Was it Something I Ate? Food Sensitivities in the Breastfed Baby: Part 3

By Lindsey Hurd, MS, RD, LDN, IBCLC and Owner, Angel Food Lactation & Nutrition, LLC

Last month we probed a little deeper into understanding how mom’s gut influences baby, what causes an unhappy digestive system, and what we can do about it.  From leaky gut syndrome to food sensitivities in baby, maternal dietary modifications have become the first line of defense, despite the inevitable difficulties one may face when narrowing the focus of problem foods. A mom’s diet during pregnancy and during lactation is often a hot topic among anyone close enough to ask questions about her experience… even someone in the checkout line at Target! From your Aunt Sally to your Grandpa Joe, everyone seems to have an opinion about what a mom should and shouldn’t eat.

Often times we hear myths such as spicy foods, cruciferous veggies, beans, garlic, etc. cause excessive gas and GI upset in babies therefore moms should always avoid these foods. What about allergy risks? Shouldn’t moms avoid high allergen foods to reduce the risk of their baby suffering from allergies?  Most importantly for our discussion here, once an allergy or sensitivity in baby has been detected, many foods are considered to be a cause for concern and are encouraged to be eliminated all at once. This is often with no direction into the how, why, or to what capacity… so what’s a mama to do with all of this information? As a Registered Dietitian specialized in lactation related food sensitivities, below are tips and tricks I share with each client I see, via skype or in person, on how to make an elimination diet work for you. 

First Things First…

How do we know when our baby is showing signs of an allergy, sensitivity, or is just ‘being a baby’? Throughout the first few years of life, we go through many phases of maturation, growth spurts, improved function of the internal organs, and cognitive development that lead to variability in bodily functions. As our little ones grow, much like a child or teenager, these phases can be fast or slow, contributing to symptoms signifying the ease or difficulty in coping with such change. When infants have variations in their digestive habits, something many parents have held under strict observance, it can lead to a lot of anxiety and concern about the normalcy of what they see. Each infant’s stool pattern and appearance have individual variations of normal, similar to that of older children and adults. This could be a series of blog posts on its own! For the sake of our discussion on allergies and gut health, the top two signs that tell us something isn’t quite right are the presence of blood and/or mucus in their diapers.  

Digestive symptoms such as these often appear around the 2-month age mark when immunity shifts from maternal based to becoming more dependent on baby. At the onset of symptoms, the presence of blood can become slightly tricky. If accompanied by other symptoms of discomfort, it can be associated with an infection, much like a stomach bug for children or adults. However, once screened negative for infection, the continuous presence of blood, dark brown in appearance, begins to direct us toward mom’s diet as a potential causative factor. Mucus often times is paired with green stools and can signify irritation in the baby’s digestive system. If found independent from blood, this sign of irritation can be associated with food sensitivities. If mucus is found in combination with blood-tinged stools, it can be an additional indicator of an allergy present in baby. As with all abnormal symptoms, it is best to check in with your baby’s doctor to rule out other causative factors, especially those medical in nature. 

To eat or not to eat…That is the question. 

Corn, tomatoes, cow’s milk, OH MY! Often times the prescription for an elimination diet comes with lack of clarity in what to avoid, how to avoid it, and what to eat instead. Moms are so responsive to their baby’s needs that most are quick to do whatever they can to help their baby find a little relief. This, however, can come at the expense of their own sanity and nutritional status. Determining which foods to eliminate requires in depth knowledge in the mother’s specific dietary habits, baby’s specific symptoms, and an understanding in how the two intersect. Most often, moms come to my practice having already eliminated a handful of foods, randomly selected from a list of ‘top allergens’ or a friend’s personal experience with no regard to their intake. Unfortunately, often times this elimination is only partially complete as ‘hidden’ foods are consumed with no knowledge of the allergen’s presence. Listed below are the top 4 steps toward completing an appropriate elimination diet and getting you and your baby on your way to tip top shape! 

1. Recruit your support team. Find evidence based blogs, peer-to-peer support, a personal chef, cooking classes, and most importantly a registered dietitian experienced in lactation related food sensitivities to help you as you progress throughout this process. Having your toolbox full of resources will definitely be the best investment of time and energy in getting you back in control of your diet. Organizing your course and plan of attack, prior to removing potential allergenic foods, will help with efficiency and the level of control during this unpredictable process! 

2. Create a food log & symptoms log. Personalization and preservation are the two top goals for me as a professional working with moms on elimination diets. For 3-4 days, I recommend keeping a log of every food and beverage you consume, the time of consumption, and the time and type (breast or bottle) of feeding for your little one. Additionally, it is best to log the time and type of symptoms you see. Although this can be a huge undertaking, it is the gold standard in narrowing down potential causative factors in mom’s diet. 

3. Take it one food at the time. Finding purpose in each action we take can release our reactionary response of jumping in with both feet. When offering little thought into the aftermath of this technique, we find that as the allergy symptoms begin to fade, we are left with confusion and uncertainty of the true offender! This can make the road toward reintroduction very tricky and sometimes unsuccessful. To preserve your sanity and protect your preferred food selection, it is best to choose one food to eliminate at a time. It is frequently stated that 2-3 weeks are required to see a complete recovery from an eliminated food. While this statement is valid in some cases, for many, improvement appears within 24-48 hours after food elimination begins. Visualizing this change on a short-term basis allows for continued elimination until baby is well and the preservation of mom’s diet is honored… especially when meal preparation and planning are difficult enough! 

4. Reintroduce when the time is right. Unless otherwise directed by your pediatrician, do not fear the process of reintroduction! Permanently eliminating the food from your diet does not allow your baby the opportunity to build up adequate immunity toward this food prior to consuming it directly via solid foods. Before considering this step, allow time for your baby’s body to heal and demonstrate its ability to be symptom free for 2-3 weeks. This is most important prior to initiating this final step. Once successful, begin with the least offensive food and reintroduce in small amounts, eating a portion once per day, or once every other day. Give this step 3-5 days and if all is well, continue down the list until your diet is back to normal. It is important to keep great inventory of your intake and your baby’s symptoms via your food log to keep a good hold on what’s going on just in case symptoms resume. If your baby begins to show signs of intolerance, back off slightly until he/she is symptom free again, holding steady at the highest stage possible. Give your baby’s immune system a couple days to settle into this allergen load. Once ready, begin again, slowly introducing as tolerated. 

The key to success during an elimination diet is personalization, education, patience, and breastmilk! Despite having a potential allergen or sensitivity within mom’s milk, the immune boosting cells, digestive enzymes, and anti-inflammatory properties, to name a few, far surpass the effects of the sensitivity... especially when considering the potential harm from alternate sources of infant nutrition. For most, the benefit of breastmilk is crucial in the continued development of baby’s immune system and in prevention of further concern down the road. Although this process varies for each mom/baby dyad, the steps toward successful elimination hold true for each case. 

Want to find out more? Visit www.angelfoodlactationandnutrition.com to schedule a Skype consult with Lindsey and begin your journey toward better health and a happier baby today! Want to stay connected between posts? Find Angel Food Lactation & Nutrition on Facebook at www.facebook.com/angelfoodlactationandnutrition for current articles, events, fun discussions and more!

Was it Something I Ate? Food Sensitivities in the Breastfed Baby

Witten by Lindsey Hurd, MS, RD, LDN, IBCLC, and Owner of Angel Food Lactation & Nutrition, LLC

From a gassy gut to red inflamed skin, breastfeeding moms often question the influence of their diet on behavior and symptoms in their little one. There’s no denying the influx of food sensitivities and allergies in children and adults, but what about the smallest members of our society? In my practice, I see many families who have infants showing signs of food intolerance, often times leading to symptoms such as eczema, bloody stools, sleeplessness, reflux, digestive discomfort from gassiness, abdominal pressure, and the infamous mucus-filled stool. “Is it something I ate?” mom asks. “Is it a virus or bacterial infection?” “Where did this come from? She was fine a week ago!” The world of food sensitivities is vast and perplexing, yet we are beginning to find our way as we learn more and more from our families each day. Over the next few months, I will be sharing a little insight into theories of why we are seeing this influx, how babies receive components of mom’s diet in her milk, and what we can do about it. 

What’s With The Influx??

There are many theories aiming to define the cause of food allergies, however none have been proven as fact. Some include the hygiene hypothesis, the dietary fat hypothesis, antioxidant hypothesis, and the vitamin D hypothesis. The hygiene hypothesis discusses our hygiene habits, from our current water system to the use of cleaners and hand sanitizers & soaps. This may contribute to the lack of exposure to pathogens (germs) and therefore suppressing the development of our immune system possibly leading to a greater risk of allergies and sensitivities. The fat hypothesis, vitamin D hypothesis, and antioxidant hypothesis dive further into our dietary intake and focus on quantities of healthy fat consumption and fresh fruit/vegetable intake as compared to a diet consuming highly processed foods, lacking key nutrients that are necessary for optimal functioning of the body.  Regardless of the exact cause, we know the increase in food sensitivities is real. 

Maternal and Infant Immunity

Mothers and babies, although becoming two at birth, are still incredibly connected in their need for one another.  In pregnancy, mom begins to share healthy bacteria, or microbiota, and immune boosting antibodies to her baby en utero. That’s right, before she is even exposed to her new environment! Mom’s amniotic fluid contains these bacterial warriors specifically made for her baby as she learns what she will need to survive in her future environment. As she initiates her swallowing reflex, practicing for her big job of feeding, she begins to lay down the start of her future microbiome. Once baby is earth-side, she relies on her mother’s breast milk to continue this amazing level of immune support as she slowly becomes dependent on her own body to provide protection. 

How does one establish immunity you ask? Mom absorbs something called antigens, or substances that stimulate the production of antibodies from her environment by way of her digestive system and through her nose, mouth, and respiratory system, etc. This creates antibodies to help her fight off any offending bugs or substances that may harm the body. When a mom is breastfeeding, she passes these antibodies on to her baby. Through her breast milk, she offers immunity toward anything that may be harmful in their specific environment. This explains how mom can get sick, but baby remains healthy or contracts a much smaller version of the illness. Given that part of mom’s immunity is based on antigens present in her digestive system, it makes sense to imagine how food can cause the production of antibodies. This is especially true if she is sensitive or intolerant to a certain food. In turn, baby receives these antibodies from mom’s milk and responds to the food in a similar fashion. 

How Do I Know If I Am Intolerant To Foods?

Many children and adults will become intolerant or sensitive to certain foods at multiple points in their life, however these sensitivities come and go with variability in its duration. The key signs of childhood or adult food intolerance are usually digestive or dermatologic in nature. This includes diarrhea, constipation, excessive gas, abdominal pain/bloating, variability in stool appearance, and alterations in skin appearance such as eczema, rash, acne, etc. Many times, adults have experienced these symptoms for so long they are unaware of its presence or feel it is normal for their bodies. Treatments and medications may be chronically used, masking the underlying problem. Therefore, dietary modifications are not pursued, leaving the gut-wrenching effects of these ‘repeat offenders’ present in the body.  

You may be thinking, “Yikes, that’s me!!” If so, congratulations! You have just identified the first step in removing or minimizing your digestive and/or skin related woes from your daily life. Better health is right around the corner for you and your baby… the next step is to determine what the offending food(s) might be. This process is most successful with daily self-reflection of dietary intake and physical symptoms. As always, seeking assistance from a Registered Dietitian specialized in food sensitivities will not only offer reliable, evidence-based information, but also help you navigate through your day-to-day life with new eating patterns! 

As you work through the removal of offensive foods, of equal importance is achieving the optimal gut environment… Next month, we will discuss how food sensitivity alters the maternal and infant digestive system, ways to restore balance, and how mom’s digestion relates to breastfeeding. This is a fascinating concept; you won’t want to miss it! 

Can’t wait a month to find out more? Visit www.angelfoodlactationandnutrition.com to schedule a Skype consult with Lindsey and begin your journey toward better health and a happier baby today! Want to stay connected between posts? Find Angel Food Lactation & Nutrition on Facebook at www.facebook.com/angelfoodlactationandnutrition for current articles, events, fun discussions and more!

Also, check out The Boob Group podcast episode, Breastfeeding the Dairy Intolerance Baby, for more information about food intolerances and breastfeeding.