An Allergy Elimination Diet

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
  • Slow or stalled weight gain in infants

The top 7 food allergens are:

  • Dairy
  • Egg
  • Soy
  • Wheat
  • Citrus (acidic fruits)
  • Peanuts/Tree Nuts
  • Shellfish

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.

Milk: Does It Really Do a Body Good?

Dairy Terminology

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 Beginning

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.

Adding Protein

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.

Adding Grain

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.

Recommended Reading

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.

Radiation Concerns, Japan to West Coast

Follow me on Twitter, please. I’m trying to extract real news and science from the fear mongering surrounding the disaster in Japan.

Because of damage to Japanese nuclear reactors, radiation is being released.

The amount released has exposed dozens of people who live or work quite close to the reactors and will increase their chances of radiation illness and even cancer. But, the short term danger to those of us hundreds or thousands of miles away appears to be non-existent. Radiation getting into the winds which blow from Japan to the West Coast will not be dangerous even if there’s a complete Chernobyl-type meltdown.

A longer term fear involves contamination of the atmosphere, crops and water with long-lived radioactive iodine and other isotopes. Even this longer view still doesn’t point to any dramatic rise in the risk of illnesses including cancer for Americans. Experts are recommending postponing planned trips to Japan for a variety of reasons mostly involving loss of infrastructure, but they also caution that increased radiation exposure could occur the closer one gets to the cities in Japan containing these damaged nuclear plants.

To summarize, we don’t need potassium iodide right now, we don’t need to lose any sleep and we do need better sources of energy than nuclear power plants. We’re very much OK and not at risk from nuclear meltdowns 5000 miles away.

My thoughts are with the Japanese and those of you here with family in harm’s way.



Gisele Bundchen, Nutrition Expert?

Here is my recent article, published in The Huffington Post about breastfeeding.
A lively discussion is taking place at the bottom of the page over there.

Gisele Bundchen, Nutrition Expert?


In a recent magazine article, Ms. Bundchen was quoted saying that breastfeeding should be the legal norm for all babies for the first six months of life.

Of course, this generated a storm of protest about “feeding choices” and whether or not we should listen to someone with her lack of credentials. Lost in the fabricated drama and controversy is the fact the we mustlisten if her advice and high profile can save babies’ lives. I’m sure that this one famous mother’s words will be heard and heeded by more mothers than we pediatricians can possibly reach. (Ms. Bundchen’s statement that post partum weight loss is faster because of breastfeeding is very much in line with current medical literature and will certainly appeal to most new mothers.)

It’s easy to misinterpret a forceful metaphorical statement about “chemical food”–infant formula–and the crucial lifesaving value of breastfeeding for six months. And, that’s exactly what pundits did to turn this into an “us against them” issue. “How dare she . . . ”

While it is tragic that a supermodel-mom dispenses better advice than many doctors and most governmental agencies, it’s impossible to misinterpret what the World Health Organization says about these artificial (chemical) feeding options:

The protection, promotion and support of breastfeeding rank among the most effective interventions to improve child survival. It is estimated that high coverage of optimal breastfeeding practices could avert 13 percent of the 10.6 million deaths of children under five years occurring globally every year. Exclusive breastfeeding in the first six months of life is particularly beneficial, and infants who are not breastfed in the first month of life may be as much as 25 times more likely to die than infants who are exclusively breastfed.”…

There is a common misconception that in emergencies, many mothers can no longer breastfeed adequately due to stress or inadequate nutrition, and hence the need to provide infant formula and other milk products. Stress can temporarily interfere with the flow of breast milk; however, it is not likely to inhibit breast-milk production, provided mothers and infants remain together and are adequately supported to initiate and continue breastfeeding. Mothers who lack food or who are malnourished can still breastfeed adequately, hence extra fluids and foods for them will help to protect their health and well-being.

If supplies of infant formula and/or powdered milks are widely available, mothers who might otherwise breastfeed might needlessly start giving artificial feeds. This exposes many infants and young children to increased risk of disease and death, especially from diarrhea when clean water is scarce. The use of feeding bottles only adds further to the risk of infection as they are difficult to clean properly.”

Moreover, not breastfeeding has been found to double the risk of SIDS (Sudden Infant Death Syndrome)

Read just one sentence above aloud:

“Infants who are not breastfed in the first month of life may be as much as 25 times more likely to die than infants who are exclusively breastfed.”

No parent in America is allowed to let their infant travel in a car in the “second best” way possible: Car seats are the law in all 50 states. A breastfeeding law will not be passed soon, but there is a moral, ethical and medical imperative to get this nutrition information to mothers and families any way we can. Hyperbole is easy to ridicule but, in this case, the hyperbole will prevent the deaths of many, many babies worldwide.

The World Health Organization estimates that one-and-a-half million babies die from lack of breast milk each year. 1,500,000.

If Gisele Bundchen’s magazine interview, comments and the resultant furor cause more mothers in developing nations to breastfeed, thousands and perhaps tens of thousands of babies will be alive a year, two years or five years from now who might otherwise have succumbed to diseases caused or fatally exacerbated by lack of mother’s milk.

I certainly wish that this legal proposal/metaphor had been issued by the government, health insurers or the American Academy of Pediatrics. In lieu of those recommendations, the very intelligent suggestion of a really smart mom will have to do.

Dairy Terminology

The following is a list of ingredient names that indicate the use of dairy in a food.

Avoid foods that contain any of the following ingredients:
  • artificial butter flavor
  • butter, butter fat, buttermilk
  • casein
  • caseinates (ammonia, calcium, magnesium, potassium, sodium)
  • cheese
  • cottage cheese
  • curds
  • custard
  • half and half
  • hydrolysates (casein, milk protein, protein, whey, whey protein)
  • lactalbumin, lactalbumin phosphate
  • lactoglobulin
  • lactose
  • milk (derivative, protein, solids, malted, condensed, evaporated, dry, whole, low fat, non fat, skim)
  • nougat
  • pudding
  • rennet casein
  • sour cream, sour cream solids
  • sour milk solids
  • whey (delactosed, demineralized, protein concentrate)
  • yogurt

Ingredients that MAY indicate the presence of milk protein:

  • brown sugar flavoring
  • caramel flavoring
  • chocolate
  • high protein flour
  • margarine
  • natural flavoring
  • Simplesse
  • A “D” on a product label next to a “K” or circled “U” may indicate the presence of milk protein.


Weight Loss After Pregnancy

I see a lot of moms in my office who would like to lose weight and get back into shape faster. Most of them are either being too hard on themselves or someone who should be supporting their wonderful mothering is being to hard on them.

Nursing babies “cost” about 1000 calories per day so breastfeeding is one of the most efficient ways to make sure that the extra fat and water added during pregnancy are transferred to the rightful owner.

Nursing moms, and almost everyone else, need about 1800 calories/day to “get by” and much less than that is not healthy. Here are a few tips for getting into shape safely and a little bit faster:

  • Eat healthy foods. (All together now, “duh.”) This really is overlooked, though. Emphasize nutrient-rich foods which are not “calorically dense.” Avoid greasy snack foods and so-called healthy foods like cheese and whole milk. Eat more fruits, grains, pastas and beans and avoid red meat and salads laden with dressing.
  • Try to build some outdoor activity into your day. (“In my spare time and with my spare energy??) Somehow. Walk with your baby every day and try to get a jogging stroller added to your wish list. Slings make carrying your baby more efficient and burn more calories. In my experience, even moms who really didn’t have the time and energy to exercise a little, feel just great when they somehow do it.
  • Drink more water. Avoid soda and juice. These are truly empty calories.
  • Combining 100 to 200 fewer calories per day of higher fat foods (that’s just a couple spoonfuls of dressing or a piece of cheese) with 20 to 40 minutes of a good walk with your baby (200 calories out) will lead to exactly the weight loss and conditioning you want. Add in a little formal or informal yoga and stretching and you’ll get there even sooner.
  • Above all, be nicer to yourself. This is not a contest nor a sprint. You are an extraordinarily important and extraordinarily busy person: a Mother. Get into shape at a pace that suits you, not the rest of the world.

Dietary Recommendations for Pregnancy

I see most of the couples in my practice prior to their delivery. I like to do a prenatal discussion fairly early but most people come in during the last month or two of pregnancy. One reason I’d like to talk earlier is to discuss the best pregnancy diet. There is excellent medical and common sense evidence that the best nutrition during pregnancy gives the best outcome. Specifically, moms with any family history of allergies should avoid dairy products. There is not much disagreement in the medical literature about the benefits of a dairy-free diet to the developing fetus. Allergies are increased by prenatal exposure to this allergenic protein. Whatever you do, avoid the outdated advice to increase your milk intake during your pregnancy.
Avoid alcohol and other noxious chemicals. We know that medium to large amounts of wine, beer or liquor can seriously damage a baby and produce Fetal Alcohol Syndrome. It’s now recognized that lesser amounts of alcohol at critical stages of pregnancy lead to “Fetal Alcohol Effect.” If we know this, why would you drink at all during pregnancy?

The warning signs in super markets about swordfish telling pregnant women to limit the number of servings per month would lead me to a similar conclusion: Why eat any mercury-containing fish at all?

Stay active, eat as well as you can focusing on meals with lots of fruits, veggies, reasonable amounts of healthy protein, avoid alcohol, decrease or eliminate dairy products to have the healthiest pregnancy and the healthiest baby.