(OT) Nursing an allergic baby, Mom goes on 'total elimination'

[Guest guest]

To try to ease her nursing daughter's severe digestive

problems, Associated Press writer Boone tried eating only a handful of

foods and adding new ones, one at a time.

BOISE, Idaho (AP) -- About the only thing I knew for certain when I

had my daughter last December was that I would breast-feed. Every parenting

book I'd read and every childbirth class I'd attended emphasized nursing's

nutritional, developmental and emotional benefits for babies.

Boone, with Nina, ate only organic turkey, rice and squash.

What I didn't know was one important thing: Some babies are allergic to

foods found in their mother's breast milk, and my baby was one of them.

As a first-time mom, I didn't recognize the warning signs. Nina's frequent,

anguished crying was colic, I figured, and her runny nose and chronic diarrhea

were just the result of her first bug. Her difficulty nursing? That was

probably just me not " doing it right. " And I assumed she woke up

every 40 minutes during the night because she just hadn't learned how to sleep

yet.

At first, Nina's pediatrician eased any fears I had. My daughter was growing

like crazy, and developmentally was right on track. But when the diarrhea

failed to go away after a month and a half, and blood started appearing in her

diapers, we visited a pediatric gastroenterology clinic and got the news: Nina

had a severe food intolerance to dairy and soy products.

An estimated 6 percent to 8 percent of children under 3 have food allergies,

according to the U.S. National Institute of Allergy and Infectious Diseases. A

minority of those experience digestive-tract symptoms, ranging from pain and

diarrhea to internal bleeding, chronic inflammation, extra tissue growth and

failure to thrive.

Some good news: Most babies outgrow this type of allergy by preschool.

Unfortunately, there are no easy tests to determine just what the offending

foods are. Breast-feeding mothers typically rely on " elimination

diets " - cutting out some common allergens and seeing what happens.

" It gives the child the best chance for outgrowing the allergy, "

our nurse practitioner, Barbie Doherty at Idaho Pediatric Gastroenterology,

told us.

Cutting dairy, soy first

Under her supervision, I cut all traces of dairy and soy from my diet and began

keeping a food journal.

But Nina didn't get better. She got worse -- more internal bleeding, more

pain and more sleepless nights that left us both in tears.

Nina's doctor advised cutting more allergens from my diet. I began

avoiding wheat, eggs and nuts, which along with dairy and soy cause the vast

majority of food allergies. And because my food journal suggested they might be

causing symptoms to flare, I also avoided fish, shellfish, citrus fruits,

tomatoes and corn.

It was hard, but gratifying when Nina's chronically runny nose and eyes

cleared. Her intestines continued to bleed, however, and her pain continued. I

looked in my pantry and realized: Thousands of foods, additives and preservatives

remained in my diet, all of them suspect.

At Nina's appointment that week, Doherty and I discussed my options. Nina

could either go on an expensive hypoallergenic formula until she outgrew her

food intolerances, or I could try a " total elimination diet, " eating

only a handful of foods and adding new ones, one at a time.

Remember all those " breast is best " baby books? I did, and chose

the total elimination diet, or TED.

Doherty supported my choice, but reluctantly. She'd seen few parents in her

practice who had succeeded with this method, and she noted that there is

limited research on its effectiveness.

There's no clear consensus on TEDs among doctors. Some, like ,

a clinical professor at the University of Washington and chairman of the allergy

and immunology section for the American Academy of Pediatrics, say total

elimination diets are seldom the best way for breast-feeding moms to deal with

food allergies.

Turning to formula

" I can think of times when it might be beneficial to eliminate classes

of foods, such as milk and soy, but if you have to do more, why continue to

breast-feed? " said. " You're going to have to limit yourself

so much that you could possibly cause nutrition problems. "

Don't Miss

National Institutes of Health: Food allery overview

Kids With Food Allergies: Food allergy

support

Ask Dr. Sears: Advice from pediatricians

generally recommends hypoallergenic formulas, instead.

Critics warn that elimination diets can prolong a child's suffering while

the mother tries to select the right foods.

But Dr. Bill Sears, an associate clinical professor of pediatrics at the

University of California, Irvine, School of Medicine, is a proponent of total

elimination diets to allow continued breast-feeding.

" It's only been in the last 10 years that it's been appreciated that

these babies don't have just colic, " he said. " A colicky baby is a

hurting baby, and 90 percent of the time they hurt for one of two reasons:

Either they have a food intolerance or reflux or both. "

Parents should develop a food-allergy treatment plan only under a doctor's

care, health experts note, and should get their baby a complete exam to rule

out more serious health problems.

My husband and I talked it all over.

The formula wasn't covered by our insurance, and it would cost about $800 a

month - more, as Nina grew. Not only could the TED save us a ton of money, it

also would mean that Nina would get the other benefits of breast milk, such as

fewer ear infections.

Our decision was made, and I picked my new menu: organic turkey, rice and

squash, seasoned only with canola oil, sea salt and black pepper.

The first few days were kind of fun, as I sought new and interesting ways to

combine my few ingredients.

Nutrition worries

At the end of the first week, however, I'd lost close to 10 pounds and

realized I needed to eat more. I bought a rice steamer for work and a deep

fryer for home, frying either the turkey or the squash in canola oil at least

once a day for a calorie-rich meal.

I worried that Nina wouldn't get enough nutrition from my breast milk on

such a restricted diet, but a call to a lactation consultant assured me that I

would have to be on the TED far longer than the few months I had planned for my

milk supply to suffer.

The goal was to get Nina symptom-free and then add foods back into my diet

slowly, watching her for any adverse effects. I daydreamed about pears,

envisioning them baking for dessert, sweetening my rice cereal in the morning,

serving as a compote for baked turkey. After the pears I planned broccoli, more

for its nutritional super-food status than anything.

Your Health Tools

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For support, recipes and firsthand experience, I turned to Web sites run by

organizations like Kids with Food Allergies. Lots of moms were nursing on

nothing but turkey, rice and squash, or other TEDs, I realized.

Jen Maidenberg, a mother of two in West Orange, New Jersey, dropped to only

four foods plus olive oil and sea salt for four weeks because her son,

9-month-old Oliver, suffers from severe food intolerances.

" The most challenging thing was not being able to get something quick

to eat when I was out. When you're nursing, you get hungry a lot so you have to

be prepared, " she said.

Maidenberg eventually had to switch Oliver to formula. But she said the TED

improved her own health as well as his.

" I'd been diagnosed with IBS (irritable bowel syndrome), but I discovered

it's clearly some sort of food because it cleared up on the diet, " she

said. " This is the best I've ever felt in my adult life. "

Maidenberg discovered that milk, wheat and gluten make her IBS act up.

Ultimately, although Nina improved, she was still bleeding occasionally

after two months on my total elimination diet. We then learned that a mild

bleeding disorder was complicating her reactions, and she was on the extreme

end of the food intolerance spectrum.

Doherty and I agreed to switch to the prescription formula.

I battered myself with questions: Had I weighed the risks and benefits of

breast-feeding correctly? Would it have worked if I'd tried quinoa, blueberries

and zucchini, or some other magic combination? I was proud I'd been able to

stick to the diet, but I was heartbroken that it hadn't " fixed " my

baby's illness.

Gradually, however, I've come to realize: Despite all the baby books and

expert advice, each child responds differently. Nina healed slowly on the

formula, but she healed.

At the very least, the TED saved us the roughly $1,600 expense of a

two-month supply of prescription formula. At best, I gave Nina some benefits of

breast-feeding until she was 4 months old. And when we try solid foods (a

landmark I hope is just around the corner), I'll have a better idea what we can

try right away and what will have to wait a year or two. E-mail

to a friend

http://www.cnn.com/2007/HEALTH/10/10/nursing.diet.ap/index.html?iref=mpstoryview