When Baby gets sick

No piccies on this one, yet, because on my lap I have a small sleeping child, who is suffering, once again from some tummy bug. She seems to get these from time to time, no matter how many times I wash my hands, or how much care I take over preparing food. I use medicated wipes when we're out and wash our hands when we come in, I've even been known to change all our clothes, as soon as we get home, but it doesn't seem to make much difference, she still gets them. It is so frustrating! Perhaps I should be rejoicing that she hasn't had one in a while but I'd much rather that she didn't have one at all!

When her first tummy bug hit, I poured over as many online articles as I could, to find the best advice I could, as to what I should  do with my poorly babe - particularly as she had a cow's milk allergy. What I discovered was that the only approach was to let the bug run its course, meanwhile, if Baby was yet to be weaned, you just kept the usual milk flowing. If that failed (due to excessive vomiting) then water mixed with rehydration salts is the next best thing. In fact hydration is the most important thing.

Once food was involved, it was a different story. Some times, when Baby has been poorly, food has been clearly the last thing on her mind, but other times, she has made it known that she really wants something to eat, which then leads to the dilemma of what to give her that won't exacerbate the problem.

It seems there are two basic approaches - either the 24 hour starve and then BRAT (Bananas, Rice, Apple sauce and dry Toast) diet - this approach is now considered outdated. The other approach is to let the poorly child have some food if they feel like it (but not citrus) This approach works on the assumption that the sick body benefits from nourishment. These days many advocate eating pro biotic yoghurt in order to help restore the balance in the gut - something not suitable for us then!

All of this feels pretty unhelpful when you have an unhappy baby, and are dodging difficult nappies. My approach is to try and stay off food for 24 hours, if possible, as I find this usually does seem to starve the bug. However, now that Baby's older she doesn't see why she shouldn't eat, so if Baby gets hungry I feed her small amounts of bland food. We avoid her usual soya milk, fruit juice, anything oily or sugary and try to ride it out.

The only good piece of news, for Baby and I, is that as I am still breastfeeding Baby, breast milk is still the best! Baby can have as much of that as she can get out of me, when she is ill and can't or won't have solids. I've noticed that, as I allow her to feed on demand, she usually drives up my milk supply  (although it might take a day or so to get sufficient for her needs). The only downside to this, is that it's best if I avoid coffee and chocolate, as that can pass through the breastmilk and irritate Baby's gut even more.

One other good thing, that I have discovered, is that mini bread sticks (we get ours from Waitrose) can be really useful. They're plain, bland and unsweetened and more appealing to Baby than dried toast! When she feels like eating, I often give her these, to see how she gets on with them. Also, as they are a little dry, they encourage her to drink and stay hydrated.

As soon as Baby's appetite has returned, the next step I have usually taken is to introduce egg (poached, not fried) with toast. Eggs are packed with nutrients and often, I find, are easily digested. Until recently, my next step has been mashed potato (mashed with its own cooking water) with maybe some steamed chicken or fish along with some steamed carrots. However, on the last occasion, we all caught it - even The Hub with his cast-iron constitution didn't escape. The Hub broke all my rules! 

He felt like fizzy drink, so drank fizzy drink, he felt like eating (after an initial period where he just wanted to sleep) so he ate and he recovered pretty quickly! What The Hub ate was a dish from his childhood. Although it didn't look appealing, I found that it really hit the spot for my recovering stomach too. 

Basically, it's a Chinese dish, which consists of rice cooked in a lot of water for a long time, until it reaches a thick and 'creamy' consistency. During this time, the rice becomes all mushy and broken down. Eaten for centuries by the Chinese as breakfast (they might refer to it as 'porridge') or indeed at any time of the day, it is used also as a first food for babies. It can be dressed up or down and have all manner of things added to it. It can be made sweet or savoury.

From what I can tell from looking up recipes online, there are really no rules to this dish - you add whatever you like. The Hub's mother usually makes it as a breakfast, adding small pieces of a kind of Chinese pork sausage, along with spring onions (I think). When The Hub made it, chicken being his favourite 'sick food' (he craves chicken soup when suffering from cold or flu) he added some pieces of chopped chicken near the end (long enough for them to cook through). Et voila! Job done!

Looking for a recipe to explain just the basic method, I found one that I could have reproduced it myself but this website explains it so well, I'm just going to include a link. If you would like to experiment with different recipes, this guy's site has got the lot! Or if you just want one simple method, check out this one.

Meanwhile, back to today, I'm going to wait and see what Baby wants. Frustratingly, my little fussy one has been known to turn her nose up at Congee!

How about you? What works for you, when you're child is ill?

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!!