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Tuesday, December 14, 2010

Feeding the Milk/Soy Protein Intolerant (MSPI) baby, Perspectives by Heidi


Breast milk remains the best option for infant feeding.  In addition to its traditionally known immunoprotective and many other benefits, it also offers the mother the option of tailoring its composition to suit her baby.  This is especially true in regards to babies who are intolerant to corn.  To my knowledge, every infant formula contains corn syrup solids with the exception of alimentum ready-to-feed.  And, as alimentum ready-to-feed contains broken-down milk proteins, this option may not be a viable one for the most intolerant infant.

Many mothers find it helpful to begin with eliminating milk and soy, and then moving on down the list of the top allergenic foods: egg, peanuts, tree nuts, fish, shellfish, wheat, corn. Interestingly, some babies who appear to tolerate almost nothing their mother eats may tolerate a rotation diet where the mother eats a very basic total elimination diet but then adds in something different low on the allergen scale every 3 days or so.  This technique may also be a helpful option for babies who are highly intolerant of most foods they attempt to eat themselves.

For mothers who cannot or chose to not breast feed, there are several formula options for the MSPI infant.  The first category is the formula options which contain a milk protein that is broken-down for easier digestion.  This category includes alimentum, alimentum ready-to-feed, nutramigen, pregestimil.  The second category are the formula options that contain no intact milk proteins but are made up of individual amino acids.  These include neocate, elecare, and nutramigen amino acid. These are tolerated well by most infants, but do contain corn syrup solids.

It is recommended that solids be delayed in MSPI babies until they are six months of age.  And, starting with mild fruits or vegetables at this time.  Good options for first foods include sweet potato, pear, and winter squash.  Each food should be trialed for at least 5-7 days prior to considering the food a "pass."  The Jonega allergen scale can be a helpful guide for food introduction as well.  It may be found here: http://www.allergynutrition.com/resources/FAQ/15/Foods%20Most%20Frequently%20Associated%20with%20Allergy.pdf

For babies with difficulty gaining weight, adding higher-fat foods such as avocado, sunbutter, fatty meats, and healthy oils such as olive and canola to the diet may be helpful.  Sweet potato fries, grains cooked with added oil or earth balance soy-free, coconut yogurt, and making "fudge" from exra-virgin coconut oil (solid at room temperature), agave nectar, and carob or cocoa powder are some high-calorie foods children enjoy.

What techniques have you found helpful to find success in adding new foods to your diet as a breastfeeding mother?  Any great food ideas to help your lower-weight infant or toddler gain weight?  What solids foods have you had success with in your highly intolerant infant?

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