January 20, 2020

When Should I Feed My Baby Peanut Products?

When should I feed my baby peanut products? If your family has a history of food allergies or sensitivities, this can be a nerve racking question. Experts say the prevalence of peanut allergy among children in Western countries has doubled since 2005. While fear may persuade you to delay offering peanuts to your child, research indicates this is a riskier approach.

None of us want to experience anaphylaxis. None of us want to put our children at risk. And peanuts are hard to avoid. Your grocery store, favorite restaurant, mother’s day out, daycare or school can be filled with peanut products. Peanut ingredients may be hiding in Asian dipping sauces, curry, egg rolls, spring rolls, barbecue sauce, ice cream, candy, and cookies. Discovering the presence of peanuts is not as easy as looking for the word. Peanut ingredients may go by these names: arachidic acid, arachis oil, beer nuts, peanut oil, peanut butter, peanut flour, peanut meal, peanut protein, hydrolyzed peanut protein, hydrolyzed plant protein, hydrolyzed protein, hydrolyzed vegetable protein, mandelona nuts, cacahuètes, Earth nuts, ground nuts, goober nuts, goober peanuts, mani, Nu-Nuts, oncom or onchom (Indonesia), Valencias (Valencia is a variety of the peanut plant.), and kernel paste.

With a world full of peanuts, knowing how to reduce the risk for allergy can make you rest easier for years! Children who have severe eczema and/or an egg allergy are considered at risk for peanut allergy. That doesn’t necessarily mean you shouldn’t introduce peanuts at an early age.

baby

Introducing peanuts early significantly decreases the frequency of developing a peanut allergy and modulates immune responses to peanuts in those at high risk for this allergy.

Researchers in the Learning Early About Peanut (LEAP) trial (Du Toit G, et al. N Engl J Med. 2015;372:803-813) studied 640 infants at risk for peanut allergy who were between four and 11 months at the beginning of the study. They were randomized and assigned to separate groups based on sensitivity to peanut extract determined by a skin-prick test. One group had no measurable skin response. The other group had a wheal measuring one to four millimeters in diameter. The primary outcome of the study was assessed within each group as the proportion of participants with peanut allergy at five years of age.

The results among 530 infants with a negative skin test was a prevalence of 13.7% peanut allergy at five years for those who did not consume peanuts and 1.9% prevalence for those who consumed peanuts. Among 98 infants who initially had a positive skin test, the prevalence of peanut allergy at five years was 35.3% for those who did not consume peanuts and 10.6 percent in those who consumed peanuts. From this and other immune response data collected, researchers concluded that introducing peanuts early significantly decreases the frequency of developing a peanut allergy and modulates immune responses to peanuts in those at high risk for this allergy. Another study published earlier this year confirmed these findings.

Like much medical research, this result runs contrary to common sense. It seems as if it would be best to avoid something deemed likely to harm you, but in this case the opposite is true. Exposure to peanuts seems to reduce the frequency of allergy even in those at risk.

The American Academy of Pediatrics guidelines now recommend that you put your fears aside and introduce peanuts to at risk infants as early as four to 6 months. A child with severe eczema and/or egg allergy is advised to be tested for peanut allergy prior to introduction. A positive test means your doctor should help determine whether to introduce peanuts, how much, and over what period of time. Medically supervised feeding tests may be required.

The guidelines further recommend that infants with mild to moderate eczema be introduced to peanuts around six months of age to reduce the risk of peanut allergy. If these infants have successfully tolerated other solid food(s), they may have peanuts introduced at home without a doctor’s office evaluation, although such an evaluation can be considered.

Per the current guidelines, infants without eczema or food allergy who are not at increased risk can have peanuts introduced freely into the diet together with other solid foods in accordance with family preferences and cultural practices. This was the recommendation of my grandchildren’s pediatricians.

My family has a history of food allergies, sensitivities, and celiac disease. My second grandson had mild eczema at four months and my granddaughter is primarily tube fed due to a paralyzed vocal cord and a related swallowing problem. In spite of all of this, my sons were able to introduce peanuts at home without medical supervision.

They both kept the delivery method simple-a small bit of full-strength smooth peanut butter on a spoon. Because peanut butter is thick, this even worked for my granddaughter who is at risk for aspirating thin liquid. Many healthcare providers suggest a different delivery method.

In fact, Massachusetts General Hospital instructs parents to not give plain peanut butter to any child under four. While my grandchildren have suffered no ill effects from plain peanut butter, I like the detailed instructions, safety tips, and recipes MassGeneral Hospital for Children provides. If your pediatrician does not offer detailed instructions, these are great guidelines.

Most likely, your child’s pediatrician will bring up this subject at a well-care visit. If your child reaches six months of age before that happens, it may be necessary for you to initiate the conversation. Just add introduction of peanuts to your list of questions to ask the doctor. It is important to check with a physician before formulating a plan.

Research is one thing, but parental protectiveness is something much stronger. While you may intellectually understand it’s important to feed your baby peanuts, you may have a real aversion to doing so, especially if you grew up in the era during which guidelines recommended waiting.

If you are afraid to feed your baby peanuts, get some backup. Ask your doctor if a clinic or local hospital offers medical supervision that you can take advantage of. Ask a trusted friend with medical training (MD, APRN, RN, EMT) if they might be willing to come to your home to supervise you. Make sure a partner or friend is home with you to watch for signs of an adverse reaction. If your partner is responsible and less averse, it may be advisable for you to turn this task over to them and remove yourself from the situation to lessen everyone’s anxiety. Sometimes the best thing we can do is rely on someone else who we trust.

When you begin to wonder “When should I give my baby peanut products?”, the answer seems to be clear–sooner is better for reducing the risk of peanut allergy.

https://www.nejm.org/doi/full/10.1056/NEJMoa1414850

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5589409/

https://kidshealth.org/en/teens/nut-allergy.html

https://www.aappublications.org/news/2017/01/05/PeanutAllergy010517

https://pediatrics.aappublications.org/content/143/4/e20190281

https://www.massgeneral.org/children/food-allergies/introducing-peanut-products-to-your-baby.aspx

Corn is Everywhere!

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January 12, 2020

Gluten-Free on the Cheap

When you have to be gluten-free on a tight budget, it’s good to know how to eat gluten-free on the cheap! As we settle into 2020, those lovely credit card bills arrive to remind us just how generous we were during the holidays. Once that happens, I always feel like I should implement an austerity program to keep me financially on track for the rest of the year. If you’re like me and you’re new to the gluten-free world, you could easily panic over an anticipated increase in household costs.

The internet is filled with articles to multiply your concern and get the adrenaline pumping. Read a few sites and you’re sure to know that gluten-free bakeries charge a premium for breads, cakes, and cookies, and most restaurants upcharge when substituting a gluten-free bun. Continue reading and you’ll discover that gluten-free food is about 86% more expensive. That’s a lot.

While all of this reading may leave you feeling alarmed, it’s worth noting that articles warning of the expense of a gluten-free lifestyle typically assume that all of us will primarily purchase and consume prepackaged convenience food or restaurant substitutions. That seems like a reasonable assumption given that many of us have lives that are often overbooked. But with a few simple tips, even the busiest of us can manage to eat gluten-free on the cheap most of the time.

Soooo…how can you eat gluten-free on the cheap when you’re really busy and don’t have time to spend in the kitchen?
rice
Here are five tips to keep costs down:

Remember that many inexpensive common foods are naturally gluten-free
For example:
Brown rice – a 16oz bag costs 78 cents and contains ten servings. Even microwave rice bowls are less than $1 per serving.
Black beans – a 15oz can costs around $1 and contains 2-3 servings. A 16oz bag of dry beans runs less than $1.50 and contains about 13 servings.
Frozen corn – you can buy a 32oz bag for under $2. That’s about 10 servings. A 15oz can runs about 50 cents and has 3 servings.

You can easily throw together a filling burrito bowl using microwaveable brown rice, canned black beans, canned (or leftover) corn with a sprinkle of cumin and a spoonful of salsa. You’ll spend less than 10 minutes in the kitchen and less than $2 per serving. That’s about the price of a drink at a fast food restaurant. You may still have room in the budget to add cheese, rotisserie chicken, sliced avocado or Wholly Guacamole for a more gourmet bowl.

And that’s just one example. A veggie and cheese filled fritatta only takes a few minutes to prepare, especially when you use leftover veggies. Fritattas are great for breakfast, brunch, or dinner.

Fresh fruit is a healthy gluten-free snack. To keep costs down, cut up your own pineapple, cantaloupe, and honeydew. It won’t take as long as you imagine and you can always plant the pineapple tops in pots to grow on the porch or in the window. That’s like getting a free houseplant each time you eat a pineapple.

Get your Omega 3s from canned tuna, salmon, or sardines. All are readily available and less expensive than fresh fish. Tuna salad can be eaten on top of greens, out of an avocado or tomato half, or on a cucumber slice eliminating the need for gluten-free bread.

Potatoes, sweet potatoes, broccoli, carrots, and squash are all inexpensive to purchase and easy to prepare. If you don’t have time for even minor prep, consider frozen vegetables. As a whole, they’re cheaper than preprepped fresh vegetables.

Check the discount store shelves
If you’re looking for gluten-free chicken stock, snack bars, bread, or pizza you may immediately head for a specialty store that charges more for everything. Before you do that, peruse the shelves of your local discount market or dollar store.

The Dollar General by my house has gluten-free labeled items like chicken stock, snack mix, and nut bars plus a variety of raw nuts and dried blueberries, cherries, apricots, pineapple, and mango. They also have corn tortillas. Down the street a few blocks I can get gluten-free frozen waffles, pizza, and pretzels from the regular grocery store.

Walmartgrocery.com carries Bob’s Red Mill® almond flour for a fraction of the cost of a health food store. They also have Great Value Gluten-Free Brown Rice Elbow Pasta in a 16oz bag for $1.96 and Lance Gluten Free Original Crackers in a 5oz box for $3.72. The Tate’s bakeshop gluten-free cookies at Walmart run about $1 per bag less than the Whole Foods Market® price.

Limit premade ingredients to the basics
Instead of buying a loaded frozen gluten-free pizza, I choose a plain cheese pizza then add toppings like pepperoni, salami, spinach, or bell peppers at home. On average, this method saves me $2-3 per pizza. You can even create a cheeseburger pizza by adding seasoned, browned ground beef and cheddar cheese to a plain cheese pizza.

If you keep pizza sauce on hand, you can buy premade pizza crusts instead of pizza. There are many gluten-free frozen crust options available from cauliflower based to balls of dough you roll yourself. The selection may be limited in your area, but keep an eye out because stock changes frequently. Near my home, the constant change is frustrating. About the time I find something I like, it gets rotated out. The good news is this allows me to sample a wider range of products.

It’s also easy to create soup from basic ingredients rather than paying more for a complete gluten-free version. Make simple chicken and rice soup in the microwave using dollar store gluten-free chicken stock and Minute Ready to Serve brown or white rice. Add a snack pack of veggies from the convenience store for more flavor and nutrition.

Pomì strained tomatoes can serve as a base for tomato soup, chili, pasta, and pizza sauce. A 26.46oz box costs $2.96 at Walmartgrocery.com. With nothing more than a tube of Italian Herb stir-in paste, honey (or a sugar packet from a restaurant), salt, pepper, and garlic powder, you’ll be amazed at what you can create. Simply measure to taste, stir everything together, and heat.

Instead of buying protein or snack bars, make your own trail mix with nuts, seeds, dried fruit, and chocolate chips or gluten-free pretzels. It’s fun to play with these combinations and you won’t have to pull out the nuts you don’t like. For less waste and fewer arguments, each family member can have a refillable jar of personalized mix in the pantry.

Check out fast food websites
I’m not recommending fast food as a regular part of any diet, but when you’re in a hurry or traveling and are on a budget fast food can be a viable gluten-free option. Most fast food chains list nutrition information on the web.

Wendy’s small chili, a baked potato with butter, and small iced tea costs around $6 and doesn’t require you to ask for any modifications. A half apple pecan chicken salad costs less than $5 and is also gluten-free as is the taco salad. And you can top off your gluten-free meal with a small frosty for $1.

You can be sure that I’ll stop at an In-N-Out Burger® at some point when I’m in LA. My whole family loves the protein-style burgers and fries. If I want to consider other menu options, I can easily pull up or print out their handy allergen information PDF and carry it with me.

Other fast food restaurants and build-your-own pizza chains offer gluten-free choices. There may be a risk of cross-contact on prep surfaces and in fryers so it helps to be familiar with a particular location in order to feel comfortable you won’t be exposed.

Take home leftovers
If you’re paying a premium to order a gluten-free meal, don’t be shy about taking home a couple of ounces of steak, half a chicken breast, or a couple of spoonfuls of chicken salad. These can be repurposed as the protein in tacos, burrito bowls, and salads. Even leftover French fries can become part of a microwave breakfast casserole.

Repurpose protein
Leftovers aren’t the only thing that can be repurposed. Rotisserie chicken from the grocery store or smoked meat from a BBQ joint can be turned into quick, delicious gluten-free entrées that no longer resemble baked chicken or BBQ.

Chicken can be made into chicken salad, used as a topper for a green salad, and put into stir fry, curry, enchiladas, tacos or quesadillas (with corn tortillas, of course). Rotisserie chicken is also a great protein addition to pasta primavera and chicken tortilla soup.

Pulled pork can be added to pasta or nachos and used to fill tacos, tamales, baked potato shells, and shepherd’s pie. Chopped brisket can be turned into stroganoff, cottage pie, or chili, and can be added to baked beans.

At times you may end up buying some overpriced, less than delicious gluten-free product, but following these simple tips will help you hold down the overall costs without lots of extra time in the kitchen.

Choosing items that are not marked-up because of a gluten-free label saves money. Buying already cooked protein reduces cooking time immensely and, as you can see, a few basics give you a great deal of menu flexibility. Just be sure to read the label on grocery store items and ask the BBQ joint about seasoning to determine whether anything contains gluten.

With a little practice, you can easily live within a budget while remaining gluten-free…and you don’t have to spend hours in the kitchen!

https://glutagen.com/the-cost-of-a-gluten-free-diet/

https://menu.wendys.com/en_US/product/classic-chocolate-frosty/

http://www.in-n-out.com/docs/default-source/downloads/menuallergenchart2018.pdf

http://www.cooking2thrive.com/blog/soups-on/

http://www.cooking2thrive.com/blog/dump-soup-perfect-for-a-lazy-day/


Disclosure of Material Connection: I have not received any compensation for writing this post. I have no material connection to the brands, products, or services that I have mentioned. I am disclosing this in accordance with the Federal Trade Commission’s 16 CFR, Part 255: “Guides Concerning the Use of Endorsements and Testimonials in Advertising.”

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January 6, 2020

Stuck Inside? Organize.

Stuck inside? Organize. This winter may bring weather that keeps you inside where it’s snuggly and warm. Once you’re tired of binge watching, it’s a great time to organize. I always like to start with the kitchen.

Pull-out drawer organizers

A few years ago on such a day, I installed pull-out cabinet drawers in two of my kitchen cabinets. It was a great decision! I can get to everything in the back of the cabinets and it makes cooking much more pleasant.

The drawers came pre-assembled and were easy to install. I needed a drill, but nothing more. You can choose from wood, chrome, or plastic in a variety of sizes and configurations. These can make old cabinets feel customized and modern.
drawer

Adding under-shelf storage to open kitchen shelves is another way to both organize and create additional space. If you have glass jars with metal lids available, fasten each lid to the bottom of your shelf with two screws, fill the jars, and then screw them into the lids.

The jars can be uniform or different depending on your style. Filled with colorful contents, they’re sure to add visual interest to any room. With these installed in the kitchen, you can have almonds, sunflower seeds, dried cherries, dried mango, trail mix, granola, coffee, tea, or candy at your fingertips.

Buy larger; store smaller

Jars are also great for storing items inside your cabinets. I buy spices in bags and then transfer small portions into glass spice jars that I place on a stair step organizer in a small cabinet by my stove.

Rather than buying jars, I save glass yogurt jars, jelly jars, pimento jars, pickle jars, etc. This means I have a variety of sizes and shapes to fit specific needs. When I feel like I have enough on hand, I add newly emptied (washed, of course) jars to my donation box.

Reimagine tools

I sometimes pick up display racks from stores that are going out of business and selling the fixtures. I don’t go crazy, but I’ll buy a couple of items here and there and then use them the next time I organize. My plastic lid organizer is a divided acrylic box that came from a defunct bookstore.

Tins that arrive at Christmas can be used to hold tea bags, sweetener packets, yeast packets, yogurt starter, or dried chile peppers. They’re also great for snacks you don’t want the kids to see in the pantry and picnic supplies you don’t use often. Stackability is a great reason to use tins in some spaces.

Somehow I ended up with too many mini loaf pans. Rather than get rid of half of them, I repurposed some to hold cupcake liners, spice bags, cheesecloth, and silicone bands. I’ve also used stoneware crocks in similar ways.

Safe for exploration

My most recent organizing projects have been to baby proof my kitchen for curious grandchildren. I removed cleaning products from the cabinet under the sink and placed a rubber band around the cabinet door knobs. The only other accessible cabinets contain cookware so I didn’t need to add hardware for safety.

There are two low drawers a toddler can reach. I use one for dish towels. I filled the other with measuring cups and spoons, a collapsible colander, a small rolling pin, and other child-safe items. Having a drawer the children are allowed to play in lessens the chance they’ll get into the cookware cabinets when I tell them no.

My two oldest grandchildren have spent hours playing with the items in that drawer. They turn measuring cups into pots for their miniature stove. They grab a variety of cups and stand on a stool at the sink pouring water from one to the other.

KB took each and every item out of that drawer and licked it one day. Of course I had to wash everything afterward, but it entertained him for a long time. Having these items accessible gives me an opportunity to introduce cooking tools and terms to the kids when they’re small. By the time they’re ready to cook, they’ll be familiar with the language and comfortable in the kitchen.

Convenient and efficient

Organization as a tool to improve efficiency makes sense to me. Organization as an end unto itself does not. I embrace the time it takes to make things easier to find and reach. Past that point, organizing feels like a waste of time. In fact, if I end up with too many levels of organization, I can’t remember where I put things.

The good news is, at the end of an organizing day I know where to find the ingredients for a cup of hot chocolate that I can drink when I go back to binge watching!

https://www.containerstore.com/s/kitchen/cabinet-organizers/lynk-chrome-pull-out-cabinet-drawers/12d?productId=10017298

https://www.homedepot.com/b/Kitchen-Kitchen-Storage-Organization-Pull-Out-Cabinet-Organizers-Pull-Out-Cabinet-Drawers/N-5yc1vZci43

http://www.cooking2thrive.com/blog/make-the-kitchen-your-happy-place/

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December 29, 2019

Can’t You Do Better?

“That scarf doesn’t match your sweater. Can’t you do better?” That was how our conversation began. My mother’s first cousin Colene never held back an opinion. And yet she never made you feel bad. How did she manage that?
better
This is the question I’m pondering a month after her death as we approach the new year. The day before she died, a nurse said, “I loved Colene. She was so much fun – even when she was saying she was going to kick us in the teeth!”

I can hear her saying it now. She was fun. She was feisty. She was independent. She was confident enough to take driver’s ed at the local high school when she was 70 years old. And she was successful. She got her driver’s license and drove until she was in her 90s.

My cousin Johnny has a similar gift. He served in a state legislature in the Northwest for 30 years, retiring in 2017. He is disconcertingly direct and unafraid to let you know where he stands. Unlike most politicians, with Johnny there is no spin, no hedging, and no equivocating. Rather than being reviled for this, he is admired, trusted, and respected.

Colene and Johnny were not related, but they knew and liked each other. Dinner with the two of them was an annual event not to be missed. Conversation was lively, sometimes uncomfortable, but always uplifting…always uplifting.

When I ask myself, “Can’t you do better?”, that’s what I’m asking. Is the result of my interactions uplifting? It sounds like an impossible bar, but I have two shining examples that it is not.

Both of those examples felt free to state their truth, share opinions, and be direct. And that’s what they wanted in return. They didn’t have a need for anyone else to conform to their way of thinking. In fact, they welcomed differing viewpoints. That’s what made the conversations interesting.

And perhaps it’s as simple as that. Having the courage to listen, state my truth, share my opinion, and be direct without the need to control the response may be all it takes to leave people feeling better. It certainly builds trust. It has other benefits as well.

Building Trust
I trust you more if I know you’ll level with me. When you don’t, I sense it and become wary. I don’t like feeling that way. If it happens often, I will no longer rely on you. I will feel I must guard myself.

In order to be at our best, do our best work, and thrive, it is important to have people in our lives who will level with us. I remember the poet Miller Williams saying he trusted his wife to tell him when to stop writing because a poem was finished. He relied on her for this. He believed it made his poems better. I can’t argue with that. They feel right to me.

Creating Safety
There’s another benefit to voicing how you really feel without expectation of anyone else. Doing this creates an environment of safety for others to do the same. I always felt free to tell Colene the truth, even when it was not what she wanted to hear.

Once she could not walk, she sometimes asked me if she could go home. I didn’t tell her she might someday or leave her hanging with a we’ll see. I kindly and gently told her no. If she asked why, I would remind her that she could not walk and her house was not set up for lifts and wheelchairs.

She knew all of this was true. She felt it even when she could no longer absorb the words. There was never an argument, hysterics, or whining. She asked a simple question. I gave her a simple answer and the conversation shifted to something else.

Showing Respect
Stating your truth without equivocation shows respect for yourself and also for the listener. Feeling respected builds our sense of worthiness.

Maintaining Bonds
Colene made some pretty strong stands. Many years ago, she objected to one of her relatives’ choice in spouses. On the day of his wedding, she got in the car with her father, mother, and sister to go to the ceremony. A couple of minutes later, she said, “I’m not going to this wedding. I think it’s wrong.” Her father stopped the car, let her out, and she walked home.

In many families, this boycott would have created lingering hard feelings. That was not the case. Colene and the groom remained close until he died at age 91.

Her opinions were well-thought and her sentiments so sincere, you knew she wasn’t condemning you when she disagreed. She was just following her heart and her conscience. This is another characteristic she shared with Johnny and there’s something disarming about it that maintains bonds rather than threatening them.

Living Fully
If I am always holding back, I cannot live fully. It may be tempting to believe that I can garner favor or earn love by syncing my responses with those whose love or admiration I desire. If you have tried that approach, you know as well as I do that it never works that way. Ultimately, those who appreciate me will appreciate me and those who don’t, won’t.

Holding back my truth may sometimes help me avoid embarrassment, shame, humiliation, and feeling alone in a particular moment, but over time it diminishes my spirit and damages my soul. That’s a huge price to pay for momentary comfort. And it may mean that I will miss out on supportive friendships I wouldn’t otherwise have a chance to cultivate.

As I process my grief over losing Colene, I often repeat the question — can’t I do better? Of course I can. And I intend to. That still doesn’t mean she’d approve of my scarf choice.

https://www.marcandangel.com/2010/04/12/3-communication-tips-for-building-stronger-relationships/

https://my.fearlessliving.org/its-all-about-r-i-s-k-2/

http://www.cooking2thrive.com/blog/leave-the-past-behind/

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