Archived Q&A and Reviews
My baby has had bad reflux from 3 weeks old (he is now 3.5 months old) and I traced the problem down to the food I was eating when breast feeding. His symptoms are vomiting, acid smelling milk when it comes up, crying, red-faced and his body arching in a bit of pain, gas and bad hiccoughs. I eliminated wheat, dairy, soy, eggs, nuts and shellfish and it works well. My issue is that this is a restrictive diet and now that I'm working finding the time to pump is extremely difficult and I don't think I can keep it up during the day for much longer. My nanny has tried formula a couple of times today and he actually seems ok with it so far (although he was a little weird tonight so it might be a problem) even though it contains soy and dairy so I'm a bit confused as to why it doesn't affect him as much as my milk when the same ingredients are in it unless there is a delayed reaction.
Has anyone had similar experiences? My baby also has dry skin on his leg which seems to be spreading and I'm concerned that it's related as it might be an eczema. I'm considering using goats milk formula but am not sure where to get it or any risks attached. Anyone with similar experiences who could point me in the right direction would be very much appreciated at this point as I'm pretty confused. Thanks in advance. Gabrielle
First, are you sure you must continue to eliminate *all* of those things from your diet? If you have not tried re- introducing the suspect foods, one at a time, to see if the baby has a reaction, you should. It may be, for example, that you must strictly eliminate dairy but could eat wheat -- which would make the restricted diet much easier for you. My apologies if you know this already and were merely describing the problem in shorthand fashion.
Second, as to introducing formula, a few things are possibly going on. One is simply that your baby is a little older and his digestive system a little better developed than it was when you first began the elimination diet. Two, your breastmilk has a protective effect on the digestive system of your baby. Combifed babies tend to have fewer formula-tolerance issues than do formula fed babies for this reason. It's possible that as long as most of his diet is breastmilk, your baby will do fine with some formula, but he will struggle more if and as the amount of breastmilk he gets decreases and the amount of formula increases. (The same thing, by the way, is true when you introduce solid foods. Some recent research has shown that gluten intolerance occurs much more often when wheat is introduced into a baby's diet after the baby is no longer breastfeeding than when the baby gets whea! t and breastmilk during the same period of time!) Three, it may just be that, in the limited quantities he's had, the chemical alterations that the proteins in regular formula undergo make them more digestible/tolerable for your baby.
So, you should continue to breastfeed as long as you possibly can, as much as you possibly can. If you must stop pumping (and I sympathize -- although I did manage to keep with it, I hated it), start with any plain-old-formula and see how your baby does on it before you experiment with more expensive hypoallergenic types. I would also suggest talking to your baby's doctor about formulas -- he or she may only know what the formula companies advertise, but undoubtedly has more knowledge and experience than you do! anon
If this is your first baby, I just wanted to point out that the ''symptoms'' that you are describing ''vomiting, acid smelling milk when it comes up, crying, red-faced and his body arching in a bit of pain, gas and bad hiccoughs'' are all just very normal baby behavior. Maybe there is no problem with allergies or breast milk and you baby is just behaving quite normally! Everybody seems to want to blame allergies for everything these days, even normal behavior! Have you talked to your pediatrician and to a few other moms who have kids your age? Good luck! -another mom
Symptoms such as lots of vomiting, acid-smelling milk, arching and pain, crying, gas & hiccups could also be acid reflux. My baby arched almost constantly when she was little, and always turned to one side, and after seeing a gastroenterologist, she and the second pediatrician who looked at her suggested this, and prescribed liquid Zantac, which is an antacid. The only way they can know for sure is to do many invasive tests, and the Zantac is harmless. Within a week, her symptoms disappeared completely. What they told me is that it's best to treat this, because acid reflux can damage the esophagus, and from what I've heard from other parents, I'm guessing this is a condition that's often undiagnosed because everybody's used to babies fussing and vomiting. For what it's ! worth, the doctors initially had trouble believing that our baby had the problem because she did not vomit, hardly ever. Frequent vomiting is one of the first symptoms they look for. Janet
Don't recall the original post, but did want to comment on acid breath, gas, pain, etc. being normal. While my infant son (now in college) was being exclusively breastfed I vividly recall his breath being incredibly sweet and delightful smelling. It was only when we graduated to other foods that his breath started to smell badly. He never experienced gas, pain, etc. while being exclusively breast fed. This definitely does not sound normal to me. Perhaps he's reacting to something you eat. j.b.a.
Follow up from the original poster: Thanks for all of the advice and to add some details...
- Aidan does have acid reflux (diagnosed by two doctors earlier and started around 3 weeks old) and I was against putting him onto zantac as he seemed so little for this.
- The milk based formula did cause issues as he got so congested he couldn't feed properly after only a few bottles. Soy formula seems to be fine and I read a study that checked long term re-productive affects of infants solely fed milk based v. soy-based formula (over 35 years) and there were no differences as I had concerns about the estrogens. I'm only using it to supplement if I don't have quite enough breast milk.
- Cutting wheat, dairy, soy and eggs out of my diet works incredibly well. It is so noticeable within hours if I break the diet (he is absolutely fine otherwise) so even though it's hard I'm going to stick to it as I've also heard that some of the drugs such as zantac do! n't always work esp. where a food allergy is suspected (I think it's actually an intolerance but they call it an allergy for convenience:)
So, I think if you have this issue try eliminating foods and if this doesn't work ask about zantac or a similar drug. I haven't heard of any long term issues with zantac it's true and it might work well for others.
Thank you for all the advice, sometimes it's just nice to hear of others with the same issues even if you cannot change much. gabby
My husband has severe food allergies and eczema. I was told breastfeeding as long as possible would lower the risk of my baby developing allergies, and have exclusively breastfed my son since he was born 5 months ago. I have also been pumping vigorously and have stockpiled a huge supply of frozen breastmilk -- there is no room in our freezer for anything else. Unfortunately, our son has developed severe eczema over the last two months, and the pediatric allergist told us the baby may be allergic to protein elements in my diet (she said it may be dairy, egg, or wheat that is passing through my milk) and we should wean quickly and switch to Alimentum hypoallergenic (hydrolyzed protein) formula. The stuff tastes and smells awful... even mixing a tiny bit of Alimentum into my breastmilk makes it taste foul and our baby has refused it so far. So my question is three-fold: 1)is it possible to donate frozen breastmilk? and 2) does anyone have suggestions on how to get our baby to take Alimentum/gross-tasting formula-- should we go cold turkey or just gradually increase tiny amounts into breastmilk? and finally 3) has anyone had success in improving eczema by using Alimentum instead of breastmilk? We are also now using elidel, aquaphor, eucerin, etc. Thanks, Mom with milk
I urge you to seek a second opinion. Mysteriously, pediatricians are not particularly breastfeeding friendly. Please speak with a lactation consultant before weaning your son. For example, you could eliminate the possible allergens from your diet... giving your son an allergen free supply of breastmilk. (Although, I will admit that this can be extremely difficult and limiting.) I wish you the best of luck!
Both my children had allergies to proteins passing into my breast milk, resulting in eczema. But I continued to breast feed both past their first birthdays. What I did do was eliminate what seemed to be the most troubling elements from MY diet. You might want to consider trying that before you switch to formula. (I wanted to keep breast feeding in spite of the allergies because I have heard that breast feeding is strongly protective from the development of allergies later in life.) In my case, I eliminated milk products and eggs (but I did not exhaustively eliminate every product with a trace of milk or eggs! ). I also tested (eliminated then added back) wheat and peanut butter. If you try this approach, go slowly, because the eczema can take a long time to clear up after the allergic reaction is gone. You can also ask your doctor if you can give your baby Benadryl because that can help break the cycle. We started introducing formula while I was still nursing after I returned to work (because it was too hard to pump enough). We used Nutramigen, which I thought tasted horrible, but both my children accepted it without a problem. I did not mix it with breast milk, but gave them separate bottles of formula. With my son, we used formula until he was almost two, because I was afraid he was allergic to soy (something like 2/3 of babies allergic to milk are allergic to soy) and rice milk did not seem to provide enough nutrition. At 2, I had him tested for allergies and he turned out to be all! ergic to milk and eggs, as I suspected, and also allergic to nuts (but not peanuts). The allergist said most children grow out of these early allergies by the time they are 4 or 5. Good luck! Stephanie
I feel for you! One of my closest friends went through this with her child. You do not have to stop breastfeeding if you are willing to eliminate certain foods from your diet. Ask your pediatrician or allergist about doing RAST blood tests. They aren't highly accurate at this age but they can be helpful in pointing you in which direction to experiment in eliminating things from your diet. Sometimes babies with really bad ezcema can have dramatic positive test results. The most common allergies are milk protein, wheat, egg, and soy (I think in that order). So you can either cut them all out at once and then gradually add them back in or cut them out one! by one. But there are also other possibilities (fish, citrus, nuts, etc.) When you do an elimination trial you must be very thorough though (ie no milk means no butter, no ice cream, no whey, no casein, etc.) and it takes about 10 days. My friend's son had multiple (about 10) different allergies and his ezcema dramatically improved after she eliminated those foods from her diet. She breastfed him for about 11 months and decided to switch to Alimentum or Neocate (can't remember, one of those type) because she wanted more freedom of diet. But only switch if YOU want to, not because the allergist says to. It's not necessary. Breastfeeding has many advantages, both related to and not related to allergies. Alimentum (and all those types of formulas) do taste disgusting; I'm afraid I don't have any tricks for getting your kid to take it. Good luck! pediatrician mama
Get a second opinion about weaning, call a La Leche League leader about the diet thing. See http://www.lllusa.org/web/OaklandCA.html for numbers You can try eliminating allergens from your diet now -- might be easier than weaning. Start with dairy, then soy, wheat, and go then nuts. See: http://www.lalecheleague.org/NB/NBJulAug98p100.html There is a Mother's Milk bank in San Jose. Not sure how it works though. Jennifer R
Ack! Don't stop breastfeeding! The first advice you got was much more accurate than the more recent. IF your baby's eczema is caused by something you are eating, the best thing to do is stop eating that. (Dairy is the most likely culprit.) Go on a strict elimination diet yourself for a few weeks and see if baby improves. If not, you'll have to figure out a different solution. If so, you can make your own decision about the cost/benefit ratio of feeding your baby formula (and a very specialized formula at that) vs. having to eat a restricted diet yourself, though of course it's much healthier for both the baby and you (not to mention a heck of a lot cheaper) to continue breastfeeding and avoid dairy or whatever you determine the problem is. As for donating your current stash of breastmilk, if you determine that you can't feed it to your own baby, yes, it may be possible to donate it. Different milk banks have different policies, though in general you must donate a minimum of 100 ounces and they may or may not be willing to take milk that was pumped before you signed up, passed their medical tests, and received their storage bags. There is a milk bank in San Jose; contact them and ask. Alternatively, you may be able to give it to a friend who's having trouble pumping enough milk for her own baby (I know several women who've been involved in such arrangements, either as donor or recipient). Holly
I don't know if I have any specific answers to your questions, but I wanted to relate to you our recent exerience with the same problem. We just went through 4 months of craziness and fear over ! food allergies and breastfeeding. My husband has allergies and asthma. When our 3 month old developed rashes and hives, we were told by the pediatrician that it was food allergies. I threw out bags and bags of milk, fearing that something I ate could be hurting her. Over the next three months the reactions progressed to eczema and eyelid pinkness/swelling. They were always within minutes after she nursed. Fortunately, Benedryl worked immediately for her reactions. I agonized over whether she should have formula, and if so, which one because she seemed to react to both dairy and soy. But I continued to breastfeed. Instead I eliminated every possible food allergen from my diet (wheat, dairy, eggs, seafood, nuts, citrus, soy). However, we were prescribed an Epipen, just in case. It took 3-4 months of note-taking, observing and brainstorming to come up with a list of what we thought triggered her ''attacks''. When s! he was 7 months old she finally got a skin-test. To our surprise, NONE of the foods (she was tested for 9 single and combination allergens) caused a reaction. I have since added all those foods back to my diet (the allergist said if I could wait on shellfish and peanuts it would be an added security) and she is just fine. We learned through this experience that our baby's immune system just needed time to mature. She is 8 months old now, eating many different cereals,vegetables and fruits and still breastfeeding. Even though I was worried about the decision to not use formula, I am so glad I didn't. Removing all those ingredients from my diet was challenging, but certainly not impossible. Did your allergist give you any other choice but to wean? Is it possible that you could begin an elimination diet and still breastfeed part-time to see if your son's condition improves? When our daughter had her ezcema, we used a combinati! on of Aveeno colloidal bath packets and Aveeno cream. I wish you all the best in making a decision. evalune
I really feel for you... You might want to try to find a different pediatric allergist who is supportive about breastfeeding and knows something about lactation. If you are having a successful breastfeeding experience, I'd really try to hold onto it. My son has eczema, though it didn't start as early as your son's. What has helped us the most was to see a pediatric dermatologist. (I would refer you to our dr., but we live out of state now.) Boy, they know eczema inside and out--yes, much better than the pediatric allergists. You may have to go to UCSF to see one (not sure if Oakland Children's has any). When my son was around 1 or 2 months old, he *did* have an allergy problem with something in my milk, though, with gastrointestinal symptoms. Believe it or not, a lactation consultant (Janaki Costello, she's wonderful, she's in the phonebook) helped us nail down the problem (after our pediatrician dropped the ball). I'm so *glad* we called her, because she helped us figure out what to eliminate (just dairy products) and gave us very clear info, and the problem cleared up *immediately* and my son's weight gain jumped. Last, some eczema advice (take it with a grain of salt, because all eczema cases are different). Elidel actually irriated my son's eczema--they don't tell you it's a rare side effect, but be on the lookout. Also, Aquafor and Eucerin did, too. The best thing for *him* is plain old vaseline smeared on after a tepid bath (this also happens to be the cheapest). Good luck! Kristine
My son was exclusively breastfed until 7 months and had eczema. It wasn't until I fed him yogurt that he had a severe skin reaction and the pediatrician determined he had food allergies. Since then we have discovered that he is allergic to dairy, eggs, wheat and soy. Wanting to keep him on breastmilk, I eliminated these foods from my diet and his skin improved a great deal. You may want to try eliminating common allergy- causing foods from your diet one at a time and see if this helps. I'm sure you know from your husband's allergies how hard it is to be on such a strict diet, but I felt it was worth it. We also did the whole Aquaphor, Eucerin, cortizone (our doc didn't recommend Elidel for infants) regimen, but it was so good to get at the cause, not just treat the symptoms, while at the same time keeping him on breastmilk. Also, there was a posting a while back recomme! nding flax seed oil (mixed with applesause or cereal, when your baby can eat solids). It really helped this mom's child's food-allergy eczema. Hope this helps. Jodi
Here's our experience: at about 6 months our son (now 4) had full-body eczema as well as failture to thrive and his GI doctor had hinted at weaning to Nutramigen (same as Alimentum). He also said as our son's GI tract matured, the eczema and malabsorption of nutrients would subside (it did!). Personally, I did not see a huge change from cutting out dairy and wheat from my diet, but did manage to break the eczema cycle with a prescription cortisone (forget which one) which we only used for about a week, coloidal oatmeal baths, Aquaphor rubs, and eliminating ALL fabric softeners. And Trader Joe's laundry detergent has worked best for us. At one year we started on Nutramigen with no problem despite it's foul taste and smell, and I continued nursing as well, until he was 19 months (as self-! weaner, but that's another story). He's still skinny but getting pretty tall and has been eczema-free for about 3 years. Good luck!