'tips' posts

As your baby grows, you’ve probably started wondering when and how to start feeding your infant solid foods. Here are some general tips to consider:

Is there a safe age to start feeding solid foods to my infant?

Yes, most infants this is between four and six months of age.

Why is there a ‘safe’ age to start feeding solids?

There are a few reasons why this age is safest. The first reason is because prior to four months of age, an infant is not developmentally ready to safely eat from a spoon.

To be able to swallow solids safely, an infant needs good head control; to be able to sit well with support; and to have lost the “extrusion reflex” (the reflex which enables newborns to tightly latch and suck from a nipple, but makes them shove a spoon out of their mouth).

The second reason an infant should be fed solids between four and six months is something many families are not aware of: it is also a strategy to prevent common food allergies. This is one of the strongest reasons I passionately advocate for infants to be exposed to as many foods as possible during this crucial three-month window.

Starting solids and preventing food allergies:

In the past, healthcare providers have advised parents to avoid potential allergens such as peanuts, eggs, and milk. New evidence is now showing that this practice might have played a role in the increased incidence of childhood food allergies in the U.S

Why might this occur? The ...

Jingle bells may no longer be ringing in your ears, but the constant barrage of New Year’s resolution pressure probably is! Yet for all the commercials that promise the next great way to shed pounds or get more physically active in the New Year, children are left out of the resolution discussion. But that doesn’t necessarily mean that they shouldn’t be involved in setting healthy goals. Why not turn your New Year’s goals into a family affair?

For children, the goal shouldn’t be “pounds lost” but “healthy habits made.” Set an example for your children by not trying every fad diet but instead making a more concerted resolution to live a healthy lifestyle. Here are some fun ideas to involve your kids in your healthful resolutions...

As a regular gym-goer, every year in January I experience what I call the “New Year’s Influx.” We’ve been plagued throughout the month of December with messages about New Year’s resolutions to live healthier lifestyles, of which physical activity is a vital component. As a result, the population of my gym grows exponentially as people act on their resolutions to exercise.

This gives me the chance to exercise my own New Years resolution: patience!

Whereas usually during my post-work workout, treadmills and ellipticals are easy to come by, now it’s a fight to claim one. And if you’re lucky enough to get one, you get the stink-eye if you’re on there for one second over the thirty minute limit. In spite of the added stress that this causes, as a health educator I always find it refreshing to see a mass recommitment to self-care. Inevitably though, by the end of February, the influx dies down. This phenomenon raises two questions:

Do you have a groin bulge that seems to come and go, often absent upon waking in the morning? Or perhaps you already know you have a hernia? Hernias are very common and occur in approximately 1 in 4 males (less common in women), so chances are you or someone you know has or has had an inguinal hernia. The main question I always get asked is "should it be fixed?"  

As a general surgeon, I see 4-5 patients every week with a newly diagnosed inguinal hernia. Many are self-referred after discovering a lump in the groin, while many others are referred from their primary care provider after the hernia is discovered during the physical exam. After verifying that a hernia is the correct diagnosis (other possibilities are a groin strain, swollen lymph node, etc.), I have a discussion which addresses the aforementioned question. As an aside, these are very common and also found in the pediatric population (see a similar discussion by one of our pediatric surgeons)

To understand hernias...

We have come upon the time of year when we reflect back on the events of 2012 and look forward to new beginnings in 2013. About 45% of Americans make New Year’s resolutions every year and frequently these resolutions are health-related.

Why not let 2013 be the year you resolve to be updated on colorectal cancer screening?

Why should I worry about colorectal cancer?

Colorectal cancer is the second leading cause of cancer death in the United States. The average lifetime risk of developing colorectal cancer is about 5%. In the colon, cancer usually arises over time from abnormal polyps, called adenomas. This provides us the rare and life-saving opportunity to intervene and remove polyps to prevent cancer from developing. Pre-cancerous polyps or early cancers do not always cause symptoms, highlighting the need for routine screening.

Simply stated, there are large studies showing that screening for colorectal cancer prevents cancer. Screening saves lives. Screening detects cancer at an early and more treatable stage. How can you argue with that?

Who should be screened for colorectal cancer?

Regardless of your age, you should discuss any GI symptoms you are concerned about with your healthcare team.

If you are without symptoms...

The holidays are a busy time! Some love the hustle and bustle of the holidays and others can be worn down with to-do lists, shopping, planning and parties. Individuals with hearing loss can be especially impacted by the holidays if they are attending parties and group gatherings. They may be listening to unfamiliar voices and meeting people for the first time. Here are a few tips to support your family member through this busy time of the year.

Friends and family members can support someone with hearing loss in the following ways:

• When attending group settings or restaurants, try to find a quiet area.
• If you notice someone is not tuning into the conversation, try to repeat, rephrase or state the topic.
• At times your family member may just need a listening break. Excuse yourselves and find a quite space to visit alone for a few minutes. Or better yet, participate in “people watching” and really give those ears a break!
• Help with introductions by saying “you remember Bob, we met him last year at the holiday party.”

• A little understanding can go a long way. If you are curious what your family member might be experiencing, listen to the hearing loss simulator and choose “speech in a restaurant”. I can guarantee you will be shocked to experience the impact of hearing loss on speech understanding. Imagine working that hard to understand speech for a few hours at the end of the day in a loud setting.

For individuals with hearing loss:

With the busiest long-distance travel period upon us, and my own upcoming 29 hour flight itinerary, I thought it would be an appropriate time of year to present my two favorite topics as one: travel foods!
Whether you are boarding an airplane or cramming into the car, providing the right fuel for your body can support an enjoyable travel experience and deliver you at your destination feeling energized and (physically) prepared for your visit.

Traveling by air

Nearly 90 million Americans already have digestive issues, so 35,000 feet up is not the time to exacerbate existing disorders or experiment to see if you can contribute to this statistic. Here are some general flight food tips to keep your tummy travelling well.

• Carbonated drinks. Stomach gases already expand by approximately 30% when you reach flying altitude, hence why downing bubbly beverages can make you feeling like Mr. Clause by the time you are deboarding.
• Alcohol and caffeine. Sure that Jack and Coke takes the edge off turbulence, but alcohol and caffeinated beverages contribute to dehydration. Besides irritated skin and eyes, this can also put you at greater risk for respiratory infections and DVT (deep vein thrombosis). After clearing security, fill or purchase a water bottle and bring onboard, sipping 8fl oz every hour onboard.
• Avoid fried, fatty foods before flight. These foods are already taxing on the GI system (fatty foods take longer to digest), but when traveling at even higher altitudes can cause exaggerated complaints of heartburn and acid reflux.
• Cruciferous vegetables. Wait, did the dietitian just say I don’t need to eat broccoli? These cruciferous vegetables (Brussels sprouts, cauliflower, broccoli, cabbage) contain a complex sugar, raffinose, which results in excess gas production in the intestines. Pre-flight is the only time you’ll catch me advising you to stay away from these nutritional powerhouses, as the decrease in cabin pressure results in expansion of stomach gases and a not-so-comfortable traveler. They get the thumbs up the other 360 something other days of the year.
• Legumes. Skip the chili before you board. Beans have a high raffinose content, and are loaded with difficult to digest soluble fiber.
• Dairy. Milk and dairy contain lactose, and many of us have a threshold as to how much we can tolerate as we need an adequate amount of the enzyme lactase to breakdown lactose before running into trouble.

Suggestions for in-flight meals:

• Skip the salty, fatty snacks and instead pack your own. Eat a light meal before boarding and eat small snacks every few hours onboard as needed. Avoid large meals while traveling. Check out these 15 in-flight meal suggestions.

Traveling by ground

Although you may have the option of stopping during your car trip, it may be smarter to pack your own foods to ensure your tummy remains a happy traveler. For the sake of your car-mates, I would advise avoiding most of the aforementioned flight foods above if you already struggle with these on the ground. I would also emphasize simple, ‘no-assembly required’ foods for car travel. You also have the option of packing a cooler to keep foods safe while en route.

Suggestions for car-trip snacks and meals:

• Bars (Larabars, Odwalla): Select a bar with at least 3g dietary fiber and 5g protein.
• Fresh fruit (wash before packing in the car): Avoid those with pits (cherries). Try single serve applesauce.
• Easy-to-eat veggies: Pre-washed cherry tomatoes, baby carrots, broccoli florets served alongside a thick (no-drip) dip.
• Yogurt and berry parfait: layer yogurt, fresh berries in traveling cup and seal with a lid).
• Simple sandwiches: toast bread before adding spread to avoid soggy sandwiches.
• Wraps: layer hummus, lettuce, veggies and seal in foil or saran wrap.
• Homemade trail mix: chex mix (or low sugar cereal), toasted nuts, air popped popcorn, dried fruit packed in ziplock.
• Instead of soda: Water, 100% vegetable or fruit juice (can be cut with seltzer water).

Whether traveling by air or ground, make sure you consider the foods pre-trip to ensure you are as comfortable as possible while traveling this season!