Signs that allergy might be causing your breastfed baby to wake frequently - Mothering Forums

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Old 07-16-2005, 04:11 AM - Thread Starter
 
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Its coming up a LOT on this forum although this is the co-sleeping forum, and not a sleep problems forum per se.

:-)

But, I want to mention something that I posted buried in another thread. Babies who wake EXCESSIVELY frequently, like every 1.5/2 hours are VERY OFTEN waking because of some health issue. Not always, of course, but OFTEN enough to warrant looking into the possibility.

Allergies, especially food allergies, are a common cause of night waking. I hope this information is helpful. Its mine, so please don't repost without attribution.

Signs of allergy/sensitivity in a breastfed baby
-Honeysucklemama (2005)

What is NORMAL for a breastfed infant:

- The normal breastfed baby nurses about 7-8 times a day, takes two (or more) 1-2 hour naps a day, and usually sleeps 10-12 hours at night, waking about every 2-3 hours to nurse, with one longer sleep stretch of about 4-7 hours.

- The normal breastfed baby MAY spit up small amounts when burping, but the spitting does not seem to bother baby. Baby may be gassy, especially when a poop is on its way, but the gas is not horribly painful, and is easily passed. Baby may even sleep through the gas passing.

- Normal breastfed nurse for about 10-45 minutes a session, and seem content while nursing, and afterwards. They may fall asleep while nursing, or may coo and smile on and off while nursing. They do not seem distressed by eating, and are relaxed and seem content.

- Normal breastfed infants have fussy periods, and content periods. Although they prefer to be held, they are usually content in a bouncer or on the floor for reasonable periods of time (15-30 minutes) before fussing to be picked up. They have their fussy periods, but are usually easily calmed by holding, rocking, or nursing.

- NORMAL gain is an ounce a day until 4 months, half an ounce a day until 6 months, and then 2-4 ounces a week after six months.

- Normal exclusively breastfed baby poop is VERY loose, mustard yellow, and has little "curds" in it. It can be pasty or watery, but should not soak completely into the diaper. It usually has a "curried yogurt" smell, but does not smell foul.

- Normal breastfed babies stool at least daily until 1 month of age, and may stool every time they nurse. After 1 month of age, breastfed babies can stool as little as once a week.


Signs of allergy in a breastfed infant:

Physical symptoms:

- Spittiness: Large amounts RIGHT after nursing, or in-between nursing, or small amounts on and off all day. Baby has a lot of “wet burps” or swallows frequently during the day even when not nursing. Baby seems bothered by the spitting and has fussy periods when the spitting seems worst.

- Gassiness: Very frequent gas, or gas that is very painful and accompanied by painful abdominal cramping. The gas may be very smelly, and may seem to be more bothersome at night.

- Green, stringy, runny, and/or bloody poops: Allergy poops are often GREEN, either slightly green, or even the color of grass or army green. Stringy mucus can be found, and sometimes streaks of blood. Baby may poop unusually often, or VERY infrequently. Baby may seem unusually uncomfortable while stooling, and may seem (to Mom) to be constipated. For babies who stool frequently, the stool may be unusually runny and may soak into the diaper.

- Red allergy ring: Babies with food sensitivity will often have a red rash right around the anus. The rash can also spread and cause an angry rash all over the buttocks, or genital area, wherever the poop touches.

- Eczema or a red rash: Babies with food sensitivities often have eczema, or unexplained red, dotty rashes on their face, neck, and torso.

- Poor weight gain: Allergic babies tend to show a slow down in weight gain between 2 and 4 months, again between 4 and 6 months, and another one between 6 and 9 months. Allergic breastfed babies often gain well under normal starting at about 3 months, even though they may actually have gained very RAPIDLY at first.

- Congestion or cold symptoms: Congestion or a runny nose that hangs around for weeks and weeks and seems unrelated to any cold or viral infection can signal a food sensitivity.

- Repeated ear infections: Babies who are allergic to something in mom’s diet may have ear infections with unusual frequency.

Behavioral symptoms:

- Fussiness: seeming to always want to be held, and are rarely content when on their own. They often hate the carseat. The fussiness may not be soothed even by carrying, holding, or rocking. When younger, they might have been diagnosed with "reflux" or colic. They may have a definite evening colicky period starting at about 2-3 weeks of age that expands gradually to encompass more and more of the day as baby gets older.

- Poor sleep: Baby may not nap well and often wakes frequently at night, every 1.5 hours or two hours all night long. Baby may seem unable to nap alone during the day and may need to be held to sleep.

- Breast refusal: Baby seems to "fight" the breast. May cry, push away, or pull on and off the breast. May bite down and act agitated while nursing. May act hungry, and suck on hands or fingers, but still refuse to nurse.

- Bottle preference: Some breastfed babies will suddenly seem to only like bottles. This, really, is just breast refusal taken to an extreme.

- Infrequent nursing and/or short nursing sessions: Nursing well only every 4 hours or so, refusing to nurse at other times. Extremely short nursing sessions: nursing sessions of less than 5 minutes.

- Cluster nursing: Baby seems to want to nurse ALL the time. Mom may feel like baby is attached 24/7.


Allergy symptoms in an older infant:

Allergy symptoms in an older baby tend to be more subtle and may include sleep problems, frequent ear infections, frequent colds, slowed weight gain, and breast refusal.

Other possibilities:

Low maternal milk supply: A baby who is getting insufficient milk will often be VERY fussy, may seem to want to nurse constantly, cluster nursing for hours in the evening. Baby may sleep poorly, and wake often to nurse, and will have slowed weight gain. If low supply is the cause, other physical allergy symptoms will NOT be present. Allergy can lead to low supply, however, if baby is not nursing well. These babies, however, usually gain well at first, and have other confirming signs of allergy.

Hyper-lactation/overactive let-down: A baby who is very gassy, has green explosive poops, gains weight excessively quickly, and often chokes, sputters, or coughs when nursing might have a mother with hyper-lactation syndrome or overactive let-down. Usually this happens when baby is nursed frequently on BOTH breasts, on a schedule, or is timed at the breast. Babies will generally NOT be spitty, and will not have other physical signs of allergy like rash. OALD generally resolves pretty quickly by changing nursing technique. When changes in nursing technique do NOT resolve OALD, consider allergy as a secondary cause.

Reflux: The symptoms of reflux overlap with the symptoms of allergy because allergy can CAUSE reflux. Some reflux, however, is structural. Generally babies with structural reflux will not have stool changes, and will not respond to maternal dietary changes.

Viral infection or “tummy bug”: Viral infections can cause spitting, fussiness, and lower GI problems like runny, green, mucasy stools. The stool can be irritating and can result in a rash, or a red ring around the anus. Viral infections usually have a pretty sudden onset. The runny, mucasy, green stools resulting from a viral infection usually resolve in 2-3 weeks. Viral infections of the GI tract are more common in babies in daycare situations, or babies with older school age siblings.
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Old 07-16-2005, 07:39 AM
 
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thank you! my 9 month old baby wakes every 30 minutes, nurses once an hour at least, has horrible gas and cried for the first 7 months of his life nonstop. Also cradle cap has returned. (any thoughts on that?)
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Old 07-16-2005, 09:26 AM
 
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Some of the information you posted is not accurate.

1) First you say a baby waking every 1.5/2 hours is "VERY OFTEN waking because of some health issue", then say that breastfed babies wake every 2-3 hours to nurse.

A baby waking every 2 hours to nurse is NORMAL. It's important to say that. Repeatedly. Mothers in our society get a huge amount of disinformation about this.

2) "Bottle preference: Some breastfed babies will suddenly seem to only like bottles. This, really, is just breast refusal taken to an extreme."

No, it's not. Bottle preference is not a sign of an allergy; bottle nipples flow faster and babies don't have to work as hard. Some babies will develop a preference for a bottle because it's easier.

3) "Cluster nursing: Baby seems to want to nurse ALL the time. Mom may feel like baby is attached 24/7."

This is NOT a sign of an allergy!!! Cluster nursing is NORMAL; nursing is based on supply and demand, and babies cluster nurse to tell mom's body to increase its output. It's a sign that everything is going just fine.

Regarding sleep, you also specify how long babies 'should' be sleeping, but don't include any information on age. Many normal babies do not sleep for long stretches until somewhere after their first year - it's not a sign of an allergy!

I'm not sure where you got your information, but this really needs to be edited before someone gets confused.
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Old 07-16-2005, 11:00 AM
 
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I'd like to add something else about the list.

While many of the things are things that babies with allergies will do, EVERY BABY will do some of the things on the list at sometimes whether they have allergies or not. The list also doesn't quite set a clear context for things. For example, the needs of a one month old baby are rather different from the needs of a six month old and this difference is not the result of a problem.

I would say that if you are looking down the list and you see a number of things that your baby does and these things concern you, you should seek more information and more systematic information than can be supplied in a post, before you assume that your child has an allergy. Research shows that breastfed infants have fewer allergies.

http://www.perinatalweb.org/associat...s/positio1.pdf

Finally, while it is true that babies with allergies want to be held all of the time, it is also true that all babies want to be held all of the time. It's a core assumption that AP parenting makes about babies as such. It's not a pathology.
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Old 07-16-2005, 02:45 PM
 
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As far as the pp's critiques go, the op is a good place to start in determining if allergies may be a consideration. But it is always a good thing to get information from many sources.

Alas, it seems that my frequent-night-waking baby doesn't really have any signs of allergies. Hmmm, is that good or bad? lol (no, I know it's a good thing). He does like to be held a lot, and actually refused to be put down much until he was 6 mos. He did start gaining less weight, but that coincided with crawling and being happy playing on his own and not being held constantly.
Hmmm. Still worth considering that there is something causing night waking- maybe there is something making him uncomfortable?

Thanks for the post honeysucklemama

Becky
Keagan 11.5 mos

Becky, partner to Teague, SAHM to Keagan (7yo), Jonah (2yo)
 

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Old 07-17-2005, 03:34 AM - Thread Starter
 
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Hi,

I'm sorry if this information was offensive to some. It certainly is not my intention to cause offense. BUT, I also think there is nothing wrong with me posting something that might be helpful to others. You can find ALL this information in other places, some in the very same references people post here and on the breastfeeding forum. I simply compiled it in a way that made sense to me, and to other moms who I have connected with who have allergic infants. In the end, if nothing there is helpful to you, you are welcome to ignore the thread entirely.

Trust me, though. When you HAVE an allergic baby, you'll recognize your baby in those descriptions.

Beyond that, on the specific criticisms, I never said that ALL of the symptoms were necessarily indicative of allergy, just that they CAN be. And, when many symptoms are all together in one place they can be indicative of allergy. LOTS of babies like to be held all the time, but a baby who is never ever content on the floor can be terribly draining for a mother, even the most dedicated AP mommy. SOMETIMES babies like this are legitimately suffering. Finding out if allergy is a possibility hurts no one, and might help a suffering mother/baby pair from being told over and over they should either "CIO" or just "deal with it".

Sadly, although a LOT of people outside forums like this get the "CIO" advice, within the AP parenting circle a lot of parents who have legitimate concerns get told "just deal with it". I don't really think either extreme is helpful.

I'm the mother of three allergic infants that I nursed for several years, I also am a lactation counsellor who specializes in the management of nursing problems in allergic infants and toddlers. The list is gleaned from both my experience, and from research. I post it so it might be helpful to other mothers who are questioning whether their child might have an allergy.

:-)

Yes, babies all have unique temperaments, and some babies definitely have a much higher need to be held and touched. THere is definitely nothing wrong with that. BUT, some babies ARE legitimately hurting, and no one realizes because moms don't have the information.

Often "high need" infants become totally different babies once their allergies were discovered and treated. Certainly, this does not mean an AP mommy should be any less AP, but it does make life easier for mom AND baby. I'm probably the very definition of AP in practice in just about every way, but I can tell you I'd MUCH rather have a baby that will sit down and play independantly once in awhile, than a baby who needs holding 14/7. AND, if the REASON baby needs to be held 24/7 is becase they are hurting, what possible gain is there in ignoring that possibility??

You can certainly post your objections, but there is absolutely no harm in anyone looking into the possibility of allergy.

Normal sleep cycles in an infant past the newborn period are 3-4 hours in length with a brief awakening period mid-cycle. Most infants who are past the newborn period will have SOME longer stretches of 4-5 hours at least once a night. A breastfed baby who persistantly wakes every 1.5/2.0 hours all night long well past the initial newborn period is usually waking out of discomfort. This does not mean that a baby who wakes that frequently necessarily has a problem, but it can. Often parents who HAVE babies like this are left to suffer needlessly for MONTHS because no one even suggests the possibility that the nightwaking they are seeing might NOT be normal and might be a result of some physical issue.

Incidentally, I did not contradict myself. What I said is a normal baby (after the early weeks) usually wakes about every 2-3 hours with ONE LONGER SLEEP STRETCH of about 5 or more hours. The uncomfortable baby is waking every 1.5/2 hours all night long with no longer stretches. BUT, you don't have to talke my word for it. The information on sleep cycles is out there. Unfortunately, this information is usually used to justify a CIO approach because a baby is waking "out of habit". I am simply mentioning that such frequent waking on a regular basis can also be explained by problems like allergy.

I can back up everything on my list with references from the literature, and personal experience, but it isn't really the point, is it? I'm trying to help other moms who MIGHT want such information since I've BTDT three times over.

Peace,

honeysucklemama
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Old 07-17-2005, 03:46 AM - Thread Starter
 
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The flow of the nipple has been used to explain bottle preference, but there have been a number of excellent double blind studies in recent years that more or less debunk that idea. Few babies "prefer" the bottle no matter how fast the flow. AND, babies who do usually have a mother with low supply, are in pain because of some kind of mouth or ear problem, or have a food allergy. We are designed by nature to nurse, and nursing is pleasurable. When babies REFUSE to nurse in favor of a bottle, there is generally some reason other than the flow of the nipple.

Again, this is not intended to be a DEFINITIVE list, but a list that might be helpful to guide a mom into looking into the matter more closely. If her baby had several of these symptoms, there is no harm in looking into the idea??

Allergies are actually much more common these days that previously thought. It is estimated that fully 8% of the pediatric population has documented testable food allergies. Recent studies also implicate allergy in at least 33% of all colic, and at LEAST 50% of all cases of reflux. Some studies put the incidence of allergy caused reflux as high as 70-80%. Reflux is the number one most common pediatric issue in infants under one year, and perscriptions of reflux drugs like zantac are at an all time high.

If you have never nursed an allergic baby who have NO IDEA how difficult it can be, and most moms with allergic babies suffer alone for a LONG TIME before connecting with someone, anyone, who can help them. If ONE MOM with an allergic baby sees this list and gets help for themselves and their infants, then I'll be happy I posted it no matter how much flack I get.

Peace.
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Old 07-17-2005, 01:04 PM
 
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“We need to determine if unrealistic parental expectations, rather than infant pathology, play a role in creating parent-infant sleep struggles – one of the most ubiquitous pediatric problems in the country.” – Dr. James McKenna

I think it's wonderful that you want to help; that's why we're here. I am not trying to attack you; I have tremendously enjoyed your other posts, and agree that CIO can be the unfortunate recommendation for a nightwaking baby. But accurate information is also important in creating realistic expectations, and parents in our society get a HUGE amount of advice regarding sleep issues, not to mention breastfeeding.

First, anyone making a long list of pathological behaviors risks including behaviors that are normal. Typically the writer will offer a disclaimer up front that says some of the items on the list are normal; pathology is not a behavior, it’s a pattern of behaviors.

Quote:
Originally Posted by honeysucklemama
Trust me, though. When you HAVE an allergic baby, you'll recognize your baby in those descriptions.
Actually, I DO have an allergic baby, and also an allergy-free baby. And I recognize both babies in these behavior descriptions. That's a problem - as one pp said, all cosleeping, breastfed babies will have at least one (probably more) of these behaviors at some point. You don't specify in your original post, as you do in your subsequent posts, that one should be looking for multiple things. One could read this list and conclude that cluster-nursing, or wanting to be held frequently, or needing help to get to sleep is a sign of an allergy, and that is not accurate.

Quote:
Beyond that, on the specific criticisms, I never said that ALL of the symptoms were necessarily indicative of allergy, just that they CAN be.
You said
Quote:
Babies who wake EXCESSIVELY frequently, like every 1.5/2 hours are VERY OFTEN waking because of some health issue.
“Are VERY OFTEN” is categorical, and different from "they CAN be". Maybe you didn't notice your emphasis.

Also, you did not specify the age of the baby; did not say 'beyond newborn', as in your most recent post, but this information is important. For young babies waking every 2 hours is NORMAL, necessary for the establishment of a good milk supply, not something that should alarm a new mother.

You are talking about a subset of the total infant population: infants who cosleep AND breastfeed. Of all infants, these are the ones that tend to wake most often. As Dr. James McKenna noted in one of his studies (here), babies who breastfeed and cosleep nurse more frequently. If you look at the graph you will see plenty of normal, healthy infants nursing 5-12 x per sleep episode, which works out (assuming a 12 hour sleep episode total) to every 1-2.4 hours.

Quote:
Sadly, although a LOT of people outside forums like this get the "CIO" advice, within the AP parenting circle a lot of parents who have legitimate concerns get told "just deal with it". I don't really think either extreme is helpful.
I would say a recommendation that says that VERY OFTEN cluster-nursing infants who are "seeming to always want to be held, and are rarely content when on their own” have a physical ailment is extreme.

I can't think of a single bedsharing or CIO book/article that doesn't start off by saying a mother should first determine if there are physical signs of an allergy or other medical issue. And I would say your characterization that AP moms mostly tell each other to 'just deal with it' is grossly unfair.

Quote:
Yes, babies all have unique temperaments, and some babies definitely have a much higher need to be held and touched. There is definitely nothing wrong with that. BUT, some babies ARE legitimately hurting, and no one realizes because moms don't have the information.
I agree with everything you've said here, but your OP does not put it this way. It lists a series of infant behaviors that are completely normal and says VERY OFTEN the cause of these behaviors is physical. And it includes behaviors that have nothing to do with allergies, such as cluster nursing and needing help to get to sleep.

Quote:
Normal sleep cycles in an infant past the newborn period are 3-4 hours in length with a brief awakening period mid-cycle.
‘Beyond the newborn period’ many breastfeeding mothers will notice a previously long-sleeping baby suddenly wakes more often at night to nurse. This is not a sign of an allergy or other ‘problem,’ and it does not help mothers to tell them that if their child suddenly is wakeful, cluster nurses or needs help to get to sleep that there is USUALLY A PROBLEM, no matter what the cause. Jan Barger, IBCLC, Kathy Kuhn, RN, Kelly Bonyata, IBCLC

Quote:
A breastfed baby who persistently wakes every 1.5/2.0 hours all night long well past the initial newborn period is usually waking out of discomfort.
As Dr. McKenna has noted, “current clinical models of the development of "normal" infant sleep are based exclusively on studies of solitary sleeping infants.” McKenna's sleep research has shown that this is simply not true for breastfeeding, cosleeping infants. Again, see the above article by Jan Barger.

Babies receive up to one third of their total calories at night. Moms who work may find their breastfed, cosleeping babies waking more often to 'reconnect' than sahms.

Quote:
Incidentally, I did not contradict myself. What I said is a normal baby (after the early weeks)
You did not say 'after the early weeks'.

Quote:
I can back up everything on my list with references from the literature, and personal experience, but it isn't really the point, is it?
Yes it is. I have never read anything that said cluster nursing, wanting to be held, being "unable to nap alone during the day", or "need[ing] to be held to sleep" is a sign of an allergy. If you have specific references it would be helpful to share them.

Attachment parenting creates attached infants who frequently want to be held to sleep and can't nap alone. Cluster nursing is not a sign of an allergy. Just as you want to be helpful, I want to be helpful. Telling moms who are nursing their babies for the umpteenth time, who are tired, that their baby's cluster nursing, sudden wakefulness or wanting to be held is USUALLY the sign of a problem (of whatever cause) can cause undue stress on the mom and make her feel as though something is "wrong”.
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Old 07-17-2005, 02:23 PM
 
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chicagomom!
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Old 07-18-2005, 04:42 AM - Thread Starter
 
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Hi,



I'm glad I have some redeeming qualities.

I'm not a doctor, and I don't pretend to be. I don't even play one on television.



I'm not going to have a huge debate here which is not my intention AT all. I'm actually sorry I tried to respond point by point to anything. Call it a knee-jerk response. In other words: "how DARE you call me wrong", I'll SEE your expert and raise you two Ph.Ds. Blame it on the fact that I am always typing late at night when sleep deprived and grouchy. Blame it on ego, or moon spots, or anything you like.



Just so that you know, the list is part of a larger FAQ I am working on for a FA forum I co-host. The question "is my baby allergic" comes up a lot, and the list is a quick and dirty way for a mom to either realize she should look into the matter, or that it is unlikely. It has already been edited many times with input from other mothers of allergic infants, and is a work in progress. I will certainly look at what I have written in light of your concerns. At one point I did try to take into account ages and stages of development, but the list because too long, confusing, and unyieldy. There are entire books about what is "normal" at different points for a breastfed infant. I certainly can't reflect all that in a symptomology list of behaviors in allergic infants.

For now, if you'd prefer a disclaimer on the top (or near the bottom as it may be) I'll say that IN MY PERSONAL EXPERIENCE as a mother of allergic children, and from reaching out to other motheres with allergic children, these symptoms are often found in allergic infants.

I still hold by my insistance that an infant who wakes frequently, all night long, every 1.5 hours every night has some physical problem. Can I back that up with stats and research articles?? (Here I go again) Yeah, but it doesn't really matter. I'm not posting from stats and research articles, I'm posting from my experience.I have FOUND it to be so with both my own children, and the children in my FA group, most of whom had been told "its normal" and suffered for months and month before deciding that MAYBE something else was going on with their child.

You, of course, have no reason at all to trust MY experience, nor do I expect you to. But, I suspect that most moms reading this have the capacity all on their own to decide if my experience has any worth. In the end, we all post from our EXPERIENCE, and people have to decide on their own whether or not it is worth the computer it is typed on.

Hopefully a mom will move from a forum LIKE this one, to an LC or an allergist or someone who is adept at separating the possibility of allergy from what is not allergy. BUT, most parents don't even know to ask, or are given horribly bad information. Few pediatricians, and, sadly, many LCs don't know anything about allergies and the nursing infant. The MEDICAL response once allergy is identified is to hand mom Alimentum, or when that fails, Neocate. Many people in the medical establishment, and this includes certain populations of LCs, out right deny that a breastfed infant CAN be allergic to things in their mother's milk.

What I am saying is there is all kinds of information out there. (Including a LOT of information supporting CIO and other non-AP practices). Hopefully a mom who sees her child in those descriptions will be astute enough to look around and read and seek help. I doubt there is any great danger of a mom with a NORMAL infant abandoning AP practices in favor of CIO because she saw my list.



I'm trying to keep this light-hearted and I am DEFINITELY not trying to have an argument. I'll leave that to the guys on Monty Python. I'm trying to help other mothers that might be where I was 7 years ago, nursing a miserable infant, miserable, depressed, and seriously sleep-deprived with no one to turn to who had ever nursed a baby like mine. Getting told baby was "spoiled" by the CIO-crowd was no more comforting that being told "your baby is high needs" by the AP camp. Both advice was well-meaning but useless and isolating. I didn't need to be told by AP-parenting friends "that I was doing the right thing". I KNEW I was doing the right thing. What I needed was some help. Help virtually no one in any capacity (save one) could offer.

What my baby had was severe allergies. AND, once I found THAT out, I had a totally new baby. YES, still attachment parented, and YES still sensitive, dynamic, and wondefully needy, but OH SO MUCH happier. I still thank the good Lord for putting me in the path of that one LC who actually knew how to deal with allergic babies. At this point I'd certainly be a lunatic without her.



As for your specific criticisms, I'm not sure where you want to go with that. Obviously you feel I am imparting poor lactation information. And, obviously, I am just as certain I am not.



So, do we draw swords at 20 paces and duel? I'm not trying to be flip, honestly and I hope you don't take it that way. Should I post experts to counter your experts?? Should I trot out my CV and give you a list of 20 references?? Should I list my work experience and where I came up with my information point by point??

Honestly, I don't have the time and energy for that. And, if that is what is required to satisfy that I am not a dangerous imparter of bad information then I respectfully withdraw my list from consideration.



I "thought" I was being helpful to some of the mothers on this forum who might have babies with food allergies. There have been a few on this forum recently, like in the last week, who I'd bet money have babies with allergies and sleep problems resulting from such. One or two, especially the moms who have been posting here with "reflux" made my heart ache. I have soooooo BTDT, and I know I can help. So, maybe I just need to go back to offering one on one help as I always have been. And, maybe after I have been posting here for awhile you'll realize that I am actually not an idiot.



BTW, I really really like that bouncy and feel like that late at night when I am typing out silly things on forums instead of sleeping.

What I WILL say, however, is that lactation information is by no means uniform, and there are some areas where there is considerable debate. In addition, some well held (and written about) ideas in lactation have been recently debunked or changed. This is part of the genesis of lactation as a real science as WELL as an art and can only help improve the care of all nursing mothers. AND, there is even room for disagreement in the field of lactation science. In the end what matters is we are all trying to do our best for one another, which is why I bother to post anything here at all when I could just as well be in my nice warm bed with my lovely co-sleeping infant (and my in room 4 and 7 year old).



Peace.

Honeysucklemama (who has just figured out how to use those smilies and so apologizes if she used too many of them)
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Old 07-18-2005, 05:04 AM - Thread Starter
 
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I forgot to add that if you are HONESTLY curious about where some of that information comes from, then I'd be happy to have a conversation with you. But, to be honest, I didn't get the sense that you were curious, merely that I was being "slapped down" as not being AP-friendly. Bad mommy... imparting bad information and making AP-parents question their judgement.



I know that is probably all in the interpretation and not your actual motivation, but there you go. As I said, sleep deprivation is not good for one's mood. I should really GO TO BED instead of sitting here typing with a sweaty baby on my breast. Sweet smelling baby bouncing away in time to my typing.



I understand that you are fearful that someone with a normal AP-attached infant might start to think their infant has a pathology, and that you are trying to guard against that. But, I will also tell you that there is also a danger that parents who are suffering with babies who actually have problems will be ignored by the AP community, or eventually turn to weaning or CIO out of sheer desperation.

When a mom is near desperation with sleep deprivation the knee-jerk "that is normal" is JUST as dangerous as the risk that a mom with a "normal" high needs infant might see a pathology where there is none. In fact, desperate moms are EXACTLY the ones who are most vulnerable to CIO and other baby-unfriendly techniques. I can attest PERSONALLY that the "CIO" people were easier to take than the AP friends who just kept telling me "its normal" when my mommy-sense was telling me something was afoot.

And again in parting is that silly bouncy I love.



Peace.
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Old 07-18-2005, 12:47 PM
 
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I’m sorry if you feel offended.

You said:
Quote:
I also am a lactation counsellor who specializes in the management of nursing problems in allergic infants and toddlers.
You started this thread, explicitly stating you have professional credentials. As such, your word carries more weight than an average mom sharing her own personal experience.

You have also stated that you have research studies to back up your claims.

Quote:
The list is gleaned from both my experience, and from research.
Quote:
there have been a number of excellent double blind studies in recent years that more or less debunk that idea.
But now you state that if I question anything you say, or ask for such research I am attacking you. I am not attacking you; as I noted previously I have tremendously enjoyed your other posts. But this one is different – you started this thread. You stated your credentials up front, referred to research and then gave an authoritative list of behaviors you believe are USUALLY associated with a physical problem. This list includes normal infant behaviors such as cluster nursing, a baby wanting to be held all the time, and needing help to get to sleep, items that come up frequently on this particular forum. You even started your post by noting that the things in your list come up frequently on this forum. Then you concluded that babies with these behaviors USUALLY have a physical problem.

I have never seen claims like this published in any study, on Lactnet or LLL. If you have research for these, it would be helpful if you would provide it. Otherwise, please change your post. You are not simply sharing mother-to-mother observations, you are offering explicitly professionally credentialed advice. So yes, your information does need to be accurate, and it is perfectly reasonable to question it. Sorry if you feel offended by that.

Again, what you wrote was more than mother-to-mother stories. You started the thread explicitly to offer advice to the many co-sleeping, breastfeeding women here; you stated your professional credentials, and you refer to research.
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Old 07-18-2005, 12:56 PM
 
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I forgot to add that if you are HONESTLY curious about where some of that information comes from, then I'd be happy to have a conversation with you.
I've kept quiet, but I am HONESTLY curious about where all of that information comes from and I think it would be very kind if you could post these resources for others. Thank you.
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Old 07-18-2005, 01:16 PM
 
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Originally Posted by SoHappy
I've kept quiet, but I am HONESTLY curious about where all of that information comes from and I think it would be very kind if you could post these resources for others. Thank you.
:
call me a sceptic, but I gotta do my own research before accepting any one person's statements. I do, though, personally agree with about half of what is in the OP, and think it is good advice, in general, and a good place to start in trying to determine the root cause of nightwaking problems.
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Old 07-18-2005, 05:49 PM
 
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Quote:
Originally Posted by honeysucklemama
I forgot to add that if you are HONESTLY curious about where some of that information comes from, then I'd be happy to have a conversation with you.
Add me to the list of moms who would like references to the research, please! I'm a research freak -- nothing like a juicy study to sink my teeth into. (My first Mothering article had no less than 60 references!) I'd also be curious about your lactation credentials...not to be snarky, but I wonder if you have the legal authority to offer medical advice. Otherwise, you need a big disclaimer in your info.

My first baby showed all of the behavioral symptoms you list, and some of the physical symptoms, yet doesn't seem to have any allergies (and we did go through all kinds of elimination diet stuff). He didn't nap. He didn't sleep well. At one point, he was waking every 45 minutes or so at night. He wanted to be held all the time and was usually not content. None of the usual activities soothed him. He had frequent ear infections and strange bowel movements. We have concluded that our difficulties were neurologically based, not dietary. His personality today, at age 8, fits with who he was as a baby. His sleep patterns matured as his nervous system matured, and now he sleeps well. But we were mystified when he was young. I read the literature, looking for clues, and found a few that pointed us towards the neurological basis of his problems.

Like you, we suffered through a lot of difficulties with none of the usual answers being at all descriptive of our baby. I understand the frustration and the desire to help other parents. But I'm sure you can see that it would not be appropriate for me to use my personal experience to advise other moms that their babies might have neurological problems just because they exhibit similar behaviors as my son!

OTOH, my second baby was just about the opposite in temperament from my first. She fit the "normal baby" descriptions much better than he did. She slept so well in comparison to DS that we almost cried. She took two naps a day! She slept like a "normal" baby at night! She was happy and easily soothed. Yet -- she wanted to nurse all the time. (I have NEVER understood those claims that normal babies nurse 7-10 times a day, etc. -- not my babies, and not any of my friends' BF babies -- more like 20-30 times a day! :LOL ) She cluster nursed. She fussed at the breast sometimes. She went through periods of night waking, and periods when she wouldn't nap alone. She had weird bowel movements -- a chiropractic adjustment fixed that, and suddenly her BMs were perfect breastfed baby poop. Again, we know pretty definitively that she has no allergies. And again, her personality at age 5 is very much in line with how she behaved as a baby.

I agree with chi-mom that those particular behaviors that she pointed out could be very misleading in the context you present them, in that they are NORMAL BF baby behaviors. Usually a diagnostic list like yours that includes symptoms that are also seen in normal populations will indicate that X number of symptoms should be present to suspect the condition, or that, say, the behavioral symptoms are only considered suspect IF they accompany X number of physical symptoms. Otherwise, you risk what you are seeing here -- confusion over perfectly normal behavioral/physical symptoms that in and of themselves do not indicate pathology. If you're going to offer diagnostic information (and again, you need a disclaimer if you are not certified to offer medical advice), you have to hold yourself to a very strict standard of accuracy.

Anyway, hope this is helpful in your quest to help babies and parents. Again, I'd like to see the list of studies backing up your info that you offered to share. Thanks!
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Old 07-18-2005, 05:53 PM
 
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Cluster nursing is not pathological, and does not belong on a list of pathologies. ALL breastfed babies will cluster nurse; this is how they increase mom's output.

Mothering.com, Cynthia Good Mojab :

Quote:
Perceived insufficient milk syndrome or perceived insufficient milk supply occur when a mother actually has an adequate milk supply but misinterprets her nursling's behavior (e.g., fussiness, frequent nursing, consumption of formula after breastfeeding, etc.) to mean that she does not have enough milk (Hoover 2002, p. 219; Riordan & Auerbach, 1999, pp. 312-314). Because of this belief, the mother may introduce or increase supplementation. With the use of supplementation, her breasts are stimulated less, receiving the signal to make less milk, and a downward spiral of milk production begins. Thus, without intervention, perceived insufficient milk syndrome can lead to actual secondary insufficient milk syndrome.

Therapeutic interventions include thorough assessment and teaching, as needed, effective latch-on and positioning, behavioral feeding cues, normal feeding behavior (e.g., frequent nursing, night nursing, cluster nursing [several nursings in a shorter time frame than usual]); breastfeeding techniques such as breast compression, pumping or hand expression, and switch nursing (repeatedly offering the other breast after the baby has finished nursing from one breast to help increase milk supply); medical evaluation and treatment of the nursling; referral to mother-to-mother breastfeeding support groups; the use of herbal and/or prescription medications that are known to increase milk supply (galactogogues); and acupuncture (Hoover 2002 pp. 223-226).
(emphasis mine)

Making a statement that cluster nursing is a "sign of allergy in a breastfed infant" is not accurate, and could be harmful to a mother-baby dyad working to establish or strengthen their supply.
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Old 07-18-2005, 07:50 PM
 
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I've started this post several times, because I keep trying to think of a qualifier, but I can't come up with a good one. I keep trying to say the list might be good "if you added a disclaimer" or something else, but I just can't say it because there are so many behaviors on there that are totally normal!

Cluster nursing for a few hours is normal.
Waking every 1 to 2 hours is normal. (Tiring, yes, but not abnormal.)
Wanting to be held every single waking minute is normal. (Again, tiring, but not abnormal.)
Hating the carseat is sooo normal.
Needing to be nursed to sleep is normal.
Refusing to stay asleep unless Mom is in bed, too is normal.

And the way you've worded some of your information makes it seem as though these things are not ever normal. When you say, "Babies who wake EXCESSIVELY frequently, like every 1.5/2 hours..." it doesn't matter if you only say they are "very often" suffering from allergies as opposed to "always". Just the fact that you say "EXCESSIVELY frequently" makes it seem that waking that often to nurse is abnormal, when, in fact, it is totally normal. "Excessively" automatically means outside of the norm. I know you are using references, but you have to realize that there is a difference between a baby who sleeps in a crib and/or is ff and a baby who is bf and co-sleeps. Studies stating that babies only wake that much if there is some pathology are not based on breastfed, co-sleeping babies. As chicagomom already said, Dr. McKenna has done *extensive* research on mother/infant sleeping pairs and it is *totally* normal for a baby to wake that much. In fact, it would be abnormal for a breastfeeding, co-sleeping baby to wake less than that, according to his research. (Not to say that it is "bad", but it is outside of the norm.)

I also think saying a baby should be able to play happily on a blanket or bouncer for 15 to 30 minutes is totally inaccurate. They can't move, for goodness sake! Why the heck would they want to be all alone on a blanket instead of in someone's arms, where something is actually happening? I don't like sitting still for 20 minutes staring at the wall, so why should my baby? I could hardly put my baby in the bouncer to pee long after I eliminated her allergic foods. The problem wasn't allergies - she just loved being held!

I think you have great intentions and the list could be helpful, but there are waayyy to many normal baby behaviors listed as symptoms of a problem. Any average baby with a secure attachment to one caregiver could exhibit every single one of those nursing/sleeping/needing to be held behaviors and have absolutely nothing wrong with it.
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Old 07-18-2005, 08:50 PM
 
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Wow, I am fascinated by how aggressive this whole discussion has gotten. Had I come across this thread back in the early days of my son's food sensitivities, I probably would have found it interesting and useful - sort of. I do think that the list has way too many things that can happen in different circumstances, AND based on personal experience, a baby doesn't have to have several of the signs to have the food sensitivity. (I hesitate to call it an allergy). I guess my point is that it just isn't so easy to diagnose this problem from a list like this. It can present itself in so many ways. An unknowing (and desparate) mama may say "oh yeah, my kid has this sign and this sign" and jump into an unnecessary elimination diet. Or...she may see many signs that her LO doesn't have (as mine didn't) and go for a long time without addressing the food issue. Not every baby with a FA has a red ring...

Something else that this lists fails to address (and others have touched upon) is that some babies just exhibit these behaviors (nursing often, wanting to be held all the time, needing mom to sleep, etc) without any serious problem. Search for "high need" on here, and you'll come up with several posts.

Mama to Marcus (1/05) and Arianna (3/10). hbac.gif

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Old 07-18-2005, 10:51 PM - Thread Starter
 
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How about if I went back and edited my original post to remove any mention of professional credentials and then simply stated that the list is derived from my own personal experience and the experience of a group of about 40 food allergy moms who helped me compile the list. Would that help? Then no one has to get up in arms about me acting as any co-called expert and leading moms down the wrong path.

I could also state that you are, of course, free to consider my experience invalid if you so desire. (I suspect most moms who read this forum are capable of discerning for themselves if my list is useful at all to them, and if they think that my experience has any value.)

I could also state up front that HAVING one or any of the symptoms does not mean that you have an issue, nor does having none of them mean you don't. As I said, I'm not trying to post a definitive list, just a list of behaviors that IN MY EXPERIENCE have been associated with allergy.



Would that douse the flames?



I suspect that is not so much the list itself, but the fact that I started out listing it with some so-called professional credentials. As a relative newbie to this forum I imagine it was really irritating to have me come out as some kind of self-styled "expert". I apologize. Mea culpa. Consider any mention of professional redentialling officially retracted. I'm a mom just like the rest of you. I happen to be a mom who has three babies with allergies, and I am regularly in contact with a group of moms who have babies with allergies. It was a mistake to say anything else at all, and I mean that honestly. I'm not being flip. I should have framed the list differently and I suspect it would not have raised people's ire.

I'm still willing to share with people where this information comes from, but I'm not going to do it here. I think this thread has gotten WAAAY too antagonistic, and I really feel like I am being attacked here even though I am really trying hard to be non-confrontational. As I said, I'm not going to match point for point, expert for expert, and I'm sorry that the thread has come to this.



Peace.
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Old 07-18-2005, 11:01 PM
 
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I wasn't trying to be aggressive. I think the list isn't a bad idea, honeysucklemama. It's just that all those behavioral things are normal.....
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Old 07-18-2005, 11:47 PM
 
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Do you really feel like you are being flamed? I'm sorry to hear that. I'm sure you didn't expect to get called out on this stuff. I can only speak for myself in saying that I was certainly not flaming you, and while I see other posters disagreeing with you, I don't see flames there either. I think that some of the previous posters are concerned that some of your info is inaccurate and therefore possibly harmful and misleading to BF moms. If you saw someone posting something that you believed to be inaccurate, wouldn't you challenge it? I'm sure an accurate list of what to look out for that might signal an allergy in a BF baby would be a wonderful resource that many of us would be happy to pass on, but this isn't quite there.

The only reason I wondered about your credentials is because of the issue I mentioned as far as needing to be careful to have a disclaimer about this list not being a substitute for medical advice. If you are "just a mom" (and maybe you are? Maybe your counseling is in a lay context?) you need a disclaimer. That's all. If you had never posted anything about credentials, I still would have disagreed with some of the items included on your list and how you've chosen to present the info. Again, you NEED to explain that those normal behaviors are normal. And you need to correct the info you have about what normal BF babies do -- otherwise, your info is simply incorrect.

If you were posting this and just saying it was based on your experience and the experiences of others you know, I would be even more critical of your info. A sample of 40 mothers with allergic babies is NOT an adequate basis for making the claims you are making...this is elementary research design. The only way your list can be considered accurate is if the anecdotal info you have also matches up with the research. You said it does, so why not include your references in footnotes to your list? It would strengthen your list considerably, and would give your readers the opportunity to verify for themselves (as many would want to do) the basis of your info. If you'd like me to send you an example of a fully referenced info sheet, LMK.

I will PM you for the studies you've mentioned. I would really like to investigate this further, since as I said, my DS exhibited a lot of the symptoms you describe, but the cause does not appear to be allergies. I'd like to see if the research points to any other possible causes of these kinds of behaviors.
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Old 07-19-2005, 12:00 AM
 
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I hope you don't think I was flaming you, either! I think you have some very interesting information, and just because I disagree with some of it, doesn't mean that I don't respect the message you are trying to convey. I do have one very allergic child, and another not so allergic, both of whom did many of the things in your list. I am also very allergic myself. I think, for me at least, sensory dysfunction/spiritedness plays a huge role in not only my allergies, but in also my own personal sleep problems. I also think it's normal for babies to show some of the behaviors on your list, and not necesarily signs of there being any problem that needs to be fixed (other than the parents' perception of the existence of a problem).

But, I totally agree that allergies should be ruled out when babies are excessively nightwaking! Not just food allergies, but environmental ones as well.
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Old 07-19-2005, 04:10 AM - Thread Starter
 
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I am hypersensitive I'm sure. Call it sleep deprivation. Dd does not sleep, and I am WAY tired. After I "cheated" and had some real food over the last few days, my infant has been miserable. I have not had longer than a 30 minute stretch of sleep for 3 days.

ALSO, as a larger source of grumpiness, I had to choose between nocate for my currant infant who has MFPI OR eating an extremely limited diet that consists of nothing more than peaches, buffalo, and wild rice. BUT, because I am so dedicated to nursing I have been willing to do that for more than 9 months, despite the fact it makes me cranky.



PLUS, during the seven years I've been dealing with my own kiddos with majorly severe food allergies I've read just about everything out there and then some and pestered just about every doc and holistic practicioner in my town.

Its a sore spot, the food allergy issue. But, I don't think I was objecting so much to being challenged, as the WAY I was challenged. One or two of the posters (and it doesn't matter who) more or less came right out and accused me of posting BAD and possibly dangerous?? information.

I'm paraphrasing but what I GOT was:

Boy, there are THINGS on that list that are WRONG. Shouldn't someone edit this so people aren't mislead?



Wouldn't it have been far more friendly and helpful to have posted something like:

'Gosh, that is an interesting list. Are you sure about XYZ information because I have heard differently. Do you mind sharing with me where you got your information? I really want to make sure nursing mothers get the best possible information!!'

I bet I would have responded a LOT differently. Wouldn't you have?? It is the difference between "debate" where there is a winner and a loser, and "reaching understanding" where we all win. I don't want to debate, but I'd be glad to try to reach an understanding. But, that requires putting down the dueling pistols, or the dueling experts, so to speak.

Anyway, I promise not to let my sleep deprivation get the better of me. So, I changed my mind and I'm back, and I’ll even stop moping now even though I'd KILL for a DQ sundae like the one being advertised behind me on TV RIGHT NOW!!!!



Beyond this, call "flame" a poor choice of words. I actually am not really offended since I am pretty hard to offend. I just wasn’t sure I wanted to take the time to respond in detail mostly because it seemed the response to my post was, shall we say, inordinately harsh?? And, because I am a busy SAHM of three who is really sleep deprived and was not expecting such controversy.

Anyway, here goes a long, long, long, answer. Bear with me:

Firstly, it is helpful to understand the definition of “allergy”. At ONE point different food induced responses were called variably “intolerance, allergies, or sensitivities” depending on their symptomology. But, allergists these days simply refer to ANY negative immune response to a food as an allergy. These responses can be IgE mediated, or the more typical food allergies we hear about (like to peanut) or they can involve other parts of the immune system and, consequently, other areas of the body. There is a wealth of information out there on allergy in general, but these review articles are pretty good summaries. I choose these articles because they are readable, and available on line in full-text form. BUT you can find hundreds of recent articles on food allergy backing up a lot of the physical symptoms I listed.

http://pediatrics.aappublications.or...ode=pediatrics

http://www.aafp.org/afp/990115ap/415.html

To pull out a few key points: Only a small subset of food allergies, those typically associated with IgE antibodies show up on traditional allergy tests. So-called “true” food allergies, the ones that can result in typical anaphylaxis, are present in about 8% of the pediatric population. It is NOT uncommon for a child with documented gastrointestinal food allergies to test negative on RAST or skin testing. Also, the kinds of allergies that cause lower GI discomfort, gassiness, colitis, and cramping are usually not the kind that show up on food allergy tests.

Because there are no convenient medical tests for the other kinds of food allergies, and their symptoms can be varied and uniquely effect each person, there are no clear numbers for the percent of the population who have non-IgE mediated allergy. HOWEVER, we can get a clue for how high these numbers when you read studies like the following. The first one indicates that REFLUX is caused or worsened by cow’s milk allergy in at least 50% of all cases of reflux. Other smaller studies show even higher percentage of causality.

http://pediatrics.aappublications.or...ode=pediatrics

Colic is well known to be associated with cow’s milk and other proteins in mother’s milk.

So, is food allergy rare? Given the prevalence of colic, reflux, and true food allergy in the pediatric population I’d say rare is really not a correct designation.

So, how about my dreaded list of food allergy symptoms: To start, here’s some lists, similar to mine, from a few well-known references. My list was synthesized from these sources AND others, and put in non-medical terminology. I’ve also used experience as a lactation consultant to come up with additions to these lists, but I think you’ll see that nearly every thing on my lists are backed up in these references. In fact, I exclude SOME things on the list because (in my experience) these are generally not present in exclusively breastfed infants before they are given solids directly. I have also excluded some symptoms also because, in my experience, they tend mostly to be found in older children past the first year.

Quote:
From “The Nursing Mother’s Companion 5th Edition” page 150-151

If your baby pulls away from the breast crying and refuses to nurse, don’t assume he is ready to wean. There are a number of possible reasons for this behavior but when it persists it can frequently be traced to certain foods in the mother’s diet to which the baby is sensitive. Typically this behavior starts when the baby is two weeks of age. He may also act fussy and have very frequent, sometimes greenish, stools. Other symptoms may include gassiness, redness around the rectum, a mild rash anywhere on the body, or a stuffy nose. Fussiness while nursing and refusal to nurse may occur sporadically or may increase as the day goes on. Although baby refuses the breast, he may eagerly take breastmilk from a bottle
(That last sentence sounds a LOT like bottle preference, does it not??)

Here’s a list from the same reference about symptoms of “reflux” from page 155. If you read the description Huggins goes on to associate reflux with food allergy in many if not most cases. Since we already established (see studies above) that a great deal of reflux is caused by allergy, the symptoms lists will overlap.

Quote:
Symptoms of this problem can include sudden or inconsolable crying, arching during feedings, refusing the breast or bottle, frequent burping or hiccoughing, bad breath, gagging or choking, frequent throat inflammation, poor sleep patterns, slow weight gain, frequent ear infections…”

Some babies with reflux will seem to want to eat all the time and may grow very fast.
(Sounds like cluster nursing doesn’t it??)

Quote:
Other babies may not only cry after and in-between feedings, but they fuss at the breast and may refuse nursing altogether. Oddly enough they may take that same milk from a bottle that they would not take from the breast.
(Again, there is that pesky bottle preference).

Quote:
Some babies seem to suffer more with lower belly discomfort than with regurgitation and heart burn. Besides crying these babies symptoms may include gassiness; stools that are very frequent or green, mucas, or even bloody; and redness around the rectum. A baby may have a stuffy nose or a rash on her face and upper body. She may want to nurse all the time.
(There is that cluster nursing again.)

Quote:
From “Breastfeeding and Human Lactation (2nd edition) by Riorden and Auerbach page 656.

Vomiting may be accompanied by chronic diarrhea, colic, colitis, excessive crying, reluctance to feed, and poor sleep patterns. Eczema, uticaria, a severe diaper rash, and excessive pallor may also be present. Individual infants may respond differently to allergenic foods.. […..] one infant may develop diarrhea, colic, or GI problems; another may respond through his central nervous system and become irritable or hyperactive; and a third may have dermatological symptoms such as urticaria or eczema.

“The list of allergy symptoms is long: an allergic child may have rhinitis, otitis media, coughing, asthma, conjunctivitis, nausea, vomiting, anorexia, and frequent respiratory infections.

Quote:
From "Breastfeeding: A Guide for the medical profession (5th edition).” By Ruth A. Lawrence (Page 626.)

Symptoms associated with food allergy include asthma, urticaria, and rhinitis as well as colic and failure to thrive with chronic respiratory and gastrointestinal disease. [….] Sleep disturbances have been reported in a series of children evaluated with a prospective double blind crossover design. Another symptom reported in two siblings was insatiability despite adequate weight gain. This was confirmed by history and reproducible reaction to dietary elimination and subsequent oral challenge.
(Insatiability is a baby who seems to want to nurse all the time, and looks a LOT like “cluster nursing”.)

From Lalecheleague.org

Quote:
IgE-mediated reactions can include symptoms in the upper gastrointestinal tract such as nausea, vomiting, reflux, refusal to eat, and eating ravenously; lower GI symptoms may include blood in stools and diarrhea. IgE-mediated disease can also cause respiratory symptoms such as wheezing and perpetual congestion; atopic dermatitis, eczema, and various rashes; an extreme reaction is anaphylaxis which leads to cardiovascular collapse and shock. Symptoms of non-IgE-mediated allergic disease (or cow's milk colitis) are usually limited to the lower GI tract, causing diarrhea and blood in the stools. The presence of symptoms outside the gastrointestinal system generally indicates IgE-mediated hypersensitivity.
From the Sears website:

http://www.askdrsears.com/html/4/t041800.asp#T041803

Notably, here is the list of some of the behaviors some of which really would only be readily apparent in an older child, but would show up as fussiness, crankiness, and “high needs” in an infant.

Quote:
fatigue
migraine headaches
hyperactivity
crying
irritability
night-waking
anxiety
crankiness
sore muscles and joints
From beloved Kellymom:

http://www.kellymom.com/babyconcerns...ity.html#signs

Quote:
If a breastfed baby is sensitive to a particular food, then he may be fussy after feedings, cry inconsolably for long periods, or sleep little and wake suddenly with obvious discomfort. There may be a family history of allergies. Other signs of a food allergy may include: rash, hives, eczema, sore bottom, dry skin; wheezing or asthma; congestion or cold-like symptoms; red, itchy eyes; ear infections; irritability, fussiness, colic; intestinal upsets, vomiting, constipation and/or diarrhea, or green stools with mucus or blood.
I want to note, however, that I actually don’t agree with her that food allergies and sensitivities in breastfed infants are rare. As I said above, something that includes 8% of the pediatric population, and also MAY include a large percentage of infants who have “colic” or “reflux” may not actually be very “rare”.

And from another place in her website:

http://www.kellymom.com/nutrition/so...s.html#allergy

Quote:
Following are some reactions that may help you recognize an allergy in your baby:

Bloating, gassiness
Skin rashes (for example, a sandpaper-like raised red rash on the face), eczema, hives
Runny nose, stuffiness, constant cold-type symptoms
Red itchy eyes, swollen eyelids, dark circles under the eyes, constant tearing
Diarrhea, mucousy stools, intestinal upset
A red rash around the anus
Generally cranky behavior, fussiness, irritability, colic
Vomiting or increased spitting-up
Asthma
Ear infections
Poor weight gain due to malabsorption of food
Okie dokie.

I included on my list only the symptoms that seemed to be most common in the breastfeeding mothers I was in contact with who were exclusively nursing their infants.

BUT, LOTS of lists including most everything I have on my list, right?? In fact, many of the symptoms on my list are on nearly every one of the other lists.

Oh yeah, AND lots of respected sources USE lists as a way to help a mom and/or figure out what MIGHT be happening with her infant. So, I guess lists are not inherantly mis-leading??



OK, now on the MAIN points of disagreement. I don’t think people were really disagreeing with MOST of the list, especially the physical symptoms that are pretty well documented. I suspect that MOST of the disagreement really falls to TWO main points I list under behavior. The sleep information, btw, shouldn’t even be in dispute. Poor sleep patterns are mentioned in just about every list of food allergy symptoms. And, if you want a good sense of what constitutes “normal” sleep there are a number of excellent books that review sleep cycles and patterns in young children. You can look up the stats yourself or how long an infant generally sleeps and by what age, and what infant sleep cycles look like.

So, the two MAIN issues of disagreement seem to be “cluster nursing” and “wanting to be held all the time” (the high needs personality).

Firstly, the “cluster nursing”. I think it is important, even critical, to have a definition of what clinically constitutes cluster nursing.

Cluster nursing is a period of VERY frequent nursing, generally at night or in the early morning that is typically followed by a period of deep sleep. Cluster nursing is most apparent in the first few days after birth, at 3 and 6 weeks, and during other growth spurts in an older infant. And, this is a very loose definition. In fact, Riorden only uses the term “cluster nursing” to refer to the nursing pattern present in very young infants in the first 2-4 days of life when they are establishing milk supply. In her close to 800 page textbook, which is often seen as one of the “bibles” of lactation information, cluster nursing is not mentioned one other single time other than in the immediate neonate period.

But, MOST importantly, cluster nursing is something that happens in a normal infant WHEN that infant is gaining normally, is generally content at other times of the day, and does not exhibit other clinical signs of colic or reflux.

The PROBLEM here is that cluster nursing is used in a general way to describe any infant who is nursing frequently for extended periods of time. Unfortunately, inexperienced lay counselors often call things "cluster nursing" and tell them not to worry when; in fact, mom has an actual problem. It is inadvisable to tell ANY mother that cluster nursing is “normal” unless you have asked her for additional details about baby’s weight gain, general behavior, sleep patterns, and health, and stooling pattern. ONLY when everything else seems fine should you jump to the conclusion that the behaviors is innocuous "cluster nursing". This is simply good LC practice. Assume that there PROBABLY is no issue, but make DARNED SURE you have the entire picture before offering an assessment.

Here are some issues that can “CAUSE” that very frequent nursing often referred incorrectly as cluster nursing.

Low maternal milk supply: A mom who has low supply can have a baby who seems to want to nurse ALL the time. This constant nursing is generally worse in the evenings when low supply tends to be most apparent. The main way to distinguish this is that the so-called “cluster nursing” lasts all day, and is accompanied by sub-normal weight gain.

OALD and oversupply: A mom who has hyperlactation syndrome often has a baby who seems to want to nurse all the time. This occurs because baby is rapidly filled up on lactose rich foremilk, which dumps rapidly into the intestines leaving the stomach empty. Baby will often then “feel” hungry again after a short period of time and want to nurse. This is differentiated from “cluster nursing” because baby usually seems colicky or gassy much of the day, may have green frothy and frequent stools, and may gain weight excessively rapidly in the early weeks (upwards of 2 ounces a day).

Colic/reflux/food allergy: I don’t think I need to repeat the references above, but both these disorders are associated with very frequent nursing often incorrectly, but commonly, called “cluster nursing”. Most of the food allergy lists contain “constant nursing” which can be mis-represented as cluster nursing. So, I’m not sure THAT should be in debate either. Obviously, many reliable sources indicate that a baby who seems to want to nurse all the time might be symptomatic of a food allergy.

I actually think it is far more dangerous to simply tell some mom “oh don’t worry, cluster nursing is normal” than to have some mom see “cluster nursing” on a list of POSSIBLE symptoms of food allergy. But, yes, if it is semantics that is causing the main issue here, I’ll gladly remove the term “cluster nursing” from my list and replace it with “long periods of constant nursing where baby does not seem satisfied at the breast”. The reason I used cluster nursing is because it is the way moms describe this KIND of pattern of nursing in their own words.

The second area of “concern” is the description of an allergic baby vs the so-called “high need” baby. In other words, this paragraph:

Quote:
- Fussiness: seeming to always want to be held, and are rarely content when on their own. They often hate the carseat. The fussiness may not be soothed even by carrying, holding, or rocking. When younger, they might have been diagnosed with "reflux" or colic. They may have a definite evening colicky period starting at about 2-3 weeks of age that expands gradually to encompass more and more of the day as baby gets older.
And, yes, “high needs” babies often want to be held all the time and are very attached. And, yes, many of the behaviors of allergic babies overlap with the “high needs babies” BUT, and this you can only take from my personal experience, food allergies look a LOT like the description of “high needs” babies Sears gives. So, how can you tell the difference? An allergic baby usually has other confirming symptoms of a physical nature, and will dramatically improve in mood and irritability when the food allergens are removed from the diet.

THIS, is harder to back up with medical research papers because main-line medicine tends to dismiss behavioral connections to food sensitivity. But, you don’t have to look hard to find annecdotal evidence supporting the idea that food allergens can make a baby needy and miserable, and eliminating the foods can make a world of difference in baby's outlook and mood and level of contentness AND, everyone knows what a colicky baby and a refluxy baby looks like. So, clearly since food allergies are related to those issues, then food allergies can cause behavior issues. Even all of the list above include one or two behavioral signs of food allergy. Why should it not? A uncomfortable baby is going to exhibit all the same kinds of behaviors an ADULT shows when they are in discomfort: neediness, irritability, etc, etc.

Does that mean that all ‘high need’ babies are allergic?

No.

Does that mean that “high need” babies have a pathology?

No.

I, in fact, have THREE BABIES/children who are BOTH high need AND allergic. And, I can tell you that it actually is not hard to separate the behaviors in my children that result from food issues, and the behavior that is driven by their intense personalities.

Oh yeah, and THIS is from the Sears website:

Quote:
Our daughter-in-law, Diane, shared her experience as a colic detective: "At three weeks of age Lea started to cry all day long. She would awaken in the morning fussing, and by late afternoon it would turn into uncontrollable screaming fits. There was no way to calm her down. After a few sucks at my breast, she would throw her head back, arch her back, and start screaming. Within three days of eliminating all dairy products from my diet, her colic greatly improved. I'm glad we didn't just accept that she was 'colicky' and that 'some babies just cry all the time'.
In MY experience a LOT of so-called high need fussy infants improve dramatically when the problem foods are eliminatd from the diet. Apparantly, Dr. Sears agrees as well.



AND, what about bottle preference? Well, it is pretty clear that breast refusal is a common result of food allergy. More than one list mentions that above. AND, just as listed in Huggin’s book, these babies OFTEN will take the milk from a bottle. Voila, bottle preference. Incidentally, other causes of bottle preference are low maternal milk supply, ear infection, stuffy nose, sore throat, and mouth sores, and teething. In most cases, a fast flow nipple IN AND OF ITSELF will not cause bottle preference unless baby also has some other involved factor. With a WORKING mom who is pumping and bottle feeding a great deal, the most COMMON cause of bottle preference is low supply. COULD bottle preference BE a result of the faster flow of a bottle. Yes, it is possible, but I doubt it. I rarely have come across a mother/baby dyad where some OTHER factor was not contributing to, or causing, the preference. This is from my CLINICAL experience, btw. There simply aren’t any studies out there on late-onset bottle preference. Lots of people have their own OPINIONS, but there isn't a single study out there about this particular issue. SO, we all rely on our clinical experience.

Anyway, so WHO AM I? Well, you may or may not care since I am really trying hard NOT to post as any kind of so-called expert. (Thus my apology for the way I introduced the thread). I am a mother of three allergic infants the oldest of whom is seven. I am the member of an active group of breastfeeding mothers who are dealing with infants with food allergies. I am a lactation consultant with 5 years experience and the co-host of an expert moderated breastfeeding board co-hosted by Kathleen Huggins the author of the “Nursing Mother’s Companion”. I was trained by Kathleen, and have worked closely with her for the last 5 years. I also helped her edit the most recent edition of her book. If you look closely and are curious you can find me referenced there. In the five years I have been Kathleen’s co-host we have fielded probably 10,000 questions from nursing mothers, many of them about allergy, reflux, and colic. Because of my personal experience, and the experience of these mothers, I have become a quasi-specialist in nursing allergic infants.

So, after ALL that I do stand by my assessment that, in my clinical experience babies who waken unusually frequently with NO longer sleep stretches often are uncomfortable for some reason. When the sleep problem persists before the typical periods of time for infections, cold, teething, etc, food sensitivities are VERY often to blame. MOST babies, even young babies, will sleep at least a three hour stretch from a young age (and yes you can back this up with sleep research, look around). Babies who wake every 1.5/2 hours all night long, night after night, are being bothered by something. The something CAN be many things (low supply, teething, illness, ear infection) but is VERY often food sensitivities especially when the behavior persists and other causes have been ruled out.

So, some of the above is from my clinical experience, and some from personal experience, and it doesn’t really matter to me if you “agree” per se. You are free to disagree, to read up, to explore, and even to find OTHER clinicians who disagree with me. We all have unique perspectives. And, in the end I don't WANT anyone to just out an out agree blindly. Either what I posted make sense to you, or it doesn't. You may NOT agree with me, but it isn't "wrong". Some issues having to do with lactation and/or food allergy don't come DOWN to "right" or "wrong" which is why there are all kinds of ways you can gather information out there INCLUDING boards like this one.

And, last but not least, as a MOTHER of three beautiful attached children, and not as a clinician, I do NOT think it is unreasonable to expect a young infant to be content on the floor or in a bouncy chair for 15-30 minute stretches a couple times a day. Most babies are. Even SEARS (Mr AP) admits that "most babies" are NOT "high needs infants". A baby who cries the MOMENT you set them down for any reason could just as easily be an uncomfortable baby as a high needs baby. AND, we all deserve the chance to use the toilet without having to balance a baby on our lap even if baby has to be RIGHT THERE on the floor in a bouncy.



Peace and a good night to you all.
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Old 07-19-2005, 11:59 AM
 
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What an interesting discussion, thanks everybody!

Hoping I don't contribute to the OP"s sense of being flamed, I gotta say that when I started to read this, I also was under the impression that the OP wished to impart her "professional" knowledge. So, of course, having long distrusted health care professionals telling mothers what to do, I started reading with a critical eye. Within seconds I was batting my eyes. My children are not allergic at all, but they sure did those things!!!

I definitely see the point of saying, hey some children are fussy not out of sensitivity of character or general sense of discomfort, but not because of food allergies. Even breastfed children can have those! Because, let's be honest, because allergies are LESS common among breastfed children, some mothers may not think about the possibility that their fussy child is allergic to something. But this list,posted not in a thread about the topic but as its own thread, came across as, "I'm a professional, and food allergy is right on top of the list of causes of fussy behavior", and I dare to bet that the OP didnt' want to impart THAT. It's a bit like a new dentist would come on board and start telling us that breastfeeding is a very important cause of tooth decay, while we all know (thanks in part to this board) that it's not even though it may be a contributing factor and in SOME RARE cases it may actually be true. There aren't many big parenting boards where breastfeeding is NOT usually identified as the source of all childhood trouble; this is actually the only mainstream board I can think of.

OP, Sorry about your children's allergies, though. That must be very hard for everybody involved
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Old 07-19-2005, 12:41 PM
 
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Just to say.... my very allergic son, now 4, had all of these symptoms TO THE EXTREME!!!! The first thing I thought when I saw this post was that I wish I had seen it then. Maybe because much of the regular medical establishment had no advice to offer. My son was almost never off the breast, and when he was he was crying.... all the doctors could offer was a suggestion to switch to formula.If you have had an allergic infant you may not even know in your sleep deprevation what questions to ask. I know that many things on this list are normal.... but the wanting to nurse ALL the time , and in the arms all the time.... these are to the extreme. Nothing like any other child I have met.I am talking, nursing almost all night, with my partner walking with him the rest. We slept in shifts. This lasted up to when he was two. It was a nightmare, and it was lonely... especially for someone trying to be AP.I found this to be accurate to my experience. This especially hurts because regular doctors didn't offer any help, and there was no mention of the possibility of allergies at all. It just made me feel all the more like an AP freak. Now that I have seen more "normal" babies, I can assure you that this is not the regular "nursing all the time" or " wanting to be in arms all the time". I could never understand why people looked at me like" Yeah your baby wants to be held all the time(Duh!!!)"
And I didn't find the responses to be very welcoming to a newer poster.I know that things can be misconstrued in writing, but much of this did seem to be an attack. Be kind to newer posters, we could drive away a potential great contributor of the board.

:
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Old 07-19-2005, 05:05 PM - Thread Starter
 
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:-)

I don't feel flamed by disagreement or even comment. I "felt" flamed by some of the ways that disagreement was framed. I don't even think that refers to the majority of the people on this thread anymore at this point.

And, as I said, I'm over being grumpy now. I actually got a 2 hour stretch of sleep last night.

Yahoo!




AND, I AGAIN apologize for starting my thread posing as some kind of "expert". I definitely understand how that probably raised ire, especially in a community like this one (including myself) that has good reason to be suspicious of health professionals. After my personal allergy journal I don't trust the opinion of very many MDs. And, sadly, many LCs also turned out to be useless.

Given my situation, I doubt my dedication to breastfeeding is in question?

But, here is the deal with breasteeding and allergies. Breastfeeding is not to BLAME, and I never said it was. These babies would have allergies regardless, and the allergies would be much more severe on conventional formulas. That is the FIRST piece of advice I give to a mom of an allergic baby who is resistant to eliminating something the baby is allergic to, and thinks formula would be "easier". In MOST cases once the mother of an allergic baby weans, she ends up on the "formula parade" trying formula after formula as the symptoms get worse and worse until she ends up with a miserable baby and a VERY expensive hypo formula.

Hey, having said that (and risking more violent disagreement), it IS appropriate for some moms to wean to formula when dealing with a severely allergic infant. It is unrealistic, despite the fact that I am willing to do it, to expect most moms to put up with a severely restricted diet for months at a time. Luckily, cases like mine are pretty darned rare. I suspect even the most dedicated AP mommy MIGHT question the advisability of a diet that is so limiting to the mother.



And, I just want to add on to what the last poster says: yes, all these behaviors CAN be normal to a certain extent in "normal" infants. But the issue here is the duration and the extremity. Yes, those behaviors are normal for most infants once in awhile. But, when it is day after day after day something else is probably going on.
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Old 07-20-2005, 12:42 AM
 
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Honeysucklemama, I was not questioning your credentials, not questioning your intentions, not flaming you or calling you any kind of names. I was questioning what you wrote. You presented a list of symptoms. When one does this everything on the list gets equal weight, unless one makes qualifications and explains the contexts of the behaviors, which you did not do.

Despite your obviously good intentions, you presented things as pathologies *specifically indicative of allergy* that not only are not pathologies in and of themselves (and you did not clarify under what circumstances they are and are not), but additionally might also be caused by numerous other things.

If I were to make a list of things that might indicate that my baby has an ear infection, one of the things I might include is crying. A baby with an ear infection may cry. But a crying baby does not necessarily have an ear infection. A baby with an allergy may cluster nurse, but babies who cluster nurse do not necessarily have an allergy. You did not make these kinds of distinctions clear, and for women who cannot see what you wrote in the contexts that you did not provide this is troubling. It is not your credentials that were the problem it's how you wrote your post. Adding your credentials compounded the problem, because you have given authority to your ambiguous list. And now you have given the authority of your teacher to this list as well.

I apologize if I was passionate in my response. I have responded strongly because, in short, these particular behaviors are the very things that attached babies do, and the same things that tired parents and new nursing moms worry about, and the same things that our society attacks AP for as abnormal. Do they SOMETIMES indicate a problem? Yes. Is that problem SOMETIMES an allergy or other food sensitivity? Yes! But that is not what you said, and saying that up front is important because these things form the core of what we argue about with our families and perfect strangers who don’t understand why she isn’t sleeping through the night YET, why we are nursing them AGAIN, why she is only happy with mamma, and why she won’t nap alone. See Ferber, Weissbluth and Ezzo for further, professionally-styled examples of the same.

Honeysucklemama, I wish you peace (and a good night’s rest). Your story of perseverance in breastfeeding despite allergies with three children is inspiring. It can be maddeningly frustrating to have an unhappy baby and not know what to do, and your commitment to and compassion for mothers in a similar situation deserves recognition. It is often only through hearing other mothers’ stories that we find the strength to go on when things are rough; thanks for taking the time to share yours.

And now off to nurse my allergy-free 2 year old to sleep (which, incidentally, will be our tenth time today, but that's another story).
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Old 07-20-2005, 03:43 AM - Thread Starter
 
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Hi again, Chicagomom.

I think we are equally passionate, perhaps?

I'm not reading to the top of the thread cause I don't wanna. I don't want to feel upset again, and I don't want to associate any user names with negative feelings. But at one point the accuracy of my information was called into question, not the manner in which I presented myself. I posted a list that was well researched and backed up in many other reputable sources, and I was called "misleading". And, it peeved me even though it shouldn't have. I'm human. The only reason I posted any more information at all is because people honestly said they were curious. Sadly, posting information that is derived from clinical experience requires that one HAVE clinical experience. I debated a great deal about including that at all, and edited and re-edited my post many times.

But, in the end I decided that either I am welcome to post here "as I am" or I am not. Part of who I am is what I do, and I am not ashamed of it. I HOPE that I can use these skills to help people in this community in addition to getting support for my OWN situation. I would actually hope that if there were a person with a particular area of expertise they would be willing to share that with ME. One of the WONDERFUL things about belonging to a community is that we all bring special areas of expertise to the table. I'd hope I could pick the brain of the local child therapist, or the local home schooling mom, or the local CD-making mom, or the local OB-mom if she were around.

So, I left that part in there. Maybe I shouldn't have, maybe I should have. Who knows. But I'm not going to lose any more sleep about it. I have my 9 month old to do that for me.



Anyway, I THINK what you are saying is that you disagree with the "symptomology list" concept in general, and not the information per se. You had a problem with the WAY the information was presented, and the way I introduced it (which I already apologized for). You seem to be saying that such a list may lead mothers with high need infants to incorrectly decide their children might have a problem when, in fact, they are simply different than OTHER children because they are attachment parented, right?

For me, lists of symptoms are a tool like anything else. And a useful tool. Sears website is full of such lists, as is the LLL site. I can see that the WAY I presented the list was not the best, but I don't see a problem IN such a list.

And, to be honest, I am unclear what the danger is if a mom sees a bunch of things on a list and decides to look into the possibility? The worst case scenerio is that a mom might THINK some of the things she is seeing in her baby are a result of allergy, when in fact they are not.

So, perhaps she sees some symptoms on the list that are NOT a result of allergy and ARE a result of being high needs? Well, in that case she'd look into the idea and find that allergy was not to blame. So, no harm, no foul, no allergy.

I think you also suggested that a child may HAVE allergies and NOT show any of those symptoms at all and so the diagnosis would be missed?? I suppose that would be possible, but, to be honest, I REALLY am having a hard time imagining how that could be the case. A child with a food allergy usually has some confirming symptoms, although they might be subtle. And, true food allergies nearly always show some physical sign like eczema, rash, etc.

Anyway, I'm trying to think about how I could address your concerns.

Maybe a graduated list with a disclaimer??

Most babies with allergy will exhibit one or more of the physical symptoms. Perhaps a graduated list: babies with allergies USUALLY show one or more of these physical symptoms. And then on the behavioral symptoms: these behaviors are normal in most infants from time to time. It is the duration and the severity that is important. Perhaps even a description of a high need child?

Anyway, maybe NO list no matter how presented would be OK with you. I don't know. I am actually trying to understand.

I think we all come at things from our experience. Some moms will read this list and see their allergic child and get help. That is the target audience I was after. I think YOU saw this list and saw "yet another" health provider trying to pathologize babies who are attachement parented. Maybe you've had one too many experience up front and personal with people like that? Most of the time we are passionate BECAUSE of things that have happened to us in our lives. No one has a strong response to something unless it pushes their emotional buttons.

But I think that it might be helpful to understand that I am EQUALLY passionate for this reason: As much as there is a risk that a parent of a "normal" AP infant might see that list and be mislead, there is a risk as well that a parent of an allergic, hurting baby might be told over and over by the AP community that "this is normal" and suffer for YEARS with no help. It happened to me. My oldest child nearly cost me my health and my sanity. And, the VERY AP people who I turned to for support just kept placating me with descriptions of "high needs" infants. Turns out my infant WASN'T normal, even for a high-needs, attachment parented infant. Too bad dh, ds, and I had to suffer SO LONG without getting help because my concerns were routinely dismissed as "normal" by the very people we hoped could help us. We probably would have been better off in the "regular" crowd who would have insisted the bahavior was NOT normal, and we would have been driven to find a solution long before my baby had an anaphylactic reaction at 9 months of age.

So, we are at an impasse. You feel the real danger is that parents will see their AP-parented infant and see pathology where there is none. And I feel the REAL danger is that suffering mother/baby dyads will persist for years in terrible pain and isolation because they are told over and over that things are "normal" when they are not.

So, perhaps we need to agree to disagree and let readers of the thread sort things out for themselves.

Anyway, I AM praying for more sleep tonight. I am at a real low, and, let me tell you, the formula can is looooking real good to me right now. I'm not sure how much longer I can keep this up. The thought of another Buffalo burger makes me want to puke.

Peace and good night.
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Old 07-20-2005, 03:48 AM - Thread Starter
 
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the idea that at least the DISCUSSION the list provoked has been valuable.



Anyway, thanks for your kind words. They are needed and appreciated.
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Old 07-20-2005, 06:31 PM
 
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Honeysucklemama, how do you think it happens that babies can have such severe and all-encompassing food intolerances as yours do? I've been thinking a lot about this, as my DD has intolerances to many foods, also, although definitely not nearly as many as yours! I'm just thinking that this cannot have been "normal" throughout human history or we probably wouldn't have made it this far, kwim? It seems like MFPI must be new to human beings and I'm wondering what causes it. Vaccines would seem likely, except that most babies exhibit symptoms before they've had any vaccines - unless they got HepB right after birth. My DD didn't have that shot, but she showed symptoms of food intolerances starting at about 3 weeks.

I know this isn't really the place for that, but if you have any ideas on this, could you tell me where to look or maybe PM me? I'm just so curious as to how this could be happening. Thanks!
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