Weaning an intolerant BF baby

[hobnob57]

dd2 is ebf and intolerant to lots of things. The Gastro said that we'll probably never get to the bottom of her intolerances until weaning, and since I've already excluded dairy, soy, gluten, nuts & egg he felt that her symptoms of abdominal pain and mucus in stools were sub-clinical and I shouldn't try to exclude anything else. Her weight gain was fine. That was in March.

At Easter she was teething for 3 weeks, got a 48 hour sickness bug, had a reaction to soy and was generally in a bad way. Since then, I have begun BLW with her and she has developed very sore tummies and wind and infrequent dirty nappies (once a week). Her sleep is affected and some days she is too sore to nap. The GP tried her on lactulose in case this was the problem but she still took a week to produce another dirty nappy which was soft, formed and full of courgette skin so the food is going down.

She was weighed 6 weeks ago (just before the bug) and she she is the same weight now as she was then. The HV wants me to up her solids to 3 times a day. I feel that even on once a day her tum is struggling with the new foods and I should take things slowly. She loves the food, though. She got a rash on her face after her soy reaction and it never really went away. Since weaning it flares up quite badly and looks a bit eczema-y at times. I don't know if this is relevant.

Sorry for the ramble. I'm not even sure why I'm posting TBH. I'm just hoping that someone with similar experiences might be around to tell me how it was for them.

I suppose my questions are:
what order of introduction of foods is recommended? I'm doing root veg at the moment.

Can intolerances prevent weight gain? Is it worth a RAST test to see if anything obvious crops up that we haven't thought of? I already think that she's not happy with red pepper (she stole some off my plate)

What do I do if, in 2 weeks' time she still isn't gaining? I'm really loving BLW and so is she.

If your DD has been ill, it's not surprising that her weight gain has slowed a little. I'd go with your instincts - you and your baby know best. If you (and she) think that 3 solid meals a day is too much for her, then it probably is at this stage. The advice for allergic babies is to wait until at least six months before introducing any solids at all. Anyway, breastmilk has loads more calories and nutrients than pureed veg so if you are worried about weight, surely it's best to fill her up on breastmilk not veg??

Have you considered removing red peppers from your diet as well? I know your doctor said not to, but this sort of stuff does get into your breastmilk. Peppers are part of the nightshade family, which also includes tomatoes, chilli etc. (my DS reacts to all these - and even to a bit of paprika if I put it in his mince)

Personally I reckon that BLW is the way forward, especially for allergic children. I have found that my DS can sometimes sort of 'smell' when he is going to react badly to a food so I like to give him a chance to reject things he doesn't want to eat.

Hope all goes well - I don't wish to scare you, and hopefully you'll never need this, but have you got antihistamine in the house in case your DD encounters something that she has a strong reaction to? Also, have you been referred to an allergy specialist?

should also have said - it's so lovely to read your post (while obviously v. sad for you that your DD is going through this!!) because I am so impressed that you are still able to bf despite having to exclude so many things from your diet. I know how hard this is because I have done it too but at least my little DS can have gluten so well done - you are amazing

I had wondered about tomatoes etc. but we rely on them so much for meals now that I honestly don't know what I'd eat for dinner beyond meat & 2 veg or coconut milk-based sauces. I'm a bit worried that my restrictions might be affecting my milk quality now. I know they didn't initially as she gained weight no problem (comfort feeding too), but I wondered now that we've hit 6 months that her needs are greater and deficiencies may be becoming apparent? I suspect it's balderdash but you get paranoid, don't you?

as far as antihistamines go I hadn't considered them. DD1 was dairy and gluten intolerant and all their symptoms have always been gastro-related, apart from gooey eyes and face rashes. But I'm definitely going to make sure I'm in company if I ever test her with egg or dairy.

yes, it's VERY difficult cooking without tomatoes and I freely admit it! Pureed carrot is a reasonable substitute in some recipes, but we eat a lot of meat-and-two-veg style meals. My DS is very allergic to onions and garlic too, and those have been even harder to exclude (I used to be vegetarian and virtually lived on onion/tomato-based meals with cheese, egg and nuts - all now forbidden as well). Still, I have never regretted altering our diets, not for one second, because it has really worked for my DS.

Dietary restrictions don't affect the quality of your milk at all. You're so right about it being really hard not to be paranoid, and I had a bit of a panic about nutrition when DS got to 6 months so I checked this out with a couple of breastfeeding experts. Seriously, you could eat complete rubbish for months on end and your body will still make the perfect milk for your baby, whatever her age and stage (I'm currently making toddler-milk!)

When DS was ebf, his reactions were mostly 'gastro' and eczema but he had much stronger reactions when exposed to his 'problem foods' directly. I'd definitely ask for some antihistamine, if only for peace of mind - hopefully you will never need it but it can't hurt to carry it around with you.

Dear hobnob
I so feel for you, having been there and having had the same responses from doctors/HVs that I need to answer something. Sorry it's so disorganised.

But my experience is HVs know NOTHING of food intolerances, play them down and give unhelpful and incorrect advice. Doctors don't know much either and always suggest lactulose although one should first find out what the actual problem is.

The only way to get to the bottom of food intolerance is a systematic try/remove approach (and the emphasis is, unfortunately, on systematic). It is painstaking but if you feel your baby/you suffers enough it's worth it, and the only way to go.

Some questions, sorry I you mentioned them already:
Are you breastfeeding, if not, what milk is your baby on?
In case your baby really is intolerant to foods, some basics are really important:

• Not to try any new foods until she is (more or less) symptom free, otherwise you'll never know what the reactions are coming from. You now need to find a state at which your baby is doing well, even if it means cutting out all solids again. If her nappies are funny that's ok as long as she is pain free. She can survive for long times on milk only, so there is no need to worry but if you skip this bit here, things will just get messier and messier.

• Once she is symptom free, then you can start trying solids again. Only introduce ONE new thing per WEEK, as it can take that long for symptoms to become clear and otherwise again you won't know what is causing them. On the first day give 1tsp (just once that day!!), second day 2tsp, 3. day 1 TS, then as much as the baby wants. Do NOT let the HV press you to giving more food/food more often (they will!!) as this will do no good.

• Keep a food diary (if you are breastfeeding, also for yourself). It is tedious but the only way to get to the bottom of things and will REALLY help you in the long run (also to convince doctors later on if things don't improve).

• Do not try several things from the same group in a row but vary: Try a fruit, the following week a grain, then a meat, then a vegetable (for example).

• If she gets symptoms that you feel cannot be tolerated, wait until she has had 2-3 symptom-free days until trying something new. Do not give anything else but what you know she can tolerate (+the new thing you are trying). This will mean you will have to prepare everything yourself...

• Note that many food intolerant babies tolerate foods better if they have been cooked/frozen (so e.g., our baby eats her fruits boiled, then frozen, then thawed even if she can't have them fresh).

• Avoid high-allergenic foods and prefer low-allergenic ones. Here some examples of foods to TRY:

FRUIT: apricot, raspberry, blueberry, pear, avocado VEGETABLES: sweet potato, courgette, broccoli, cauliflower, aubergine, artichoke MEAT: start with lamb GRAIN: rice, IF you think she reacts to wheat/gluten, try millet, buckwheat... (of "normal" grains, try oat before wheat) You are not in a hurry to introduce oil.

I assume you know about hidden dairy and soya sources? It is really important to avoid things completely(!) if you are to avoid them at all. If she reacts to wheat badly, she may also react to meats where the animal has been fed grains, so try grass-fed meat (if you can afford it...).

I hope any of this long message was helpful, I know it's very different from what HVs tell you to do but I have come a long way and my experience is, nothing else helps. Others are free to disagree!

I would just like to add a little support to let you know that you are not alone. I find it all very confusing and no-one really seems to know the answers that we are looking for. My son is now three and has multiple allergies, plus ezcema. My experience is that the Health Visitors are not of any use. Mine advised me that I could not be referred until my son was six months but when he got to six months and I went to the GP, prepared for a battle, he referred me straight away to a paedatric allergist. She referred us on the Guys and St Thomas in London. Even there, they say that there is no answer, mum knows her child best and should trust her instincts. There are some books out there with order of weaning and allergy free recipes. Get yourselves some anti-histamines.

Greenbananas I'm so intruigued about what you can possibly be eating as a family . I seriously can't imagine life without onions, garlic and tomatoes!

Emilybrown I'm ebf, but have a tin of neocate lcp from the gastro clinic for cooking with. I'd like her to get used to the taste of neocate if possible since I'm not convinced she'll be weaned fully in the daytime by the time I go back to work in mid August and dd1 was a nightmare taking pepti at that age. However I tried her with gluten-free porridge this morning with neocate and despite taking it yesterday with gusto she turned her nose up at it today.

She's never really been symptom-free, even before weaning which is why this is all the more difficult. She seems to be pretty sensitive to my milk. However, before the hot weather she did stop being constipated and was quite well but now she is constipated again. I don't want to become reliant on lactulose.

I've stuck with root veg for a while and fruit is definitely giving her a strange reaction. Sore rash on face which later flakes and congested, raspy breathing as she is eating the fruit which clears up in the hour after she has finished. Weird.

I'm reading the Brostoff and Gamlin book which is very helpful. I'm just really at a loss as to when to ask for medical advice and when to just work things out on my own now. For example the fruit thing. Do I need to tell someone? Is it serious enough to avoid fruit? etc.

I suppose I could ask for an allergist referral as opposed to the gastro?

ask for a pead immunologist referral................ring anaphylaxis campaign for nearest name/clinic.

be firm with your gp on this matter,
good luck!

I'd see your GP about the congested raspy breathing and yes, yes, ask for a referral to an allergist. I strongly echo EmilyBrown's advice about the food diary. As you're bf, you'll need to write down everything you eat too. Hopefully you won't find anything too drastic.

As for our family exclusion diet - it's fine now that I've got used to it. Just glad that our DS is healthy. Hope everything works out for you soon - sounds like you have been having a worrying time.

I phoned the duty doctor and she got me to phone the dietician (?!). They never return calls, but I'll keep trying and if that fails ask for an allergist.