In an effort to walk my talk

“One Minute is Better Than Zero Minutes.”

I say that often, probably every day.  And I believe it.  There are articles out there that discuss the cumulative effect of meditation or prayer, exercise, healthier eating, and even sleep.  But that isn’t the only reason why I believe it and say it.

The goal for myself and the people I see each day is not a matter of A+B+C= better health later.  I want people to feel a little bit better, smile a bit more, and enjoy everything they have going on in their lives a bit more each day.  Even when it’s crazy, full, busy, or whatever other word we use to describe our lives that also chips away at our appreciation of it.

What if the tasks we set ourselves are actually out of reach or are not sustainable?  What if that 60-minute meditation or 10,000 steps are just not going to happen today?  Well, now the day is crazy AND we didn’t do the thing we were supposed to do to relax and de-stress.  Fail.

But what if it was attainable and sustainable?  Truly, we could do one minute.  And some days we might get a few more.  Could we feel successful?  How would it change our days to feel successful in doing something to care for ourselves?

I am in my office 12 hours a day and doing anything for myself isn’t going to happen unless it happens at work.  So I play around with things that make me feel like a self-care ninja.  I feel like I am cheering on my one year-old self.  Amazingly enough, they help with my mental energy and my overall feeling about how my day went.  It is often really simple stuff:

  • I take the long way around the office and grab a glass of water
  • I lay out on my floor and stretch for 1 minute
  • I do a plank for as long as I can
  • I walk out the back door and breathe a bit of fresh air
  • I eat a carrot instead of a dark chocolate peanut butter cup

What can you do in your day to secretly engage in a bit of self-care and be successful now?  Let me know what you come up with!  Take care, Dr. S

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Midwifing the Midwife

It goes without saying that there are dozens of people who make it possible for midwives to be there for families.  And it’s not just being able to pick up where we leave off.  It’s continuing to be on even when we return home and to work without sleep and still drifting between reality and the surreality of birth.  Despite carrying our own special streaks of wildness and independence, we must live humbly in community as it is impossible to survive without.

Our partners, kids, parents, extended families, friends and ‘framily,’ and co-workers don’t always love the life they have unwittingly walked into with us.  That wildness and independence is at once captivating and overwhelming, even for us midwives.

This article reminds me again how intensely grateful I am.  Thank you.  http://www.mothering.com/articles/married-to-the-midwife/

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This whole food allergy thing is nuts

If you were listening to NPR this week (listen here), you may have heard that feeding babies peanut products prior to 12 months of age is actually preventive in terms of developing true allergies to peanuts.  Not too long ago, we were recommending to parents that they wait until 3 years old to start nuts.  Then the advice and the guideline shifted to waiting until one year old.  Sound confusing?

What can be frustrating and is fascinating to me is that what we ‘know’ about nutrition is always changing.  The world of food allergies, intolerances, and sensitivities (they are not the same thing in my books) is no longer a small and isolated world.  Phrases like ‘gluten free’ and ‘vegan’ show up on even the most mainstream of menus.  It is no surprise that we are learning more about the things we put in our kiddos bodies, not just from a biochemical nutrition perspective, but also as allergy prevention.

Based on articles in the last few years (some links below) and my own observations, it seems like the ‘sweet spot’ for introducing foods is 4-7 months of age.  By introducing, I mean offering tastes and sampling of different foods and creating a palate that is curious about and enjoys different flavors and consistencies.  The other aspect of food introduction is to induce or educate the immune system gently to prevent allergies, intolerances, or sensitivities.  What we introduce during this time is the part that changes the most.  Last year I would have said peanuts were not on this list, now they are a maybe.  I would also like to offer that the quality and wholeness of the food is important in this process of introduction.

Here are some other ideas I have people keep in mind:

  • Start by looking at your own plates; if there isn’t anything on there that you would like to introduce to your five month-old maybe it doesn’t need to be in your body🙂
  • Work from your family’s diet and your goals for family eating.  You are introducing a way of eating and a way of life.  If you are not happy with the way your family eats, the time to change is when you have little people really paying attention.
  • Introduce slowly at first, taking 2-3 days to see how your baby reacts to food at first.  Then you can speed it up a little as you watch them take to eating, digesting well, and being interested in more.
  • If there are foods that parents and/or other siblings react to, try to introduce those foods all on their own so you can see if that is true for this new eater.
  • Worldwide, eating together is the way that we share our love, appreciation, and connection with one another.  Let that be the center of food introduction and family eating for years to come.

Enjoy!  Dr. S

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If you want more tips, discussion, and thoughts from Dr. Sunita, subscribe to my email list for my newsletter and inside scoop.  Thanks!

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More reading:

http://articles.chicagotribune.com/2012-09-12/health/ct-x-0912-food-allergies-20120912_1_food-allergies-environmental-allergies-first-child

http://www.nytimes.com/2013/03/25/health/many-babies-fed-solid-food-too-soon-cdc-finds.html?_r=0

Postpartum ‘Must Haves’ That Have Nothing To Do With Buying Stuff

I would love to replace the typical birth registry of items that all new parents “need”. Instead, I want new parents to receive a different kind of checklist.  A checklist that would include ways to prepare for parenthood and postpartum that could actually help prevent postpartum depression, isolation, and suffering.  And yes, hand-me-downs would still be incredibly helpful!

I have no doubt that baby swings and swaddle blankets have saved sanity and have probably saved lives. But if we are really concerned about healthy families and getting off to a good start, why don’t we talk more about what families really need and want to be successful? First and foremost we have to be honest about a few things. Shopping for cute baby things, asking our friends and family to do the same, and happily preparing for the arrival of our little ones is more fun than acknowledging that postpartum and parenting can be hard work. Setting up a registry on Amazon and inviting people to buy stuff is way easier than truly asking for help.  Almost no one likes talking about postpartum or new parent trials and tribulations.  No one wants to hear “It’s Hard”.  Duh.

I not proposing a “The 11 Things I Wish Someone Had Told Me Before I Had My Son” news feed item.  I am proposing a punch list of actual work that I would like to see done on this project that you are managing:  Brand New Human Life.  Here are the things I would like to see more families do and be supported in doing:

Do some ‘Meet and Greets’ or re-establish care with someone you have seen.  Seeing someone with a specialty in postpartum, parenting, and/or marriage counseling are big perks, but the most important features are that you trust and like this person.  Think of a stressful time in your life- would you call this person?

  • Women’s bodies go through a lot in pregnancy and birth.  It is reasonable to think that things will not land where they once were before, no matter which way the baby comes out.  It is also reasonable to think that there may not be a lot of time or energy to get on a ‘Body Back’ program.  Honestly, even if there is, having help in this arena is crucial to avoiding sciatica, back pain, neck pain, plantar fasciitis, or other physical pain that make it difficult to care for your baby, exercise without injury, and feel human again.  This is where acupuncture, massage, and physical therapy come in.  These are not just indulgences; they are important facets to your long-term recovery, and most private insurance plans cover these services.  There are also low-cost community resources or sliding scales available if you do not have insurance coverage.  Locate these people, see them once or more in pregnancy, and start building your recovery team.
  • If you are planning to breastfeed, know who and where your lactation resources are and how you can access these services.  The first 2-3 weeks can be the toughest and is the most common time to stop breastfeeding.  Having information at your fingertips beforehand is so crucial.  Most area hospitals have lactation consultants on site who are wonderful and generally available every day.  The challenge is what to do about those urgent, after-hours, or weekend breastfeeding issues.  In case you are now wondering how often that really happens, I am here to tell you that everything involving children happens after-hours, weekends, and urgently.  There are many lactation consultants who do home visits and have after-hours phone lines.  Find out who they are, get some business cards, and keep them handy.

La Leche League International (http://www.llli.org/) has podcasts, forums, and links to almost every resource breastfeeding related.  Get familiar with the website and look up a group in your area.  I would suggest that you attend this group at least once in pregnancy so that you are familiar with a name, a face, and location before you make the trip postpartum.

  • Your pediatric provider is actually a pretty critical person for you as parents in this postpartum time.  Once you are discharged from hospital or midwifery care, you are handed over to your child’s care provider. Moms are typically seen at 6 weeks for one postpartum follow up in hospital-based care, and are seen at least 3-4 times in the 6-8 weeks following birth with out-of-hospital care.  These types of care clearly provide different ‘safety nets’ for families as they transition into postpartum and parenthood, which is why your pediatric provider may be your closest ally.  Set up some Meet and Greets and choose someone who you like and trust (sound familar?).  You are going to be seeing each other quite often in the first year.

Sometimes people come in with a list of interview questions from online sites, and there are great ones out there (http://www.askdrsears.com/topics/parenting/child-rearing-and-development/choosing-pediatrician).  Knowing a pediatric provider’s background is important, but most of that is online in his or her bio.

Use the time you have face-to-face with a prospective provider to find out a few things:  Do you like and trust this person?  Does this person seem agenda-oriented or patient-oriented? Does this person have resources if breastfeeding is challenging or your baby is not gaining weight? Will this person have a whole-family approach or a only-the-baby-is-my-patient approach? How have they handled situations regarding breastfeeding, sleep, or maternal postpartum depression or anxiety? Truly, even when the baby is the patient, the parents’ well being is critical to that baby’s health (http://parenting.blogs.nytimes.com/2013/07/17/who-will-screen-for-postpartum-depression/?_r=0).

Does that sound like a lot of work?  That’s why we get 9 months to start gathering tools and resources that will serve our entire family for months and years to come.  Your baby is not a finished product when he or she arrives, nor is this process.  And it’s actually a lot of fun sometimes too.

Enjoy!  Dr. S

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Birth and rebirth

Ro elfThis week my son turned 4 years old.  It seems like he has been here for a minute and at the same time that I have known him my entire life.  Of course this has me thinking about my pregnancy, what I was doing when I went into labor, my labor, my labor, my labor (that’s one ‘labor’ for each day), his birth, our first night all snuggled into bed together, and those postpartum weeks.  I have to say-  it was glorious.

It wasn’t glorious because I ‘did everything right’.  It was glorious because I was just able to be.  For the first time in years, I did not have a phone call, email, or page to return.  No one needed me or wanted anything from me except him.  What made those whole eight weeks I was home with him even better was the feeling of being held.

Imagine being a little newborn baby and being cradled tightly and warmly.  Imagine being a postpartum mom and being cared for tightly and warmly.  Would that make a big difference in how you saw those days and weeks at the time, and how you look back on them now? I am a midwife and I witness everyday how midwifery care holds women and families.  I experienced being held by my midwife, partner, family and friends.  I can still feel the feelings of warmth, safety, and weightlessness I had then even if the memories are already starting to become fuzzy.

Every family deserves a midwife. It’s not about having the perfect birth (whatever that means), being a medication-free warrior, or running wild in the country side with scissors.  It’s about being caught by strong, capable hands when you are dropped into parenthood with a new, fragile life without any guidance other than ‘don’t do (fill in the blank) or your baby will die’.  Your baby’s birth is your rebirth.  You are fresh, newborn parents.  Our society and health care system shouldn’t drop you.

Needless to say, I have some thoughts that all families can use to create their virtual midwife if it does not work out to have a real-life midwife.  I think of it as an alternative to the three-page birth registry of ‘must have’ items.  Stay tuned for those thoughts…

In the meantime, hold and be held.  Bask in it.  And happy birthday…Dr. S

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What’s D got to do with me?

Vitamin D: why do we talk about it so much and what does it have to do with your winter time health?

The way that our bodies make Vitamin D endogenously (on our own & without supplements) is through sun or UV exposure. If you can get outside for 15-60 minutes a day for some fresh air and sunshine, your body can start to make its own.

However at the latitude of the PNW, we get next to nothing in the way of UV exposure in our winter months. And if you happen to be darker skinned and/or advanced in your years, your body is even less efficient in grabbing what it needs from the sun. As a result, many of us do rely on supplementation to get the biologically active form of Vitamin D.

When most of us talk about Vitamin D supplementation, we are discussing the form Vitamin D3 or cholecalciferol. This is important to know as not all prescription versions, supplements, or fortified foods contain this version. This is the biologically active version that our body needs for many of the tasks that Vitamin D is involved in.

And what exactly is Vitamin D3 up to in our bodies that affects our growing families?

– Calcium absorption in the intestines:

Calcium is an important nutrient for our bone development, but also for our muscles. The importance of Vitamin D applies to pregnant moms growing a baby’s bones & muscles in her body, a breastfeeding mother growing her baby’s bones & muscles outside of her body, growing children and teens, and keeping our bones & muscles strong as we age. Maintaining adequate Vitamin D levels has been linked to a 20% reduction in hip & non-spinal fractures.

– Immune modulation and reduction of inflammation:

This involves a series of signals and receptors such TLR and VDR, and the engagement of bacterialcidal or anti-bacterial activity. Vitamin D plays an important role in our body’s innate response to bacteria. As part of this process, many of our immune cells that fight off infections and decrease inflammation are also switched on.

This process is critical to preventing illnesses like colds and flu, autoimmune conditions such as Type 1 Diabetes, and even some cancers (including breast and prostate cancers)

This article (with its references at the end) is a great snapshot of what Vitamin D can do for your immune system this winter:

http://www.huffingtonpost.com/…/vitamin-d-vs-common-cold-_b…

Be well! Sunita

Pineapple doctor says…

On the heels of my cold and flu remedy ideas, I thought I would also share some of my favorite cough remedies. When I get sick, it goes right to my lungs. And I don’t really get the opportunity to slow down or take sick days, so having remedies that keep me from coughing all over everyone is essential in my life.

I do try to avoid the over-the-counter syrups as they are mostly corn syrup and dye, and the ‘nighttime’ ones leave me feeling unfit for much of anything. Keep in mind, I am sharing adult doses and that kid doses are going to vary based on age and severity of symptoms.

– Catnip tea: Catnip is a household favorite for many of us who have cats. Luckily if you are allergic to your cats (as I probably was for 11 years), you can use their medicine as your own. Take about 2 tsp of the loose herb per cup, steep, strain, and drink 4 cups per day. Catnip is in a class of herbs that we call ‘nervines’ that help relax the nervous system as well as decrease spasmodic activity like chronic coughs. I also use Sleepy Time or Well Rested teas alongside the Catnip at bedtime to help decrease my cough for the night. And of course, I put delicious honey provided by some local bees via one of my favorite local doulas.

– Honey Loquat Syrup: This is a traditional Chinese formulation of several herbs including loquat, fritillary, licorice, coltsfoot, schisandra, menthol, and many others. The effect is soothing, anti-inflammatory, anti-tussive (meaning anti-cough), and tasty. Just take 1 Tbsp, add to warm water, and drink 4-5 times per day.

– Acupuncture and cupping: Acupuncture is pretty much my go-to medicine for everything and has been for nearly 10 years. I do credit my semi-regular tune ups with staying fairly healthy over the years despite the constant barrage of critters in my air space. Within the realm of Chinese Medicine, acupuncture is really only one branch. There are other techniques like Tui Na, Gua Sha, and cupping that are needle-less and incredibly powerful for moving things along in the body. I find these techniques to be the most effective when the cough lodges itself in my upper chest or lungs, as well as preventing the process altogether.

– Water and fresh air: at the risk of repeating myself…I will. This time of year we tend to be indoors more, drinking less water because it is not as warm and sunny, and blowing dusty, hot, and dry air into our lungs. It is a recipe for crunchy, crackly lung tissue. And how lucky are all of us that we live in a cool, damp climate to counteract the hot, dry indoors? I admit that I have to remind myself to drink water and get outside everyday, and now I am reminding you too.

– Pineapple juice: I found out this week that the nickname a family has for me is Pineapple Doctor (which I love!). You can probably guess that it has to do with Bromelain and having used it in their care in the past. And it so happens that I came across this article this week and thought I would share it: http://www.naturalcuresnotmedicine.com/pineapple-juice-is-…/.

I do want to emphasize that not all juices are alike. Freshly prepared pineapple juice or eating the fruit is very different in its medicinal content than many of the processed versions you will get on the shelf (which often contain added sugars and corn byproducts).
Try these out, let me know what you think, and please share your tried-and-true remedies!

Be well, Pineapple Doctor

Felled by the Fall?

Over the past few weeks cold and flu season has kicked into full gear, as it generally does. Between the darkness, kids back to school, being indoors more and getting less fresh air, and sugar-filled holiday season, our immune systems have a tough time warding off illness. Even though it is inconvenient and uncomfortable, getting sick is part of our immune systems’ strength training process. Adult and kids alike need to keep our immune systems exposed, educated, and resilient without getting knocked down too hard.

As a family, we use supplements like probiotics and Vitamin D pretty regularly, but we do like to get our immune boosters through food if we can. There are a couple tricks that our family uses to keep (relatively) healthy through this time of year:

– Hydration: It seems like such a simple thing, but it is imperative at this time of year. We are inside more, subject to the drying forces of forced air, radiated, or wood-stove heat. That dry heat, which combats the dampness outside, also dries out our mucous membranes. And these mucous membranes are our primary defense when someone sneezes, coughs, or generously wipes critters all over you. In order to keep our mucociliary elevator running smooth, it requires lubrication from clear fluids. This can be clean water, herbal tea or broths. Keep in mind that sugar and caffeine de-hydrate, so for every cup of juice, coffee, tea, or soda, please add in one extra cup of water.

– Spicy Tea: This changes every year but it is common occurrence in our house to have a pot simmering on the stove on most days that includes household spices and seasonings that stimulate our immune system, create ‘heat’ to combat the colds, and improve digestion (which often get dampened by the sugar and rich food of holidays). My brew this year has included: fresh ginger, fresh garlic, black peppercorns, cinnamon, licorice root, and cloves. I am pretty imprecise when it comes to this tea and just throw in a few teaspoons of each. Simmer, strain, and drink!

– Mushrooms: There are so many wonderful things we can say about mushrooms. They can contain Vitamin D (!!), they grow readily in our environment (which can give some sense of their purpose in this climate), they contain a multitude of immune modulating chemicals, and they taste great with butter. I use mushrooms often this time in of year in my soups, as a side dish, and in tea form. The medicine in mushrooms is best released in hot water extracts, so even if you don’t like the taste or consistency of mushrooms, you can simmer, strain, and drink. My favorites for immune modulation are: Reishi, Lion’s Mane, Cordyceps, and Shitake. There are several sources for dried mushrooms locally and online, and great mushroom farms locally like Sno-Valley Mushrooms. You can add these to your Spicy Tea or make this part of your hydration plan.

– Elderberry: My n=8 from last year was pretty clear on this one. Yes, it is a small sample size, but it was interesting nonetheless. My son and I were the only ones taking pure Elderberry extract daily (1/4 tsp for him and 1/2 for me) last year. And we were the only ones that did not get the flu-like symptoms of fever, chills, sweats, cough, and body aches that the rest of the extended family did over the holidays despite the fact that we were the two most exposed. And that has been true every year we have used it. It’s not enough to use Elderberry or Sambuccus preparations over the counter, it has to be the ‘good stuff’. We like the Wise Woman or Heron Botanicals brands (no affiliation) because they are high quality and potent.

– Essential oils: we now have a diffuser going in the house and two in the clinic because essential oils help keep the air ‘sanitized’. Our favorites are eucalyptus, clove, tea tree and lavender at home.

– Sleep: It’s dark for a reason. Enough said.

There are so many more ways we can support our bodies and families during this time. Try these out and let me know what you think. And please share your favorite tips as well!

Be well! Sunita

My top 5 ‘get well’ tricks…

Many people ask me what I do with my own family, whether it comes to vaccinations, diet and nutrition, or managing illnesses.  I will confess that we have stayed incredibly healthy for the last 7 years, until now….these last two months have knocked us down and dragged us out.

Since we have a veritable natural pharmacy in our kitchen and many years of practical knowledge, it makes it easy for us to whip up remedies at the first sign of runny noses or congested sinuses.  This isn’t always true or practical for every household.  In light of this, I thought I would share my Top 5 ways that help our family clear illnesses faster (if we have to get them at all!) that are simple and accessible to most:

  • Bone Broth: Don’t worry if you are vegetarian, vegetable broth works too.  When we simmer bones of animals or vegetables (and I recommend both in the crock pot), we reap all the benefits of the water-soluble minerals in their most naturally-occurring form.  And if you use bones, you also get some protein and fat, which give you a little nourishment when your appetite is low.  Not to mention that this addresses hydration; if you want the mucous to flow out, you need to keep it more fluid!  For more info and recipes: http://www.jadeinstitute.com/jade/bone-broth-health-building.php
  • Warming Herb Tea: toss some cinnamon, cloves, fresh ginger, black pepper, licorice root, a bit of fresh garlic, and a pinch of cayenne into a pot.  Simmer, add honey, and drink it all day long.  We call ’em colds for a reason, so your best strategy is to warm and stimulate your immune system to burn off the critters.  Again, if you are drinking tea all day, you don’t have to worry about whether you are hydrated or not.
  • Steam inhalations: with or without essential oils, this is one of the best and easiest ways to treat your respiratory tract.  Often times we get sick in the winter, but not because the bugs are more vicious this time of year.  We sit inside, turn on our heaters, and blow hot, dry, dusty air into our lungs and sinuses.  Our windows are not open and we get much less fresh air.  Simply by re-hydrating our sinuses and lungs with steam, we can help our body freshen up and clean out.
  • Chinese medicine: I can’t say enough about how effective herbs and acupuncture have been in my life.  In fact, I credit my regular acupuncture tune-ups with not having been sick in nearly 7 years until now.  Not everyone is lucky enough to have in-house acupuncture treatments, but if there is one modality I lean on the most it is acupuncture and 5,000 years of Chinese herbal medicine.
  • Rest: Stay home.  Keep your kids home.  Don’t go to the store, the mall, the community center, playgroup, or work.  Stay in bed, keep your critters to yourself, and give your (and everyone else’s) immune system a fighting chance.

It seems simple because it is.  Preventing and recovering from illness really is basic.  If we do not water, feed, and rest our bodies and tend their basic needs, our bodies won’t provide for us either.

Have a happy, healthy, and critter-free holiday and new year!  Dr. S

Re-visiting Iron Deficiency in Babies

Re-visiting Iron Deficiency in Babies

Check out this link to an article describing the benefits of iron supplementation for babies who are born early and/or smaller for their age (under 5 1/2 pounds).  We have known for some time that babies do download quite a bit of their iron in the last weeks of a mother’s pregnancy and now we are looking at identifying and supplementing these babies differently.  

However, this can also stimulate a discussion with your care provider on how you can provide iron for a child through a breastfeeding mom’s diet and an older infant’s own diet of iron-rich foods.  Meaning: it doesn’t all have to come from supplementation.