Saturday, March 3, 2012

Quinn's Food Problems

I've been contemplating this post for a long time. The information shared here is what I have found, through internet research, to match with what we believe was bothering our sweet baby boy. We have tested it through an elimination diet and re-introduction of the offending foods. That is the best we can do since allergy testing in children under two is inaccurate. Quinn's doctor supports us in our conclusions. If you have a weak stomach, you may not want to read the parts about Quinn's symptoms because I will talk about nasty diapers. ;)

I wouldn't normally share this on this blog, but I want this information to be available to another desperate mother who might just be googling the same key words I was

Quinn has had a rather rough journey to becoming a happy baby. It took us almost 5 months to figure out all of his food sensitivities. Most of his sensitivities ended up being standard irritating foods, but one of them was rather surprising and took me a long time to figure out: chocolate. Well, not just chocolate, but also tea and coffee. Not just caffeinated tea and coffee, but also decaf. The common link between all these foods? The chemical theobromine.

Theobromine is a chemical that is very similar to caffeine. It has mild stimulating effects on the body, but it much more gentle. Caffeine is actually broken down into theobromine (and several other chemicals). Coffee actually doesn't contain much theobromine, but it does contain caffeine and theophylline, which is also broken down into theobromine (and several other chemicals). Chocolate is the strongest source of theobromine that humans ingest, followed by tea, cola, acai berry, coffee, and carob.

I had not heard of theobromine before running across information about it by chance, but I quickly realized that I was familiar with it. Theobromine is the chemical in chocolate that is poisonous to dogs (and most small animals--but most of them are smart enough to not eat it). It turns out that it is also poisonous to humans, just most humans cannot ingest enough to produce a reaction. The elderly are more susceptible to "chocolate poisoning" than the general population. And there are those who are naturally more sensitive, like our little Quinn.

We had quite the multi-layered problem, though. Quinn is not just sensitive to theobromine, but also dairy, tomatoes, caffeine (perhaps because of how it metabolized into theobromine, but we cannot be sure), and (most recently) beans. He also has reacted badly to my vitamin supplements, but we are slowly figuring out which ones he can tolerate and which ones I will have to avoid. We had to wade through all those issues before we figured out the chocolate problem.

It would take pages to type out the whole narrative of Quinn's issues, so I will just share our summarized timeline that we kept to help us keep track of our progress.

*******

Timeline of Quinn’s Problems

September 11, 2011--born
Sept. 19-21-- begins having gas, crying spells, lots of forceful spitting up, runny and mucusy diapers, rash all over body, severe rash on bottom especially around the anus (bleeding blisters), eczema (blistering/cracking in some places), congestion

October 18-- most dairy removed from mother’s diet
Oct. 20-- 1 month appointment, gaining weight and developing fine. Given Rx for cream to help with eczema.

November 7-- begin to see some improvement in symptoms. Rash disappears, diaper rash is much better. (20 days into dairy elimination)

Nov. 12-- test dairy, lots of crying, gassiness, and spitting up for the next several days
Nov. 16-- 2 month appointment, gaining weight and developing fine

Early December--still lots of crying spells, forceful spitting up, gas (turns into very stinky gas), poop becomes very watery (basically brown water) with lots of mucus. Bottom still irritated, especially around the anus. Eczema unchanged.
Mid December-- mother removes major caffeine sources from her diet. Seems to help with symptoms somewhat
December 27-- mother removes all vitamin and mineral supplements from her diet, except soy lecithin. Within a few days, gas has improved some, spitting up the same, crying the same, poop is runny but not watery, still lots of mucus in poop, bottom still irritated. Eczema unchanged.

January 8, 2012-- mother removes chocolate from her diet. Spitting up is greatly reduced, stinky gas almost completely gone, crying spells improve but remain, poop remains similar
Jan 12-- begins probiotics
Jan 17-- mother removes tomatoes, onions, peanuts, tree nuts, and fish from her diet. Begins to attempt to lessen her soy intake.
Jan 18-- mother removes all tea and coffee from her diet. Spit up almost completely disappears the same day, crying greatly reduced, baby still has lots of gas but is not bothered by it as much
Jan 20-- mother tests tomatoes. Baby cries a lot more, increase in spit up, tiny red rash on cheeks, chin and neck
Jan 22-- mother tests tuna (fish). No reaction.
Jan 23-- mother tests peanut butter. No reaction.

Jan 27-- mother is eating onions and tree nuts with no reaction

February 3-- mother tests dairy again. Baby’s reaction: lots of painful gas, crying, extra spit-up, and a small rash on face and body
Mid-February--mother begins to slowly add vitamin supplements back in. Baby reacts to prenatal multivitamin and a full dose (1000mg) of calcium with painful gas and runny diapers. Baby is fine with a half dose (500mg) of calcium. Magnesium is fine. Vitamin D is fine.
Feb 22-- One month mark of a happy baby.
Feb 24-- baby reacts to beans with lots of painful gas

March 2-- Mother tests coffee. No noticeable reaction in baby to one standard cup of decaf coffee
Mar 6-- Mother tests 2 cups decaf black tea (day 1 of test to see baby’s tolerance to tea and coffee over several days)--baby is slightly more spitty and very gassy at night
Mar 7-- 2 cups decaf coffee (day 2 of tolerance test)--baby definitely  more spitty, has more trouble falling asleep, restless

Mar 8-- 2 cups decaf tea (day 3 of tolerance test)--baby more spitty and gassy than normal, fussy, less content than normal, slight rash coming up on cheeks and neck
Mar 9-- 2 cups decaf tea in evening(day 4 tolerance test)--rash more distinct, not as gassy or spitty during the day, still not as good of a sleeper as normal, gassy at night
Mar 10-- no tea or coffee--baby woken up from morning nap by gas, not very spitty. 

June 7-- Baby gets into a bag of M&Ms (plain milk chocolate), eats several (unknown how many). Rough night (tummy ache and gas), diarrhea the subsequent day.
June 14-- Mother eats spaghetti with tomato sauce. That night is very rough--lots of gas for baby. Spitting up the next day.

July 10--1 cup of regular coffee. Baby spits up a bit throughout the day (normal is no spit-up at all). Only takes one nap (not outside of normal for 10 months old).
July 11-- 1 cup of regular coffee. Lots of spit up. Rats.

October 24-- Quinn eats Colorado Pie (tomato paste on meat, bit of cheese mixed in). Bit of a rough night but no more than normal. Diapers normal the next day. Slight amount of irritation around the mouth where the tomato touched. Cleared up quickly but did leave some dry, flakey skin.


January 10, 2013-- Quinn has first chocolate chip cookie. No issues. Tomatoes still irritate skin slightly and possibly cause softer bowel movements, but no major issues from the small amounts we have allowed him. Haven’t yet tried a tomato-heavy meal like spaghetti. He handles small amounts of baked dairy ok, but seems to have some trouble with constipation in the days after eating it. Decaf coffee and tea are a non-issue (with me drinking them--not Quinn). I (mother) haven’t been drinking any heavily caffeinated drinks recently because I’ve realized they make me feel awful and keep me up very late.




*******To summarize the foods in my diet that we found to be problematic: dairy, caffeine, vitamin supplements (specifically the prenatal and calcium), chocolate, tomatoes, coffee, tea, beans

To summarize Quinn's symptoms: 

-rash all over body (severity lessened with elimination of dairy; mostly disappeared with the elimination of tomatoes)
-runny, watery, mucusy diapers (severity lessened with the elimination of dairy, wateriness and color improved significantly with the elimination of my vitamin supplements, resolved almost completely with the elimination of theobromine-containing foods)-severe diaper rash (bleeding blisters resolved with the elimination of dairy, severe irritation lessened with the elimination of caffeine and tomatoes, irritation cleared up with the elimination of theobromine-containing foods)
-lots of painful gas (lessened with each food elimination)
-lots of spitting up (lessened with each food elimination, but the projectile spitting up resolved within 24 hours of removing theobromine-containing foods)
-very, very stinky gas (increased during the Christmas season--when I began eating more chocolate--and resolved when I eliminated chocolate)
-eczema (improved with the elimination of dairy, but some slight patches still remain)
-congested nose (resolved with the elimination of dairy) 




If you look at the list of symptoms of theobromine poisoning (or chocolate poisoning), you can see that Quinn had quite a few of the symptoms. Diarrhea, vomiting (projectile spit-up), and painful gas top the list for human babies. However, if you look through my list above, you can see that many of the offending foods cause the same symptoms. For instance, dairy, tomatoes, and caffeine cause spitting up and dairy and tomatoes also cause gas...so on and so forth. Multi-layered problems like this one can be very tricky to track down.

The best thing I did to figure this out was to start keeping a strict food log. I wrote down every single thing I ate (even if I ate 2 donuts in the space of 3 hours after having a chocolate bar for dessert). ;) It was quite eye-opening to see what I was actually eating, versus what I conveniently forgot that I ate. More importantly, I kept track of all the times that Quinn cried hard or when he fussed as part of this food log. Over time, the patterns emerged. Most moms say that a pattern emerges within a week, but it took me closer to 4 weeks to see the patterns, probably because there were so many things contributing to our problems.

Once we began to see patterns, we began eliminating things. At one point I was off of nine different foods at the same time because we were so desperate to find the answer to Quinn's problems. I don't recommend cutting everything out all at once like that, but sometimes you have to do what you have to do. And even once we found the foods that were causing Quinn problems, I still had a hard time avoiding them.

I had adjusted to avoiding dairy before the really hard eliminations began. I had an incredibly hard time staying away from tomatoes and chocolate. I had no idea how much I depended upon chocolate to calm myself down throughout the day or how much we used tomatoes in cooking. Tea and coffee were a bit easier, but my mornings were still a bit rough without my hot "wake up" drink--until I found an herbal tea I could enjoy.

But it has all been worth it, since the end of January, we have had a happy baby. He still is more gassy than I believe is normal, but is generally just fine with it. He rarely spits up (wow!) and his diapers, although not perfectly normal, no longer irritate his little bottom. It's lovely to kiss his smooth, pink cheeks. He smiles easily, cries only when he needs something, and actively engages with our family. I am relieved and happy to have a baby who is no longer wailing inconsolably for long periods of time. Now if only we could get him to stop nursing all night... ;)

UPDATE: I conducted a tolerance test on theobromine-containing drinks (coffee and tea). Two cups of decaf coffee did not bother Quinn, but two days in a row of drinking two cups of decaf coffee did lead to more gassiness and spitting up. Mix decaf black tea in there (which contains more theobromine than coffee), you start seeing more and more of the symptoms of theobromine poisoning. I have concluded that I can have a cup of coffee or tea here and there, but I can't have them every day.  I was going to test chocolate after the coffee and tea tolerance test, but Quinn has started teething, so that confounds any results we think we might see. :-/

If you've gotten this far, then you're either related to me or a desperate mom. Thanks for reading! Feel free to ask questions in the comments!



~Regina

(Note: I have no medical training. You will notice that most of my linked sources are from wikipedia. The information here has been tested only in our family and works for us. Please discuss all problems with your doctor. Make sure you have your doctor's supervision before starting any elimination diet.)

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