I haven't blogged in a while, been feeling quite a bit overwhelmed the last few days. I got an email from the kids GI doctor at the end of last week. We had done a pH probe study on my almost 3 year old and the results were the usual, leaving more questions than answers. But that's just how it goes with these kids. The littlest monster did really badly with the probe in, it's placed down into the esophagus via the nose. That in itself is very uncomfortable but he was gagging, retching, vomiting, refluxing and reswallowing through the entire 22 hours he had it in place. Most of that is to be expected with this test, but not to the extent that he was doing it. Well lo and behold I found a sippy cup wedged in between his crib mattress and the rail that had the residue of curdled old cow's milk in it the day after his probe was removed, while I was changing the sheets after he vomited all over his crib. The night before his probe was put in the hubby and I went out to dinner alone, yes you read that right we were ALONE! We left the kids with the sitter, who happens to be 16 and super sweet. She knows all about the kids food issues, but for some reason she gave the little one a cup of the hubbys fat free cow's milk when she put him to bed.
So I ended up having to email the doctor as soon as I made my discovery. The little one had been reacting to the cow's milk and that explained all his increased symptoms while the probe was in place. So this unexpected food challenge proved yet again that he still cannot tolerate cow's milk. Once the GI had the results from the probe study in hand he emailed me to let me know that they didn't show a level of acid reflux that would explain the littlest ones on going symptoms, not to mention what he experienced while the probe was in place. So we are to do a top 6 allergen elimination diet. This "diet", along with it's sister the top 8 allergen elimination diet, are considered the "silver" standard in diagnosis and treatment of non IgE mediated food allergies, such as eosinophilic disorders.
What we will do is removed all dairy, soy, wheat/gluten, eggs, nuts, and fish from the littlest ones diet. On top of those we will keep out of his diet his other "known" allergens, corn, citrus, and berries. The "gold" standard in diagnosis and treatment in these types of disorders is an elemental diet consisting of an amino acid based formula like Neocate, Elecare, or Nutramigen AA. Since the littlest one cannot tolerate these formulas at all, we've tried them all many times hoping that he would be able to use them and failing everytime, we have to use the elimination diet approach instead.
Once the littlest one has been on the diet consistently for about 6 weeks we will reintroduce one food at a time to him, about one food a week, and watch for any and all reactions. If he reacts once the food has been reintroduced then that food is considered a "failed" food and will be kept out of his diet. If there is no reaction to the food then that will be considered a "safe" food and will be added back in.
This diet is going to present all sorts of issues for me and my cooking and being able to provide a balanced and varied diet to him, but I am up to the challenge, I think. First off I will have to find him a new "milk". After we took him off cow's milk I tried a few different ones and the one that he seemed to like the best was almond milk. I've found it easy to cook with and he drinks it well. But with the new diet nuts are out. So back to the alternative milk aisle at the health food store I will go and grab a few to try out with him. I'm going to see if I can find a vanilla flavored hemp milk, it is one of the alternatives milks that's nutritional profile is the most similar to cow's milk, the fat and protein content. I tried it with him before, but bought the chocolate flavor which I was to find out he doesn't like chocolate milk at all, even his beloved almond milk.
There are a few different diets out there that I can pull from to come up with recipes and meals that he should be able to eat safely. Paleo is one that comes to mind. Basically the belief is that its best to go back to how humans ate before we became farmers, you eat what man would have been able to hunt or gather. I've found some really interesting looking recipes and will be trying those out. I guess it will be back to basics.
My biggest concern is finding a pizza crust recipe that he will like. Pizza is one of the only foods that I can count on that the littlest one will always eat. He loves pizza, always has. Weather it was with real cheese, or with Daiya cheese, he will eat it and eat it well! Since I will not strictly adhere to the Paleo lifestyle finding a gluten and wheat free pizza crust will be one of my top priorities. Once I've found one that is up to his standards, and mine, I will share it with you ASAP.
The hubby and I have a get away planned so once I am back from that this diet will get going in full on mode (I am still waiting on all the specific directions from the GI doctor), I can't ask my parents, who will be taking the kids for us while we are out of town, to take on this challenge when I haven't even set it up or even tackled the first of the obstacles myself yet.
So stay tuned for even more restrictive ingredient recipes that are good!
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