Jones & Bartlett Learning Author and Health Policy and Law Expert Joel Teitelbaum Weighs in on the Latest Affordable Care Act Litigation

More than six years after becoming law, the Affordable Care Act (ACA) remains heavily litigated.  Since 2010, dozens of lawsuits have been lodged against it, with four of them reaching the United States Supreme Court – a remarkable number given the law’s relatively short lifespan and the fact that the Court only grants approximately 80 of the 8,000 case petitions it receives each year.  ACA litigation continued apace over the past year, with two new important decisions handed down in May of 2016.

One decision was issued by the Supreme Court, but in fairness the word “decision” is a bit of an overstatement, as the Court – currently reduced to 8 members following the death of Justice Scalia and the Senate’s failure to take up President Obama’s nomination to replace him – punted on the merits of the case.  At stake in Zubik v. Burwell is whether religiously-affiliated, not-for-profit employers that oppose contraception are effectively “complicit” in the provision of contraceptives to their women employees by virtue of filing a form with their insurance carrier that attests to their opposition, which in turn triggers a process by which the insurance provider and the federal government provide the contraceptive coverage.  (Under the ACA, for-profit companies that employ more than 50 people must provide insurance coverage for the 20 types of contraceptives for women approved by the Food and Drug Administration, but not-for-profit companies can exclude themselves from this requirement by filing the form.)  Under the separate process, the employer is not on the hook for any associated costs, and coverage is supplied through an insurance policy that is distinct from the employer’s.

Nonetheless, multiple religiously-affiliated, not-for-profit employers sued, claiming that the filing of the form violates the Religious Freedom Restoration Act, a statute prohibiting the federal government from “substantially burdening” religious beliefs unless the law is necessary to achieve a “compelling” government purpose.  On May 16th, the Supreme Court sent the case back to the federal Court of Appeals, expressing “no view on the merits of the case, [including] whether petitioners’ religious exercise has been substantially burdened, whether the government has a compelling interest, or whether the current regulations are the least restrictive means of serving that interest.”  In a brief opinion, the Court wrote that both the employers and the federal government stated in briefs to the Court that it was feasible that “contraceptive coverage could be provided to petitioners’ employees, through petitioners’ insurance companies, without any such notice from petitioners….  Given the gravity of the dispute…the parties should be afforded an opportunity to arrive at an approach going forward that accommodates petitioners’ religious exercise while at the same time ensuring that women covered by petitioners’ health plans receive full and equal health coverage, including contraceptive coverage.”

 The second noteworthy ACA decision of 2016 was handed down by a federal trial court judge just a few days before the Zubik opinion was issued – but House of Representatives v. Burwell is a case that may eventually end up at the Supreme Court as well, given what’s at stake: whether the ACA’s insurance premium cost-sharing subsidies are subject to annual appropriations by Congress.

Under the ACA, insurance companies that want to sell products in the online marketplaces set up by the law must cover certain “essential health benefits” and demonstrate an “actuarial value” (i.e., the percent of covered claims paid by the plan) ranging from 60% to 90%.  Eligible people who buy these qualified health plans are entitled to both premium assistance (in the form of refundable tax credits) and cost-sharing subsidies.  Eligibility for premium assistance ranges from 100% to 400% of the federal poverty level; eligibility for income-adjusted cost-sharing assistance is effectively capped at 250% of poverty, though the majority of marketplace plan enrollees receive this type of assistance.  The federal government pays both types of subsidies directly to health insurers, which in turn pass on savings to those members who qualify for one or both types of subsidies.

Under the ACA, premium assistance subsidies are considered mandatory (as opposed to discretionary) spending, require no annual appropriation, and are not specifically at issue in House of Reps. v. Burwell.  However, Republican members of the House of Representatives sued the Obama Administration over the ACA’s cost-sharing provisions, contending that the law as written requires those subsidies to be appropriated annually.  Unsurprisingly, the Administration argued that interpreting the ACA in this way would produce severe health insurance market defects that the ACA was, in fact, designed to cure.  But the trial judge agreed with the plaintiffs, concluding that the cost-sharing subsidies are subject to annual appropriations, and that Congress is at liberty to decide whether to appropriate the needed funds.  As is typical in high-stakes cases where an appellate court is likely to supersede a trial court decision, the trial court judge stayed her ruling pending appeal, meaning that for now the cost-sharing assistance will continue to flow to insurance companies and the people they insure.

In the end, for the time being at least, the parties and the law in both Zubik v. Burwell and House of Reps. v. Burwell are left in a state of uncertainty.  Thus both cases bear close watching: Zubik could implicate the operation of the ACA’s contraception mandate, while House of Reps. v. Burwell could produce the kind of result that could fundamentally undermine the ACA as a whole.

TetelbaumJoel Teitelbaum, JD, LLM is an Associate Professor and the Vice Chair of Academic Affairs in the Department of Health Policy at the George Washington University School of Public Health and Health Services. He also serves as Managing Director of the School’s Hirsh Health Law and Policy Program. Along with co-author Sara Wilensky, Professor Teitelbaum is the author of Essentials of Health Policy and Law, Third Edition from Jones & Bartlett Learning. (Qualified instructors are invited to request review copies here.) Professors Teitelbaum and Wilensky are also the authors of an annually updated chapter on health reform which may be bundled with any Jones & Bartlett Learning text at no additional cost.

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New Edition of Best-Selling Understanding Viruses Features NEW Virology Animations that Educate and Entertain

Understanding Viruses, Third EditionThe highly anticipated Third Edition of Understanding Viruses by Teri Shors of University of Wisconsin – Oshkosh will publish July 29th.  Understanding Viruses continues to set the standard for the fundamentals of virology. This classic textbook combines molecular, clinical, and historical aspects of human viral diseases in a new stunning interior design featuring high quality art that will engage readers. Preparing students for their careers, the Third Edition greatly expands on molecular virology and virus families. This practical text also includes the latest information on influenza, global epidemiology statistics, and the recent outbreaks of Zika and Ebola viruses to keep students on the forefront of cutting-edge virology information. Numerous case studies and feature boxes illuminate fascinating research and historical cases stimulate student interest, making the best-selling Understanding Viruses the clear choice in virology.

The Third Edition features NEW Virology Animations on antiviral drug mechanisms that educate and entertain!  See one for yourself.

Visit Jones & Bartlett Learning to learn more and download sample content of Understanding Viruses, Third Edition.

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Review: Handbook of Home Health Care Administration, Sixth Edition “should be on the shelf in every branch of every healthcare at home provider”

Handbook of Home Health Care Administration, Sixth EditionIn an outstanding new review for Handbook of Home Health Care Administration, Sixth Edition by Marilyn D. Harris, Home Care Technology Report raves that it is, “…a textbook that should be on the shelf in every branch of every healthcare at home provider.”

In fact, the review goes one step further with its praise,

“Let’s modify that. It should never be on the shelf but should live on the administrator’s or branch manager’s desk. In the current edition, which is a comprehensive, 1,000-page tour de force, editor Marilyn D. Harris has assembled a team of over 80 authors to cover, in detail, everything a private duty or certified agency administrator needs to know to be compliant and successful.”

Handbook of Home Health Care Administration, Sixth Edition is a comprehensive text that reflects the current state of home health care administration. With contributions from leading experts in the field, it addresses key aspects of home health care, including finance, human resource development, legal and ethical issues, management information systems, marketing, quality management, research, and current technology for patient care.

The Sixth Edition includes seven new chapters:

  • Status of Home Health Care: 2015 and Beyond
  • The Roles of and Competency Requirements for Paraprofessionals
  • Disaster Preparedness
  • Pediatric Home Care
  • Beyond Medicare-Certified Home Health Services: An Overview of Other Types of Home Care Services
  • Expanding Your Performance Improvement Program: Using Process and Other Measures to Improve Care
  • ADRs, CERTs, RACs, SMRCs, ZPICs, and Other External Audits

Want to learn more? Preview a sample chapter now or visit our website.

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New White Paper Shows Frequent Use of Navigate 2 Enhances Student Learning Experiences

close up of hands on laptop sized for FBIn our continuing efforts to measure the real-life impact of Navigate 2, we recently surveyed students and instructors who used it over the course of a semester. In our new white paper, we examine the findings that those who used Navigate 2 often reported more positive learning experiences. Read the white paper now.

The majority of instructors had positive experiences with Navigate 2. Overall, 77% rated Navigate 2 as a helpful learning tool. Moreover, instructors who accessed Navigate 2 often during their course consistently rated the product more positively than those who reported accessing it only sometimes.

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When asked about their experience using Navigate 2:

  • 74% of instructors said they want to continue using it
  • 71% of instructors said they would recommend it to other instructors

The majority of instructors who used Navigate 2 often during their course said that the activities helped their students learn.

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Overall, 73% of students surveyed were satisfied with Navigate 2. Moreover, students who accessed Navigate 2 often reported an 82% satisfaction rate compared to 58% for those who used it sometimes. Therefore, it can be concluded that using Navigate 2 with higher frequency can result in enriched learning experiences.

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What’s more, when asked if they would recommend Navigate 2 for their course in the future, 68% of students said that they would. For students who used Navigate 2 often during their course, 76% said they would recommend it. Additionally, of those who would recommend Navigate 2, the reasons most frequently cited were its helpfulness as a study tool and ease of use. For example, nearly 80% of students found Navigate 2 easy to use.

The majority of students reported that Navigate 2 activities were helpful to their learning, especially when used often:

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When asked if the Navigate 2 eBook allowed them to be more flexible with their study time, 67% of students said that it did. For those students who used the eBook often, 69% said that it made studying more accessible. Students said specifically that the eBook was easy to use and allowed them to study more flexibly.

“The [Navigate 2] chapter quizzes have greatly helped me grasp the most important information in a chapter and it has definitely helped me earn more points on my exams.” – Student Testimonial

“The [Navigate 2] flashcards and practice exams helped me to focus and learn the material. Additionally, Navigate 2 helped me to apply the knowledge and to carry the lessons from chapter to chapter.” – Student Testimonial

“[Navigate 2] has helped me understand concepts better and in a quicker way with the available tools and resources.” – Student Testimonial

When asked to rank Navigate 2 features on a scale of 1 to 10, students rated ease of use and organization the highest. The assessments and study center also received high ratings.

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In addition, after their experience using the Navigate 2 eBook, the majority of students preferred it to using a printed text alone.

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“[Navigate 2] allowed more flexibility for reading my assignment. I could access the content anywhere without having to carry around a textbook.” – Student Testimonial

“[Navigate 2] is a very useful tool which gave me the ability to read the book online, as well as take chapter quizzes and look at review materials.” – Student Testimonial

“Navigate 2 is an easy to use way to access and submit assignments, review lessons, and prepare for exams.” – Student Testimonial

Conclusions

  • The majority of instructors found Navigate 2 a helpful learning tool
  • The majority of students would recommend Navigate 2 to others and found it easy to use
  • Students who used Navigate 2 more often reported higher satisfaction rates
  • Students overwhelming said that the Navigate 2 eBook made content more accessible
  • After their experience using Navigate 2, students preferred it to a printed textbook alone

To learn more about Navigate 2, visit our website.

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Postpartum: Exercise Tips

Lilah Al-Masri, MS, RD, CSSD, LD

Lilah Al-Masri, MS, RD, CSSD, LD

Simon Bartlett, PhD, CSCS, ATC

This month, our special guest bloggers, Lilah Al-Masri, MS, RD, CSSD, LD, and Simon Bartlett, PhD, CSCS, ATC, authors of 100 Questions and Answers about Sports Nutrition & Exercise, offer expert postpartum exercise tips.

You have just given birth.  Congratulations!  Now you are probably wondering “how soon after birth can I start exercising?”  The American College of Obstetricians and Gynecologists (ACOG) recommends a gradual resumption of exercise as soon as you feel up to it.  However, it would be prudent to wait for your six-week postpartum checkup to ensure everything is okay before launching into an exercise routine.

Generally, if you exercised throughout your pregnancy and had a normal vaginal delivery, it would be safe to begin light exercise such as walking, stretching and modified push-ups within a week of giving birth.  It is important to begin slowly by doing light aerobic exercise such as walking for a few minutes and increase the duration of each walk by an additional few minutes each day.  Try not to push yourself too hard too soon.  Let your sense of comfort be your guide.

If you had a c-section, make sure that you check with your doctor first and expect to wait until you recover from your operation before going back to your exercise program.  A typical incision from a c-section can take anywhere from 4-6 weeks to heal and may be some time after that before you feel ready to start exercising again.  However, easy walking is recommended as it can promote healing, help prevent blood clots, postpartum blues and other complications.

If you weren’t active during your pregnancy or tapered off your regular fitness routine during the months leading up to your delivery, make sure that you check with your doctor or midwife before beginning exercise.  Remember that your joints and ligaments will still be loose for about three to five months after delivery, which can make you susceptible to falling and joint injuries.

Some women like to engage in group exercise classes and if you want to participate in group exercise classes find one that is taught by a postpartum exercise specialist.  Many YMCAs, recreation centers, gyms and yoga studios offer excellent exercise classes for new mothers.  Additionally, low-impact classes that focus on toning and stretching are very effective.

Remember, exercise is good for you, but don’t overdo it for the first few months after giving birth.  Your body needs time to heal, and you need time to adjust to your new role and bond with your baby.  If you have any concerns about developing a workout routine, consider consulting a professional such as an exercise physiologist that has certifications with either the NSCA or ACSM for help.

Many women that have given birth have legitimate questions and concerns about exercise and their body. The following lists some of those questions:

How careful should I be with my abdominal muscles after birth?  During pregnancy, some women develop a gap in their abdominal muscles as their stomach expands during pregnancy and labor, a condition called diastasis recti.  It takes four to eight weeks after giving birth for this gap to close.  If you start doing abdominal exercises before this gap fully closes, you run a very real risk of damaging those muscles.  To find the gap where the muscles have separated, lie flat on your back with your knees bent. Place the fingers of your left hand, palm facing you, just above the navel.  Place your right hand on your upper thigh.  Inhale deeply and then exhale.  As you exhale, lift your head and shoulders off the floor and slide your right hand up your thigh toward your knee.  This will make your abdominal muscle tighten; you should be able to feel the gap where the muscles have separated.  If you feel a gap, consult your doctor to see if it is safe to begin an abdominal strengthening program. Your health care provider can provide you a program that incorporates pelvic tilts, leg slides, crunches and/or sit-ups.

What effect does exercise have on breastfeeding?  The simple answer to this question is it won’t.  As long as you drink plenty of water, vigorous exercise will not impact the amount or composition of your breast milk.  If your breasts are sore or tender; avoid any form of exercise that aggravates the condition. Try wearing a supportive sports bra while working out, and try to nurse your baby before you exercise so your breasts won’t feel uncomfortably full.

Are there physical signs that I’m exercising too much too soon?  Too much physical activity after birth has the potential to cause your vaginal discharge to become redder and flow more heavily, a condition called lochia.  This is a warning to slow down.  It is important to inform your doctor immediately if vaginal bleeding restarts if you thought it had stopped or you experience any pain while exercising. Another sign of over exercising, is feeling exhausted instead of invigorated when you are done.  This is a warning to slow down and take it a little easier.

What is the best way to lose weight after giving birth?  From an exercise standpoint, the most effective way to lose weight after delivery is to engage in regular aerobic activity such as walking, jogging, swimming or biking.  Exercise duration should amount to 150 minutes or more each week and involve the major muscles groups of the body to be effective.  The key is to be patient and consistent and with proper dietary intervention the mother should aim at losing no more than a pound a week, especially if breastfeeding.  For further information on postpartum weight loss, view the Postpartum: Nutrition Tips.

The key to regaining normalcy after childbirth is to listen to your health care provider, listen to your body for any unusual changes and give yourself the time needed to get back to your normal lifestyle.

This six-part blog series discusses the current nutrition and exercise recommendations for women before, during, and after pregnancy.  Pregnancy can certainly be a trying and confusing time and these articles are intended to provide answers to the most popular questions women (and often their providers) ask.

http://www.jblearning.com/catalog/9780763778866/More information can be found in 100 Questions and Answers About Sports Nutrition and Exercise by Lilah Al-Masri, MS, RD, CSSD, LD and Simon Bartlett, PhD, CSCS, ATC.

Do you have a nutrition or exercise question? If so, submit them to adefronzo@jblearning.com. Questions will be answered on a monthly basis.

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Today Is World Blood Donor Day

twitter-woman blood donationWith the recent tragic events in Orlando, people have been lining up to donate blood to help the victims of the attack. Today also marks World Blood Donor Day, a yearly campaign from the World Health Organization (WHO) to raise awareness for the importance of donating blood that saves lives in communities all over the world. This year’s theme is “Blood connects us all.”

According to Dr. Ed Kelley, Director of the Department of Service Delivery and Safety at WHO,

“Voluntary blood donors come from all walks of life but they have one thing in common: they put others before themselves — people they don’t even know. Each time they donate blood, they commit an act of selfless heroism.”

Learn more about how blood donation connects us all:

Please join us in celebrating the importance of donating blood, especially in light of the vicious and senseless violence committed over the weekend in Orlando. To find out how you can donate blood, please visit the Red Cross website.

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Jones & Bartlett Learning Publishes The Case Manager’s Handbook, Sixth Edition

The Case Manager’s Handbook, Sixth EditionWe are excited to announce the publication of The Case Manager’s Handbook, Sixth Edition by renowned author Catherine M. Mullahy. Presented in an accessible and conversational style, this practical resource helps case managers learn the fundamentals, study for the Certified Case Manager (CCM) exam, and advance their careers after the exam. Completely updated and enhanced with information on the latest developments affecting case management, it reflects the rapidly changing healthcare landscape, including the significant effects of the Affordable Care Act (ACA).

“For the past 10 years, as a Vice President with Mullahy & Associates, I have had the pleasure of working side by side with Catherine. As colleagues and friends, we have worked together in case management for over 40 years. Her vision for all that case management can be is contagious and shared with every word she speaks and writes. It is amazing to watch her transform a room of silent, often skeptical nurses, social workers, physicians, and therapists into a group of enthusiastic, networking professionals filled with hope, energy, and renewed passion for case management. I believe you, too, will be both informed and inspired as you read and refer to this sixth edition of The Case Manager’s Handbook.” – From the Foreword by Jeanne Boling, MSN, RN, CCM

The Sixth Edition includes new chapters on pediatric case management, workers’ compensation case management, key factors driving today’s healthcare system, the case manager’s role in the era of value-based health care, case management and healthcare provider strategies for managing the high-risk or high-cost patient, and transformative healthcare approaches for the millennial generation. In addition, each new print copy includes Navigate 2 Advantage Access that unlocks a comprehensive and interactive eBook, midterm and final exam, instructor’s manual, and learning analytics reporting tools.

Can’t wait to learn more? Preview a sample chapter now or visit our website.

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Happy National Nurses Week

NursesWeek2016logoToday marks the beginning of National Nurses Week, a nationwide celebration of nurses and the vital work that they do.  Observed annually, National Nurses Week begins on May 6 and ends on May 12 to commemorate Florence Nightingale’s birthday. This year’s theme is “Culture of Safety. It Starts with You.”

According to the American Nurses Association (ANA), a culture of safety includes:

  • Openness and mutual trust when discussing safety concerns and solutions without individual blame
  • Marshaling of appropriate resources, such as safe staffing- and skill-mix levels
  • A learning environment in which healthcare professionals learn from errors and proactively detect systemic weaknesses
  • Transparency and accountability

Watch the Nurses Week Video with ANA President, Pam Cipriano:

Join us this week in celebrating some of our favorite people– nurses!

We want to know how ‪‎nursing‬ or a ‪nurse‬ in particular has impacted your life. Join the conversation on our Facebook page and share your story.

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Review: Nursing Ethics, Fourth Edition “will help stimulate the moral imaginations of nursing students and professional nurses”

Nursing Ethics, Fourth EditionEthics are, without question, an essential component of nursing practice. For instance, the American Nurses Association deemed 2015 as the “Year of Ethics.” In addition, Gallop continually finds that the public sees nursing as the most honest and ethical profession.

Now our highly regarded Nursing Ethics: Across the Curriculum and Into Practice, Fourth Edition by Janie B. Butts and Karen L. Rich has received a 5-star review. Debra Gorman-Badar, BS, MA, from Saint Louis University, writing for Doody’s Review Service, assesses that it,

“…will help stimulate the moral imaginations of nursing students and professional nurses so that they are able to recognize ethical issues and…apply analytical skills in ethical decision making.”

Written to help prepare students and professionals for the moral issues they will encounter in nursing practice, the completely updated and revised Fourth Edition reflects the evolution of nursing ethics within heath care.

New to the Fourth Edition:

  • Coverage of the 2015 American Nurses Association’s Code of Ethics with Interpretative Statements
  • New case studies and activities throughout each chapter
  • Boxed features highlight research notes, legal perspectives, and ethical reflections
  • Expanded content on the ethical competencies of nurses
  • Each new print copy includes Navigate 2 Advantage Access that unlocks a comprehensive and interactive eBook, student practice activities and assessments, a full suite of instructor resources, and learning analytics reporting tools

Interested in learning more? Preview a sample chapter now or visit our website.

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Postpartum: Nutrition Tips

Lilah Al-Masri, MS, RD, CSSD, LD

Lilah Al-Masri, MS, RD, CSSD, LD

Simon Bartlett, PhD, CSCS, ATC

This month, our special guest bloggers, Lilah Al-Masri, MS, RD, CSSD, LD, and Simon Bartlett, PhD, CSCS, ATC, authors of 100 Questions and Answers about Sports Nutrition & Exercise, offer expert tips on postpartum nutrition.

Congratulations!  If you are reading this article, it means you have delivered or you are getting close to delivery.  Nutritional intake postpartum is important, as there must be a balance between fueling your body for healing and breastfeeding and weight loss.

This article will focus on several nutrition concerns women have postpartum – weight loss, breastfeeding needs, healthy snacking, fluid consumption, vitamin and mineral intake, caffeine and alcohol consumption, and exercise.

Weight Loss

The goal is for gradual weight loss postpartum at the rate of approximately 1lb/week (or 4.5lbs/month) after the first month.  Although many want to return to their pre-pregnancy weight quickly, rapid weight loss may lead to fatigue, decrease bone mineral density, negatively impact mood, and may interrupt milk supply (if breastfeeding).  Most women return to their pre-pregnancy weight within a year by eating a healthy diet and incorporating moderate exercise back into their routine.  Remember, the weight gained during pregnancy was gradual so the weight loss will be gradual as well.  Don’t fall victim to fad diets, as they will most likely set you up for short-term success and long term disappointment.

Breastfeeding Needs

An additional 500 kcal/day is recommended for woman who breastfeed.  This may be higher in cases where the mother is underweight, exercising vigorously, and/or nursing more than one infant.  The increased needs can be met by adding healthy snacks similar to those consumed during pregnancy.  By listening to your body’s hunger signals, you will be able to stay well fueled.

Healthy Snacking

In addition to consuming well-balanced meals, snacks are a very important to help fuel breastfeeding and ensure safe weight loss.  Use your hunger level to gauge if you need to consume a light, moderate, or heavy snack.  Examples of a light snack would include fresh fruit, raisins, dry cereal, low-fat Greek yogurt or low-fat pudding. A moderate snack would include fruit with peanut butter, oatmeal, cereal and milk or yogurt parfait.  A heavy snack would include a peanut butter or lean protein sandwich, cheese and crackers or omelet.  For more information refer to Healthy Snacking 101.

Fluid Consumption

Fluid needs increase with breastfeeding and women who are breastfeeding may notice increased thirst.  It is important to drink enough to quench your thirst.  It is often advised that fluid intake for women should be 91oz or 11.5cups per day.  This, though, can vary due to activity level and environmental conditions thus hydration levels are best assessed by urine color and frequency.  You know you are well hydrated if you are urinating frequently and it is pale yellow in color.  Top fluids to consume include water, fruit juices, low-fat dairy, decaffeinated coffee and tea, low-sodium soups, and water-rich fruits and vegetables.  Limit sodas, sugary beverages, and drinks containing caffeine and alcohol.

Caffeine and Alcohol Consumption

According to the Institutes of Medicine, breastfeeding mothers can consume occasional small amounts of caffeine and alcohol.  A moderate amount of caffeine would be 2-3 cups of coffee/day or approximately 200-300mg/caffeine per day.  Guidelines for consuming alcohol include 1) waiting until your baby has established a breastfeeding pattern (~3 months of age), 2) wait at least four hours post-single alcoholic drink before breastfeeding, and/or 3) express breast milk prior to consuming an alcoholic beverage to use for a later feeding.

Vitamins and Minerals

Two minerals that often require special attention for postpartum women include calcium and iron.  See chart below for more information.  In addition, postpartum woman should consume a variety of foods to provide the vitamins and minerals necessary for healthy and breastfeeding.  These vitamins and minerals are plentiful in a varied diet, but it is often recommended that breastfeeding mothers continue to take a pre-natal vitamin.  This is best discussed with your Physician and/or Registered Dietitian.

Minerals RDA Benefit Sources
Calcium RDA:

1000mg (19-50yo)

1300mg (adolescents)

Protect bone density, aid in muscle relaxation, blood coagulation, transmission of nerve impulses, may slightly increase weight loss milk, cheese, yogurt, tofu,

cottage cheese, fish (sardines, salmon, clams), greens, calcium-fortified

beverages such as orange juice and soymilk

Vitamin D RDA: 600 IU Enhances calcium absorption fatty fish, fortified dairy and soy products, fortified eggs, fortified cereals
Iron RDA: 15mg Indicated to help return to pre-pregnancy levels and/or if blood loss higher than normal during vaginal delivery dried fruits, iron-fortified cereals,

lean red meat, fish, poultry, dried fruits

Exercise

Exercise postpartum is an important part of physical and emotional recovery.  Specific guidelines for postpartum exercise (vaginal and Cesarean delivery) will be discussed in the June 2016 article.

Quick Tips

  • Plan ahead. Make sure you have plenty of healthy foods and snacks on hand prior to the baby’s arrival.
  • Hydrate! Grab a water bottle or two.  Always carry a water bottle with you.  If you are breastfeeding, keep another one next to the chair or in the room you intend to use for most of your nursing.
  • Keep snacks accessible. Placing them by your water bottle, in the diaper bag, and near the chair you nurse will ensure you have the fuel you need when you are hungry.
  • Nursing is a great time to hydrate and snack. While sitting to nurse, you have ample time to provide your body with nourishment.
  • Eat balanced meals – meals that include carbohydrates, proteins, and fats.
  • Consume calcium rich foods throughout the day.
  • Do not weigh yourself more than one time/week. Remember the goal is gradual weight loss.
  • Avoid fad diets. Instead focus on consuming healthy meals and snacks.
  • If you feel that you need nutrition support, consult with a Registered Dietitian.

Nutritional needs postpartum vary and it is valuable for women to be in tune with their body’s needs and understand the basic recommendations.  If you feel confused or feel that your questions are not being answered to your satisfaction, make an appointment with a Registered Dietitian who can help you meet your needs for a safe and healthy recovery.

Stay tuned for next month’s article that will focus on postpartum exercise recommendations.

This six-part blog series discusses the current nutrition and exercise recommendations for women before, during, and after pregnancy.  Pregnancy can certainly be a trying and confusing time and these articles are intended to provide answers to the most popular questions women (and often their providers) ask.

http://www.jblearning.com/catalog/9780763778866/More information can be found in 100 Questions and Answers About Sports Nutrition and Exercise by Lilah Al-Masri, MS, RD, CSSD, LD and Simon Bartlett, PhD, CSCS, ATC.

Do you have a nutrition or exercise question? If so, submit them to adefronzo@jblearning.com. Questions will be answered on a monthly basis.

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