Feed the Baby Hummus: Parenting Practices Around the World – PediaCast 420
- Dr Lisa Lewis, author of Feed the Baby Hummus, visits this week as we explore parenting practices from countries and cultures around the world. We hope you can join us!
- Feed the Baby Hummus (Book)
- Parenting Practices Around the World
- Feed the Baby Hummus by Dr Lisa Lewis (Familius Books) (Amazon) (Barnes & Noble) (Audible)
- Communicating Medicine: Harnessing the Power of Social Media in Healthcare (2019 Conference)
- Preggie Pals Podcast
- Baby Doctor Mamas Podcast
Announcer 1: This is PediaCast.
Announcer 2: Welcome to PediaCast, a pediatric podcast for parents. And now, direct from the campus of Nationwide Children's, here is your host, Dr. Mike.
Dr. Mike Patrick: Hello everyone, and welcome once again to PediaCast. It is a pediatric podcast for moms and dads. This is Dr. Mike, coming to you from the campus of Nationwide Children's Hospital. We are in Columbus, Ohio.
It is Episode 420 for December 19th, 2018. We're calling this one "Feed the Baby Hummus: Parenting Practices Around the World"
I want to welcome everyone to the program.
It is our final installment of PediaCast for 2018. Why? Well, it's almost the end of the year.
And we are preparing to spend time with family this holiday season. It's also a time when those of us in Emergency Medicine, at least here in Nationwide Children's, we cover a string of shifts in the emergency department over either Christmas or New Year's so that our colleagues can enjoy a few days off to spend with their loved ones.
Last year, I worked Christmas. This year, I'm working as we ring in the New Year.
And you know, I have to say, this is something I miss about being a General Pediatrician in a private practice which I did for just over ten years, our office was closed on the holidays. Although, back then, we did take phone call from home and rounded on hospital patients on Christmas and New Year's.
But it wasn't a fall day by any stretch. And you really only did that if you were the person on call for the practice. You know, which you did in our case like once every seven years.
So it was, at least, you know, once every seven for Christmas, once every seven for New Year. So it was very livable.
Emergency departments, on the other hand, they don't close. And so like many others in the public safety and service industries, we have the honor of serving while others are celebrating.
But, you know, it's actually a privilege as we meet the needs of those who are in crisis, and sick, or injured during the holiday season.
Because, as much as I don't really want to go into work on Christmas or New Year's, you can bet the people who have to go to the emergency department as patients, they really don't want to be there.
On the other hand, time with family is also very important and treasured which is why it's nice to alternate years working over Christmas and then New Year's and then Christmas again so that we too can spend a few days with our families.
I hope you are able to spend time with your family over the holiday season.
For those of you who'd be traveling, safe journeys to all. We look forward to reconnecting with another podcast mid-January.
And you may be wondering why mid-January. You know, we got Christmas, we have New Year's, and then we're taking another week off at the beginning of January.
As I travel Oklahoma City to give a Grand Rounds presentation and an afternoon workshop on social media for medical professionals at The Children's Hospital of Oklahoma University Medical Center.
And, you know, I know it's a parenting podcast. But we acknowledge that we do have a large number of pediatricians, and family practice doctors, nurse practitioners, physician assistants, in the audience.
And so, I do think this is something that would be of interest to you because we have something coming up here at Nationwide Children's in 2019 that you may be interested in.
By the way, I'm very excited for the opportunity to travel Oklahoma City. And looking forward to meeting my pediatric colleagues in the Sooner State on January 9th.
If you practice at The Children's Hospital there in Oklahoma City, and you're in the PediaCast audience, please do reach out and say "Hello!" before and or during my visit because I would love to meet you.
Now, what I was hinting at, we have an exciting opportunity in 2019.
If you are a healthcare provider and would like to know more about engaging patients, and parents, and the public, on social media, with evidence-based educational content.
How can you lend your voice to the digital conversation in an efficient and effective manner while in the midst of a busy clinical practice?
Well, as it turns out, we think that's a really important thing to do because the more of us who are involved in social media and online, the more likely it is that moms and dads will find good evidence-based information when they're out there searching, which all of us tend to do on the internet, looking for information, healthcare information.
So, we have ideas to share on this topic and we're going to present an all-day conference here at Nationwide Children's Hospital on Friday, June 14th, 2019.
The conference includes an afternoon of hands-on workshops where you can sharpen engagement, writing, and interviewing skills.
And earn Category 1, Continuing Medical Education credit for participating.
Plus, it's just going to be a lot of fun. You can stay in Columbus for a weekend if you like visiting the world-famous Columbus Zoo and Aquarium, which is the house Jack Hanna built.
You know, I've been to many, many zoos around the United States and I have to say, the Columbus Zoo really is one of the best zoos in the country. Definitely, not to be missed if you are in the area.
We also have a wonderful Science Museum, known as COSI, C-O-S-I. The Franklin Park Conservatory and Botanical Gardens are wonderful. We have a terrific metro park system and walking trails, art galleries in The Short North, lots of mall and pop restaurants which you can check Yelp or TripAdvisor.
So if you are a medical provider and interested in getting involved in social media as a platform for educating patients, parents, and the public, please do consider joining us again here in Columbus on June 14th, 2019.
The conference is called "Communicating Medicine: Harnessing the Power of Social Media in Healthcare" and I'll put a link to the conference registration page in the show notes of Episode 420 over pediacast.org.
Alright! So what are we talking about today?
The author of a terrific book for parents will join us shortly
Dr. Lisa Lewis is a Pediatrician in Texas who has traveled the globe extensively and developed an interest in the parenting philosophies and practices of different countries and cultures.
She recently wrote a book released by Familius Publishing called "Feed the Baby Hummus: Pediatrician-Backed Secrets from Cultures Around the World"
The book features tips from over 40 countries, so it's quite the resource and would make a terrific gift if you're looking for a last-minute holiday, Christmas, New Year's, birthday, if you're, a parent that you know has a birthday around this time of the year. Either a new parent or soon-to-be parent on your shopping list, this would be a great book to pick up.
Before we get to Dr. Lewis, I would like to remind you, we are on Facebook, Twitter, and Instagram, and I love it when you connect with us there.
Also, it's really easy to get in touch outside the social media. We have a contact page at pediacast.org and we have a telephone number, 347404-KIDS, 347404-5437 if you would like to let us know what's on your mind with a recorded message.
And we really do appreciate hearing from you and suggestions on a topic, so if you have a question for us, and you want to point us in the direction of the news article that you may have seen or even a journal article, please feel free to do that, we do love to hear from the audience.
Also, I wanted to remind you, the information presented in every episode of PediaCast is for general educational purposes only. We do not diagnose medical conditions or formulate treatment plans for specific individuals.
If you have a concern about your child's health, make sure you call your doctor and arrange a face-to-face interview and hands-on physical examination.
So let's take a quick break and then I will be back with Dr. Lisa Lewis to talk about parenting practices in other countries and cultures.
That's coming up right after this.
Dr. Mike Patrick: Dr. Lisa Lewis is a practicing pediatrician with over 20 years of experience. She's also a writer and has contributed to many magazines, blogs, and websites including New Parent Magazine, blogging moms, and multi-cultural kid blogs.
In addition to writing, Dr. Lewis has traveled extensively around the world and has a keen interest in the medical and parenting philosophies of other countries and cultures.
She recently wrote her first book published by Familius entitled "Feed the Baby Hummus: Pediatrician-Backed Secrets from Cultures Around the World"
That's why she's here to talk about her book and the parenting practices, moms and dads, who lived in places different than our own.
So let's give a warm PediaCast welcome to Dr. Lisa Lewis. Thanks so much for joining us today.
Dr. Lisa Lewis: Thank you for having me.
Dr. Mike Patrick: Really, really appreciate it.
So your book Feed the Baby Hummus, the subtitle I love, Pediatrician-Backed Secrets from Cultures Around the World, tell us about your book.
Dr. Lisa Lewis: Well, Feed the Baby Hummus is a baby care guide with inspiration from other cultures. In the book, parents will find baby roaring advice with parent education from other cultures. And the book basically draws from my own comical background, world parent interviews and research. The content of the book provides parenting advice from both at home, here in the United States and around the world.
I myself tend to follow much of the American Academy of Pediatrics Guidelines in Clinical Practice. And this book reflects the AAP background plus my own experience in practice. I also include information from cultures around the world basically via interviews such as Skype, surveys, and face-to-face discussions, plus, as I mentioned, research and written sources.
Dr. Mike Patrick: You know, and I love this about the book that, you know, it's still based on evidence. And as you mentioned, you followed guidelines from American Academy of Pediatrics and, you know, best practices if you will.
But the fact is that there's a lot of areas of parenting where evidence is not necessarily clear. And, you know, in other parts of the world, parents may do things a little bit differently and it doesn't necessarily make it wrong if it's not harmful for kids.
And so I think it's really interesting then to sort of bring in what folks are doing in other countries.
Why did you write this book?
Dr. Lisa Lewis: Well, I first began writing this book because of my love for parent education. I think we talked quite a bit in the clinic and it helps to have handy resources at home. And that's been kind of a passion of mine.
I do have a multicultural background. My mom is Lebanese and my dad was actually from East Texas.
As you mentioned, I have quite a bit of international travel experience. And in some instances have had been the benefit of actually interviewing a parent in their native country. As they may be families who have moved to the United States from all around the world.
And I would hear differences in a way they parent from putting their baby to sleep, how they feed the baby, and philosophies associated with parenting.
I've also been an advocate for parenting differences, much of our parenting practices are cultural and passed down from generation to generation.
I've recall being in the newborn nursery when I was first down in practice. And several of the staffs were perplexed by a mother who has from another country, and the family was really just fussing over her and stared at her bedside and would actually serve her food and feed her and pampered her. They essentially thought she was spoiled and needed to get it together.
But really having family or even friends helping a new mother out can reduce the new mother stress, like unless it's the mother-in-law.
Dr. Mike Patrick: Right.
Dr. Lisa Lewis: This type of example is one we can learn from and choose to embrace if we have the ability to do so. But if it's not comfortable, a parent can move on and think about another way to do things.
Dr. Mike Patrick: I love that about this book.
Tell us how the book is organized. So if someone, they pick up a copy of Feed the Baby Hummus, what are they going to find inside? And how do you ever broken down?
Dr. Lisa Lewis: That's a good question.
It has major sections that discuss behavior and development, decisions to make, and diet and nutrition, building immunity and body care. Each section is divided into a chapter, which has 28 chapters total. And include baby care advice to give the information about topics parents commonly ask about in the clinic.
Dr. Mike Patrick: So if a new parent is looking for a baby care book, this really is comprehensive. So we're going to talk about philosophies in different cultures and countries, but really, it also serves as just a stand-alone baby care guide, too. Right? That's pretty comprehensive.
Dr. Lisa Lewis: Right, that's exactly right.
Dr. Mike Patrick: So I picked out some of my favorite sections from the book that I wanted to talk about in a little bit more detail.
And the first one is a very common problem that parents, as soon as they bring their baby home, you know, it's going to be an issue. What are some ideas both advice, you know, from pediatricians here in the United States but then also what parents are doing around the world when babies are fussy?
So how can we best soothe fussy babies?
Dr. Lisa Lewis: Well this one of my favorite topics also, there's just so many, so much information that surrounds us, and so many different opinions.
And first, in the book, I do provide a parent checklist with reasons, maybe try on simple suggestions to soothe them such as picking them up, holding the baby, changing the environment to a peaceful one, singing a soothing song or playing calming music.
And one try and true way to soothe babies that many parents use and sometimes overused is a baby bath, and baby baths are very calming, a warm bath as many of us know is a great way for parents to lovingly enjoy time with their baby.
In the book, I described how to create a relaxed, calming environment with the details, supply list.
So in Malaysia and other parts of Asia, parents often use a ladle, it's called a gayang to bathe their infants. The baby is placed in a chair, or secured in a washing bowl. Using warm water from a separate container, the ladle is used to scoop the water from the container to bathe the baby.
Parents also apply Telon oil.
Telon oil is a mixture of oils including coconut and caraway oil, believed to keep the baby warm. That, I would advise parents to use with caution, just because sometimes babies have topical reactions with new and different types of oil, but it is very popular in Malaysia.
Other soothing technique that has actually caught on in the United States, in Europe, in the past several years is baby massage.
In India, baby massage is considered normal baby care. Baby massage can be accomplished at home by following simple instructions.
And a parent has the option to create their own form of massage. If a parent does try infant massage, there's a list, just feisty tips in the book like supporting the baby's head and avoiding parts of the body that have openings such as the face, inner ears, genitals, and anus.
And everyone seems to know about rocking a baby for soothing, baby rocking in our culture is usually thought of it as a horizontal maneuver. But in some parts of Sumatra, a baby is rocked vertically, in up and down fashion.
I'd like to try that myself and I can't quite get the hang of it, that I think It's very interesting and worth thinking about.
Dr. Mike Patrick: See, now, with our kids when they were babies, you did the vertical rocking thing. But completely a little bit of a different reason, I knew when I grew up, I wanted them to like roller coasters.
Dr. Mike Patrick: And so, you know, you get that little rocking action. They get that up and down motion right from the beginning. And sure enough, they love roller coasters.
Dr. Lisa Lewis: That's great.
And also, gentle speech may also support a baby's contentment in Japan, mothers, and other family members naturally speak to their children in a quiet, gentle tone while closely observing their needs.
And loud speech around babies is discouraged in Japan.
And one other thing, I'm thinking about that I do want to mention that's not in the book, in 2017, we traveled to Saint Croix and I interviewed a grandmother named Sarah Harvey about family last soothe and parenting. And Ms. Harvey talked about soothing a baby and she said "Strip the baby down to the diaper and put him on your chest. The baby feels your heart, he lets out a sigh and relaxes."
So I thought that was kind of interesting, kind of that modified skin-to-skin contact with the heartbeat.
So, I like that one.
Dr. Mike Patrick: That was really cool.
And then, Nigeria. You know, we sometimes talk about letting babies cry it out when they're fussy at night. That's not allowed in Nigeria, right?
Dr. Lisa Lewis: That's exactly correct.
And actually, a pediatrician friend of mine gave me some information on that. And one of the things that I mentioned in the book is that she said, "If your neighbors hear the baby crying, they'll come over and knock on the door and try to help you out because it's just not allowed."
Dr. Mike Patrick: Because they want to sleep, right?
Dr. Lisa Lewis: Right.
Dr. Mike Patrick: No, no. I understand.
So in, you know, a lot of babies, to put the problem, I think, in our culture is that parents, especially as the babies get older, you know, they get to be over four months old, and now, both parents have to go back to work, and if the baby is crying all night, then they're not getting a good night sleep, and then everybody's kind of upset the next day.
How do you kind of balance that?
Dr. Lisa Lewis: Right.
In our country, and in many families, follow a strict sleep regimen. Like the Dutch parents are very scheduled while many other parents are more spontaneous and relaxed about their baby's sleep time, I think most pediatricians would agree that respecting their baby's sleep schedule will breed a more content baby.
And sleep environment is important, baby's like, you know, familiarity. I typically suggest as much as possible to keep a sleep environment consistent.
And all babies like to wake up and see you. So another recommendation is to stop all the night-time play and cooing, that will reduce the stimulation and hopefully help the baby sleep.
And soothing music, you know, kind of like, as we talked about a couple minutes ago. Soothing the baby before bedtime can be relaxing but it needs to be stopped after the baby goes to sleep or the music can actually wake him up.
One of my personal favorite that passed to parents and helped me with my baby is to place the baby in the crib when he is drowsy but not fully asleep. If the baby is in a deep sleep when you put them down, when he wakes up, he's going to be confused and wonder where you are.
So let him have the memory of being put down.
And then, for babies who wake up immediately, the parent's hands should be placed gently on the baby's tummy to make contact.
And this brings me to another point of helpful tip. If the baby cries at night, he needs to go back to sleep, is to tend to her but keep her in her sleep area.
Dr. Mike Patrick: I think that one of the things that I came across in the book was the idea of co-sleeping. And we hear about this often in United Stated and we also, you know, there are cases where babies can suffocate in a parent's bed or a parent rolls over on their baby and I've actually seen that several times in the emergency department with bad outcomes.
But in the same time, you know, you do want to be close to your baby and to be able to meet their needs and let them know you're there.
How can you co-sleep safely?
Dr. Lisa Lewis: Yes, this is a passionate topic of mine because co-sleeping is something that parents, as you mentioned, can enjoy. And many pediatricians have parents come in and say they just don't want the baby in a separate room.
It's a typically, I would recommend using a bassinet next to the bed. And actually, there's some of, in there's some co-sleepers that fit in the bed as well. I definitely don't recommend putting the baby in the bed next to the parent without their own separate sleep area. Many cultures around the word do co-sleep, and probably co-sleep safely, but they don't have pillow-top mattresses and blankets and pillows. Many countries just co-sleep on hard surfaces.
And so, for us, we got to keep our baby in a separate sleep area. But if we want to co-sleep, we can have a next to us bed in a separate sleep area.
Dr. Mike Patrick: So again, those ABCs of safe sleep that babies alone in their sleep area and on their back and in a crib or a safe container.
Dr. Lisa Lewis: Yes, that's right.
Dr. Mike Patrick: And speaking of safe containers, I love what they do in Finland.
Dr. Lisa Lewis: Yes, the baby box in Finland. That's so wonderful. Yes. That baby box with a, created actually, I have to think back about the 1930s and it's part of the government benefit for the families, and they actually give the families a box with multiple items that they can use for their baby. And the box can be used for sleeping and place in the bed. It's just amazing.
A few states in America have caught on to that as well.
Dr. Mike Patrick: Very interesting.
And then, another sleeping practice that really caught my eye was in Northern Europe. So like Scandinavian countries, Sweden, Denmark, Norway.
Dr. Lisa Lewis: Yes, and I have a disclaimer, I never tried it.
Dr. Lisa Lewis: But I think, you know, we, fresh air is just so good for babies. But the Scandinavian northern moms will take their babies out in the cold, and allow them to nap. They have them wrapped up. They use a lot of wool and blankets, and the babies are very content sleeping out in the cold.
Dr. Mike Patrick: And of course, this would not be young babies. And you're going to want to, you know, check them often that they're not getting too cold, don't leave them outside. And you also mentioned, avoid direct sunlight.
Dr. Lisa Lewis: That's right. Yes.
Dr. Mike Patrick: So I love the safety tips along with, okay this is what parents do in other cultures. And they hear, you know, you may want to try something but hear some safety ideas to go along with that, very important.
Dr. Lisa Lewis: Yes, and in the book, I recommend, kind of a middle ground, just still makes me very nervous because we don't really have the experience that how to wrap the babies and to make sure they are appropriately warm since our culture has never really embraced that practice.
Dr. Mike Patrick: Another interesting chapter is just sort of a checklist of what baby items that new parents need at home. So when you're expecting the baby, what are the basics that parents really should have on hand when a newborn is coming home.
Dr. Lisa Lewis: Right. So babies really don't need a lot to survive and be content, they need food, clothing, diapers, wipes, the car seat, and really their own separate sleep areas.
But for parents who want to have more convenience, they can use items like a breast pump, a high chair, pacifier, rattles, toys, the baby bathtub, monitor stroller, the list of possibility goes on and on.
And one of my favorite international finds with the wool breast pads, breastfeeding, mothers use in Northern Europe and Norway.
And the wool breast pads keep the breast warm and comfortable. And between breastfeeding, they're actually reusable.
Dr. Mike Patrick: Very very interesting. And where is that again where they do those?
Dr. Lisa Lewis: In Northern Europe and Norway predominantly.
Dr. Mike Patrick: And can, are there something that folks make themselves? Or can you purchase those somewhere?
Dr. Lisa Lewis: I'm sure they can be made themselves. But they can be purchased as well.
I actually found some on Amazon, I didn't order them but I had seen some, another lady had. But you can actually order some yourself, when I checked previously on Amazon.
And they're easy to take care of, you can actually soak them in warm water and kind of a wool-specific detergent. And rinse them by hand and squeeze the pads and just let them dry. So they're easy to use and easy to take care of.
Dr. Mike Patrick: And will keep you warm.
Dr. Lisa Lewis: And will keep you warm, that's right.
Dr. Mike Patrick: One item that a lot of parents, especially newborns have on hand is a pacifier.
And here in the United States, you know, we try to get babies off the pacifier when they're, you know, by the time that they're about a year old or so. Maybe a little older.
What are some traditions in other countries? Some places have pacifiers much longer than that, right?
Dr. Lisa Lewis: Yes.
Some countries have pacifiers for two or three years. And I've read research and looked into it, and it's really kind of more, I think, parental preference and the cultural maneuver.
So using a pacifier, many of the speech therapists would want a baby off by about age 1, 1 and a half. But I can't really find any evidence that it's totally harmful to keep the pacifier going.
So, I typically recommend kind of, if a baby is very attached to it, I have kind of a gently wean to slowly get rid of the pacifier, just because it's a lot easier to not have to carry it around.
But if you look at countries like Switzerland, they just really don't worry about when the pacifier goes away. They just let it naturally leave.
Dr. Mike Patrick: And I've seen on social media, in the past couple of years, some folks in the orthodontia fields say that kids having pacifiers for a longer period of time can change the shape of their mouth, and that can sure be dental problems.
But the evidence that supports that is also kind of on the weak side, isn't it?
Dr. Lisa Lewis: Right. And I haven't found anything that really jumps out at me and I could change my opinion if I do, but so far, I don't see using a pacifier unto the toddler years. If it's not excessive as a health risk in any way.
Dr. Mike Patrick: And then, another chapter that I really enjoyed was things that parents should ask, potential babysitters or daycare providers.
And so, you know, if you're going to, once your baby's getting old enough and you're heading back to work, what are the kind of questions that parents should be asking someone who's going to take care of their kids?
Dr. Lisa Lewis: Right.
I've got a list that I'm hoping will help parents, and questions for nannies, daycares, and even family members. Caring for a baby or typically depended upon the needs of the family and very personal.
There are some questions that can help a parent immensely make decisions to benefit their baby.
One is: "What is your experience with babies?"
An untrained, inexperienced individual caring for a baby can be a complete disaster.
How would they know how to feed the baby or even console here when she cries?
So definitely, parents want to make sure that their caretaker is experienced and trained.
The second question would be: "What will you do if my baby cries?"
They'll be typically crying for a reason, and a crying baby should be tended to.
And for private nannies, sitters, family members, an important question is: "Will you take care of my baby when she's sick?"
Some people will simply bow out on those days. And they really don't want to become sick themselves. Of course, if the baby's in daycare and gets sick, you're on your own.
So the parent should really ensure that they have a backup or can take time off work themselves when their baby is sick.
It's also helpful to ask what type of routine a caregiver has, and what type of activities are provided during the day.
If the baby is going to daycare, I would inquire about the ratio of adult to child on the daycare. It's important to know that there's enough workers to tend to the baby when needed.
The daycare should have one worker per three to four babies. And daycare as well, I would see if you can get a feel for the staff turnover rate, your baby will attach to her caretaker.
And it's nice to see some local employees loving on your baby. And I said local, I meant loyal.
Dr. Mike Patrick: And local, too. You know, you don't want to send them off too far away.
Dr. Mike Patrick: One of the…
Dr. Lisa Lewis: Local, too, I guess.
Dr. Mike Patrick: Right, exactly.
Dr. Mike Patrick: And then, you mentioned, too, for the daycare centers, it's a good idea to ask about staff turnover and, you know, how long do folks work there. It gives you an idea of the, you know, the environment, and how well employees are supported, and the ratio of caretakers to babies, too.
Dr. Lisa Lewis: That's so true. Because, if the employees are not happy, they're going to leave. And if there's high staff turnover, then you kind of wonder about the environment in the daycare.
Dr. Mike Patrick: One of the, one of the things, especially if you think more now as kids are getting older and then to more the pre-school years. In Italy, the tradition of the Montessori Method of Learning has really come out of Italy. And I've heard of that, we have some Montessori Schools around here.
What exactly is that?
So, Montessori School is basically, is a philosophy that comes from Dr. Maria Montessori
who created actually a schooling system in the late 1800s in Italy. And she thought that with the appropriate and respectful guidance that children's minds will gain the knowledge and experience they need.
There's been a lot of books written on the Montessori Method, and one of my favorites is the Absorbent Mind by Maria Montessori. If anyone would like to read about it.
It has caught on, and they're several group here in Texas, there's some charter school sitter, actually Montessori-driven.
And it's, I'm an advocate for Montessori and I've seen it worked well on multiple children for many years. There's actually been some new studies out that show that children who are on Montessori environment have excellent child development, you know, developmental abilities.
So, Maria Montessori believed children should be spoke into kindly. Kind of a gentle form of education and I think it fits a lot of people's parenting style.
Dr. Mike Patrick: And it really is pretty unstructured, right? There's a lot of creative choices and self-reactivity and collaborative play. That really sort of let natural interest develop on their own.
Dr. Lisa Lewis: That's right. In the early years, it's definitely, there's lots of individual choices and that there's a lot of hands-on learning.
And the teacher that actually taught to speak gently to a child and well-covered the child and not, not a good way to say it, you know, kind of yell across the room "Hey! You stop that!"
There would come over and address the child in a respectful manner and talk to the child and redirect the child or help the child make the choices needed.
It gets a little different when they get into the elementary and middle school curriculum with people staying long enough. And they, children would still be able to make them more, to make choices that the curriculum is more rigorous and it is, it's a good method of learning, I would say.
Dr. Mike Patrick: So even topics that you may not be as interested in, you may have some choices of how that topic is presented to you, whether you're a visual learner, and auditory learner, processor. You kind of really individualizes the educational experience.
Would that be a good characterization?
Dr. Lisa Lewis: That's exactly right. The children are able to make a lot of choices, that the teachers also teach the children to kind of redirect their interest into other areas, that makes sense.
Dr. Mike Patrick: Exactly.
Let's move on to feeding newborns. What do parents need to know about feeding babies?
Dr. Lisa Lewis: Well, most parents know that breastfeeding is the best way to feed a baby and has numerous health benefits. Most pediatricians, including me, will strongly advocate for breastfeeding. New moms should hopefully be educated and prepared to start breastfeeding in the hospital.
As a mom leaves the hospital, breastfeeding support should be continued with their pediatrician, family members, or like patient nurse.
It's hard to breastfeed for the first time without good sound advice. Sometimes, feeding on the breast alone doesn't work out as planned. In our society, new mothers have the option to breastfeed exclusively, pumped breastmilk and give bottles, supplement with formula or formula-feed exclusively.
It is important for family members and friends to take a non-judgmental approach toward mothers who are unable to choose to breastfeed or they don't want to breastfeed. If they have some medical reason not to breastfeed or meant to choose not to breastfeed, I really believe we should take a non-judgmental approach towards those mothers at interviews. And later, I met a mother on Iceland who detailed how Atlantic mothers are non-judgmental toward other mother's feeding practices.
It was a very refreshing attitude because I've seen so many people come in the office in tears trying to get their breastfeeding plan together, and they are upset because it's not working out, or they have to supplement with formula for various reasons, and they feel that their community around them, their friends, their family are not supporting with their wanting to do.
So the bottom line is this:
If a mom's breastmilk is dried up and she's giving formulas when the baby is fed.
And in Iceland, people who hang out with formula-feeding mothers aren't raising eyebrows, giving unsolicited advice.
Dr. Mike Patrick: I think, the thing we need to remember is that, it was given on my soapbox here, is that breastfeeding is best. There's no question about that.
However, you kind of look at the whole picture. And, you know, we have talked about risks and benefits with anything that we do, and breastfeeding typically does not take place in an isolated box.
And so, you know, you really have to look at how difficult, and the support systems, and what's available, and timewise, and then make a decision based on the whole picture, which if you can do breastfeeding fantastic, but we also have to realize that there are situations where it doesn't work out.
Dr. Lisa Lewis: Right. I agree a hundred percent.
Dr. Mike Patrick: Now, whether you're breastfeeding or formula-feeding, new babies are going to have a lot of burps and gas and hiccups and you have a chapter dedicated just to those things.
Dr. Lisa Lewis: That's right. And again, because it's a very common question in the clinic.
With burping, most parents can naturally find a physician to burp their baby. And I described several positions in the book, where one of the most common positions is upright over the shoulder.
And earlier, I mentioned vertical rocking in Sumatra, and a gentle up and down motion might help a baby burp. But of course, the parent doesn't want to go too fast or the baby might spit up.
A popular technique for burping is also laying the baby, faced down, on the parent's lap, or holding him like a football.
And with gas, it's just simply can't always be prevented. Frequent burping helps, many providers try to work with the parents to ensure there's a reduction of air intake around the nipple.
A baby who is sucking in air has to process the air and then this becomes extra gas.
And I usually tell parents, "Don't stress too much over hiccups."
It's just hard to figure out why the baby is hiccuping. Yes, definitely extra gas or less burping can reduce hiccups. But a pacifier might help relax the upper body. And typically a baby who has frequent hiccups will work that out on her own.
Dr. Mike Patrick: The gas business, you know, if gas goes in and often comes out. And when a baby's cry, you know, they tend to bear down. And then it's more likely that you're going to pass gas. And then you get this idea, "Oh, maybe my baby was in pain." And they pass gas and then they stop crying. But really, that passing of gas may just be coincidental because they were bearing down as they were crying.
So, goes doesn't always hurt, correct?
Dr. Lisa Lewis: Right, that's exactly correct. It's not always painful. Although, we've all had gas pains. And so, the perception could be that it's painful, but most of the time it's not.
Dr. Mike Patrick: Now, the hiccups.
One of the interesting things I read in the book was the Latino folk remedy for hiccups. That's very interesting. Tell us about that.
Dr. Lisa Lewis: Yes, this is probably the only folklore I really included in the book. I just thought it was so fun and basically, as I meant, they're not just wanted to pass it on.
Get a small piece of red thread, and then the parent wet the thread, and with their own saliva, and then places the thread on the baby's forehead. And then wait around. And at some point, the hiccups go away.
So they, as I mentioned, they'll disappear anyway. But at least, you did something.
So we all like to fix things, and that, this folk remedy is one of those examples.
Dr. Mike Patrick: Absolutely. And a lot of fun to pass down, too.
And then, as we then move into starting solid foods, tell us what, you know, here in the United States, you know, it's pretty standard. You start solids sometime between four and six months. It seems that as time has progressed, we're leaning more towards six months. But, you know, and then you're doing the stage 2 foods as they get a little older, and stage 3 foods with the more, the thicker, and chunks when they get to be nine to twelve months old.
Tell us what's going on in other parts of the world in terms of starving solid foods for babies.
Dr. Lisa Lewis: There's some other parts of the world like South America get to start solids before age four months. But we see that the research shows that that could be detrimental to the baby's health, and risk the possibility of allergies.
And with starting solids, because cereal is not necessary in the diet, in the early months, I typically recommend starting a solid diet that's heavy in fruits and vegetables. And as you mentioned, sometimes, before six months or about six months, I typically tell parents that if they have started it at four months or want to start at four months, I don't see that it's harmful. But if they, or want to push it to closer to six months, that might be better.
Most parents that come in the clinic with picky toddlers complain that they aren't eating enough fruits and vegetables.
So for this reason, I think it's best to start fruits and vegetables and keep them going from an early age.
Cereal's okay, but instead of rice cereal, I recommend choosing healthy cereal like oatmeal. When I was trying to diet, we recommend that, it was really blend and boring. And this was really just based on caution.
And when introducing foods, solids, we now know babies can eat any food except honey as long as they're puree.
And as I mentioned, because we're not afraid to branch out, and historically, babies in America were fed blend foods, many babies are missing healthy spices in our culture.
Babies in Mexico and Central America eat foods that contain cilantro, mild peppers, chili powder. Because the baby's taste buds, they're not acclimated to a new spice, I do recommend starting by adding a small quantity of spice to the baby's food. In other words, don't start out with 5 Alarm Chili.
Dr. Mike Patrick: Probably not a good place to start.
Dr. Mike Patrick: In Uganda, pumpkin and papaya are common first foods.
Dr. Lisa Lewis: Yes, yes. That was one of my favorite founds, I actually found that in a study. And that was in Uganda. And one of the first foods that parents give when the baby's weaning from breastmilk. And malnutrition is very high in Uganda, but these two foods are quite plentiful and very very nutritious.
Pumpkin has a lot of fiber, beta-carotene, vitamin A, and which is important for the baby's brain, skin, immunity, and eye health.
And in the back of the book, I had a recipe for a pumpkin puree actually.
Dr. Mike Patrick: Now that's fantastic.
And then we're going to talk, get to the recipes, there's some great recipes in the book from around the world, too.
And then, as we move on to finger foods. Even if it's more of a chunky consistency and its natural state, you can puree these things, right? And make them smooth and safe for babies, and they can eat all sorts of things that way.
Dr. Lisa Lewis: That's right.
It is very easy, it might seem daunting, but it's very easy to make a puree. And you just basically can throw it in the blender and add some water. You don't have to buy a real, fancy machine. Although there's quite a few out there.
And for purees and finger foods, just really discuss the limit. The parents have the ability to branch out and offer foods they haven't thought of trying, even for the family.
And in practice over the years, I've seen a number of Italian families who are cooking their family's food using olive oil, pureeing or chopping of the meal, and giving the foods to their baby.
Cooking in this way, for everyone it once reduces the food prep for the families. And Italian babies certainly have access to some really tasty purees.
And definitely, I definitely recommend soups early on. When I say early on, from six months and up, several countries throughout Europe give their babies a variety of soups. And babies can enjoy the broth and soups. And a parent can easily puree the vegetables or even chop them up for an older infant for a meal.
The finger foods must be easily swallowed, soft, and chopped into small pieces.
A parent should offer finger foods representing really what the family would ordinarily eat, and also add in their variety of foods, they're healthy for the baby.
For example, a parent might serve banana, peaches, peas, chicken, or beans. Just because that's what the family usually eats. But if they're feeling adventurous, they can add something that's not a usual staple on the family diet, like garbanzo beans which are really rich in fiber and protein.
Dr. Mike Patrick: And we have some great examples on the book, things that we may not think about using for babies and putting into a puree, but like kiwi, and blueberries, mango, avocado, you know, beads, even olives, and onions.
Dr. Lisa Lewis: Right, that's right.
There is a nurse that I worked with that was originally from Columbia that gave me some, a few ideas, and one was to slice olives. And then I found out that there's many other countries including Portugal that give their babies sliced olives as well.
Dr. Mike Patrick: And one topic that a lot of parents have questions about these days is peanuts. When the best time to start peanut is, and now there's some, you know, we used to say "Wait until after they're a year old." And then we've seen a big increase in peanut allergies. And now, the thought is that we actually want to introduce those a little earlier.
What are you telling your patients in terms of introducing peanut products?
Dr. Lisa Lewis: I usually tell them that my philosophy has actually changed over the years. So what I said five years ago is different from what I'll say today.
And I usually tell them that it's fine to start peanut. I typically tell them in a puree around seven or eight months. I have to tell you, I had trouble embracing that philosophy because it was so drilled into my head early in medicine, but I went back and read the studies, and I believe that yes, we can start peanut products, and even almond spread, and different types of nut purees at any time the baby starts to solids.
Dr. Mike Patrick: Absolutely.
And we've had some allergists on the program in the past, and for those parents of babies with severe eczema or history of immediate reactions to food, then, you know, you do want to send them on allergists and allergy testing and began the supervised introduction of peanut product. Even as young as four months in order to try to prevent peanut allergies from developing.
Dr. Lisa Lewis: That's a very good point. And those atopic or allergic babies definitely will need to make sure that they're reacting to their food and appropriately.
Dr. Mike Patrick: And then, of course, we don't want to give peanuts to babies. Those are choking hazard, right?
Dr. Lisa Lewis: Right, it's exactly, and that should be given and it should be in the form of a puree or a spread.
Dr. Mike Patrick: And peanut butter, you can thin that out, add some cereal or yogurt or dissolve it in some breastmilk. And there's those peanut butter puffs that you can dissolve and use as well.
So lots of opportunities. But hopefully, we'll see how this pans out. But the hope is that we had seen fewer peanut allergies, you know, ten years from now as we do start to embrace earlier in reduction.
That's the plan.
Dr. Lisa Lewis: Because our country has a, just a really high peanut allergy rate compared to the rest of the world.
Dr. Mike Patrick: And then, you do mention, no honey until after age twelve months.
Remind us why that's the case.
Dr. Lisa Lewis: Well, honey can carry a botulinum toxin and this could be harmful to a baby's neurologic system. And so, it's just recommended to hold off until they get older, after age one year.
After a year, it's a wonderful, healthy food to give to babies. Especially local honey that can help reduce allergic reaction in a baby, child.
Dr. Mike Patrick: And in terms of pollen, and if you start, you know, the younger that they are, they started getting used to the pollens in your area, then maybe would become sensitized to those.
Dr. Lisa Lewis: Yes, that's the thinking with honey, just to reduce the risk of environmental allergies, correct?
Dr. Mike Patrick: And again, not until twelve months because of the fear for botulism. And in fact, I think it was down in your neck of the woods where there were some pacifiers that folks were buying, they had honey as part of the pacifier, and they were some cases of botulism.
Dr. Lisa Lewis: Right, that's a pretty scary thought to know that your baby is actually sucking a pacifier and suffering from botulism, yes.
Dr. Mike Patrick: So, you know, no honey including on pacifiers until after age twelve months.
We had mentioned that you had some recipes in the back of the book.
Tell us about some of those.
Dr. Lisa Lewis: Okay.
Well, the recipe section was actually fun to put together. My daughter was born in China, and her first food was congee, which is a rice soup.
So I included our early family recipes for congee.
And several of the recipes give examples of how to start mild foods for your baby with spices. I have family and some friends from various countries who contributed recipes as well.
One example is a blogger from India who contributed baby-friendly zucchini sticks. And this recipe is so simple. She, I let her wordings. On the recipe, she said, "I promise, your baby will reach for them."
And so, it's just a really simple recipe to make.
As most of them, I think they're pretty easy to make. There's one, the Costa Rican recipe takes a little longer but it's very flavorful.
Dr. Mike Patrick: And of course, hummus. We have to mention hummus, right?
Dr. Mike Patrick: Since we want to feed the baby hummus, and that's from Lebanon, correct?
Dr. Lisa Lewis: That's right. And very interesting, I have to tell you a funny story about that because with my mother being Lebanese, my whole family thinks that, maybe I shouldn't say this out loud, but they all think the title of the book was a natural heritage. But actually, the publishing company helped come up with that title because they really like the international cuisine that we talked about in the book.
But hummus is, most of us think of it as a little harsh-tasting, and many respects depending on your recipe.
And what Lebanese and Syrian people tend to do for the baby, just add a little bit of yogurt to the hummus just to make it milder and more palette-friendly, I should say. And many babies start eating hummus very young, for the three centuries, by adding a little bit of yogurt early on.
And then, gradually, the yogurt goes away and the babies keep eating regular hummus like you and I would do.
Dr. Mike Patrick: That's great. And it's great to have a hummus recipe.
Dr. Lisa Lewis: Right. Thank you.
Dr. Mike Patrick: That you can use for your babies.
Dr. Lisa Lewis: Right.
Dr. Mike Patrick: So we've really just scratch the surface of your book. There's just so much wonderful content and tips from 40, more than 40 countries. So we certainly have not mentioned 40 countries, there's tons still to talk about.
Dr. Lisa Lewis: Right. Yes.
The book covers multiple parenting topics including bonding with the baby, baby development, baby worrying, the upper choices, I even talked about naming your baby.
And as we've discussed diet and nutrition, it's a large section because this is an important part of taking care of the baby's health.
Baby care section essentially takes the parents to the baby's body parts and discusses how they care for them. I discussed what's normal, what's not, and when to call the doctor.
And then, in the appendix, also, there's a shopping list for new parents. It's a bit long, not all the items are necessary. But at least it's a good starting point for parents to choose what items they feel are best for their baby.
Dr. Mike Patrick: And then, you talked about caring for eyes, and ears, and the umbilical cord. So really, just comprehensive newborn care. You really just, you know, need this book and head home with your baby and you'll be all set.
Dr. Lisa Lewis: Thank you.
Dr. Mike Patrick: So tell folks where they can find Feed the Baby Hummus.
Dr. Lisa Lewis: Well, Feed the Baby Hummus is available directly from the publisher, Familius. It's also on Amazon. And many Barnes & Noble stores, and on the Barnes & Noble website. And multiple independent bookstores across the nation. It's also available on Kindle and audible.com.
And there's a Feed the Baby Hummus Facebook page which covers upcoming events such as this podcast, reviews, information about the book, and baby-nurturing topics.
Dr. Mike Patrick: I love those, the, I listen to a lot of audiobooks. And I'm fascinated that baby book to help new parents is available on Audible. Though it doesn't lend itself to using as a reference, but certainly for listening to it straight through, what a wonderful way to engage that book.
Dr. Lisa Lewis: Yes. I thought so, too. I do prefer myself for reference of a copy of a book, but I think that there are many people who prefer to just sit and listen, and that's fine, too.
Dr. Mike Patrick: Listen to it, but have a copy on hand so you can look up things as they come up with your baby.
Dr. Lisa Lewis: Right. I have a copy for reference.
Dr. Mike Patrick: Exactly.
Well, Dr. Lisa Lewis, Pediatrician and Author of the book Feed the Baby Hummus.
Thanks so much for joining us today.
Dr. Lisa Lewis: It's been a pleasure speaking with you, Dr. Mike.
Dr. Mike Patrick: We are back with just enough time to say thanks to all of you for taking time out of your day and making PediaCast a part of it, really do appreciate that.
Also, thanks to our guest, Dr. Lisa Lewis, Pediatrician and Author of Feed the Baby Hummus.
Again, if you need a last-minute holiday shopping ideas, especially for new parents, on your list, do check out Dr. Lewis' book Feed the Baby Hummus wherever great books are sold. And we'll have links to help you out in the show notes.
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It's a collection of podcasts for moms and dads. It includes PediaCast along with many other terrific podcasts for parents.
Including the Preggie Pals Podcast with your hosts Sunny Gault, Annie Laird, and Stephanie Glover. If you're expecting a baby, or you know someone who is, a wonderful pregnancy podcast to check out is the Preggie Pals Podcast.
Just to give you an idea, some recent episodes, Coping with Morning Sickness, Keeping Your Pregnancy Low Risk, Gender Prediction: Fact Vs. Fiction, The Truth About Gestational Diabetes, Preeclampsia: Symptoms and Treatment, Prenatal Anxiety and Depression, Prenatal Testing and Genetic Counseling.
So really a wide range of topics that really interest those who are expecting a baby sometime soon.
So please do check out the Preggie Pals Podcast, I'll put a link to it in the show notes over pediacast.org for this Episode 420.
And then, once the baby is born, you want to check out Baby Doctor Mamas, babydoctormamas.com.
It's a fairly new podcast from a couple of pediatricians who are neonatalogists. So they take care of premature babies and sick babies in the hospital, but there are also moms with young kids at home.
And so, lots of insight, lots of medical knowledge, it's a great program. Check out Baby Doctor Mamas at babydoctormamas.com. I'll put a link to that on the show notes as well.
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Similar to this program, we turn the science up of a couple of notches and offer free Category 1, Continuing Medical Education credit, for those who listen.
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Thanks again for stopping by, I hope all of you have a wonderful holiday season with friends and family. So important, just relax and have a little bit of fun.
Until next time, this is Dr. Mike saying stay safe, stay healthy, and stay involved with your kids.
So long everybody!
Announcer 2: This program is a production of Nationwide Children's. Thanks for listening. We'll see you next time on PediaCast. Announcer 2: This program is a production of Nationwide Children's. Thanks for listening. We'll see you next time on PediaCast.