On this page I’m going to attempt to pull together all of the information we have on diet, allergy, intolerances and gastric reflux disease. Some infants presenting with signs of gastric reflux may have their symptoms relieved entirely by changing their diet but the majority will still need medications to control their gastric reflux. However, it is my experience that if there is a food allergy present, it is impossible to gain good control of gastric reflux disease with medication alone.
If there is a history of any allergy (including hay fever) in either parent there is an increased risk that their children will have allergies and if both parents have allergies this is further increased to 50-60%. Even in a non-allergic family there is a 5-15% risk of allergies.
Studies have shown that about one third of infants with gastric reflux disease will have a cow’s milk protein allergy or intolerance.1 Skin prick or blood RAST testing will often not pick up this “gastrointestinal” food allergy as it may be a delayed reaction, and is best diagnosed by an elimination diet and challenge. This involves removing dairy from the mother’s diet if breastfed or a trial of a non-cow’s milk based formula. A trial of a dairy free diet is in fact the first recommendation on our treatment guidelines: Silent Reflux and Managing Uncomplicated Reflux. Some parents have found that unproven forms of testing such as Kinesiology have helped them to remove offending foods. GRSNNZ doesn’t endorse these and would recommend that limited diets also be supervised by a dietician, that a medically qualified health professional be involved (paediatrician, allergist, immunologist etc) be involved and if appropriate the foods be challenged after a suitable time lapse.
Cow’s milk protein allergy should not be confused with lactose intolerance. Breast milk always contains lactose even if the mother is on a strict dairy free, lactose free diet so a baby who responds to a change in their mother’s diet, does not have a lactose intolerance. Lactose Intolerance vs Milk Protein Allergy
For more information on infant feeding options: Infant Feeding and Food and Reflux
Solids should be introduced around six months of age.2 In addition to this we recommend that gluten not be introduced into the diet until around one year of age. See Gluten can cause gastro-oesophageal reflux disease! for more information on gluten. The later we add high allergen solids into the diet the less likely the child is to develop an allergy to them. The high risk foods are cow’s milk, gluten, soy, peanut, tree nuts, egg and fish. Good first foods that are less likely to cause a reaction include plain baby rice, kumara and pumpkin. Taking the introduction of solids slowly should allow you to work out which foods cause problems.
If you have further questions try our site search, our gastro-oesophageal reflux discussion forum at www.everybody.co.nz or contact us.
Bibliography:
Allergy Today Spring 2006 ( page 48 )
Crying Over Spilt Milk Survey December 2006
http://www.allergyclinic.co.nz/
Allergy Today Summer 2006/07 ( page 8 )
References:
1 Gastroesophageal reflux and cow’s milk allergy in infants: A prospective study. URL:http://cat.inist.fr/?aModele=afficheN&cpsidt=3022081. Accessed: 2010-08-21. (Archived by WebCite® at http://www.webcitation.org/5sA3Q7aKH )
2 Ministry of Health. Starting Solids. URL:http://www.healthed.govt.nz/uploads/docs/HE6014.pdf. Accessed: 2010-08-21. (Archived by WebCite® at http://www.webcitation.org/5sA4rODFG
Written by Roslyn Ballantyne (RN), Regional Coordinator for © Crying Over Spilt Milk Gastric Reflux Support Network New Zealand for Parents of Infants and Children Charitable Trust December 2006. Updated August 2010.
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