Online sources of information:
- A food “sensitivity” is either an “intolerance” or an “allergy” to a food protein.
- An allergy causes hives, breathing problems, and low blood pressure. Food allergy is rare in babies.
This document describes the management of food intolerance.
Common food intolerances that make babies fussy includecow’s milk protein, soy protein, eggs, wheat, rice, corn, beef and nuts.
- Cow’s milk protein intolerance is most common. This is often called milk-soy protein intolerance (MSPI).
- Lactose intolerance involves milk sugar (not protein) and is rare in babies. Deficient lactase enzyme is the problem.
Don’t commit to a difficult elimination diet until you've condsidered these things.
Symptoms of Food Intolerance
There is no single test to nail down the diagnosis of food intolerance.Try to be patient and report symptom changes accurately. The doctor will rely on experience, judgement, trial and error to sort things out. Change just one thing at a time to avoid confusion about what is making the difference.
Symptoms occur because the protein molecule of the bothersome food makes its way to the breastmilk and inflames your baby’s gut.
- Fussiness is a key symptom for most of your baby’s awake time, even during and after feedings.
- Grunting behavior is common, due to gut inflammation. Your baby acts like he needs to poop, but the grunting persists after he passes gas or stool. Your baby might spend more time grunting than not grunting, even while sleeping.
- Blood in the stool should be reported. If your baby is consolable and otherwise well, don't panic, as it's fairly common, even without an intolerance. Sometimes there's blood in the stool that can be detected only by a special stool test.
- Mucous in the stool is common, and can be normal, if it’s the only issue. Combined with other symptoms, it may be considered a problem.
- Spitting up, skin rashes and nasal congestion are common in babies, but may indicate a food intolerance.
Maternal Elimination Diet
1. Symptoms of food intolerance are often “dose related,” so if you simply eat less of the problem food, symptoms improve. Since cow’s milk protein is the most common cause of food intolerance, a logical first step is to avoid obvious milk products, such as milk, cheese, yogurt, pudding, butter, etc. If symptoms improve, continue avoiding these foods.2. If symptoms do not improve after eliminationg obvious dairy, read labels to avoid hidden milk protein in processed foods.
- NOTE: If symptoms are severe, consider reading labels first to get symptoms under control sooner. Then, slowly add milk back into your diet as you monitor for return of symptoms.
- Once you eliminate the problem protein, symptoms should improve within 2-3 days, but it may take a week or two for your baby’s gut to heal enough for symptoms to resolve.
- If you accidentally eat the problem protein again, your baby’s symptoms usually reappear within a few hours.
- Note that soy LECITHIN and soy OIL are fats, so you can eat them while avoiding soy protein!
5. Do not eliminate several things at once. A severely limited diet may result in weight loss and decreased milk supply.
6. A history of an eating disorder makes an elimination diet risky, as it may trigger prior symptoms of the eating disorder.
7. One of the many benefits of breastmilk is that the large variety of proteins and other substances in your breastmilk desensitizes your baby to these proteins, so your baby can tolerate a wide variety of foods in the future.
Babies that develop intolerances typically outgrow them, but eating can be challenging until then.
Research on the prevention and management of food sensitivities is ongoing, and there’s a great deal of confusion, and sometimes unnecessary “rules,” about what to eat or avoid while pregnant and breastfeeding.
Stay tuned!
An Elimination Diet - How to Get Started
A local experienced Mom, Amanda Feser, provides the following information to get you by as you figure things out!
Things you CAN eat!
- Milk: Almond, Oat
- Yogurt: Soy or Almond milk yogurt in smoothies
- Butter: Earth Balance soy/dairy free buttery spread
- Bread: Rotella, Orowheat whole grain bread
- Wraps: Egglife wrap ( www.egglifefoods.com )
- Meat: Fresh meat, chicken, fish, bacon, Dilusso deli meat, most fresh deli meat
- Cereal: Honey Nut Cheerios, Life, Kix, Captain Crunch, Chex
- Snacks: Tortilla chips (most), Wheat Thins, Ritz Crackers, Zesta Saltines, Rold Gold Pretzels, Smart Pop, Boom Chicka Pop Kettle Corn
- Sweets: Oreos, Duncan Hines cake mix, Enjoy Life brand cookies and candy bars, Annie’s Vanilla Sugar Cookies, Non-dairy Ben & Jerry’s, Jiffy Corn Bread Mix made with Almond Milk, Pillsbury Dark Chocolate Brownie Mix or Fudge Supreme Premium Mix.
Meal ideas to prepare at home:
- BLTs
- PB&J
- French toast
- Eggs, bacon, sausage, toast
- Cheese-less pizza: Mama Mary’s thin and crispy pizza crust, pepperoni, vegetables
- Spaghetti: most noodles are safe, Prego Roasted Garlic & Herb Sauce, Hamburger or Johnsonville Italian sausage, Rotella bread with safe butter
These words indicate the presence of
milk protein,
so AVOID these things.
---Yogurt, custard, pudding, ice cream, sherbet, nougat
---Milk and cream: milk protein, milk solids, powdered milk, dry milk, evaporated milk, condensed milk, cultured
milk, sour milk solids, buttermilk, buttermilk solids, milk derivatives, malted milk, acidophilous milk, lactaid,
lacteeze, homogenized milk (1%, 2%, whole, skim, low fat, non-fat), half & half, sour cream, whipped cream.
---Butter: whipped, solid, artificial or natural butter flavor(diacetyl) butter flavored oil, ghee. [Note: Cocoa butter is OK!]
---Cheese: processed, cream cheese, feta, ricotta, cottage cheese, quark, cheese curds
---Casein: hydrolyzed casein, casein hydrolysate, rennet [Note: “non-dairy” items may contain casein]
---Caseinates: ammonium, calcium, magnesium, potassium, sodium
---Whey: delactosed whey, demineralized whey, whey protein concentrate
NOTE: These words suggest possible
cow’s milk protein:
Flavorings (brown sugar/caramel/natural), chocolate, high protein flour, margarine, Simplesse
NOTE: “Lact….” means milk.
Avoid foods that contain these “lact…” words:
lactose, lactalbumin, lactalbumin phosphate, lactulose, lactoglobulin
Don’t avoid foods with lactate, lactylate
Ingredient list above is from “Food Allergies in Babies in Children” by Janice Jonega, PhD, RD
Tacos for dinner!
Old El Paso Taco Shells or Mission Corn Tortillas
Add water to drained, cooked hamburger
Add spices: 1½ TBSP Cumin 1 tsp Chili powder
1½ tsp paprika ½ tsp garlic powder,
1½ tsp salt, 1 tsp pepper ¼ tsp cayenne pepper
Guacamole with cilantro, onion, cayenne and tomato
No bake oatmeal cookies
1/3 cup sugar 2 tsp cocoa
2 TBSP almond milk 2 TBSP peanut butter
¼ tsp vanilla ½ cup quick oats
Stir together sugar, cocoa, and milk and microwave on high for 1 ¼ minutes until boiling, stirring once.
Stir in PB and vanilla, and then oats. Drop onto wax paper. Freeze.
Local Food Establishments
who are helpful for special diets:
- Goldenrod Pastries: dairy and soy free
- MoMo: has a binder with menu ingredients
- Red Robin: has a helpful allergen menu
- Source Eat Fit: ingredients are listed
- Piedmont Bistro& Venue: very accommodating
- Fazzoli’s: Pasta, Italian sausage, Marinara
- Lazlo’s: Steak or Salmon without butter.
- Taco Bell: Fresco bean burrito, Fresco chicken or steak soft taco
- Wendys: Spicy Chicken sandwich, Nuggets, Hamburger & Fries
- Chipotle: Everything except Sofritas, cheese and sour cream
- Jimmy Johns: Bread, chips, meats/toppings OK. No cheese or mayo.
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