Hi everyone!

We hear from many Moms (and Dads) out there who are looking for a list of common symptoms to help them identify a potential cow’s milk allergy.  This is why we decided to create a video about the Common Symptoms of a Cow’s Milk Allergy  for our NeocateUS YouTube channel! 

Also, if you enjoy receiving information from Neocate this way (via video) please let us know by posting a comment on our YouTube channel.  We are continuing to work on more videos and we would love to hear from you!

So, what kind of other videos would you like to see on our channel?

-Sarah 

Our post today is a guest blog entry from Rachel Miller, Baby E’s mom. We’d like to thank Rachel for guest blogging for us.

Never could I have imagined that adding another bouncing baby boy to our family last summer would not only add extra snuggles and smiles, but that it would also add a seemingly long and sometimes stressful journey into the world of food allergies. 

Baby E was born last August happy and healthy.  He was welcomed home by mom, dad, and his two big brothers.   Almost right away Baby E started showing signs of possible reflux.  We had been down the reflux road before since big brother 2 had reflux when he was a baby.   So when Baby E started sounding like something out of Star Wars (think Darth Vader), I mentioned to his doctor that I was concerned his nasal congestion was being caused by reflux.  So, Baby E was put on reflux medicine and it seemed to help a little bit. 

Baby E Before

Then came the eczema.   Baby E was like a snake (but way cuter).  He started shedding away his soft newborn baby skin, and angry red baby acne took its place.  The doctor said it was completely normal and likely caused by hormones.  It was at this point that I started to consider the possibility that Baby E may be reacting to something in my diet.  Refluxand terrible skin?  But, I shrugged it off.

Then came the mucous-filled diapers.  I knew from having been down the breast-feeding diaper route before, mucous is an uninvited guest.  Seeds, yes.  Mucous, no.  He also had terrible tummy aches and painful gas.  He would often cry and had a hard time settling down.   Gas relief drops didn’t seem to help.

Then came the blood and green poops.  There is really no way to shrug off lime green bowel movements with streaks of visible blood throughout.  I immediately took Baby E back to the doctor where they took a stool sample and made sure Baby E didn’t have an infection.   No infection.  And so our journey began.  

 I knew I wanted to continue breastfeeding Baby E, so at the doctor’s recommendation I cut dairy out of my diet immediately.  Baby E seemed to make slow improvement after only a few days.   We then eliminated soy as well.  After almost two weeks of being dairy and soy free, Baby E had “better” diapers but not normal. 

This is where TED entered my life.   Total Elimination Diet. 

Unfortunately, my doctor was not able to offer much advice or information about TED, so I found most of my information from infantreflux.org and kellymom.com.  Determined to get kick mucous out of this diaper party and to continue to breast-feed my “intolerant” child, I started eating nothing but chicken, turkey, rice, potatoes, apples, and bananas.  Being on such a restrictive diet allowed me rid Baby E of mucous diapers, reflux, and his eczema.  Then I slowly added foods back into my diet and waited for a reaction. This was how I was able to determine that Baby E cannot tolerate dairy, soy, eggs, and tomatoes.  So now, I am still breastfeeding but avoiding these foods in my diet, and Baby E is doing great!   

Baby E After

Our journey is still continuing.  Since starting solid foods Baby E has had reactions to pears and infant oatmeal cereal.  In spite of this, I feel lucky and blessed that Baby E is doing so well and that I am able to continue breastfeeding him. 

-Rachel Miller

Here at Neocate, we get lots of questions about diapers. I mean lots! Many questions relate to constipation or diarrhea. We’ve posted about constipation in the past, but I thought it would be helpful to pull together our past comments on diarrhea, as well as provide some more medical information on the topic courtesy of the National Institutes of Health, or NIH.

Defining “Diarrhea”

Simply defined, diarrhea is loose, watery stools. It also means having these loose stools three or more times a day. There are more specific guidelines, but most people know diarrhea when they see it. Diarrhea happens to everyone, usually about once a year for adults and twice a year for young children.

Typically, diarrhea is acute, meaning that it lasts one or two days and then goes away. This type of diarrhea is typically caused by an infection. If diarrhea lasts more than two days, it can be something more serious. Diarrhea lasting more than two to four weeks – chronic diarrhea – may be a symptom of a chronic disease or condition.

The concern with diarrhea, especially when it lasts more than two days, is a risk of dehydration. Our bodies absorb most of the water and some minerals at the end of our digestive tract. When we have diarrhea we can’t absorb those things, leading to dehydration, which can be serious.

Diarrhea in Infants

New parents quickly become experts at several things, one of which is changing diapers. Since infants go through about eight diapers a day, parents easily pick up on anything abnormal. Every baby’s stools are different in terms of how watery they are, which makes defining diarrhea in infants difficult. To keep it simple, diarrhea is typically a sudden onset of frequent bowel movements that are more watery than usual.

The risk of dehydration from diarrhea is much higher in children than most adults, and especially in infants. Since infants can’t tell us what they’re feeling, it’s important to keep an eye out for signs of dehydration. With children and infants, you shouldn’t hesitate to call their healthcare provider if you have concerns. For infants under 4 months, the recommendation is that you contact the doctor at the first sign of diarrhea or dehydration.

Diarrhea and Food Allergies

Pulling this all together, diarrhea is one of the top signs of a food allergy, especially for infants. In infants with food allergies, diarrhea often lasts more than just a few days and may even be combined with other symptoms. It’s not uncommon to also see blood or mucus in the stool. Diarrhea can also result from lactose intolerance, which is not as severe as a food allergy, but which may also require a change in diet.

Like we hear from many Neocate parents, diarrhea is often one of the first signs to clear up after they start using Neocate. This is because Neocate doesn’t contain any lactose (or any dairy at all!) or whole proteins. These substances would normally cause a reaction in the body that leads to poor absorption and diarrhea. Infants are able to absorb the nutrients they need from Neocate without the bad reaction that often results in diarrhea. Most parents tell us that the switch to Neocate has meant more solid stools and many fewer diapers.

- Rob

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A few weeks ago I had posted some highlights from the U.S. National Institute of Allergy and Infectious Disease (NIAID) guidelines on food allergies that came out in December 2010.

Today I wanted to share the World Allergy Organization’s (WAO) guidelines on cow’s milk allergy (CMA). WAO is a leading source of allergy information worldwide for medical professionals and consumers. The WAO Diagnosis and Rationale for Action against Cow’s Milk Allergy (DRACMA) Guidelines were released in April 2010. They are open to the public, which is great. Feel free to review them by following the link.

They may be best to share with your allergist, pediatric gastroenterologist, dietitian, or general pediatrician if your little one has been diagnosed with or is thought to have CMA.

Keep in mind it is a large document (~100 pages...whoa!).It really does a great job at providing recommendations on the proper diagnostic tools needed for an accurate CMA diagnosis (as 50 - 90% of food allergy diagnoses are not actually food allergies). The WAO also provides information on amino acid-based formulas (AABF), such as Neocate, and where the use of AAB products is best in the management plan of patients (e.g. Eosinophilic Esophagitis patients).

Hopefully this will help you and your child’s doctor in understanding the proper guidelines in accurately diagnosing and managing your child’s CMA. Let us know what you think of it. Is this useful information for you or your child’s doctor?

Christine

In food allergy circles, we usually think of symptoms and side effects as results of food allergies, not the other way around. In most cases that’s true. Science has shown a strong link between food allergy and atopic dermatitis, a form of eczema. Last month Dr. Jon Hanifin, a respected dermatologist, gave a talk to colleagues discussing the link between atopic dermatitis and food allergies. The research he presented suggests that for some patients it may actually be atopic dermatitis that comes first and acts as a precursor to food allergies.

Atopic dermatitis is often one of the first signs that a parent or caregiver notices in their child which helps lead to the diagnosis of food allergy. As Dr. Hanifin explained, about 6-10% of children are diagnosed with atopic dermatitis, and of those about a third will be diagnosed with a food allergy. Which begs the question: If parents notice signs of atopic dermatitis first, and an allergy diagnosis comes later, couldn’t atopic dermatitis be causing some instances of food allergy?

What We Know:

-In cases of food allergy, offending foods cause reactions in the body which involve the immune system

-Immunoglobulin E antibodies (IgE) are immune substances which are normally in our bodies at low levels, but are higher with food allergy

-Allergy symptoms often involve the skin (including our digestive tract, which is like an inside skin), an important barrier that keeps most outside “things” from getting inside

-One factor of atopic dermatitis is “holes” in the barrier our skin provides

What Dr. Hanifin Proposed:

In the past it was assumed that food allergies came first, causing both high IgE levels and atopic dermatitis. Dr. Hanifin suggested that in some patients atopic dermatitis is caused by “gaps” in the skin (likely due to genetics), which means that foreign substances can enter the skin and cause adverse reactions. He thinks it may be proteins that get through these gaps which allows the body to become sensitive to certain foods, leading to a food allergy.

What does all of this mean? The biggest message here is that patients with atopic dermatitis, especially those under five years, should be tested for food allergies. While avoiding food allergens may not help improve atopic dermatitis, it could certainly prevent or improve other serious side effects of allergies. The second message is that more research needs to be done into the causes of atopic dermatitis and its relationship to food allergies. Any research that leads to better health, through reducing instances of atopic dermatitis and/or food allergies, is good research! Tell us about your experience: Was atopic dermatitis the first sign that you saw of your child’s food allergy?

- Rob

Here at Neocate, we often talk with concerned parents who tell us they’ve read other stories from parents whose children had a terrible rash that was only helped by Neocate after lots of trial and error. Frequently, these parents tell us they don’t feel their doctor is familiar with food allergies. Just yesterday a father told me that his pediatrician kept telling him that “every baby gets rashes, it’s normal; he’ll grow out of it.”

Some pediatricians and many parents are surprised to learn that about seven percent of children have food allergies. Many parents who eventually learn that their child has a food allergy, which can only be treated by changing the diet, wish their journey to a solution had been shorter and simpler. Here are some tips for what you can do if you feel your doctor isn’t recognizing your little one’s rash as a possible sign of a food allergy.

Take Careful Notes

A rash is often the first sign of a food allergy that a parent notices. While it’s true that almost all babies experience diaper rash at some point, this is not the same as a rash caused by food allergy. Diaper rash, like many rashes, is caused by something on the outside: wet or rubbing diapers, scented lotion, rough fabrics, or even fabric softener. It’s important to rule out these other causes that might contribute to eczema, atopic dermatitis, or itching.

If you’ve eliminated potential causes, it’s more likely that the rash is caused by something on the inside: a food allergen. If you document all steps you’ve taken to eliminate other culprits, the doctor is more likely to consider a food allergy as the cause of your baby’s rash. If you notice that your baby has a rash and you think it might be related to a food allergy, check to see if your baby exhibits any other signs of a food allergy. It’s unusual for a baby with food allergy to only have a rash. Make a list of your baby’s symptoms which could also be caused by a food allergy to provide to the doctor.

Many parents tell us that they went through multiple different infant formulas before finally finding relief with Neocate. Some infants don’t even tolerate breast milk because of dairy foods in the mom’s diet. Make notes of the different symptoms that did not go away with each formula you’ve tried. Many doctors assume a soy formula or hydrolyzed formula will help if the baby has a milk allergy. However, many babies with a milk allergy also have a soy allergy and can be extremely sensitive to even small amounts of milk protein.

Make an Appointment with Your Baby’s Doctor

When you discuss your baby’s rash with the pediatrician, explain that you think you have ruled out other causes, and explain the list of changes you tried that did not help. Inform the doctor that food allergy is common among infants, and explain the other symptoms your child is experiencing which could be related to food allergy. Skin creams are commonly prescribed for rashes. While these creams may help to reduce inflammation and itching caused by a food allergy, they will not help other allergy symptoms such as diarrhea, gastroesophageal reflux disease (GERD), or wheezing. Only a change in the diet will truly solve the problem.

When you see your pediatrician, you may also want to request a referral to an allergist (narrow your search by selecting the “Food Allergy” specialty). The allergy testing that these professionals perform provides the best information to help your child find a diagnosis and relief from a food allergy.

Finally, share with the doctor your knowledge of Neocate, the amino acid-based formula that makes such a difference for babies with food allergies. It’s important to follow the steps to help give your baby’s rash the best chance to heal. We know that it is so hard to see your little one feeling so uncomfortable but remember it may take some time, even after you start using Neocate.

What steps did you take to know that your baby’s rash was caused by food allergy?

- Rob

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A friend told me she went to an office Halloween party as a peanut allergy. I wondered: What would you wear that says, “I am an allergy?” I still don’t know the answer to that question! Thinking about that made me wonder: Since babies don’t come with labels and can’t tell us what they experience, how do they tell us “I have an allergy?”

More and more, children are diagnosed with food allergies, with cow’s milk allergy being the most common. In fact, more than 100,000 babies each year suffer from milk allergy. There are multiple clues pediatricians look for that help diagnose a cow’s milk allergy that you can look for too. Below is a list of eight questions to help parents of infants identify a potential milk allergy, designed by Dr. John Moissidis, a Board certified pediatric allergist at The Asthma Allergy Clinic in Shreveport, La.

Milk Allergy Symptoms

1. Diarrhea Diarrhea is common in babies, but if it is persistent (an average of two to four times a day for more than five to seven days) and/or if there is blood or mucous in the stool, it could signal a more serious milk allergy.

2. Vomiting Babies often spit up bits of food, but vomiting beyond the typical mealtime regurgitation should be examined by a doctor. Reflux symptoms, such as spit-up and difficulty swallowing, can also be milk allergy symptoms.

3. Skin Rash There are many causes for infant skin rashes like eczema. Milk allergy is one possible cause, especially if the rash occurs along with some of these other symptoms.

4. Extreme Fussiness Every baby cries, but crying continuously and inconsolably for long periods of time is abnormal. When there is no apparent reason, this is usually called colic. Sometimes this extreme fussiness is actually caused by the gastrointestinal pain resulting from an allergy to the proteins found in milk.

5. Low or No Weight Gain Most infants double their weight by six months and triple it by 12 months. But when babies are not getting the nutrition they need because of excessive diarrhea and vomiting, they are unable to grow like they should.

6. Gassiness All babies have gas, but when it occurs along with several of these other symptoms, it can also signal an allergy to milk proteins.

7. Respiratory Problems Colds are common for infants, but wheezing, struggling to breathe and developing excess mucus in the nose and throat is not. For some kids, these respiratory problems can be the baby’s reaction to the protein found in milk.

8. Failure to Thrive Babies with milk allergy often suffer from a lack of proper nutrition characterized by dehydration, loss of appetite and lack of energy. This overall failure to thrive is often the result of the effect the other symptoms have on the infant’s body.

My baby has one or more of these symptoms – what now?

Babies with an allergy to cow’s milk protein cannot process the complex proteins found in milk-based baby formula, and many babies also react to soy-based infant formulas. Because of this, infant milk allergy is treated by either eliminating the milk proteins from the nursing mother’s diet or by replacing the regular formula with an amino acid-based formula.

An amino acid-based formula is safe for babies with milk and soy allergies because it is made using amino acids, the building blocks of protein. Amino acids are small enough that they won’t cause an allergic reaction in the way that complete protein chains or partly broken down proteins found in other formulas will.

The next step should be to schedule an appointment with your child’s pediatrician in order to receive a more thorough evaluation and diagnosis. Bring this information with you and ask your doctor if your baby might benefit from an amino acid-based formula.

What symptoms did your baby have that led you to suspect a milk allergy?

- Rob

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Grocery shopping is always a hard task, but it is even harder when you are shopping for someone with food allergies! Worse, the ingredients your little ones may be allergic to can be hidden within the food label. With our latest series, we will aim to uncover some of the sources of hidden allergens.

New food labeling laws require the top eight food allergens to be listed on food labels. This is really helpful for those reading food labels; however, sometimes allergens can be hidden in the long words in the ingredient list.

Dairy is one of the ingredients which tends to be hidden in foods that you may have otherwise thought were safe. I wanted to share with you a list of some ingredients to watch out for. Some of these definitely contain diary, while others only possibly contain diary.

When viewing the list below, it’s important to always err on the side of caution. If you think there may be traces of dairy in something, call the manufacturer of the product you would like to purchase and inquire. If they cannot guarantee that the product is free of dairy, avoid it!

Foods with dairy ingredients:

• Milk and milk products(including condensed, derivative, dry, evaporated, goat’s milk and milk from other animals, low-fat, malted, milkfat, milk protein hydrolysate, nonfat, powder, protein, skimmed, solids, whole)
• Butter, butter fat, butter oil, butter acid, butter ester(s), buttermilk
• Casein, casein hydrolysate, caseinates (in all forms)
• Cheese
• Cream
• Diacetyl
• Ghee
• Lactalbumin, lactalbumin phosphate, lactoferrin, lactulose
• Pudding
• Recaldent®
• Rennet casein
• Sour cream, sour cream solids, sour milk solids
• Tagatose
• Whey (in all forms), whey protein hydrolysate
• Yogurt

Foods with potential dairy ingredients:

• Artificial or natural flavorings (anything which is derived from butter, cream and egg flavors)
• Chewing gum
• Deli meats
• Fat replacers
• Many types of chocolate (although dark chocolate is often free of dairy)
• Margarine
• Prebiotics (galactooligosaccharides, also known as GOS, are derived from dairy sources. Don’t worry, Neocate Junior with Prebiotics only contains prebiotics in the form of fructooligosaccharides, also known as FOS, which are derived from vegetables.)
• Salad dressings

For a more complete list of foods to avoid when accommodating for a dairy allergy, visit the Food Allergies and Anaphylaxis Network website or check out Alisa Marie Flemming’s book Go Dairy Free: The Guide and Cookbook for Milk Allergies, Lactose Intolerance, and Casein-Free Living and website for more resources.

Can you share any foods you have found that have surprising hidden dairy ingredients?

- Nita

As a parent, it’s hard to hear that your child has been diagnosed with Failure to Thrive, often written as “FTT.” I often talk to parents who are confused by the diagnosis and not sure exactly what it means, so I thought I’d take the time today to answer some basic questions.

For those who don’t know, FTT is a medical term and is used to describe poor weight gain over an extended period of time. It is often used when diagnosing infants, children and the elderly.

What’s the background on Failure to Thrive?

FTT has been used for more than a century when diagnosing those who are unable to grow or maintain their weight properly; however, it still lacks concise guidelines because it describes a condition and not a disease.

Most diagnoses of FTT are in infants and children and can be a result of something else that may be going on -- such as food allergies. The first few years of life are very important for growth and development; therefore it is important to ensure that your little one is gaining the proper amount of weight and has proper nutrition. Most babies double their birth weight by 4 months and triple it by age 1; however, children with FTT often don’t meet those milestones and are lagging on their growth charts.

What causes Failure to Thrive?

FTT can be the result of a variety of social and medical factors.

Social Factors. With obesity on the rise, many parents fear that they are “over-feeding” their children, so they may restrict calories. You will be happy to learn that children (especially young ones) are excellent self-regulators. They lack the desire to eat simply because food is present or out of boredom, which many of us do not! They eat out of necessity and because their body needs the nutrients the food will provide. With that said if you have a young child, follow their hunger cues. If you feel that they are gaining weight too quickly later in life, you may want to consult your doctor or dietitian.

Medical Factors. Most often FTT is caused by allergies or GI conditions such as:

• Gastroesophageal Reflux Disease (GERD), which can cause an irritated esophagus which may cause a child to refuse to eat;
• Chronic Diarrhea which causes the body to rapidly lose important nutrients and calories provided by food;
• Food Allergies to proteins in things like milk which require a restrictive diet that may lead to the inability to maintain or gain weight; or
• Illness when the body goes into overdrive trying to fight the infection, using up all of the nutrients it has stored to do so.

How is Failure to Thrive treated in infants and children?

Depending on the cause of FTT, it may be easier than you think to help your little one gain the proper weight he or she needs to get back on the growth charts. If it’s caused by a disease or condition such as GERD, Short Bowel Syndrome or a milk protein allergy, you may want to introduce an elemental formula such as Neocate. This will not only aid in weight gain, but can also help with the condition itself. Another option would be to add a product that contains additional fats and carbohydrates like Duocal. It is protein-free and virtually tasteless, allowing you to add it to foods or drinks consumed by the most picky and allergy-ridden eaters.

If you have been told that your child has FTT, make sure that you have your doctor note it on any medical necessity letter or documentation. This may provide some leverage when applying for reimbursement for elemental formulas.

Have any of your little ones been diagnosed with FTT? How are you helping them to gain weight?

-Nita

References:

http://kidshealth.org/parent/food/weight/failure_thrive.html# http://www.lpch.org/diseasehealthinfo/healthlibrary/growth/thrive.html

I often speak with parents of milk allergic babies and I hear a lot about rashes that appear on the baby’s face and body. It is heartbreaking to hear how much they itch and scratch uncontrollably. And for many parents it is hard to determine if their child has just a typical baby rash or if it is a symptom of something more serious – like a rash caused by an allergic reaction to cow’s milk.

Atopic Dermatitis or eczema are two types of rashes that are commonly caused by a milk allergy. But without a diagnosis from the doctor of a cow’s milk allergy, how would a parent know that this is the cause?

You should always refer to your pediatrician to help you understand what is causing your little one’s eczema, but it’s also important to look at the big picture. Sometimes a baby with cow’s milk allergies, will also display other symptoms in addition to a rash. For instance, you may also see symptoms of diarrhea, vomiting, gassiness, wheezing, runny nose, and colic.

If you do see a rash accompanied by any of these other symptoms, make sure to keep detailed notes and share all symptoms with your doctor so that your little one can get diagnosed and treated faster.

Also, make sure to work with your pediatrician to come up with a plan for healing your baby’s skin – no matter what is triggering the rash, it is important to heal your baby’s skin as soon as possible. Some recommendations the doctor might suggest include:

• Bathing your baby in soothing lukewarm water

• Avoiding bath oils and perfumed powders

• Applying an over-the-counter lubricant to your baby’s skin

• Keeping your baby’s fingernails filed short so the scratching won’t do as much damage

• Dressing your baby in soft cotton fabrics to prevent possible fabric irritation

• Keeping your baby cool and avoiding hot, humid environments

• Trying to keep your baby distracted from the itchiness with fun activities

Did your little one have a rash due to a milk protein allergy? Tell us about your experience and what you did to treat it.

-Christine