November 29, 2008

Elimination Diet

How does one eat enough calories and get enough nutrition while on a elimination diet?

I believe the key is quantity. While breastfeeding you are to eat 500 calories more than your normal caloric intake plus adequate amounts of water to maintain your milk supply.

The Dr. Sears diet has you start by eating only turkey or lamb, baked potatoes and sweet potatoes, rice and millet, cooked green and yellow squash, and pears. Substitute rice milk for cereal or in cooking. I stretched this diet a bit and was not quite that strict.

For breakfast I ate rice crispies with rice milk and turkey bacon or cooked millet cereal. For lunch I ate turkey lunch meat and sweet potato soup mixed with rice. For dinner I had chicken, roasted potatoes, squash, and pears. I added different varieties of squash such as acorn squash and squash soup as well. I also ate two snacks and a before bedtime 'dessert' to make sure that I was getting enough calories. Not the most exciting diet but it did work. I also added a calcium, magnesium, and zinc supplement plus my normal pre-natal vitamin.

The Dr. Sears elimination diet recommends using this basic bland diet for 2 weeks before adding in new food categories. I didn't last that long. By the end of one week I was bored with my new diet and in search of new foods. My favorite find was cookies, granola, cereal bars, and bagels made my the company Enjoy Life. This company makes snack foods that are free of the common eight allergy foods (dairy, soy, gluten, wheat, eggs, peanuts, tree nuts, and shellfish). I especially loved the Snickerdoodle cookies. I did stay away from the chocolate snacks though.

My first add-on to my diet was avocado. Avocados are low allergenic risk and high in healthy fats which helped keep me full longer. I then added corn cereal and oatmeal, non-gassy vegetables such as carrots, peas, and green beans, and fruits such as peaches, apples, and bananas.

Once I had some basic variety I then starting challenging with the big food categories once a week. At this point, I had been on the elimination diet for approximately 3 weeks and my daughter was symptom-free. My first challenge was soy (I used soy yogurt) because soy is added to virtually every processed food product out there and is amazingly hard to avoid. Thankfully, my daughter had no reaction. However, I did limit my amount of soy to 1 serving per day to be cautious. My next challenge was wheat. I add wheat spaghetti noodles (avoid the tomato sauce). Again my daughter had no reaction. Having the ability to eat both soy and wheat products opened up my potential food options tremendously.

My next challenge was eggs. This one didn't go quite as well. I had a horrible stomachache about 1 hour after eating them. Then my daughter had a lot of spit-up after her next nursing session. That evening she developed skin irritation on her cheeks, an irritable stomach, and was generally much more fussy that usual.

At the point, 1 full month had passed and we were back at the pediatrician for a well check. Per my pediatrician's recommendations I did not challenge my daughter with peanuts and tree nuts.

Along the way we did have a few hiccups. I found that my daughter did not do well with chocolate. Exactly 12 hours after eating egg-free and dairy-free chocolate cake my daughter had serious stomach pains. At first I thought that it was unrelated, but then again exactly 12 hours after my next piece of cake the same symptoms re-emerged. I found that I could not eat guacamole. Apparently the spices and onions made her gassy. I also could not eat large quantities of tomato sauce (ie. spaghetti sauce) and so I had to avoid that as well. As my daughter got older and her stomach became more mature and I was able to add all of these foods back into my diet.

November 28, 2008

Back Story

My daughter was born in December 2007. Her initial diet was nothing but breast milk. She was a very fussy baby that had gas, belly pains, minimal spit-up, and rarely vomiting. With all of her stomach problems she was a terrible sleeper and was consistently needing to be rocked, walked, shushed, and fed. She ate ever 1-3 hours around the clock.

At 6 weeks she developed a sun burn-like rash on her cheeks that I treated with aquaphor. By 7 weeks the dry rash spread to cover her entire body. It was worse on the backs of her knees and behind her ears. At her 2 month well check she was diagnosed with infant eczema and was put on a strict regime of lotion, hydrocortisone cream, and fragrance free everything. In addition, the pediatrician recommended that I eliminate all dairy products from my diet. After just 3 days of a dairy free diet her skin improved tremendously, however, she was still very gassy and irritable. At this point I went on an elimination diet as recommended by Dr. Sears. Her symptoms continued to improve, however, just 1 week later she had blood in her stool. At this point the pediatrician recommended that we discontinue breastfeeding and use the hypo-allergenic formula Neutramigen only. I was devasted as I was not ready to stop breastfeeding just yet. I continued to pump to maintain my supply, maintained my strict diet, and did a lot of crying. After 1.5 wks of formula only, I re-introduced breastmilk back into my daughter's diet despite my pediatrician's recommendation not to. She remained symptom-free and was much less fussy overall.

After 3 weeks of a strict diet I slowly added back in food groups watching for reactions. Thankfully I was able to eat wheat and soy products. I was unable to eat eggs. My daughter began spitting up and had a belly ache/gas later in the day. I also unable to eat milk products. My daughter's skin problems flared up shortly after re-trying milk. Other foods that gave her stomach issues included chocolate, tomato sauce, and spicy foods.

So, since February 11th, 2008 I have been dairy and egg free so that I could continue to breastfeed my daughter. It has been a challenging diet but well worth the trouble.

Official Allergy Results

My 1yo skin testing showed an allergy to egg yolks, egg whites, and casein (a cow's milk protein). Strangely enough, she tested negative for actual cow's milk. Strange! How can that be exactly?

So for the next year (and maybe longer) we are on a strick no egg and no milk products diet. This blog is designed to document our journey through this process and to provide helpful insight to other parents with similar dietary restrictions.