WARNING: This post is graphic and will contain pictures of diapers filled with technicolor poop. I went back and forth about providing photos in this post, but overall, I know it will benefit those who need this information to see them. If you get squeamish or aren't interested in hearing about our breastfeeding journey with Little Man's digestive issues feel free to skip this one!
UPDATE: I was getting questions about how things turned out for us, so I posted our 15-month MSPI update!
UPDATE 2: I had a second baby with MSPI, I posted about that here.
MEAL PLAN: I created a five-week downloadable meal plan with grocery lists for breastfeeding moms who suspect they have a baby with food allergies or intolerances, learn more here!
I know it's taken me a while to write this post, it's been a long time coming. As a Registered Dietitian, when I write about health issues that I, or my family experiences, I want to be able to provide both professional expertise and personal experience when I write about it.
That's how I felt with my amenorrhea recovery story, and that's how I feel with Little Man's digestive issues. PS this post is almost 3000 words! It's a long one, but I worked hard to give you every detail I thought would be helpful and every resource I found! I hope you find it useful!
Before we get started I want to interject one more thought or two: In most cases, it's (fussiness, poop changes, gassiness, etc.) NOT something the mother ate and many moms cut foods out of their diet unnecessarily. I highly recommend reading this post written by a respected nurse and lactation consultant.
I 100% agree with everything she says in that post so I won't reiterate it here. As an RD I knew this, so I took a relaxed approach, and I was going to assume that nothing I ate was a big deal until proven otherwise.
I think our pediatrician believed I was a typical "first time Mom" too worried about what was going on with his stool when I mentioned a few things that looked weird to me, but actually, it was quite the opposite. I think this is why it took us 11 weeks to get a food allergy diagnosis, but let me backtrack.
Symptoms Of Food Allergies
Little Man's stools had always been very yellow and filled with mucus. I mentioned this to his pediatrician at both his one month and two-month appointments, both times he said it was fine.
At our two-month-old appointment, Little Man had dropped off the growth chart. In one month he had barely gained a pound. So, I saw multiple lactation consultants and began pumping after almost every feed.
I started taking supplements, drinking all the tea, and feeding him as often as I could. I poured my heart out in my fourth-trimester postpartum updates, his low weight gain worried me so much. A couple of weeks later, around 11 weeks old, I ordered a super fancy all organic, grass-fed formula from Europe that I never got the chance to give him (thank God, it would have destroyed his stomach even more.)
Right before the formula arrived, I found myself staring at a diaper and my brain all of a sudden registered "hey, wait a minute, oh my god, is that blood?" It took a while to register because we hadn't had a stretch of sleep longer than 2-2.5 hours of sleep in those 2-3 weeks.
We googled "blood in baby poop," and Dr. Google told me that it was probably normal, probably just small tears from him straining. However, every single site said blood in poop warranted a visit to the pediatrician, so I timidly made an appointment assuming he would tell me everything was fine.
He took one look at the photo and said it was the wrong color, had too much mucus, and there was blood that shouldn't be there. He mentioned food allergies/sensitivities, and that's when I told him about Mr. Hungry's food sensitivities.
He said since there was a family history, he didn't want to draw blood and do a workup on such a little baby if he didn't need too. Please note, Mr. Hungry did not have issues as a baby so I still doubt this connection, I think it was a random "act of God" but what do I know?
Anyways, we agreed I would avoid dairy and eggs, and he gave us a can of Similac Alimentum (a hydrolyzed formula) and told me to supplement for a while until his weight came back up. However, because his weight gain was so low, I decided I didn't want to mess with the trial and error of eliminating one food at a time.
My gut told me to go top 8 free (dairy, soy, wheat/gluten, eggs, nuts, peanuts, fish, and shellfish), because who better able to do this than an RD who is a CLT and that specializes in GI health?
I felt if I didn't remove all the potential allergens, I wasn't giving breastfeeding the best chance we had.
As an RD, I can say if you don't have a low weight gain situation on your hands, then please don't do this. Trial the foods one at a time and work with an RD while you do it (I can help you, see my services page.) A top 8 free diet is very restrictive, don't do it unless you have to. If not careful you could end up with malnutrition and too low of calories to support breastfeeding.
We started supplementing with the Similac Alimentum, and things got so much worse. I wasn't surprised by this. Hydrolyzed formulas often didn't work for my patients with food allergies when I worked at WIC. They still contain the allergen. It's just broken down more. For some kids, this is a good workaround, but for many, it is not.
Little Man had blowouts every hour, and he wouldn't sleep, it was the worst week, and I just knew the formula was to blame. When I called the pediatrician, he agreed to discontinue formula and give the diet a couple of weeks to clear the allergens out of my system, but if that didn't work, we needed to see a specialist. In the meantime, I felt he needed a supplement, so I ordered an elemental formula. (UPDATE NOTE: This formula has been linked with Ricketts in babies who were exclusively fed it. There is an issue with phosphate absorption and babies on this formula need to supplement phosphate. We didn't supplement with phosphate, but he was still getting breastmilk too.)
Elemental formulas are made of aminos acids (the building blocks of protein) plus fats and sugar, so they don't contain any of the allergens. Y'all it's 54% corn syrup, it broke my little Mama heart to supplement with anything, much less something with so much straight sugar, but I knew he needed it so, I tried to "let go and let God."
Once I started the top 8 free diet every day and every week got a little better. He became less fussy, and he went from having multiple blowouts a day to pooping 1-2 times a week. His diapers became hummus like in texture and more yellow-brown than green. It took almost four weeks for the black specks, which I thought were "seeds" but I now know were dried blood to go away.
Other things improved as well that I can't be sure were related but might have been including:
- this weird "cough" cry he had since birth
- baby acne he had all over his face went away
- dry skin in the diaper area and back of the ankles got better
- severe cradle cap - like I would run my hand over and watch the flakes fall down it was gross
It's hard to say whether those things were related or whether he "grew out of them."
Before we knew about the food allergies and we assumed it was my breastmilk supply I was always confused if he wasn't getting enough to eat, then why did he have so many poopy diapers a day? Now it finally made sense. He was getting enough, but he was not absorbing it.
He started to put on weight more steadily, about 4-6 ounces per week vs. 2-3 ounces (we have the red cross baby scale; I would monitor his weight every ten days and call the doctor with an update).
He got back on the growth chart, barely, but he is there. At his 4-month appointment, his pediatrician said he was not worried about him at all whereas previously he had been concerned. (Excuse me while I down a glass or two of wine, nothing like hearing your pediatrician say they "had been worried.")
Reintroduction Attempts
Honestly, I thought that I was being overzealous by pulling out the top EIGHT allergens. I mean, come on, he couldn't be sensitive to all those foods? Could he? After his four-month appointment, the goal was to follow the official protocol I found from the Academy of Breastfeeding Medicine to find out what I needed to keep out of my diet and what could come back in.
(Too my knowledge this is the only published protocol on the subject, and the pediatrician was not even aware of it. There seems to be a lot of guessing in this space and not following a protocol, which I know from my LEAP clients is kind of worthless. There should always be systematic reintroduction when dealing with an elimination diet.)
I introduced fish and shellfish by eating it every day for a week, and he had zero reactions, nothing changed.
However, when I added almonds by eating almond butter and drinking almond milk, he had a diaper sooner than he usually would, and it was very green. Two days after I started eating them he became super fussy and wouldn't nap AT ALL.
At this point we were still struggling with nighttime sleep due to all the habits we accumulated, so that wasn't a good indicator. I can't be sure that nuts were the issue, but I decided to play it safe and pull them out again.
We decided to tackle his nighttime sleep by following the Taking Cara Babies ABC's of Sleep (with our pediatrician's blessing because the program allows you to keep a night feed), so I waited a few weeks to introduce anything else. After we got him sleeping a consistent 10-12 hours in his crib vs with me (yep you read that right),
I decided to try out some rice cereal mixed with formula around 17 ish weeks. (We had given it to him around 13 weeks, after the Similac Alimentum and before the elemental formula to help with weight gain. It didn't help, and we discontinued it because we were supplementing with formula which was helping.)
Anyway, I was reasonably confident he could tolerate it. Other than it turning his poop forest green, which is common because of the iron in the cereal, he did well with it.
Next on my list to try was eggs. I ate eggs on a Friday and a Saturday. He then had two poopy diapers two days in a row, which is unlike him. He usually goes every 4-7 days max. Again, we experienced the same bout of random fussiness, but we couldn't be sure if it was stomach pain or the short catnap he took in church that morning throwing his nap schedule off that caused it.
Then three days later he had a diaper FILLED with mucus. I hadn't seen a diaper like that in MONTHS, and I felt so bad for him. There is nothing like feeling like you caused your child's pain to bring in the Mom guilt FULL FORCE, but I knew I needed to test foods, so we knew for sure which foods were problematic.
It took about a week for the egg to get out of my system and his diapers went back to normal. So now I know for sure he reacts to:
- milk (was in the formula he reacted to)
- soy ( was in the formula he reacted to)
- eggs
- nuts (or at least almonds, probably)
This may be a good place to mention that I have been eating coconut this whole time and it doesn't seem to cause an effect. Most allergists agree that a coconut allergy doesn't correspond with a nut allergy but the FDA still categorizes it as a tree nut for allergy purposes.
I have not tested gluten or peanuts yet and I probably won't for another couple of months. I'm just going to let go of reintroduction until he is 8 or 9 months, mostly because it's hard to eat baked goods without eggs anyways, hence no gluten. I miss peanut butter, but not enough to cause another episode, so we wait.
Over the weekend we gave him some pureed carrots, and he has done well with them so far. So hopefully we will be able to liberalize his diet a little. (PS I'm 100% a fan of Baby Led Weaning, my decision to start with rice cereal and purees even surprised me because I thought I would skip those.
It's what I felt was the best decision for my child, and I'm hoping to ease into Baby Led Weaning around the 6-7 month mark.) He does mostly feed himself with his spoon though!
Which is a messy affair!
Breastfeeding Now
People often ask me "How long am I going to breastfeed for?"
The question always takes me by surprise because every day we are still breastfeeding is a gift. Despite the allergies, I believe it's 100% the best nutrition for my child, but I'm taking it one day at a time.
There isn't a day that goes by that I don't worry if he is getting enough to eat (or absorbing enough), but I also don't want to overload him with corn syrup if I don't have too.
Please don't misunderstand me or think that I'm judging Moms who chose to formula feed. Fed is best, plain and simple. I'm so incredibly thankful that formula is out there to help babies who need it, like him.
He gets a bottle of it every single night and other bottles if I don't have enough allergen-free pumped breastmilk (I've separated the stuff that contains allergens).
However, when I think about stopping breastfeeding so I can eat some peanut butter, I remember that means Little Man gets more corn syrup. That's a huge motivator for me to continue.
If he could take a standard formula, I think I'd be less motivated, but then again, we probably wouldn't be in this situation. It's hard because I never know whether I should be confident in my breast milk supply because he has this stomach issue.
We also recently learned that his tongue- tie he had clipped at a couple of days old reattached and he probably needs to be removed again. They should have given us exercises to prevent reattachment, but they didn't, so that's great. So, as I said, I take breastfeeding one day at a time.
Sure, I dream of making it to 1 or 2 years old, but I take it just one day at a time. I also think, for my piece of mind we will ask for a referral appointment with the specialist and allergist so I can have some clearer direction as well. Now that he is a little older, I'm also going to ask the pediatrician to do a full work up on him, just in case there is something we are missing.
Now What?
Overall, the good news is, I was able to figure out what to remove from my diet, and he may be small, but he is steadily gaining weight, staying on the growth curve, and is a happy boy nowadays.
The bad news is it turns out I was not overzealous and that I'll need to continue to be gluten, dairy, eggs, soy, peanut, and nut free for the next few months. Some days I feel like the diet is the hardest thing I've ever done, and others it isn't that big of a deal. I take each day as it comes and I try to remember it's temporary, it may be for a few more months, but ultimately it's temporary.
I hope this post is helpful for those of you googling "blood or mucus in baby poop." I want to urge you again, not to pull things out of your diet before you know if your baby truly has an allergy.
If I had pulled foods out before seeing the blood (or you can also get a stool test to test for microscopic blood), then I would have never known how terrible his allergies are. If I didn't know, I might have "cheated" more often on a diet ultimately leading to prolonging the issue.
Also, I highly recommend you read this post from Happy Healthy Mama, she shares a similar journey, but without the weight gain issues, so she didn't have to supplement.
Her updates and photos are slightly different than ours. The pictures on her blog and the update she shared were beneficial to me so it will likely be helpful to you as well!
UPDATE: I was getting questions about how things turned out for us, so I posted our 15-month MSPI update!
UPDATE 2: I had a second baby with MSPI, I posted about that here.
MEAL PLAN: I created a five-week downloadable meal plan with grocery lists for breastfeeding moms who suspect they have a baby with food allergies or intolerances, learn more here!
Favorite Products
Here are some of my favorite top 8 free substitutes I've been living off of:
- Good Karma Unsweetened vanilla flax milk
- Coconut milk (canned or carton)
- So Delicious coconut milk creamer - original or canned coconut milk for creamer
- Plant Oat oat milk
- Sunflower seed butter (Trader Joe's or Sunbutter) instead of peanut butter
- Coconut butter (love Nikki's dark chocolate or cake batter)
- Sprouts Vegan Protein, Chocolate
- Health Warrior Vegan Protein, Chocolate
- Health warrior pumpkin seed bars - dark chocolate or sea salt
- Guacamole - for flavor instead of cheese
- Brown rice tortillas - Food for Life Brand
- Hope hummus - for flavor
- Chickpea pasta like Banza
- Bacon instead of cheese
- Enjoy Life chocolate chips
- Free2B Suncups
- Siete cassava tortillas and chips
- Dr. Praeger's soy & gluten free meat substitutes (I don't usually like meat subs but this was helpful during Lent.)
- Popcorn
- Plantain or sweet potato chips instead of crackers
- Little Northern gluten, dairy, egg, and soy free bread (I liked the seeds and grains version)
- Chosen Foods vegan mayo - only soy free substitute I've found!
- Sprouted Seed Crackers Simple Mills
- 88 Acres All Products
I'll update this list as I find things since I'll be doing this a couple more months!
Karly says
thank you for writing this post. Its great information to have.
I can relate on the breastfeeding. Any amount is awesome. We've also had struggles and have to supplement but that doesn't mean our journey is over any time soon. As time consuming and hard as it is, Im not ready to give up yet. (Im pretty much strictly pumping too). It does annoy me a little who when people ask how long you going to breastfeed/ pump for? Like that milk is gold why does it matter! LOL.
You're doing great mama, stay positive and keep up what works for you & baby!
Kelli Shallal MPH RD says
Thanks, Karly, you too! <3
Carly says
Thank you for addressing food allergies in babies! When we started my daughter on solids she had 2 severe vomiting reactions to oats (took us the 2nd time to realize that is what is was from since there was a 2 hour delay in the reaction) and she was eventually diagnosed with FPIES. She is now 20 months old and we still have to introduce foods 1 at a time for a week at a time before we can say it is safe so it has been a long and tedious process! I don't think I would have made it this far without the support of our wonderful allergist! I am still breast feeding/pumping when at work 3 times a day and get plenty of questions/strange looks when people hear that which can be so frustrating.
Just know that you are doing wonderful things to support your little guy and whatever happens and the choices you make will be the perfect ones for the two of you <3
Kelli Shallal MPH RD says
I'm sorry to hear your little one has had an uphill battle introducing solids but I'm glad you have a good support system, I'm definitely going to see an allergist. That's AWESOME you are still pumping 3x a day. #GOALS
Arianna says
This is a great informational and impactful post about food allergies in babies. I hope this helps any mama's out there who are struggling with the same issue. Happy to hear Hungry Baby is doing improving day by day.
Thanks for sharing! Sending all the love and positive vibes your family's way!
Kelli Shallal MPH RD says
Thank you Arianna!
Danielle says
From one FA mama to another, I just wanted to say you’re doing an amazing job and to hang in there!!!! My little boy (now almost 7) was diagnosed with anaphylactic food allergies to milk, soy, peanut, and eggs at 9 months old. He nursed until 4 years old, which meant, like you’re doing, I also avoided those foods as they made him sick. Taking one day at a time is what gets us through this life. Kudos to you for continuing to breastfeed as you care for your son. He’s adorable!
All my best!!
Kelli Shallal MPH RD says
wow, that must have been so scary! > 3 YEARS wow girl you deserve a medal, a margarita, and a big plate of pancakes with peanut butter and a side of eggs topped with cheese every day! very inspiring!
Hunter says
Hi! I just wanted to thank you for posting this! This is my second baby with food intolerances. My first was dairy soy and wheat/ gluten. He’s now 3 and has outgrown them all. My 3 month old we have the same intolerances as you, dairy soy wheat eggs peanuts and treenuts.... plus corn. Some days it feels like the hardest thing ever. Really appreciate you sharing your story, I think sometimes my fam thinks I’m a little nuts, it’s nice to see another mama who has experienced this and is seeing success, tho i wouldn’t wish this journey on any other mama or babe. I know the mom intuition is strong and I ultimately feel that formula would not resolve our issues. Thankfully he’s gaining like a champ. I’ve enjoyed looking at some of your recipes and am excited to see some of the creative ways you enjoy food with this diet. It’s definitely caused me to think outside the box to still provide fun, healthy meals I can enjoy alongside my family. Best wishes!
Kelli Shallal MPH RD says
Love hearing this! Thanks so much! Luckily we've successfully introduced peanuts and wheat so I'm feeling blessed there! Still dairy, soy, nut, and egg free though hoping he outgrows them sooner than later!
Alergia says
Very informative article abou tfood allergy, it really helped me
Ashley says
Thank you so much for this article! It is my exact situation...
I went online and did some searching on the mucus issue because my pediatrician asked about it, and I didn't think my 7 month-old had mucus poops until I pondered on it later in the day and realized he actually does 😔
My 4 year-old has a slew of food sensitivities, so I'm not new to the game, but I think I wanted so badly for the baby not to have the same issues that I looked the other way... But he is just not gaining weight like he should be at all. The last I hadn't cut out yet was eggs, but that is my next step and I think it'll do the trick. But I appreciate your knowledge on what to supplement with! I am also very against corn syrup, but we'll see if it helps. He needs some more fat in his diet and I can't get him to eat much of solids (I too, was going to stay away from grains, but just bought some rice cereal out of desperation).
Wish me luck!
PS... How is your little one faring with foods now?
Kelli Shallal MPH RD says
Hi Ashley! Ugh so sorry you are going through that again. I'm not even pregnant yet and I can't help but think about that for when we have more children. I really don't want to go through that again so I feel you waiting it out, I would have done the same thing. Definitely run your supplement choice by your pediatrician, that one is the last one I would recommend. I never tried a soy-based formula, but kind of wish I would have. I'm not sure if he would have been able to tolerate it but he doesn't seem to have an issue with soy now. And thank you for asking how he is doing now, I need to put an update up! I just scheduled it for next week, but the short answer is he does not tolerate eggs or dairy. He can have baked eggs though (like in muffins etc.)
Kelli Shallal MPH RD says
Oh, one more thing! We did a ton of rice cereal, but if I could go back I would do more oat cereal than rice, because of the high arsenic in rice. I hope that helps!
Kate says
Thank you for this article, currently going through a mystery allergy with my son! I had a quick question, how long would you say it took to get back to normal diapers when you initially cut everything out? I'm wondering how long I should wait before I know if what I've cut out has made a difference or not!
Kelli Shallal MPH RD says
2 weeks to 30 days!
Kayleigh Williams says
Your article was really helpful. I knew my baby had milk protein intolerance from very young, and he was putting on lots of weight but struggled still with stomach issues until I pretty much did the same and cut everything. We found he also can’t tolerate soy and is sensitive to eggs. How did you make sure you got enough calories? My son is 15 weeks and sometimes I feel faint and weak because I know I’m not eating enough (I already lost baby weight plus 3kgs)
Kelli Shallal MPH RD says
I focused a lot on healthy fats! Spoonfuls of sun butter were where I got the majority of my calories for a while! I also drank vegan pre-made protein shakes and larabars. Most of all though, I had to prioritize myself. That meant eating while standing up, eating at weird times, eating sometimes while the baby cried, whatever I could do to get those calories in because my milk supply was low so I needed them!
Shelby says
Thank you for a well written article! I wish I had found this 6 month ago when I was at the height of our feeding crisis, but it is nice to know other families have gone through similar experiences. Unfortunately even being top 8 free my daughter still had severe reactions to breastmilk and we had to go completely to an animo acid formula at 4.5 months once she started to vomit blood (it was the scariest thing I've ever been through). Although it was really hard to accept our breastfeeding journey ended prematurley, it probably saved her life. At 8 months we only have about 15 safe foods, but she is finally thriving!
Kelli Shallal MPH RD says
That sounds so hard and scary, I'm so so so glad the elemental formula allowed her to thrive!
Maria says
Hi Kelli, thanks a lot for this post, for the updates on MSPI and for the weaning symptoms post, and in general for running this blog, you are doing a lot for so many of us out there. I read your posts multiple times as I am going through these problems with my little one. My baby is gaining weight very slowly and he drop from 50 to 15 percentile. Doctors don’t seem to care much because they say baby looks good and healthy so it must be smaller genes. I am on the elimination diet since 3 months (my son is 4,5 months old now) and I have taken out of my diet way more foods than just the top 8. I saw improvement in the poop as is there is almost no mucus and haven’t seen blood in a long time. However his weight gain worries me so much just like you. Is this due to the fact that he might still have trouble absorbing nutrients from breast milk? I tried supplementing but he just doesn’t want to take the bottle, like no way. I tried as well feeding him with some cereals with the spoon which went well twice and then he started refusing that too. So we are on breast milk only. I just wonder if I have to give up breastfeeding completely and feed him with formula only.. sooner or later he will have to take that bottle as he will need to survive. However I am totally not ready and don’t want to put him on formula 100 % but this slow weight gain is just so frustrating after all the struggles. There are days when nursing is simply a nightmare, he refuses or eats super little, but that seemed to be due to the reintroduction attempts ( like egg which didn’t go well).
I feel the only real help I get is from your blog because none else I know with MSPI have problems with weight gain.
Can I ask if your little one was also gaining so slow after the elimination diet and finding the problematic foods? Should I still be confident that breastfeeding is the best I can do for him?
Thanks and greeting from Poland!
Kelli Shallal MPH RD says
Oh man, I can FEEL your frustration and I know what it's like! Can you email me at kelli@hungryhobby.net and maybe we can find a time to chat? But, in answer to your question, yes his weight gain was too slow and we supplemented. We got in the routine of having a bottle of formula at night before bed and any time I gave him oatmeal he had it with formula. The first formula we gave him was a disaster, was supposed to be hypoallergenic (Similac alimentum) but he couldn't tolerate it. The second formula was neocate and we heated up really warm, sang to him, bounced him around, and my husband could get him to take it. So, maybe try and get someone else to give him the formula bottle. I wanted to give up breastfeeding too, but the formula was like 90% corn syrup so I kept going with both. Also, FWIW I just had a second baby who also has MSPI. I've learned a lot having a second one with the same issue, happy to talk to you about it over email!
Jessi O. says
Hello!!
Thank you so much for posting photos with this blog!!! My poor kiddo is 20 weeks old and his diapers were looking like the mucusy ones for months. We had a lot going on with me having oversupply that wasn't reducing despite 8-12 hr block feeding since 2 weeks old when lactation consultant saw us and suggested this plus cutting all dairy. Cutting dairy right off the bat made a huge difference, but wasn't perfect. However, he is rarely fussy and is 80th percentile and growing well, so I wasn't too concerned until he had blood in his stool after both rotavirus vaccines. I kept putting it down to my milk, but two weeks ago he was having a tough time with a sore tummy which prompted me to look into it further. I found this blog post and had a "so it's NOT normal" moment. I have was in the verge of cutting out eggs and/or wheat, but before I did I had a brainwave and went through all my vitamins and snackfoods. I don't have soy in my diet for other reasons, but it turned out I was inadvertently eating it on a daily basis because of a vitamin I was taking and granola bars I like. Within 72 hours the mucusy stools were gone and we're on an every other day poop schedule, but it's still green and it's more on the watery side (not at all like my firstborn's bright yellow toothpaste consistency poops!!). I was wondering if you noticed/can remember a transition period before poops became yellow and thicker? I'm guessing after 20 weeks his poor guts may need some time to heal, but I'm also worrying that it's a sign I still have more foods he needs removed from my diet.
Kelli Shallal MPH RD says
So glad this was helpful! With my first (who this post was written about) we put him on formula so that made his stool a little thicker pretty quickly. However, with my second we had the same issue occur but without all the weight gain issues, etc. Once the mucus cleared up from me going egg and dairy-free it was still pretty watery yellow and stayed that way until he started solids. But, there was no mucus or blood after going egg and dairy-free! Hope that helps!