Question:
Can you give me some advice on introducing solids to my baby. She is 20 weeks old, breastfed, and has silent reflux. I commenced an elimination diet as I was convinced he also had an allergy/intolerance to something in my diet. I reduced my diet to lamb, turkey, zucchini, squash, potato, sweet potato, brown rice and rice products (rice milk, rice cakes, etc).
I would really appreciate if could get some advice from you regarding introducing foods back into my diet. I have re-introduced some vegetables and most meats (on an occasional basis) but need some direction on what do from this point onwards. I look forward to hearing from you. Rosemary
Joan’s Answer:
Dear Rosemary,
You were right using an elimination diet as the only way to see if your baby is food sensitive. Managing your own diet and that of your baby can get complicated for various reasons. Following are some ideas to consider.
The first priority is to make sure you still have sufficient amounts of foods so you have enough nutrients to maintain your own health and produce sufficient breast milk. I hope you did not lose weight. It is a good idea to have a diet consult from an APD [Accredited Practicing Dietitian]. You can work towards a much less strict diet. You can also get support from books written by dietitians such as the Royal Prince Alfred Hospital Elimination Diet Handbook or my Are You Food Sensitive?
A very useful help is the Family Sensitivity History outlined and explained in Chap 4 in Are You Food Sensitive? showing how much you can learn from clues in the family after noting all the symptoms from the list, and all the suspect foods and environmental factors that are worthy of watching in your own family. This information can be added to the important list of additives and natural chemicals, explained in Chapter 3 to form your own Family Elimination Diet. This means a much less strict diet.
As you started a more strict diet you can first add in all the allowed foods here knowing they are unlikely to be high risk of bad reactions. Having said that I do want to emphasize that each baby is an individual and will have reactions that do not fit any lists of what is supposed to happen. That is why I call the process Diet Detective Work.
Having got the general information from the family and diet you can read about managing food sensitivity in a baby, in Chap 8. You can note all the foods that can be introduced one at a time from low to higher risk taking into account how severe the baby’s symptoms and distress are. This means using the rule that the more scared you are of the baby having a reaction the smaller the amount you give to begin the diet trial. Of course if the baby has severe allergic symptoms or the possibility of severe reactions it is very important to discuss food trials with your doctor. Are You Food Sensitive? also contains a Food Glossary which lists many important foods and gives them a risk rating so you can decide what you wish to trial.
Breast feeding is no barrier to diet investigation. In fact that is where you start when the baby is four months. Foods can be introduced via you eating them while breastfeeding and then later feeding small amounts directly to your baby.
When your baby has reflux all the food issues that can affect food acceptance are even more important. Managing introduction of solids is an important chapter in Reflux Reality, the new book which you should give to yourself as it has so much helpful information you can benefit from.
The other book I have written with ideas that may help is Fussy Babies. It has chapters on understanding all the parts of eating development, [including the idea of treating your baby as if he is a food gourmet], food sensitivity and supersensitivity. The idea of supersensitivity describes the little known idea that many babies, especially food sensitive ones, are very sensitive to many sensory inputs from the environment such as noise, bright light, scratchy clothes and many more. Fortunately the supersensitivity can decrease with diet investigation.
Overall introduction of solids can go smoothly but you know as a reflux mother that is usually does not. Having all the information you can, and using an APD, can mean much less frustration and distress for you.
All the best with your diet investigation.
Joan
Specialist Food Sensitivity Dietitian
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