The 3 day introduction rule

[*Liz*]

Silly silly question - but thought I would see what others do.

As DD is MSPI and likely intolerant to other things we haven't found yet we need to take it slow. ATM she is less than 6 mths but we were trying solids early to help her reflux.

She is a windy windy windy baby. VERY windy if I even have the teeniest bit of hidden dairy. Gave her rice cereal yesterday with EBM and she got VERY gassy - so much so that she was awake from 4am this morning and couldn't get back to sleep with her tummy ache bugging her.

Obviously it *could* be a coincidence though.

So what do I do - give it for 3 days and see what sort of a mess she gets in - or just say 'nope' and discard that from the list?!!

[~inbalance~]

I was wondering the same thing after our awful first try with cereal!    Should I give it up completely being totally certain it is what caused the problem, or do I try it again today and tomorrow?  I have decided to leave it for a few days and then try the cereal again I think.  If he responds the exact same way then I will know.  But I am already fairly certain it is the cereal he reacted to, or at least the iron as was suggested on our BC. 

I am with you with not knowing what to do this time though.  With T I was never that cautious, but he never reacted to anything.  I feel like I am walking on eggshells this time around. 

[~*Nicole*~]

If it were me, I'd be inclined to toss it aside and wait a couple/few weeks and then try again. Unless you are really unsure and think it was coincidence, why put them through misery straight away again? There is no severe allergy (swelling throat, hives, etc.) but discomfort so you can just pick a new food to trial for 3 days and see where you go from there. But that's just me. I don't know what is ped. recommended. We didn't have any intolerances so I'm coming from the no experience zone!

I know they say the digestive system matures as LOs get older so I am wondering if they'll be able to tolerate these things later on....as they say LOs grow out of dairy intolerances often, etc. And the idea that starting cereal is recommended (in US at least generally) at 4-6 months, gives me the impression major changes in digestion take place within a few month period to go from unable to tolerate solids to being able to within a couple month span.

[~ Vik ~]

Could the cereal have milk protein in it? When we discovered Dylan's allergy the ped in the ER told us to avoid cereals even if they say "may contain traces" - in his experience they generally do contain the protein because they are processd on the same equipment as the cereals containing skim milk powder. We actually went to a specialty store and bought an organic milk and soy free cereal and Dylan tolerated it quite well.

Also rice cereal can be so tough on them, could you try oat or barley instead? Or move right to pears?

As for the three day rule, I think that it's just to ensure that if there is a reaction you know what food caused it. So you don't have to keep trying the same food if you think that it's causing a reaction, but don't introduce another new food for at least 3 days, kwim?

(posted at the same time as Nicole)

[~inbalance~]

Vikki, what cereal did you use?  I bought My Organic Baby - no milk or soy listed but again said 'may contain traces'.  I'm wondering what else is out there because the only other ones I see everywhere are Nestle, PC, or Milupa, all with dairy I think.

[Alison_3]

Liz-
FWIW, our GI specialist told us to skip the cereal all together because it's so tough on their tummies.   

[*Liz*]

Thanks ladies.

Going to wait for this reaction to end and then move onto fruits and veggies.

Poor kid has been in a lot of pain. Interesting point about the factory Vikki. I've always ignored that but if she is sensitive enough to react to hidden dairy via BM then she will obviously react to direct protein even in very small quantities.

[EloysH]

Poor Megan!   

You could also try rolled amaranth or rolled quinoa if you can get your hands on it for the first cereal.   Recommended by my dietician.

Now you know we have been through a few food trials here. If it is an obvious and severe reaction then I would stop immediately. I  stuck to the 3 day rule for new foods if we weren't getting a reaction or if I was unsure.  Some Mums will keep going for longer if the symptoms are not clear (for food intolerance can take more than 3 days to show).

 I got him onto about 5 foods using the 3 days rule.  I had to *know* without a doubt whether it was the food or not. And even then, we had overlap with teething and this hindsight showed me that I need to re-trial our one failed food (pear) incase it was just the teething.  So a very slow process.

Now that he is on 12 foods I am doing 2 days at a time if the food is low risk.  However if the foods is anything that we know he is sensitive to I will be using very small quantities at first.  The theory is that even though he can't tolerate very much of the problem food, i need to expose him to small tolerable quantities so be can build a threshold of tolerance.  The threshold is dynamic and always increasing as he is exposed to more, builds up a tolerance over time and matures.

I would definantly retry problem foods or groups at a later date if you think they were a problem at first.

For low risk foods I guve up to one tablespoon a day for 3 days.

For moderate salicylate ( a problem area)  (basically his first fruit & non borin vege besides pear) will be 1 teaspoon every 3 days for two weeks then up the quantitiy from there.

For amines ( a slight problem area) ( banannas/paw paw/pork/ slow cooked meats/charred meats) it will be 50g or half a bannana every 3 days for 2 weeks then up to one serve every 3 days and so on until he reacts.

[*Liz*]

Thanks Eloise - I just can't get anyone to put their cards on the table and TELL me what to do. It is really frustrating. I am trying to get a dietician referral but I doubt I will get anyone that will say much beyond 'watch her iron and calcium levels'  .

Something certainly happened with the rice cereal as we had blood and mucous again today. Plus an unsettled few windy nights  .

I am going to start with fruit and veggies I think. The GI said no milk/ soy until 12 mths now, and no gluten until 9/10 mths (that is direct to Megan).

Quinoa is a good idea though else I am going to get a VERY hungry EBF baby on my hands  . I guess there are proteins I can introduce at 6/7 mths as well though. And potatoes.

[EloysH]

Liz, my dietician was very very keen to get K onto chicken quickly to help keep hunger at bay and help him sleep better at night and esp since we wouldn't be eating dairy anytime soon.  By 6.5 months she wanted him on meat twice a day, we moved to lamb fairly quickly and now about to start beef mince.

Sosorry she has had such a tough time with the cereal!! I hope this doesn't means that she's not ready for solids yet.  Surely, a second and third intro of foods will tell.   We started with white peeled  potato ( he handled the starch well)  because its low salicylate.  Then Swede, choko, chicken, pears  ( only ripe, thickly peeled).   Then green beans  (he wasn't windy) then lamb. The quinoa and amaranth, dairy free butter, rice bran oil a little with cooking).  At 7 months I have included dairy free gluten free toast with dairy free marg.  He loves it! All these foods are defined are  "low risk" for Kai - gluten free, slow salicylate, low amine, dairy soy free, nut free etc.
 
We are going to trial a little gluten directly in the form of oats (in his 7th month) if he tolerates it after 3 days in my diet. I'm not sure what we will do after oats though. Oh yes that's right, I will be doing the wheat challenge through my milk and see how he goes. 

 It is also absolutely fine to try the legumes and kidney beans although some bubs have problems with the fibre content.  She said to try those at the rate of 1-2 beans or a few lentils per day for 3 days and see what happens. 

[*Liz*]

When did you start Eloise??

She might not be ready  , well hunger wise and developmentally she seems fine, and surely I cam find some stuff for her  . No rush at this age of course.

[EloysH]

Not till 6 months,  (except those few days of rice cereal around 5 months) I was too worried about his gut not being ready with his intolerances and all. 

My normal paed said I could do earlier to keep the food down.  But when I went and saw an paediatric allergist, she said that solids is usually the undoing for many food intolerant and allergic kids.  This is because they are either too sensitive for alot of foods and given too much too soon or the wrong foods too soon.  So I guess for kids like ours, given the statistics "slowly slowly" is the way to go.

Kai was pretty darn nugry for the last few weeks though, swiping at our foods and crying for stuff... waking 3 times a night with full feeds.   

BTW last night I was thinking about Megan's sore gut and I remembered something. The dietician and my RPA food eating guide says specifically not to buy rice cereal with rosemary in it.  Sometimes this ingredient is hidden in the words like herbal antioxident or something similar. Rosemary is used as a preservative and it a VERY HIGH salicylate and the cause of much grief to the little ones if they are sensitive to it. The cereal really just needs to be rice and nothing else.

[*Liz*]

Well the rice I used was 100% wholegrain baby rice, with a trace of added thiamine. Nothing else in it at all. Unless it falls into the 'labeling loophole' as I know they often can.

Do you know where I can find lists of the salicylate/ chemical content of foods. Not to do it properly just just so I can see if I can see any patterns based on my diet and her issues.

This episode of blood and mucous is quite upsetting as this is the first time I can't think of ANY possible hidden dairy or soy in the last 5 days.

[~ Vik ~]

what cereal did you use?

Sorry it's taken me so long but I had to call the store since I had none left! It's called Healthy Times and I bought it at a local health food store.

[~inbalance~]

Thanks Vikki