Nursing an allergic baby on a diet of rice, turkey

By REBECCA BOONE

updated 4:19 p.m. ET Oct. 2, 2007

BOISE, Idaho - About the only thing I knew for certain when I had my daughter last December was that I would breast-feed. Every parenting book I'd read and every childbirth class I'd attended emphasized nursing's nutritional, developmental and emotional benefits for babies.

What I didn't know was one important thing: Some babies are allergic to foods found in their mother's breast milk, and my baby was one of them.

As a first-time mom, I didn't recognize the warning signs. Nina's frequent, anguished crying was colic, I figured, and her runny nose and chronic diarrhea were just the result of her first bug. Her difficulty nursing? That was probably just me not "doing it right." And I assumed she woke up every 40 minutes during the night because she just hadn't learned how to sleep yet.

At first, Nina's pediatrician eased any fears I had. My daughter was growing like crazy, and developmentally was right on track. But when the diarrhea failed to go away after a month and a half, and blood started appearing in her diapers, we visited a pediatric gastroenterology clinic and got the news: Nina had a severe food intolerance to dairy and soy products.

An estimated 6 percent to 8 percent of children under 3 have food allergies, according to the U.S. National Institute of Allergy and Infectious Diseases. A minority of those experience digestive-tract symptoms, ranging from pain and diarrhea to internal bleeding, chronic inflammation, extra tissue growth and failure to thrive.

Some good news: Most babies outgrow this type of allergy by preschool.

Unfortunately, there are no easy tests to determine just what the offending foods are. Breast-feeding mothers typically rely on "elimination diets" — cutting out some common allergens and seeing what happens.

"It gives the child the best chance for outgrowing the allergy," our nurse practitioner, Barbie Doherty at Idaho Pediatric Gastroenterology, told us.

Under her supervision, I cut all traces of dairy and soy from my diet and began keeping a food journal.

But Nina didn't get better. She got worse — more internal bleeding, more pain and more sleepless nights that left us both in tears.

Thousands of possible triggers
Nina's doctor advised cutting more allergens from my diet. I began avoiding wheat, eggs and nuts, which along with dairy and soy cause the vast majority of food allergies. And because my food journal suggested they might be causing symptoms to flare, I also avoided fish, shellfish, citrus fruits, tomatoes and corn.

Resources for nursing allergic babies National Institute of Allergy and Infectious Diseases Kids with Food Allergies American Academy of Pediatrics Dr. Bill Sears

It was hard, but gratifying when Nina's chronically runny nose and eyes cleared. Her intestines continued to bleed, however, and her pain continued. I looked in my pantry and realized: Thousands of foods, additives and preservatives remained in my diet, all of them suspect.

At Nina's appointment that week, Doherty and I discussed my options. Nina could either go on an expensive hypoallergenic formula until she outgrew her food intolerances, or I could try a "total elimination diet," eating only a handful of foods and adding new ones, one at a time.

Remember all those "breast is best" baby books? I did, and chose the total elimination diet, or TED.

Doherty supported my choice, but reluctantly. She'd seen few parents in her practice who had succeeded with this method, and she noted that there is limited research on its effectiveness.

Total elimination diet or hypoallergenic formula?
There's no clear consensus on TEDs among doctors. Some, like Paul Williams, a clinical professor at the University of Washington and chairman of the allergy and immunology section for the American Academy of Pediatrics, say total elimination diets are seldom the best way for breast-feeding moms to deal with food allergies.

"I can think of times when it might be beneficial to eliminate classes of foods, such as milk and soy, but if you have to do more, why continue to breast-feed?" Williams said. "You're going to have to limit yourself so much that you could possibly cause nutrition problems."

Williams generally recommends hypoallergenic formulas, instead.

Critics warn that elimination diets can prolong a child's suffering while the mother tries to select the right foods.

But Dr. Bill Sears, an associate clinical professor of pediatrics at the University of California, Irvine, School of Medicine, is a proponent of total elimination diets to allow continued breast-feeding.

"It's only been in the last 10 years that it's been appreciated that these babies don't have just colic," he said. "A colicky baby is a hurting baby, and 90 percent of the time they hurt for one of two reasons: Either they have a food intolerance or reflux or both."

Parents should develop a food-allergy treatment plan only under a doctor's care, health experts note, and should get their baby a complete exam to rule out more serious health problems.

My husband and I talked it all over.

The formula wasn't covered by our insurance, and it would cost about $800 a month — more, as Nina grew. Not only could the TED save us a ton of money, it also would mean that Nina would get the other benefits of breast milk, such as fewer ear infections.

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