Protein in sensitive toddler

[RiverandJulie]

Hello,

I have a 17 month old boy.  The back story is that he was born at 29 weeks by c-section.  We adopted him while he was still in the NICU and he always had some gastro issues (EFF).  I suspect he may have had undiagnosed silent reflux.

  Once he started solids he became especially gassy, waking up a lot with pain and gas. We have gotten his sensitivities somewhat under control.

We eliminated gluten and it has made a HUGE difference.

But, beans still seem to cause him gas, and he is on lactose-free milk or almond milk, because lactose seems to give him stomach pain.  
We haven't figured out cheese yet, some seems ok, others dont.

So, the back story leads to my real question is, how do I know if he is getting enough protein? He does not like any meat or avocados.  Beans seem to affect his tummy.

He eats some eggs, quinoa and peanut, almond, and sunflower butter.

Do I need to make sure he is getting one of these every day, or does he need less protein then I think.

Any other food ideas for him?
Thank You

[lfpalmer]

Let's talk protein first. You say "He eats some eggs, quinoa and peanut, almond, and sunflower butter;" those are plenty of protein foods. I'm sure there's other protein in his diet as well. What else does he eat?  

Breastmilk is 5 to 10% of calories from protein and a child does their most growing and neurological development on that diet. The protein from cow's milk is diluted to make infant formulas with similar protein levels, as higher levels cause health problems. According to multiple authorities, the ideal percentage of calories from protein for older children and adults is 5 to 10 percent, with 15% being a suggested upper limit. I have lots of protein info in a power-point presentation here: http://www.thebabybond.com/Beyond%20Breastmilk.pdf  if you are interested in more details, or if you need some ammunition against the judgements of others. 

So, this comes to about 11 grams of protein per day as a minimum, 15 grams per day as a healthy amount of protein, and 40 grams as a maximum for a large toddler. One egg provides about 5 grams of protein, there are 7 grams in 2 TBSP peanutbutter, and a typical jar of babyfood peas provides 6 grams of protein. He doesn't need all of that in one day as he's going to be getting a gram here and a gram there from foods you wouldn't even consider as protein foods. A medium potato has 3 grams, for instance.

I'm going to talk milk and lactose with you shortly. 

[lfpalmer]

By the way, protein is 4.3 calories per gram, and that 40 gram maximum I gave you is quite high and for a very large child.

About that lactose-free milk and uncertainty with cheese...  Lactose is a baby sugar and babies are designed to digest it. Except for incredibly rare cases, all babies can "tolerate" lactose, when they are healthy. When a child's digestive system is upset by sensitivity reactions to foods, such as milk proteins or soy proteins, they will temporarily stop making adequate lactase enzyme and thus have problems digesting lactose. Other things that will reduce lactase enzyme availability are diarrhea of any cause, and antibiotic use. So, a child who reacts to milk may do somewhat better on lactose-free milk, but they will not be entirely free of symptoms. In almost all cases, it's the milk proteins that are problematic for babies and young children (as well as a large number of adults, though lactose intolerance is common in teens and adults as well). In cheese, the proteins are partially pre-digested by the bacteria that make the milk into cheese. Different kinds of cheeses will have more or less intact milk protein. This is the likely reason you are unsure about cheeses. I recommend your child receive NO milk, cheese, dairy yogurt, cream, whey, casein, or other milk ingredient. Even butter has small traces of protein in it; enough to keep many a child sensitized. Watch out for things like "non-dairy cheese" or "non-dairy whipped topping." Strangely, these products are generally filled with milk proteins. For marketing reasons, the term "dairy" seems to only mean lactose. Any vegan product should be entirely milk-free, and if a product says "no milk," that should be OK. You need to read ingredients.

Goat and other common animal milk proteins are very similar to cow proteins and most (but not all) who are sensitive to cow's milk proteins will eventually develop sensitivities to other milks. Unfortunately, raw milks have the same proteins (and no, they don't digest themselves unless you're talking a little protein and lactose digestion in very soured milk). In studies, as well as in people I've worked with, these are shown to be just as allergenic for most of those who are already reactive.

[RiverandJulie]

Thank you so much for the detailed response!  I am feeling much better about the amount of protein he gets.  He eats a lot of oatmeal, veggies and brown rice and fruits and is a small toddler (21 lbs)

I am going to rethink lactose, as it was brought on by a stomach bug with a long bout of diarrhea.  Maybe we will try it again, and if it doesnt work out, we will eliminate dairy.

Thanks again!

[lfpalmer]

Along with a few of the foods you mentioned earlier, it sounds like a great diet.

You have the right idea about the lactose. Since it started with a bout of diarrhea, it could have been a lactose intolerance of a cause that should have been temporary. If milk is not tolerated even with lactase enzyme, it's milk proteins. One to three doses of liquid milk (flavored if you need), with and without lactase enzyme, should give your answer.