Nutrition in year one

Written by Dr. Megan Gruesser, board certified pediatrician at Community Physician Network. To schedule an appointment with Dr. Gruesser, visit her physician profile.

A baby’s nutrition will evolve in their first year of life.  A newborn only requires breastmilk or formula for the first four to six months of their life.

Despite what grandma tells you, babies do not need any extra water in those early months, as it can mess up their electrolyte balance.

Even though breastmilk is best for babies, it can be deficient in Vitamin D and iron. Moms should continue taking their prenatal vitamins if they are breastfeeding. However, the pediatrician may also recommend that breastfeeding babies take a vitamin supplement as well – either a vitamin D supplement or a multivitamin with iron supplement.

Most babies are not developmentally ready to spoon feed until they are four months old.  So, you can expect your pediatrician to discuss starting solid foods off a spoon at four to six months of age.

Table foods are not usually introduced until eight to nine months of age to prevent choking and aspiration.

Breastmilk or formula is encouraged to continue until 12 months of age, at which time you can transition to whole milk.  However, you may continue to breastfeed beyond 12 months old if you choose.

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When should parents look for a pediatrician?

790274Written by Dr. Megan Gruesser, board certified pediatrician at Community Physician Network. To schedule an appointment with Dr. Gruesser, visit her physician profile.

I think new parents should start looking for a pediatrician for their newborn four to eight weeks prior to their due date. This may seem really early to some, but you never know if your baby may want to come into the world earlier than expected.

Once baby arrives, life as you know it can become quite hectic, so it’s comforting to already know which doctor is going to see your baby in the hospital or after discharge.

Starting your search for a pediatrician early may afford you the time to meet with multiple pediatricians and practices. By doing this, you can learn the variances among physicians and their groups, and help find the perfect fit for you and your newborn.

Many pediatricians offer meet and greet appointments with expecting parents at no charge. Take advantage of these and make sure you come with plenty of questions!

Items you should consider when making your decision include:

  • Is the office close to my home, work, or daycare?
  • Is it a larger or smaller practice?
  • Does the practice accept my insurance?
  • How quickly can I get my baby in to see the physician for sick or well visits?
  • Will we see the same physician every time we come to the office?
  • Do physician extenders work in the practice (PA’s or NPs)?
  • Does the practice offer evening and/or weekend hours?
  • What are the physician’s views on vaccines?
  • Who answers questions after hours and on the weekends?
  • Does the practice offer any other services like lab or xray?

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Losing the baby weight

pregnancy_bellyFor many women, getting back in shape after baby is born is a high priority. Experts remind mothers that slow and steady is the healthy way to approach losing baby weight.

The Academy of Nutrition and Dietetics offers these suggestions:

• Give your body at least a month to recover from childbirth before you try to lose weight.

• Never skip meals. Focus on eating nutrient-rich, healthy foods instead of counting calories.

• Drink six to eight glasses of water per day and even more if breastfeeding.

• Eat at least 4 1/2 cups of fruit and vegetables each day.

• Eat healthy, protein-packed snacks during the day.

• Slowly work your way back to a regular exercise routine, and avoid any fad diets that purport to make you lose weight quickly.

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Extreme Morning Sickness: Symptoms & Risk

A second royal baby is on its way! The Duchess of Cambridge and Prince William announced this morning that they are expecting their second child.

Clarence House said the Duchess Kate Middleton was being treated at Kensington Palace for severe morning sickness.

She suffered from morning sickness during her first pregnancy with Prince George, who was born in July 2013.

Dr. Sara Pierce, OB/GYN at Community Physician Network, talked to WTHR in 2012 about hyperemesis gravidarum, or extreme morning sickness, the condition for which the duchess is being treated. She explains the symptoms and what can put moms at higher risk.

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How to nurse an adopted baby

parents-with-babyHave you ever heard of the term ‘induced lactation’? Induced lactation is used to describe the process of bringing in milk when there has been no pregnancy.

The production of breast milk is triggered by the production of the hormone prolactin. While the production of this hormone is commonly triggered by a pregnancy, the hormone itself is produced in the pituitary glad, not the ovaries. Therefore, a woman does not need to be pregnant to produce milk.

Inducing lactation can take several months so the recommendation is to start well before the baby arrives, if possible. There are several methods to induce lactation from which a mother can choose:

• If the mother knows when the baby might arrive and wants to get started, she can take hormones. After milk has been produced she can stop the hormones and start using a breast pump to continue production.

• She can start pumping without the use of hormones to stimulate the production of milk.

• She can wait until the baby arrives and use herbs or hormones, along with the baby at the breast to stimulate a milk supply.

Every body reacts differently to hormones, so it is not possible to predict whether a mother will produce a full milk supply for her baby.

Many mothers will need to add a nutritional supplement for their babies. To best mimic breastfeeding, supplementation can be done with the use of a nursing supplementer.

These are containers (either reusable hard plastic or soft, disposable plastic bags) that hold a milk supplement. They have a small tube that is placed in the baby’s mouth while suckling at the breast so that the baby gets both the mother’s milk and the supplement.

This extra breast stimulation helps with the mother’s milk supply and feels more like breastfeeding since all of the nourishment is given at the breast.  Putting the baby to breast with the supplementer provides many of the benefits of breastfeeding regardless of the amount of milk the mother produces.

 For more information regarding induced lactation and the use of a nursing supplementer you can visit or contact a Community Health Network lactation consultant.

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Tips for being healthy parents

parents with baby - twitter

While having a baby provides many wonderful experiences, it can also add stress to a relationship. A strong, healthy relationship between parents provides a healthy environment for your baby.

The following are ways the American Academy of Family Physicians suggests parents can keep their relationship strong once baby joins the family:

  1. Find time to spend together, as well as individual alone time for each of you.
  2. Schedule date nights at least every other week, if possible.
  3. Take time to talk to each other about everything you’re feeling, both the good and the bad.
  4. Disagreements are to be expected, but make sure you handle them respectfully and fairly.
  5. Listen to each other, and make up after disagreements.

Follow Community Health Network on Twitter for daily health and wellness tips.

Source: Health Day

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Breastfed toddlers are happy, healthy toddlers

breastfed-toddlerAs breastfeeding becomes more common, many wonder if breastfeeding beyond the first year is healthy or normal. The answer is yes! The benefits of breastfeeding, for both mom and baby, do not disappear on a baby’s first birthday.

Many experts recommend continuing to breastfeed beyond one year. The World Health Organization and the Canadian Pediatric Society recommend continued nursing for at least two full years, or longer, if it is mutually desired. In fact, the average global age of weaning is three years.

While breastfeeding is crucial for young babies, toddlers also benefit from breastmilk.

Most toddlers are actively exploring their world by putting everything in their mouths, including germs. Their immune systems are not fully developed, but breastmilk can provide the additional protection they need. As the amount of breastmilk they consume decreases (due to weaning), the percentage of antibodies and other immune building factors in the milk actually increases. Nature knows how much toddlers need infection protection!

While some moms choose to wean to cow’s milk at age one, breastmilk continues to be the biological norm for human children. As many mothers know, toddlers can be picky eaters and continuing to nurse them is like giving them a vitamin. Even if they’re not eating all of their table food, they can get the additional nutrients they need to grow and develop, both physically and mentally, via breastmilk.

In short, if you and your baby enjoy your breastfeeding relationship, there is no reason to abruptly stop just because your infant is growing. Nursing for the first few years of life is natural, healthy, and can continue to be part of the way you mother your child.

Breastfeeding support
For support as you breastfeed, consider one of the many resources that Community Health Network provides.

Sources: and

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Ten reasons to breastfeed

Breastfeeding_2Here are ten somewhat amusing, but totally serious reasons to consider breastfeeding.

  1. A lot of smart people think it’s a good idea to breastfeed, including the American Academy of Pediatrics, the American Dietetic Association and the World Health Organization.
  2. These smart people must have been breastfed because breastfed infants have, on average, an additional seven IQ points.
  3. Feed baby great, eat well and lost weight. Breastfeeding require an additional 500 calories per day. So, enjoy!
  4. Go shopping! Use the $700 to $3,000 you’ll save by not buying formula to purchase shoes, cameras, baby supplies…you name it!
  5. Be a model employee. Miss fewer days of work. Breastfed infants are less likely to develop upper respiratory infections, allergies, ear infections and diarrhea. This means that you are less likely to change multiple dirty diapers while missing work.
  6. Breastmilk is fast food. It’s always ready, with no preparation necessary. It’s just the right temperature and there’s no need to wash bottles or nipples.
  7. Flat stomach? No problem! Breastfeeding releases a hormone that causes your uterus to contact back to its original size.
  8. Don’t be a statistic. Breastfeeding lowers the risk of obesity for baby and mom.
  9. All joking aside…breastfeeding provides your baby with protection against Sudden Infant Death Syndrome, childhood leukemia and Type I diabetes.
  10. Mothers who breastfeed have a decreased risk of osteoporosis as well as breast, ovarian and endometrial cancers.

For support breastfeeding, contact a Community lactation consultant or join our support groups. Information can be found online.

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Could Tylenol taken during pregnancy be linked to ADHD?

valerie-mossOh, no! Not Tylenol! The Journal of the American Medical Association, Pediatrics recently released an article about a Denmark study that suggest acetaminophen (the active ingredient in Tylenol) taken during pregnancy can lead to ADHD-like symptoms in the child.

The preliminary study looked at a large cohort of pregnant women over a span of time, and noted that women who were exposed to acetaminophen were more likely to have children who developed ADHD. This leaves many women questioning if Tylenol causes ADHD, and if so, why are their doctors prescribing it?

“It is important to remember that there is not a direct cause and effect relationship between Tylenol and ADHD, and that this study is still in the preliminary stages,” said Valerie Moss, M.D., OB/GYN at Community Physician Network. “Additionally, acetaminophen is one of the few medications that can be used as a fever reducer in pregnancy and it does have definite benefits over other pain medications during pregnancy.”

Of note, this study reviews women exposed to different amounts of Tylenol and in different trimesters during pregnancy.

“Most pregnant women are not taking large amounts of Tylenol and I would advise that all medications be used sparingly in pregnancy unless medically necessary,” said Moss.

She encourages women to keep in mind that there are other non-medical alternatives that can be used for pain relief during pregnancy including soothing baths, pregnancy exercises, support belts, and massages.

“As always, it is important that you consult with your doctor first before starting or stopping any medications during pregnancy,” said Moss.

To learn more about Dr. Moss, visit her physician profile.

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New guidelines to decrease C-sections

The American College of Obstetricians and Gynecologists and the Society for Maternal Fetal Medicine recently developed new recommendations to help decrease the number of primary Cesarean sections (C-section). We asked Community Health Network OB/GYN, Dr. Indy Lane, to tell us what the new guidelines mean for soon-to-be mothers.

“A primary C-section is one performed in a woman’s first pregnancy,” said Lane.  ”While there are many situations in which a C-section is necessary for the safety of the mother and/or baby, there are both short and long term consequences of an operative delivery versus a vaginal birth.”

The new recommendations for labor management challenge the traditional definitions of abnormal labor patterns in the hopes of reducing what is thought to be an overuse of Cesarean delivery.

Currently, the most common indications for a C-section are abnormal labor progress (34%), fetal distress (23%), and abnormal fetal position (17%). The new guidelines examined these indications and released ways physicians can provide patients with better odds of a successful vaginal delivery.

Lane explained, “Traditionally, a woman’s labor progress was considered abnormal if she labored longer than 14-20 hours during the early stage of labor. New data suggest that it is reasonable for a woman to labor beyond 20 hours in the early stage if there is at least some cervical change.”

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