Yeast Extract

I shake my tiny fist at Whole Foods.

MSG is nasty nasty stuff that gives me a headache.  I hate it.  I can always tell when I’ve ingested it because the headache is pretty distinctive… similar to both a pressure headache and a dehydration headache but not quite the same as either.

We went to Whole Foods and got a whole bunch of wheat-free junk food, including some nummy cheese flavored nuts.

Nummy, addictive cheese flavored nuts.

That gave me a nasty headache.  At a time I had to stay at work for several hours.

Argh.

So, looked at the label.  Yeast Extract strikes again.  The “healthy food” version of MSG to fool people who are checking the labels for MSG.  I hate it when we forget to check for that.  We’re good about not buying the few fru-fru products our local grocery store offers that have it, but totes forgot to check when we looked at the ingredients at WF.  For shame, Whole Foods.  For shame, addictively nummy nut company.  I could eat your damn nuts if they didn’t have that yeast extract crap in them.  Luckily we also got some equally nummy but not-headache-inducing imported nut mixes from Spain (now labeled “Mine” rather than “Ours”).  You don’t need MSG to be nummy, just to be addictive and to give me headaches.  Grrr.

Note:  #2 loves MSG and is totes unaffected by it.  Lucky her.

Do you ever screw up when you buy food?

A little bit of dentistry just for CPP

Because he loves it when we post about floss.

Two things.

1.  Tenure-related stress causes cavities.  Two cavities and a fracture.  Fun times.

2.  Apparently Glide floss does not get off enough stuff from between teeth and is a sub-optimal floss even though it doesn’t snap like regular floss.  However, as I have been using Glide floss for 5 years I said I did not believe that was the problem and asked what else could lead to gingivitis and plaque build-up the likes that have never been seen in my biannual (biennial?) twice yearly cleanings.  She suggested anemia… which I have had.  I’m on vitamins again.

So yeah, stress and anemia are bad for your teeth.

Do you have anything tooth related to share?  Then totally post it here try to send it directly into #1′s mind, because it icks out #2.  Thanks.

Things to be paranoid about

• Plastic
• chemicals
• sunscreen
• organic food
• artificial sweeteners

The problem with a lot of these things isn’t that the research says one thing or another but that the research doesn’t KNOW.

With something like standard vaccines, we know and there’s good research and a long track record (yes, we’ve read the research and we are pro-)… this other stuff, we really don’t.  There may be small bad effects that affect certain sub-populations or that are dangerous in large quantities.  Research on small animals is mixed, etc.  It’s just really hard to say one way or the other whether this stuff is completely safe or not.

What I generally do is avoid what I can but don’t freak out if I can’t avoid it.  Unless I’m pregnant or nursing… then I seem to care a bit more.  Dratted hormones.

So we don’t use plastic if there’s a better alternative.  Our glasses are glass and our bottles are metal.  For cleaning we mainly use vinegar and seventh generation stuff, which also has the direct benefit of not hurting my sensitive skin.  For sunscreen we pay extra for the better rated sunblock.  For food we lean towards whole foods and avoid additives.  We buy organic when it isn’t too much more expensive or when the item is listed on a dirty dozen list.  We avoid artificial sweeteners mainly because they taste nasty, but we’d avoid them anyway, sticking with things that don’t require sweetening or small amounts of sugar or fruit juice.

Some of these things do seem to have direct benefits even when the science is mixed.  HFCS is very controversial, but when I stopped eating foods with it I immediately felt better.  Whether that’s the HFCS or all the correlated things they put into processed foods that also happen to have HFCS, I can’t say.  Sometimes it doesn’t matter if it’s correlation or causation, you just need an indicator of what to avoid.  Cutting out HFCS also helped me cut down on sugar intake because my sweetness craving went down.  (Not saying most people need to cut sugar– I have specific insulin problems.)

With these uncertain things, we don’t tend to know WHAT is actually making the difference, but we do know that people who eat healthy fresh unprocessed foods and exercise and stay out of direct sun and etc. etc. etc. have better health outcomes.  Is it because they don’t take the marshmallow?  Or because they have less stress?  Or health insurance?  We really can’t say.  So if it doesn’t hurt to do a bundle of things correlated with healthy outcomes even if we don’t know what actually causes the healthy outcomes, well, why not.  On the other hand, it doesn’t make sense to make too many sacrifices for uncertain science.

Moderation in all things.  Plus, we know long-term stress has direct bad outcomes on health.  So do what you can and don’t stress about the rest.

What are you paranoid about?  Nothing?  Have your paranoias changed over time?

Sunscreen (or maybe sunblock)

So before I left the natural parenting group, they convinced me that modern sunscreen is evil.  I’m not sure whether or not it’s true that sunscreen is actually evil, but what can you do?

Anyhow, there’s this webpage that rates sunscreens for toxicity.

The problem with it, the natural mothers say, is that companies will game the system and will use similar new or untested chemicals that aren’t included in the ratings list.

So what do they recommend?  Old fashioned sunscreens sunBLOCKS! that are mostly zinc oxide (and not micronized zinc oxide or whatever that term is).  These include:

Badger (we special order from Amazon)

California Baby (you can get this one at Target)

and I think that’s it.

These sunscreens tend to leave your kid kind of pale, and they’re much thicker than regular sunscreen.  But there’s my PSA.  If you’re worried about sunscreen toxicity, those are the brands to go with.  According to some possibly crazy ladies and a website.

#2 says:  NOTE  distinguish sunscreen (which works by chemical reaction with your skin) from sunblock (more of a barrier method than chemical, and often more natural minerals) (guess which one is better for those with skin problems?)

#1 notes that none of the other websites seem to distinguish between the two, so she thinks that sunblocks are a type of sunscreen, a subset of the greater sunscreen category.

#2:  bzzzt, wrong.  People tend to use them interchangeably but those of us with complex skin problems aggravated by sun exposure and allergies know the difference.  As summer approaches, vampiric #2 stocks up on sunblock and stays far away from sunscreen.

Tips for nursing and working

An earlier post on nursing addressed issues of supply.  Check it out for what could go wrong with your pump.

Working mom resources:

www.kellymom.com is a great resource for all things nursing.  Unfortunately it isn’t as thorough on the issues of pumping and working while nursing as it is on issues of say, poo.  A great resource is the book, Nursing Mother, Working Mother: The Essential Guide for Breastfeeding and Staying Close to Your Baby After You Return to Work.

Here’s some brain-dump in Q&A fashion.

My baby won’t take the bottle and I have to start work in a week:

The baby is more likely to take the bottle if mom is not in the house.  A good time to introduce it is when you are not around and the baby is sleepy.  Often another caretaker (dad, the nanny, a grandparent etc.) can sneak the bottle in at that time.  Additionally, some babies will be more likely to take the bottle facing out rather than facing in (and some vice versa), depending on if they want the bottle experience to be similar to or different from nursing.  Similarly, if you can get away with never warming the bottle you’re in better shape than if the baby insists on it being warmed, but if warming it up is what it takes, get a bottle warmer.  (NEVER heat milk up in the microwave– it causes pockets of burning.)

My baby doesn’t drink much from the bottle, but drinks plenty from the tap:

It’s recommended to introduce the bottle sometime between 3-6 weeks.  Earlier and they might develop nipple preference/confusion because bottles flow faster than breasts (this is rare, but a huge hassle when it does happen).  Later and they might reject the bottle entirely.

Even if the baby doesn’t drink much from the bottle at daycare that’s not a big deal.  Look up reverse-cycling.  So long as they’re wetting, pooing, and gaining weight, as appropriate for their age group they’re good.  Nursing at drop-off and pick-up is great too, especially if you’re worried.  Cosleeping also helps working moms because they can nurse while you sleep and your sleep cycle gets synched up theirs.

I don’t have a fridge/freezer at work, what do I do?:

Breastmilk is amazing stuff.  So long as you don’t freeze it, it will stay quite happy at room temperature or cooled for quite some time.  The freezer-thing kit that comes with your pump should be enough until you can get the fresh milk home.  The same is not true for milk that has been frozen.  So it is better to not use the freezer at work if there’s a chance the milk could melt on the way home.

My milk separates in the fridge, is that a problem?:

Nope, the cream is just rising to the top, just like cow’s milk.  It is still good to go in the bottle.  Go ahead and shake it a bit.

I don’t get more than a couple ounces out each time I pump:

Not a problem!  That is totally normal.  It just means you don’t have a big oversupply.  You are doing fine.  I never got more than 2 oz out a pump unless I was at a conference sans baby and had infrequent opportunities to pump.  I would pump extra on weekends and if my supply was running low I would do a session in the middle of the night or before my morning nursing.  My baby ate nothing but breast milk for hir first 8.5 months and I pumped until 18 months.

Working moms, anything else to add?  Questions?  Comments?  Concerns?  Stories?

Breastmilk supply

I find myself constantly writing these comments over and over again, so I think I’ll write a post I can reference.

Breastfeeding is really really difficult at first.  It doesn’t really come naturally either for mom or for the baby.  (Some folks suggest it comes easier if the baby is allowed to nurse immediately after birth, which may be true, but there’s still a lot of learning involved.)  Reading up on it is helpful, and having the number for a good lactation consultant or LLL can work wonders.

Breastmilk is demand-induced supply.  The way the baby tells your breasts to make more milk is by sucking as much as ze can, even after the breast is empty (the breast never gets completely empty, but it definitely will go down in amount stored with each feeding).  Unfortunately, there’s a delayed response between the baby saying, “I want more” and the body actually making more.  The breasts will have more storage capacity and more milk in them later, so long as the baby keeps sucking.  A common mistake encouraged by the formula companies is to feed a bottle of formula at this point, but when you do that, the breast doesn’t get the message to make more milk and so the baby still doesn’t have enough to drink the next time, so there’s more formula supplementation, and eventually the mother loses her supply and stops nursing.  A recommendation is no formula for the first two weeks (assuming the right number of wet diapers) until the milk supply is set in.  Another trick you can do that cuts down on the painful (to mom) crying is to pump so that you get a small oversupply, so that your breasts are ahead of the curve on supply.

Your baby starts out with a tummy that’s about the size of a dime.  That means lots and lots of nursing while you and the baby learn how to nurse.  As the baby grows, the tummy grows, and it wants more milk but can go longer between feedings.  It is normal for a baby to eat frequently, especially during growth spurts.

Later on, you may think you have a lower supply. Read these links on kelly-mom:

http://www.kellymom.com/bf/supply/
and
http://www.kellymom.com/bf/supply/low-supply.html

Remember too that babies will lose some weight after being born, and that’s normal.  Additionally breast-fed babies have a different growth-curve than formula-fed babies and don’t poo as much.  An older breast-fed baby can go a LONG time without a poo and that is also normal.  (The resulting poo is generally ginormous though.)

A few more things to point out if you suspect a low supply later:

1. You may be about to have your period. Your supply will go back up after it is over.
2. You may be anemic. You need to eat more iron: pills, red meat, oatmeal etc.
3.  At some point in nursing your breasts become less milk storage devices and more milk creation devices. This is normal. Just because they’re squishy doesn’t mean they’re not making enough milk.
4. The one major thing missing from kellymom is discussions about pumping problems.  If you’re just going by pump output, you may need to clean out your pump. Is there cat hair on the motor membrane? The medela PISA seems to be designed for the rubber membrane to rupture every 9 months (at least the versions I and my similar baby aged colleagues had… the earlier ones were more hardy and the later ones may be as well). Do you need to replace the little white flappy things on the horn?

How to insure a good supply:

Mom needs to do NOTHING for the first two weeks (longer if c-section) except sleep, eat, drink water, nurse, and relax.  She needs to be waited on hand and foot.  She is not to be allowed to clean or cook or anything.  She needs to conserve her energy and her sleep for learning how to nurse and making food for the baby.  The #1 determinant of ability to nurse long-term is support.  (Obviously there are cases in which breast-feeding is impossible, like after some kinds of breast reduction surgery, or because of genetic problems, and thank God we have formula, but for most people it is lack of support that is the problem.)  Kellymom now has a forum in addition to being an awesome resource otherwise.

I could talk a lot more about breast-feeding, but I think I’ll just stick to the issues of supply.  Do you have any questions, comments, concerns, stories?

Dissecting an emergency room bill

Recently DC did what almost all DCs do at some point in their lives and stuffed a bead up hir nose.  Right before bedtime.  On my birthday.

Because it was a bead with a nice big hole in it, it wouldn’t sneeze out.

DH tried to tweezer it out but that just caused bleeding and an upset DC.

Google told us that things stuck up noses can be aspirated to the lungs and that can cause infections and abscesses and so on.  Google recommended the emergency room if home remedies didn’t work.  They didn’t.

So we paid the copay and a doctor and a couple nurses tried all the home remedies we tried to no avail.  Eventually they had to knock DC out so ze would stop squiggling and they could get the bead out.  Which they did.  DC will never ever do that again.  Only kleenex up noses from now on.

Weeks pass.  I dreaded seeing the bill (though not horrible amounts as we do have a tony emergency fund these days).  I figured it would be big, especially with the general anesthesia.

I did not figure quite on HOW BIG, however.  DH had had an emergency room trip for something much more scary a few years back and that only cost us something like $800 and there was lots of monitoring and stuff involved.

Cost?  $3000.  BC/BS bargained them to about half that.  Cost to us:  $1400.

But no indication of what that $3000 was for.  DH called up.  (And called up again a couple days later, and again until finally they called back.)  They told him that they could not tell him what the charges were for unless he showed up in person with proof that DC was his DC.  So he did, because we have general principal of not paying bills unless we know what they’re for.

$1400 just for going into a room at the emergency room.  That is the lowest amount they charge for just going into a room, a level 1 charge.  They also have a level 2 and level 3 charge!

$90 for the anesthesia (this I thought would be a lot more pricey)

$300 for a “minor ER procedure” (we think this was them poking around before anesthesia, tickling and attempting suction)

$870 for a “major ER procedure” (more people standing around while the doctor used suction, possibly also the post-anesthesia observation)

$280 for what we believe is the IV.

What was really interesting was the other info the lady gave us.  Her boss has been getting a lot more complaints about costs since these cost rules were put in place ($1400 just for entering a room!) and she can’t cut the cost of any one item, so no discounts there, but she has been settling debt for smaller amounts.  But, you have to make an appointment with her.  And she wasn’t there.  More hurdles.

After much agonizing about whether or not to try to set up an appointment with the “boss,” we decided to just pay the bill.  At least we’ll be getting 1% back from the credit card.  And hey, we’re halfway towards paying our family deductible… if there’s an emergency this summer we’ll at most have to pay $1500 for it.

DH recommends that you ask the doctor if it’s ok to wait for the next day to go to an Ear, Nose, and Throat specialist.  On the other hand, we were very happy to have the sense that all was right with the world at the end of the ER visit, and waiting another day would have been frustrating and probably not worth it for our sanity, even if it would have saved us several hundred dollars.