Helping Children Create a Positive Relationship With Food

The development of lifelong eating habits begins in infancy. Children who have a positive relationship with food struggle less with poor food choices and body image concerns.  The Division of Responsibility is an approach to raising healthy eaters developed by Ellyn Satter, a renowned Registered Dietitian Nutritionist and Family Therapist.

The Division of Responsibility is tailored to a child’s developmental stage. Parents and children are responsible for different aspects of feeding, and children assume more responsibility as they age. Infants choose feeding times and volumes, while parents select breast milk or formula. Parents of toddlers are responsible for offering balanced meals and snacks at regular intervals, and the child is allowed to determine what food items they would like and how much. In addition to giving children autonomy of choice, Satter also recommends occasionally offering chips and sweets to prevent children from prioritizing them over other foods.

Satter’s approach to feeding capitalizes on children’s innate ability to regulate their food intake and gradually accept new foods. Studies have shown some infants adjust how much formula they drink depending on the calorie concentration. The higher the calories, the less volume they take in. On average, children must be exposed to a new food 10 times before they will choose to taste it, and possibly a few more times before they accept it. The process is slow, but when children experiment with new foods at their own pace they develop a positive relationship with food and gravitate toward balanced meals.

Whether you are just starting to plan your approach to feeding, or are currently embroiled in conflict at the dinner table, Ellyn Satter has a multitude of resources to help. Free information is available through The Ellyn Satter Institute.

Other good resources include Fearless Feeding and Creating Healthy Eaters.

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We’re updating our space!

We always want the very best for our patients and their families–you deserve it! That’s why we are updating the entire Childbirth Center with new flooring, new paint, new fixtures and a remodeled lobby.

We are working on the unit in sections, so if you are visiting us within the next two months, you may notice some parts of the floor look different from others. So far, we’ve completed the lobby renovation and a couple of the patient hallways. In these next several months we will continue the updates.  The contrast between old and new is easy to see, and we’re so pleased with the fresh new look. We hope you like it, too.

Thank you for your patience during this project that will last until October. Overlake remains committed to your experience throughout this renovation, while also building toward the upcoming Project FutureCARE and an entirely new Childbirth Center in 2020.


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Pelvic Floor Therapy

You may have heard about or even experienced physical therapy (PT) for back, shoulder, knee and foot issues, but have you heard of PT for your pelvic floor?

Many women suffer from pelvic floor pain after giving birth. Some women have pain even before they get pregnant. Injury to the pelvic floor muscle can lead to leaking of urine, feces or pelvic joint pain over a period of time.

Your Pelvic Floor – Why it Might Hurt

Your pelvic floor consists of the group of muscles between your hips, which cradle your bladder, uterus and rectum. After giving birth, those muscles are sometimes injured or torn and can be tender. Pain in this area can also be from spasms and scarring following birth. Additionally, women may also experience pain during sex.

Pelvic Floor Therapy to the Rescue

The good news is that there are trained PT professionals—pelvic floor therapists—who specifically treat pelvic floor dysfunction including pain in the vagina, leaking and pelvic joint problems (also known as pelvic girdle pain). A pelvic floor therapist can help you stay healthy and pain-free before, during and after pregnancy. During pregnancy, she can treat pelvic, back, shoulder and foot pain. Some women see a pelvic floor therapist during late pregnancy for help stretching the pelvic floor muscles in preparation for birth.

Therapy treatments vary based on your particular circumstances. You may only need pelvic floor exercises (often called Kegel exercises), which often require specialized instruction to be done correctly. Or, treatment can be much more extensive, including pelvic floor massage and pelvic girdle joint treatment using various PT techniques. More advanced treatment, especially if you have sexual pain, involves working with you and your partner to help reduce sexual pain to meet your intimacy goals.

Finding Help

If you think you would benefit from pelvic floor therapy, ask your health care provider for a referral. Overlake has several  physical therapists trained as pelvic floor therapists who can help.

You might also consider taking a Pelvic Floor Fitness class geared specifically for expectant and new moms. For more information, contact Family & Community Education at 425.688.5259 or send an email.

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Team Overlake Raised Nearly $28,000 for March of Dimes

March for Babies_Team PhotoThe 2016 March for Babies walk proved to be one of the best yet, with more than 100 members of Team Overlake in attendance in their pink shirts and sunglasses. This year’s team pulled together to raise nearly $28,000 for March of Dimes research, which focuses on maternal
health, preventing premature birth and supporting babies in NICU. Led by the Childbirth Center, Overlake has supported March of Dimes for the last four years, and was the top area fundraising team in 2015. Donations are still being counted, but as of this writing, Overlake is poised to be top area fundraiser again in 2016.

Thank you to each and every person who supported us this year!

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Delayed Cord Clamping at Birth

In recent years, there has been ongoing debate regarding the optimal time to clamp the umbilical cord at birth. The current practice at many centers in the United States is to immediately clamp the umbilical cord at time of delivery. However, numerous studies have demonstrated safety and advantages to delayed cord clamping (DCC), a practice endorsed by the American College of Obstetricians and Gynecologists Committee Opinion statement published in 2012, which recommended DCC in preterm neonates, when feasible. In term infants, DCC is typically considered clamping 60 seconds after birth, typically at 1 to 3 minutes after delivery. In preterm infants, DCC is considered clamping between 30 to 60 seconds after birth. When DCC is performed, a newborn receives a placental blood transfusion that may increase their blood volume by up to 40%. Over time, this transfused volume of red blood cells naturally gets broken down, leaving iron for the body to use by developing cells. In the brain, iron is essential for normal development and is important in helping form the insulating sheaths around nerve fibers, a process called myelination, which increases the speed at which nerve impulses travel.

Based on multiple randomized controlled trials, there are many potential advantages to performing DCC compared to immediate cord clamping in preterm babies, including decreased overall mortality, blood transfusion incidence and the risk of intraventricular hemorrhage. DCC reduces the incidence of intraventricular hemorrhage by nearly 50%, thereby preventing one case of intraventricular hemorrhage for every 15 neonates treated.  While more studies are needed to better understand the long-term impact of DCC on neurodevelopment, emerging studies continue to demonstrate safety of this natural and cost-effective practice.

As part of the birth plan, I encourage all parents to discuss with our obstetricians and midwives how to optimize their birth experience, which should include a conversation discussing the possibility of performing DCC to promote the benefits of placental transfusion for their baby.


1. Committee on Obstetric Practice American College of Obstetricians and Gynecologists. Committee opinion no. 543: timing of umbilical cord clamping after birth. Obstet Gynecol. 2012; 120(6): 1522–1526.

2. Backes CH, Rivera BK, Haque U, et al.  Placental transfusion strategies in very preterm neonates: a systematic review and meta-analysis. Obstet Gynecol. 2014;124(1):47-56.


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Poem for Parents: The Last Time

This poem has been around for years. The author is unknown, but the thoughts and feelings are timeless.

The Last Time
From the moment you hold your baby in your arms,
You will never be the same.
You might long for the person you were before,
When you had freedom and time,
And nothing in particular to worry about.
You will know tiredness like you never knew it before,
And days will run into days that are exactly the same,
Full of feeding and burping,
Whining and fighting,
Naps, or lack of naps. It might seem like a never-ending cycle.

But don’t forget…
There is a last time for everything.
There will come a time when you will feed your baby
for the very last time.
They will fall asleep on you after a long day
And it will be the last time you ever hold your sleeping child.
One day you will carry them on your hip,
then set them down,
And never pick them up that way again.
You will scrub their hair in the bath one night
And from that day on they will want to bathe alone.
They will hold your hand to cross the road,
Then never reach for it again.
They will creep into your room at midnight for cuddles,
And it will be the last night you ever wake for this.
One afternoon you will sing ‘The Wheels on the Bus’
and do all the actions,
Then you’ll never sing that song again.
They will kiss you goodbye at the school gate,
the next day they will ask to walk to the gate alone.
You will read a final bedtime story and wipe your
last dirty face.
They will one day run to you with arms raised,
for the very last time.

The thing is, you won’t even know it’s the last time
until there are no more times, and even then,
it will take you a while to realize.

So while you are living in these times,
remember there are only so many of them and
when they are gone,
you will yearn for just one more day of them

For one last time.

– Author Unknown

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Introduction of Complementary Foods

Breastfeeding is the best nourishment for infants. The World Health Organization recommends exclusive breastfeeding until 6 months of age. At the same time, the American Academy of Pediatrics (AAP) states that many families introduce “complementary foods or solids” earlier than 4 months of age. Many parents perceive that introducing solids would reduce fussiness. Complementary feedings mean giving baby solid foods that complement breast milk feedings or formula feedings.

The AAP website for parents recommends waiting to start solid foods until the baby is developmentally ready. It depends on the baby’s digestive readiness and developmental readiness.

You’ll know your baby is ready when they:

  • Are able to sit up with minimum support
  • Are able to keep their tongue inside the mouth
  • Their tongue thrust reflux is gone
  • Are eager to participate in mealtime and watch parents and others during mealtime
  • Are able to pinch or grasp things and put it into the mouth
  • Are able to refuse and turn away when not interested in feeding
  • Are able to take pureed food presented from the spoon

Two advantages of introducing complementary foods are that it reduces the risk for iron deficiency, and it lowers the risk for food allergies. In fact, the American Academy of Allergy, Asthma and Immunology recommends introducing complementary foods between 4 and 6 months of age to decrease the risk of developing any food related allergies. Signs of allergies are hives, skin rash, facial swelling, vomiting, diarrhea, wheezing and difficulty breathing. If baby shows no signs of allergic reaction, then a second ingredient food may be added.

When you choose what to give your baby, use a wide variety of food. Baby foods can be prepared at home under clean, sanitary conditions or store bought. The food you give to baby should be rich in iron like iron fortified cereal, meat alternatives or meat. Introduce single ingredient pureed foods like vegetables, fruits, cereal or meat. Babies do not need juice or any added seasoning like salt or sugar.

If baby is uninterested in trying complementary foods, wait and try again in a few weeks. It is a new experience for the baby and should be enjoyable.

Be sure to have a discussion with your child’s pediatrician before introducing any foods.

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What the Affordable Care Act Means For Breastfeeding Moms and Their Families

Lactation Consultants and other health care providers have been lobbying and pressuring lawmakers for breastfeeding protection and promotion for years. Now it’s here, but legislation jargon can be very confusing. Here’s what you need to know:

The Patient Protection and Affordable Care Act of 2010 (ACA) provides provisions to encourage mothers to achieve and exceed their breastfeeding goals, including:

Health insurance benefits to help cover costs associated with providing breast milk to infants, including coverage of breastfeeding education and supplies in non-grandfathered health insurance plans.

Prior to the ACA, the IRS agreed to include breastfeeding supplies as an eligible expense for health savings accounts (HSAs) and flexible spending accounts (FSAs) thanks to the promotion of the American Academy of Pediatrics (AAP).

Coverage for breastfeeding education: As announced in the Health Resources and Services Administration (HRSA) 2011 guidance, breastfeeding benefits for non-grandfathered health insurance plans include pre- and postnatal counseling by a trained provider in conjunction with each child. Women may access comprehensive lactation support and counseling from trained providers. The benefits are available at no cost share to consumers.

Breastfeeding supplies benefits: The ACA requires non-grandfathered health insurance plans to cover the cost of breast pump rental or purchase at low or no cost to consumers.

Insurance Coverage: The breastfeeding coverage applies to all health plans except grandfathered plans. Under the law, 23 preventive health services for women are to be covered with no copayment, co-insurance or deductible in non-grandfathered plans. Many private employers already cover these services. For more information about Women’s Preventive Health Services visit

The National Breastfeeding Helpline: The National Breastfeeding Helpline from the U.S. Department of Health and Human Services’ (HHS) Office on Women’s Health has trained breastfeeding peer counselors to provide support by phone. The counselors can help answer common breastfeeding questions. They can also help you decide if you need to see a doctor or lactation consultant. The Helpline (800.994.9662) is available for all breastfeeding mothers, partners, prospective parents, family members and health professionals seeking to learn more about breastfeeding. The Helpline is open Monday through Friday, 9 a.m. to 6 p.m., EST. Help is available in English and Spanish.

What can expectant or new mothers do? 

  1. Set your breastfeeding goals.
  2. Find a pediatrician who is supportive of your breastfeeding goals.
  3. If you are working outside the home, talk to your employer about returning to work. Develop a workday plan for pumping while away from your baby. See a lactation consultant, and plan to attend our Strategies to Provide Breastmilk Through Pumping While Returning to Work class.
  4. Contact your insurance company and ask what exactly is covered and where to go to obtain breastfeeding education and supplies. Some insurance companies let you go anywhere and then get reimbursed, while other companies require patients to go to a specific provider or retailer.
  5. Enroll in a breastfeeding class.
  6. Obtain a breastpump through your insurance, if able. We recommend obtaining your pump after baby arrives as you may need a hospital grade rental pump, and some insurance companies only cover use of those pumps if you have not already obtained a personal use pump. Please contact a lactation consultant at 425.688.5516 to see what pump is best if your insurance gives you multiple options.
  7. Once your baby is delivered, put your baby skin to skin and breastfeed your baby within the first hour. Continue offering your breast often.

Enjoy your baby, and ask for help with breastfeeding if needed. Overlake offers prenatal breastfeeding classes and prenatal lactation consultations. Once your baby is born, you will receive education and assistance with trained nurses and, if needed, lactation consultants in the hospital. After you go home, support continues with your post-partum follow-up appointment. You can also make appointments for one-on-one visits with Outpatient Lactation for further assistance with any breastfeeding issues and needs for returning to work. Additionally, we have a great support group for new mothers called After Baby Comes.

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Overlake’s March for Babies Team Raises Money With Bake Sale

March for Babies_ambassadors

Kaitlin (9) and Makenna (5) are Overlake babies who were both born 4 weeks early; Kaitlin spent 10 days in our NICU, and Makenna spent 11 days there.

Overlake Childbirth Center’s March of Dimes Team hosted a bake sale on the Overlake campus this past Wednesday and raised $1,389 toward their goal of $25,000!

Last year, Overlake’s team received first place for fundraising.

The March for Babies is an annual event that raises money for The March of Dimes. The 2016 walk will be held April 30 at Fisher Pavilion at Seattle Center. Registration begins at 8 a.m.; the walk begins at 9 a.m.

Click here to donate to the Overlake team.


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