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Tuesday, April 28, 2009

Colic, Reflux, Allergy, Oh My!

Warning: for those who are squeamish when talking about baby poop, consider yourselves warned! 
I just changed Mister Baby's diaper and saw something that may or may not be cause for alarm. Normally, a breastfed baby produces stools in 'every color of the rainbow,' as I've heard it described. There are lots of reasons why it could be anything other than 'mustard butt,' which, at least in this household,  is what we call the bright yellow stuff. Yellow-brown, brownish-yellow, green, dark green - it could mean a variety of things besides just what you've eaten for that day. 
Greenish poo can mean a couple things - if the baby is getting only the foremilk instead of the hindmilk, for instance, it can produce frothy, greenish poop. Getting the baby to nurse longer or continuing on the same breast at the next feeding can often help. This can also be caused by overactive milk supply, causing the baby to sputter, cough or gag at the breast because the milk is simply too much for him. I tend to have this, at least until my milk supply regulates itself over time, and right now Mister Baby is fussy at the beginning of a feeding or pulls away from the breast and gets sprayed in the face. When he pulls away, I'll sometimes use a cloth or nursing pad to absorb the excess milk and we're good to go. Mister Baby seems to match several of their criteria, including  spitting up a lot, crying and irritability sometimes (but what baby doesn't?). If you think you're producing too much milk, here are some good ways to tell:
However, these are criteria for other problems, too, namely a milk protein allergy, which is the part that concerns me. Overactive milk letdown is an easy problem to fix; not so much so for the dairy allergy. Or at least while it's not difficult to fix, the results can sometimes take longer to see. Ask me how I know: I dealt with endless screaming and inconsolable crying for eight long weeks with my daughter before I figured out the problem. Other big red flags with her were a persistent "allergy ring" around the anus that I dismissed as simple diaper rash, stool that changed from normal bright yellow to green to brown and then to blood, and lots of mucus. Considering I have Crohn's Disease, I was scared to death that it was manifesting itself in my infant daughter already - knowing that she could inherit this horrible disease from me anyway, I couldn't bear the thought of her suffering from it so early in her young life. 
We had already visited one of the pediatricians in our group before, only to come home with a prescription for Zantac to treat acid reflux. I never got that filled, because I wasn't totally convinced it was reflux. Sure, she spat up a lot, but there were also episodes of literal projectile vomiting that scared the hell out of me - at times it was so forceful that I couldn't even find where it landed. I was afraid to feed her after she'd vomit up an entire feeding and then be hungry again. 
Then her symptoms manifested themselves in bloody, mucusy poop - not a pretty picture, especially when there were times I'd find that instead of stool in her diaper. After that, I knew something was really wrong, and visited the kellymom website to get some very helpful advice on diagnosing a milk protein allergy. My daughter showed probably all of the red flags, but I was relieved that this was at least something I could deal with on my own and hopefully it would resolve itself with a change in diet. 
I visited our pediatrician at my daughter's 8-week checkup and she was just as concerned as I was, only her answer to the problem was to put the baby on formula for three days and see if there was an improvement. By this time, I already knew that it could take up to ten days for her symptoms to disappear, and that going on formula would do nothing, since it wasn't enough time to see improvement. After the three days I would continue nursing her while on my same diet; how was that going to change anything? 
I told her I wanted to change my diet and see what happened, and her response: "'s been my experience that moms say changing their diet doesn't really work." I thought, either they weren't eating totally dairy-free, in all its forms, or they didn't wait long enough for signs of improvement. I knew it could take a while and was willing to wait it out if it meant I could continue nursing. I left there disgusted, but at least had convinced the pediatrician that I would do it my way, for now. 
The thing is, you don't have to stop nursing: there is absolutely no such thing as being allergic to breastmilk. Your breastmilk, designed for your baby, is Nature's perfect food. It's what's in your breastmilk, like dairy, soy, wheat or other allergens, that can cause baby a problem if they're allergic. Just like we know that alcohol and drugs in breastmilk can affect a baby, so can the food you eat. So any doctor who tells you your baby is 'allergic to your milk' is full of BS. Unfortunately, I think some doctors just don't know enough about it to properly advise a patient, because I've read a lot of misinformation out there that seems to come directly from the mouths of our esteemed pediatricians, of all people. 
The challenging part is eliminating all forms of dairy from your diet - not just milk, but caseins, caseinates, and all those other foreign-sounding ingredients that don't look like dairy but really are. Sometimes it's confusing, and the label can even bend the truth a little by saying "not a significant source of dairy." Well, maybe not to them, but it is to your very sensitive baby - so be on the lookout for these impostors. (One culprit I can think of is my flavored coffee creamers that I like so much. Darn it.) Note: lactose-free is not the same thing as dairy-free. Changing to lactose-free products will not solve the problem. 
It became more of a challenge to find products I could actually eat safely. One nearly surefire way for me to tell was by following a parve diet labeled with the OU symbol - if it doesn't have a "D" next to it, you know there is no dairy. The Orthodox Union is very strict about food labels and what goes into products, and they regularly inspect manufacturing plants and their equipment to make sure they are indeed kosher. This definitely took 90% of the guesswork out of it for me, and I recommend it to anyone who faces the same dilemma. 
There are so many things on the market today that, if you're willing and truly dedicated to going dairy free, it can be quite easy. Rice-based ingredients are usually a good bet, especially since they often don't have soy-based proteins in them that can also be allergenic as well. You can get rice milk (which I still use to this day), rice- or tofu-based ice cream and other treats (yum!) and a variety of other specialty foods that make eating less of a chore and heal your baby's sensitive tummy, too. And hopefully your child will grow out of the allergy around 9-12 months, like mine did. Thankfully my daughter tolerates cow's milk just fine now. If not, at least you know you can feed your child some safe, yummy alternatives to milk, and for the little ones, know you can still continue to nurse them safely and provide them Nature's perfect food. 
• Other great websites to check out for information and recipes: For info and recipes on this and many other common allergies