions made with bottle feeding; what kind of bottle should i give my baby, and what kind of formula is best for my baby?

The best advice I can give parents when starting out, is buy 3 different types of bottles in the beginning. If you're still breastfeeding, pump for one feeding a day, and test out each bottle on your baby. They will tell you what they like. I want to be clear - start testing bottles and nipples only if you plan to bottle feed. It is best to stick to exclusive breastfeeding or exclusive bottle feeding within the first few weeks of development, so as to avoid nipple confusion.  

We as a generation are fortunate to have all the resources we do for such a time in our lives, but like many things that have been fine tuned over time, the over-abundance of choices can be very overwhelming. Lets talk about some of the details to consider when choosing a bottle for your baby. As of 2012 BPA (Besphonal-A) a chemical that is said to create hormone-like substances was banned from the manufacturing of plastic bottles. Most of the bottle companies were producing products without BPA long before the ban, but with this is mind it is safe to say you shouldn't just use any old bottle lying around. With these developments the option between plastic and glass bottles has surfaced. Consider your activity level as a mom, traveling with glass can be risky. For one, it is gonna be the heavier option and can potentially break. Lets not forget your budget, glass bottles will certainly be a more expensive purchase. On a positive note, by choosing glass you are narrowing down your options a great deal, and they also last a lot longer than your traditional plastic bottle.  

Now lets address nipples. Nipples are often a source of confusion for parents; You have slow flow, fast flow, orthodontic, traditional (bell shaped), or the latest on the market flat topped. These will vary with the manufacturers. They are produced in both latex and silicone, so you will want to consider any potential allergens you or partner have when deciding. NUK and Gerber produce the orthodontic, these nipples are said to be better for baby's teeth as the flat part rests on baby's tongue. The Bell shaped are said to be best for babies that both breast and bottle feed. It said to mimic the breast and reduce nipple confusion. The flat topped are the trendiest on the market currently being produced on most every new bottle, however the most popular bottles (tommee tippee, Comotomo, and Adiri) are still producing with the traditional bell shaped nipples. As for flow, this is often based on the child's development age. A newborn will require a slow flow as they are still learning how to feed. As the child develops over time you will notice cues that baby is not getting what they need, and you will want to consider the nipple flow when making changes as baby matures.

Just when you thought you were finished summing up all your options, we now will briefly address formulas. In this case you will want to seek out a formula that baby best responds to. One should watch baby closely after feedings and make sure they are comfortable and not having any issues digesting. This can be overwhelming to some, as not all babies respond to formulas the same way. Baby should seem rested, full, and keep the formula down post feed. Some babies spit up.- they just do. What we want to avoid are spit ups that are several ounces, as this can lead to acid reflux, discomfort, and lack of weight gain. Formula's are tough to nail down and are often chosen through trial and error. I would recommend doing your own research on what is available and most comparable to what you feel most comfortable feeding your baby. The marketing of formula's will seem focused on a few different brands (and while a topic for another day), this can make your decision making process a bit difficult. I urge you to search outside of the box, and ask your community how they made their decision. 

As you can see, there are prominent challenges for both breastfeeding and bottle feeding, and we are truly only scratching the surface on this topic. Try and practice patience with this process. Your baby is an ever evolving creature and this is just the first of many changes they will endure. 

Next week we take a look at weaning with solid foods, and choosing food for baby.  I will also be listing my direct resources for this months topic!