Food intolerance during infancy is sometimes underestimated. Unlike food allergy, food intolerance does not cause life-threatening symptoms. However, the impact of food intolerance in infants can be significant, causing reflux, stomach or bowel cramping, green mucousy stools, eczema – and usually a very distressed bub. Identifying trigger foods through an elimination diet is a lengthy, fraught process, and once food triggers have been identified, preventing exposure to those foods, particularly when a mother is breastfeeding, can be equally challenging. Thankfully most infants will outgrow food intolerance in their early years.
We spoke with Inner West Mum Megan Anderson, whose son, now thirteen months old, has suffered from severe reflux and food intolerance since birth. Megan is keen to increase awareness of food intolerance in infancy and to encourage other families who may be experiencing similar to seek appropriate medical advice.
‘My son was extremely unsettled right from the beginning,’ says Megan. ‘He screamed constantly. Previously I’d had some experience of newborns through my work; this didn’t seem to be your average newborn fussiness. My mum, who is a midwife and early childhood nurse, agreed. She also pointed out that his stools weren’t normal either: they were a horrible green colour and mucousy.
‘Three days after my baby was born, as the obstetrician was doing his hospital rounds, I burst into tears. I told him I couldn’t get my son to settle. He asked the paediatrician to visit. The paediatrician saw my son refluxing and suggested the usual first-line interventions for reflux – lean back while breastfeeding to slow down the flow and hold him upright after feeds – which did seem to help a bit.
‘We came home on day five and my son was still so unhappy. He screamed in pain all the time. I knew I needed to see a paediatrician, but the next available appointment was more than three weeks away. I couldn’t wait that long; my son couldn’t wait that long.
‘I was able to get in touch with the paediatrician who had diagnosed my son’s reflux in hospital. He provided a script for a reflux medication. He also told me that sometimes very early onset reflux can be due to a dairy intolerance, and since I was breastfeeding he suggested that I limit dairy in my diet. That was the first piece of information that made me think that perhaps something was actually causing the reflux.
‘So I cut out dairy from my diet as advised and my son got a little bit better. I noticed, however, that on the days when I ate Thai food he was particularly unsettled. I knew that a lot of babies who are intolerant to dairy are also intolerant to soy, because the proteins are similar. The Thai food contained soy. So I cut out soy too and he got a little bit better. He was still uncomfortable and wasn’t sleeping much, but at least he wasn’t screaming in pain around the clock.
‘When my son was eight weeks old I took him to the US to join my husband on a work trip. While we were away he was absolutely miserable, despite now being on two reflux medications. On the return flight to Sydney, we were chatting with another passenger who told us his daughter also had reflux. He recommended a paediatric gastroenterologist in Sydney who had helped his family. As soon as we arrived back, I asked my son’s GP for a referral to the gastro specialist whom the passenger had recommended.
‘I managed to get a cancellation appointment several weeks later, when my son was twelve weeks old. The first thing the gastroenterologist noticed was that his breathing was not normal. The reflux was still so bad that he was aspirating stomach acid. He had a hoarse voice because the acid was burning his vocal cords. It felt awful to know that my poor baby was in so much pain.
‘The gastro specialist told us that since my son was passing mucousy stools, there were still allergens present in his diet. He recommended hypoallergenic formula. But I wanted to keep breastfeeding. By then my son wouldn’t take a bottle. Breastfeeding was the only way I could get him to settle – I didn’t want to take that away – and what if he was actually worse on formula and my breastmilk dried up? The gastroenterologist respected my decision to continue breastfeeding. He explained that after dairy and soy, the most common foods causing gastrointestinal symptoms (but not involving skin) were eggs, wheat, corn and rice.
‘I cut eggs and wheat from my diet straightaway. Initially my son seemed to be doing better without dairy, soy, eggs or wheat. But then he got worse again. I realised that a lot of the wheat-containing foods that I’d substituted in my diet were corn-based. So I cut out the corn and he got a lot better. He wasn’t totally settled though, and it was clear he was still having some gut pain.
‘We continued to identify more and more foods to which my son is intolerant through an elimination diet. We discovered peanuts were problematic – in fact, all legumes are an issue for him – as are fish and shellfish. The foods in my diet were ever decreasing, but it was what had to be done. We also discovered he was also reacting to certain medications containing bovine-derived materials that I was consuming, as well as his vaccines, which he now receives at a clinic that handles patients at risk of adverse reactions.
‘Now at 13 months, we’ve reached the point where my son can tolerate about 15 safe foods directly, including several veggies, fruits, tree nuts, oats and rice. Unfortunately he cannot eat a wide variety of finger foods like most babies and toddlers. We also have to be careful around other young children who tend to drop food.
‘I’m still breastfeeding and I’m planning to keep doing so until he can eat a more varied diet. The breastmilk is a good source of protein and fats that he otherwise wouldn’t be getting easily. I’m super strict about what I eat – I have to be. My diet may be boring but my motto is, nothing tastes as good as sleep feels!
‘Intolerance is poorly understood, even among health professionals. Some people say, “But he’s growing so well, how can there be an issue?’ My son is growing well because he’s a champion breastfeeder and we work hard at including sources of protein and fat which he can eat. Others will say, “Is it really a problem if he eats a certain food and his poo is a bit mucousy?” Mucousy stools, or worse bloody stools, are signs of an inflamed, damaged gut, and with that comes days of pain. It’s just not worth it.
‘The fortunate thing about intolerances is that most children do grow out of them during their early years. The unfortunate thing is that there is no clear answer as to when that will be. I know we’re better off than many families dealing with similar issues. At least we know what our son’s triggers are. And I cannot imagine what it would be like to have a child at risk of anaphylaxis.
‘It’s been quite a journey. Finding the right medical professional to help my son has been so important. Facebook support groups, full of parents who have walked that road before you, have been great too. My mum has been amazing through it all. And my husband has been wonderful too. I’m so lucky that he loves to cook – he always comes up with really nice dishes even with my dietary limitations.’
If you suspect your baby has a food intolerance or allergy, please see your GP. It is important to seek professional advice when eliminating foods from your or your child’s diet.
You can find out more about food allergies and intolerance at these excellent websites:
Raising Children: Recognising Allergies
ASCIA: Food Intolerance
You might also like:
The Relentlessness of Reflux
Travelling as a Family with Food Allergies