This is a 4-topic series focused on nutrition for babies and toddlers with eczema. I’m passionate about nutrition and believe that it’s of utmost importance to our health – after all, it’s one of the daily survival activities of breathe, drink, eat and sleep! I’m honored to have Judy Converse, founder of Nutrition Care for Children LLC, to help out in this series. Judy is a licensed nutritionist, a registered dietitian for more than 20 years and authored the first web-interface accredited learning module for health care providers on nutrition and autism.
More on Judy Converse, MPH RD LD – Judy has a master’s degree in public health nutrition and a bachelor’s degree in food science and human nutrition. She authored 3 books including Special Needs Kids Go Pharm-Free and Special Needs Kids Eat Right: Strategies to Help Kids on the Autism Spectrum Focus, Learn and Thrive. She has also testified for safer vaccines and consulted with industry partners on specialized formulas for infants and children with inflammatory conditions. Judy is available for nutrition consultation at http://www.NutritionCare.net
Breastfeeding – Impact on Eczema and What’s in the Breast Milk?
MarcieMom: As mentioned in the previous Q&A, allergy testing is not accurate for an infant. Many moms with eczema children feel really stressed about whether it’s what they eat, that ends up triggering the rashes via the breast milk. Judy, how does the mom’s body process the food that she eats into breast milk? Do the proteins (or whatever else?) in common food allergens like cow’s milk, wheat, egg, peanut and soy go into the breast milk and therefore capable of producing the same allergic reaction as if it’s ingested directly by the baby?
Judy: I was one of those moms whose baby could not tolerate my breast milk. It was devastating. I agreed to a trial of hypoallergenic formula and had mixed feelings when it helped my son. In my training, there was no explanation for this. I was taught that there was no such thing as a baby allergic to breast milk, but here we were. What I ate clearly affected my son too. So when I did go back to nursing him, because I wanted him to have all the benefits of breast milk, my diet was limited to rice, meats, some vegetables and fruits, and nuts for fats. I ate a lot of pecans and walnuts, and a little peanut butter, because I craved fats and was shirking all the fish I loved to eat (this was 1996, and we lived near the ocean). Well, those are the only tree nuts that my son is still quite allergic to at age sixteen, even though he has never eaten them himself! His only exposure to pecans, walnuts, and peanuts was via my diet through breast milk. He has shown IgE reactivity to these ever since.
I don’t know if we can confidently say that we know everything about how we process dietary proteins into breast milk, but we can likely assume variation across individuals. There is an interesting conversation here on this topic. Certain things don’t seem to vary much – like how much total protein is in mom’s milk, mineral levels, or total calories – these can waiver very little – but vitamins, types of fats, or amounts of fats can vary quite a bit relative to mom’s food intake, and toxins certainly do too.
One of the emergent pieces is the gut biome, again – that is, what microbes populate the mom’s gut, and the baby’s gut, and are either of their intestinal lumens compromised in any way? Is there any permeability that shouldn’t be there? If mom harbors a suboptimal biome that allows for “leaky gut”, then larger fragments of food proteins may enter her blood and will be picked up by breast tissue, which is richly vascularized with high blood flow. If on top of that, the baby’s gut biome is weak or his gut wall is leaky, you have a double hit for increased odds for eczema and allergy. So, again, several moving parts to this puzzle: The mom’s diet, mom’s gut biome, digestion, and intestinal wall integrity; mom’s toxicity level, stress, fatigue, and endocrine functions that regulate her milk production. Then we have the same factors to consider for the baby, including stress. The mucosa that lines a baby’s throat and gut is less developed and more permeable than an older child’s or an adult’s, so mom having a healthy gut may be the best prevention, to keep larger food peptides or proteins out of her milk in the first place. Antibiotics, certain toxins, heavy metals, and vaccines can interfere with intestinal wall permeability and function too – and infants now get more exposure to these than ever.
MarcieMom: What about some foods that a mom ought to eat more when breastfeeding? I understand that the field of epigenetics is gaining more attention as results of studies on animals are promising – the eating and health habits of one can reduce the chances of an individual being diagnosed with a disease he is genetically predisposed to. Should a mother who is breastfeeding then consume more anti-inflammatory foods, probiotics or foods that aid skin repair? If yes, which foods would you recommend and how to ensure that moms don’t over consume?
Judy: Anti-inflammatory, probiotic foods are good for everyone. Though there is plenty of debate on this topic, this generally means eating a plant strong diet: Lots of fresh raw organic vegetables, greens, and fruits, along with traditional fats like those from organic meats or dairy products, butter, whole unprocessed, unsweetened organic coconut milk, olive oil, and oils from organic raw nuts and seeds. Humans have always made and eaten fermented foods. If you don’t like or can’t eat yogurt, kombucha, kim chee or sauerkraut, naturally cured meats, poi, or other fermented foods, or if you don’t have access to safe raw dairy products (which contain healthful fats and enzymes that are altered or lost when pasteurized), you can supplement with probiotics. There are now hundreds of probiotics products available. Look for diverse strains and high potency, over 15 billion colony forming units (CFUs) per dose. I often use much higher doses than that in my practice.
Beyond that, if there are still skin symptoms, then work with an experienced provider to identify the trigger foods. I usually use an ELISA IgG food antibody profile for this in my practice. There is debate about that too, but used in the context of a total nutrition assessment (which should always include signs, symptoms, a food diary, and a medical history – never just lab tests alone) I can use that lab result as a jumping off point to make a good elimination plan for my clients. Then we add in anti-inflammatory supplements if more is needed: Things like nettles, curcumin, fish oils, N-acetyl cysteine, and of course the right probiotic.
MarcieMom: Thanks Judy, I think a mom shouldn’t blame herself or feel guilty if somehow her breast milk triggered an allergy reaction. After all, as you’ve pointed out, there are so many parts to the puzzle, and it’s not as simple as not eating something and then everything will turn out fine. But of course, it’s still a good thing to eat healthy – I’m feeding my family lots of anti-inflammation foods!