Research on Breastfeeding

Thanks to everyone for the great discussion about breastfeeding issues in exercising, dieting women. Let me try to clear a few things up based on what I've read in the current medical literaure. And no one on runango can accuse me of citing "obscure research" this time.

Lacation, diet & exercise

1. Lactating women need 330-500 calories/day more than non-lactating.

This is to address Carrie's comment (I really enjoyed your math, but it looks like you may have overestimated the amount of milk produced per day). I really, really take issue with the BFing taking 500-700 cals/day. The Bois is probably eating 35 - 40oz a day. There are 20 cal in each ounce of milk. So he is ingesting ~700-800 cals, but for sure it must take more cals for your body to manufacture it, KWIM?

The energy cost of exclusive breastfeeding from birth through six months postpartum is 500 kcal/day. This estimate is based upon the average volume of milk produced (780 mL per day), the average energy content of milk (67 kcal/100 mL). In well-nourished women, the energy cost of lactation is subsidized by mobilization of tissue stores (approximately 170 kcal per day) I assume these are tissue stores you have built up during pregnancy... if anyone can explain this better, I'd love to hear it. Therefore, the recommended dietary allowance (RDA) for energy is 330 kcal per day more than nonpregnant, nonlactating women.

DRI, Dietary Reference Intakes: For Energy, Carbohydrate, Fiber, Fat, Fatty Acids, Cholesterol, Protein, and Amino Acids (Macronutrients). Standing Committee on the Scientific Evaluation of Dietary Reference Intakes, Food, and Nutrition Board, Institute of Medicine. National Academy Press, Washington, DC 2005.

2. Most studies indicate that lactation has little effect on post-partum weight loss (didn't come up, but just an fyi). The biggest factor affecting your post-partum weight is how much you gain in pregnancy (see previous posts from when I was pregnant).

1. Brewer, MM, Bates, MR, Vannoy, LP. Postpartum changes in maternal weight and body fat depots in lactating vs nonlactating women. Am J Clin Nutr 1989; 49:259.
2. Dugdale, AE, Eaton-Evans, J. The effect of lactation and other factors on post-partum changes in body-weight and triceps skinfold thickness. Br J Nutr 1989; 61:149.
3. Öhlin, A, Rössner, S. Maternal body weight development after pregnancy. Int J Obes 1990; 14:159.
4. Schauberger, CW, Rooney, BL, Brimer, LM. Factors that influence weight loss in the puerperium. Obstet Gynecol 1992; 79:424.
5. Parker, JD, Abrams, B. Differences in postpartum weight retention between black and white mothers. Obstet Gynecol 1993; 81:768.
6. Greene, GW, Smiciklas-Wright, H, Scholl, TO, Karp, RJ. Postpartum weight change: how much of the weight gained in pregnancy will be lost after delivery?. Obstet Gynecol 1988; 71:701.

3. You need at least 1500 calories/day to maintain your milk supply.

Reduced maternal energy intake has a limited effect on milk volume, unless dieting is extreme. In one study, dietary restriction to 1500 cal per day for one week did not reduce milk production. However, daily milk volume decreased 15 percent when less than 1500 cal per day were consumed.

1.Butte, NF, Garza, C, Stuff, JE, et al. Effect of maternal diet and body composition on lactational performance. Am J Clin Nutr 1984; 39:296.
2. Michaelsen, KF. Nutrition and growth during infancy. The Copenhagen Cohort Study. Acta Paediatr Suppl 1997; 420:1.
3. Hennart, P, Vis, HL. Breast-feeding and post partum amenorrhoea in Central Africa. 1. Milk production in rural areas. J Trop Pediatr 1980; 26:177.
4. van Steenbergen, WM, Kusin, JA, Kardjati, S, de With, C. Energy supplementation in the last trimester of pregnancy in East Java, Indonesia: Effect on breast-milk output. Am J Clin Nutr 1989; 50:274.
5. Brown, KH, Akhtar, NA, Robertson, AD, Ahmed, MG. Lactational capacity of marginally nourished mothers: relationships between maternal nutritional status and quantity and proximate composition of milk. Pediatrics 1986; 78:909.
6. Imong, SM, Jackson, DA, Wongsawasdii, L, et al. Predictors of breast milk intake in rural Northern Thailand. J Pediatr Gastroenterol Nutr 1989; 8:359.
7. de Kanashiro, HC, Brown, KH, Lopez de, Romana G, et al. Consumption of food and nutrients by infants in Huascar (Lima), Peru. Am J Clin Nutr 1990; 52:995.
8. Orr-Ewing, AK, Heywood, PF, Coward, WA. Longitudinal measurements of breast milk output by a 2H2O tracer technique in rural Papua New Guinean women. Hum Nutr Clin Nutr 1986; 40:451.
9. Prentice, A, Paul, A, Prentice, A, et al. Cross-cultural differences in lactational performance. In: Human Lactation 2:Maternal and Environmental Factors, Hamosh M, Goldman AS (Eds), Plenum Press, New York 1986. p.13.
10. Strode, MA, Dewey, KG, Lonnerdal, B. Effects of short-term caloric restriction on lactational performance of well-nourished women. Acta Paediatr Scand 1986; 75:222.

3. Weight loss does not affect milk production.

Moderate weight loss with or without exercise does not adversely affect lactation (in women with a normal or above normal BMI). In one study, breastfeeding women were randomly assigned to an 11-day program of diet, diet plus exercise, or control at 12 weeks postpartum. Weight loss averaged 1.9, 1.6, and 0.2 kg in the three groups, respectively, while milk volume and composition and infant weight gain were similar during the short study period.
Longer periods of dieting are also had no adverse effect. In one report, 22 of 33 women who completed a 10-week weight reduction program lost an average of 5 kg. Daily milk production was similar at the beginning of the study and 10 weeks (759 versus 802 mL).

1. Dusdieker, LB, Hemingway, DL, Stumbo, PJ. Is milk production impaired by dieting during lactation?. Am J Clin Nutr 1994; 59:833.
2. McCrory, MA, Nommsen-Rivers, LA, Molé, PA, et al. Randomized trial of the short-term effects of dieting compared with dieting plus aerobic exercise on lactation performance. Am J Clin Nutr 1999; 69:959.
3. Butte, NF. Dieting and exercise in overweight, lactating women. N Engl J Med 2000; 342:502.

5. Your current BMI won't affect milk production.

1. Dewey, KG, Heinig, MJ, Nommsen, LA, Lonnerdal, B. Maternal versus infant factors related to breast milk intake and residual milk volume: The DARLING Study. Pediatrics 1991; 87:829.

2. Butte, NF, Garza, C, Stuff, JE, et al. Effect of maternal diet and body composition on lactational performance. Am J Clin Nutr 1984; 39:296.

3. Michaelsen, KF. Nutrition and growth during infancy. The Copenhagen Cohort Study. Acta Paediatr Suppl 1997; 420:1.

6. You won't lose bone mineral density for good.

Bone mineral content declines during lactation, and compensatory remineralization occurs after you stop breastfeeding and normal cyclical menses start again.

1. Kent, GN, Price, RI, Gutteridge, DH, et al. Human lactation: Forearm trabecular bone loss, increased bone turnover, and renal conservation of calcium and inorganic phosphate with recovery of bone mass following weaning. J Bone Miner Res 1990; 5:361.
2. Lamke, B, Brundin, J, Moberg, P. Changes of bone mineral content during pregnancy and lactation. Acta Obstet Gynecol Scand 1977; 56:217.
3. Specker, BL, Tsang, RC, Ho, ML. Changes in calcium homeostasis over the first year postpartum: Effect of lactation and weaning. Obstet Gynecol 1991; 78:56.
4. Sowers, M, Corton, G, Shapiro, B, et al. Changes in bone density with lactation. JAMA 1993; 269:3130.

7. Exercise doesn't affect milk production

Specifically, aerobic exercise does not affect milk volume. In a randomized trial, volume and composition of breast milk and infant weight gain were comparable for exercising lactating women and controls.

Dewey, KG, Lovelady, CA, Nommsen-Rivers, LA, et al. A randomized study of the effects of aerobic exercise by lactating women on breast-milk volume and composition. N Engl J Med 1994; 330:449.

8. Protein and mineral content of milk do not change with the mother's diet. Fat and vitamin content DO change with a mother's diet.

I regreted my oatmeal diet when I read this.

See Uptodate Article Maternal nutrition during lactation by Nancy F. Butte, PhD for #8 and more on this subject.

Switching to Solid Foods

1. The optimal time to start adding solid foods is 4-6 monts of age. There is no nutritional advantage before this and the baby needs the tongue and neck motor skills that allow safe eating.

s.a and mommy dearest had some concerns about introducing solid foods too early. Here is what I learned.

Interestingly, one study notes that by 4 months of age, most infants usually have doubled their birth weight. When infants have doubled their birth weight, and weigh at least 13 pounds (5.9 kg), they may need to begin supplementing their liquid diet with additional foods to support growth and satisfy hunger [10] . The Bois actually doubled his birth weight (to 12 lbs) a long time ago and he now weighs 14.8 lbs... I no longer blame my diet or exercise for his hunger!!!!!

Committee on Nutrition American Academy of Pediatrics. Supplemental foods for infants. In: Pediatric Nutrition Handbook, 4th ed, Kleinman, RE (Ed), American Academy of Pediatrics, Elk Grove Village, IL 1998. p.43.

Holding off on the introduction of solid foods until after the infant is 6 months of age may cause decreased growth because of inadequate caloric intake, iron deficiency, delayed oral motor function and/or dislike of solid foods.

1. Committee on Nutrition American Academy of Pediatrics. Supplemental foods for infants. In: Pediatric Nutrition Handbook, 4th ed, 2.Kleinman, RE (Ed), American Academy of Pediatrics, Elk Grove Village, IL 1998. p.43.
3.Guthie, HA. Introduction of solid foods – Part 2. Consequences of early and late timing. In-Touch 1998; 15:1.
4.Underwood, BA, Hofvander, Y. Appropriate timing for complementary feeding of the breast-fed infant. A review. Acta Paediatr Scand Suppl 1982; 294:1.
5.Illingworth, RS, Lister, J. The critical or sensitive period, with special reference to certain feeding problems in infants and children. J Pediatr 1964; 65:839.

The Benefits of Breastfeeding

This is just a reminder of the many, MANY benefits of breastfeeding. Popular media can sometimes make it seem like there is controversy over whether or not breastfeeding has advantages for the infant... but read below and hopefully you will agree with me that it should be a CRIME to not breastfeed an infant if you are able to do so...

1. Increases IQ (measured at 27 years of age)

Breastfed ≤1 month: 99.4
Breastfed ≥1 to 3 months: 101.7
Breastfed 4 to 6 months: 102.3
Breastfed 7 to 9 months: 106.0
Breastfed >9 months: 104

Prevents

1. gastroenteritis

2. respiratory disease

3. otitis media

4. urinary tract infections

5. sepsis

Provides long term benefits against

6. obesity

7. cancer

8. coronary artery disease

9. allergic conditions

10. diabetes mellitus type 1

Improves

11. neurodevelopmental outcome

12. cognitive development

13. visual function

14. hearing function

15. stress reduction

See Uptodate article Infant Benefits of Breastfeeding by Richard J Schanler, MD

Of course, I'm not even getting into the maternal and economic benefits.

So what am I going to do with this information? Eat a more varied diet, supplement The Bois with formula until he's four months (that's is a little over a week) and then start rice cereal fortified with iron (assuming he has good enough neck and tongue control). And again, I don't blame my diet or exercise for the inadequate milk supply considering how much he has grown since his birth and what a little artist he is.

Milk supply problems

Sunday night, after giving up the diet and eating the most amazing homemade quiche, my milk supply ran out. The Bois had breastfed half an hour earlier, but then started screaming inconsolably. We thought he was tired, so we put him in bed, but he just kept screaming. This is very uncharacteristic for him. I put him on the changing table, where he always laughs, smiles and plays. I even blew the hairdryer on him, but he could only muster a desperate attempt at smiling and laughing through the torrent of tears and screams. I was very worried. Finally after an hour of screaming (which has NEVER happened), I suggested we make a bottle. We gave him a big 8 oz. bottle of formula and he calmed down, laughing and smiling again. He had never needed so much milk when I had none!

I felt so horrible. I took the diet too far. I wish I would have known about the minimum of 1800 calories a day earlier. And honestly I should have been eating more fat and protein. I managed to eat a lot over the weekend and gained about a pound.

Now my milk supply seems to be almost back to normal, but it's still not enough to meet his needs. I'm not sure whether to blame myself or to believe he just needs more calories now.

Happily he seems unaffected by the whole thing: He's still laughing like a sheep and at less than four months he rolls front to back and back to front and can put a nook back in his mouth! I'll spare you more first-time parent bragging for now :).

I'll leave you with some picture from our mountain hike adventure with the kids...

I hope you all had a great weekend.

Dieting, lactation & black strap molasses

I talked to Jane in lactation and confessed everything about my caloric intake, my current weight and the amount of exercise I do. Let me first say it is amazing what you can learn by talking with someone educated on the subject. In the age of the internet, person to person exchange of knowledge is sadly often overlooked.

Also I want to say thanks to Olga for writing about her experience with lactation and weight loss (see comments to last post).

Here's what I learned from Jane:

- The group of women she sees the most trouble with milk supply in is long-distance runners, she admits that some of it may be dehydration, but she suspects most of it is caloric deficiency.

- You need at least 1800 calories a day when you are breastfeeding. She gave me the same number for breastfeeding and running, interestingly. She also said losing 2 lbs a week sounded like a healthy amount (not that I will continue losing that much, I just thought it was interesting).

- It is very hard to produce vitamin-deficient milk because everything that is needed is stripped from your body. Fat content can go up in your milk if you eat more fat, but doesn't necessarily go down if you eat less. Also, if you don't get enough protein, you can hurt yourself (muscle breakdown).

- Anemia is common in breastfeeding women and she recommends molasses as an iron supplement. (Molasses is a byproduct from the making of refined sugar and contains all of the vitamins and minerals that are taken out of sugar). She said it's great on oatmeal. :)

- The baby will let you know by tugging at the tit consistently at feeds if he/she isn't getting enough milk

Here is some info about black strap molasses (from The World's Healthiest Foods):

I'll have to give it a try.

I have noticed that The Bois seems hungrier than usual the past week, and now I may have an explanation. I need to get at least 1800 calories a day for him, and for my own good, I need more protein and more iron.

Little Daniel Boone deserves the best.

The Oatmeal Diet

I've received some requests for all the details of the oatmeal diet. So whether you want it or not, here it is in all of it's glory (or foolishness)...

It has gone through a slight metamorphosis since it's inception, which I wrote about previously.

First of all, I buy oatmeal in the 100 calorie packets, some "regular" flavored, some "sugar free maple."

Breakfast:

3 bowls (1.5 packs each) of oatmeal with sprinkle of TVP and sprinkle of fiber one cereal.
480 calories
3 pieces of lefse
90 calories

1 viactiv chew
20 calories

Lunch
2 wraps consisting of 1 piece of lefse, 1 piece of tofurkey, slice of tomato, bunch of sprouts, one carb ketchup and mustard.
75 calories each!

Dinner

Large bowl of oatmeal with TVP and fiber one cereal
550 calories
One and a half medium sized acorn squash.
250 calories
one viactive chew
20 calories

Total Calories 1560

My basal metabolic rate = 1300
Lactation plus excercise = 1500

Net loss: 1420

While this may be a lot of calories for someone who is not exercising 2 hours a day and not breastfeeding, it is easy to eat less oatmeal or less gords as needed to suit your personal weight loss needs.

Skinny & Happy

Turns out I can't stop losing weight. I'm down to 111 lbs, 9 lbs less than my pre-pregnancy weight. Clearly the oatmeal diet works. And apparently breastfeeding does make weight loss easier. We ate lots of rich food in Washington DC (stayed at a wonderful B&B), ate out (actually all really healthy food), but when I was hungry for a snack, I ate oatmeal. I ended up losing 2 lbs there. And I continue to wake up lighter every day.

Not a bad problem to have, but I am a creature of habit (as you may have noticed). Now that we're back home, I can't get myself to stop eating my oatmeal, acorn squash, sprouts, tomatoes and lefse. I have been adding TVP to the oatmeal, which helped with the protein situation. And supplement bananas, apples, tofu and cottage cheese as needed. But there just aren't many calories in those. And, of course, I should mention that breastfeeding burns 500-700 calories a day.

So how thin is too thin? I think I'm actually where I want to be, but don't want to stop the diet! The thing is, I pride myself on being a strong woman who can run ultras and swim miles at a time, but I like the fact that I'm losing weight without trying. And SR is giving me tons of positive feedback (no one minds being called "gorgeous skinny b####"). Although he does find all the oatmeal and gords a bit weird.

Dare I say staying at a healthy weight is as challenging as losing weight? At least I find this to be true while I'm breastfeeding. So now that my BMI (18.2) is underweight, I've probably got to stabilize, but I still feel healthy and strong. And the lighter you are, the faster you can run, to a point. From the information I found on the internet, Paula Radcliffe's BMI is 18.0, so I probably don't want to be below that.

Stay tuned, I'll hopefully end up staying at this weight, which seems about right for me. And if you're feeling adventurous, try the oatmeal diet and let me know how it works for you.

Washington DC

We went to Washington DC last week for the national internal medicine jeopardy competition. SR was on a team that represented our state. Since I have known SR, he has impressed me with how quickly and accurately he remembers medical trivia and eponyms. Am I possibly the only woman out there who is turned on by this? :) I guess it runs in his family as his dad was actually on Jeopardy in Denmark and won.

Sadly, SR's team didn't get to advance to the second round. But that didn't stop us from having fun in DC.

Kanlaya Thai

The White House

Looking like normal tourists

Of course our trip involved a lot of running. On the second morning, we took a running tour starting in Rock Creek Park.

To The Potomac

And of course it wouldn't be a vacation if we didn't have a photo of us staring lovingly into each other's eyes.

We did make the mistake of driving 16 hours there. The poor Bois. 3 month olds don't get excited about road trips like the young adults of America and Europe who fancy themselves wandering and spontaneous. He's looking a bit haggard here.

And he's got parents who both like to steer the ship, chose the route and plan the day.

But somehow we made it through the trip still in love.

And we were so proud of how little we spent. Plus, the car ride lent itself to many Danish lessons for me and French for SR. I want so badly to speak Danish like I speak English, but of course that takes some work if you live in an English-speaking country. Oh, how I adore challenges.

And I would be lying if I said The Bois didn't have a good time. At least with his dad.

Running Song of the Day: Désenchantée by Mylène Farmer

We are on a little trip to Washington DC. Can't spend the last night writing, though. I'll just say we're squeaky clean after our family bath. I'll write and post pictures when we get home.

50k Relay Win!

It's fitting that the first win I mark in my running book is our win. This 50k relay consisted of a 13 mile technical, hilly part in the woods (which I ran) and an 18 mile double loop on wide open land (which SR ran). There were mixed, male-male and female-female teams.

The weather was a perfect47 degrees with no wind and not a cloud in the sky. We could see the flawless reflection of houses and sky on the lakes in the area. We drove quite a while to get there with step-daughter and The Bois. We had to stop for a bathroom break just before we arrived. Step-daughter is not crazy about going in the great outdoors. The Bois was the only one smart enough to wear a diaper.

Upon arrival, we saw the ultra running types warming up and chatting next to cars with license plates such as TRL RUN. As seems to be the norm with longer races, there were people from all over the US.

I made the strange decision to wear a brand new pair of trail running shoes. My left leg had been bothering me so much on Thursday that I had thought I couldn't run the race. I didn't run on Friday so I had no idea if I'd be able to run at all. I made the decision that new shoes would mean pressure on a different part of my foot and therefore potentially less pain in my leg. Plus they were cool-looking shoes.

50kers and 50k relayers all took off at once.

I realized quickly that my feet were going numb. My shoes were too tight! I just kept running on the stumps thinking it would have to get better. And after the first mile it did. Amazingly, my left leg felt almost normal.

Once we ascended a steep climb into the woods, I felt like a gazelle,young and strong and free. I smiled to myself as I jumped over and around rocks and roots, sand and pine cones.

SR, step-daughter and The Bois drove around to meet me at 5 water stations! SR kept telling me I was the fourth woman and I could take it slower. He seemed to think we would win even if I had a bad day.

I continued to pick up speed and passed a woman and two guys after the half-way point. At the end of my leg, I ran with a guy who is a running coach in Colorado. After he joined me, he said, "I kept trying to catch up to you so I could tell you that I think you have talent for this. You are going so fast and it doesn't look like you're working at all." I smiled. Of course, if I really had talent, I'd be the first woman, but anyway... I talked about running that very trail pregnant and and he talked about overcoming ALL (acute lymphoblastic leukemia) recently. He was 51, used to be sponsored by Nike (!) and had bounced back to racing again.

We talked about getting old. I told him that stiffness was one of the wost diseases of the elderly. He looked at me and smiled. He said he told his clients to visit nursing homes and observe: "you don't have to be immobile just because you're old" he said.

I finished as the 3rd relay woman and received The Bois reverse baton from SR. He took off after calmly explaining The Bois was in dire straights and needed some milk.

I sat with step-daughter and breastfed The Bois. Many people looked and smiled. Luckily there was no problem with the milk supply this time.


By the time SR finished the first loop, he was ahead of all the relayers and 50kers.

I sat and talked and played and had a great time with step-daughter. SR came in 16 minutes ahead of the next relayer. We won with a time of 3h59 minutes on the dot.

The first 50k finisher came in not too long after SR. He was a very large man, very strong, who was from Germany. It looked unreal that this Arnold Schwarzenegger-type (pre Governor days) would win, but win he did.

We had BBQ and received our awards and all went home happy.

I got my first mother's day present from step-daughter and could hardly fight back the tears. We really mean a lot to each other now. There is no turning back... and I am so happy about that.

Feeling weak

On Monday, I returned to the oatmeal diet (see Postpartum Diet & Fitness post). And boy does it work. Yesterday after my run I weighed 51.1 kg or 112.6 lbs. I am almost 8 lbs less than my pre-pregnancy weight. Of course I am thrilled, but feel sore everywhere. I thought it was just my legs from the race, but then I went swimming today and my left arm felt sore and lame. Another sign that I am not getting a well-balanced diet is I am getting sores in my mouth. Add to that the continuous bleeding I'm having from the IUD and you'll understand why I'm not myself.

We have a 50k relay coming up on Saturday. We will be passing of The Bois off as a baton (reverse baton). I am worried though about how weak and sore I feel, so I am going to eat a big proteinous dinner tonight and start adding textured vegetable protein (TVP) to my oatmeal.

Obviously some other things are missing from this crash diet, so I will need to modify. I'll let you know what I come up with.

Just got back from a bike ride with The Bois. I'm trying to return to a car-free life. Now that the weather is nice, it should be easier. Last year I went 6 months without filling my car with gas (before I met SR) and I'd love to be able to do that again. Ideally, I'd like to live completely off the grid, but that would not be easy, especially when it comes to convincing the step kids. I do contemplate what the world will be like in a few short years when we can't travel by car, when our resources have run out. Of course we talk about alternative energy, but the world is going to change dramatically as fuel runs out.

I've been slowly weaning myself from buying new things (craigslist makes this much easier), but there are certain things it's hard to go without buying new (running shoes for example).

In other news, The Bois has begun to laugh like a little sheep.

He is being held here by a friend who we call Magma.

(You're probably thinking I bought his outfit new, but I haven't bought any new clothes for him... again, craigslist is great!).

Finally, the blog has become even less anonymous. Today I was sitting in an auditorium at the hospital before SR gave a Grand Rounds presentation and one of the residents shouted to me "SLG, my wife loves your blog! She was so upset when you made it private!" I got incredulous and intrigued looks from the many members of the audience, some of whom may be reading this right now.

Bike riding song of the Day: Indianer by Danser med Drenger

Half marathon 3 months post-partum

Yesterday SR and I competed in a half marathon in the area. I was so nervous about it that I didn't want to say much in the blog beforehand. It was a rainy, windy, cold, muddy day. But that didn't seem to deter many people; there were over 350 participants.



We ran in a team for our hospital. I lined up next to a teammate, a competitive runner I was friends with from medical school. I have a secret long-standing goal of wanting to beat him in a race (little did I know today would be the day). SR, of course, lined up at the front. He was, after all, the winner of this event last year.




The gun went off. As I started running, I just kept thinking about how I needed to keep a 7:08 pace the whole race. That was the fastest we figured I was capable of for 13.1 miles. I ran the first mile in 6:45 and felt really good. Somehow I believed I could keep it up. The second mile was even faster. It was a straight path over mud and bridges, mud and bridges. The miles flew by at first, but then I slowed down to a more than 7 minutes per mile pace. My knee started hurting and I found myself just wanting the race to be over. The knee has really been bothering me since the ultra 3 weeks ago. But, it wasn't just my knee; I was tired, really tired.

Aren't these races supposed to be fun??? Two women passed me. I was crushed. I kept telling myself to try to enjoy the race and do my best. But I wanted to get to the end to see SR and get home to see The Bois. I put the same Nik og Jay song on over and over to put myself in a trance, trying to go the same speed until the end and not get passed by another woman.



I finished in pain, in 6th place. 3 places higher than last year! I guess I'd be lying if I said I didn't have a good time.








My time was a minute and a half slower this year: 1h36m on the button, but it was most likely slower conditions. I was shocked to see the male winner of the race two years ago come in right behind me.

It took me a second to remember what I was doing and where I was. I realized SR would be around there somewhere. Then I spotted him. Step son and step daughter were there, too along with their mom. They got to see their dad win the race. SR seemed happier about that fact than about actually winning the race.

The most amazing part of the race was that someone found our camera at the end of the trail, where it had been sitting for a week (we thought we had lost it). They turned it on and saw a picture of SR, knew who he was and handed it to him.

On the way home, SR mentioned he was disappointed in both of us. His time was also a couple minutes slower than last year. He's the only person I know who would be disappointed in himself after winning such a big race. And he said he thought I could have gotten second. He just pushes both of us because he believes we can do well. And it makes us train harder. But all I knew was I was worn out; it was the ultra three weeks ago, the weight loss and, of course, The Bois. But, in the end, I'd be much more worn out if I didn't have the joy of running.

We gathered The Bois from the babysitter and went to take a nap. SR fell asleep immediately. I was so exhausted but buzzing from the race; I couldn't sleep. I just sobbed. I don't really know why.


I did think about how much I like ultras in contrast to half marathons. Today I missed the long, meandering trails through beautiful landscape. Maybe I'll focus more on ultras in the future (I've always felt I'd be more cut out for those) . We actually did just sign up for the 50k on Angel Island by San Francisco in July. Needless to say I'm excited about that.

sealegs grandma

****before I start the post, I just want to say thanks for all the info generated about the bike trailers; I respect how all of you mothers and non-mothers out there feel about putting an infant in a bike trailer. I don't want to convince anyone out there to do it if they are not comfortable with it. Without research into the safety of this, it's difficult to make a recommendation either way. I put my recommendations in the last post about safety for those of you who do want to use the trailer in this way. Of course, if you live in a state with helmet laws, you will be breaking the law if you do it (because you certainly should not put a helmet on an infant), and I don't encourage that! So, Nancy #1, you make a good point.****

So, I am sad today because SR is gone. This is the first time we have been apart for more than a day since July (when I was in Residency in Oklahoma) and I just hate it. We made a little pact back then that we wouldn't ever again be apart from each other for more than a day. Well, I had to take ACLS (advanced cardiac life support) renewal and he had to take ATLS (advanced trauma life support) and the courses were in different cities, his lasting two days.

Every time the phone rings, I think it's someone calling to tell me he got into a car accident.

Before he left, we just stood there kissing on the stairs, not wanting to say good-bye. And as he was getting into his car, we gave each other a look. A look that said we love each other and there is nothing more important.

My mom sort of witnessed all of this. She has been here helping out with The Bois. She said for the first time last night: "I have it straight in my mind now, that you are in a better relationship with SR than you were with ex-husband. You wouldn't have had any trouble being away from ex-husband for days at a time."

In fact, she loves SR. She said "He cooks, he cleans and he's great with kids... what woman wouldn't love that???"

Perhaps that's when it got a little weird. Later when she heard the phone ring, she got all giggly and said "I bet that's SR!" She answered it with a mischievous school girl voice "Hello?"

"My lady?" SR said, thinking it was me. And my mom had to hand it over.

SR and I do joke about my mom and his friends flirting with him, loving his suave foreign doctor ways and his great cooking. But it's all in fun. And I think the truth is my mom and her friends are just glad to see me so happy.

All that being said, my mom is questioning SR's idea of the two of us taking The Bois on a trip climbing and camping on Mount Whitney (highest peak in lower 48). She has nightmares about it, in fact. I honestly know nothing about taking infants up to high altitudes. I'll have to (of course) do some looking into it before we commit.

The perfect father.

The mischievous grandma.

The young revolutionary.