Saturday, December 31, 2011

End of the Year

Last big dinner of the year we made was Christmas Eve dinner, menu is below. The real hits in my book were the soup and the tenderloin. The salad was a bit of a flop but the broccolini, potatoes and carrots/parsnips were all solid.


Lemon Ricotta with Squash and Sage on Crostini


Spicy Pumpkin Soup with Pepita Streusel and Cinnamon Marshmallows


Arugula with Figs, Ricotta, Prosciutto, and Smoked Marzipan


Broccolini with Pecan Brown Butter

Honey-Glazed Roasted Carrots and Parsnips

Mustard-roasted Potatoes


Roast Beef Tenderloin with Port Sauce


Pecan Pie

Pumpkin Cheesecake

A couple of pics of the little fellow - he is a lucky man with all the love that has been lavished on him now in the first month of his life!

Thursday, December 8, 2011

Baby food!

We have a son - William Atticus Foster! Erin labored for a relatively short time though it was not easy in any way. He was born December 1st at 6:15am in our bathroom at 38.5 weeks and 8lbs, 40z!

He is perfect in every way. We are just spending lots of time at home with him these days enjoying every moment, every poop, every full-body yawn, each half-smile and his big, curious eyes.

Atticus is now a week old, so I thought I would write a little about what he's been eating... breast milk! And below is the video I compiled of his first week's adventures:

Breast milk
This is fascinating stuff. Reading about breast milk ties all sorts of things together from geo-political controversy around Nestle marketing formula aggressively in South America to evolutionary biology in how boys who breastfeed get different milk than girls that breastfeed (who knew!!) to the disparity in groups of people who breastfeed to the immunology and the nutritional aspects of the stuff to the anthropological concept of technology=advancement... I'm going to try and stick to the more nutritional aspects here.

Immunologic benefits: Since the 1930's when the first studies were published, we have known that there seems to be a immunologic benefit to breastfeeding with the largest reduction seen in respiratory and gastrointestinal illness. One of the coolest things I read was that the IgA (a type of immunoglobulin) that is in breast milk is produced by B-cells in the woman's breasts that migrated there from her gut! So basically all of the immunologic memory that the mother has from the exposure that she has had in her gut get passively transferred to the infant providing huge amounts of protection against diarrheal disease which is the second most common cause of infant mortality worldwide (used to be the first)!

IQ benefits: This is one of the more poorly understood aspects of breastfeeding in part because at least in the developed world where most of the data comes from, women who breastfeed also tend to be more educated, wealthier etc - so teasing out the effect of breastfeeding on intelligence is fundamentally a statistical problem of dealing with bias and confounding since no one will every be able to randomize breastfeeding vs not. In any case, at this point, there definitely does seem to be a real association between breastfeeding and IQ of probably about 5-10 points, and it is probably NOT solely the result of higher maternal education, better bonding or attachment etc - it is in the milk!

So then the question is why does breast milk and not just breastfeeding give this advantage? There has been a lot of research into the role of omega-3 and omega-6 fatty acids - mainly docosahexaenoic acid (DHA) and arachadonic acid (ARA). These compounds are required for efficient neurotransmission and are involved in neurite outgrowth, dendritic arborization, and neuron regeneration after cell injury - all good things and necessary for brain development. Of course the formula companies have jumped on this and market their products as including these compounds now - what is not yet known is whether this attempt to simulate breast milk will translate into outcomes, so far the results have been mixed.

Last thing about this (I promise): while one my least favorite phrases in medicine is that there is a genetic and environmental component to a disease or condition because I think that is basically a meaningless phrase, there is a cool example of gene-environment interaction in this case. A study published in 2007 showed that the beneficial effect of breastfeeding was only seen in a subset of children who had a particular variation in a gene involved in the metabolism and regulation of DHA and ARA in the brain! In the children without the variation, there was no benefit to breast milk, in the children with the mutation, they did see a benefit that largely accounted for the 5 or so points seen in epidemiologic studies - how cool is that??!!

So here's to Atticus on completing his first week of life, to his beautiful and loving mother, to his having the mutation in FADS2 :), and to his own exploration of food - breast milk and beyond!