Thursday, October 09, 2008

maybe a food allergy

Well my meeting with the nutritionist yesterday was very interesting and educational.

We went over our (mostly Danny's) whole history, from birth. Looking at the fact that he was born congested, had bad gas in those early months of nursing, started getting skinny around 7 or 8 months, and "stuck" (the word the PT used) developmentally around 6 or 7 months, is very prone to constipation, snores and often has a stuffy nose, etc.

It all adds up to a very high likelihood of an allergy, and more specifically a food allergy. And looking at the timing of when his weight and development issues started - right around when I started giving him lots of yogurt and cheese - it seems likely that he may be allergic to dairy. This is a whole new world of info for me, and I'm sure I'll butcher the explanation and there are many of you who much more about this than me. But here goes,briefly as I understand it...

1) It seems that when people don't properly digest the proteins in milk, there are byproducts of that digestion that get into the bloodstream and travel to the brain and can act like an opiate on the brain. Possibly affecting brain function, and therefore development. Some of this is controversial theory (based on my own internet reading since this appointment), but there is evidence to suggest it could be true. This could be a good explanation for why he was rolling over for a while and then stopped, and why his development never seemed to progress after a certain point. It was around that time that we started giving him dairy. This might also explain why he seems so 'mellow' to us sometimes - he is often content to just lay around and suck his pacifier or hold a stuffed toy. Maybe he's effectively feeling a little 'high' from the affects of the dairy on his brain.

2) It also seems that if someone is allergic (or 'sensitive') to a food, then their body would not be properly absorbing the nutrients from that food, and potentially other foods they are eating at the same time. This could be a good explanation for why he was chubby and at appropriate weight percentile at 6 months, but by 9 months his weight gain had significantly slowed, his percentile had dropped, and he was looking like a very skinny kid - it was during that time that we started giving him dairy. If this is the case - then stuffing more dairy fat in him to try to fatten him up would likely have the opposite affect.

It's not definitive, but certainly a very strong circumstantial case. I've gone ahead and made an appointment with a pediatric allergist to have him tested. That appointment is in a couple of weeks. But in the mean time I agreed with the nutritionist to take him (and therefore me, since I'm still nursing) completely off dairy. And after spending a lot of time talking with her about ideas, I think it's not going to be as hard as it may seem.

We're taking Callie off the dairy too. She does have some mild symptoms of a sensitivity (some mild excema on her cheeks which I am very interested to see if going off dairy will eliminate this), but mostly because it's easiest for me if we're all on the same diet. And the more reading I do the more I realize that non-human milk is not at all necessary for humans to consume, so I think she'll do just fine without it. She's still getting my milk, and all of the nutrients in cows milk can be easily replaced in other ways.

The thing we will miss the most is cheese. And I'm not totally clear whether we can still have other cheeses (goat cheese, buffalo mozarella, etc.), I have that on my list of follow up questions.

My concern with cutting out the diary was regarding how we make sure to replace those missing calories and fat and other good nutriends. She had a lot of great suggestions for this - including:
  • nut butters. There are lots of options other than peanut butter - sunflower seed butter, almond butter, cashew butter, pumpkin seed butter, etc.
  • there are lots of good organic 'buttery spreads'. (I think the word margerine has a negative connotation in the organic world, so they don't call them that, but it's basically like margerine, just made with all natural/organic ingredients.)
  • she showed me some examples of little snack foods that don't have dairy. things like these, and these.
  • we talked about a lot of different milk options. We will be sampling some different options like soy, almond, oat, rice and hazelnut milks and see what we like. they don't have as much fat as whole milk, but they do have all the same calcium and vitamin D.
  • Olive oil. Olive oil. Olive oil.
  • Soy yogurt. I have already been eating this, and I like it a lot. I also discovered some yogurt made from coconut milk, so we'll be trying that soon.
  • Cod Liver oil - a spoonful to mix in their cereal or other food. Has the omega-3 fats, vitamin D, and apparently is also very good for constipation.

I am to keep track of everything the babies eat in a diary for a few days. I will send this to her, she will do a full analysis of the nutritional content in their diet, and then we'll meet again next week to review that and talk about what might be missing and how we can add things.

She also had some interesting (and terrifying!) input about how they should be getting their food and liquids. She feels very stronly that at 1 year old children are capable of (and should be) learning to feed themselves with a spoon. She said that we should let them try to spoon feed themselves for at least 3 minutes at the beginning of every meal. It has to be regular and consistent, so they have an opportunity to learn. Oy! this sounds so messy. But she said that soon they will refuse to eat because they want to be eating independantly, and they will only want to eat finger foods, which is not a good habit for later in life. And interestingly, lately Callie has been refusing to eat anything we try to feed her - she only wants finger foods. So we'll give it a messy, messy try. Also she's not a big fan of sippy cups. She said that at 1 year old they are also ready to drink from a regular cup, and that we should be giving them the opportunity to learn this. She feels that a sippy is no different from a bottle - they still have to tip it up and suck - so there's no reason to bother with sippys and you should go straight from bottle to regular cup drinking. yikes! So we're in for some messes.

I'm sure there are lots of opinions on these subjects and I'm sure we'd get lots of different advice depending who we ask. But I felt very comfortable with her, she seems extremely experienced and knowledgeable and reasonable, so I will go with her input for now. Even if it turns out that we don't have a dairy allergy, I think we'll all be healther with this diet anyway. So there's really no downside, as long as we're diligent about replacing the nutrients in other ways.

Also a brief follow up to my earlier post: I want to be clear that I am not at all apposed to vaccinating my children. I absolutely will do it, I think it's important for them and for other children around them. I'm just beginning to believe more and more that it isn't as necessary to get it all done quite as early as the CDC has been telling us. A slightly delayed vaccination schedule is just fine, there is continually growing support for this among a lot of parents and medical professionals, as long as they've had everything they need before they go to school. My pediatrician had no concern about delaying their vaccines, as long as we catch up later. These kids aren't in day care, and presumably won't ever be. So as long as we're caught up before they go to school, I think we will be just fine.


Gab said...

Going to an allergist is the best thing you can do. As a mom of a peanut allergic child, I would say hold off on giving your children nut butters until you see the allergist - many kids are allergic to multiple foods. The last thing you want is a life threatening reaction. And feel better knowing that MANY kids grow out of milk allergies so stay positive! Just my two cents. :)

Bea said...

I will be watching to see how the diet develops and if it helps. Good luck!


Jaimie said...

We have been living in the rice world. Jake never had enough dairy on his own (most of his was through mommy) to have symptoms like the ones you have been seeing. Jake just flat out got hives so I don't know if it would be different or not. We are to avoid all dairy not just cows milk.

I know Jake is allergic to peanuts and you because of me of course. But we were advised not to give any type of nut anything. They did tell us to avoid soy too, but that is so hard. I just don't give him things primarily made with soy (milk, cheese). I don't mind most stuff made of soy.

Even though we are down to nursing just a couple of times a day (if I'm lucky) I can still tell if I have eaten something I shouldn't have. I had a very very hard time giving up dairy

cat said...

Good luck with the diet. Sesame seed is a great source of calcium and you can mince them and mix into food. Avocado pear is a wonder food off course. In South Africa a lot of us at private nurse practitioners do a delayed/spread out vaccination schedule. We just find that you have less side effects.