Breastmilk causing mucous/breathing problems??

[smorehou]

I'm not sure if this is the right place to put this.  I used google for awhile and came across this forum and it appeared helpful.

My little one is 5 weeks old.  For the first 3.5 weeks, he seemed to always be "stuffed up"... kind of gurgly with a bit troubled breathing, but not trouble with lungs but more sounded like mucous that he couldn't seem to get out of his throat.  Nobody (nurses, doctors) seemed to be concerned, so whatever...

now, on about 4 weeks he had to go to the hospital with blood in his stool.  It was diagnosed as being an intollerance to cow's milk protein in the breastmilk.  So he was put on Nutramegen - a special forumla for that condition - and mother was prescribed a dairy-free diet for 1 week.  The blood cleared up almost immediately.  What we didn't expect - or even really notice at first - was that the mucous/gurling cleared up as well.  We didn't really think about it until just this morning when he went back on breastmilk for the very first time since the ordeal.  And within half an hour he's breathing funny again.

I know "breathing funny" isn't really a very good term.  Its not actually affecting his respiration.  Its just that you hear these pops and gurgles like there's mucous or something a little sticky in his throat or sinus constantly.  Like he's got a little cold but with no other symptoms. 

No fever, no runny nose, no unusual coughing or sneezing.  It does seem to "bother" him a little.  Especially when he's trying to sleep then you hear a little "pop" (like a bubble running past the mucous" and he wakes up and struggles for a bit.

Thoughts?

 - Steve (dad)

[to-mama]

Funny you say that. I drink a lot of milk and my little one also had blood in stool and he has the exact symptoms you're describing. I thought it may be weather related or related to my diet. Sorry I'm not much help but just wanted to share that. Hope someone else can help you

[homemademom]

I'm sorry to hear about your trouble Steve. Did your wife go back to eating dairy after the week or is she still dairy-free?  If she's still eating dairy, it's likely that the blood will come back too, in addition to the the breathing issues. It can also escalate to skin problems (eczema, rashes, etc.).  Unfortunately, she will probably need to remain dairy free for the duration of nursing.  Reactions to dairy proteins are some of the most common among infants and small children.  

Now, the good news is that there are lots of dairy alternatives out there: rice and almond milk, pure ghee or coconut oil for butter, some "fake" cheeses (though check for casein and whey, as those the proteins in dairy products).  There is an allergy forum here at mothering that has a lot of great resources, too.  Best of luck!

[smorehou]

No, she's been completely milk/dairy free since the diagnosis.  We even take it further than most probably would... we've cut out anything with "natural flavoring" or "caramel" because we read that those too can contain milk proteins.  Odd about casein, because that's the 2nd ingredient in the Nutramegen.

Anyway, here's the update.  After I posted about he breathing he did have another poop with some blood in it, so we immediately went back on the Nutramegen (after 3 breast feedings).  Here we are a couple days later, and sadly there is still blood in his poop.  So I don't know if the diagnosis was wrong and its something else, or if there was just still milk protein in her system and the breast feeding caused a flareup in the already stressed system of our son???  I really don't know.

The plan at this point, is to continue on the Nutramegen for a week to see if it clears up again.  My wife is afraid to ever go back to breast milk as she now feels she's "poisoning" our son and its really stressing her out.  I'm afraid we're probably not going to go back to breast feeding.  Its not necessarily milk proteins... it could be soy... or something else entirely.  She's on a Class C (for breastfeeding) non-oral medication called Humira as well which means that there's not enough studies to show that its safe for breastfeeding but also nothing to indicate that its not.  There have been one major study by OTIS which concluded the molecules are too large to pass into the breast milk, and even if it does it can't be digested anyway - so it "should" be safe.  But we really can't rule that out as being the issue either.  But since it appeared to be resolved initially by switching to the milk-free formula... that's the direction the pediatrician and my wife feel most comfortable going and I'll support that.  So... PRESUMING the blood that is there now is simply due to the recent irritation and it goes away SOON, then I think the plan going forward will be to move first to a cheaper brand of hypo-allergenic formula (Alimentum) because in the long-term we just can't afford the Nutramegen (> $400/mo - and that's while he's still eating like a 5 week old!) and then after a few months we'll try a soy-based formula like Isomil, and if he tolerates that then we'll stick with it until/if the pediatrician feels its time to try to introduce milk again.

Unless anyone has a better plan...

[etsdtm99]

I don't know the timeline exactly but for milk protein it does take 2-3 weeks for it to get out of mom's system  - and i've heard the statistic that 50% of babies who react to milk protein react to soy as well ..  Mom could also do an elimination diet where you cut out a lot of things and then slowly add them back to see what baby reacts to . that way baby could still get the health benefits of breastfeeding (plus the cost saving of not having to buy the formula) 

oh, and my kids who were milk protein intolerant had congestion as newborns - it can be normal in the first few weeks as babies don't know how to 'clear' their throats or cough things up like we do and they get some mucus from birth - but the stuffy nose sounds is a food allergy symptom in babies, as well as the bloody poop, diaper rash, skin rashes etc. 

[homemademom]

I really feel for your wife. I breastfed 3 children with food sensitivities and it was very stressful at first, trying to identify the problem foods and then learning to cook and eat with those restrictions. I'm not one to be pushy about breastfeeding, and given that you are here looking for solutions tells me that you understand the importance of breast milk. Let me just say that if your wife is interested in figuring out the source/sources of your baby's sensitivities, it can be done through an elimination diet and food/reaction journal.

Here's a link about that: http://www.askdrsears.com/topics/feeding-infants-toddlers/food-allergies/elimination-diet

If it's not your wife's medications, it's likely that she was inadvertently eliminating one (or more) of the offending foods while avoiding dairy, which is why your baby's reactions abated for a time.  Soy and corn come to mind (just because that was my experience; it turned out my baby was allergic to corn, which is in so many foods). It can seem daunting at first, but was well worth it to me once the foods were identified.  

If you do end up going exclusively to formula, might I suggest giving your baby a good infant probiotic? Breastmilk contains the vital beneficial bacteria that forms the basis of his immune system.  There are a few brands out there that contain many of the strains found in breast milk.  I would look for a dairy-free/major-allergen free one from Klaire Labs and Udo's Choice (just note that some varieties of Udo's contain dairy, so make sure to get the right one).

[motherhendoula]

This must be a very stressful time for you guys....you mentioned Humira - (my daughter is on Remicade - which is very similar medicine.) does your wife have an autoimmune disorder? Does she have food sensitivities herself? Have you considered a gluten sensitivity? While the blood in the poop certainly does sound like dairy / soy and YES the mucus - snuffly thing is pretty common reaction to dairy, there are more things Mom may need to avoid. It may make her a little crazy at first but i think she could do a more drastic food elimination diet and actually, after baby is 6 months old he may not have the same reaction as he does now.

[smorehou]

Yes, the Humira is related to an autoimmune disorder.  A rare arthritic condition that causes uncontrolled swelling of joints and eyes - pretty scary really, but completely under control with the Humira.  From everything we read and everyone we talked to - and that included her doctors doing an extensive amount of research prior to us getting pregnant - it should be very unlikely that the medication is causing this issue.

Thank you for the link regarding elimination diet.  I think that's a good idea.  Easy for me to say :)  But I think she'll agree.  Not sure why the pediatrician didn't suggest something like that.  He didn't even mention soy - he seems very certain its the milk and that 1 week of my wife being dairy free should have done it.  She was VERY careful.

Nutramegen has soy oil and a variety of corn products.  I think soy oil must not (necessarily) contain soy protein though (?) because Alimentum claims to be milk, soy, and corn alergen-free... and it too has soy oil in the ingredients.  Anyway, I'm gathering that because Nutramegen has quite a bit of corn products in it, and he was (initially) fine with a Nutramegen-only diet, that corn is probably ruled out?

Of course there are a plethora of benefits to breast feeding and our plan was for our son to be 100% breast fed.  Actually, that went out the window in the first 20 minutes of his life.  He was born with a low blood sugar count and mother was in recovery from an emergency c-section (planned c-section due to the arthritis was scheduled for 4 days later) so they gave him formula.  2 days later he again was given formula by the nurses when mom's milk hadn't yet come in.  Its kind of funny... everyone beats the "breast is best" mantra during the whole process... except for the nurses working in the maternity ward.  They are pretty quick to offer up formula and soothers.   Anyway, other than that... the plan was breast-only :)   So much for plans :(

I'll take your advices and references to my wife now... thank you.

 - Steven

[smorehou]

Yes, the Humira is related to an autoimmune disorder.  A rare arthritic condition that causes uncontrolled swelling of joints and eyes - pretty scary really, but completely under control with the Humira.  From everything we read and everyone we talked to - and that included her doctors doing an extensive amount of research prior to us getting pregnant - it should be very unlikely that the medication is causing this issue.

Thank you for the link regarding elimination diet.  I think that's a good idea.  Easy for me to say :)  But I think she'll agree.  Not sure why the pediatrician didn't suggest something like that.  He didn't even mention soy - he seems very certain its the milk and that 1 week of my wife being dairy free should have done it.  She was VERY careful.

Nutramegen has soy oil and a variety of corn products.  I think soy oil must not (necessarily) contain soy protein though (?) because Alimentum claims to be milk, soy, and corn alergen-free... and it too has soy oil in the ingredients.  Anyway, I'm gathering that because Nutramegen has quite a bit of corn products in it, and he was (initially) fine with a Nutramegen-only diet, that corn is probably ruled out?

Of course there are a plethora of benefits to breast feeding and our plan was for our son to be 100% breast fed.  Actually, that went out the window in the first 20 minutes of his life.  He was born with a low blood sugar count and mother was in recovery from an emergency c-section (planned c-section due to the arthritis was scheduled for 4 days later) so they gave him formula.  2 days later he again was given formula by the nurses when mom's milk hadn't yet come in.  Its kind of funny... everyone beats the "breast is best" mantra during the whole process... except for the nurses working in the maternity ward.  They are pretty quick to offer up formula and soothers.   Anyway, other than that... the plan was breast-only :)   So much for plans :(

I'll take your advices and references to my wife now... thank you.

 - Steven

[homemademom]

I know what you mean about the nurses. I was really surprised at my pediatrician's response when I had supply issues this time around with my baby (he had an undiagnosed tongue-tie causing all kinds of problems). My doc was really unconcerned about what my baby was eating and just wanted to see him gaining weight. That's also an important goal, but it didn't really motivate him to help me figure out what my baby's problem was.

For your info, the "top 8" food allergens are dairy, soy, eggs, wheat, peanuts, tree nuts, fish, and shellfish.  I've read that corn is #9, but not one for which the US requires special food allergy labeling.  But really, any food can be problematic (my daughter had reactions to coconut and sesame). The good news is the majority of infants outgrow their "allergies" (or sensitivities), but avoidance of the particular food protein is really important to give the body a chance to desensitize.  

[MomtoJunebugs]

Congrats to you and your wife with your new baby! It must be so frustrating for you both to have these breastfeeding issues. I just wanted to add that I have Rheumatoid Arthritis and have been pregnant and nursing while on Enbrel, Remicade and Humira. It shouldn't make any difference, the baby shouldn't have any effects.

I've also nursed a baby with dairy issues, not as severe as yours seem to be. It always took 2-3 weeks to get the dairy out of my system to where it made a difference to my daughter. I had to be dairy-free for the first 2 years, and then we tried introducing it to her and she was fine. 

Good luck with everything, I hope things take a turn for the better for you all.

[smorehou]

Thanks for that.

We're still using the Nutramegen, as per doc's orders, and he's doing fine.  Mom is still 100% dairy-free, and next week is the next time we're going to try breastfeeding again.  If there are any symptoms this time around, then we'll resign to using the formula moving forward... but I'm optimistic.  In hind-sight, I wish the doc would have suggested she remove more than just dairy from her diet.. soy and eggs in particular.  Because as it is, if her milk still causes an issue now we've basically wasted the past 4 months of her efforts.  Had she been more restrictive, then we could go forward re-introducing one thing at a time.

So my advice to anyone reading this thread in the future with similar issues... cut out ALL of the major allergens from mom's diet for at least 3 weeks - keeping careful mind to the fact you're also cutting out nutrients that you need (so supplement accordingly) - and then gradually reintroduce those foods to your diet, one at a time, starting with the least probable culprit.

 - Steven

[PatioGardener]

First, I want to say how sorry I am that all 3 of you are going through this!
 

Originally Posted by smorehou 

Of course there are a plethora of benefits to breast feeding and our plan was for our son to be 100% breast fed.  Actually, that went out the window in the first 20 minutes of his life.  He was born with a low blood sugar count and mother was in recovery from an emergency c-section (planned c-section due to the arthritis was scheduled for 4 days later) so they gave him formula.  2 days later he again was given formula by the nurses when mom's milk hadn't yet come in.  Its kind of funny... everyone beats the "breast is best" mantra during the whole process... except for the nurses working in the maternity ward.  They are pretty quick to offer up formula and soothers.   Anyway, other than that... the plan was breast-only :)   So much for plans

I wonder if being exposed to cow milk protein can trigger an allergy (or make it worse) in a little one prone to allergies?

It makes me really angry that health care professionals don't see the risks when they give formula. Grrrrr....

I agree with the others about the time it takes to clear dairy from milk, and also the cross-reaction between soy and dairy.

I hope your son and wife get to a point where they can nurse safely.

Good luck!

[APToddlerMama]

Originally Posted by smorehou 

Thanks for that.

We're still using the Nutramegen, as per doc's orders, and he's doing fine.  Mom is still 100% dairy-free, and next week is the next time we're going to try breastfeeding again.  If there are any symptoms this time around, then we'll resign to using the formula moving forward... but I'm optimistic.  In hind-sight, I wish the doc would have suggested she remove more than just dairy from her diet.. soy and eggs in particular.  Because as it is, if her milk still causes an issue now we've basically wasted the past 4 months of her efforts.  Had she been more restrictive, then we could go forward re-introducing one thing at a time.

So my advice to anyone reading this thread in the future with similar issues... cut out ALL of the major allergens from mom's diet for at least 3 weeks - keeping careful mind to the fact you're also cutting out nutrients that you need (so supplement accordingly) - and then gradually reintroduce those foods to your diet, one at a time, starting with the least probable culprit.

 - Steven

From what I've heard, milk and other foods can take more like 6 weeks to clear.  My little guy has a billion food sensitivities.  What has your wife all cut out?  For us and a couple of friends who have dealt with similar issues, milk, soy, eggs, wheat, corn, and nuts have been the big ones.  But, everyone is different.  My son is the only person I know who has a serious issue with sunflower oil.  I wish you luck...it is really tough. 
 

[smorehou]

At the advice of the pediatrician... she's only cut out cow's milk (and any foods containing its proteins such as casein).  That's it.  I suppose there is one advantage to only cutting out one item... *IF* it works, its much simpler and quicker to get on track.  Of course, if it doesn't work you're practically starting from scratch and just wasted 4-6 weeks on crappy diagnostic logic.  That's why I provided my advice above and its also why we're "giving up" if it doesn't work.

I am in the "breast is best" camp... so don't get me wrong.  But I'm also a realist.  I was formula fed and I turned out fine.  Formula is nutritionally complete and is perfectly adequate sustenance for an infant.  Its not poison.  At some point, parents have to think and decide for themselves and weight risks and benefits.  We're not willing to let our child be an experiment and allow his digestive system to repeatedly get traumatized while we attempt to figure out what is in the breast milk that he doesn't agree with.  He's doing perfectly fine on the formula, so there's a strong argument to keep him on that.  We'll give it one more try, having followed the doctors recommendations (which, yes, I wish we had gone beyond those and cut out soy, egg, etc as well - but only hindsight is perfect), and then we'll have to move on.

 - Steven