An elimination diet for breastfeeding mothers should only be attempted in consultation with a medical specialist as they can have far-reaching effects on a baby’s health. An elimination diet aims to isolate and avoid food items in a mother’s diet that negatively affect her infant’s health and development.
Generalized opinions about the cause of an infant’s decline in health and wellbeing are commonplace. Fussiness is one such baby trait that leads mothers to believe their child is intolerant to specific food items in their diet.
There are many factors to consider before an elimination diet is attempted, and concerned mothers tend to blindly follow the status quo of eliminating dairy in their diet; however, switching to soy-based products may not necessarily ease the symptoms if the infant has a milk soy protein intolerance (MSPI) which in itself causes several health conditions. Babies with MSPI display a high level of fussiness.
We will look at what an elimination diet is and why it is so important to consult with a medical specialist in this regard.
Symptoms of food allergies in babies
About 7.6% of children in the United States are affected by food allergies.
Breastfed babies will show the following allergy symptom:
- Bloody stool with no other sign of illness
- Wheezing and other respiratory problems
- Nasal congestion
- Swelling of the tongue, lips, or face
- Tightness in the throat
- Pale skin
If you notice any of these symptoms, call your pediatrician right away. Because symptoms can sometimes be misleading, it is best to visit your pediatrician and have your baby checked. You will also be advised on how best to determine if it is in fact a food allergy.
Food allergies vs food intolerance
Be careful not to confuse a food allergy with food intolerance as the symptoms might be similar, but allergies have more severe symptoms that involve raspatory issues and skin outbreaks.
An allergy is when your immune system reacts to a type of food, and intolerance occurs during digestion, where the symptoms are gastrointestinal.
One way that your pediatrician may recommend determining the cause of a food allergy is to follow an elimination diet.
There are 8 different food groups that are known to cause allergic reactions in about 90% of cases; they are:
- Cow’s milk (dairy products)
- Tree nuts such as almonds or walnuts
There are in excess of 160 different allergenic foods, and any one of them can affect your baby. For this reason, it’s vital to deal with a food allergy decisively.
What is an elimination diet?
An elimination diet aims to identify a potential food allergy in infants. It eliminates suspected food items from a mother’s diet to avoid carry-over into her breast milk that may cause the allergic reaction.
There are two types of elimination diets, namely:
1. Eliminate all at once
- This does not mean that mom stops eating altogether but simply eliminates all dairy products, soy, and eggs from her diet.
- The baby’s condition and behaviour must be monitored over a period of 2 to 4 weeks to note any changes. Although these food items will clear your system in a few days, they take a while longer to pass through the baby’s system and heal the digestive tract.
- If there is improvement in your baby’s condition, introduce one food item at a time back into your diet and continue monitoring your baby.
- In cases where there is no improvement, chances are that it may not be food-related or other food types need to be eliminated and the process repeated.
As you can see from this trial-and-error approach, it may take a month or longer to identify the cause of your baby’s condition, and dealing with the ongoing symptoms can be detrimental to the health and wellbeing of both mother and baby.
2. Eliminate one food at a time
- Eliminate one food item at a time (dairy, soy, or egg).
- Follow the same 2-4 weeks observation period and note any changes in your baby’s behaviour.
- If your baby does not display any more symptoms then you have identified the food source.
- If there is no improvement you may want to repeat the process with different food types.
The only way to safely try an elimination diet is to consult with your pediatrician, who will consider the health history of both parents, family, and the baby and lifestyle choices and diet. Each individual case is unique and requires the attention of a medical specialist.
As mentioned earlier, MSPI (milk soy protein intolerance) can mislead parents because the usual reaction is to substitute milk (dairy) with soy.
What may further confuse parents is that infants with MSPI will cry up to 18 hours a day, and parents will believe their child has colic. Unlike MSPI, colic will not cause weight loss or any other health problems.
Milk soy protein intolerance (MSPI)
Elimination diets focus on primary food groups and dairy, or cow’s milk is usually first on the list for the elimination trials. This is because the protein in cow’s milk can pass into breastmilk relatively intact, and the baby’s inability to digest the protein creates the problem.
Breastfed and formula-fed babies can develop MSPI. About 2.7% of babies under 12 months old have an intolerance to cow’s milk, and of this number 60% will also have an intolerance to soy.
MSPI is a temporary condition that dissipates with age. It is an inability to digest the protein in cow’s milk and soy.
Besides the constant crying, other symptoms of MSPI are:
- Weight loss
- Vomiting repeatedly
- Skin rashes
- Changes in appetite from refusing to eat to excessive eating
- Fussiness and irritability
- Blood or mucus in their stool
MSPI may often be confused with lactose intolerance, but the two conditions are very different. MSPI is an intolerance to the protein, whereas lactose intolerance is caused by a deficiency in the enzyme that breaks down sugar (lactose) present in both human and cow milk.
It’s rare for lactose to cause issues in infants, but the condition may develop in older children over 5 and adults.
There is no specific test to diagnose MSPI; however, an elimination diet where both cow’s milk and soy are eliminated from your diet will reveal if your baby is suffering from MSPI. This will also become the treatment for MSPI – no cow’s milk or soy in your diet.
It’s also better to wait until your baby is 6 months old before you start introducing solids in their diet. Formula-fed babies can be fed with a hypoallergenic formula.
It is evident just by looking at the symptoms of MSPI that the condition will adversely affect your little one’s health and development. The sooner you can address the issue, the better it will be for your baby.
Some mothers may consider switching to formula as a quick fix solution. Still, in retrospect, this may deprive your baby of the much-needed antibodies in your breastmilk that strengthen your baby’s immune system.
If I eliminate dairy from my diet, will my baby not develop a calcium deficiency?
No. You may develop a calcium deficiency, but your breastmilk will have enough calcium for your little one.
Your body will provide for your baby (isn’t nature wonderful), but you may have to take calcium supplements or eat calcium-rich foods like broccoli, collard greens, kale, sesame seeds, almonds, and canned sardines or salmon.
How long does MSPI last?
Most babies will outgrow MSPI by their first birthday, while some will only shed the intolerance in the period up to 6 years of age. Stick to your pediatrician’s advice on when it will be appropriate to try introducing cow’s milk and soy into your baby’s diet. If in any doubt, speak to your pediatrician.
My baby has a lot of gas. Is this normal?
The digestive system creates gas in every one of us, and unlike babies, adults are more polite in passing gas. Trapped gas can cause discomfort in babies that can lead to crying sessions. You may want to check your diet and how you are feeding your little one.
A lactation specialist will be able to advise you on other ways to feed your baby. As far as your diet is concerned, gas is a by-product of the digestive system and will always be present.
Try limiting “high gas-producing foods” like cabbage and beans but do not totally eliminate them from your diet as they provide essential nutrients.
Food allergies or intolerance can dampen any mother’s spirit to the point of absolute frustration. The easiest way to solve the issue is through the trial and error of an elimination diet. It may take a bit of time to identify the food type causing the reaction, but it is necessary to correct the diagnosis.
Elimination diets may deprive a mother of a healthy and well-balanced diet, but there will be no shortage in her breastmilk for her little one. With the right advice from a medical specialist, changes in your diet need not be a burden on your system, and to prevent this, you may need to take supplements for a while.
Your baby’s health and development should be your first priority, and by consulting your pediatrician early, you will get the best advice on current issues that will make life more pleasant for both you and your baby.