Category Archives: Elimination Diet

Living and breastfeeding on a restricted diet.

Failure to Thrive or Low Breast Milk Supply?

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Recently I’ve been in contact with friends who are very stressed out because their babies are dropping growth curves. They have all been breastfeeding and were now being encouraged to switch their babies to hypoallergenic formula.
I myself had the same thing happen when my second baby was about 4 months old. She had bovine, soy, egg, and cocoa intolerance but was growing fine on my breastmilk while I was on an elimination diet. At about 4 months old she dropped a growth curve and her weight was plateauing. On a regular follow up with our GI, the doctor freaked out and said that the elimination diet wasn’t working and that we should switch to a hypoallergenic formula.
I wasn’t comfortable giving up breastfeeding given that our baby was happy and developing in every other way. I also felt that my milk supply had dipped somewhat, particularly with the return of my first menstrual cycle. I consulted the breastfeeding clinic who followed me and they checked my prolactin levels via a blood test. We got the results the next day and my levels were extremely low (25). They highly recommended that I begin domperidone (which I had been on while breastfeeding my first baby.) Within days my baby was gaining weight again and by her 6 month checkup she had jumped from 37th % to the 75%.
So the take home message here is that sometimes we are looking for problems with a baby when in fact the problem can be as simple as the mother’s milk supply.
I really think this doctor was too quick to jump to the conclusion that my milk was harmful rather than there just wasn’t enough of it.

5 Ways to Simplify An Elimination Diet

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While following an elimination diet is encredibly tough for a new mom, it does represent a big challenge for those around her as well.  Over the years, we have developped a few tricks and routines that help us make it just a bit easier:

1. Cook for the whole family

There is nothing worse for an MSPI mom than sitting at the table salivating and starving while everyone else eats something she can’t.  Cooking two separate meals each time you sit down is also an incredible time drain – especially with a new baby around.  Make it a priority to prepare food that everyone in the family can eat.  This helps normalize the situation and simplifies life enormously.  If you’re not sure where to start, check out our delicious recipes.

2.  Find someone you trust to cook for you

A big part of having a new baby in the house is eating take out.  On an elimination diet this is not really possible so if you can find a parent, sibling, friend or caterer who will follow the strict rules required by an elimination diet, it will make your life a lot easier.  It is very important that this person understands about cooking for someone with allergies.  Ask them to prepare a full meal (at least a main course and vegetable) once a week.

3.  Cook in bulk

Buy a chest freezer and a really big pot and start cooking in bulk.  Prep time is not usually that much longer, and when you have those crazy days when you can’-put-down-your-baby-and-the-other-kids-are-sick or you’re just too damn tired to cook,  you can just pull something out of the freezer and pop it in the oven or microwave and your good to go.

4.  Buy a slow cooker (Crockpot)

While I usually despise most kitchen gadgets, our slow cooker has become an indispensable part of dealing with our elimination diet.  The most useful way to use one is make an all-in meal that has your protein, carb and vegetable in it already, like our slow cooker apricot pork tenderloin.  You could also check out a slow cooker cook book and to see if there are any recipes you can use or modify to suit your needs.

5. Keep Reading This Site

This site is full of useful stuff, and we are adding more all the time.  Don’t forget to check out the forum as well.

MSPI and Soy Oil and Soy Lecithin

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As the name states, MSPI (milk-soy protein intolerance) is an intolerance to proteins found in certain foods – namely dairy and soy.

When embarking on an elimination diets, Moms are generally advised that it is safe to eat foods that contain soy oil and soy lecithin – two fats derived from soya beans. This makes going on the elimination diet easier, since many prepared foods contain these products. In principle, these fats are highly refined and do not contain any of the offending proteins that would irritate a MSPI child’s GI tract. In practice however, this is not always the case. Many MSPI Moms find that they need to eliminate soy lecithin and oil from their diet in order to resolve their child’s issues. The dietician following us at the Montreal Children’s Hospital, made it clear that this was far from a rare occurance. Our pediatrician even told us of a Mom who resolved her child’s intestinal bleeding only after eliminating her chewing gum, which contained soy lecithin.

My feeling on the subject is that it likely has to do with the quality of the ingredients used in prepared foods. If the lecithin or oil is not sufficiently refined, traces of offending protein will remain. Even a fragment of undigested protein in Mom’s breastmilk can be enough to irrate a sensitive child.

What does this mean for a new Mom going on an elimination diet? The general recommendation seems to be that soy oil and soy lecithin can remain in her diet initially. If the child’s MSPI symptoms are not resolved after two weeks or so (the time it takes for offending proteins to be completely removed from breastmilk), then eliminate soy oil and soy lecithin.

Soy lecithin has also proved problematic for parents who are formula feeding their MSPI child. It appears as though both Nutramigen and Alimentum contain soy lecithin, which means that some sensitive children will have to be fed Neocate.

See also :   Soy Allergy (Wikipedia)