Constipation - yoghurt/gluten?

[trimbler]

Hi, I'm still kind of in denial that DD might have some kind of food sensitivity but here goes...

History of green, runny, frequent, mucous stools from birth until I started block feeding, she had tongue tie divided and meds for silent reflux. Then they turned yellow but still very frequent. When first having tiny tastes of solids (fruit/veg only) at 6mo her stools became more frequent, she had discomfort and then got flu etc so we gave it a break. Tried again at almost 7mo and fine... Until first giving oats (ready Brek), when she skipped a day's bm and screamed during naps and evening on the first day, then only screamed during pm nap on days 2&3, stopped after that. Less severe reaction when tried ready Brek later but remained cautious about grains, she was fine with rice. Yoghurt had a similar reaction when first introduced but then less severe later. She's been fine with small amounts of cous cous, pasta, bread (made with only wheat flour but also containing soya, as it seems most bread does), and cheese. Unsettled again when tried egg yolks but later realised that may have been due to having more wheat during that period. Now day 3 of reintroducing yoghurt and she's really unsettled, straining and passing much harder stools. Btw she has a small umbilical hernia from all the straining Haven't given oats for ages either, just decided to try and reintroduce one trouble food at a time.

Sorry to ramble but have to go now, would really appreciate any thoughts?? TIA

[deb]

Hmmm....Could be any of a number of things. I did find that when we started grains in general, tummy troubles definitely ramped up; we had to try a few different grains before we found one that didn't cause troubles (and it was a different grain for each of my girls that they tolerated, so no one right answer there IME).

Dairy tends to cause the opposite problem - diarrhea - when there's an issue, but it could manifest as constipation too.

Honestly, for now I'd cut as much of the grains as you can for a little while, give them time to clear her system, and go from there - try a challenge with one of the milder grains like oats or millet in a couple of weeks and see if she can tolerate it.

Also, make sure she's getting enough liquid, especially now we're getting warmer weather; a shortage of fluids is another recipe for constipation. Have you tried pureed prunes or prune juice? You could even add a bit of prune juice to water and give it to her via syringe, or in a tiny cup (think a plastic shot glass) to practice drinking; odds are she won't get nearly enough to put her off milk/formula (which she should still be getting a decent amount of), or you could even add some juice to her milk (I have friends from another country/culture who introduced many new foods/flavors first via bits of juice in the bottle with the milk).

Oh, one more thought: has she had antibiotics at all? Probiotics can help restore the gut flora balance that gets upset when abx are used.

[trimbler]

Thanks Deb, forgot to mention that we're right under a ww storm atm so of course that could be contributing too...

So what do you think about the cheese/yoghurt? It does seem that she's fine with cheese but yoghurt constipates her, but I can't understand why that would be, especially as I've heard that some find cheese constipating. The fact that cheese doesn't seem to affect her suggests to me that there can't be a major dairy issue eg an allergy, would you suggest continuing to offer yoghurt but perhaps just make sure it's not too much? Forgot to say she seems fine with butter too. She seems to have had better BMs today having had some yoghurt again at breakfast, but was extremely unsettled napping, eventually filling her nappy during nap time. Do you think it's more likely that the fussiness etc is due to things like OT and ww, with BMs interfering with sleep, rather than the yoghurt, given her tolerance of cheese? She did have a negative lactose intolerance stool test when very young, but I gather false negatives are common with that.

As for grains, she's already had quite a long period without any grains except rice, before I reintroduced wheat, and I chose that to start because she's never had a conclusive reaction to it. She was absolutely fine with that until I introduced egg yolk, but she coincidently then had two portions of wheat a day as I offered toast alongside fruit mixed with egg yolk, as well as pasta/cous cous later in the day. So it might have been the egg or the increased wheat? But it does seem strange to me if she had problems with oats but not wheat, now I'm wondering if the problem was with the added iron to the oat cereals, rather than the grain itself?? I'm struggling to walk the path between just offering everything as the HV tells me, and cutting out lots again... Sorry, I guess I just want someone to tell me I'm making it all up and it'll be fine, but life isn't quite that simple, right? :p

To answer your other questions, she gets prune or dried apricot purée every morning, sometimes with pear too, also has some peach most days and limited apple/banana. I spoon some dilute apple juice every morning too, also at lunch if she's constipated. She's quite good at drinking water from her sippy cup if she needs it, I certainly noticed her drink much more when it was really warm and also when we suspected she had the sore throat that the rest of the family had. She gets four bfs a day too. She's never had abx directly but I had them in labour. Do you think probiotics would help and if so, what would be recommended for babies? The ones I see in the shops all seem to be low fat but maybe that doesn't matter so much?

[deb]

You can actually get baby probiotics in health food stores; it's a slightly different mix of bacteria than for adults (I didn't know this when mine were babies). It usually comes in a powder form in a refrigerated part of the store and can be mixed with drinks.

FWIW, Natalie had room-clearing gas as a baby (I'd had abx in labor as well), and one day I opened one of my probiotic capsules and put some of it on my nipple and after that her gas disappeared, like the next day! If I'd known then what I know now, I would get the baby stuff, though.

[trimbler]

Ooh ok will look them out, thanks! Lol, took me a while to work out what 'room-clearing gas' meant - I must be tired 

[deb]

Sorry, I keep forgetting that you call it "wind" on your side of The Pond!

[trimbler]

Well we understand both, it was actually the 'room-clearing' bit which took me a while, guess I was thinking more of bowel clearing and also having a guilty conscience about our cluttered room... Oh I'm so going back and forth in mind about this whole thing, wondering whether there's really anything going on and I should see our GP or if it's just all in my head and the screaming is down to stuff like OT! I mean, they can be fine without a certain food and then fussy once it's introduced but that could still be a coincidence, right? Still suspicious of yoghurt... but then I remember we're in the ww storm and I know we have OT...

[ZacsMumme]

Hey trimbler,
My T was terribly intolerant to dairy, soy, wheat and fructose. Surprisingly he got constipated more than diarrhoea once on solids too. Either can indicate a problem with a food. We were eventually put onto a private biomedical pead who said double the probiotics and this helped his constipation a lot. Yogurt is still not to
Tolerated by T, but he can have cheese. The proteins change I think in making of cheese.

If your not sure about a food definitely cut it for a while and see if things settle.

[*Liz*]

I agree that dairy intolerance can also cause constipation. It isn't as common as diarrhoea, but it does happen.

[trimbler]

Thanks - that's interesting Sara, so the wheat, soy and fructose issues have been sorted with probiotics but not all dairy, just the cheese? So I guess he doesn't have cow's milk either? Did you find just a tiny amount of these foods would set him off, or was it more if he had too much? I think we're cutting the yoghurt again from tomorrow and see how things go, might try reintroducing oats next, once things have (hopefully) stabilised, to ring the changes! Must hunt for probiotics too...

Update - just bought optibac probiotics for children online, went for the 30 day pack but no idea how long I'd need to give them to notice a difference, or whether DD will need to take them long-term or once she has the bacteria in her system, will that be enough?? Anyone know if you can get them on prescription in the UK?

[ZacsMumme]

Probiotics didn't fix Ts intolerances, removing the food did. But during the period where his gut was in a bt place they helped a lot to balance his gut back out and colonise his digestive system with good bacteria and eased his digestive issues such as constipation.

He has only been having cheese the last 3 months or so there is no way he could have had it a year ago but it is one of the dairy products that seems to be less of a problem for many. I'd my hubby is lactose intolerant, cheese is fine but milk, ice cream etc terrible!

Given she's only 10 mths I'd personally cut the yogurt and oats, and maybe retry one of them again in a few months once her gut is settled. Also, keep a food diary as intolerances can arise after up to a week of consuming a food.

[trimbler]

Thanks, so is T back on the wheat/soy/fructose now? I have such a hard time knowing for sure that yoghurt is a problem, there are always other things which could be the cause of the fussing. The constipation isn't too bad in itself, she usually still has BMs but there's much more straining, initially she was screaming with the straining but not recently, just looks uncomfortable and her output was definitely not measuring up to her input so she was getting backed up and then loses appetite or her reflux seems to worsen. I suspect that whatever it is, it's not very severe, so that's why I'm struggling to know for sure? Maybe as you say the probiotics will help settle things down, but I'm still not sure how long to use them for?

Another question - what do you all do for breakfast? I've given toast but I don't like to give too many portions of grains in a day just in case so then I'm left with just rice with lunch and dinner, if I want some decent texture - I like to use mini pasta etc sometimes too. When oats seemed to be an issue I thought maybe yoghurt with fruit and baby rice would work - now not. Wheatabix seems like it might be harder to digest but maybe I should give it a go, since she seems to be ok with some wheat, but again I'd feel like I'd used up her daily wheat allowance! We haven't tried other grains yet but it would be nice to have something quick and easy (ie readily available breakfast cereal!) rather than having to rely on buying specialist grains and making it up from scratch every time... What do you do?

[deb]

This is one place that BLW (baby led weaning) can be great - make meats and veg for yourselves and share with her (making it the right texture for her, of course!). If she doesn't see you eating all that stuff, she won't want any either. (I have to refresh myself on your LO's age.)

Honestly, I'd keep it simple for now, stick with meat and veg and breastmilk/formula (whichever she's still on). You can re-introduce the other stuff later on - no rush. For now, food is at least as much about introducing flavors and textures and the idea of eating at a table and self-feeding ever-so-gradually more than it is about nutrition, so at this stage you can afford to take your time more than you could if your LO were, say, 3YO. If I'd known way back when mine were starting on solids what I know now, I would have done things way differently. (We all would have gone Paleo a lot sooner for starters! LOL)

[trimbler]

Yeah I guess you're right, over here the medical advice is to offer as wide a diet as possible from the start, with the exception of undercooked eggs, honey, too much salt etc. So that's what I keep getting if I bring it up with the HV, for example. She'll start with a childminder in about 4 months so I'd ideally want her to be on as unrestricted diet as possible (for her) by then, especially since the childminder has others to look after, which I guess is why I'm keen to keep trying the grains and dairy. I'm unclear as to whether offering it now is actually doing her long-term damage, in which case I'd want to leave it longer. But I kind of thought that shouldn't be the case unless it's celiac? Which I very much doubt, given the mildness of her possible symptoms?

She's been running a fever today so not much appetite anyway, we'll see how that pans out...

[deb]

Any celiac testing I've had done comes back negative, but when I have gluten, I get more migraines, I get joint pain, I get brain fog - I'm intolerant to it but not to the degree that true celiacs are, nor am I allergic to it (it doesn't give me an immune response like hives or anaphylaxis).

Before I went off gluten, I was unable to digest brassicas/crucifers; they gave me horrible tummy cramps and diarrhea.   Once I'd been off gluten (and frankly pretty much off all grains) for a while, I was able to eat them with minimal discomfort, and I've actually discovered to my surprise that I like cabbage (and that it now also seems to like ME)!

So yes, there can absolutely be a gut damage factor that needs healing to work. I'd give it at least 2-4 weeks and then maybe try a challenge, and go from there.