FAQ's: Is this an allergic reaction?

'Is this a reaction?'

It's one of the most frequently asked questions on online food allergy forums. 

Am I the only one who squirms slightly, when these pop up?

I completely understand why people ask these questions. As a mother myself of a child with a Non-Ige mediated food allergy I've been in that place where something-is-happening-and-you-don't-know-what any number of times!! The worry you go through, the need for answers, can become all consuming - even when the reaction is not in the least life-threatening. Something is happening to your child which is unpleasant and you immediately feel the need to understand/stop/control/prevent it from happening again! 

It doesn't help that these potential reactions often take place at inconvenient times - you know; in the evenings, in the middle of the night or at weekends, when getting hold of anyone can be quite tricky - especially someone with the expertise to help you! 

You need reassurance, understanding or maybe just a shoulder to cry on. You may have had a poor night's sleep or are having trouble keeping up with the washing or any one of a number of other things could also be pressing on your mind/attention. One other sudden, unexpected urgent thing on top of it all just seems too much to deal with. That's when people often turn to allergy forums/websites.

A lot of the contributors on these sites/forums are very experienced mums who have dealt with food allergy over some time. Some of them are also medical professionals (bonus!). You can learn a lot from them about suitable products, recipes etc. and forums can be a great place to safely rant/let off steam!! BUT one needs to be careful! Not all contributors are as experienced as others or medically qualified, so I get quite anxious when I see people ask the 'reaction question'. A photo might be offered  of a child's rash (some clearer than others), or a picture might follow of a poo-filled nappy. 

Pictures of rashes aren't always that clear! They're quite hard to photograph!

The problem I have with this is not that someone's shared the picture (although I often wish that some people would be a little more discreet about how they go about it - try to display children's private parts - you don't want to encourage the wrong kind of attention), but that it's really quite difficult to tell what could be the problem just from a picture of a rash or a nappy, or because a child has been sick or had a bout of diarrhea. This is because the symptoms to an allergic reaction can be so similar to a whole range of other illnesses - some as simple as a virus, which just needs to run its course, or a tummy bug, which still isn't great, but still just needs to run its course. 

I get concerned because despite the fact that most of these sites carry disclaimers, people seem far too ready to listen to advice from someone they've never met and I've often seen good advice disregarded over advice which I would consider not so helpful (please note, I'm not saying don't do this, just be careful). Yes, I know you don't always get the help you need even from your local Doctor - we got through two local GP's, who didn't spot the symptoms, before getting our diagnosis when we went private - but online forums are just not the ideal place to arrive at a diagnosis! Doctors will need to go through various assessments before they reach a verdict - they'll need a bit more info than a few pics! 

If you're new to all this and want to know where to start, you may find the 'Is it cow's milk allergy?' website helpful. It can give you some guidance as to what symptoms to look for and how you can go about getting a diagnosis. Their assessment sheet, is particularly helpful - it could be a very useful piece of evidence to take along with you, when you visit your GP.

If you're not new to all this and are just not sure if your child has reacted to something they ate today or even yesterday, the truth is this: if it's a delayed reaction the answer may not come immediately - it could take some time (days, weeks or maybe even months) to really work out where the problem really lies. 

So how can we tell, or get some idea as to what's going on?

Well first things first, if you suspect your child has had an allergic reaction that is potentially life threatening, you should use an epipen (if you have been prescribed one) and then call an ambulance. If you don't have an epipen, call the ambulance straight away! See here for more details about what to look for (and what to do) from NHS Choices.

If, like us (with 'Baby's' Non-Ige mediated milk allergy), your symptoms do not require immediate medical attention, then having cleaned up the initial mess and/or administered any necessary medication, then as much as we might like it to be sorted NOW, I'm afraid it's not that easy. I've found you usually have to kind of sit it out, wait for things to settle down, or for something else to happen. Often, else happening or even not happening can help you work out what's going on. 

So, for example, one time when we gave 'Baby' a scheduled food challenge at home, it took a while for symptoms to develop. She had a bit more wind than usual and her stools gradually changed colour and became looser, and she got the odd tummy ache, which then faded away. To begin with, I wasn't sure if it was the malted milk biscuit we had given her that had caused the problem or not, so let the challenge continue, to see if things would calm down. However, as the reactions became more intense and her botty began to get sore, I knew that I needed to stop. Although she was clearly tolerating milk better than she had previously, it became obvious to me that her body was not able to progress any further, it would just get worse. In all, this process took a couple of days.

I've found the best thing, if you suspect some specific item of food caused the problem (more obvious, I know, when undergoing a planned food challenge), is to remove it from your child's diet (unless it's gluten - see why here). Whether your kiddo is under the weather or experiencing a reaction, it's just not the right time to experiment with anything new. You need to stick to foods you KNOW are safe and wait for their body to settle down and recover. There's no point making them sicker, by giving them more of the same!

Then a few weeks later, keeping everything else 'safe' try again. If the same reaction occurs, then you may well have found the 'culprit'. At this stage, contact whichever healthcare professional (GP/Health Visitor/Allergy Nurse/Dietitian etc.) is overseeing your progress and discuss it with them (I have heard from some people who feel that they have been discharged from local services before their allergy has resolved or before they feel ready. If this has happened to you, and you still have concerns, you it would be best to go back to the GP, or find a new one.). If however, your little one appears to be fine with that food item, when it's presented to them (over three or four days) or, if it's not a scheduled 'milk challenge' and you've no idea why it's all happened, then maybe it's time to consider the following:

1) Are there any bugs going 'round?

Sometimes, when I have thought that 'Baby' has perhaps had a reaction to something, it has turned out to be a virus or tummy bug. The symptoms may be similar. Once when she had a sore throat and a tummy ache I was rather confused - her allergic reactions had never included a sore throat! I hadn't realised that there were glands in the abdomen.  

It's extremely easy for little ones to pick up tummy bugs. They crawl around on the floor and stick all kinds of things in their mouths. Unfortunately its par for the course with little ones. Its bound to happen sooner or later!! Then, unfortunately, it's a case of 'What can't be cured, must be endured!' 

Current advice in this instance is keep your child at home (this is important for up to 48 hours following the last issue of vomit/diarrhea to prevent spreading it around), keep them hydrated and feed them if they're hungry - keep it fairly bland though! See NHS Choices for more information.

Something else to consider, even if there are any bugs going around is the following...

2) Do the symptoms match the pattern of previous reactions?

The difference, with 'Baby,' is that if it's an allergic reaction her observable symptoms have usually taken place within the twenty four hours following an exposure to milk. Anything that continues beyond this (in our case, but not in all cases), is a bug, as far as we are concerned! So use your knowledge of how your little one tends to react.

For 'Baby' her reactions in the early days were intense tummy cramps, wind and diarrhea, within an hour or two of ingesting something which contained milk (and a very sore botty, from the diarrhea, when she was in nappies). But of course reactions can change, so this isn't a completely reliable measure! 

This caught me off guard recently, as I hadn't realised that 'Baby's' tummy was coping with milk more easily than it has done previously. So the intense tummy cramps were evident, but occurred much later - maybe five or even six hours later. Also the tummy cramps weren't followed by diarrhea. Her stools were still that distinct yellowy colour that always followed previous reactions, but instead, she appeared to tend towards constipation. 

Something to remember is that reactions can also become more intense - if the individual is unwell, or stressed or following exercise or has drunk alcohol (adults only, of course) or is affected by hormones (ladies, if it's you, consider your time of the month/pregnancy etc.). Also reactions can be different if it's an allergic response to another type of food.

3) Have you been out and about?

We manage things so well at home now, that most slip-ups occur when we've been out and about. It may follow a meal out at a restaurant or a cafe - in which case you can soon work out where things went wrong! However, whenever you're out and about you can come into contact with milk or its traces all too easily. 

Once (I am pretty sure - we'd not been anywhere else that day) 'Baby's' reaction stemmed from contact with traces of milk from a supermarket trolley (you see lots of kiddies eating all kinds of stuff whilst they're perched in the seats of these, I saw one spilling Actimel all over himself in one just today)! Hence I always take my wipes everywhere I go now - I religiously clean trolley handles apart from anything else, you'd be amazed at how dirty they can be! And, if we're eating out, I try to establish which restaurants/menu items are safe for 'Baby' before we go and communicate with staff about her milk allergy. But, even when you think you've covered your bases, life can throw you a curved ball. Looking back at days/times/events can help you here!

I've mentioned this before, but, when 'Baby' was younger she kept having tummy aches an hour or so after leaving a particular baby and toddler group ('Baby' was actually an articulate tot by this time, so she could actually give me some idea of what was happening inside her). After three or four weeks of this  I finally worked out that it was a particular day and time and that it must be because in this group children were allowed to wander around with food (sticky cakes were provided) and were leaving traces of their food (containing milk proteins) on the toys. It may have been minute, but it still caused my little one to react! Not everyone is as sensitive as this, so it might not be a problem for you, but it's as well to be aware!

The answer was to wipe 'Baby's' hands very thoroughly before eating, so she didn't transfer any traces to her food, and wash them thoroughly once we got home. If I stuck to this she was fine. Whilst at the group I also had to be vigilant - to make sure she didn't put anything in her mouth. Fortunately, for us, she's never been much of a one for doing that! 

Another time this helped was when I realised it was my trips to cafes like Starbucks and Costa that were causing the problem - about an hour or so after I left 'Baby' would have a severe tummy ache, even when she had been asleep in her pushchair the whole time and not touched/ate/drank anything there. My conclusion was that she must be reacting to the milk that had become areosolized when it had been frothed.

To test my idea, I eventually decided to just pop-in and grab a take-away coffee. If I did this the tummy aches stopped.  This was confirmed when one day The Hub decided to sit in with a coffee (did he think I was imagining things) and her tummy ache came back!  He did this a couple of times before he became more convinced. (This kind of reaction to milk is thought to be rare, but I have heard/read of other cases of the same (see here), so it is entirely possible. But I wonder if it has been under reported.)

More recently, timing helped me work out that 'Baby' had been exposed to food containing milk whilst at school. I knew because each time it occurred she had an intense tummy ache at more or less exactly the same time of day. It was always around 5 pm. At this stage apart from the snack that I always gave her after school, I knew that the last thing she had eaten was food from school (every child at her school has to have school dinners). 

It's harder to track what is in your food, when you're eating out and about!

Frustratingly this took a lot longer to solve, as there was no obvious pattern to this one, apart from time of day (it didn't happen every day) but also because other children at school had been having tummy bugs, which clouded the issue. It was only once we started a new term, with no new tummy bugs doing the rounds, that I could be sure that she hadn't picked up something from someone else! 

It's definitely much harder to solve this kind of thing when your child is spending time in another environment, particularly when you can't be there to help manage it. A food diary (see below) can help, when you can't see an obvious pattern, but my attempts to keep a food diary in this situation were frustrated because (from what I could gather from 'Baby') the menus published by the school kept changing and didn't match-up with what she was offered! Once the school became aware of the problem and put a better tracking system in place to prevent it happening, funnily enough the intense tummy aches stopped! 

4)  Is there a pattern as to when reactions occur?

Keeping a food and symptom diary can help isolate problems. It helped us, once, when 'Baby' was much younger. Food and symptom diaries are time consuming (particularly if still breastfeeding - you need to include your intake too) but can be a valuable tool for identifying a problem. 

Basically you track everything your the allergic individual has eaten/drank (including medication) and keep note of any potential symptoms that occur. Recording visible symptoms with photographs can also be helpful. If kept carefully over a week, or maybe longer, you should hopefully start to see a pattern emerge.

It might look something like this (sample of one day):

Date:	Food/Drink Ingested	Symptoms
Breakfast                   8 am	Cheerios with Soya milk (75mls) Water to drink	None
Snack 10.30 am	Two small rice cakes Four slices banana	None
Lunch 12.30 pm	Half Tuna Sandwich (Pure, Hovis Best of Both/Hellmann’s Mayo) Handful of crisps* 3 slices apple Small glass orange juice	Tummy pain between 2.30 and 4pm
Snack 3.00 pm	None (tummy still hurting)
Dinner 5.30pm	Homemade Shepherd’s Pie Robinson’s Jelly & Swedish Glace (Vanilla) Water to drink
Anything to add: 100mls soya milk 6.30pm Diarrhea around 7pm Wakeful: 11pm, 2am, 4.30am

NB. Don’t forget to include milk feeds (if still breastfeeding), *brands of food and any medication.

If you prefer a more techie approach, there are apps like this one (I've not tried it, by the way) that can help you record what's going on.

4) Is there something you've missed?

Sometimes we've found that we haven't checked our labels properly, or taken it for granted that something is safe, only to find that it isn't - this was much more common in the early days of 'Baby's' allergy. The first time this happened it was a packet of salt and vinegar crisps. I just hadn't expected to find milk in those (I still had a lot to learn)! It was only once the reaction had occurred that I began to ransack the cupboard to examine all the ingredient labels on everything I'd eaten that day and discovered where I'd gone wrong!!

Another time, we discovered that it was jam (butter had been used to clarify it) that was the problem! Check home made or artisan-style jams for this - I've not seen it on any jams in supermarkets (hence I had never imagined it could be a problem)!

Click on this link for the full story!

5) Could it be a 'may contain'?

If your child is reacting and you've ruled everything else out, look at products which carry 'may contain' warnings or which could potentially have been made alongside milk products (for example chocolate and ice lollies that you know have not been made on specifically dairy free premises). 

Remember that 'may contain' warnings are not legally required on food labels, so some products may look safe - no milk listed in the ingredients or even hinted at in a 'may contain' warning - but they may still actually have picked up a trace, during the manufacturing process, which could cause a sensitive allergic individual to react. 

Not all individuals with a milk allergy react to small traces, it depends on how sensitive one is, but they have definitely been a problem for us in the past. It is becoming less of a problem in baked goods, now that 'Baby' appears to be tolerating a certain amount of baked milk, but milk that has not been baked so well is still a problem, therefore I would not risk products such as chocolate, yogurt or ice cream which 'may contain' traces of milk.

Clink on this link for a previous post for more details about 'may contain' risks.

And finally...

If you think you've isolated a problem that you didn't have before, please make sure you discuss it with your health care professionals - doctor, dietitian, etc. I know from personal experience that this isn't always as easy as it should be - some are more helpful/better informed than others, but hopefully they'll be able to help you confirm your suspicions. 

It's important to do so, as otherwise you/your little one may end up living on a more restricted diet than is necessary and miss out on vital nutrients. It may also affect the medications that you could be prescribed. But also, when it comes to registering your child at school, if you declare an allergy, they'll often ask you for a letter from your Healthcare Professional regarding your child's condition. Take it from me, getting appointments etc. can take some time, so it's better to have it all in place in advance!

Related posts:

Warning! This jam contains milk!

'May contain' - an attempt at explanation

Challenging 'Baby'

A spoonful of medicine and an allergic reaction

Back to the dietitian...

Signs & Symptoms - back to the start

Signs

 Have you ever noticed these - on your shopping trolley?

Have you ever stopped to take in just how many signs there are around us? Looking for a sign to illustrate this post, I suddenly realised just how many there are - they are well everywhere; it's like an epidemic (just try counting them, next time you go out somewhere). But how many of these are completely necessary - of how many do we actually take notice or even understand? With Baby the signs were there, clear to read - if only I had known how!


Going over old ground
For those of you who have been following the 'story so far', some of what is written in this post will be familiar to you. Sorry if I bore you by 'going over old ground', but I have in mind those new to this blog, who might be wondering whether they or someone close to them might have a problem with milk - in which case this particular post (focussing on what alerted us to Baby's problem) could perhaps prove useful. So, for the purposes of this post, I'm going...

Back to the start

By the time I eventually saw our family doctor, the diagnosis of cow's milk protein intolerance had already been reached and clearly proved. In some ways, I wish I'd visited the family doctor first (rather than the two locums I actually saw) as, when he asked me about her symptoms and I rattled them off, he nodded and agreed that they were classic signs. 


Truth to tell, I'm not entirely sure when Baby first exhibited signs of having a problem, but as we were having other issues at the time (let alone the fact that we were trying to get our heads around having a new baby) maybe I just missed them to begin with. All I know is that I first became aware of soreness in her nappy area, around two weeks into her little life. 'Agh! Lie still!' I would yelp in frustration. Baby would writhe with an incredible show of strength in her tiny frame, and I would struggle to change her. 

As soon as it dawned on me that her resistance was due to soreness, I felt horrible rush of guilt for feeling so frustrated. Immediately resolving to be more gentle when cleaning her up, it took at least a few more days for me to realise that the writhing preceded, not just accompanied each nappy, and that the nappies were rather frequent. Were they too frequent? I didn't know/couldn't be sure however, the signs seemed to escalate - particularly at night. This was when the cycle of feed, cry, nappy, cry much more, feed again to comfort and soothe, seemed to be endless and I was lucky to get a few hours sleep. 

Seeking help

The Hub being back at work was sympathetic but, being able to do little about it (although he did turn to his favourite reference book - the Internet, searching for clues) managed to sleep through. I was exhausted. Quizzing the midwives got me nowhere, neither did two visits to the doctors. I was getting near to the end of my tether, and wondered whether it would do any good to go to A&E - I wasn't sure if it would fast track  us to being seen by a paediatrician or whether I would be dismissed as an over worried first time mum. And then came the decision to see someone about her tongue tie. To get a private referral. 

I sometimes wonder how things would have turned out, had we not 'gone private'. How long it would have taken to get the correct diagnosis - after all I'd already seen two doctors locally. I've met others for whom it has taken longer - although they had different symptoms such as reflux, vomit and eczema. All I know is that the time for which it lasted seemed unbearably long. Part of me felt it must be what having a new baby was like whilst another part of me knew it was wrong. 

Baby's Symptoms

Thankfully we did see the paediatrician, thankfully he enquired beyond the tongue-tie , thankfully he was a specialist childhood allergies, thankfully to him our case seemed pretty straightforward. Once I had described, in as much detail as I could, what had been happening, the paediatrician was able to make a fairly swift diagnosis; the diarrhoea, the writhing prior to a poo (presumably caused by tummy cramps), the frequent explosive blasts of yellowy brown watery poo, all taking place not long after a feed. These, in addition to the sore botty that wouldn't clear up (burning caused by acidic poo) all pointed to one thing as far as he was concerned - cow's milk protein allergy. 

'Testing' the diagnosis

Me, wanting to be sure that he knew what he was talking about (having had two misdiagnosis, I was understandably cautious) questioned how he could be so sure. Apparently, at the age Baby was then, (she was just a month old) the only two likely causes of all her discomfort and distress were an infection or cow's milk protein allergy. Due to fact she was being breastfed, and so young, the infection was the least likely but (to rule out the possibility) a sample was to be collected and tested. Meanwhile, I was to steer clear of all products containing the slightest amount of cow's milk. 

It was this latter course which was to prove the diagnosis. Sure enough, within about three days, the symptoms had vanished and I had a completely different baby. It felt like the miracle for which had been praying. The test results, which were to follow later, merely confirmed what we already knew - there was no sign of an infection.

Other symptoms

The symptoms I have described are common to many other food intolerances or allergies. There are, however, quite a number of other possible symptoms that can accompany the same condition, such as:


Bloating
Flatulence
Reflux/vomit
Feelings of nausea
Stomach rumbling
Colic
Constipation
Eczema
Hives
Wheezing
Headaches
Dizziness
Lethargy
Itching
Runny nose
Swelling
Weight loss (if left)
Malnutrition (if left)


Interestingly enough, it seems that individuals can exhibit a different set of symptoms at different times of their life. So a young child might begin by exhibiting symptoms affecting the gut, but later (when they're older) have the kind of reaction that affects breathing.

How can one know for sure?

If you are trying to work out whether you or someone else you know might have this problem, it can be quite tricky to find out. It's easier when they're a baby, as problems with cow's milk among babies are fairly common. It is possible, however, for symptoms to go unnoticed, or for people to develop symptoms later in life. Older sufferers have much more variety in their diets and so identifying the cause of a problem, can be like looking for a needle in a haystack. So what about diagnostic tests?


Quite a lot of people have heard of skin prick tests. Medical opinion is divided on how useful they are and blood tests don't always detect problems that do exist, as I found out following the tummy bug I had the other year. Part of the problem is that such tests work on detecting a response in the immune system, which might occur with an allergy but not with an intolerance.


A first step towards pin pointing a problem might be to keep a food diary - listing everything that is consumed, alongside any possible symptoms. Doing this can help to identify patterns and perhaps the cause. Following this, excluding 'suspects' from your diet  (one at a time) can help confirm what is triggering the symptoms, and therefore what is causing the problem. 


These so-called 'exclusion diets', such as the one that Baby and I have had to follow are most reliable way of confirming that a food is causing a problem but it is recommended that these are carried out under medical supervision, as are food challenges (where following an exclusion, a small amount of the 'problem' food is reintroduced back into the diet). This is because otherwise you could be missing out unnecessarily on important nutrients.

So how do I know?

Although the blood tests that I had (following my tummy bug) the other year proved that I wasn't coeliac, the fact that wheat along with other certain foods caused me intestinal pain and dihorrea, (accompanied by headaches when the reaction was particularly strong) was enough to convince the doctor that I was intolerant to some foods. Like with Baby's problem the unknown factor was and remains - whether the intolerance will be short lived or last for life.

The house at poo corner - tales of the food intolerant kind

Not that great a subject, is it? But, nevertheless, one which (like the yucky stuff) needs dealing with. I don't know about you, but I'm not good with wee, poo, sick or snot - one of the reasons why I decided against becoming an infant teacher. When you deal with small children, these bodily substances tend to come with the territory. Ironic then, that having a little one with a milk allergy, I've had to deal with what I consider more than my fair share of the yucky stuff! 

'Oh no! It's a dodgy poo!' 

Something my poor husband has heard all too frequently. He (preferring not to mention bodily functions aloud) almost winces whenever I yelp the above phrase. Unfortunately for him, if something distressing happens to me I tend to let it out - to get it off my chest. Now we have Baby, anything unpleasant that happens to her affects me quite deeply - the sight of a dodgy nappy gets me going like nothing else. This particular post has been inspired by another such nappy - just the other morning.

Why can't I just get on with it quietly?

It's just a dirty nappy, isn't it? All babies have them, don't they? Normally dirty nappies don't bother me, in fact I do most of the nappy changing in our household. However, the kind I'm talking about DO bother me, because they tend to involve diarrhoea (not to be confused with a slightly looser bowel movement - I know the difference). The ones that I'm talking about mean one of two things: either a tummy upset, or a reaction to something she's eaten. Either way, I have a miserable baby on my hands and it's going to mean a whole lot of washing for me to sort out - these nappies tend to leak!!

What if it's a tummy bug?

My least preferred option, because Baby's had a few of these (even though I try to be careful with hand washing and hygiene). It's horrid seeing her miserable and feel that there's nothing we can do about it. They last between 5-10 days and she doesn't usually want to eat anything. I hate the fact that I daren't go anywhere as I don't want to spread it around to others. In some ways I prefer to be at home because it's easier to change her nappies/clothing etc. (and wash my hands properly in hot soapy water afterwards) but the pair of us usually end up with a bad case of cabin fever as a result.

What if it's a reaction to food?

Having had a few of these, I think this scenario is easier to deal with - we now know we can do something about it. In the early days (before she was diagnosed and we cut the dairy out of my diet) it was harder because we had no clue as to what was causing Baby's discomfort, distress and diarrhoea. It was heart-breaking seeing her writhing in pain both before the nappy, because her tummy hurt, and then after, because her skin was so sore. We tried to keep her as clean as possible and be incredibly gentle, when cleaning up the mess, but otherwise the Hub and I just felt so powerless to do anything about the cause. 

Who needs more washing?

The episodes were pretty much constant and so therefore was the discomfort too. Added to this, many of her lovely early baby clothes were completely ruined by the yellowy brown tell-tale stains from leaky nappies - even when we used Napisan for extra stain-busting power. 


These days we don't get lots of nappies if there's a reaction to food. Usually there's one or two, several hours apart. They tend to come swiftly and unexpectedly - which is one reason why (although I know I can't leave it too long) I've held back from potty training. I know from my own experiences with food intolerance that when the body has decided to reject the food it doesn't want, you lose an element of control over your body which is distressing and can be embarrassing too, if you're caught out away from home.

However, the good thing about one of 'Baby's' reactions is that the symptoms don't seem to last longer than 24 hours (so long as we've eliminated the source from either her diet or mine) which means we're back to normal quite quickly. They're are usually because her strictly dairy free diet has been breached in some way. 

It's fairly easy to spot (now that we know what to look for) in that she is more clingy than usual (I'm guessing that's because her tummy is feeling uncomfortable). She may also pass an unusual amount of wind, from the gases which build up in her stomach. Also, 'Baby' will want her nappy to be changed (normally nappy changes result in a battle of wills) and her botty will be quite sore from the poo - it's like a burn. Thankfully, once we've cleaned her up with plain water, the soreness usually clears quite quickly, unless it's a bad reaction. If this is the case, once we've cleaned her up, we slather her botty with vaseline to protect her skin, from contact with the acid in any further unwanted episodes.

Once we've established it's likely to be a dietary breach, it's just a case of identifying the cause.

Identifying the cause

We've got pretty good at this by now, we just have to consider the following:

1. I've eaten something with dairy in it. 

As I'm still breastfeeding this is still possible. This possibility usually has me racking my brains; thinking back over the last 24 hours and re-examining labels on food packets, to see if I've unwittingly eaten something that may have contained milk. More recently, however (completely by accident) we've established that I've eaten a few things that would definitely have caused a reaction in the past, that haven't - such as a biscuit made with milk. This is a definite improvement on what used to be, but I just need to work out the limits, so I don't overstep the mark.

When 'Baby' was three months old, I ate a packet of salt and vinegar crisps - completely unaware that dried milk powder had been used in the flavouring. The result was a miserable baby and a disastrous nappy within the hour! It was only when I saw the nappy that I realised the cause of her distress and checked the labels on the packets of everything I had eaten. It was this incident that surprised the pediatrician - he decided that as the milk in the flavouring would have been minimal, her sensitivity must be quite strong and that there was no point in us returning to see him until she was at least one!

Once you suspect there may have been a breach of the diet, you have to be really vigilant and suspect anything - even Free From food stuffs are not immune. Once I couldn't pin the blame on anything but some Free From chocolate mints that came from one of the major supermarkets. I only knew this for sure, when I visited one of their stores and saw a sign recalling the product - within certain dates - which matched the packet I had at home.

One further possible source that may go under the radar is medication! I always ask the Doctor to check that there is no milk, whatsoever, in any medication that he prescribes for me (or baby). I also check the labels on vitamins, although these seem to be aware of dietary needs.

2. 'Baby' has eaten something with dairy in it. 

Now that 'Baby' has been weaned onto solid food (apart from the milk she has from me) this is a distinct possibility. Once we ate at a carvery and the dodgy nappy she had later that day confirmed my suspicions - they must have put butter on the veggies. Baby, being quite a bit older than before, and presumably more tolerant by this stage, didn't actually have the dodgy nappy until the evening. She had another the next morning, but it was less severe - possibly because I ate the same as her and it took a bit longer for the milk protein to pass through my milk and into her.

3. Either 'Baby' or myself have eaten something else to which she is sensitive. 

We were warned, when weaning 'Baby' that she may be sensitive to other foods also. This meant that we had to be exceptionally careful - adding one new thing to her diet at a time, for four/five days, before trying something new. This is because a reaction to a food may not become evident, until after you've eaten something several times. However, sometimes it can take even longer to cause a reaction, as we were to discover. 

It was 'Baby's' Vitamin D drops, which caused the problem. We had been advised to give her these from the age of six months (this is standard advice for mothers who continue to breastfeed beyond the first six months, as breast milk does not contains much Vitamin D). It wasn't until about six months later that we realised we had a problem, when 'Baby' came down with what I thought was a stomach bug. 


When the 'bug' didn't go away, I kept a strict food diary, and eliminated different foods from her diet (one at a time) to try and find a pattern. This took about three weeks. Eventually there was nothing else to eliminate but the vitamin drops. When I stopped them, hey presto, the dodgy nappies 'miraculously' stopped! When I reintroduced the drops, they began again, so there could be no doubt - the vitamin drops were the cause!

So back to her most recent nappy...

The nappy the other morning was not as bad as in the early days - so hopefully one day there will be no reaction whatsoever. She hasn't been writhing around in the day but was rather restless overnight.The poo wasn't runny, like it used to be - just a bit more yellowy and much softer than normal but the skin on her botty was an angry red colour. Unusually it has stayed that way for a few days. 


Thinking back over the last few days, I can't think that we have given her anything with cow's milk in it, so maybe it's something else that's causing the problem. Maybe it's because I've just started having coconut milk recently, and the proteins from that are coming through my milk and affecting her. Or, maybe it's because we've upped the amount of soya milk she's having and she's developing a sensitivity to that. Perhaps it's some ingredient in the new type of Free From biscuits she ate on Sunday. Who knows at this stage? We'll just have to take all the foods that are under suspicion out of her diet and then (once her skin has cleared up) add them all back in again, one by one, until we find the culprit!!