Page 13 - Today's Dietitian (February 2020)

Teh’s maternal instinct was right. She intolerance or allergy is identified, and changing mom’s diet leads to improved
saw a dramatic improvement in her son’s the baby is formula fed, is to change to a outcomes in babies with MSPI, and
reflux and colic after eliminating dairy hydrolyzed infant formula,” says Nicole formula is not indicated.”
from her diet. Lattanzio, RD, CNSC, CSP, a Phoenix- In some cases, formula may serve
Fortunately for both Carroll and Teh, based dietitian who owns The Baby as a temporary intervention. “It really
they possessed the skills as dietitians to Dietitian, PLLC, and works with fami- depends on the baby and if they’re
do their own research and learn about lies to select the most appropriate infant thriving despite having MSPI,” Lattan-
and understand their infants’ condi- formula. “These formulas are hypoal- zio says. “If baby is having issues with
tion. But for the general public, access to lergenic and available over the counter. growth and possibly anemia related to
medical professionals who are aware of They’re appropriate for both milk and MSPI, he or she may need some formula
MSPI can be hit-or-miss, leading many soy protein intolerances as well as other supplementation during the time mom
to turn to the internet for answers. allergens such as eggs.” is adjusting her diet.”
“A big problem is that moms are des- However, not all babies respond well Since MSPI often resolves near the
perate and cling to inaccurate infor- to a hydrolyzed formula. “If baby contin- end of infancy and babies start solids
mation shared in Facebook groups ues to have symptoms of intolerance or around six months, it’s important for
or blogs,” Carroll says. “This type of allergy with a hydrolyzed formula after parents to start with solids their chil-
‘research’ can be helpful, but it can also about two weeks, the next line of treat- dren haven’t reacted to and try only
be dangerous because it can encour- ment is an elemental infant formula,” small amounts of the problematic foods
age additional restrictions that are not under the guidance of a pediatric gas-
always necessary.” troenterologist and dietitian once other
Inspired by her own experience, Milk soy protein solids are well tolerated.
Carroll founded a blog called Dairy- “I remained dairy-free for about 10
Free for Baby (dairyfreeforbaby.com), intolerance is a months with both children,” says Teh,
an evidence-based online resource for condition that whose second child experienced both
women breast-feeding infants with milk and soy intolerance. “I reintro-
MSPI. There, she shares creative dairy- affects somewhere duced both foods very slowly. I started
free recipes and credible information on with foods that had dairy and soy as
managing the condition for women who between 2% and ‘hidden’ ingredients, and, when that was
are suddenly faced with going dairy-free. tolerated, I slowly advanced to foods
Because management of MSPI comes 5% of infants, often that had more dairy or soy in [them].
during the chaotic time of having a new Sometimes it would be through what I
baby, families are sure to benefit from a presenting around was eating, and other times it may have
supportive medical team that includes the infant’s third or been in a food I was feeding directly to
the care of a dietitian. my baby.”
For new moms who want to breast- fourth week of life. Carroll had a similar experience. “We
feed, RDs can help by guiding women started with one food category at a time
through a diet free from dairy and pos- when my son was a year old,” she says.
sibly soy. A woman should learn not only “Luckily, he had outgrown everything!”
alternative sources of protein and cal- And though some women may dis-
cium to support her needs for lactation Lattanzio says. “These formulas are cover that they enjoy having less dairy in
and postpartum recovery but also the made from 100% free amino acids and their diets long-term, many are ecstatic
many hidden sources of dairy and soy, are hypoallergenic as well. Elemental to relax about reading labels and once
such as supplements that contain lac- formulas are significantly more expen- again enjoy their favorite foods. “I can’t
tose. Dietitians also can serve as integral sive and require a prescription to obtain; describe how wonderful it was to eat
members of the family’s medical sup- therefore they should be used only when cheese again,” Carroll proclaims.
port team, coordinating with pediatri- necessary.”
cians and gastroenterologists on when Dietitians also should support Diana K. Rice, RD, LD, CLEC, is known as
a family should consider eliminating mothers who wish to continue breast- The Baby Steps Dietitian and is the founder
additional allergens and advocating for feeding despite pressure to switch to of Diana K. Rice Nutrition, LLC, where she
families who suspect their infants have formula from friends, family, and other works with families to eat well and reduce
MSPI when others on the medical team providers. Lattanzio often finds that the stress surrounding their food choices.
are doubtful or uninformed about the providers sometimes see switching She specializes in pre- and postnatal
condition. to formula as the preferred first line nutrition as well as feeding young children
Of course, not all new mothers choose of treatment with MSPI. “I encourage and is a strong advocate for cooking with
to or can breast-feed. In these cases, moms to advocate for themselves and kids, family meals, and body positivity.
special formula is indicated, as infant their breast-feeding goals. If mom is
formula almost always contains either open to changing her diet and has the For reference, view this article on our
milk or soy proteins. “The initial inter- education to do so, that should be the website at www.TodaysDietitian.com.
vention when a milk and/or soy protein first treatment. More times than not,
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