I have not commented yet on the power of support that other mothers can provide when you are struggling to determine if breast feeding can continue while your infant's food allergy continues.
The support of many moms is what assisted in getting through 5 weeks of bloody diapers to now 2.5 weeks of no bloody stools.
Thank you Moms!
I encourage everyone to talk about what is going on with your little ones to other moms because their support and wisdom made the difference in my successful continuation of breastfeeding.
This week - I have added an article on food allergy and use of probiotics in the resource section: http://www.ncbi.nlm.nih.gov/pubmed/9042042
It took 4 days after the cease of bloody stools and addition of probiotics for the mucus in her stools to cease. She is tolerating the primadophilus reuteri by Nature's Way quite well despite the statement on the bottle: "May contain trace soy and m
Friday, August 27, 2010
Sunday, August 22, 2010
Week 3-4: The challenge
It has been about 2 weeks since Olivia has had a bloody stool. Yeah! So this week starts the challenge.
When completing an elimination diet it is recommended that you challenge the food for 3 days before moving on to the next food. If symptoms arise you must cease intake of the food and wait for symptoms to clear.
I decided to start with eggs because I really miss eating breakfast out with friends. I can always order fresh fruit and poached egg (poached to avoid the potential butter used in a pan) but just fruit and tea is currently unacceptable.
Which foods you start with really differs with each practitioner. I like to start with foods you suspect are not a problem to allow easy addition of foods every 3 days.
The challenge plan:
Aug 22nd: Egg
Aug 25th: Tomato
Aug 28th: Almonds
then black beans, peaches, citrus, corn, peanuts, shellfish, quinoa every 3 days.
I will likely (unless recommended otherwise by her doctor/s) not reintroduce to my diet soy and dairy until she is at least 6 months old as this is very likely the source of her allergy.
I am also not challenging gluten foods due to my own intolerance....I have not eaten gluten in over 5 years.
When completing an elimination diet it is recommended that you challenge the food for 3 days before moving on to the next food. If symptoms arise you must cease intake of the food and wait for symptoms to clear.
I decided to start with eggs because I really miss eating breakfast out with friends. I can always order fresh fruit and poached egg (poached to avoid the potential butter used in a pan) but just fruit and tea is currently unacceptable.
Which foods you start with really differs with each practitioner. I like to start with foods you suspect are not a problem to allow easy addition of foods every 3 days.
The challenge plan:
Aug 22nd: Egg
Aug 25th: Tomato
Aug 28th: Almonds
then black beans, peaches, citrus, corn, peanuts, shellfish, quinoa every 3 days.
I will likely (unless recommended otherwise by her doctor/s) not reintroduce to my diet soy and dairy until she is at least 6 months old as this is very likely the source of her allergy.
I am also not challenging gluten foods due to my own intolerance....I have not eaten gluten in over 5 years.
Monday, August 16, 2010
Week 2: Professional Opinion
I was able to speak with the Pediatrician earlier this week and he had spoken with Peds GI doc who recommends powdered Primadophilus by Nature's Way. I noted when I went to purchase it that it is dairy/soy free but can contain traces of milk and dairy.
He is not sure about the Pancreatic enzymes as only 1 of the docs recommends this and it is not a general practice.
They both think that it is still cow's milk protein allergy.
An interesting article title Guidelines for the diagnosis and management of cow’s milk protein allergy in infants (http://adc.bmj.com/content/92/10/902.full ) suggested for breastfeeding mothers to avoid dairy for 2 weeks and up to 4 weeks before evaluation.
I have now been avoiding dairy for 4 weeks as of last Friday August 6th. Her last episode was on Sunday August 8th pretty close to the 4 week time table.
I don't regret starting an elimination diet so soon because after 2 weeks there was no resolution and I wanted to continue breastfeeding. I am being careful to include foods from each group daily and will soon add the foods back in.
I did start a Calcium supplement (found that Vitamer brand - private label for many natural food markets is allergen-free).
Dinner tonight:
Grilled chicken with potato salad (potato, black olives, chopped blanched zucchini, blanched onion, white wine vinegar, EVOO, salt, pepper, basil)
Sliced pears
He is not sure about the Pancreatic enzymes as only 1 of the docs recommends this and it is not a general practice.
They both think that it is still cow's milk protein allergy.
An interesting article title Guidelines for the diagnosis and management of cow’s milk protein allergy in infants (http://adc.bmj.com/content/92/10/902.full ) suggested for breastfeeding mothers to avoid dairy for 2 weeks and up to 4 weeks before evaluation.
I have now been avoiding dairy for 4 weeks as of last Friday August 6th. Her last episode was on Sunday August 8th pretty close to the 4 week time table.
I don't regret starting an elimination diet so soon because after 2 weeks there was no resolution and I wanted to continue breastfeeding. I am being careful to include foods from each group daily and will soon add the foods back in.
I did start a Calcium supplement (found that Vitamer brand - private label for many natural food markets is allergen-free).
Dinner tonight:
Grilled chicken with potato salad (potato, black olives, chopped blanched zucchini, blanched onion, white wine vinegar, EVOO, salt, pepper, basil)
Sliced pears
Wednesday, August 11, 2010
Week 2: Found it!
I have been searching and searching for a soy/dairy free probiotic for Olivia and myself.
A few articles have indicated use of Probiotics to assist with immune function in the infants' gut as a means of decreasing reactivity to large food proteins.
Ther-Biotic®Infant Formula at by Klair labs (www.protherainc.com)
I phoned the company to ensure soy/dairy free and reviewed a document confirming testing of dairy free -
http://www.protherainc.com/images/prod/labanalysis/K-TIF%20Lot%200506502%20Milk.pdf
The professional price is reasonable: 15.50 per bottle (2.5 oz)
Klair labs also produces a line of hypoallergenic vitamins - which I have also been searching for:
VitaSpectra is an interesting formula (for me not Olivia):
It is a powdered multiple vitamin/mineral supplement typically used for for children with Autism Spectrum Disorders. So it is formulated for someone following a gluten-free/casein-free diet. It is also hypoallergenic: VitaSpectrum™ is free of common allergens, including milk/casein, fish, shellfish, tree nuts, peanuts, wheat/gluten, yeast, and soybeans. No starch, maltodextrin, stearates, artificial sweeteners, colors, flavors, or preservatives are used.
Before starting either of these I want to talk to the Pediatrician and I want to finish the 2 week elimination diet. We are still waiting to talk to the gastroenterologist - we will see.
A few articles have indicated use of Probiotics to assist with immune function in the infants' gut as a means of decreasing reactivity to large food proteins.
Ther-Biotic®Infant Formula at by Klair labs (www.protherainc.com)
I phoned the company to ensure soy/dairy free and reviewed a document confirming testing of dairy free -
http://www.protherainc.com/images/prod/labanalysis/K-TIF%20Lot%200506502%20Milk.pdf
The professional price is reasonable: 15.50 per bottle (2.5 oz)
Klair labs also produces a line of hypoallergenic vitamins - which I have also been searching for:
VitaSpectra is an interesting formula (for me not Olivia):
It is a powdered multiple vitamin/mineral supplement typically used for for children with Autism Spectrum Disorders. So it is formulated for someone following a gluten-free/casein-free diet. It is also hypoallergenic: VitaSpectrum™ is free of common allergens, including milk/casein, fish, shellfish, tree nuts, peanuts, wheat/gluten, yeast, and soybeans. No starch, maltodextrin, stearates, artificial sweeteners, colors, flavors, or preservatives are used.
Before starting either of these I want to talk to the Pediatrician and I want to finish the 2 week elimination diet. We are still waiting to talk to the gastroenterologist - we will see.
Monday, August 9, 2010
Week 1: Trouble in Paradise
Ahhh. Bloody stools this AM.
To be descriptive it was a large breastmilk stool with some orange looking streaks in it. I think it is blood? Her stool also seemed to be more watery than usual as if she was having some diarrhea.
Every-time this happens it just breaks my heart and I have to ask myself - Am i doing the right thing? do I continue?
Reading an article in J Pediatr Gastroenterol Nutr. titled Food-induced eosinophilic proctocolitis. 2000;30 Suppl:S58-60.I saw it can take 72-96 hours (or 3-4 days if your brain does not feel like doing the math) for resolution of blood.
If I go back that far it could be from the meal eaten out - argh - potential cross contamination.
Also on another note-
I found this interesting article about maternal use of pancreatic enzymes to treat blood in stool- will have to discuss with pediatrician.
http://journals.lww.com/jpgn/pages/articleviewer.aspx?year=1999&issue=10000&article=00069&type=fulltext
To be descriptive it was a large breastmilk stool with some orange looking streaks in it. I think it is blood? Her stool also seemed to be more watery than usual as if she was having some diarrhea.
Every-time this happens it just breaks my heart and I have to ask myself - Am i doing the right thing? do I continue?
Reading an article in J Pediatr Gastroenterol Nutr. titled Food-induced eosinophilic proctocolitis. 2000;30 Suppl:S58-60.I saw it can take 72-96 hours (or 3-4 days if your brain does not feel like doing the math) for resolution of blood.
If I go back that far it could be from the meal eaten out - argh - potential cross contamination.
Also on another note-
I found this interesting article about maternal use of pancreatic enzymes to treat blood in stool- will have to discuss with pediatrician.
http://journals.lww.com/jpgn/pages/articleviewer.aspx?year=1999&issue=10000&article=00069&type=fulltext
Sunday, August 8, 2010
Week 1: Search for new foods
It has been 5 days on the elimination diet and myself, a foodie, is struggling with boredom on this diet.
I found it is important to add color to my plate to ensure I will not be having a brown and white meals all the time (ie a plate of chicken and brown rice.)
Summer Seasonal Colorful foods to add on the elimination diet phase:
Yellow and green summer squash
Avocado
Greens:Chards, Kales, etc.
Plums
Berries (except strawberries)
Broccoli (Olivia does not have colic or I would reduce the amount of these)
Yams/Sweet potatoes
Also not forgetting the power of presentation - laying foods in the plate differently can change it up.
I made a rub for the BBQ lamb last night of Organic B. Sugar, Ground ginger, Ground cinnamon, Salt and Pepper which seemed to be a major treat and served this with summer squash and a nice large salad - no dressing this night. Yum!.
So far so good - Olivia appears to be doing better on this diet, time will tell.
She had a Pediatrician appointment on last Wednesday and her weight was up 10 oz in 1 week. Wow!
We also had lab tests done to ensure she is not becoming anemic from blood loss or is having insufficient absorption of protein - all normal.
Here was a great post from Dr. Greene's webpage encouraging continued breast-feeding: http://www.drgreene.com/qa/milk-allergy.
I found it is important to add color to my plate to ensure I will not be having a brown and white meals all the time (ie a plate of chicken and brown rice.)
Summer Seasonal Colorful foods to add on the elimination diet phase:
Yellow and green summer squash
Avocado
Greens:Chards, Kales, etc.
Plums
Berries (except strawberries)
Broccoli (Olivia does not have colic or I would reduce the amount of these)
Yams/Sweet potatoes
Also not forgetting the power of presentation - laying foods in the plate differently can change it up.
I made a rub for the BBQ lamb last night of Organic B. Sugar, Ground ginger, Ground cinnamon, Salt and Pepper which seemed to be a major treat and served this with summer squash and a nice large salad - no dressing this night. Yum!.
So far so good - Olivia appears to be doing better on this diet, time will tell.
She had a Pediatrician appointment on last Wednesday and her weight was up 10 oz in 1 week. Wow!
We also had lab tests done to ensure she is not becoming anemic from blood loss or is having insufficient absorption of protein - all normal.
Here was a great post from Dr. Greene's webpage encouraging continued breast-feeding: http://www.drgreene.com/qa/milk-allergy.
Thursday, August 5, 2010
Week 1: Eliminating for Olivia
Olivia was born the end of June and by her 3 week birthday her weight was still below her birth weight and she began to starting to have blood in her stools. So begins learning to eat for Olivia.
I hope this blog will be a resource as I go down the path of discovering Olivia's allergies. I hope to link to articles, websites and recipes that provide a source of information.
Today we start with our dietary story:
As a Registered Dietitian I know all of the nutrition benefits of breast milk but as a first time mom I now understand some women's desire to breast-feed. For me it is a hormonally driven desire in addition to a knowledge driven desire so if I can do it I will.
I hope this blog will be a resource as I go down the path of discovering Olivia's allergies. I hope to link to articles, websites and recipes that provide a source of information.
Today we start with our dietary story:
Week 1 and 2: We eliminated dairy and soy from my diet and continued to have blood in her stool. 1-2 diapers every 3-4 days. Dairy allergy is the number 1 allergy in infants. (see the kellymom link below)
Now it is week 3 and I have started an elimination diet - no dairy, no soy, no corn, no nuts, no wheat, no peanuts, no eggs. I have also added to this list a few potentials that I had been eating a lot of lately - no tomatoes, no peaches, no citrus, no quinoa.
Because I am needing nutrition for lactation I make sure I have all the food groups represented (except dairy - but I will get to that).and do not restrict caloric intake.
Grain: Brown Rice. Brown Rice Noodles. PLAIN Rice cakes (Tried Quinoa but ended up with a blood diaper within 4 hours - not sure if it was really from the quinoa at this point).
Protein: Organic Chicken, Turkey, Buffalo, Lamb and beans
Fruit: Apples, Pears and Plums and berries (except strawberries)
Vegetables: Sweet potato, summer squash, carrots, celery, all greens (lettuce, kale, etc.)
High Calcium Foods: This is where it gets tough greens are considered high in calcium but remember lactating women need 1000 mg per day. (Reference DRI Tables: fnic.nal.usda.gov)
I plan to include non-dairy calcium sources such as fortified rice milk, greens and molasses (See http://lpi.oregonstate.edu/infocenter/minerals/calcium/ for more ideas)
Here we go.........
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