Anyone else on an elimination diet (Fed up or RPAH?)

[EloysH]

Hi

Just starting on the elimination diet as developed by the Royal Prince Alfred Hospital in Sydney under supervision of a dietician for DS2's reflux and food intolerances.

The diet:
http://www.sswahs.nsw.gov.au/rpa/allergy/
and described in the book "fed up" by Sue Dengate.

Anyone completed a food challenge on this diet?  Any tips for surviving the first 4 weeks?

I am doing  the moderate level, dairy, egg, nut, gluten and soy free for 4 weeks. It seems quite hard to find snacks.  I have already tested gluten and won't be testing diary by food challenge.  I will test for sals, and then amines when the frsuit 4 weeks is complete.

I have the supporting cookbooks, but not all recipes are dairy, nut, egg, gluten and soy free. 

Has anyone used the egg replacer in recipes?  Is it yuck?

[Edesanja]

I'm not doing the diet as you know, but am dairy, egg and most soy free. I use egg replacer all the time (and have done for  quite ages since DD was egg free too). I don't have any problems with it - I use it in baking as well as things like meatloaf. I do have a friend whose son is dairy, egg and gluten free and she hates the stuff. Don't know if it's just preference or maybe doesn't work so well in gluten baking?? (but then the Orgran No egg is designed as gluten free as well so you'd imagine that people who are gluten free use it in their baking).
I have another friend whose son is egg free and she made meringues with it once! There's no way I'd be prepared to give that a go - seems so wrong! From memory they didn't turn out so well!

[EloysH]

thanks for the feed back on egg replacer!  Did you notice an improvement of his symptoms with the soy free?

[Edesanja]

thanks for the feed back on egg replacer!  Did you notice an improvement of his symptoms with the soy free?

Ummm.... possibly??? Until the mistake with the egg, reflux-wise we were going really well for a week or two. Not sure if it's to do with the soy or not. I might test it when things (eg SLEEP!!) settle down a bit. I'm still eating the tiny bit of soy flour in my parents' bread and apart from that it hasn't been a big deal to eliminate it, so really I'm not too concerned.

[Gypsymom]

The diet:
http://www.sswahs.nsw.gov.au/rpa/allergy/
and described in the book "fed up" by Sue Dengate.

I can't see which foods you can/cannot eat on that link. Am I missing something? I'm doing nothing but the Sears 'low allergenic foods' (and not all of those yet) so I think I'm down to less than 2 dozen foods total. See http://www.askdrsears.com/html/4/t041800.asp Only day 3 but yikes, I thought I had it bad before!

Anyways, I find the hot rice cereal with rice milk to be quite filling and more satisfying than a lot of other choices. The other brain wave I added tonight was apple butter (a condensed fruit product that contains nothing but apples, no dairy) on - you guessed it- rice cakes! 

BTW, what do you say to people who ask you "so why don't you switch to formula?" (when you explain you can't eat such and such...)

[EloysH]

You need to purchase the booklet it has all the food lists, shopping items and recipes. There is also a recipe book.  otherwise teh Fed Up site probably has enough info if you check out the food lists there. There is a support group for the USA also.   The RPAP diet has quite a few allowed foods, for breastfeeder, the moderate version is suggested which includes more than just pear for fruit and about 12 vegetables, quite a few meats and it is up to you whether to to gluten free or not.

What i like about this diet is that it is systematic, over 12 weeks you will know exactly what LO can and can't tolerate, and for things like salicylates, we will know what thresholds LO can tolerate.  This diet of mainly to determine food intolerances as opposed to allergies, although allergy foods are  avoided.   

I might check the Dr Sears Diet and see what he includes just to compare.

Its mainly older people tjhat ask about formula.   I just say I am idealistic with my commitment to breastfeeding and know that a restricted breastfeeding diet is better for him that formula and also that this will allow me to determine his intolelances in the most gentle way through the milk as  opposed to waiting for solids intros.

[Gypsymom]

What i like about this diet is that it is systematic, over 12 weeks you will know exactly what LO can and can't tolerate, and for things like salicylates, we will know what thresholds LO can tolerate.  This diet of mainly to determine food intolerances as opposed to allergies, although allergy foods are  avoided.

I can certainly see the appeal of having it all spelt out (and a cap on the guessing game). Like you, I still really hope to make it at least 12mo, BFing. In a few weeks, i've got a biz trip (DH needs to be there too so we are *all* going!!!) and I agreed to try to keep things pretty stable until we get back from that. There is no doubt that DS2 is doing dramatically better on an ED (although certainly just MSPI was easier!!) but I'm still working on getting him 'clear'.

You are doing so good, Eloise. Way to go! 

[EloysH]

Good on you Shannon, although I don't know if I couold juggle work around an ED.  I take my hat off to you. The dietician said to wait 4 weeks until we declare him "clear"

[Gypsymom]

The dietician said to wait 4 weeks until we declare him "clear"

So no off-list foods for a month? I was going to try adding back some things that I'm pretty sure were ok after 10 days or so. To me, the confusing part is the ones where a little is tolerated, but not a lot. We're getting more heavy wet diapers now (rather than poopy *every* change) and a nice bright yellow, but still slimy. Hoping that starts to recede this weekend.

I think most people in my RL think I'm totally daft ;-)

How is Kai doing so far? Have you figured out more snacks? I feel unsatisfied much of the time but feel worried about gaining from so many carbs 

[EloysH]

I just want 4 weeks of good, we are still having suspect poos. You can start challenges after 7 consecutive good days and after being on diet for 2 weeks.     There are lots of things i know he can tolerate a bit of, that i have had to cut out.  But the only systematic way to work out his thresholds for toerance is to treat each of those groups in isolation, one at a time eating increasing amounts of that food groups over 5 days and noting symptoms.  When a reaction is noted, the dietician will somehow hlep me work out his maximum tolerance for that group.  So I may be able to eat 1.2 cup of salicylates a day, for instance.

Snacks a better, I have made some chickpea dip with guten free costinis baked some gltuen free pear muffins, got beautiful gluten free bread, got my fruit, and vege snacks carrot, celery cucumber.  I also have some frozen pre cooked chicken breast portions that I have been throwing on a basic salad of allowed veges.

Sorry that everyone thinks you are daft!  I think you are very clever indeed and ahead of the pack

[Gypsymom]

one at a time eating increasing amounts of that food groups over 5 days and noting symptoms.  When a reaction is noted, the dietician will somehow hlep me work out his maximum tolerance for that group.  So I may be able to eat 1.2 cup of salicylates a day, for instance.

So on day 1 you might have 3 almonds, day 2: 6 almonds, day 3: 12 almonds, day 4: 20 almonds, day 5: almond butter? And then you quit as soon as you get a reaction either going back to the previous step or stopping altogether (if the rx was day 1)? What about for foods that are less discrete (ex. wheat) in that you could eat all kinds of things that contain wheat. Do you trial just one type at a time, say pasta, and then after 5 days try another wheat food such as pancakes (without egg or milk assuming those are still out) or do you think you declare wheat safe after the pasta?    Maybe the book explains this and should try to get a copy.

Re: pear muffins. Could you share that recipe? I am going need some food for the plane for my biz trip and most 'perishables' are not allowed.

Having support here makes this possible, albeit very hard. Thanks for being so brave, Eloise! Is it mean of me to wish my DH to have to eat this way for a few days? He's just like - 'this is great, S is doing much better. Just don't eat anything off your list" 

[~Sarah~]

Hi girls-
I feel like I may be starting late in the game, and I am not even sure if DD is truly MPI or not, but I feel like I need to give an ED a go-I notice her reflux being worse and her being very off after a glass of milk and after my morning coffee with cream and yogurt for breakfast.

I know you girls have a much more involved problem than I think I do, and I am looking to you for inspiration. 

You see cutting out milk should be no problem for a lot of people, but my entire family are dairy farmers, and I pretty much still love on dairy-so I am actually feeling very overwhelmed on how to even start bc everything I eat seems to have dairy in it!

I am just looking into things now-I will probably be dropping in
\
Good luck!!

[EloysH]

Hugs Mommy mertel, the first time I had to diet restrictions with DS1 was dairy, not even hidden dairy I found it much tougher than this time, because it was all so new and overwhelming.  So you are not alone!   After a good three weeks though, it didn't seem so painful and I was able to just get on with it.   Second time round is much easier 

Shannon,  I wish I could answer you questions, I'm not entirely sure how to do the food challenges as I am not up to that bit yet  Speaking to the dietician on Monday though so will let you know if  I get info on the mechanics of food challenges.   One note though: - for nuts we coudn't use almonds as they are really high in salicylates so would give a confounded result.  Apparantly the choice of off foods for the food challenge is very important.  The booklet I have doesn't describe in detail how to to the challenges!

An another note i am really down and shocked today     Kai has been subtly getting worse since I started the full ED.  His poos have been getting worse and worse too. Last night he woke for an hour 3am -4am refluxing, this morning he actually spat up - rare for him and is clearly uncomfortable, which is from days of the past.  I am really really annoyed that i am trying so hard but STILL problems. 

I have made a few mistakes, but all I can think of this diet in a way is making me in some areas eat more widely than I did before, and more restriced in other areas. It's asking me to eat all the fart foods that I had been avoiding up until now like garlic, leek, shallot, cooked cabbage.  The dinner I made last night was quite strong tasting of leek and garlic with lots of cooked cabbage.   When Kai had reactions in the past garlic was always involved in the meal.  I thought that he should be ok with those now that he's older.  So now I am going to cut those back out and seek adivce from the dietician on Monday!!!!      argh!!!

[~Sarah~]

{{{HUGS}}} Eloise-I know you had mentioned to me on the BC board about garlic

I sure hope that is the culprit and not something else!

[Edesanja]

Sarah, I agree with Eloise. The first time you elimiate something is the hardest, even if it's *just* dairy because it just seems so restricting, everything you think of has dairy in it and you have to learn how to read labels and take totally a different approach to food. It gets easier though I promise you (and I was a BIG dairy eater too!).