Thursday, August 6, 2009

Eating more with less – how I breastfed my food allergic children, Part Two

This post is from Allergymom.

Some told us it was was impossible for a breastfeeding mother’s diet to cause allergies in the baby. Some spoke to us like we were morons. Some spoke to us like we were conspiracy theorists glancing fearfully over our shoulders. Some made me doubt my own sanity. Almost everyone advised us to supplement with formula. Apparently, my son was not growing well on breast milk and needed more than that.

But we did find one very compassionate and experienced pediatrician. She had breastfed her own dairy-allergic child on a maternal exclusion diet. She told us about reading labels and keeping food diaries. We also found a pediatric allergist, a leading researcher in the field who is making headlines today with his success in trial studies to desensitize children with dairy, egg and peanut allergies.

I found alternative foods and recipes. I became an intrepid cook in my kitchen eager to try out Iron Chef challenges in reverse – “let us make bread and brownies without wheat, eggs and dairy.” Out of the woodwork came mothers who had successfully breastfed their children on Maternal Exclusion Diets. I found numerous blogs dedicated to cooking without allergens. I found support from breastfeeding mothers and mothers of children with food allergies. I felt entirely sane again.

I made mistakes along the way. I ate “non-dairy whipped topping” containing whey, a cow milk protein. I bought rice cheese that was lactose-free but still contained casein, a cow milk protein. But I learned with each mistake and quickly became a whiz at label reading. I did not consider breastfeeding my son beyond a year. I was still trying to get my bearings in the world of food allergies. We had good health insurance which paid for hypoallergenic formula. My son was not ready to wean, I was not entirely happy with weaning either. But he did well on hypoallergenic formula and it was the easy thing to do. I wondered if I gave up too easily. I promised myself, that given another chance, I would try harder. And that chance did come my way.

I caught on to my daughter’s symptoms very early on, within the first few days of her life. I became my daughter’s advocate. I confidently passed on food allergy knowledge from my children’s allergist to the not so allergy-aware pediatricians. I scoffed back at the doctors and returned their disbelieving stares. For the first time in my life, I was thankful for the ordeal we went through before my son’s food allergy diagnosis. My daughter is a premature baby who spent the first two months of her life in the NICU and like most babies in the NICU was started on a Human Milk Fortifier containing cow milk protein with her feeds of pumped breast milk. If she had had to suffer in the same way as my son, she might not have made it.

Sitting in the pediatrician’s office today, I looked into my little girl’s cherubic face, a tear drop still glistening in the corner of her eye after her one-year vaccinations. She reached for my shirt and peered down the front urgently, looking for the familiar comfort she knew. As I cradled her in my arms and she latched on, the nurse smiled sweetly at us and closed the door quietly behind her. I looked at my little girl’s half-closed eyes and content expression and felt confident in my decision to continue breastfeeding her for the second year of her life.

Eating more with less – how I breastfed my food allergic children, Part One

This post is from Allergymom.

A month ago, I was looking forward to having some of my favorite foods again – baked brie, hummus, lamb kebabs, grilled shrimp and a variety of cashew and pistachio desserts from the South Asian subcontinent.

Today, however, I am looking forward to breastfeeding my daughter for another year foregoing all those favorites. I made this decision at my daughter’s one-year checkup when the pediatrician inquired if I was going to wean my daughter to fortified rice milk or hypoallergenic formula. That is when it hit me. Breast milk or rice milk? The answer seemed obvious to me.

I am breastfeeding my daughter on a Maternal Exclusion Diet. I have eliminated from my diet all the top eight US allergens and then some – like gluten grains and high-protein legumes. This is because my daughter has multiple food protein allergies and food protein induced enterocolitis (FPIES). Many of those foods she is actually allergic or intolerant to, such as dairy, soy, wheat, eggs, legumes, pork and beef. The others, like tree nuts and shellfish, are recommended as a precautionary measure so as not to sensitize her and trigger new allergies. Her reactions range from mild to acute and are triggered when I consume any of the foods she does not tolerate, even in very small amounts, and then breastfeed her a couple of hours later. Her symptoms, depending on which allergenic food, take anywhere from a few hours to few weeks to resolve.

It sounds terrible. But it is not. I eat many rice-based dishes, lots of fruits and vegetables – well over the 5 a day and 7 a day recommendations – and eat chicken for protein. I drink fortified rice milk and take a calcium supplement. I am eating healthier than ever in my life, and I look and feel healthier too. I still treat myself to hot fudge chocolate cake and chocolate pudding, all allergen-free. I still enjoy every meal every day.

Luckily for me, this is not my first time on a Maternal Exclusion Diet. I learned the ropes two and a half years ago with my son. He also had allergic reactions to food proteins in my diet. Back then I had no knowledge of food allergies. I was doing all the right things. I was giving my son breast milk, the best food in the world for a baby. I had a plentiful supply and he was a ravenous eater.

But he was colicky and had myriads of symptoms – spitting up, incessant crying, reflux so bad he could only sleep if held vertically, stuffy nose, chronic diarrhea that never seemed to get better. And at three months of age, he failed to thrive. His growth curve just plateaued off and he fell off the bottom of the chart.

After a lot of searching on the Internet, I found out on Kellymom about dairy allergy symptoms in breastfed babies and the concept of entirely cutting out the allergen from the mother’s diet. The symptoms matched those of my son’s. Cutting out dairy, or even dairy and soy, was not making much of a difference. I ate chicken, rice and carrots for a week. And lo and behold, my son’s symptoms went away. It was a few more weeks until his intestines healed enough for him to recover on the growth charts.

And I was able to add more foods back into my diet in a way similar to introducing solid foods to a baby – one at a time and watch for two or three days. From that point on, I never looked back.
We had seen many specialists for my son – ENT, GI, special infant care – all of whom scoffed at my suggestion that my son was reacting to foods in my diet.