Behavioural issues, possible food sensitivities – where to start?

[Tigerle]

Hi, I am new to this sub-forum and new to the issues being discussed! Thank you for reading.

DS is currently being evaluated for Asperger’s syndrome, mostly due to behavioural issues – aggression, inflexibility, anxieties, tantrums and meltdowns, sensory-seeking behaviours. I want to look at possible food sensitivities/allergies too, but am feeling somewhat overwhelmed. Where do I start?

Some history: DS was 5 weeks premature and while being EBF and gaining well, had frequent and major spit-up episodes, back-arching and some respiratory problems until he was about 6 months old, when things suddenly got much better – reflux was never properly diagnosed, but we gave him an acid blocker for a few months which appeared to help. I also cut down on caffeine and dairy, though I didn’t fully eliminate it. Introducing formula and solids at 7 months because I needed to be hospitalized for surgery did not exacerbate symptoms.

I weaned at 1yo old for health and work reasons and he has continued to eat and grow well. However, at about 20 months, he suddenly turned into a picky eater (and by suddenly I mean that a happily fruit-and-veggie eating kid, who was halfway through a bowl of blueberries, stopped eating, pushed the bowl towards me saying “Mama eat!” and we have had to painstakingly reintroduce fruits and veggies ever since...nor has he ever eaten blueberries since – “too sour!”)

Fast forward to today at 4 and while still picky, he’s eating a fairly varied diet, a selection of fruit and raw vegetables, wholemeal bread, pasta, meat, eggs and dairy, nuts. He’s tall for his age but also skinny and pale. We’ve noticed a tendency to reactive hypoglycemia and a need to keep his blood sugar up to ward off meltdowns – which might explain behavioural issues in the mornings and before dinner, but not during or after...

This winter, I noticed a constant low-grade sandpaper rash on his cheeks, which gets exacerbated by exposure to the cold and which the ped says is just winter air, not to worry about (dry skin that reacts to cold is common in our family). He also occasionally has hot red cheeks and ears, sometimes just on one side, sometimes both sides of his face, no fever. We haven’t been able to come up with anything that may be linked with, again just exposure to the cold, but he is outside at least for a bit in order to go to preschool everyday as it is.  No stool anomalies I can think of.

DH and I have no food sensitivities or allergies that we know of, but there is a history of hay fever, citrus allergies and nut sensitivity in the extended family (grandmother, uncle, cousins).

We started introducing CLO (nordic naturals strawberry) which appears to have helped somewhat with his behaviour. Also have recently introduced magnesium and zinc supplements.

So this is just a shot in the dark and there is no place to start that would be immediately obvious to me, and it does not feel warranted to me to just start a gfcf diet and go cold turkey on beloved pasta dishes for 6 months, just checkin’, as it were.

What kind of non-invasive, non-upsetting (or only moderately invasive/upsetting) stuff could I start with? Ask the ped for allergy testing citing the red cheeks? Eliminate dairy for three days? Any suggestions or btdt advice would be much appreciated!

[kjbrown92]

Personally I'd go gfcf for a month. Three days is not going to tell you anything. It takes some people 2 weeks to get dairy out of their system (our family runs about 4 days) and about a month for gluten to get of their system. And personally I think everyone should try it. Yes I'm serious. There's corn pasta that tastes almost identical to wheat pasta, and there's rice pasta, buckwheat pasta, and also blends of quinoa and rice, and others. There is still plenty of food to eat. Not a lot of prepackaged stuff, but you'll be eating healthier because of it.

Not knowing anything about reactive hypoglycemia vs. regular hypoglycemia... I know that with regular hypoglycemia the goal is a low glycemic diet to keep it constantly low. Does that mean you feed him a lot of carbs/sugar to keep it high all the time? Or am I misunderstanding? 

Also, keep a food journal during that month on the gfcf diet to see if you can figure out the red cheeks. It can be the sign of a food intolerance, or it could be a salicylate sensitivity (that is a bucket reaction so it might not happen if he were to eat just a few grapes or apples, but if he were to eat a lot of sals in one day, he'd get the red cheeks - makes it a little harder to figure out). My kids got the red cheeks as a straight food intolerance (soy for DS, apples for DD2).

A book you might want to look at is Dr. Doris Rapp's "Is this your child?" She has an elimination diet in there, but she adds food back in much too quickly to tell anything since food intolerances can take up to 3 days to show up. But she does have some good info in there about behavioral responses to food.

[Tigerle]

Thank you for your suggestions!

Originally Posted by kjbrown92 

Personally I'd go gfcf for a month. Three days is not going to tell you anything. It takes some people 2 weeks to get dairy out of their system (our family runs about 4 days) and about a month for gluten to get of their system. And personally I think everyone should try it. Yes I'm serious. There's corn pasta that tastes almost identical to wheat pasta, and there's rice pasta, buckwheat pasta, and also blends of quinoa and rice, and others. There is still plenty of food to eat. Not a lot of prepackaged stuff, but you'll be eating healthier because of it.

It's a hard one to figure out a good time for this though, beecause they have these birthday parties in preschool with muffins being brought in all the time, also birthdays and holidays with family are tricky...I'm not sure I'd be able to get everyone on board to be honest unless I could point to an actual proven issue, family hasn't been too understanding of food issues in the past. I wouldn't mind going gfcf so much at home, and we eat little prepackaged stuff anyway.
 

Not knowing anything about reactive hypoglycemia vs. regular hypoglycemia... I know that with regular hypoglycemia the goal is a low glycemic diet to keep it constantly low. Does that mean you feed him a lot of carbs/sugar to keep it high all the time? Or am I misunderstanding? 

No, on the contrary, we try to keep his carbs low and feed him protein-rich meals and snacks to keep blood sugar regulated. Not necessarily low, just to avoid spikes. I don't check the glycemic index though, just make sure there's not too much white bread/junk.
 

It can be the sign of a food intolerance, or it could be a salicylate sensitivity (that is a bucket reaction so it might not happen if he were to eat just a few grapes or apples, but if he were to eat a lot of sals in one day, he'd get the red cheeks - makes it a little harder to figure out).

i have never heard of salicylate sensitivity, that's something to watch  - DS eats a lot of apples!

[kjbrown92]

Originally Posted by Tigerle 

Thank you for your suggestions!

It's a hard one to figure out a good time for this though, beecause they have these birthday parties in preschool with muffins being brought in all the time, also birthdays and holidays with family are tricky...I'm not sure I'd be able to get everyone on board to be honest unless I could point to an actual proven issue, family hasn't been too understanding of food issues in the past. I wouldn't mind going gfcf so much at home, and we eat little prepackaged stuff anyway.
 

Tell them that you're trying it out. My dd2 went to preschool with dietary restrictions. If he has behavior issues and you tell the teachers that you're seeing if this would help, it seems like they'd be supporting that, since they are the ones dealing with his behavior. If you know there's a birthday/holiday, make a cupcake just for him because he's "special". I always try to make my kids' treats a little "better looking" so that they don't feel deprived. I also bring our food when going to family dinners, etc. or I host so that I can control all the food (and if someone asks what they can bring, I say fruit salad specifying which fruits or green salad, with no croutons or cheese). We've been restricted with more than that for the last 2.5 years, and dairy and soy on and off my DS's whole life (he's almost 11yo). If you can help him with diet, wouldn't that be a fantastic thing? Considering how long it takes to get out of one's system, doing it "just at home" will probably not tell you anything about whether he's sensitive to them or not. A neighbor of mine asked me millions of questions about the gfcf diet because she said she wanted to get her daughter (autism spectrum, ADHD) off drugs. She tried the gfcf diet for one day, and then said "meds are easier." To me, it seems like changing diet is so much easier. And I also found out, when going on the diet with my kids, that I had sensitivities too, that I didn't know about (that's why I say I think everyone should try it, just to see).
 

[tanyalynn]

GFCF was helpful for us.  My son's never had enough symptoms for a diagnosis, but his health wasn't ever good/right.  For him, it took about 3 or 4 months of gfcf to stop banging his head on the wall.  He didn't have other behavior stuff going on back then, but he got sick a lot, and had some coordination stuff going on, things were just not right.  I guess for most people it's not that long, but for him, he needed gfcf plus a set of supplements to get his body working enough better to see improvement.

And I agree with Kathy--I think most of the people I know would see improvement if they cut out gluten and dairy, they're so insidious, gluten especially.  For us, no digestive issues, just fatigue and mental fogginess for me, and head banging, or now that he's older, walking in circles, for my son.  But I've read of so many different things that going GF can improve on this forum, it's mind-boggling.

When you say he's pale, have you considered iron deficiency?  I'd want to test before supplementing (iron and ferritin), but a) that's a good one to know and correct, and b) removing gluten from the diet and adding in cell salts can be helpful in improving or at least maintaining good iron status in people who are otherwise prone to being low. 

There's a wiki on salicylates, let me see if I can find it...

http://www.mothering.com/community/wiki/artificial-colors-and-salicylates-and-the-feingold-diet

ETA: early on, I never ate other peoples' food unless it was something very simple like a plain fruit or veggie tray.  I didn't ask their permission or try to explain it other than saying, we have health things going on, we need a special diet.  My kids were 15mos and 3.5 yo, so younger than yours, so it's a bit harder when they're older, but asking about what's going to be at events beforehand and making something similar, and getting a few recipes for cupcakes and the like (there are more and more gf cake mixes around all the time), really helps with the transition.  But I made it very clear to people that I didn't expect them to accommodate us.  It was a bit hard for my MIL, she liked to cook for us, but I was honest in explaining that we went to visit to see her, we loved being with her and talking with her and the kids loved to tell her all about their friends and their life, and the food wasn't the star of the show, she was.  And over time she's become more comfortable with it.