Is Blood in Stool Always Milk Allergy?

[ccg01]

Well... the short story is we are being referred to a pediatric gastrointologist (sp?). Usually takes about 2 months to get in... but they normally review the case when they get it and bump you up if they think it warrants it. What kind of tests can they do, do you know? It seems like it's more a matter of my eliminating foods...

Doctor isn't convinced it is an allergy, since DS has absolutely no other symptoms that usually present in addition to the blood, is thriving, no rash, no fussiness, etc. Is supportive of my trying milk product elimination to see if it helps. We do have Crohn's and celiac sprue (only one case of the latter, seems to have been later years onset, my aunt was diagnosed in her 70s) in the family, but again, no other symptoms. Dr. went to his office review all the other causes while I was there and didn't come up w/anything that really fit, so is thinking it may still be a fissure. Is going to talk to his colleagues as well.

As for the staying away from formula -- two reasons, one the recommendations and research supporting EBF until at least six mos, two, am afraid it will become too easy and impact my milk supply. I was thinking more of using the prior day or two's milk than the really big freezer stash. Hmm. Confusing, it all is... :

[~ Vik ~]

TBH, I don't know what tests a pediatric gastroenterologist would do   (Dylan's food problems are all allergies, so we saw an allergist and had scratch and blood tests)  I know that many moms with reflux/MPI/MSPI babies have seen them, so it would be worth a post on the http://babywhispererforums.com/index.php?board=13.0 board.  The moms there will be able to give you a fantastic idea as to what tests are generally performed and what the doctor will likely do!

As for the staying away from formula -- two reasons, one the recommendations and research supporting EBF until at least six mos, two, am afraid it will become too easy and impact my milk supply.

I completely understand.  You're right, the WHO recommends exclusive breastfeeding until 6mo old as the best food for infants.  And if your doctor isn't convinced that it's an allergy/intolerance then the decision to supplement with a hypoallergenic formula is a very difficult one.  I guess my concern really is that it can take up to 2 weeks of a complete elimination diet to get all of the milk proteins out of his system - if you are giving him ebm from days ago that still has milk protein in it, you can't really start counting the time, kwim?  If it IS a milk allergy or intolerance, you won't be able to tell if the elimination diet is working because he's still getting the milk proteins in some feeds. 

I wonder if you could use some of your freezer stash for a few days, while you're on the elimination diet, until you can build up some of the milk-protein-free (MPF) milk for feeds.  Once you have enough MPF milk stored you could officially start feeding him only that milk, and give it the two weeks to see if it makes a difference in his stool.  I don't know if that makes sense?  Your other option is to wait for the ped gastro appointment, but if that's in a couple of months you may not want to wait that long

[ccg01]

He's now scheduled to see the ped GI doctor July 28... so not as bad as two months but still a long time away! Have been able to (knock wood) keep up with his daily feeding with pumping so far, have had to go only to the freezer stash once or twice early on, and were able to grab days when at least I wasn't consuming dairy. Yesterday, we didn't see any blood spots until the evening. So strange how it comes and goes. I have not cut out hidden dairy completely (although I'm trying to start that process)... so I know it may not be a totally accurate test. Sigh.

I think our biggest fear is this is something other than a fissure or milk protein allergy. No other symptoms, he seems totally normal, and I can't come up with much of anything online, but it is just hard to wait. :-(

[~ Vik ~]

(((hugs))) It is SO hard to wait and figure out what's wrong. At least the 28th is only 3 weeks away - it seems like forever I know, but like you said it's better than months!

TBH, if it IS MPI, and if you've not cut hidden dairy, it's not THAT strange to me that the blood comes and goes It probably comes after you've consumed something with trace/hidden dairy, kwim? Cutting all dairy can seem so daunting (I know, I've been there!) but you won't really know for sure until you do. Cutting obvious dairy is a great start, and for some los it's enough, but some are more sensitive and react to the tiniest bit. 

Dropping off more (((hugs))) and hoping that your appointment gives you some answers! I will be keeping my fingers crossed that it's something simple to treat too!

[ccg01]

Well, it is still "coming and going." I think it's lesser amounts than it was... and have printed off the KellyMom list of hidden dairy and have been watching things carefully dietwise the last few days. Knock wood, the pumping is going well this time around so I've been able to keep up and not have to go into the freezer stash.

It IS hard to wait. Part of me keeps wondering if it is something else, like oversupply, my hope is of course it isn't something worse.

[~ Vik ~]

I'm so glad that pumping is going so well for you! I'm glad you found a list of hidden dairy ingredients. There's a bw one too (http://babywhispererforums.com/index.php?topic=135427.0) if you want to compare and make sure all of your bases are covered Sounds like you're doing really well!

Although I've read that oversupply can mimic some reflux symptoms, I haven't heard of it causing blood in stool... I could be wrong, but I haven't come across that. I will be thinking of you and hoping that it's something simple/treatable/non-worrisome/etc. (((hugs)))

[chars mum]

When we saw the Ped Gastro doc, we had already seen a couple docs who had ordered abdominal x-rays and an abdominal ultrasound.  Also had blood drawn and a stool sample sent off for analysis.  We saw an Allergist who did a skin prick test for allergies prior as well.  The only test that showed anything was, of course, the stool sample which was positive for blood and mucous.   MPI is generally diagnosed through process of elimination and a thorough history of the current problem as well as family history (how about anyone with allergies - food, environmental?  Eczema?  Asthma?).  Might be worth your while to think back to when you first saw blood in his stool and keep a little running log.  Also may be a good idea to let doc know that you have seen improvement since you cut out most dairy. 
Good luck!  Hang in there!!!!

[ccg01]

Thanks to both of you! I am seeing improvement, a bit of blood today, but I found out last night by checking godairyfree.org that the chicken burrito I so carefully picked because it wouldn't possibly have milk... has milk... argh. At least DH found that site and now I can check most everything! Am going to start a food log and of course I'd noted the blood on his EASY logs... it started Memorial Day weekend here. I ate a LOT of dairy the first month.  It was the easiest thing to grab cheese or yogurt, etc...

We mostly have environmental allergies (pollens, etc.) in the family. No food ones other than my brother gets a rash around his mouth from pineapple.

However,there's an interesting bit --my mother's sister told her that she (my mother) was fed goat's milk as a baby because with cow's milk she would scream and cry and cry. (I am not sure if this was after she was an infant or if my g'mother didn't breastfeed... my mother was the youngest, born about the time formula became more common so I suspect they tried it w/her but no way to know for sure). Mom has no issues with dairy now, but it does make me wonder if there's a link.


DS has not had any tests yet,I suppose they will order those at the visit if they thing needed. They didn't ask us to bring a stool sample, which I thought odd.

[~ Vik ~]

We mostly have environmental allergies (pollens, etc.) in the family. No food ones other than my brother gets a rash around his mouth from pineapple.

FWIW, neither my DH or myself are allergic to any foods.  The only person on either side of our families with food allergies is my sister, who is allergic to tree nuts.  Children don't inherit specific allergies, but rather they inherit the tendency to be allergic. Dylan's allergist explained that even though dh and I don't have any food allergies, our environmental allergies made it more likely that Dylan would be allergic to *something*.  Sorry if you already knew that, but I found it really helpful when the allergist explained it to us!  Interesting about your mom too!  If she did have MPI and grew out of it, maybe that bodes well for you guys too

And I am with you on the frustration on finding milk ingredients in items that you would never even think!  Like deli meat!  (When I was doing my dairy elimination I had a ham sandwich on bread that I had made myself, sure that it was safe, and then dh read the ingredients on the ham and there was casein in it.  WTH? )  To this day it makes me crazy when I'm reading ingredients at the store.

I think it's odd too that they didn't ask for a stool sample.  Especially since blood in the stool is the most obvious problem?  TBH, I would probably bring a stool sample in anyway.  You could just put a dirty diaper into a ziploc bag and bring it with you - if for some reason they don't want it you can just throw it out at the office.  I bet the 28th can't come fast enough for you!

[chars mum]

With some luck your DS might produce a nice sample on the day of your appt!     Since he has no other symptoms, I would think then that the minimum they would do test wise would be to draw blood to make sure he isn't losing enough to cause anemia. 
Keep us posted!

[ccg01]

Thank you both! I will definitely plan on taking a diaper of the dirty sort with us... and maybe he will even produce a fresh one while there.

The blood has persisted, but the last two bowel movements were clear of anything visible... so maybe that's progress? Have been dairy-free of even trace amounts since last Saturday's hidden dairy debacle. Am still a bit concerned it might be wheat as well... since that's what I've replaced some of the dairy with -- do you know how long wheat takes to clear the system?

[~ Vik ~]

I would say progress for sure!!

I don't know how long wheat specifically takes to get out of your system, but 2 weeks of elimination is generally the advice.  Then if no improvement is noted you reintroduce it - sometimes moms don't realize the elimination is working until they do the reintroduction and symptoms worsen.

Have you considered soy? I ask because many babies and children wil MPI are also intolerant to soy. There is lots of information on the board on MSPI if you wanted to have a look.

[ccg01]

One step forward, one back it seems... had several without blood then it is back again later today for the last three movemens.  Just want to cry... I am starving all the time, no time to cook and now wondering what I am eating that is causing this... assuming still it is my diet. (Even worse to think that it might be Crohns, although that doesn't seem to appear until late childhood per my reading up on it... and it would likely have other symptoms, like not thriving.) Wondering about a hamburger roll I had at the work cafeteria with a grilled chicken sandwich... might have had milk in it I guess... or maybe it is soy as well. Argh! Feeling like I am grasping at straws.

Thanks for listening to my worries!

[~ Vik ~]

Big, big (((hugs)))

Elimination diets can be so frustrating   Especially since everything seems to have hidden ingredients - it's so hard to know what you're eating, especially when out, and what might be bothering your lo.  Are you keeping a food journal?  Might be the only thing that will help you pin some of this down.

Re: always starving, try to keep fresh fruit and veggies around.  That was what kept me from starving when I was doing my dairy elimination.  Just remember that the closer the food is to nature, the safer it is.  There's no milk or soy or gluten in fresh fruits, veggies, rice, fresh meat, etc.  It is hard when you have no time to cook, but if you have "grab and go" (apples, bananas, grapes, peeled/washed baby carrots, celery, cherry tomatoes, etc.) you have something to eat on the fly when you're hungry. Italian and Catalina salad dressing tend to be dairy free (though not sure about soy, tbh, as I never had to eliminate that) for salads or dipping veggies.  Remember that you have to be eating enough (and resting enough!) to keep your supply up

Another "survival" thing for me was making big roasts, even though it was only DH and myself.  Pork roasts, roast beef, entire chickens (or 4-6 breasts) - if I was taking the time to cook something for supper, I made enough for that night plus leftovers for at least one other meal, sometimes two.  Fortified instant rice helped too - it wasn't really any work, and it had flavour when I made it with broth instead of water (you'd have to check for soy in commercial broths though!).  One night would be pork roast w/ potatoes and carrots (a bit more work), the next night would be leftover roast w/ instant rice and corn (almost no work).  It's definitely not easy, but we got into a bit of a routine and it helped so much.

It might be worth starting a new thread?  Maybe about the difficulties you're having with the elimination and finding what foods are the triggers.  I know lots of moms on the boards have had to do eliminations, and you're sure to get other great advice and tips to help you and your wee man.

Dropping off loads more (((hugs))) for you both. xxxx

[ccg01]

Thank you for the hugs and suggestions for food! Have a roast in the crockpot today. Also trying to keep enough fruits around... it does help.

Thinking now that we are a week away from the appt. that I am just going to keep off the dairy and see what they say next week... rather than taking more shots in the dark. It seems there is some improvement... maybe wishful thinking/maybe not. We had DS at regular ped. on Monday as he was crying like mad for the sitter and DH. Dr. thought roseola/we also think now maybe he just wanted mom or dad and not sitter as it happened for her the next day (better yesterday). Anyway, he has gained 14 oz. since his last appt... so in two weeks, which was good news! Dr. really thinks it is a fissure but says that the ped. gastro is very thorough so that gives me peace of mind that we may get some good advice next week. Just hoping it won't involve stopping BF'ing.