Things I'm Learning - Milk Allergies

The Imp was a pretty mellow baby. He cried when his diaper needed changing, when he was gassy, when he was overtired. But he was happy to be handed around to willing arms, grinned his toothless grin to any friendly face that came within range, and slept through the night at six months of age.

Then he became a toddler. From about 14 months on, there were temper tantrums. His willful independence started to assert itself. His stubborn temperament began to make itself known.

I can't imagine where he gets any of these traits.

Ahem.

A natural stage of childhood, I assumed. And it was. All part of the transition from dependent infant to independent little person, I thought. And it was. The lead up to the dreaded "Terrible Twos", I reassured myself. And it was. It was all those things - but turned up to eleven. Everyday simple things would cause extreme reactions. Aggression. Anger. Total lack of impulse control. My kid (that gentle, happy, cooing baby) had become that kid. The one that would. not. sleep. ever. The one that Did Not Play Well With Others. The one that bit other kids, that pushed the littler kids over at daycare. The brat that erupted into screaming, shrieking tantrums that would last an hour and a half, six or seven times a day, over nothing. The one that, when told not to do something, looked at us, oozing defiance, and did it anyway. And did it again and again, no matter what reasoning, cajoling, or expert-sanctioned behaviour modification strategies we threw in his direction. The child that bit, hit, kicked, head butted, and actually spit at us when we tried to change his diaper, or put his shoes on, or give him breakfast. We had THAT kid.

One of the really little guys at daycare actually cringed whenever The Imp went near him.

I was horrified. And mortified. And pretty sure that I must be the worst parent who ever lived to have spawned this awful, impossible to control child. I was pretty near the hairy edge of what I could deal with, so stressed that my stomach was literally tied in knots, causing me such pain that I spent big chunks of entire days curled into a ball on the floor. I was so frustrated, I wept daily.

It was awful. But it was our normal, and I didn't know what we were doing wrong.

Then my dad came to stay with us for a few days.

And he gently pointed out that the behaviour we were dealing with was very reminiscent of what he had experienced with my sister when she was about the same age. She'd also had uncontrollable anger and behaviour issues, which through trial and error (and terror that she would have to be medicated or institutionalized) they learned was caused by an allergy to milk. Dad said that within six hours of eliminating milk from her diet, she was an entirely different child.

The clouds parted. The angels sang.

Even though I was aware of my sister's milk allergy, even though HWSNBN and I had discussed, way back when I was pregnant, the possibility of different things being handed down from either of our families, it never occurred to me to associate The Imp's behaviour with his food. And I never wanted to be that mom. You know the one - the one who makes excuses for her "perfect" child's gawdawful behaviour.

Hearing my dad describe the uncanny similarities between The Imp's rage and my sister's childhood, it was like getting permission to explore whether his terrifying behaviour maybe, just maybe, wasn't our fault.

photo credit: luvi on flickr

The next morning, The Imp was a very different little boy. It literally was like day and night. Diaper change? No problem. Getting dressed in the morning? Easy peasy. Drop off time at daycare, which had become a half hour ordeal of screaming every day? "Bye bye Mummy. See you later!" as he ran off to play with the other kids.

And he stayed that way for the several days we managed to keep milk out of his diet. He slept better. The aggression towards the other kids at daycare melted away overnight. Small upsets could be addressed with words, and hugs, and kisses. The difference was gobsmacking.

Then he had some cheese at lunch one day through an oversight on my part.

The onslaught of his towering rage that evening was mind. numbing. Right back to hitting, spitting, biting, head butting fury.

Clear cause and effect.

It's been about a month now. There's been accidental ingestion of milk products a handful of times. Every single time has resulted in the same off the charts uncontrollable behaviour.

The takeaway:

1) Lactose intolerance and milk allergies are not the same thing. Lactose is the sugar in milk, and intolerance usually leads to gastro-intestinal distress of varying degrees. Milk products can often still be used, as long as something like Lactaid is taken with, or lactose is removed from the finished product. A milk allergy, on the other hand, is usually a reaction to proteins in milk, like casein or whey. Reactions run the gamut from skin rash and hives to anaphylactic shock. Behaviour issues are less common, but do exist, at least anecdotally.

2) Milk ingredients are in everyfuckingthing. Read labels some time; look for whey or casein. Almost all processed food, even that labeled "lactose-free" has some kind of milk ingredient in it. Hot dogs. Hot dog buns. Most margarines contain milk ingredients. Crackers, bread & other baked goods: the ones that don't say "milk ingredients" outright on the label usually contain whey powder, and if the label says "enriched flour", it's likely milk ingredients that do the "enriching" even if no milk ingredients are listed on the label. Caramel colour, found in many processed foods, including Coca-Cola, (incidentally, do you know how hard it is to find ingredient lists or nutrition information on Coca Cola's own website?) is often derived from casein. If you don't make it from scratch, odds are good it's got some kind of milk in it.

3) Can't substitute goat's milk, or sheep milk, or any other mammal's milk. (Except human, apparently, as The Imp seemed to have no problem with my own supply.)

4) You don't "grow out" of a milk allergy. Symptoms may change over time, but the immune system's response does not magically disappear. My sister, now in her 30's, still struggles with it.

5) I cannot possibly express the depth of my gratitude for my father's perceptive observations and his gentle approach in sharing them with us. Had he not come to visit at that moment, noticed the similarities 30-odd years apart, and spoken up about them, it's difficult to imagine what our life would be like now. It really was becoming more than I could bear. I didn't realize how much it was affecting me until it went away. Don't get me wrong, The Imp is still a two year old. There are still tantrums of the stomping feet and being obstinate when thwarted variety, but words can be used to address them, they're over quickly, and they happen a few times a week instead of all day long every day.

6) I'm no doctor. I don't even play one on TV. I am far from qualified to offer any kind of medical, psychological, or psychiatric advice. Even my parenting advice, well, take it with a grain of salt, I'm figuring it out on the fly, just like everyone else. But for the love of all things holy, and possibly your own sanity, if you have a child with behaviour issues, at least be open to the idea of exploring food allergies as a contributing factor. I'm not saying every child on Ritalin just needs to stop consuming milk. But if there's a chance that behaviour issues are exacerbated by food allergies, isn't that worth at least investigating? We didn't do our homework a few evenings ago and accidentally gave The Imp milk - his behaviour until we finally managed to get him to sleep? A couple hundred years ago would've merited an exorcism. It was agony watching him go through that - he was literally howling and writhing in his fury - and knowing we had unwittingly caused it by giving him a chock full o'milk ingredients hot dog for dinner at the beach really made me feel like the worst mom ever. Perhaps with some justification this time.


So in answer to the question "Got Milk?" in our house the answer is now a resounding "Hell, no!" and I'm on the hunt for truly dairy free products. I've had some luck with kosher and vegan stuff, and I've been adapting recipes I know and love by substituting rice- or soymilk for regular milk, and vegetable or olive oil for butter, but I'm wondering if anyone can steer me in the direction of some great, absolutely 100% dairy free resources. Websites (preferably not of the hysterical-omg-you-guys-milk-causes-autism variety), books, organizations... Help?

Things That Are True - Breastfeeding

“Your rack is shrinking.”

Said my husband, the poet, the other night as I was undressing for bed.

And it’s true.

The Boobs of Doom, we named them early in my pregnancy, when they swelled from a B to a D cup seemingly overnight, when my aureolae grew to the size of demitasse saucers and my nipples became rather aggressively brown and determined to have a look around for themselves. Post partum, as the milk came in, they ballooned to a DD/E. Yes, from a B to an E. That’s 4 cup sizes for those of you playing along at home… We began to affectionately call them The Boobs That Ate New York.

My husband, delighted, felt like he was married to a 1950’s pin up.

I found my new mammarian bounty cumbersome. Although I appreciated that the giant boobs balanced out what had become a seriously generous ass, I couldn’t get used to them. They were in the way. Running to catch the elevator left me gasping in pain. No bra could adequately contain them, and they were inconvenient, leaking milk at inopportune moments. And the nursing pads, and their failures. Classy, that breast pad peeking up out of the top of your shirt, milk leaking out of your no longer protected nipple below. Especially in the grocery store when you’ve finally carved out 15 minutes for yourself away from your adored but exhausting little one, and someone else’s baby starts to cry and oh dear here come the pins and needles and… Gush. Awesome.

I may be the only woman in the history of breasts to rejoice that mine are slowly disappearing. I am so happy, now that The Boy is getting most of his nourishment from solid food, that these unruly milk factories are now tucking themselves sensibly into D cups again. (D cups! What I once would have considered “stripper boobs” are now something I find sensible…)

But here’s the thing:

I have loved breastfeeding. LOVED IT. Far more than I ever could have guessed, back in the unknowing days of my pregnancy, reading all the reasons that breastfeeding is a Good Thing, approaching it as an intellectual concept, wanting to do what was best for my child.

I have loved it so much more than I would have imagined in those early difficult days. (And they are difficult. Don’t let anyone fool you on that count. It is hard, and it does hurt, and you will torture yourself with guilt for wanting to give up, even if you keep going. Gawd, the senseless guilt we new mothers heap on our own heads…)

And here’s why I have loved it so:

I’m an admitted control freak. I like to know what’s coming. I have to have a plan. I have to know how it’s all going to happen, fit together, and turn out in the end. And I've always been this way. My parents tell stories of having to prepare small-child-me for outings by describing, in detail, what was going to happen. Once they didn’t know there would be a dog at a friend’s home we were visiting, and apparently I freaked out to an embarrassing degree.

Being a control freak and a brand new mom simultaneously is… Well, it’s imfuckingpossible, frankly. I felt so out of control. I felt so lost in not-knowing. Things were happening to me and around me without me having any clue what was coming next. For someone like me, this was at times sheer torture.

But I could feed my child.

Even when I was so tired I couldn’t remember my own name, I could feed my child. I held on to that, like an anchor keeping me still in the maelstrom that my life had become.

Yes, there are a million reasons to breastfeed. You can read about them somewhere else. Here’s the one that made the difference for me, and that I don’t see discussed much: breastfeeding gave me a tremendous sense of power.

And not the wrong kind of power – not power over something or someone. Not a power born of ego. At a time when I was plagued with insecurities, buried in guilt, and terrified of Doing It Wrong, watching my baby grow and thrive, knowing that my body was his sole source of nourishment gave me a real sense of quiet competence. I have, my entire life, always defined myself intellectually. As I watched him grow out of the tiny onesies I’d so lovingly bought before he was born, and saw his skinny little newborn legs fill out and develop pudgy rolls, I gradually grew into a sort of awe for my physical self.

Look! Look what my body can do.

The Boy at 3 months


His body takes breast milk I've made and turns it into eyelashes. And fingernails. And teeth! As an atheist, this is the closest to a sense of reverence I have ever been.

The Boy sleeps - 10 months old

Even today, as The Boy reaches 11 months on The Outside, I look at him and rejoice in how healthy and happy a little guy he is.

The Boy at almost 11 months

And I forgive my still alarmingly generous ass, and the way I look in a bathing suit at 11 months post partum, and all the physical imperfections my control freak self used to pick apart in the mirror.

Because look what my body can do.

The Boy at the playground a couple of weeks ago

Now that The Boy has started self-weaning (we're down to 3 or 4 feeds a day), I won’t miss The Boobs That Ate New York.

But I’ll miss what they’ve represented.

Things That Are True - You Know You're a Mom When...

You know you're a mom when you are breastfeeding your baby, enjoying a laid back morning, and the sun is streaming in through the window. As its rays catch the fine blond hairs on your son's upper lip just so, your first thought is:

"Oh God, in about 13 years I'm going to have to hide my laughter when he is sincerely trying to turn that into a mustache."

Things I've Learned - Breastfeeding and Formula

Before my son was born, I was absolutely, completely, without question, 100% committed to breastfeeding. I was so NOT interested in anything else that I skipped the sections in all the books about bottles and formula. Didn't even read them. "I'm not going to need that," I thought smugly to myself. I couldn't even wrap my head around why someone who could breastfeed would choose not to.*

I was so intent on breastfeeding that I wasn't even going to buy a pump to use for the occasional evening out. I was planning on being happily tethered to my child for at least a year, ready to sacrifice all to do the right thing.

The Boy was born on a Monday evening by emergency c-section (another part of the books I had skipped, so confident was I that I would be able to handle whatever childbirth threw at me). I was in post-op recovery for almost an hour before I was wheeled back to our hospital room to make our first attempt at breastfeeding. The Boy was a champion eater - although it was all new and a little scary for me, he latched on immediately like he knew exactly what he was doing. The nurse who helped us was satisfied that all was well and left us to it. I fed him from both breasts and he settled down for a sleep. I felt exhilarated, despite the pain from the c-section incision, the discomfort of the catheter (yeah, not so much with the fun there...), the exhaustion of 30 hours of labour (had I known it would end in a c-section, I might have skipped some of those 30 hours)... I had breastfed my child and that was a good thing. I continued to feed him on demand through the night and all the next day. He latched on well, and although it was painful it didn't hurt too much. In the last few weeks of my pregnancy, I'd been leaking colostrum from both breasts like crazy, so I was feeling pretty confident about the whole thing.

I tell you this just to help illustrate how absolutely crushed I was when on Wednesday my milk hadn't come in yet. At all. And the colostrum I was producing wasn't cutting it. The Boy was losing too much weight and the doctor was concerned about his low blood sugar levels. He was, essentially, starving.

It was awful. A technician came in every six hours to poke his tiny little heels to draw blood for tests, which made him shriek in pain, and made me cringe in anguish. The Boy got so that if you put him in his bassinet at all, he would start to cry, anticipating the pricks on his feet. The nurses insisted that he had to drink some supplemental formula just to get enough nourishment to thrive.

The sense of guilt I felt was extreme. I wept. I sobbed. I felt helpless. I felt like the worst mother in the world. I was incompetent. I was terrified my milk would never come in. I thought, "There must be something wrong with me. I can't believe that two weeks ago I was running a multi-million dollar company, and now I can't even nourish my own child." I worried about the cost of formula and how that hadn't been part of the plan, budget-wise. I couldn't sleep; my mind reeled with fear, anxiety, and self-recriminations (none of which, by the way, are helpful in producing breast milk).

I was devastated.

The hospital was completely on board with my continued efforts to breast feed. Nurses helped me get physically comfortable and showed me various holds and techniques. They helped me work out a feeding plan, track feedings, and supplied supplemental formula to The Boy only after he had emptied both breasts, not as a substitute for breast milk. The Boy's blood sugar was so low that he kept falling asleep before he got a decent feed in, and they helped me wake him up to continue. They were really amazingly helpful. I can't say for sure, given my mental/hormonal state at the time, that I wouldn't have given up without this army of incredibly knowledgeable and supportive people mustering to my side to make it all happen.

They also did whatever was necessary to stimulate my body to increase milk production, putting me on domperidone (which sounds like champagne but isn't), a prescription drug that stimulates lactation.



Then they brought in a breast pump that was truly terrifying in appearance. It was a big, heavy, industrial-strength, shiny with chrome and metal thing from a 1950's science fiction pulp magazine that rolled in on its own wheels. (It looked a little like the big bullying older brother of the pump in the photo below.)

I was to use this scary piece of equipment to pump after every feeding, 5 minutes at a time, alternating breasts, for a total of 20 minutes each. It was completely overwhelming.

And my husband, through all this, felt even more helpless than I did.

They let us leave the hospital the next afternoon - with the formula, The Boy's blood sugar had stabilized. We had to rent a hospital-grade pump to use at home, and continue with the domperidone and the supplemental formula. I kept hoping to feel the engorgement of my milk coming in. I would gladly have traded the guilt of failure for the ache of too-full breasts.

My doctor referred me to the BC Breastfeeding Centre, and we went to see them on Friday morning. I'd had such hope for the appointment; after the amazing support at the hospital, I expected it to be a La Leche League type of experience. In fact it was a very clinical medical environment, and while I do not in any way doubt the vastness of their medical knowledge, the style of their practice did not suit me at all. I left the appointment in tears, feeling like I never wanted to breastfeed again. Once home I watched The Boy sleep, dreading the moment he would wake up and want to feed. Fortunately the public health nurse (who was totally. awesome.) was scheduled to visit that afternoon, and she talked me off the ledge. She told me,

"No matter what happens, the most important thing to remember is that your baby will be fed. He will not starve. Whether it's formula or breastmilk, he'll get adequate nutrition and thrive."

That simple statement allowed me to let go of the guilt I'd been beating myself up with, and to move on to practical matters and focus on doing what I needed to do to feed my child. Three days later, to my eternal joy, my milk came in, and I've happily breast fed since. I visited a lactation consultant who recommended a great nursing pillow (Things I Love review coming soon) and helped us achieve an optimal latch. Now, when I'm cranky and tired, feeding The Boy in the middle of the night, I just have to remember how hard those first few days were and everything shifts into perspective!

Eventually, many weeks later, I recovered from the trauma enough to buy a small, cute, quiet breast pump (a conscious choice that was as far from the hospital pump as possible) for the occasional evening out or morning when my husband, a prince among men, watches The Boy and I go out and do my own thing for a couple of hours. I love it. (Proper review in Things I Love coming soon...)


The Take-away:

1. Don't be rigid in your expectations. I didn't expect a c-section, and it never occurred to me I'd have trouble breast feeding. Much heartache could have been avoided if I'd been more accepting of circumstances earlier than I was.
2. Guilt is not useful. It paralyzes you and stops you from being able to see beyond your own failings. It makes it impossible to be pro-active.
   
3. The hospital staff is on your side. They want you to succeed.
4. Contrary to what I somewhat foolishly and naively believed, formula is not evil.
5. Pumping breast milk is not abandoning your child.
6. And breastfeeding is not as easy as it should be. How did the human race survive all those millenia?

*I'm in Canada, which has a very generous government-sponsored maternity and parental leave program. Having that full year of paid leave makes breastfeeding a lot easier. If I'd had to go back to work right away, I don't know how easy it would have been to pump several times a day...