How to support someone who is breastfeeding

Laura Mize, registered nurse, international board-certified lactation consultant at CHOC Children’s

Each year, World Breastfeeding Week is celebrated in early August  to raise awareness of the benefits of  breastfeeding. This year’s theme,  “Empower Parents, Enable Breastfeeding” was chosen to be inclusive of all types of parents in today’s world. Breastfeeding is a team effort and involves more than just the baby’s mom.

Here at CHOC, we want to help empower parents and enable breastfeeding by providing support if your child is in the hospital. We understand that having a child in the hospital is stressful, and we know that our pumping and breastfeeding moms may need extra support during this time. Your baby’s bedside nurse and the lactation team will work together to help your family achieve feeding goals.

The mom’s support person is an important part of the team too! Helping mom takes many forms and families come in many different varieties. The mom’s support person may be the baby’s dad or mom’s partner, or it may be a friend or family member. The support person has a unique role that provides needed help to mom and increases the support person’s bond with the baby. The CHOC team provides education and guidance for mom and her support person.

Here are some examples of how the support person can help on a day-to-day basis:

  • Skin-to-Skin with baby is not just for moms! The support person can also do skin-to-skin, as tolerated by baby. Ask your nurse for details.
  • Diaper changes and temperature taking at care time if it is ok with baby’s bedside nurse.
  • Serve as a gatekeeper for family and friends. Everyone wants to know how baby is doing! The support person can provide updates and guide family and friends that want to help.
  • Help mom by keeping track of when it is time to pump or breastfeed.
  • Make sure the pumping/breastfeeding mom is getting proper hydration and nutrition. Ask your bedside nurse about meals available for  pumping and breastfeeding moms.
  • Getting mom and baby into breastfeeding position can feel awkward and challenging at first. The support person can help guide mom and baby. CHOC lactation consultants can teach you what you can to do to help.
  • Wash pump parts so they will be clean and ready for next pump session.
  • Love the baby! Babies can never have too much love.

The support person plays a valuable and important role that benefits both mom and baby. Please ask your bedside nurse what you can do to support mom and baby during their hospitalization.

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Healthy drinks for kids this summer

By Christina Wright-Yee, registered dietitian at CHOC Children’s

Heading into summer in Southern California means anticipating the above 100-degree temperatures, but we know what we need to do: hydrate, hydrate, hydrate! While registered dietitians and doctors encourage you to drink plenty of fluids throughout the summer, we also want to help you make healthy decisions. Sodas, juices, slushies, iced coffee and sports drinks may be fluids, but they can be full of calories and sugar that can lead to weight gain, heart disease and cavities.

The World Health Organization (WHO) suggests limiting our added sugars to less than 5% of our calorie needs. For kids ages 2-8, this is about three teaspoons per day. For kids older than age 8, it’s no more than six teaspoons per day. New research suggests even 100% fruit juices are similar to the sugars added to the soda and other sweetened beverages, meaning juice is no healthier than soda!

The amount of sugar in your favorite beverage may surprise you! One teaspoon is equivalent to one sugar packet like the ones you might find at a restaurant or café. In the below table, the serving size for all beverages is 12-ounces, even if the average serving size is typically larger.

Sugar content in your favorite drink
Type of beverage Number of packets of sugar
Water 0
Diet sodas or sugar-free drink mix 0
Powerade Zero or Propel 0
“Light” Sodas 0-2
Unsweetened tea 0
G2 Gatorade 2.5
Sports drink (Gatorade/Powerade) 5
Lemonade 6.25
Orange juice 7.5
Snapple iced/sweet tea 8-8.5
Powdered drink mix (with sugar) 9
Cola soda 10.25
Fruit punch 11.5
Root beer 11.5
Grape juice/cranberry juice cocktail 12
Orange soda 13
Starbucks Frappuccino 14
Naked/Odwalla Juices 12-14

Remember to always read the nutrition facts label to find out the actual amount of sugars and added sugars. When choosing a drink for you or your kids this summer, you might see the terms sugar-free, reduced sugar or no added sugars. Here’s what they mean:

  • Sugar free: less than 0.5g sugar per serving
  • Reduced sugar: less than 25% less sugar than the typical brand, but this doesn’t mean it is always the healthiest option. There still might be other beverage options lower in sugar.
  • No added sugars or without added sugars: no sugar added during processing, but the product may have naturally occurring sugars.

What can you do to stay hydrated and healthy this summer while quenching your thirst?

  • Swap out your favorite drink for one lower in sugar
  • Eat nutrient-rich juicy fruits and vegetables that contain more than 90% water, including: watermelon, cantaloupe, honeydew melon, frozen grapes, pineapple, grapefruit, berries, cauliflower, bell peppers, broccoli and tomatoes. Just watch portion sizes!
  • Make your own popsicles using fresh fruits and veggies
  • Add mint and lemon to an ice cube tray and freeze with water, then pop them into water or sparkling water for added refreshment!
  • Add lemon, lime, mint, strawberries, cucumbers or berries to sparkling water or water to boost the flavor.
  • Make homemade lemonade to cut back on the amount of sugar found in store-bought lemonade!
  • Try making a watermelon slushy. Mix two cups watermelon, 1-2 cups of ice, and 1 sprig of fresh mint in a blender and blend until smooth. Add ice to reach desired consistency.

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Healthy snacks for kids this summer

By Janelle Sanchez, registered dietitian at CHOC Children’s

Summer is right around the corner, which brings with it, endless pool days, picnics in the park, and surfing. Staying hydrated is an important part of staying safe this summer. Our bodies are 60% water which maintain the function of various systems including your heart, brain and muscles. Sufficient water intake also helps to regulate your body temperate and even help prevent constipation. It is important to pay attention to not only the water you are drinking, but to be mindful of consuming foods that will also contribute to your water intake. What better way to fight off the heat than by cooling down with some refreshing treats?

Summertime also generally includes a lot of relaxation, celebrations and parties- which often translates into more fun foods than healthy foods, leading to an increased risk for weight gain.

Let’s look at some common summertime treats and try swapping those out with some healthier and more hydrating choices.

Instead of a sugary frozen slushie drink, prep some Cucumber Mint Citrus Infused Water:

  1. Fill pitcher up with water. To make a sizzling drink, use unflavored sparking water.
  2. Add 1 lemon sliced, 1 sliced lime (or as desired), 1/2 cup mint leaves, 1/2 cup sliced cucumber, and stir.
  3. Refrigerate overnight, stir and enjoy!

Instead of indulging with an ice cream sandwich, opt for a DIY Fruit and Yogurt Popsicle:  

  1. Blend your favorite fruit  in a food processor or blender on high speed until nearly liquified into a smoothie-like consistency. Try blueberries, raspberries, strawberries or banana.
  2. Pour blended fruit into a large bowl. Add Greek yogurt and lightly mix together. Blend more to get a mixed look, blend less to get a more patterned white and fruit look. For additional sweetness, try adding some agave or honey to the mix.
  3. Pour the thick liquid into popsicle molds. If your popsicle mold has slots for sticks, you can insert them before freezing. If not, freeze for two hours, then insert a wooden popsicle stick in the middle of each mold. Continue to freeze for an additional four to six hours or overnight.
  4. Run popsicle molds under warm water to easily remove.

Recipe adapted from

Instead of opting for corn dogs or pizza for a quick meal, try this Avocado Chicken Salad:

  1. Drain and shred canned chicken or tuna in a bowl.
  2. Chop up cilantro, avocado, cucumber, bell peppers, tomato, red onion and add to the protein mix.
  3. Squeeze fresh lemon juice into a bowl, add salt, pepper, and a drizzle of olive oil. Mix together, and pour over salad mixture.
  4. Eat with a spoon and enjoy! Or add inside of a whole wheat pita and enjoy as a wrap!

More ideas for healthy summer snacks for kids:

  • Frozen grapes
  • Frozen bananas dipped in Greek yogurt and chocolate chips or nuts
  • Hydration-loaded fruit and vegetable “fries” including jicama, watermelon and cucumber sticks
  • Chilled spring rolls
  • Cold pasta salad made with zoodles and a light dressing
  • Fruit-filled ice cubes

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Tips for traveling with picky eaters

By Sarah Kavlich, registered dietitian at CHOC Children’s

When you’re a parent dealing with a picky eater, childhood and picky eating can seem synonymous. It’s easy to cater to the pickiness in an effort to avoid a struggle at mealtimes. However, this can sometimes worsen their habits. With summer just around the corner and as we move into warmer months filled with fun, travel and a break from school, parents can use this opportunity to try some new and interesting foods with their picky eater. Whether you’re traveling or staying at home, this time of year can offer an opportunity to experience a new culture through food.

Tips for introducing new foods to toddlers

Remember that kids are learning to eat so consider changing your mindset before heading into meals. Remember that they won’t necessarily eat much of a new food the first time they try it. Repeated exposure to that new food will help them become more comfortable with the food over time. Research suggests it can take up to 20 encounters with a food before someone develops a preference. So, if it is a food you would like to be a mainstay in your child’s diet, don’t give up right away but also don’t force it. Maintain structure by letting your child know that everyone in your family eats the same meals, and there are no separate kids’ meals. This can be a tough pattern to break but offering a small amount of the new food alongside a few familiar foods or a favorite dipping sauce during the meal can help.

Tips for traveling with picky eaters

Exposing your children to new foods while at home, in a lower pressure environment, can help expand their palate before traveling. Start by offering just a small taste test of the new food alongside some familiar foods that your child already feels comfortable eating.

Talk about your upcoming adventure and some of the things your family might experience there, including testing new food together. Kids learn by example and often model the behavior of the people they are closest to, so make sure you have an open mind as well. It’s ok for children to have different food preferences than their parents.  If your child shows interest in a new food that you may not enjoy, go ahead and let them try it without assuming they won’t like it.

On your trip, pack a few of your child’s favorite foods or snacks that travel well like bars, dry cereal or crackers, or pick up some fruits, vegetables, yogurts, or cheese at a local market to help ease them into the new cuisine. Healthy snacks will also help your child from becoming overly hungry between meals. Use words like “exploring” and “adventure” as you offer new foods to promote a more enjoyable atmosphere. Most importantly have fun as you learn together and create lasting memories with your family.

At home before a trip, set the stage by offering some of the foods you might experience on your upcoming travels, like this healthy recipe:

Rice with Lemongrass and Green Onion


(Serves four)

2 tablespoons vegetable oil

2/3 cup finely chopped onion

1/4 teaspoon turmeric

1 cup long-grain white rice

1 3/4 cups water

2 12-inch-long lemongrass stalks, cut into 2-inch-long pieces

1/2 teaspoon salt

1 large green onion, chopped


Heat 1 1/2 tablespoons oil in heavy medium saucepan over medium heat. Add 2/3 cup onion and turmeric and sauté 5 minutes. Mix in rice. Add water, lemongrass and 1/2 teaspoon salt and bring to simmer. Cover, reduce heat to medium-low and simmer until rice is tender and liquid is absorbed, about 18 minutes. Remove from heat; let stand covered 10 minutes. Discard lemongrass.

Heat remaining 1/2 tablespoon oil in heavy large skillet over medium heat. Add green onion and sauté 1 minute. Add rice and stir until heated through. Season to taste with salt.

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How to read a food label

By Janette Skaar, clinical dietitian at CHOC Children’s

Trying to
eat healthier may be
a goal you’ve set for your
family this year. Even with
the best intentions, it may seem
confusing with all the choices
available in the aisles of
your favorite grocery store.
Shoppers today have more options
than ever before.
Sorting through food labels and
checking prices may seem
like a daunting task. Understanding food labels is key to
making the best choices for you and
your family.

Natural: The USDA allows the term “natural” to be used
on meat
and poultry that contains no artificial ingredients
or added
color. It must also be minimally processed.
It does not address food
production methods, such
as use of growth hormones or pesticides, or potential
health or nutrition benefits. The FDA has
not provided any formal definition
or regulation of the term
“natural” on food or beverage labeling.

Processed or unprocessed:
These terms may
easily misunderstood. We generally
think of anything “processed” as being
unhealthy, with lots of additives,
like boxed mac and cheese or potato chips. “Unprocessed” foods may be
healthier, since they are not in
a package, frozen or canned.

The USDA defines processed as a
food that has had a change in character. Roasted nuts, pre- washed spinach, and whole wheat bread are also processed, as well as anything
we cut, cook or
bake. Pasteurized milk is processed
with heat to 161 degrees for 20 seconds to kill listeria,
salmonella and E. coli, which
reduces the risk of serious
illness from these bacteria.
 Some foods
are made
more nutrient dense,
for example when milk
and juices are fortified with
calcium and Vitamin D.

This means not all processed
food is unhealthy.
However, we should aim to do more food
prep at home, when possible, and select minimally processed foods, such as cut vegetables or frozen
fruit, rather than heavily processed
foods like pizza and microwave dinners.
Eating too many heavily
processed foods adds
hidden sugar and sodium to our diets that may increase
the risk for diabetes and
heart disease.

Whole foods: There
is no regulated definition of this term,
but it generally refers to foods that are
in their simplest
form, that are not
processed and do not
have added ingredients.

100% whole grain: There is
a difference between the phrases “100% whole grain”
and “made with whole grains.” Whole grains contain the
entire grain kernel and
include whole wheat flour, bulgur
or cracked wheat, oatmeal, whole
cornmeal, and brown rice. Refined
grains refer to grains
that have been processed to
remove the gran and germ. A food may have a
very small percentage of whole
grains in the ingredients and
still carry the
label “made with whole grains.”
The Whole Grains
Council developed the 100% Whole Grain
Stamp and the Basic Stamp
to help shoppers identify which foods are
good sources of whole grains, and not just white bread
disguised as whole grains.
Check the list of ingredients. Since manufacturers must list the
ingredients in descending order, the first ingredient should start with the word whole,
such as whole wheat flour or
whole grain rye flour.

Buying locally grown and in-season
fruits and vegetables means eating
foods that taste fresher, have
retained more of their nutrients,
and cost

The terms
local and locally grown refer to the
distance between farm and market
and may mean
less than 100 miles, or even 450 miles, if you
are a large grocery store chain.
Buying local is becoming
more important to shoppers concerned
about their carbon
footprint and their desire
lessen the impact of food
production and transportation on the environment, while
supporting local farmers and communities. Farmer’s markets offer the opportunity
to talk to local growers and ask questions about their farming
methods. Some use a mixture
of organic and conventional methods.

Organic: This term has the most specific
and legal meaning.
 The term organic means
crops are grown with
fewer pesticides, no synthetic fertilizers or genetically modified
organisms and farm animals
raised without
the use of routine
antibiotics and are given organic feed

There are three
tiers to the USDA
labeling standards. To display the USDA’s organic
seal of approval,

product must meet the top two requirements:

  • “100% organic” which means it contains 100% organic
  • “Organic” indicating it contains
    at least 95% organic
  • “Made with organic
    (ingredient)” indicates it contains
    at least 70% organically
    produced ingredients

The USDA organic
seal is a simple way to know if you are purchasing
a primarily organic food

Conventionally grown: You won’t find
this term on your
fruits and vegetables, but it refers to the growing
and production of foods with traditional farming practices, which may
include chemical pesticides, herbicides and
fertilizers to enhance
growth. Livestock
may be given antibiotics and hormones to improve their growth and
prevent disease.

vs Conventional
? There is research support for organic foods having
lower pesticide levels, as well as organically
raised animals less likely to be contaminated with
drug resistant bacteria. The verdict on long term health
outcomes of eating
organic vs conventional
foods is still out.

If the price of organic
produce is a concern, families can use
shopper’s guides provided
by Consumer Reports
or the Environmental Working Group to help them
choose conventional foods with
lower pesticide residue. These are
commonly referred to as the
Dirty Dozen and the Clean

Dirty Dozen: Strawberries, spinach,
kale, nectarines, apples, grapes,
peaches, cherries, pears, tomatoes, celery, potatoes

Clean Fifteen: Avocados, sweet corn,
pineapples, sweet peas (frozen),
onions, papayas, eggplant, asparagus,
kiwi, cabbage, cauliflower, cantaloupe, broccoli, mushroom, honeydew melon

Whether choosing organic or conventionally grown foods, increasing your intake of fresh fruits, vegetables, and whole grains is recommended. Focus on eating a variety of foods, including those with rich colors.

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