Skin contact with yoghurt causing mild rash in baby - how reliably does this predict allergy?

[dot1]

I've been struggling lately with the decision of whether to eliminate dairy again from my diet.  dd is 4 months old, EBF, and has on a few occasions had spots of dark blood (brown) in her stool.  She has also spit up a couple times with some brown in it, and once a bright yellow streak.  She has reflux (but Dr. didn't think it needed treatment as she is gaining/thriving....and this same Dr. wasn't worried about the blood in stool).  My doctor didn't think I needed to eliminate dairy since dd is breastfed and that allergy is so rare in breastfed babies.  She figures the blood was just from fissures and bowel irritation from explosive, runny poops.   I am losing my trust in her - a good friend of mine exclusively breastfed her daughters, one of which has severe dairy allergy, the other just an intolerance.  My doctor is ignoring all the signs, but there's no other services in our community (small town)...nor is it severe enough to warrant referral to pediatric GI/allergist in cities located many many hours drive away).  I feel like I'm solving this puzzle alone....and I also feel like my doctor just thinks I'm an overly anxious hypochondriac!

So....here's what I did today...and I don't know if this was wise or not, but I wanted to know.  I put a dab of vanilla yoghurt on the back of my baby's forearm.  I got distracted before I could check right away.  However, later that same day, I noticed some red bumps in that same spot (similar in appearance to the newborn rash she had that turned into exzema, and similar to what sometimes happens on her cheeks, but usually clears up with a wash/moisturizer).  She doesn't get diaper rash.

Could the reaction just be yeast?  (though that's never been an issue...or at least I haven't thought it is - no diaper rash)  Or could this be a sign of milk allergy?  I did one elimination trial of 3 weeks - but didn't notice a difference in the reflux.  It was after I reintroduced dairy that we had those isolated incidences of blood in stool (not a regular occurence).  There is ALWAYS mucous in her poops, and they are quite runny - half her poops also require a sleeper change.

Should I try this test again - if so, how do I do it?  And most importantly, does it mean anything?  My baby's skin seems sensitive....so again, maybe this is just coincidence and I don't need to worry?  She had a nasty exzema case that cleared up with good skin moisturizing.

Please reassure me...or advise if there's something I should be doing.  Strict dairy elimination is so difficult due to the cross contamination issues (dh and dd1 both eat lots of cheese, butter, etc) - but I'll do it again if I need to.  It's just that the signs are so infrequent (other than the major spitting up/gagging) that I question if I'm reading too much into things.

Thanks!!!!! :)

[scsigrl]

Originally Posted by dot1   My doctor didn't think I needed to eliminate dairy since dd is breastfed and that allergy is so rare in breastfed babies.  She figures the blood was just from fissures and bowel irritation from explosive, runny poops.  

Your Dr. is WRONG on that one.  I don't blame you for mistrusting her at all.  It may not be an allergy but from the sounds of it she is definatelly intolerant of dairy. 

 However, later that same day, I noticed some red bumps in that same spot 

If you say she has sensitive skin, that may be the issue.  However the mucous in the stool would be an issue for me.  That's not good.

 I did one elimination trial of 3 weeks - but didn't notice a difference in the reflux.  It was after I reintroduced dairy that we had those isolated incidences of blood in stool (not a regular occurence).  There is ALWAYS mucous in her poops, and they are quite runny - half her poops also require a sleeper change.

Some people take longer to get dairy out of the system.  4-6 weeks is what I typically hear for a dairy elimination.  Again, the poop issues would push me to trying another dairy elimination.  That said, I did 2 with my DS1 and didn't notice an issue because he had other allergies as well (his are allergies vs. DD who was just intolerant.)

Strict dairy elimination is so difficult due to the cross contamination issues (dh and dd1 both eat lots of cheese, butter, etc) - but I'll do it again if I need to. 

Dairy cross contamination is actually not as difficult as many.  Hand washing and cleaning up after them to keep things relatively picked up is the easiest way to do it. 

Good luck!
 

[SweetSilver]

As per the skin test-- diary reactions are pretty quick.  A skin reaction to dairy would be visible within a short period of time.  Home skin tests can be a great way to assess allergies in some kids (my severely allergic daughter has visible skin reactions to dairy and wheat, among other things.  Very handy!)  But not every kid, even those with considerable internal reactions, will react this way.

So, I don't think your skin test show anything conclusive one way or the other.  Look at the other signs.  It was a good idea to try it because reactions to the food are a lot faster and more severe than reactions to breastmilk containing the allergen.

BTW, my daughter starting showing signs of a dairy allergy at 2.5mo, and, yes, she was EBF.  She is still severely allergic to it to the point that we carry an EpiPen Jr. for it.

[dot1]

Thanks scsigrl - I will do another dairy elimination diet.  I think I'd regret if I didn't and she did end up with an actual allergy.  I'm so disappointed in my doctor for only being concerned about wt. gain and nothing else.  

SweetSilver - What signs did you see at 2.5 months.  Did you cut dairy out of your diet, and if so when?  What were the first signs of it being severe?  

I really appreciate the insights:)  I feel so alone with this :(

[scsigrl]

I know you didn't ask me but here is out story.

DS1- 2 different 4-6 week dairy ONLY ED.  ALL dairy, tracy and major. No changes.  At 12 months, DS reacted to dairy and egg.  Epi pens from Ped.  Ped. allergist with testing at 14 months.   Allergic to dairy, egg, peanut, tree nut, corn, citrus, soy, banana, coconut.  At 3 dx with Celiac as well.

DD- Didn't sleep, bad BM's.  Cut dairy at 4 weeks, cut egg at 6 weeks.  Reintroduced at 18 months with no issue.  Allergy tests negative to everything.  Is dairy sensitive.  Have not tried egg or gluten (or peanut or tree nut because we don't keep them in the house).

DS2- Poor BM's, bad skin rash, really bad cradle cap.  Cut dairy at 4 weeks.  Cut egg at 6 again.  His skin is great for the most part but there is still something going on I have yet to figure out.  He's 4 months old so we are still D, E free.

There are lots of Mama's here with ya!  Hang in there.  Ask for recipes and find a good source of dairy free chocolate ;)

[SweetSilver]

dot1, unfortunately I realized all this after the fact.... long after!  So you are waaaay ahead of the curve.  Good for you!  

My daughter suddenly started screaming one day.  I never connected it but she started having mucousy diapers right around then.  The docs dismissed it, too.  She was always a really fussy nurser, but now she would scream and eventually I couldn't get her to nurse unless she had just fallen to sleep.  Other than a bad case of cradle cap when she was tiny, she had no eczema, no rashes.  She might have developed an allergy sooner.  I guess now that I think about it, she did have supp. formula for a couple of days because she lost so much weight due in the hospital (we used a tube taped to the breast and pumped like mad until my milk came in at 5 days.  I think she had a physical problem, like an overbite, and I had flat nipples--bad combination.)  So, she was always a fussy baby but the fussiness got really bad at just before 2 months and got worse.  Mucous started at about 10 weeks, right around the time of that big escalation in fussiness.  Either she was having GI reactions to dairy from near the beginning, or her fussy nature masked the fact that she had developed an allergy.  ??????

It was when she was about 6-7months and I let her try some yogurt.  Her chin and cheeks erupted in white whelps on top of beet red skin.  Last time she was fed dairy intentionally.  On the occasions (twice) she accidently ingested cow's milk her throat started closing inside of a minute and luckily we avoided using the EpiPen. She was still *telling* me her throat was "getting hard" and her lips were bright, so I waited it out since using it would have mandated a trip to the hospital. Serious judgment call, to be sure.  She threw up within ten minutes and was miserable for the rest of the night.  We gave her Benadryl. We now only buy cow's milk in the single-serving aseptic packages now and never allow it to be poured into a glass.

Her skin does react neatly to allergens, and for that I am thankful.  I wish I had been encouraged by the doc to drop cow's milk when I was nursing.  She just didn't take the issue seriously and I didn't question.  I feel terrible now!

[CoBabyMaker]

She figures the blood was just from fissures and bowel irritation from explosive, runny poops.....There is ALWAYS mucous in her poops, and they are quite runny - half her poops also require a sleeper change.

It sounds like you have already decided to go off dairy but I thought I'd comment anyway.  The symptoms you mentioned above are NOT normal.  You are not just being crazy.  PLEASE go off of dairy.  Like the other person mentioned, I found at least 6 weeks to be needed.  If that doesn't fix it you may need to eliminate other things.  I would also find a probiotic for her.  Hope you see some improvement soon!

[dot1]

Wow - thanks so much for these helpful replies!  

It never ceases to amaze me how doctors can be so ignorant about allergies.  A public health nurse colleague of mine also thought this sounded like allergy...and suggested I speak to an infant/child dietician instead of a pediatrician.  But the pediatrician is my gatekeeper to a referral to an allergist if we ever need one (hopefully not, but just in case).

This is all a surprise for me.  Although we have quite a family history of allergies (my sister has anaphylactic reaction to bee stings) and lots of contact dermatitis issue (bandaids produce reaction/hives in my mom and sister), there are no food allergies.  

The differential diagnosis I've wondered about is esophagitis from her reflux...that could cause the brown spots/streaks in her stools I'm guessing?  It's not a tonne of blood but there are little dark spots/streaks quite regularly....and the poop is a bit darker mustard-orange than it was when she was a newborn.  But since dairy intolerance is often behind reflux is seems pretty clear I should cut out dairy.

Will try to remember to post updates!  

Thanks again :)

[dot1]

Hi again!

Just thought I'd update.  

Saw my GP again today...and at my request, she is referring us to a pediatrician in another town who has a good reputation for understanding intolerance/allergies, etc.  Of course, once again she reiterated that she thought my baby was "doing just fine" and that she didn't think she could be dairy intolerant with all the weight she was gaining (has maintained weight around 50th percentile since birth).  I commented that of course she's gaining weight - she eats ALL THE TIME!  

The day after a big indulgence in cheese cake and a creamy sauce, dd projectile vomited her entire stomach contents twice (but she also has a cold).  Then I quit dairy cold turkey....but realized I accidentally ingested some in processed food the next day.  Nevertheless, within 3 days she went from spitting up at least 20-30x/day to about 3-4x/day.  Her stools are still very mucousy right now as she has a virus and slightly smelly diarrhea, and this morning I found a couple bright red spots....but there's also dark green spots mixed in the mucous, which may just be from having a cold.  Her stools before the cold virus would still have darker spots in them - hard to say it was blood, but I can't imagine what else it could be - we don't do any supplements (not since my bad experience with introducing Vit D).  DD's also still unvaccinated (delayed/selective planned). I'm on day 4 of dairy ED, and I'm also cutting out obvious sources of soy.

My doctor noticed dd's eczema today (it's pretty mild as I stay on top of moisturizing and avoid soaps and chemical detergents, etc.).  I just don't understand how she can't connect the dots - it seems so obvious that something is irritating dd's gut.  

Can babies be allergic or intolerant of dairy and still gain weight well???

Are there causes of dark spots in stool besides blood (in an exclusively BF baby who is not receiving ANY thing else orally, including supplements)????

Thanks again - the advice really really helps :)

[BabySmurf]

I just noticed your thread - so sorry you are going through this! I've totally been there, and it does sound like your DD has a dairy issue...or at least something that you eat with dairy.  I eliminated dairy, soy, and gluten when my son was about 7 months old.  I didn't think he had allergies, then I had two failed attempts at eliminating the dairy.  Once I got it out of our systems, things were SO much better.  I realized as I cut out the foods, that I had some undiagnosed issues with allergies as well.  I felt a lot better too, but we both had some residual issues, and I finally got a blood test when my DS was about 1.  I found out that, at the time of the test, I didn't have a big issue with dairy, but I had a huge issue with yeast.  When I eat dairy I usually eat a ton of bread, so it made sense that it looked like a dairy allergy.  I am also extremely allergic to garlic. 

It can be really hard to weed out what is causing issues, but it sounds like there is definitely something going on with your DD - poop should definitely not have mucous! Nor the bloody streaks.  And FWIW, my DS was thirty pounds by the time he was one - no issues gaining weight at all! I think it's because he was EBF until one.  My son also had the mucousy poops, eczema, and a lot of sleep issues.  When I figured out the triggers, he went from waking every 90 min to sleeping 8-10 hours straight...on occasion.  The mucous means that the GI tract is inflamed, and my poor DS has had the issue for so long before I eliminated, he still doesn't eat much in the way of solids.  I think the sooner you figure out the issues, the better things will be.  My son is 16 months old, and only eats one or two bites of food on some days, which is sort of okay for now, but I am seriously worried about him having sensory issues/fears about eating, and I don't know how much longer I can hold up almost exclusively nursing a thirty something pound child, as I am underweight :( 

Hang in there! I'm glad that you are getting a doctor that hopefully will be able to help you a little better....but remember your gut instinct is usually right.  If you think something is amiss, follow that feeling, and search the boards here - tons of good info.

[dot1]

BabySmurf, thanks so much for taking the time to reply.  Did the mucous poops and eczema also disappear once you eliminated soy/dairy/gluten?  Did you baby spit up a lot?

How long did it take after elimination to notice a difference?  How long after ingestion did you notice symptoms?  The 2nd time off dairy I noticed improvement within a couple days...and worse symptoms less than a day after my slip ups (had a bunch of butter in baking before realizing it...and next day there was cheek rash and more dark spots in diaper). 

I wonder how much the mucous has to do with dd's reflux - her spit up has lots of mucous in it too and she drools a tonne and has lots of teething behaviours....but she's been acting like she's teething since birth, so I suspect that is related to reflux.  Plus early teething is not in our family.

I cut out soy too...but then had an indulgence a few days ago, and then noticed dd didn't sleep well, was gassier and pooping less.  She's grunting with BM's and passing more gas.

I wonder how much reflux and allergies are related....could all the swallowed reflux/saliva be irritating her GI tract, which in turn causes leaky gut, which in turn increases allergic tendency?  

[BabySmurf]

Things got MUCH better, no real mucus, the wake ups subsided, and yes he was spitting up a lot when I ate those foods, and that did go away as well.  For us, we still had issues that came and went, and that's why I got the bloods test, but over all things were much better having cut out the wheat and dairy. 

Really the best thing you can do for yourself and the family is to eat whole unprocessed foods, and to stay away from the grains, starchy veggies, and dairy for a bit.  If things are good, then try re introducing the dairy and grains separately on a trial basis, and make sure they are traditionally prepared - it's much easier to digest that way.

For us, we had an initial clearing of symptoms when I cut the dairy, but then things got worse again.  If you google dairy withdrawals, you will see a lot of people have issues while the dairy gets out of your systems.  Once the dairy was completely out of our systems, his symptoms were almost gone, but still improved more after cutting out the soy and gluten.  I had dairy out of my system for about three weeks when I eliminated the soy/gluten, and by the end of four weeks, things had drastically improved.  He went from having the mucousy diarrhea up to 6 times per day, to pooping once per day or every other day almost immediately.  At three and a half weeks in he was still sick, but by the end of the week, it was all better.

The excessive drooling can cause mucousy poops, but I would think that there is something behind that and the reflux.  It's more likely that a leaky gut is causing the symptoms rather than the symptoms causing the leaky gut.  The other thing to keep in mind that if your LO has a leaky gut, she  probably inherited it from you.  I bought the GAPS diet book, and I would highly recommend it - it explains a LOT in terms of the theory of leaky gut and how it works, and why the foods we are eating are so important.  You may not consider yourself in a place where the food issues are causing a pathology such as autism, but the theory really hit home for me.  And it's a really clear and well presented source of info, and explains why certain foods have certain reactions.  The GAPS website has some of the basic principals, but the book is way more helpful. 

I hope this helps! And good for you to listening to your LO's cues, I know how hard it is to make these changes!

ETA: and his symptoms were definitely exaggerated when i had slip ups

[dot1]

Oh thank you BabySmurf!  

Have you tried reintroducting soy or gluten yet?  Wow - good for you for keeping up the exclusive nursing.  Such good nutrition.  I guess it can't hurt to see an OT who specializes in sensory issues in case it helps jumpstart the food intro and make it easier for you.   Did you take your ds to any medical specialists, allergists, etc.?

You've given me good food for thought.  I have been wondering if I have an issue with wheat (or even gluten in large amounts) as I have a cousin who just missed the threshold for dx. of celiacs, my dad has gut issues and my Grandma had bad psoriasis (which could have been undiagnosed celiac rash).  I get cramps (like mild menstrual cramps), seemingly when I eat too much wheat, pasta, etc. and am always on the border of being anemic (but not quite).  

I took dd2 to the pediatrician a couple days ago...and she agreed the stool didn't look normal (I took pics) and wants to test for occult blood and for reducing sugars (lactose intolerance).  She instructed me to eat dairy, etc. again so we get a more realistic picture with what is happening with the stool.  She was great.  It was hard to tell if there was a difference (been back on dairy for 2 days now) and dd didn't have any obvious blood in her stool this morning (still lots of mucous), but she has been fussy while nursing (arching back and almost crying a bit at times)...yet not really spitting up any more than usual.  It's such a puzzle.    So I guess we'll just wait for the results and then most likely resume dairy and soy elimination and probably add gluten in at some point.  The cross contamination and accidental ingestion thing is the hardest part....realized after the fact that I had actually been consuming dairy once/week - the dinner my hubby was cooking had some pesto in it (which has cheese).  And possibly some cross contamination in sausage.  

Anyway, thank you again for reaching out (and also to any others who have posted :) )

D.

[BabySmurf]

When I eliminated the foods from my diet, I started looking into more health benefits of food, and which foods can cause problems...I try to stay away from soy still because the health implications make me nervous.  Gluten containing foods, we can tolerate in small amounts, but if I eat too much it makes me feel yucky, so I try to stay away from that too.  Same with dairy actually.  I decided to try raw milk from a local farm, and we didn't really have issues, but once I started eating more processed foods, we started to have problems again.  It's funny, both my son and I can tolerate small amounts of allergenic foods, but if we have too much it makes both of us sick.  This is why I'm thinking leaky gut for us...and from what I've read, it's probably a fairly common phenomenon, but people either just aren't picking up on the symptoms, or it's too hard to cut out the necessary foods. 

It is really hard to stop eating the processed foods, as, at least for me, I have withdrawals like I did when I quit smoking.  Which is a good indicator that the foods are wreaking havoc in my system, and therefore on my son. 

I'm glad that your doc is listening, and you feel good about what she's telling you! That is a huge help! It really is such a big puzzle to work out, and that's why I would recommend a "healing" diet to anyone, rather than eliminating allergenic foods....there are so many other issues that may come up, and if you can fix the root of the problem, then life will be easier in the long term.  At least that's how I feel about it.  FWIW, it does sound like the gluten is a good candidate for causing the problems :)

Like I said, my biggest allergens ended up being garlic and yeast, and I NEVER would have guessed those things to be problems...the blood test should help you identify some of the major offenders.  I hope everything works out for you!!

[dot1]

Thanks again.  Healthy eating is a journey for sure!  I'll try to remember to post an update when we get the stool sample test results back.