Q&A: Baby food sensitivities

Sarah has a question that's beyond me, so I hope there's someone out there who can unravel it for her:

"I just wanted to ask you about my son's sleep problems. He's now nearly 11 months old, and he's suffered from gas pains since he was born. I hoped when he was first born that he would start to grow out of it at 6 weeks, as everyone told me he would, but he didn't. If anything, it intensified. He exhibited the classic signs of colic - drawing his knees up and crying. This would happen exactly two hours after he ate (he is formula fed - I tried breastfeeding but after three bouts of mastitis, flat nipples and chronic thrush I gave it up for a bad job), then he would sleep until his next feed. He would then be happy for two hours, then the colicky symptoms then sleep etc etc. As he grew older, at around 6-8 months, he started crying in his sleep at night then waking up screaming and impossible to console. I did think that perhaps he was having nightmares, but my mother in law assured me that he was too young for nightmares, and on the nights he stayed with her he would do this and then burp or pass wind then go back to sleep, so she assumed it was a gas pain problem. Over time, I see now that she is correct in this - when he does it now, I pick him up and generally he burps and then is calm for a couple of hours.

We discovered over the course of time that elevating his legs seems to alleviate the pain. As a result of his frequent wakings and the need to elevate his legs, we've ended up co-sleeping rather than pogoing out of bed every couple of hours to sort him out. I did think that he would grow out of this at 8 months when his digestive system matured, but it still persists. Even eating solids hasn't solved the problem. I suspect the problem may be yeast related - he had problems with this from the breastfeeding days, and he had the last white patches in his mouth at about 7 months. He also has a persistent diaper rash that doesn't clear up with zinc oxide. I haven't tried thrush creams on it yet, but that will be my next port of call. He's eating half a pot of probiotic yogurt a day to try to combat this, but it doesn't seem to be having any effect. As yet, the health professionals seem unconcerned (however, we do live in the UK where extensive testing for digestive abnormalities doesn't happen due to the constraints on the national health system), but since it seems to have not abated at all, I'm starting to get quite concerned about him. He also has a slight wheeze which intensifies when he eats a new food. In case you were thinking it may be milk related, I've tried him on hydrolised protein formulas and lactase drops and these had no effect either. I recently switched him to iron fortified follow on milk and the wind seemed to get a bit worse.

Do you have any ideas on this? I'm at my wits end, having not slept for more than three hours at a stretch for nearly a year...

My gut reaction is that it's definitely dairy related and that she needs to take him off dairy completely, make sure there's no wheat in his diet, and be aggressive about treating the yeast. But I don't really know where to start on that if he's taking probiotics already.

Is there anyone with more experience with food sensitivities, dairy intolerance, celiac, or yeast issues who could offer some thoughts?

Comments

[Colleen]

I haven't faced these issues to the same degree, but I have had to really limit dairy proteins while bfeeding my bubs. I'll share this one thing from my pede (who is an osteopath and studied with Dr Weil for a stretch): probiotics can and should be taken separately from milk products. You can buy powdered probiotics and take greater than the normal dose--I think a naturopath's recommendation would be best. My thought is if you take him off of milk products overall, you can still get the probiotics in there. Also, my son seemed to be fine with goat's yoghurt rather than cow's, if you can find that in your local food store. Hopefully the problem is developmental and even if you don't find the magic bullet, he will grow out of it eventually.

[Lisa M]

It definitely sounds like a protein problem to me. I'm bf'ing a 4 month old, and I had to cut dairy out completely when he was 2 weeks. I was amazed to find out how it takes to work dairy out of your system. I say that because Debbie might not have tried the hydrolyzed formulas for a long enough time.
Every symptom she listed sounds like classic CMA. Try the hydrolyzed formulas for a full month to determine if that helps the problem. Also be sure to look for hidden dairy in other foods he might be eating. Look for any ingredients such as: whey, casein, butter. After his system is free of the dairy proteins, she may be able to add some small amounts of dairy back in.

[Lisa M]

Oops, Sarah, not Debbie. Sorry!
Also, I think Colleen is right on with the probiotic powder. And while I don't think the nystatin works as well as gentian violet for oral thrush, the nystatin cream is excellent for diaper rashes. If her son has a form of thrush that is resistant to nystatin, try some of the monistat-type creams on his bottom.

[Sidney]

My daughter had severe milk allergies starting from her birth. I did not quit breastfeeding because I didn't want to put her on the super expensive Corn malt formula that was my only other option. Most kids with milk (casein) problems have soy problems too. Milk protein allergy has nothing to do with being lactose intolerant. I had to take milk (look for casein on the food labels) completely out of my diet. It sounds to me like it could be milk, take it out of the babies diet for a couple of months. Introduce it again and see what happens. My Mother in law has adult onset Celiac, probe your pediatrician about that. They can do blood tests for celiac. I am lucky that my pediatrician is very familiar with celiac and sees no signs of it in my children, I will have them tested when they are old enought to understand what is going on. Iron and calcium don't mix well, in fact they chemimcally bind together, so I would lay off the iron. I would start by giving him foods you know he can handle (banana's, apples) try the non-dairy casein free non-soy formula, give it some time and see how it goes. My daughter was off dairy from birth to 2 years, at 2 she was able to start eating/drinking dairies and soy with no issues. I yearned for other mom's to talk to about this, and read every spec of literature I could find on casein allergy. My daughter broke out in rashes, passed bloody stools all at the wee age of 6 weeks, it is frustrating and worrisome. I would be very worried about the wheezing as well. Can you see an allergist? They could do simple blood tests that can find these things out too! Best of luck and sorry for the unorganized comment!

[Oz]

I'm breastfeeding my son, so the only dairy he's had is through my milk, but he had trouble with diaper rash & then also blood in his stool and gas issues until I stopped all dairy. He hasn't had diaper rash since then.

When I was a baby, I had a pretty strong cow's milk allergy myself. As I was breastfed, my mom did't discover it until I was a bit older. I had a constant rash on my cheeks (face & bottom), lots of digestive trouble, & often a stuffy nose. She did a total elimination diet - the type where we ate just chicken & rice for a few weeks, then added one food each week until the discovered the culprit (cow's milk & citrus for me, though I mostly grew out of them both). Oh, and yogurt always gave me lots of trouble. It's easier on the digestion if you're not allergic but, if you're allergic to cow's milk, it's not so friendly.

Allergens can stay in the system for awhile, so they can be challenging to diagnose. Lisa M. is right that the proteins stay in the system for up to (or over) two weeks.

If it's an allergy, it's not the same as lactose intollerance. So, lactaid/lacatse wouldn't help, because the allergy is in response to the milk protein itself, not an inability to digest lactose.

I've also heard that lots of kids that have cow's milk allergy also have soy allergies - just another thing to think about, because soy is in lots of places where you wouldn't expect it.

[hedra]

Couple of questions:

1) Fully hydrolyzed formula or partially? What brand?

2) What's the poop situation look like? Just gassy? How often/day? 'a good handful' at a time, or tablespoons? Fluffy, or thin, watery, yogurty, constipated (hard, rocks)?

3) What's the range of foods eaten now? I'd like to see a whole list. Often, it is just a matter of balance if the child just is 'sensitive'. But it can be combinations of things. What's going in?

Lactase drops are highly ineffective for problems of this sort, as they help with sugars, and intolerances are usually (not always but usually) protien-related.

The odds are still good that it is milk or soy protien, as those are the two most common issues. You can look up Milk/Soy Protien Intolerance online. The good news with that is that it is not permanent, though 'outgrowing' is usually in the 2-3 year zone, not months. And there's no further issues with either soy or dairy if it was MSPI. At least not directly.

However, if he has a wheeze, there may be IgE allergies as well.

In either case, strict avoidance is important. Partially hydrolyzed formulas (Alimentum, say), are effective for 75% of kids with dairy allergy or MSPI. However, that leaves 1 in 4 still suffering.

My best (VERY best) recommendation is to go to POFAK.org, buy a year's membership to the message boards (worth every blessed penny!), and start asking there. The boards are filled with highly experienced parents of kids with food allergies and intolerances. Everything from MSPI to FPIES is represented, subtle things, serious things, combinations of factors, etc., etc. They're the resource, period, for 'kid reacts to food'. They know it all - they know the tests, they know the resources, they know the misery.

It could be a variety of other things than dairy, as well. You'll find the whole range there (coeliac sprue is another possible even in infancy, for example). Things I would consider right off:

1) Yeast, but often there's other factors involved with why it's there and what triggers it, and therefore how to respond.
2) Dairy/Soy/CORN.
3) Fructose and other fermentable compounds. Yeah, my favorite. Anything that ferments in the gut is my life, or rather, my kids' lives. And fermentation = yeast.
4) Consitutional sensitivity. I have one of 'those' kids, too. Reaction on first introduction to every blessed food. Followed by decreased reactions over multiple exposures. I only recommend repeating exposures under highly controlled circumstances, though - IgE allergy tends to get worse with exposures, not worth the risk. We did trials in-hospital. And discovered that M is just easily triggered into hystamine reactions without needing any immune system/allergy function involved at all. She gets welts, hives, eczema, and mucousy diarrhea from anything and everything. It isn't allergies, it's 'dermatographia' plus 'cold-induced urticaria' ... basically, she's allergic to change. Seriously - friction, movement, temperature, or new foods, all kick off hystamine. FORTUNATELY, this is also usually a temporary condition, and is outgrown in around 5-6 years. Unfortunately for her, it started from birth. I guess she didn't like being born a twin, or being hauled out of me by her butt... I haven't figured out what the 'stress factor was' (there is usually a stress-induced trigger, and I figure either of those would do it! Heck, being BORN would do it, some days!).

Very best of luck. I do know how you feel. I ended up using a blend of alternative stuff (so alternative it has no reasonable odds of success, but still beat the docs to the diagnosis by 3-6 months every time) and mainstream medicine. I cycled foods on a three-day basis for M, who overloaded on anything easily. I did allergy testing, food journaling, yadda yadda yadda. I spent every day scouring POFAK.

And POFAK saved my butt. They pointed me to the best doctors, helped me understand what the tests meant, what to try, when to try it. They walked me through my endless rounds of following one possible diagnosis, then another, working through what was possible, what was likely, what was unlikely. They gave me ideas about what tests to try, and encouragement to try something else when I was frustrated or defeated.

And that's how I got the diagnosis of multiple carbohydrate intolerances for my kids. Stupid Swedish genes, sigh. Lactose, plus fructose, equals not tolerating huge numbers of foods, including things that don't have either of them - inulin, fructans (btw, if that's the issue, the probiotic yogurt may be making things worse rather than better, or at least as much worse as better, equalling same - they almost all have FOS or inulin in them).

Fructose malabsorption is really common (1 in 3 adults, more kids under 3), but only causes 'recognizable GI problems' for about half. I mention it because very few people know about it or understand it well yet. But they will. It's a hot area of research.

Best of luck. POFAK POFAK POFAK. I can give you my theories and commiseration, the lot of them there can give you guidance, support, and ongoing tweaking as you work through what exactly is going on.

[sue]

hmmm..it definitely sounds like there's a yeast problem there, and yeast in and of itself can be a huge problem. I would be inclined to treat the whie patches in his mouth like oral thrush, and apply gentian violet once a day for 5 days. It's nice because it's over-the-counter, painless, and the only real side effect is the baby looks like a blueberry for a couple of days. I'd probably treat the diaper rash with grapefruit seed extract or an over the counter yeast cream like monistat here in the states. With the GSE, you make a dilution of 5 drops per tablespoon of water, and spray or spread on the baby's rash twice a day until the rash is gone. I usually couple this with an olive oil and beeswax lotion to soothe the irritated skin.

I think it's definitely worth trying a dairy-free diet for a while. You can get probiotics in tablet or powder form and use them independantly of the yogurt. In fact, my naturopath recommended that I apply a paste of probiotic powder to my nipples when I had thrush - you could probably do this to the diaper rash. They have probiotic powders that are dosed for kids, so check for those in the healthfood store. If you take him off dairy, make sure to do it for at least two weeks before judging results. If that doesn't work, I'd try wheat, soy, and other really common allergens, but since he's been on dairy based formula the whole time, that seems a likely culprit. If you take him off wheat, also, at least two weeks to see a major difference. When I went wheat-free, I noticed an improvement within 3 days or so and then a big one after two weeks.

If he has a serious milk intolerance or allergy, you probably won't see a difference with just lactase drops. Definitely hit the yeast hard - it's a nasty bug and really tenacious. I wouldn't expect just probiotic yogurt to have any effect at all. If you think he might have a systemic yeast overgrowth, there are some serious candida protocols on the market (google systemic candida protocol) I haven't personally used any of them, but know people who have used them with success.

[sue]

@hedra - I think I know what alternative diagnostics you used, and I have had great success with it as well. After 15 years (!) of trying to get a digestive problem diagnosed, I found out, by way of alternative diagnostics, that I'm gluten-sensitive. Not celiac, but still can't have wheat. It was amazing to have my symptoms disappear so quickly after such a long quest for a diagnosis. phooey on quackwatch, because it worked for me (and several other people I know, too)

[hedra]

Oh, and caution on the terminology. A lot of people are 'self-diagnosed' as having had a dairy ALLERGY in childhood. However, most of them had Milk/Soy Protien Intolerance. The reaction of MSPI is fairly confined - mainly GI, possibly some tendency to increased skin rash (especially cradle cap - enhanced inflammatory process, basically). However, IgE allergy is much more severe, and often crosses all body systems. MSPI often comes with profuse puking and mucousy diarrhea, but may show with just diarrhea or gas/colic at the lower levels.

The wheeze suggests IgE allergy. But MSPI and carbohydrate intolerances may also trigger reflux, which can trigger wheeze (by inflaming the vagus nerve). Confused yet?

Anyway, unless you were diagnosed with a blood or skin test, or had eczema or hives in reaction to dairy, but could never tolerate even the slightest trace as an infant, it is likely to have been MSPI, rather than CMA (cow's milk allergy).

Check in with POFAK, they'll help set that straight. :)

[hedra]

@sue, yeah, probably at least part of it (my alternative practitioner uses multiple methods). And non-celiac gluten intolerance/sensitivity is starting to be recognized, though there's quite some speculation that many people with that issue are actual fructose malabsorbing, but because of the HUGE issues wheat causes, removing gluten (and therefore wheat) resolves a lot. The 'results in 3 days' suggests FructMal, by the way - AND the results additional level in 2 weeks suggests NON-FructMal sensitivity. So, maybe both involved, for you. My kids seem to mainly have FructMal primary (rather than secondary, which is more likely in your case), because they improve 100% on the 4th day - totally normal perfect stooling at that point (celiac and lower grade intolerances usually require 'healing time' to get to full results).

POFAK isn't for alternative stuff, btw - only medical science approaches. But well worth it even if you're alterna-minded.

[Moxie]

How much do I love you guys? I *knew* you people would know this.

[caramama]

I've got a few thoughts, since my little one had a lot of gas/digestive issues and thrush as well...

First, I noticed that when I and the baby were on probiotics, her gas got MUCH worse. I ended up stopping taking it and instead just treated the thrush and ate regular yogurt. I think that in trying to treat yeast, we can overdose ourselves and our babies on it and have other problems because of it. You may want to try cutting it down or out for 2 weeks and see if there is any improvement.

Second, if you and/or the baby are still battling thrush, I HIGHLY recommend taking Diflucan. At this point, it will be a systemic infection and the best way to treat that in you (and in the baby) is the Diflucan. Kellymom.com has good information on it, as does LLL (IIRC).

Third, it might not be milk (as others have suggested). When I myself was having stomach problems (it was lactose intolerance, but not the typical symptoms... oh and burbing was actually my biggest issue), I needed to do an elimination diet, and I had to give it at least two weeks before I added something back into my diet. And as others have said, milk products are in SO many things and you have to cut them ALL out (whey, curds, casein, etc.). Turns out, I also have problems with carbonation (no sodas for me), things like gum and sucker candies that bring in a lot of air, and fatty foods which also apparently bring in air or form gas or something. My baby get more gas with certain solid foods, too, so you should watch out for broccoli, onions, peppers (like green peppers), cauliflower, etc.

Fourth, could it be acid reflux? If it's not the "typical" symptoms, might it be silent reflux? If this is the case, I have heard that "waiting it out" isn't such a great idea because serious damage can be done to the child esophegus (spelling?) because of the acid that continues to get up there. I think that gas can also be part of acid reflux, although I'm not positive.

And finally, I would really keep pushing your doctors (health visitors or whoever) to help you figure out what is wrong. Your child is obviously in distress and hasn't simply out grown it. I might be time to demand that they help you figure it out. And if they can't, demand they send you to a specialist who can. It's my opinion that sometimes we are the only real advocates for ourselves and our children with healthcare professionals, and sometimes we have to keep after them to get the help we KNOW we need.

You have my sympathy! Even our few months of issues was so hard, I can only imagine how hard it would be if it were still going on! Good luck figuring it out!

[sue]

@hedra - I had a simultaneous diagnosis of microscopic colitis (collagenic) as a result of a colonoscopy (I highly recommend getting a colonoscopy to all new moms. it's relatively harmless, but gives you the excuse to nap all day and leave the kids with their dad) at the same time that I had the MRT diagnosis. The GI practitioner's response was to put me on an 8 week course of anitbiotics, which did nothing except give me a yeast infection. The MRT came up wheat, oats, rye, barley, refined sugar, pasteurized dairy, and corn. We do raw dairy, so I cut out refined sugar, gluten, and corn. Maybe it was the sugar that caused the immediate results - switching meant going to primarily maple syrup for any necessary sweetening. At any rate, there's a medical science approved link between microscopic colitis and gluten intolerance. Interestingly, though, the GI never suggested diet changes. They never do. Why change your behavior when you could take a pill?

I'll look into the fructose malabsorption and keep an eye out for a possible connection...

[Cloud]

I just want to second what Hedra said- be careful about the distinction between an allergy (symptoms usually include inflammation and/or rashes, and can escalate to full on anaphylactic shock) and an intolerance (gas is a common symptom). You'll find you communicate much better with your doctors if you don't go in talking "allergy" when your kid has no allergy symptoms.

We had dairy problems while I breastfed. She grew out of it by about 8 months. Symptoms were terrible gas, and when I was still eating a lot of dairy, foul smelling poop (I know- is there any sweet smelling poop? But you probably know what I mean). We haven't really tried Pumpkin (now almost a year) on much direct dairy yet, but she has had some cheese without a return of the gas. Dairy sensitivity in a baby is usually a difficulty digesting the dairy proteins, and most babies out grow it eventually. Lactose intolerance (lactose is the main sugar in milk) is rare in babies. Full on dairy allergy is also rare.

Recently we pinned down some intermittent gas problems- it turned out that when we gave her the bread we eat, which is high fiber, she had gas. I had a major "DUH!" moment, since fiber gives grown ups gas, too.

So I guess I'm saying that dairy would be my first guess, particularly if you're using regular cow's milk based formula, but that it could be other things, too. Keeping a food diary may help you sort things out. I did this with my diet early on, when I was checking to see what was causing Pumpkin's gas. I would write down everything I ate, and also write down gas episodes. It became clear very quickly that dairy was the main problem for us, so I cut that from my diet (with great sadness). We still had some occasional problems that I eventually pinned on garlic.

Good luck, and big hugs! I know how hard it is to suspect that something you're eating or feeding to your baby is causing such discomfort.

[sheSaid]

Hedra convered everything I could think of!

I was going to suggest giving up milk/soy/wheat for him as those are the most common food allergies/insensitivities. Since you are no longer breastfeeding and wouldn't have to give it up yourself it might be a bit easier to control his food intake.

You could also make your own formula for him...
this is the website my Dr. recomended for nutrition for us when discussing solids for our son. But I am not sure I would be willing or able to do all of the things they suggested including making the formula.... Yes I want a healthy child, but I also need a mentally healthy mom :)
http://westonaprice.org/children/nourish-baby.html
good luck!

[attiton]

Rabbit doesn't have any currently known allergies, but I would like to second caramama's suggestion of Diflucan for the treatment of thrush/yeast infections.

We had a wicked bout of thrush thanks to a case of mastitis, and nystatin--as is happening more and more--did nothing for us. Diflucan for us both (as I was breastfeeding) got us back on track. I myself also used the probiotic Florastor which, at the very least, made me feel better about my own digestive tract.

Many sympathetic wishes flowing your way, Sarah!

[Jo-Ann]

My son had the same symptoms at 11 months. He cried a ton and had gas, diaper rash, eczema, throwing up and was very shy. He is allergic to dairy, eggs, peanuts, beef and pork. You can do the elimination diet or see an allergist for testing. It took many tests to figure out of all his allergies. I breastfed so I never tried to find a formula for him. It was very frustrating to watch him suffer and I had to fight with the allergist for the additional testing. It was very worth it because it changed our lives. He is now 3 and still very allergic. We carry an epi pen but he is so different than he was at that time.

I hope it is not food allergies. It is a tough road with some grief and some people just don't get it. I an not being negative. At home it is easy to control the diet.

I wish you all the luck.

[Casey]

My son battled a yeast infection for nearly 6 months (HATE the yeast) and the only thing that really kicked it for us was getting the probiotic capsules and sprinkling it DIRECTLY onto his crotch so it can do its magic. I highly recommend this method. It helped heal him literally overnight.

[hedra]

@sue, yeah, that sounds more 'gluten' than 'fructose malabsorption' - but note that FructMal is a common SECONDARY reaction to other intolerance/reaction issues - common in food allergies, common in celiac, etc. Even slight inflammation or degradation of the lining of the small intestine can set it off. If you tolerate reasonable amounts of maple syrup while avoiding gluten, likely you're not seriously fructose malabsorbing on your own. (Especially if you like the dark amber, strong-flavored stuff. High in fructose. You'd probably notice if that was setting things off again.)

I'm also a diflucan fan, though I've used gentian violet for oral thrush. If it's systemic, it can be really hard to root out. Once you're back in balance, start over. But before then... I'm okay with the harsh compounds at times. I've done the dietary approach to an overgrowth, and it works, too, but the side effects for me were NASTY - like flu, only worse. Massive die-off. Not what I'd do with a kid, most days.

Also note that MANY probiotic blends, even capsule form, include inulin or FOS. That can make things worse before they get better. Also, exact variety of probiotic may make a difference. If you're really unsure, it counts to use the expensive patented varieties (Culturelle, most of the Kirkman stuff, LB 299V (hard to find), Infacol brand in the UK (researched for colic specifically), etc.). We saw the most improvement with B using Culturelle. It also helps digest lactose, for those with lactose intolerance naturally.

I also wanted to reiterate the 'lactose intolerance is highly unusual in infancy and early childhood' thing. My kids DO have moderate lactose intolerance (even early on), and we have both the delayed form (24 hours before symptom onset, less obvious symptoms) and the typical form (15 minutes after nursing, M would cry, curl up, and have diarrhea... yeah, breastmilk high in lactose, dammit... BUT we figured out some management methods that worked, eventually). BUT, that experience is highly highly highly unusual - and even when it happens, it is usually an indication of something else 'wrong' - damage to the gut, not native issues. (We already ran the GI scoping and biopsy rounds with B, exact same profile, GI tract 'odd looking' but no damage even on biopsy, and that was looked at by one of the best pediatric celiac and malabsorption disorders GI's in the entire US, and who is not 'trust the test' but 'trust the child' oriented... if he says it isn't, I'm going to trust him... and our alternative person also said it wasn't - that it was sugars. And hey, six months later, we get ... 'it's sugars'.)

Um, sorry, going on. Yammering. Waiting for a call back on my interview... nerves make me yappy. Even more yappy than usual. ;)

[ACJ]

I can't believe how smart this crew is. Awe inspiring really. Well, that and question-making. What is eczema without gas about then? SJ has it now as an adult and has since infancy. T. developed it shortly after weaning around 6mos so I've assumed it's just hereditary suckiness. She has 2 or 3 patches on her back that seem to inflame and then ease away but of course I haven't tracked food to see if there is a correlation. To be honest, if there is a food issue, I feel like it is easier to live with eczema (okay, mild eczema) than live avoiding a major food group, like wheat. I am not allergic or intolerant at all, so it never occurred to me to that we might have to be food-aware people. Ugh. At the beginning of solids, T. was gassy after me giving her all whole-wheat foods and of course, broccoli but since easing up on the whole grains and going with smaller portions of gas-makers, she has been mostly fine.

Hmm. Any wisdom is as ever, warmly welcomed.

[Amy]

This is a total aside since we're discussing lactose, and Hedra is feeling chatty, (and I don't mean to derail from the question at hand)... but is it possible for sensitivity to come at certain times of the day and not others? If I drink milk in the morning or at night I am a-okay. But if I drink it at say 5pm, I get the worst gas pains. And lately I've noticed that #3 has taken to burping a lot and even occasionally vomiting at bedtime (6-7pm)after a bottle and/or nursing, but not doing it at other times of the day/night. Anyone else seen this?

[Amy]

This is a total aside since we're discussing lactose, and Hedra is feeling chatty, (and I don't mean to derail from the question at hand)... but is it possible for sensitivity to come at certain times of the day and not others? If I drink milk in the morning or at night I am a-okay. But if I drink it at say 5pm, I get the worst gas pains. And lately I've noticed that #3 has taken to burping a lot and even occasionally vomiting at bedtime (6-7pm)after a bottle and/or nursing, but not doing it at other times of the day/night. Anyone else seen this?

[caramama]

@ACj - I developed eczema (on my hands) as an adult when my (non-food) allergies became more sever. (Did not know I had any allergies to cats until I lived with one.) When the seasonal allergens get bad or the dust and cat dander in my office and house get bad, my eczema acts up. When it was first diagnosed, my doctor at the time told me that eczema is linked to allergies, which has held true for me.

Also, when my hands are dry, it acts up pretty bad. The worst is when they are dry and the allergens are heavy. My treatment is to treat the allergies, to moisturize my hands like crazy, and to try to wash them less and never use the antibacterial gel stuff with alcohol. HTH!

[caramama]

@ACj - I developed eczema (on my hands) as an adult when my (non-food) allergies became more sever. (Did not know I had any allergies to cats until I lived with one.) When the seasonal allergens get bad or the dust and cat dander in my office and house get bad, my eczema acts up. When it was first diagnosed, my doctor at the time told me that eczema is linked to allergies, which has held true for me.

Also, when my hands are dry, it acts up pretty bad. The worst is when they are dry and the allergens are heavy. My treatment is to treat the allergies, to moisturize my hands like crazy, and to try to wash them less and never use the antibacterial gel stuff with alcohol. HTH!

[hedra]

@Amy, I was cycling a bunch of thoughts in my head, but what I came down to was a question:

if you have dairy products at 3-5 PM or whatever that point was, did you have any at any point earlier in the day? And how much did you eat at those earlier points?

Digestive enzymes (as your body uses to digest lactose, not relevant to fructose) are produced throughout the day. But people with lower function just have less and they therefore get used up sooner. You'd have to wait for it to reach peak again. Most people who have lactose intolerance (adult onset especially) can consume dairy in moderation throughout the day, but cannot consume multiple servings at one time, or multiple servings too close together. It's possible that AM and PM are sufficiently far apart that they're tolerated well (enough enzyme present) at a single serving, but if you start too much before that, you'll max out the available enzymes before you hit the full servings-worth.

You'd have to test the theory (on a day you don't mind the consequences!) to see if that's it - if you have NO dairy in the AM, do you cope better mid-afternoon? Etc.

I know that a lot of systems have high function/low function patterns around the clock, as well - so there may be a lower motility thing going on (track to when milk supply is highest, and just after that is when digestion is likely to be most efficient, is my guess). Which would affect degree of digestion, maybe.

There are so many variables you'd have to look into - how much fat have you consumed, at what time (fats slow down transit rate which helps improve lactose digestion up to a point), whether you ate anything else 'fermentable' in the past few hours (2-4) like bread, juice, fruit... the list could be really long.

@ACJ, what caramama said. Yes, you can have eczema from food allergies, and a 'delayed form' allergy can just cause eczema without other major symptoms. But tendency toward hystamine reactions, skin sensitivity, environmental allergies, etc., also can all play a role. We treat M's eczema (cat, dairy, friction/cold/etc.) much like caramama does hers - rinse with water, not so much soap, never harsh cleaners, moisturize lightly and often, keep air moist (humidify in winter), avoid saliva exposure (a big issue with kids), low friction low pressure, avoid sun exposure (keep covered with light absorbant fabrics like cotton), treat the allergies or at least avoid triggers, etc.

[sam]

Hedra, I don't know what you do for a living, but whatever it is, I'm sure you are awesome at it. Hope it's good news with the interview, they'd be mad not to snap you up, I'm sure. And thanks for all your input into Ask Moxie.

[Cloud]

Once again seconding Hedra- if you want a probiotic, try Culturelle. As far as I know, it is the only one with clinical studies to back up its claims. We use it to get us through any antibiotic treatments w/o massive diarrhea (antibiotics cause diarrhea because they kill of the friendly bugs in the baby's gut), and also use it anytime she gets a stomach bug- it seems to speed recovery. I also start taking it whenever Pumpkin starts throwing up or having diarrhea. I think it helps me avoid getting the bug. (But that last thing is not clinically tested- just my impression, and hey, I'll try anything to avoid the stomach bug!)

And Hedra, Sam is right- you probably did great on the interview! And remember, if you ever need a second career, you'd make a great baby book writer!

[hedra]

Thanks, guys. I tend to do well in interviews, but I still get nervy. More so when it's a job I could really get into at a company I can imagine working for until I retire. Double-bonus, rare rare rare. Not my absolute dream job, but pretty close.

I write for a living, by the way. Just not baby books. Yet. ;)

[mezzaluna]

yeast imbalance and allergies do go hand-in-hand. i don't quite understand why yet - i saw something recently about yeast growing into long spiky colonies when they're not inhibited by other good gut flora, and then those spikes irritating the gut... but if their population is kept down by competition with good flora, they stay in nice gentle spherical colonies?? anyone else heard anything like this? anyway, just some motivation to deal with both problems at once because they may be the same problem.

it sounds like he does have gut damage, and just eliminating dairy isn't going to fix it all for him... but you can start with that to hopefully alleviate symptoms, and then work on healing from there. my DD had good luck recovering from an egg sensitivity through my milk with probiotics for both of us and cod liver oil for me, as well as my avoiding egg in my diet. i'm sure there are better things you could do, or things more tailored to your case, but that's one possible way to approach it.

time of day - i've been noticing lately for myself that eating wheat at breakfast gives me a low-grade headache. other times of day i seem to be fine?? it reminds me of when i was pregnant and eating carbs at all at breakfast made me nauseous. i assumed in pregnancy that it was related to circadian hormonal cycles and to the time since i late ate.

[sue]

@ACJ -

There'sa hereditary link between excema, allergies, and something else (asthma?), so if you or your husband have any of those, your kids are more likely to get one or the other. As for excema, mine is not food related, but a chemical sensitivity. I always had a little excema, but after working in museum collections management for a few years, it *really* flared up. Previous conservators had treated various artifacts with all sorts of detergents, fumigants, and whatnot. by the time I left that job, I had persistant moderate/severe excema all over my arms, from gently cradling things as I carried them around (even though I always wore long sleeves). It eventually died down to just the typical excema areas (elbows, armpits, etc) but was persistant and didn't go away until I switched to all natural lotion and soap (I make my own, but any oil and beeswax additive-free product will do) AND switched to Charlie's Soap for my laundry detergent. I've tried all manner of "free" detergents, and this is the only one, for me, that doesn't cause a reaction.

So it might be worth your while to try and change your cosmetics and laundry detergent and see what happens. That's much less invasive than dietary changes. Though you have to be strict about it - thanks to t-tapp, I just went down a size and pulled some clothes out of storage. I put them straight on, forgetting that they were last washed before I switched to the Charlie's soap. Within an hour, the excema had come back.

sigh. and now I'm wistful for the career that I was educated for, but can't have anymore because it makes me sick...

[diedre]

I need to chime in with the others and vote for completely cleaning out the diet of all the major food allergens- wheat (gluten), soy, dairy and nuts. If he is allergic, you'll see a difference really quickly (it was 24 hours for us) although it might not completely clear up for a few days, it wont take long to start making a difference.

My daughter had a yeast thing also due to antibiotics during labor and we continue to battle it. If yeast wasnt in bread and beer, I would count it as my nemisis in life! She is allergic to dairy and the powder probiotics for infants in the US all seem to be dairy based. I am b'feeding so I am on some probitocs that are not soy or dairy based. I would try to find some probiotics to give him that are not cultured in dairy or soy, keep the sugar intake really low (yeast loves sugar). We keep the yeast mostly at bay but when we dont, her tummy is all aches and pains. yeast is nasty stuff!

good luck.

[pnuts mama]

@sue- wow, my husband has acute microscopic colitis (has had only one incident since diagnosed THANK GOD) that took us quite a few months to diagnose- originally his primary had us cut out like, nearly every gd food group and (of course) it still didn't stop, and he lost so much weight! we finally went to the most wonderful gastroenterologist who immediately suspected MC, had the colonoscopy/biopsies, knew in a few days that's what it was, was put on meds and boom, all taken care of. as i remember (this was maybe 6 years ago?) he was put on steroids and something else but temporarily- i.e. he is not taking anything now. it could flare up at any time (we were told acute MC is most often triggered by stress) and i'm interested to look into that gluten connection, b/c homeboy loves him some carbs.

as a side note, a few months ago he made the connection that beef was bothering him terribly, so we recently stopped eating beef that is raised factory-farm style (no antibiotics) as well as hormone-free/pesticide free, and he hasn't had any reaction to it, which is wonderful. that is a disease that can scare the living crap out of you (no pun intended), no? whenever he has even the slightest stomach issue i get nervous that it's back- but he has his annual colonoscopy and so far, so good.

[SarcastiCarrie]

My husband cannot drink milk before bed and his mom can't have apples after 5 pm. So, sure, I guess time of day can have something to do with it.

My son had casein intolerance but only cow casein - not goat or human milk casein. At almost 3, he's mostly grown out of it. I didn't realize it until we weaned to cows' milk after a year. I now wonder if he would have been a better kid/sleeper whatever if I had cut cow milk out of my diet while nursing. Also, he did drink a lot of formula that just happened to be Carnation Good Start which uses 100% whey protein, so that was just lucky.

[Sarah]

Wow, thanks guys, this is great! As it happens, I didn't try the (partially) hydrolised formula for longer than a week, mostly because it didn't seem to be helping, if anything it made him really sick (and it STANK!!! but that's not why I stopped him on it :) ). However, to answer one or two other questions out there, he doesn't have eczema or any stuffy nose symptoms. Even the wheezing only comes intermittently. He's also teething at the moment, so that's complicating the issue - can't tell if it's gas or gums giving him problems!

I'm reluctant to take him off dairy completely, at a time when he still needs the formula. I know that the hydrolised formulas are an option, but i worry about how much processing has been done to them to get them that way (i know, normal formula is super-processed too!). I'm wondering if I should wait a couple of months until he's less dependent on formula nutritionally before I go down that road. Any thoughts?

And who knows, he may just be extra sensitive to everything!! Thanks again..

[Sarah]

Oh! and I should add - behaviourally and temperament-wise, he's sunny, calm, laid back and very smiley. He hardly ever cries during the day, just at night... Dunno if that means anything...?

[hedra]

@SarcastiCarrie, whey is cow's milk protien, but there are two protiens in cow's milk that people react to. Most react to the other fraction (casien, IIRC). And the Good Start also breaks down the protiens (slightly hydrolyzed) which also reduces reactivity for some. But my kids react to both whey and casien, and not all whey is totally pure, etc., etc. Whee.

Also, it's possible that you might have had zero impact from changing your diet. Passing the protiens is highly variable - some people don't pass much protiens from diet to milk, others pass a lot, and it varies for each person by day, time, what they ate, etc. So many variables!

For others, yes, it is definitely worth a try - remove it and see what happens - but don't just remove it kinda-sorta, it has to be a 100 % no dairy anything. New labeling laws in the US (and I think the UK also changed their labeling recently) make it easier to spot the dairy - if it says MILK, that's it.

And more important still (or at least more potentially important) if you have any tendency to reflux yourself (reflux increases the permeability of the esophagus, to the point that whole sucrose molecules can get into bloodstream, and they're 'officially too large' to be absorbed through the GI tract without being broken down!). Inflammation = leaky. Leaky means more things get into your bloodstream 'whole'.

I'm really glad to have discovered that I can tolerate goat (some) and sheep (more). I love cheese. I missed cheese. There's some mighty nice sheep and goat cheese out there... And even R, who didn't much like milk in general, likes sheep cheese. Still working on M, who gets so little calcium... sigh.

[Sarah]

Oh, and another thing! (Sorry) Someone asked what his poop was like - it's completely fine! No diarrhea, no mucus, no blood, just normal semi-firm, medium brown, medium stinky poo. Always consistent. Another person said to me that he may just have a slow gut, and therefore things stay in for longer and FERMENT (yes, she did use that emphasis - I cracked up)

[hedra]

Sarah, the fully hydrolyzed formulas are used for kids who have truly sensitive systems - yes, they're chemically created through the marvels of modern science, but no that doesn't make them risky, IMHO. It is worth a two-week trial, IMHO, because if he's dealing with constant inflammation and distress, that's a greater risk than the difference between a natural formula and the fully hydrolyzed ones. And the fully hydrolyzed ones (like Elecare, I think) don't stink so bad. At least the toddler version we tried out for B (to test if he was reacting to something else) didn't stink!

Living with long-term inflammation and distress is worth the attempt to fix, IMHO.

As far as the night vs day thing, it's really a matter of baseline awareness. We're more sensitive to discomfort at night, period. For example, G, who at 4 was finally diagnosed with a massively wrenched neck - it bent sideways like a bow in a curve even I could easily spot on x-ray - no idea how I missed THAT for so long... he was sunny, positive, cheerful, all day. And miserable at night. However, after he was treated for 'that which was causing him pain', he became MORE sunny, cheerful, positive, etc. The teachers in his pre-K class didn't think that was possible, but .. yes, it was. He was fully able to suppress awareness (or his interest and engagement in life during the day just automatically dodged the awareness), until night.

Good luck!

[hedra]

Sarah, slow gut is possible as well. But sometimes the reason it is slow is actually because of the fermentation in the first place, rather than the other way around.

For example, R had a 'slow gut' - she held onto everything, breastmilk came out as semi-solid poo. On solids, she was immediately constipated. It was fermentation. Removed the things that ferment, and she went to normal poops in a few days. It took a bit longer to show for her than it did for the fast-poopers (B and M, heh, maybe I should put their initials the other way round?). But if she's not eating things that ferment (lactose, fructose, inulin, fiber, FOS, etc.), she poops normal. If she's eating things that 'are supposed to speed things up' she locks down completely. So constipated she pukes out her nose trying to poop. Seriously. So 'slow gut' may be result, not cause.

[Sarah]

Thanks everyone. As a result of all your comments I'm going to take T to the doctor next week, see if I can force some tests. Poor little boy... It must be awful for him :(

[Stephanie]

I haven't read through all of the comments yet, so I apologize if this was stated already, but if you suspect protein intolerance (or true milk allergy) and want to use probiotics, you should probably steer clear of Culturelle (which was recommended above.)

Culturelle is grown on whey, therefore it is not dairy-free and could cause an allergic reaction in a child with a true dairy allergy. Several companies do make dairy free probiotics - they are more expensive than the shelf-stable probiotics (like Culturelle) and usually need to be refrigerated. They can be pricey.

I will second the POFAK recommendation and will also recommend the Neocate Families group on Yahoo:

http://health.groups.yahoo.com/group/neocate/

Many babies and children who are on elemental formulas such as Neocate have issues with protein intolerance or milk allergy, reflux, gassiness, eczema and colitis. (My older daughter would fall under "all of the above.") There's a wealth of information to be found there and the parents are very supportive.

Good luck!

[sue]

@pnuts mama - oooh, I'm so glad I don't have acute MC - mine is more low-level and chronic (took 15 years before i convinced someone to give me a colonoscopy). Definitely check into the gluten thing. There are so many gluten-free products now, that aside from eating out at restaurants, it's not all that difficult to follow a strict diet. Cakes, cookies, breakfast cereal - you name it, there's a decent gluten-free version (my kids like gluten free pasta better than real pasta). The only thing I really miss is toast. Just smelling it drives me crazy. But there's actually a really good GF bread mix put out by Bob's Red Mill (the gluten-free pantry one is nasty). It's worth a try...

[Nancy]

Is eczema ALWAYS an allergic reaction to something (contact, food, etc)?? BabyB has a few spots -- a knee, the back of one thigh, lower back, an elbow. She does get a little rashy on her chin and fingers because she's teething and drooling all the time.

I asked the pedi about it @ 6 months and she said to just moisturize with a gentle lotion. We go back next week for the 9 month appt and want to know if I should pursue anything else. I use Aquaphor goo (seems like vaseline to me) and Aveeno baby cream, which seems pretty artificial too. And Aveeno baby bath wash.

[caramama]

@Nancy - I don't think eczema is always an allergy. When our baby had it, the pediatrician just said that her skin was adjusting to the world. We use Aquaphor, which is very gentle on their skin and has been pretty good for it.

[Lisa]

I have't read all the comments yet, but I will when I have time, so I hope I'm not repeating anyone here.
Have you looked at Sue Dengates website - www.fedupwithfoodallergies.com.au
She is an Australian lady who has kids iwth allergies and intolerences and she and her husband have developed a low chemical diet that is hugely successfull with a vast range of different problems. It might be worth just having a look at her site to see if it's the right fit for you. She is well respected and her husband in a food scientist (I think thats right)
Hugs, hope you get it sorted

[cheryl]

@sue. Excema, allergies, and asthma or other respiratory disorders. Not always, but there is a correlation. We learned this when our Monster had pneumonia. Because she also gets excema the docs warned us about nut allergies in particular.

We had MAJOR yeast problems in our house for about 6 months. The Monster had some significant antibiotic exposure from a couple of ear infections, pneumonia, and cellulitis infection. After a couple of different prescription creams for the Monster (it was in her diaper area), Diflucan, and lots of naked time in the summer we went to a Naturopath. We are not your typical naturopath patients, let's just get that out there. But we were desperate as the yeast obviously made the Monster miserable. In the end, we did take some of her advice, after consulting our own doctor and doing our own research. We had already removed yeasted products from her diet (i.e. bread)and any sugar (bye-bye toast and jam). We chose to not use a homeopathic remedy she suggested. We did, however, put her on a powder probiotic. The amount you get in yoghurt is good, but not anywhere near the levels you can get from a direct dose.

We also started an elimination diet for her excema. Started with cow dairy, then wheat, eggs, citrus. To be honest, we never made it past dairy. Within days we noticed a huge difference in her skin. After a few weeks we decided to bring it back in and see if there was a difference. Again, within days the bumps were back. We stick to goats milk now, but she does have cow cottage cheese and cheese with little impact.

The probiotic we used for the Monster was a dairy, soy, and wheat free one. Yes, it cost about $30/month (CAD), but I beleive it was money well spent. The brand is Inno-Vite DDS Junior. It is safe for infant use and I got it at the local health food store.

Oh, and if you need a good moisturiser, for yourself or your little one on excema or dry skin I highly recommend Dream Cream from Lush. It completely clears up my excema patches and does wonders when the Monster has any flare-ups.

I think the important thing to remember when figuring out things like this is to trust your instincts with your kid and the medical team you choose. What works for one of our kids may not work for another, even if they have the same symptoms.

[emily]

Really helpful comments. My daughter has a milk protein intolerance (dxd at 2 months, after bloody stools) - she is exclusively breast fed so I am off all dairy now. She is doing much better, sleeps more, etc. - all improvements we saw over a couple of weeks.

I have a question for those of you who have experience with this. I know that kids outgrow this - so how long did you wait before giving your child dairy? My pediatrician suggested trying dairy at nine months - seems awfully soon to me.

[paola]

@nancy

Seborrhoeic dermatitis is a form of exzema but is not atopic (caused by allergy). My son suffered when a wee baby and it was diagnosed (incorrectly) as cradle cap even though it was down the sides of his face. It didn't go away with the usual cradle cap treatments and eventually the doctor prescribed a antibiotic cream that got rid of it.

Now as a 3 year old he has a bit on his forehead between the eyes( much less since we have started treating it with TRIDERM lenil plus an excellent but ridiculously expensive dermatitis cream) and on his chin which he has had for ever. The doctor said it eventually goes away by itself but as the chin is an area of the body which is exposed a lot more to dirt and grit, it is more persistent

[tibi82]

I have zero advice for solving the problem, but I do have a little for helping with gas. When my daughter was an infant, I took her to an infant massage class. It helped so much with the gas that I say that class was the ONE baby "gadget" I couldn't do without. You might have more problems doing this on an active 11-month-old than an infant, but give it a try. It really helps to work the gas out. The gas routine was as follows:

With the baby lying down, and at least 15 minutes after a meal, rub the baby's stomach in a clockwise circular motion around the belly button and reaching down towards the pubic area. Make 10-12 circles. Push the knees to the chest for 20 seconds. Then make a "paddle wheel" with both hands, pushing with the pinky edge of your hand down from the belly button to the pubic area. Do this 10-12 times. Then knees to chest for 20 seconds. Repeat the whole process three times, twice a day.

If I haven't explained myself clearly let me know and maybe I can do a little better job. My email is cgilbert AT ajfire DOT com

[Stephanie]

@Emily

I'm not a doctor, but I agree that 9 months seems a little early.

My older daughter was diagnosed with protein intolerance at 4 weeks. Despite my adherence to a strict elimination diet, she was hospitalized twice before we made the decision to give up breastfeeding and go with an elemental formula (neocate.)She was seven weeks old. At first, I felt terribly conflicted about it, but within a week the bleeding, screaming and anemia stopped; her reflux improved; her eczema disappeared and she started gaining weight, so it ended up being a good decision for our family.

We had better luck with our youngest, now 8 months old, who also showed signs of protein intolerance early on, but who responded well to me being on an elimination diet and continues to breastfeed to this day. We plan to wait until she is one to try dairy.

When my oldest was a year old, we did our first dairy challenge. Our GI doctor told use to use yogurt instead of milk or formula - I can't remember what the rationale was though (this was over four years ago.) The protocol we were told to follow was to rub a small amount on my daughter's arm, wait five minutes and if there was no sign of reaction, rub some on her cheek. Wait five more minutes and if there was no rash on her cheek, rub some on her lips. Wait five more minutes and if her lips didn't swell, give her about a tablespoon of yogurt. We did all of that, and everything was fine until we got to the tablespoon of yogurt. Almost immediately, my daughter's face broke out in hives and she started grabbing her throat gasping for breath. Fortunately, we had benedryl and an inhaler on hand and she was OK, but it was very scary.

At the time, we were told that the vast majority of kids who don't pass a milk challenge at one will pass it at age two. That wasn't the case for my daughter. In fact, she is five now and still allergic to dairy and soy. It is quite possible that she will never outgrow her allergies, although I keeping hoping that won't be the case.

I think my daughter's situation is a little unusual. As I understand it, most kids who are diagnosed with protein intolerance will outgrow it by age two (with many outgrowing it well before then.) It's much less common to develop a full-blown allergy, but it does happen.

One thing you might consider is having allergy testing done prior to attempting a milk challenge. The RAST test (a blood test for antibodies) is more reliable than the skin prick test. If your daughter's test comes back positive, you can skip the milk challenge altogether, rather than risking an allergic reaction. If it's negative, you can proceed with the milk challenge with a bit more confidence.