By Cheryl Taylor, CBE
Food allergies, or reactions, are more common than many realize, particularly when dealing with the immature digestive system of a newborn! Many babies simply cannot break down some of the larger proteins without difficulty. There are times when symptoms begin so severely, or immediately, that it cannot be missed. More often symptoms increase with exposure and it is around six weeks when you begin to realize that there may be a food source causing the discomfort you are seeing in your child.
Common symptoms that are reactions to a food allergen are:
- Skin reactions – rash, eczema, cradle cap, hives
- Loose stools – blood visible in stool
- Nasal congestion – stuffiness, accompanying cough
- Persistent ear infections
- Colic – GI pain, heartburn, stomach cramps, reflux, gas
- Dark circles under the eyes
- Frequent interruption of sleep
The top 7 food allergens are:
- Citrus (acidic fruits)
- Peanuts/Tree Nuts
While most food allergies end up being one of the top seven it is possible to react to other foods, particularly proteins. It can be difficult to ascertain what food might be bothering your breastfed infant, particularly if dairy is one of the allergens because it can take up to six weeks before it is undetectable in breastmilk, though most moms see improvement within two days to two weeks. Patience is a key element in this process!
Number One Food Allergen: Dairy
Dairy is by far the most common food allergy but also the hardest to eliminate because of the time it takes to completely leave the system. However, it does begin to lower and will continue to drop as it is scrupulously kept out of the diet. Be careful to keep an eye out for all processed foods that all too commonly have casein, whey or other hidden dairy in them.
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Often when there are food allergy symptoms the elimination of dairy, egg, soy and wheat will hit on the food allergen and improvements will be seen within the first week. If eliminating the top 4, or top 7 food allergens does not help with the identification of the culprit, consider an elimination diet that will help reduce the variables and approach it from the other direction. While it takes commitment, it is a much easier way to get clear answers to what is causing the symptoms.
Allergy Elimination Diet and a Food Diary
While doing an elimination diet keep a food diary in which you jot down everything that you eat, leaving a column to note baby’s symptoms as well. A food that a nursing mom ingests will be into the baby’s system within 4-6 hours of consumption. If an infant is extremely allergic to a food it may produce symptoms even from coming in contact with that food or as quickly as the first nursing after mom has eaten the food. Space the introduction of any food item out by 4-5 days. This is absolutely key and should not be rushed. If you are dealing with letting the system calm down after a reaction give it this same 4-5 days.
The elimination diet takes you back initially to only fruits and vegetables minus anything that is very acidic: any citrus including lemon, lime, grapefruit, orange, pineapple, tomatoes. There is rarely a reaction to veggies and fruits that aren’t acidic, though it is still a possibility. A few days of this diet will help you see if the diarrhea or visible blood in stools stops and green BM is turned more “normal” color. If one of the symptoms you have been dealing with is eczema, it will take a while for the skin to clear up and heal but you should begin noticing that it isn’t as red or flared.
The next food to add is beans. This will provide a means for increasing protein without the use of meat at least for the time being. Use one kind of bean at a time to again, reduce the variables. I would not recommend using legumes, soybeans or garbanzo beans in the beginning stages, because sometimes children that are allergic to peanuts will react to other legumes or garbanzo beans and soy is in the top 7 food allergens. There are still a lot of options with pintos, black beans, black-eyed peas, lima beans, navy beans, etc. This will let you see if your baby can handle the protein in beans and get some protein back into your diet.
The first grain I would suggest adding is rice. Sometimes it can be an allergen, but usually it is not. I would continue to keep wheat eliminated in the beginning stages. As you add other grains remember to always go through the same process of waiting 4-5 days before introducing anything else new.
I know that it is difficult, for many, to think about a diet that does not include meat, but it is my best recommendation at least temporarily while going through the process of identification of allergens. There are some couplings of allergies that include meats. Some babies that are allergic to dairy are also allergic to beef. Some that are allergic to eggs are also allergic to chicken. In all my years of working with Dr. Jay I have seen one infant that reacted severely to chicken. That experience taught me to suspect anything as a possible allergen!
You will need to really expand your thinking about veggie options. Make soups, chili with beans, steam veggies, stir fry veggies, salads…when you get to rice experiment with ones you have never tried before and flavoring them with different veggies diced and cooked with the rice.
With this elimination diet you should begin to identify what the allergens are within a couple of weeks. The most encouraging thing to see is in a couple of days after you begin veggies and fruits many will begin seeing their baby’s system calm down. Most situations begin to improve in the first 2-7 days, though some can take 1-3 weeks. Now it does take patience because their intestines and lining of the stomach are irritated from tolerating things they are reacting to, but it will calm down with a little time.
Once symptoms have subsided, and you feel you have allergens eliminated, other foods may be tested one item at a time. Take precaution to introduce only one new item at a time with 4-5 days separation. This gives you enough time to observe for any reactions and eliminate the food with 4-5 days for the system to calm down before introducing another. Being vigilant about this waiting period will make the whole process easier in the long run and provide more clear answers.
A true food allergy is something that a child is likely to maintain throughout their lifetime, but sometimes what is thought to be a food allergy is actually a food reaction. Reactions to foods are sometimes outgrown by the age of three with the maturity of the child’s digestion system.
I highly recommend the book “Is This Your Child?” by Dr. Doris Rapp. This is an eye-opening book regarding children’s allergies. It’s a thick read, but even taking a look at sections of it will help you understand that food allergies can cause digestion difficulties, skin reactions and even behavioral changes.