Keeping Your Children Healthy: Preventing Childhood Obesity

by Dr. Brent Jensen, Sacred Heart Pediatrics

All children gain weight as they grow and develop. However, putting on more weight than is needed to support growth and development can lead to childhood obesity. Over the past 30 years, the number of children with weight problems in the United States has risen at an alarming rate. Today, 1 in 3 children and teens is overweight or obese — putting them at risk for developing health problems such as early onset puberty, as well as conditions that were once only seen in adults, including: type 2 diabetes, high blood pressure, high cholesterol, or bone and joint problems.

The good news is that early intervention can protect the health of your child now and in the future.

Understanding Obesity
Understanding how children become overweight is an important step toward breaking the cycle. Although there can be some genetic or hormonal causes of childhood obesity, most weight gain is caused by children eating too much and exercising too little.

It’s easy for children to eat too much when they:

  • Are exposed to large portion sizes in restaurants or at home
  • Eat meals in front of the TV
  • Snack frequently
  • Eat foods that are calorie dense and have no nutritional value, such as: chips, crackers, fast food, and processed foods
  • Consume beverages with added sugar
  • It’s hard for children to be physically active when they:
  • Spend up to 4 to 5 hours with media, including watching TV and DVDs or playing videos — which is the average for children today
  • Go to a school where physical education class has been cut back or eliminated

What Parents Can Do
The number one risk factor for childhood obesity is having a parent who is obese. Children who have one obese parent are 50 percent more likely to become obese themselves. Those with two overweight parents are 75 percent more likely to become obese. The key to keeping children of all ages at a healthy weight is to lead by example and get the whole family involved.

You play a huge role in helping your child live a healthy life and at all ages, even as early as birth. Some tips include:

  • Breastfeed if possible. In addition to its many health benefits, breastfeeding may help prevent excessive weight gain. Breastfed babies may be more able to control their own intake and follow their own internal hunger cues.
  • At 4 to 6 months, introduce rice cereal and then vegetables. By introducing vegetables before fruit you help your child develop a taste for vegetables as opposed to the sweetness of fruits.
  • Establish a family centered mealtime where everyone comes to the table to eat.
  • Get children involved preparing meals. When they are young let them measure and mix and get their hands dirty. As they get older, give them more responsibilities.
  • Don’t allow children to graze all day. Keep their food intake to three good meals that include a protein, vegetable, and complex carbohydrate, plus one snack each day.
  • Keep portions in control. If the meal is balanced there should be no need to go back for seconds or thirds.
  • Teach children about healthy and unhealthy foods. Allow them to have unhealthy foods on special occasions and encourage them to enjoy the treat without feeling guilty.
  • Allow your children to have 2 hours of unstructured play every day.
  • Plan 15 minutes of structured exercise 2 to 3 times a day for your children, such as bike riding, walking the dog, practicing soccer, etc. And get out there with them.
  • If you are worried that your child or adolescent may be overweight, make an appointment with your doctor who can assess eating and activity habits and make suggestions about how to make positive changes.

Unraveling the Childhood Obesity Problem
In order to solve the problem of childhood obesity, we must treat it on many levels. The child must be educated and helped to make healthy choices. Parents must become involved by setting a good example and creating a family atmosphere that fosters good eating habits and physical activity. The community must be encouraged to create environments that increase physical activity and healthy eating among its citizens. For example promoting the availability of fresh produce through neighborhood markets or the creation of safe playgrounds, parks, and walking trails. Finally, the federal government must become involved with programs like Michelle Obama’s “Let’s Move” campaign.

It will take us all working together to help our next generation become and remain healthy.

Dr. Brent Jensen is a board certified pediatrician with Sacred Heart Pediatrics. His goal is to help children grow strong and healthy.

Doula Dedication

by Rhonda Gearing

I have been asked over the course of the last several years, “What is a doula?” Really, the answer can be summed up into three basic words: nurture, empower, and love. To nurture means to supply with nourishment, educate, and to further the development of; empower is to promote the self-actualization or influence; and love is warm attachment, enthusiasm, or devotion.

The word “doula” comes from the ancient Greek meaning “a woman who serves” and is now used to refer to a trained and experienced professional who provides continuous physical, emotional, and informational support to the mother before, during, and just after birth; or who provides emotional and practical support during the postpartum period.

I loved the time in my life when I was carrying our babies and anticipating each labor and birth. I had very positive birth experiences with a great support team, so it was very natural for me to want to continue to be involved in the world of pregnancy and birth. I had a purpose in my heart to offer that same opportunity to other women. It was after the arrival of my third baby that I was introduced to the term “doula,” and it has grown to be my passion…who I am.

After much research into the many programs available, I became a member of DONA International (Doulas of North America) and followed the guidelines to become a certified birth doula.

Here’s how my role usually plays out. I am generally contacted directly by the pregnant woman and/or her family sometime during the course of her pregnancy. As her doula, I provide prenatal visits, during which time we talk about her pregnancy and discuss previous prenatal visits, possible complications, and her feelings and needs as they pertain to this pregnancy. I also ask how she envisions her birth and what would make it a positive experience from her point of view. That sets the tone for how we will work together to achieve her goals. We talk about the natural stages of labor and birth along with what one might expect, for example, possible interventions, medication and natural remedies for pain relief, positions, and options along the way. I also offer assistance in creating a birth plan to express her preferences and desires, empowering her to make decisions for her and her baby.

In addition to our prenatal visits, I offer telephone and email support both during the pregnancy and in the postpartum period. At the time labor begins, I join the expectant mother at whatever point she requests, whether at her home or the hospital. My role as the birth doula remains the same whether the mother is planning a home birth or a hospital birth, including if the need arises where medical circumstances require hospital/traditional doctor care. I strive to keep the mother encouraged and empowered, reminding her that she is strong and able to maintain an active role in her care, nurturing her as she maneuvers through the journey of labor and birth.

I remain with her in labor until the baby has been born, providing continuous emotional support, reassurance, and comfort. In the immediate postpartum period, I also assist with the first feeding.

About a week after the birth of the baby, I make a home visit to talk about the birth experience and to answer any questions the new family may have, whether it pertains to the emotional or physical well being of the new mother or the baby. This is a perfect opportunity for me to provide a nurturing environment.

Studies have shown that when doulas attend births, labors are shorter with fewer complications, babies are healthier, and they breastfeed more easily. In my experience as well, I have seen this to be the case. If you’re interested in learning more about doulas or want to find one for yourself, visit www.dona.org.

Natural Birth: A Local Look

Sacred Heart Hospital in Eau Claire

715-717-4121, www.sacredhearteauclaire.org
Traditional OB care as well as Certified Nurse Midwives (CNMs). CNMs, like physicians, provide all prenatal, delivery, and postpartum care. CNMs are unique care providers because they are in the hospital well before the birth, offering labor support. Six Marshfield Clinic CNMs practice at Sacred Heart Hospital and women are encouraged to have visits with each of them. Jet tubs for labor are available, in addition to the option of birthing in water. All CNMs, along with some physicians, do water births.

Luther Midelfort in Eau Claire

715-838-3311, www.luthermidelfort.org
Women’s Health patients may choose either a certified nurse midwife or obstetrician for prenatal, delivery and postpartum care. Wide selection of prenatal classes including Lamaze and breastfeeding. Certified lactation specialists to assist both in the hospital and after discharge. Level II Special Care Nursery. Brand new, state-of-the-art facility opening December 2010.

Morning Star Women’s Health & Birth Center in Menomonie and St. Louis Park

715-231-3100, www.morningstarbirth.com
Morning Star offers prenatal, labor and birth, postpartum and newborn care through six weeks, and breastfeeding support in the Midwives’ Model of Care™. Clients may choose to deliver at the birth center or at home. Our Birth Centers are accredited by the Commission for the Accreditation of Birth Centers. All care is provided by licensed and certified midwives. In addition to maternity care and lactation support, we offer various classes, well-woman care and referrals to collaborating specialists when needed. Many insurances cover services offered through Morning Star.

LifeCircle Midwifery & Wellness Center in Shell Lake

715-338-3499, www.lifecirclewellness.com
Certified Professional & State Licensed Midwife. The provider you meet with will be the provider you birth with. Visits unhurried and in a comfortable home-like environment. Two birth rooms to choose from. Water birth always available. Pre-conception counseling, prenatal, labor, birth, newborn exams, postpartum and well-woman care provided by our midwife. Family, friends, doulas and children warmly welcomed for visits or birth itself. Other services include: Yoga classes, Aromatherapy classes, Childbirth education classes, and massage therapy. Come tour our facility!

Lay Midwives

Erin Kaspar Frett
612-801-9967, 715-273-4081, erinfrett@yahoo.com

Doulas

Rhonda Gearing, serving Eau Claire
715-533-4370, rhonda@doulainosseo.com

With Women for a Lifetime

by Martha Nieman, CNM

The term “midwife” means “with woman.” Traditionally, midwives cared for women only during childbirth. The modern certified nurse-midwife (CNM) works with teens and adult women, not only during pregnancy, birth, and lactation, but also with needs related to menstruation, sexuality, family planning, conception, vaginal health, health maintenance, and menopause.

A basic philosophy of midwifery care is that the woman has inner wisdom and self-knowledge that guides her healthcare choices. It is the CNM’s role to provide her with information, options and support, which empower her to make decisions and lifestyle changes that are best for her. The CNM provides care that seeks to promote health and prevent illness; to facilitate healthy, natural body processes; to give holistic care of body, mind, and soul of the woman in relation to her family, community and culture. The CNM takes extra time at health visits to listen to the woman and her needs, to educate, to develop a relationship, and to create an environment in which health and healing can grow. The CNM is present to offer ongoing support and guidance that is especially needed during labor and birth.

The CNM is an expert in caring for healthy pregnancies and the well woman. Research has shown that nurse-midwifery care of a woman at low risk for pregnancy complications is as good as a physician’s care. CNMs in the United States have a master’s degree in midwifery. While midwives in other countries and some American CNMs attend homebirths, most midwives in the United States attend birth in the hospital setting. This allows care following the midwifery philosophy to take place in a setting with quick and easy access to intervention should complications or emergencies occur. If problems arise during pregnancy or birth, the CNM consults with an obstetrician for recommendations for additional testing or treatment. If a woman’s condition puts her health or the health of her baby at high risk, or if complicated medical care is required, the CNM may need to transfer the woman’s care to an obstetrician. The same is true for non-pregnant women with gynecologic complications. The CNM consults with or gives the woman a referral to a gynecologist for complications. The goal is to match the woman’s need for care with the provider expert in that care.

The Luther Midelfort nurse-midwifery service was established in March 1999.  The service has grown over these years and is flourishing. It is so rewarding to see the babies and families grow; to see women year after year at their annual health visits; and to contribute to their health. Our certified nurse-midwives are committed to the women and families we serve. We are thankful to them for sharing their experience and wisdom with us. We are honored that they have included us in the important passages of their lives. They will be a part of us for a lifetime.

Martha was the first certified nurse-midwife at Luther Midelfort beginning in March 1999.  She was also the first midwife to obtain delivery privileges at the hospitals in Rockford, Ill.  She earned her baccalaureate in nursing degree in 1975 and her master’s of nurse-midwifery degree in 1982 from the University of Illinois, Chicago. Since then, she has been a practicing certified nurse-midwife, obstetric clinical nurse-specialist, and nursing instructor at Northern Illinois University in obstetric and women’s health, and nurse for Northern Illinois Hospice. She has two daughters, and her other interests include fiber arts and spirituality.

The Advice Sorting Game

by Erin Kaspar-Frett, CPM, LM, MSM

As the mother of almost three children, I have been given my share of advice. Sometimes it is difficult to know what applies to you and what simply wouldn’t work, especially in the first pregnancy. A pregnant woman can easily find herself receiving opinions of everyone from her mother to a perfect stranger at the grocery store. What care provider to use, where to birth, how to birth, how much weight to gain, how you look, what to eat, how to diaper your new baby, how to potty train, how long to breastfeed, how to discipline, where to sleep, whether to “sleep train” and anything else that happens to be involved in pregnancy and parenting might come up. And it doesn’t stop at the pregnancy; parents often spend the lifespan of their children hearing different ideas and tidbits of advice. It can create confusion and frustration in the parents-to-be, especially for new parents who may not have yet decided what their “way” of parenting will be.

From Your Care Provider
Your pregnancy care provider can provide valuable insight, backed with medical and experiential information, that may help you make decisions along your pregnancy and into the early moments of the baby’s life. As a midwife, my advice on birthing options and parenting styles is frequently solicited. I spend plenty of time with patients covering these and other pertinent topics during the months of pregnancy; this information can reassure and direct a patient toward resources and choices that fit with what’s important to her. I try to be sensitive when someone asks me for my advice, offering information that is unclouded by biases whenever possible. When I can’t, I’m clear about my bias before offering the advice. Your health care provider can be a valuable resource as you make decisions about how and when to get pregnant, choices during pregnancy, birth options, and early childhood parenting and care ideas.

From Your Family and Others
Though family, friends, and those outspoken strangers may not approach giving advice with as much care, recognize that the intent is generally to try to inform, support, and help you. Where your birth and parenting choices differ than those of your parents or the family in which you were raised, there may be feelings of rejection or offense. Remind yourself that advice from these sources may be emotionally charged and that they’re sharing because they care. Politely allow them to share their advice and then sort it in “keep” or “discard” according to what feels right to you and your partner. Even if their intent is not misguided, it can still be upsetting to hear that you’re doing something wrong or what can go wrong. Don’t worry, though! Pregnancy, birth, and parenting are as individual as a person’s looks or personality. Your child will be unique and have his/her own traits and needs. Instead of looking for the right way to parent, look for what feels right for you, your partner, and your child. It does not need to feel right to the outsider who is not part of your family!

The best advice I have ever been given about parenting is “trust yourself to know what is best for your family.” When I was young and parenting for the first time, I wasn’t sure if I could trust myself. I was a beginner and worried that I’d make mistakes. As my older children grew and matured, I instinctively knew how I wanted to parent, and realized it wasn’t necessarily right for others to follow.

Learning to listen closely to your own voice of conscience and trusting that you are the individual who was chosen to parent this child will empower you to make the “perfect” decisions for his or her wellbeing. Your confidence and united front with your partner will bring about relief from the pressure to heed all the advice.

Try It and See for Yourself
Certainly, there is much we can glean from parents and grandparents who have walked this road before. And chances are you will begin to appreciate your own parents in new ways as each stage of development passes. Take what advice you like, what seems to fit your lifestyle, and incorporate it into your family. If it doesn’t work, throw it out and try something new. Just because you begin down one path doesn’t mean you’re stuck there.

You might try new ways of parenting you have not seen anyone else try. You might use age-old, tried and true ways of parenting that you cherish from your upbringing and wouldn’t trade for anything. As your children grow and change, so may your parenting techniques. Great! There will be mistakes, regrets, or wistful hindsight, and that’s okay. Learn from these experiences and keep moving forward, empowered with the knowledge that you are your child’s best advocate and nurturer. Think of it like a plant in a rainfall, absorbing all the water needed and letting the rest run off. Parents can do the same: listen, let the advice run over you like water, and take in only what you can use for your family.

Parenting involves creativity, humility, sensitivity, and love. The next time you stand in line at the grocery store listening to that sweet woman who has raised seven children herself share all her parenting tips, listen politely, knowing that some of what she is saying will fit your family like a glove, and some of it should run off like extra water. You have the tools built into you to parent your little ones. Learn from others and then trust yourself.

Erin Kaspar-Frett is a Licensed, Certified Professional Midwife with a Master’s of Science in Midwifery from the Midwives College of Utah. She lives with her family in Ellsworth, Wisconsin and serves a geographical area within a two hour radius of her home office. For information about Erin and the safety of home birth visit www.earthmothermidwife.com.