My Food Allergic Child

by Luci Chen MD

As a physician and first-time mother at age 37, I wanted to provide "the best" for my daughter and chose to breastfeed.  However, things got off to a poor start.  My daughter was born a healthy 6 lb and 15 oz, but after a normal delivery, the nurses felt that I needed to bring home a special nursing assist device because I could not express colostrum.  Things went downhill from there.  Besides the stress of new motherhood, I had to attempt to feed formula through a small tube taped to my breast while baby nursed.  Well, fortunately my milk came in on day 3, and I realized that the nurses had over-reacted but didn't think any harm was done.  I struggled with the usual early breastfeeding issues of sore nipples, blocked milk duct, concerns about whether baby was gaining weight adequately, and the trepidation of having to return to work in only 4 weeks.

I had a great deal of support from my loving husband and wonderful support from my parents and in-laws.  At 6 weeks of age, after my return to work full-time, my daughter had discovered that she preferred to bottle feed rather than breastfeed, and I was devastated.  I briefly thought about switching to formula but realized that my original goal was to breastfeed for at least 4 to 6 months.  I sought consultation with a lactation specialist and tried my best to cuddle, provide skin to skin contact, and gently persuade my daughter to take the breast.  I eliminated all her pacifiers and eventually my daughter returned to breastfeeding after 2 more weeks of struggle.  I had been working full time and knew that she spent many hours apart from the breast, but was not emotionally ready to feed her formula at that time.

Well, shortly afterwards, she decided that she did not want to bottle-feed!  Then I struggled with a baby who cried determinedly when it came time for feeding, and resisted the bottle.  Unfortunately my place of work was over 30 minutes drive from home, where my in-laws were tending to the baby.  At least I was not anxious about child care but it was very stressful for my in-laws to try to take care of a 3 month old who was obviously hungry but wanted to have nothing to do with a bottle of expressed breast milk.  It was about that time that she also began having a visible full body rash that was patchy, dry, and itchy.  Our pediatrician diagnosed her with eczema, and prescribed topical steroid ointments.  She continued to grow nicely, however, and eventually began to drink my pumped milk out of a bottle, at least enough to prevent starvation.  Once I returned home every night, though, the minute I walked into the door, she would breastfeed like she was starving, and cry if I tried to do something else first.  I felt so guilty about being away for 9 hours every day to work outside the home.  However, my job as a new physician in an established practice limited my ability to take time off.  Unfortunately, I felt unable to demand more vacation time than the rest of the doctors since there were not any maternity leave benefits.  It was also impossible to work part time when I knew the practice hired me on specifically to work full time.

Well, by 4 months of age, my daughter's eczema had turned into a terrible mess, with many scratches all over her body and head.  It was not until one night, when she placed her fist into my husband's sour cream at dinner, and developed hives about 10 minutes later on her hand, and face where she rubbed, that I realized that this was not just eczema.  We were finally able to get a diagnosis and have her allergy tested at 7 months.  By blood tests, we now know she is allergic to all dairy, egg, wheat, and soy.  With food elimination trials, we also believe that she is allergic to pork, fish, probably shellfish, tomatoes, and onions.  Looking back to her infancy, her allergies might have been aggravated by the fact that as a newborn, we had erroneously been told to feed her formula supplements.  She probably was genetically inclined to develop allergies, but now I know that the earlier that you give the baby "foreign" proteins when the intestines are immature and leaky, the greater the likelihood of allergies as a result of that. Her diagnosis has been a life-changing event.

The best news is that I am fortunate to have continued to breastfeed, and I truly believe that this has been the best for my daughter, even though I am restricted to all the foods she is allergic to as well.  If I had even tried to wean her earlier when I encountered problems nursing, I am sure she would have had many more problems with allergies, and had been intolerant of nearly all formulas currently available.  I now know that I had contributed to her eczema with the dairy and eggs I had eaten for breakfast, and the wheat products I ate on a daily basis.  For most babies and mothers, the foods they eat are not a problem when breastfeeding, but for my daughter, all those proteins that I ate were causing her to be sick.  We consulted a pediatric nutritionist when my daughter turned one to help us determine what to do about her food requirements.  She recommended either breast milk or formula until at least age 2.  We did try one formula that was prescribed for those allergic to dairy and soy, but the taste was so vile that my daughter just let it dribble out of her mouth.  I made my husband try it, and that is when he understood why the formula was by prescription only and why it was labeled as a medical supplement.

Now at 19 months, my daughter's eczema is much better, although she is still allergic to the same foods.  Yes, we eat a rather limited diet, but it is truly a healthier diet since we eat no prepackaged foods, and I cook everything from scratch from as many organic foods as possible.  I no longer snack on milk chocolates, donuts, or buy fast food for lunch.  The difficult part is not being able to dine out at restaurants without taking a risk, and also trying to make homemade food while fitting everything else working moms do into a tight schedule.

And I still continue to breastfeed. I would never have dreamed I would be nursing for 2 years, but I can truly say that I am giving her the best.  So to all those working moms who are tired of pumping and working and trying to make it through another tiring day, congratulations and keep up the good work.  It is possible to work and breastfeed and get through those difficult periods of nipple confusion, bottle preference, bottle refusal, and continue to nurse to toddler-hood and beyond if you so choose.