Do elimination diets while breastfeeding really help fussy babies?

Advice & Tips

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If a temper tantrum flares in the Buss household these days, there is a good chance that an adult is the one throwing it. Justine Buss, mother to three kids under five, has been on a strict diet that eliminates all the foods that she suspects render her six-month-old breastfed son, Dale, gassy and pained. She’s decided that dairy and most carbohydrates are out, including gluten, corn, soy, and even fruit. That means there is no self-soothing with wine or sweets after a long day. Her afternoon pick-me-up options are pepperoni sticks or celery with nut butter—none of those glorious coffeehouse cookies or muffins so many of us have gobbled blearily from behind the stroller. Instead of coffee, she’s been drinking a chicory root tea with unsweetened dairy-free creamer.

“I’m basically on a dairy-free, caffeine-free keto diet while breastfeeding, which is rough,” admits Buss. “I’ve been able to add a little sweet potato back in, as long as I don’t go crazy. I can also have a bit of apple here and there.”

The hunger was almost audible in her tone as she said this.

So why is Buss taking such drastic measures? Last May, she began to suspect her breastfed baby was sensitive to dairy after she binged on cheese, which was followed by “two days of just misery” with little Dale. It’s worth noting that Buss was also hyper-conscious of her own diet because a dairy sensitivity is common in her family. (Even though her relatives are not technically allergic to dairy—they do not have anaphylactic reactions—consuming cow’s milk products results in stomach pain, bloating and tummy troubles for several Busses.)

After cutting out dairy, Buss says she began to suspect other foods might also be linked to her baby’s fussiness, including carbs and starches. “In a fit of just wanting to pamper myself during the newborn weeks, I had too much sugar—more than I would care to admit,” she says. “He started getting really, really gassy again.”

“It sucked, and I was surprised by how emotional it was,” she says. But she thought she detected a payoff: her son had fewer crying jags, less gas and was generally easier to deal with. “I wouldn’t be sticking to a diet this strict if it didn’t affect my little guy,” Buss says. “Psychologically, it’s worth it when it means your baby sleeps. He became a happier and more easygoing kid.”

But is there any science to back up Buss’s theories? Reports of what elimination diets actually achieve are anecdotal, and yet, online posts linking diet restrictions to improved baby behaviour spread like wildfire on social media and in moms’ groups. Most of us know someone who has tinkered with her diet in hopes it would help her baby—or have experimented with this ourselves.

Do elimination diets work for nursing moms with fussy babies?


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Melanie Hnatiuk, a Calgary-based family physician, noticed such a strong pattern of restrictive diets among breastfeeding mothers in her family practice that she and her colleagues launched a study. “We noticed women were making some pretty dramatic dietary changes, and there was really not enough evidence to support that,” Hnatiuk says, adding that nutritional deprivation can have negative consequences for maternal health that mothers often don’t consider. The results, published last March in Canadian Family Physician, showed that of 21 mothers interviewed, most believed their babies’ crying and fussing was a result of abdominal pain that was caused by something the mothers ate or drank. (The most commonly cut-out foods for the women in Hnatiuk’s study were caffeine, broccoli, cabbage, gluten, garlic, onions and beans.) But there is simply not enough evidence to support elimination diets, Hnatiuk says. “There are some studies, but they’re not convincing enough to support elimination diets, in my view.”

It’s not a self-sacrifice contest

Hnatiuk fears that elimination diets have become a badge of maternal grit for nursing moms. “It’s related to the unrealistic expectations of motherhood, and unfortunately we do it to ourselves a little bit,” she says. “There’s that element of ‘the cleaner your diet, the more you can limit yourself, the stronger you are as a mom.”

Anyone who’s ignored the need to pee—or eat—while stuck under a finally-sleeping baby knows that caring for a newborn requires tons of sacrifice. As parents, we put ourselves second (or last) much of the time—and that can include depriving ourselves of our favourite (and easiest to prepare) foods. After all that hard work of changing our diets, of course we want to see an improvement—and that’s exactly why the results are so subjective and hard to measure.

“It’s very easy to get caught up in thinking that things are a little bit better,” says Hnatiuk. But as you eliminate foods and try a new diet, time also passes, and your baby may just be getting less fussy week by week, or more efficient at nursing. “Colic tends to resolve between three and six months of age anyhow, simply as the baby matures.”

It’s such mixed messaging for moms, Hnatiuk adds.  “In our society we hear that breast is best… but there is a subtext that you’re also harming your baby, or your milk is somehow harmful or tainted. So, you still feel like you’re failing as a mother. You feel like you’re doing everything you can—literally feeding your baby yourself, with your own body—and then somehow even that isn’t enough,” she says.

I suppressed a knowing grunt when she said this. My firstborn suffered from raging colic—she was inconsolable from 4 p.m. until midnight for the first four months of her life—but I could not bear to give up my comfort foods. Having cheese, chocolate, coffee and wine made me feel like my old self, a person I could barely sense beneath the layers of Lanolin, C-section stitches and bottomless mugs of breastmilk-boosting tea. I did try, occasionally, to give up the foods I deemed naughtiest, but I could never sustain it for very long. As the weeks of colic ticked by, my sense that my milk might be problematic ballooned, eventually leading me to transition to what seemed like a much more trustworthy elixir: formula. My daughter seemed to fuss less. But was that linked to the formula, or was she simply growing out of her colic? It was impossible to know for sure. Either way, the load on my shoulders lightened when I was released from having to worry about whether what I ate was causing harm to my daughter. (Only now I was feeling guilty about of the cost of formula, and felt the glare from other mothers at play groups as they watched me prepare bottles for her. I might as well have been feeding her arsenic!)

Crystal Karges, a San Diego-based lactation consultant, registered dietitian and mother of five, encounters many women on self-diagnosed breastfeeding diets that make her wary. “A lot of these elimination diets are so rigid it literally leaves moms with nothing to eat. It’s maybe chicken and vegetables. It can really be a trigger for so many mental and physical consequences,” she says.  Like Hnatiuk, Karges also encourages her clients to resist self-diagnosing or ruling out foods before consulting a lactation consultant or paediatrician about the symptoms they’re trying to solve for.

How common is a cow’s milk protein allergy?

Experts say it’s rare for even the most colicky babies to have an actual food allergy underpinning their fussing. Babies who do have a cow’s milk protein allergy have other symptoms to watch for, such as low weight gain, skin rashes, respiratory issues, diarrhea, vomiting or bloody stools. “Different studies show different numbers, but it’s likely that less than 5 per cent of colicky infants have cow’s milk protein allergy,” says Hnatiuk. An elimination diet should only be tried on the advice of a doctor, working closely with medical on a very specific protocol for a two-week trial—don’t make sweeping changes on your own.

Karges often encourages breastfeeding mothers to widen, rather than restrict, their diets, but she knows that many parents struggle with accepting that advice. “Food is an easy culprit—it feels like something we can control or fix. A lot of these moms have so much fear and anxiety around food because they are scared of how it might impact their baby.”  There is already so much pressure on moms to breastfeed at all costs, she says. “But you don’t have to sacrifice your health or mental health—that’s not healthy for you or your baby.”

Read more:
I almost gave up breastfeeding because no one told me about nipple shields
Does your baby have acid reflux, or are they just barfy?

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