Q. What are the current recommendations for choline during pregnancy? I’ve noticed there are some vitamins with choline now but I eat 7 eggs per week (not pregnant yet).

A. Choline is essential for normal functioning of all cells, especially those in the brain, liver, and the central nervous system. Choline works together with folic acid to promote proper nervous system (including the brain) during pregnancy, and preliminary evidence suggests that choline curbs the risk of neural tube defects, including spina bifida, early in pregnancy. Animal studies suggest choline is crucial for the development of the brain’s memory center.

Before pregnancy, you need 425 milligrams choline every day. During pregnancy, choline needs are 450 milligrams daily. If you breastfeed, get 550 milligrams every day. Don’t rely on supplements or prenatal pills. Most supply little or no choline, or contain a form that the body cannot readily use.

Many women begin pregnancy with a choline-deficient diet. Choline content is highest in animal foods, so women who avoid or limit eggs, meat, poultry, and seafood may be low in choline intake.

Here are some common foods with choline:

Egg*, 1 large, cooked any way: 125 milligrams
Cod, Atlantic, 3 ounces, cooked: 84 milligrams
Ground beef, 3 ounces, cooked: 83 milligrams
Pork tenderloin, 3 ounces, cooked: 76 milligrams
Salmon, 3 ounces, cooked: 65 milligrams
Chicken, 3 ounces, cooked: 65 milligrams
Broccoli or cauliflower, 1 1/4 cups cooked: 40 milligrams
Wheat germ, 2 tablespoons: 21 milligrams

(Fortified eggs, such as Eggland’s Best, also supply the omega-3 fat DHA: see below.)

Q. Also I am wondering about omega-3 supplements. If I eat 2 fish meals a week (1 with light tuna, 1 with wild salmon), is there any benefit for taking a DHA supplement? Is there any harm?

A. Omega-3 fats are healthy for mom, so it’s a good idea to follow the American Heart Association’s advice to eat two fish meals weekly before and during pregnancy. Docosohexaenoic acid (DHA) is one of the omega-3 fats most important to brain development during pregnancy and the first two years of life. DHA is the dominant fat in the brain. Research shows DHA helps to build your baby’s brain, and promotes peak vision, as DHA is part of the retina, located in the back of the eye.

Like choline, most women don’t get enough DHA. DHA is found in seafood and in fortified foods. Pregnant women need 200 to 300 milligrams DHA every day. If you don’t eat enough fish or avoid it, rely on fortified foods and dietary supplements to get the DHA you need.

Here are some DHA sources to help you get an average of 200 to 300 milligrams of DHA daily:

Salmon, Atlantic, farmed, 3 ounces, raw: 1,238 milligrams
Expecta Lipil, 1 pill: 200 milligrams
Tuna*, light, canned, drained, 3 ounces: 190 milligrams
Eggland’s Best, 1 large, cooked any way: 50 milligrams
Cabot 50% Reduced Fat Cheddar Cheese, 1 ounce: 32 milligrams
Horizon Organic Milk Plus DHA Omega-3, 8 ounces: 32 milligrams

* Certain fish harbor high mercury levels. The Food and Drug Administration says it’s OK to eat light tuna but to limit white tuna to six ounces a week. White tuna is from a larger tuna species that may have more mercury.

Here’s the latest on how important it is to move around throughout the day in addition to getting a minimum of 150 minutes of moderate-intensity exercise a week - that’s at least 30 minutes on most days.

Unfortunately, many news stories have wrongly reported that infant formula contains high levels of arsenic, which may hamper the development of a child’s brain and nervous function. Erroneous reports have lumped all the formulas tested into the infant formula category when, in fact, toddler formulas are meant for children over the age of 12 months. Infants are children who are 12 months or younger.

Infant formula ingredients are tightly controlled by the Food and Drug Administration (FDA). Organic brown rice syrup is not authorized for use in infant formula, according to the FDA.

Mom, there is no need to worry about infant formula. In fact, a 2011 study of arsenic in powdered infant formula found that the maximum levels are at least six times lower than the maximums for drinking water established by the Environmental Protection Agency (EPA).

So what did the Dartmouth study reveal? High levels of arsenic in two TODDLER formulas that had contained organic brown rice syrup, the source of arsenic in the cereal bars and energy shots.

Baby’s Only Organic Dairy Toddler Formula and Baby’s Only Organic Soy Toddler Formula, made by the Nature’s One company, contained arsenic levels that were far above the limits set by the EPA for drinking water.

Organic brown rice syrup is used as a sweetener, often in place of high fructose corn syrup. Organic brown rice syrup supplies concentrated levels of arsenic, which is found in water, air, food, and soil as a naturally occurring substance or due to contamination from human activity. You cannot completely avoid arsenic.

Why organic brown rice syrup is allowed as an ingredient in toddler formulas, and in other foods, is beyond me. But that’s another matter.

Bottom line: Don’t worry about infant formula. It’s safe to feed to your baby.

By the way, here’s one story that accurately reported what the Dartmouth study found. Kudos, WebMD!

Here’s a picture.

Sharing a laugh before the WebMD Town Hall begins.

If you don’t have time to watch the entire 45-minute program, here’s a written excerpt of one my favorite questions and answers. It just goes to show that even people at the top struggle to fit in exercise. That’s a good lesson for new moms and moms to be who are juggling their needs with their family’s.

Question: A WebMD user asks, “I have watched the first lady exercise, and I’m always watching her husband working under pressure. Their bodies have maintained their weight and are healthy. My question is, how are they balancing time, diet, exercise, and stress, and sleep, and everything else that goes along with the healthy lifestyle?” Answer:

Mrs. Obama: Well, it’s just prioritizing what’s important, and there are some sacrifices. Sometimes sleep gets sacrificed, getting up early to get your workout in. But, you know, what I tell my girlfriends who are, you know, struggling, we’re all the same age and everybody’s wondering how to keep my weight down, the secret is good diet and exercise. Sorry. It just, it is. I know, everybody’s looking for the magic pill, but it is. But the thing is, and I tell a lot of my friends this, you have to give it some time. It’s just like kids with vegetables. If you go into the gym and walk on the treadmill and it hurts, you can’t give up because it will feel better. It will gradually, just like kids with vegetables, you will build up your endurance, and if you give yourself some time, six weeks, eight weeks, you’re going to feel better doing the workout, and then you’re going to start seeing results, and then your ego’s going to come in. You got that dress size going down, and then it makes it a little ‑‑ you get a little more incentive to get back on the treadmill. But it takes some time to build up endurance, especially if you’re going from doing nothing to doing something. And it can be walking. It can be walking fast. It can be walking on a little bit of an incline. It can be jumping rope. It can be dancing with your kids. I mean, it doesn’t have to be complicated; it just has to be something that you enjoy and know that you can’t give up on it, and you’re just thinking every day, if I just do a little bit, the next day, if I can just do it, the next week, if I can do a little more. You know, don’t feel like you’ve got to take these huge chunks, you know, you have to go from zero to doing 25 pushups on Ellen. You don’t have to be there to get ‑‑ to get the kind of benefit that you need. And eventually, your body will ask for it. So what happens with the president and I is that exercise is a de-stressor. It is the thing that just keeps you calm. So now you need it, right. So the president works out because he needs to work out. He’s got to blow off that steam. He’s got to sweat a little bit. He’s got to use that so that he can, you know, sleep at night. It becomes a necessary tool just for getting through. And we’re encouraging our girls to start early with exercise. You know, just making sure that they’ve got some routine, some sport that they do, because what I don’t want is my girls to grow up like many girls grow up, thinking that sweating isn’t cute. You know, that girls shouldn’t be on teams and learn how to fall and to compete. You know, sometimes we do that to our young girls, particularly. So I think we, as women in particular, have to be that role model for our girls especially. So when I get on the treadmill and my girls see me, I make sure they know mommy is tired. Mommy doesn’t want to work out. I would rather go back to bed, but after you go to school, I’m going up to the gym because it’s good for me and I’ll feel better once I’m done. So if you just get over that hump, just do it, and eventually just know it’s going to feel better. I promise you, so ‑‑

Elizabeth Ward: Sometimes just putting your exercise clothes on, it gets you motivated.

Mrs. Obama: That’s another thing I do in the evening. I told friends to do this: When you come home from work, put on your workout clothes. Put your gym shoes on. Do not put on your pajamas. Do not pass go. You know, because if you have the clothes on already, you’re more likely ‑‑ it’s just the notion of taking your clothes off and putting something else back on, right? Nobody wants to do that. But if you start out, and my trainer always tells me that working out early is the best thing, but not everybody can do that. If you get it out of the way then nothing gets in the way of your day, it doesn’t interfere with anything. You get up, you do it first thing. That’s why I work out in the morning, because I never know what my day is going to look like.

Kathleen Zelman: And I would add that you don’t have to do it all at once. I mean, if you’re really busy and your schedule doesn’t allow for it, increments, 10 minutes here, 10 minutes there, strap on a pedometer. Fit it into your day is another way to be active and move.

Back to the food.

I have a guest post on the fabulous site fooducate. Check out three healthy and delicious snacks that pack in the vegetables. And I posted pictures, too!

Enjoy!

Go Pats!

I’m also a mother, and, out of necessity, I am practical.

I know that breastfeeding isn’t right for every family, which is why it’s important for moms to feel confident about their infant feeding decision, which may including using infant formula.

Unfortunately, baby formula is a source for much maternal angst.

According to a study of 1,900 expectant first-time moms and those with kids one year old and younger, more than 40% of them feel guilty about using formula instead of breastfeeding, which may be why so many of them say that they’re willing to overspend on formula. Sixty-eight percent (68%) believe a heftier price tag for formula means that it’s a better quality product than store brands, such as those sold by Target and Walgreens.

That’s not true.

According to the Food and Drug Administration, all formula marketed in the U.S. must meet the same nutrient specifications, which are set at levels to fulfill the needs of infants. You’re not paying more for better quality; you’re paying more – up to $600.00 a year - for national brand packaging and advertising.

The American Academy of Pediatrics suggests breastfeeding for one year, or longer. But the reality is that more than 80% of moms use infant formula exclusively until solid foods are introduced or they supplement with formula within the first six months of lfie.

I fed my three kids breast milk and infant formula, sometimes on the same day. At the time, I was working outside the home and the breast/bottle strategy made the most sense.

Feeling guilty about what you feed your baby is a heavy burden that no mom should bear. Maybe you wanted to nurse your child and it just didn’t work out. Perhaps you planned not to breastfeed. Whatever your choice, nobody has the right to make you feel bad about it. As long as it’s safe, always do what’s best for you and your family.

Janice and Liz are moms, registered dietitians, and the authors of two cookbooks that I highly recommend for helping you feed your family: No Whine With Dinner: 150 Kid-Tested Healthy Recipes from the Meal Makeover Moms and The Mom’s Guide to Meal Makeovers: Improving the Way Your Family Eats, One Meal at a Time! I love their cookbooks, web page and Facebook page. Enjoy!