Being a parent, you may not have realized how much of a role poop would play in your life. Suddenly you become a detective, making inspections and noticing differences. It can be very different when you are talking about an exclusively breast fed baby, versus a baby who is on formula (1). Also, when a baby is on formula, it can vary depending on which type of formula is used (1). Frequency of bowel movements for healthy infants and children really vary with age (2).

Breastfed babies seem to have more poops than formula feed babies by about a factor of two (1), but the range is quite variable. For example, it has been found that per week 2-67 poops have been reported for breastfed babies and 3- 60 for formula fed babies (1).

I get many questions about constipation in babies. For breastfed babies, they may go several days or longer without a poop and not be considered constipated (1). I don’t recommend giving your baby prune juice or even water for constipation. For exclusively breastfed babies I look at how long it’s been since the last bowel movement and I encourage feeding the baby on demand. Often this is all that is needed. If you are giving your baby formula, make sure you are using the correct amount of water to mix the formula. Infant massage (bicycling of legs) can also work well- be sure to be prepared if this helps get things moving for your little one!

After solid food is introduced poop can really change in both colour and consistency. I am commonly contacted by worried parents who see food appearing in their baby’s diapers that looks the same as it did when it entered their body. This is typically not a concern as a large part of this is the baby learning how, and becoming better at, mashing the food up before swallowing it so that it is easier digested by the body. As your baby becomes more skilled at mashing and/or chewing, this lessens.

For babies who are 6 -12 months the number of poops per week have been reported as 5- 28 (1). However, as children get older their gut becomes better at conserving water and this makes for fewer bowel movements, so that by ages 1-3 they are reported to have 4-21 poops per week (1).

So, what is normal for you baby? The answer is that it depends on age and what they are eating and drinking (3). Offering your baby a variety of foods and textures, and depending on age, maintaining their fluids via breast milk or formula or having water available for them can help keep constipation at bay. I also encourage parents to offer foods that are high in fibre and that contain probiotics. If you are increasing high fibre foods, be sure to increase slowly and increase fluids accordingly. I encourage parents not to compare your baby with others (3). If your baby’s poop is soft and there doesn’t seem to be any pain, I encourage parents to not worry (3).

Lastly, know that you are not alone. I find that most parents I deal with have questions about their baby’s poop.

Wondering about your baby’s poops? Contact Jill, Nurture The Future’s Registered Dietitian at nf.nutrition@gmail.com

References:
1 http://www.pennutrition.com/KnowledgePathway.aspx?kpid=8534&trid=19628&trcatid=38
2 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1766693/pdf/v045p0II60.pdf
3 http://www.pennutrition.com/viewhandout.aspx?Portal=UbY=&id=JMznXQI=&PreviewHandout=bA==

I have been getting a lot of questions lately about how to eat tofu that is what became the inspiration for this recipe.

Good for breakfast, lunch or dinner.

1 package (350grams) Organic medium firm tofu

4 Medium red skin potatoes, diced

1 Bell Pepper (Green, red, yellow or orange), diced

1 Carrot, shredded

2 Tbsp. Tamari

2 Tbsp. Nutritional yeast

3 Garlic cloves, minced

2 tsp. each. Parsley, cumin, chili powder, ground black pepper, curry powder

1/2 Tbsp. Sesame seeds

1. Boil potatoes under tender.
2. Fry potatoes until golden.
3. Mash tofu in a bowl and add tamari, nutritional yeast, garlic and spices, pepper and carrot. Mix.
4. Add tofu mixture to potatoes and continue to fry for about 10 minutes.

Looking for other breakfast ideas? Contact Jill, Nurture The Future's Registered Dietitian at nf.nutrition@gmail.com 

You may have read my post rushed mornings #nutritionmonth and had more questions about how much caffeine is in different drinks.

Just as a refresher, for those who are pregnant, 200mg of caffeine per day (2) is the maximum, however, if for a sleep-deprived parent the maximum is 400mg per day (3).

Knowing the milligram amount can be interesting, but the problem is, it’s just not that useful. I usually recommend thinking of it as about 2 cups (8oz size) of brewed coffee during pregnancy/breastfeeding, and about 3 cups (8oz size) of brewed coffee for those not pregnant or breastfeeding (3).

Caffeine is a chemical that’s naturally found in some plants. These include coffee and cocoa beans, kola nuts, tea leaves, yerba mate and guarana (4).

Caffeine increases alertness, but what does caffeine do to our bodies?

 For adults, caffeine will reach its peak level in our blood about 1 hour after we consume it and it will remain there for 4-6 hours (5). During pregnancy the amounts vary depending on trimester: (11 hours- 1st trimester 5.6 hours, week 35 is 18 hours (7)) and for a baby in utero more research is needed but reports of up to 100 hours can be found (7). However, in a newborn caffeine can linger for 65- 130 hours (about 2-5 days) and in a 3-5 month old it can last about 14 hours. By the time a child reaches 4 months and up it seems to dissipate more like it does in adults (6).

In addition, caffeine stimulates our stomach to release more acid, which is the reason it can upset some people’s stomachs- and cause heartburn in pregnancy or cause some people to have diarrhea.

Caffeine is also a diuretic, helping to get rid of fluids from our body. Which means increased peeing, something that most pregnant women want to avoid. This can also lead to water and calcium loss (5).  

If you have caffeine with your meals, it can also affect iron absorption- again, this can be cause for concern during pregnancy.

Some people are more sensitive than others. Having too much can lead to rapid heartbeat, headaches, nervousness, anxiety, problems sleeping and irritability.

If you are pregnant, you may be wondering if you should cut it out completely. The answer is no. If you were a heavy consumer before you are pregnant and you cut it out you may find that it results in headaches or feeling overly drowsy (4). That being said, often I find that during pregnancy, especially at the beginning, things such as coffee just don’t work. Later on in pregnancy it is very common that caffeine becomes a cause of heartburn, so at that point I recommend cutting it out or looking into other sources of your heartburn to rule out caffeine. I do recommend taking into account all sources of caffeine that you may be consuming when you are pregnant and I encourage people to watch their intake and keep it below the maximum recommended amounts.

Caffeine is able to cross the placenta and also finds its way into breast milk (5). This can affect your baby. It can increase their heart rate, metabolism and make them feel more alert- just as it would for you. This goes for babies in utero or who are breastfeeding.

If you are breastfeeding, the recommendation is a maximum of 300mg per day (4). Sometimes women find that since they have got used to the 200mg in pregnancy they try to stick to that during breastfeeding. You will know if your baby is being affected by the amount and timing of your caffeine intake.

Although I don’t recommend children getting caffeine, I find that I am seeing it more and more. For kids the recommended amount is based on body weight. For ages 4-6: no more than 45 mg per day (equal to about one can of cola). For ages 7-9: no more than 62.5 mg per day (equal to about 1.5 cans of cola). For ages 10-12: no more than 85 mg per day (equal to about 2 cans of cola). For ages 13 and up it really depends on body weight – no more than 2.5 mg/kg of body weight (3). From what I see, cola, root beer and energy drinks are where most kids are getting their caffeine, and the short of it is – they don’t need it!

Wondering where you find caffeine and in what amounts?

This is where it gets confusing. If you go to different commercial coffee shops and order the same drink, there can be varying amounts of caffeine (1). Some coffee shops can provide over 200mg of caffeine in one shot of espresso, however, others can be much less (1).

So, in general what are some sources of caffeine to be aware of?*

-       Coffee

o   Instant                 76-106 mg/ 1 cup-250ml-8oz

o   Drip                       80-180mg/ 1 cup-250ml-8oz

o   Espresso               64-90mg/ 30ml-1oz

o   Decaf                    3-15mg/ 1 cup-250ml-8oz

-       Tea

o   Green tea                   25-45mg/1 cup

o   White, oolong tea

o   Black tea                     43-60mg/ 1 cup

o   Iced tea                      15-67mg/ 1 can (341-355ml)

-       Chocolate

o   Dark chocolate              27mg/ 1 bar (40g)

o   Milk chocolate               8-12mg/ 1 bar (40g)

o   Chocolate milk               3-5mg/ 1 cup (250ml)

-       Pop and Energy drinks

o   Energy drinks              80-125mg/1 cup (250ml)

o   Cola                               30mg/ 1 can (355ml)

o   Diet Cola                       25-43mg/ 1 can (355ml)

*This is by no means a full list of foods and drinks that contain caffeine, but, instead is to give you an idea of where you may be getting caffeine from, and in roughly what amount.

It’s also important to note that some cold and headache medicines contain caffeine (3).

Often, when we are feeling the need for caffeine it is because we are not taking care of our bodies. Maybe you need to get more sleep, maybe it’s because you are not eating to help maintain your energy. Although it is okay to consume caffeine, I really recommend watching your intake. As you can see from above, we are often getting more than we think.

So, what should you do if you want to decrease how much caffeine you are getting? Be sure to eat balanced foods regularly so as to avoid those energy slumps. Try switching to herbal teas that don’t contain caffeine. Also, brewing your tea for a shorter amount of time will help reduce the amount of caffeine.

Need help figuring out how much caffeine you are getting in a day, and what to do instead? Contact Jill, Nurture The Future’s Registered Dietitian at nf.nutrition@gmail.com 

References:
1 http://pubs.rsc.org/en/Content/ArticleLanding/2012/FO/c1fo10240k#!divAbstract
2 http://www.acog.org/~/media/Committee%20Opinions/Committee%20on%20Obstetric%20Practice/co462.pdf?dmc=1&ts=20130704T0537306017
3 http://healthycanadians.gc.ca/recall-alert-rappel-avis/hc-sc/2013/34021a-eng.php
4 http://www.dietitians.ca/Your-Health/Nutrition-A-Z/Caffeine/Food-Sources-of-Caffeine.aspx
5 http://www.mothertobaby.org/files/caffeine.pdf
6 http://kellymom.com/bf/can-i-breastfeed/lifestyle/caffeine/
7 http://fetal-exposure.org/caffeine/