Food sensitivities are another common cause of reflux. Most mothers of refluxers will hear at least once the suggestion that their baby is allergic to breastmilk. Actually, what’s often happening is that the baby is reacting to something in her breastmilk. While most breastfeeding mothers can enjoy a varied diet while breastfeeding, and no mother should restrict her diet unless she truly suspects that there may be a problem, sometimes a baby is so sensitive to a particular food that even a small amount of it through breastmilk is enough to cause a reaction such as reflux. Some of the more common trouble-makers are:

One symptom of food sensitivities in your baby are green stools. Here is a quote from La Leche League (click here for the entire text): "Frequent bowel movements which are consistently green and watery may be caused by a sensitivity to food or medication that baby or mother is ingesting. Careful consideration of any medications, home remedies, foods or drinks may uncover a possible cause. Consistently green, watery and foamy stools are also thought to be caused by a low intake of hindmilk, referred to as foremilk-hindmilk imbalance or "oversupply syndrome." Baby may act colicky, gain weight slowly and bowel movements may be very forceful. An overabundant milk supply or overactive let-down reflex may be involved. Breastfeeding techniques to improve the baby's control of the milk flow and intake of hindmilk may quickly reduce these symptoms."

(For more information on the topic of foremilk and milk supply, read my article What is OAL?)

The first thing to consider is that caffeine makes reflux worse. (This is emphasized because no one bothered to point this out to me until my third reflux baby.) Caffeine is in drinks such as soda (even orange soda and some root beers), coffee, and tea. It is in foods like chocolate and most likely any "mocha" flavored food. It may take 3-4 caffeine-free days before you to notice a difference in how much your baby spits up.

The easiest and most reliable way to tell if your baby has a food sensitivity is by starting an elimination diet. You must completely eliminate one food at a time and watch your baby for improvement. When you start the elimination diet, you might consider keeping a journal because the process of tracking down food sensitivities can be so complex. You should record what you eat and drink every day, and register your baby's symptoms (a simple "better than yesterday, but worse than day 4," should be fine, although you may want to specify exactly which symptoms you notice). However, if it seems too complicated, you can skip this step & maybe just mark on your calendar the last day you ate whichever food you are going to eliminate, like I did.

If anyone in your immediate family has trouble with a certain food, you should start with that one; otherwise I recommend starting with dairy, and avoiding all dairy for three weeks. (Now, don't run away yet, it's not as bad as it sounds!) This is because dairy is the most common cause of problems, and it takes that long for it to get out of both your system and your baby's (although it can take up to six weeks). Please note that most babies are sensitive to the protein in cow's milk, not the lactose, so you must avoid ALL dairy products! This can be very difficult, as even some "dairy-free" products contain dairy!

Here is a list of dairy ingredients and foods to avoid.

The other foods you need avoid only for a week or so, except wheat, which like dairy, takes that long to clear. Again, watch your baby closely for signs of improvement.

Now, I know what you are thinking: "What a pain! I can't possibly do that!" (Well, that's what I thought, at least.) It is not as hard as it sounds, though, and once you are done, you have answered so many questions, no matter what the outcome! Even if your baby doesn't show any improvement at all, you know that your baby's problems don't involve food sensitivities! I suggest starting on the day you do your grocery shopping, that way you are most likely out of the foods you can't eat, and you can stock up on substitutes that you are allowed to eat. Don't buy a lot "healthy" stuff that you don't really like. Buy more of what you normally eat; for instance, if you usually have a bowl of cereal and toast for breakfast, but are eliminating dairy, eat twice as much toast or make oatmeal instead. I also recommend dairy substitutes for those times you are really craving; Soy Delicious “ice cream” is actually very good!

Good luck!


Links:

Ask Dr. Sears: Tracking Down Food Allergies

Dairy and other Food Sensitivities in Breastfed Babies

LLL article (A side note: I just realized that the author of this paper is a very special woman who was tremendously helpful when Sam was in the hospital. She was a kind and patient resource, and I will always be grateful to her for her help.)


Support:

POFAK (Parents Of Food-Allergic Kids)

ElimAllergy Support for parents implimenting an elimination diet