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Introducing solids to your infant

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 ...

Why you should have your hernia repaired

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...

Tis The Season for Travel - Travel Food Tips

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:

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!

Healthy holiday eating and drinking tips

Happy (healthy) holidays! Here's a roundup of great tips, recipes, and videos to help you make decisions about what to eat or what to make & bring to holiday gatherings:

Flu vaccine for children

A lot of parents have questions about the flu vaccine and many parents refuse the vaccine as they feel it does not very effective. Some parents are concerned about vaccines in general and refuse vaccinating their child as they don’t want to administer “another vaccine” to their child. The best way to prevent getting flu is by vaccination.

What is flu (Influenza)?

Flu (influenza) is not just a common cold or a stomach virus as most people think. Influenza usually occurs during the winter in our region although it can occur all year around in other parts of the world. It can be a serious respiratory illness that can lead to complications especially in children and older adults. Symptoms are generally similar to any other common cold infections and can vary from fever, runny nose, nose congestion, cough, body aches and headaches. The body aches and headaches are mostly reported by older children and adults. Children may not be able to explain their symptoms and may just be fussy.

Most children get over the flu without any complications. In some children and adults, however, it can lead to serious complications including pneumonia.

How to prevent the flu:

Influenza is ...

Can Chicken Soup and Orange Juice Fight Off Illness?

Chicken soup and orange juice are popular home remedies when a cold or flu strikes. But can certain foods really make us feel better, or is it just folklore?

“There is no clear consensus about whether or not certain foods can help us ward off or relieve illness,” explains Richard Lindquist, M.D., Medical Program Director at Swedish Weight Loss Services. “However, certain foods do contribute to overall health, and that can help us withstand exposure to illnesses.”

The body needs energy to fight off illness, and good foods like healthy proteins, and antioxidant-rich, bright colored fruits and vegetables, provide that energy. And what about Grandma’s chicken soup? 

“Although a Nebraska Medical Center study did conclude that chicken soup appeared to help participants fight off colds, I wonder whether or not other factors like a healthy diet or regular hand washing contributed to these outcomes,” says Dr. Lindquist. “However, chicken soup combined with plenty of rest and fluids can’t hurt when you’re feeling under the weather.”

One thing we can be sure of is that eating the wrong foods can certainly contribute to us become ill. “If we are deficient in protein, vitamins and nutrients, our bodies are less able to fight off illness,” explains Dr. Lindquist. “Additionally, foods that cause us to put on extra weight are detrimental to our immune system. Excess fat tissue causes inflammation in the body, which compromises our immune system and makes us vulnerable to viruses.”

Even if we’re eating the right foods and avoiding the wrong ones, cold and flu viruses are highly contagious and can attack even the healthiest individuals. For this reason, it’s a good idea to take other steps to protect yourself. “The best thing you can do to prevent illness is to avoid exposure to infectious sources,” advises Dr. Lindquist. “The next best thing is making sure your immune system is up to par, and that includes good nutrition.” Some tips for avoiding, or at least decreasing, your exposure to illness include:

GERD: Something not to be thankful for at Thanksgiving

It is that time of the year when we get together with family and friends at Thanksgiving to eat heaping platefulls of turkey with greasy gravy, green bean casserole and rich pumpkin pie with whipped cream. How about seconds! This can be a difficult scenario for someone with gastroesophageal reflux disease (GERD). People with GERD may be bothered with very troublesome symptoms after ingesting large amounts of rich food.

What is GERD?

Gastroesophageal reflux disease or GERD, as it is commonly called, is a condition where you are bothered by burning chest pain behind their breast bone. This commonly occurs after meals or during the night. You also may experience regurgitation of gastric contents up into the throat, causing coughing and difficulty breathing. It may be common for many people who usually do not have GERD problems to have some GERD symptoms following a large Thanksgiving meal. Other people, however, may have these symptoms on a much more frequent basis.

What causes GERD?

With the swallowing process, food ...

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