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!
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.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.”)
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)
– 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!
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.
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 was beneficial to me so it will likely be helpful to you as well!
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.)
- Plantain or sweet potato chips instead of crackers
I’ll update this list as I find things since I’ll be doing this a couple more months!