Food Sensitivities in Breastfed Babies

In my lactation practice I am seeing more and more babies with food sensitivities (allergy and intolerances). In Australia, ten percent of babies have food allergies 1, also these numbers don’t include intolerances (non IgE mediated reactions). Unfortunately, many mothers and their uncomfortable babies are dismissed by the medical system, especially if they are gaining weight (or “thriving” – not my definition of thriving!). What tends to get ignored, is the impact on both mum and baby’s wellbeing and enjoyment of breastfeeding.  

These are all signs and symptoms of food sensitivity that I have seen in babies:

  • hives
  • rash
  • nasal congestion
  • eczema
  • cradle cap
  • low weight gain
  • unusual bowel motions (excessive number of stools or mucus or blood in stools)
  • vomiting /reflux after feeding
  • excessive hiccups or gas
  • high-needs baby
  • constant sucking
  • difficulty getting baby to sleep
  • colic
  • grunting
  • attachment difficulty / shallow latch / twisting away from the breast
  • breast refusal

Food allergens cause irritation to the gut lining, causing inflammation and discomfort. This can lead to babies taking smaller feeds at the breast, fussing and sometimes refusing to feed much at all, leading to low weight gain. Low weight gain can also be caused by impaired nutrient absorption in the bowels. Other babies gain lots of weight because they have an increased need to feed for comfort.

Before trialling an elimination diet, it is a good idea to see a lactation consultant (IBCLC) or someone who is experienced in this area. An IBCLC will do a full assessment ruling out other possible causes of discomfort or breastfeeding problems (eg. lactose overload, supply issues, tongue tie). A doctor can do a thorough check to rule out medical issues such as UTI, GORD etc. Bodywork can play a role. As a craniosacral therapist I can treat unresolved physical and emotional tensions in the body that may be contributing to unsettled behaviour.

After other causes have been ruled out, the first step is to trial a dairy elimination diet for 2-3 weeks. Cow’s milk protein is the most common cause of food allergy and intolerance in babies. Some mums choose to eliminate soy as well, as many babies who are sensitive to cow’s milk protein are sensitive to soy too. If babies are sensitive to dairy, mothers should see improvement after 3-4 days of starting the elimination diet. Stools may take longer to return to a normal consistency. Parents will have to carefully read ingredient lists on packets of processed foods to ensure there is no hidden dairy. Removing cow’s milk from mother’s diet often makes a significant difference. For some mothers this is an easy venture, for others (myself included) it was near impossible. Accidental slip-ups can happen and often there are other foods causing reactions. In these cases I refer mums to a dietitian experienced with helping breastfeeding families. Mothers who need to continue any long-term elimination diet, including dairy-free, should also have their diet checked by a dietitian.

Other factors to keep in mind that can negatively impact bowel function in babies include maternal or infant antibiotics, and the oral rotavirus vaccine (that babies receive at 2 & 4 months). Discuss these medical treatments with your doctor if you have a food sensitive baby. Exclusively breastfed babies are protected from rotavirus through breastfeeding and the vaccine is non-compulsory.

As a mother of a breastfed baby who was sensitive to cow’s milk protein I know the impact food sensitivities can have on breastfeeding, emotional wellbeing and sleep. Parents may be tempted to switch to formula, but breastmilk is still the milk of choice for these babies, providing good bacteria (probiotics), a large range of prebiotics to develop a healthy microbiome, many protective factors, stem cells and gentle exposure to other potential allergens. Most formula is derived from cow’s milk protein, though there are specialised formulas for babies allergic to cow’s milk protein. These are often expensive and taste terrible. There may also be the temptation to enrol in sleep school or hire a sleep consultant, though food sensitive babies do tend to fail sleep school! This also doesn’t help remove the cause of the baby’s distress.

It is a difficult road caring for and breastfeeding, these babies. There is a lot of self-doubt (feeling you are getting parenting or breastfeeding wrong) and an overriding feeling of helplessness. Parents need support and empathy, not to be dismissed or given advice to space feeds or switch to formula.

Here’s my tips to get through the day with a food sensitive baby:

  1. Keep on boobing!
  2. Don’t worry about routines, forming bad habits, or feeding too much.
  3. Do what ever is easiest for you in each moment.

Remember this too shall pass.

  1. *Article inspired by Robyn Noble’s webinar – Recognising Allergies in Breastfed Babies.  

Resources for mothers:

Tongue-tie and Breastfeeding

A tongue-tie (ankyloglossia) occurs when the connective tissue (frenum) under the tongue causes restriction in the tongue movement or function. It occurs in 2.8 – 10.7% babies, more often in boys and can be hereditary.

Anterior tongue-tie occurs when the frenum is attached at the front of the tongue, close to the tip. When the frenum is attached further back, or behind the mucosa, the term posterior tongue-tie is used. This term does not have consensus and the topic of posterior tongue tie (and lip tie) is a controversial one. Research is limited and opinions are divided.

Photo courtesy of Monica Hogan & David Todd

Signs & Symptoms

A baby with tongue-tie may not be able to poke the tongue out beyond the gum line / lips;  and /or may not be able to lift the tongue, or move it side to side. The tongue tip may look notched or heart shaped. This may interfere with correct attachment at the breast, leading to some of these problems:

Mother:

  • Nipple pain and damage
  • Low milk supply
  • Blocked ducts / mastitis
  • Early weaning
  • Frustration, disappointment and discouragement with breastfeeding

Infant:

  • Baby can’t latch or stay latched
  • Fussiness and frequent arching away from the breast
  • Clicking sound while feeding or spilling (poor suction)
  • Poor milk transfer – frequent small feeds or long inefficient feeds
  • Low weight gain
  • Chewing or chomping at the breast

How to treat:

Frenotomy is a minor surgical procedure performed using scissors. It is quick and the baby will often settle soon after. It can be performed without anaesthesia. Scissors are often used when the frenum is thin and anterior and unlikely to bleed much.

Laser frenectomy is an effective method for “posterior” tongue-tie / submucosal tongue-tie and lip tie that controls bleeding well. This is generally performed by a paediatric dentist or surgeon. Different lasers are used: water-lase is commonly used with infants.

Risks:

Infection is rare. Some babies may become fussy at the breast for a period of time afterwards. Bleeding is common – sucking/feeding straight after the procedure usually resolves this. There is a small risk of reattachment and scarring that may require a repeat procedure. Wound stretches and other oral exercises are often advised for this reason but may distress the baby and lead to oral aversion.

My approach as an IBCLC/bodyworker:

Sadly, I have seen many parents (and babies) whose breastfeeding journeys have been negatively affected due to missed tongue-ties. Babies with feeding challenges need to have an individualised, comprehensive feeding and oral function assessment. An IBCLC can rule out nipple infections and positioning and attachment issues which may potentially avoid surgery. Since becoming a craniosacral therapist, I further understand how cranial nerve compression and tension in the body can also cause similar symptoms to tongue tie. The tongue may be restricted, but not specifically due to the presence of a tight frenum. A couple of sessions of cranio/bodywork beforehand may address these issues and have a positive impact on breastfeeding. A procedure may be avoided or it may become clearer that a release is necessary. Cranio after the procedure can help to resolve any stress and to optimise function.

There is so much controversy, and limited research, around tongue ties, that it can be difficult for parents to know whether to go ahead with a procedure to release a tie – especially with posterior tongue-ties and lip ties. Where there is doubt about the presence of a tongue-tie, cranio is a gentle, less invasive approach than laser frenectomy. But ultimately, treating the tongue-tie can make all the difference to breastfeeding success.

Contact me for a lactation consultation, tongue-tie assessment or cranio pre or post tongue-tie release.

Laryngomalacia and breastfeeding

Laryngomalacia, also known as “floppy larynx”, is a congenital condition where tissues are softer around the voice box and collapse in, partially blocking the airway. These babies tend to present first with feeding difficulties, struggling to transfer milk, and as such, lactation consultants are among the first health professionals to notice it. It may not be until around 2 months that the characteristic squeaky breathing becomes a noticable pattern. I have seen this condition quite a bit in the last few years (and most likely missed this in my first few years of being an LC), I write this article to share my experience as I have found it difficult to find information on the internet that specifically pertains to how breastfeeding looks in these babies.

What to look for:

  • Squeaky noise when breathing in.
  • Noisy when feeding or during sleep or when lying on their backs.
  • Low weight gain.
  • Poor milk transfer (breast and/or bottle); lots of pauses when feeding; long inefficient feeds.
  • Spilling or choking or coming off the breast to breathe.
  • Mouth breathing (babies should breathe through their nose).
  • Pale skin.
  • Weakness eg. floppy arms.
  • Chest retractions – skin sucking in around ribcage eg tracheal tug – when the skin sucks in at the bottom of the neck, between the collar bones.
  • Reflux is common


Breastfeeding can be challenging for these babies, as they understandably prioritise breathing over feeding. They may seem stressed when breastfeeding, stop feeding before taking a full feed and struggle to gain weight. Some babies do better when feeding from a bottle, though others struggle with bottlefeeding too; taking a long time to feed and needing to pause often. Mothers benefit from support from an IBCLC experienced in this area. We have tools to assess milk transfer and can support you with a feeding plan. It can be helpful to do a 24 milk production assessment; weighing the baby before and after feeds for a day, to work out how much extra milk baby needs. Some mothers end up predominantly pumping their milk for their baby. Though, some babies will gain enough weight with smaller, very frequent feeds. Upright positioning or any position that ensures the babies neck is extended (to open the airway) is often better in these babies.

It is important to see a doctor for diagnosis. A GP will likely refer to an ENT (ear, nose, throat) doctor. Most babies improve with time, the condition is usually outgrown during the first year of life. For babies with mild to moderate laryngomalacia, treatment is usually to wait and watch, weighing baby regularly to ensure the baby is taking enough milk to thrive, though I have worked with a few babies with severe laryngomalacia who needed to be hospitalised or have surgery.

Have you breastfed a baby with laryngomalacia? Please feel free to leave a comment below to share your breastfeeding journey so that other mothers may benefit from your experience.

Top six reasons your baby would benefit from cranio.

Cranio is a holistic, gentle treatment that supports the nervous system to down-regulate, which triggers the body’s own self-healing mechanism.  Because it is so gentle, it is perfect to use with babies. Plus babies systems are so potent and ready to shift easily back to balance – some just need a little cranio support.

Because cranio is not well known, parents may not know the kinds of things that cranio is good at addressing. Here are the top six issues I see in my cranio/lactation practice:

1. Your baby had significant bruising around their head after birth

Some babies complete their birth journey looking pretty beat up!

Check out the squashed nose and facial asymmetry on this little bub, I had the pleasure to treat. He was not able to latch onto the breast without a shield and had issues transferring milk (before cranio).

And that bruise on his head -ouch!

If after birth, your baby had significant bruising, forceps marks, chignon from vacuum extraction, a cephalohematoma or other abnormal head shape, it is a sign that baby has undergone some difficulty during birth and would benefit from cranio. Hospital staff are used to these kinds of injuries and often dismiss it, knowing that superficially these marks do disappear over the following weeks to months. But there can still be underlying physical and emotional tensions that are not yet integrated. These stress imprints remain in the tissues in obvious and less obvious ways. Babies may be very sensitive to touch on their head and may react strongly to clothes being pulled over their head. Other infant interventions like suctioning or fetal scalp monitors may also impact the tissues, in less obvious ways but may still be held in the system.

Cranio can find these holding patterns in the body and facilitate their system to gently release, leaving a sense of peace in the baby’s system.

2. Labour was prolonged or very fast

Babies have their own experience of birth, often linked to their mothers, but with their own unique pressures and stresses. If they have felt stuck for any reason or under a lot of pressure for a long amount of time this can influence their bodies, in particular the nervous system and the neck. They may have felt scared or panicked. If a prolonged labour ended up in emergency c-section then the baby may also feel disoriented, this can show as arching at the breast or pushing with the feet, the baby can feel stuck in the birth sequence of pushing from the uterine walls.

On the flip side, a fast birth may be a shock to the baby and can show up as activation in their nervous system.

Cranio acknowledges the birth experience and allows these physical and emotional tensions to release leading to happier well-adjusted babies.

3. You have been told your baby has a tongue tie

There is much controversy around tongue tie recently. Research is lacking around posterior tongue ties and lip ties, but that doesn’t mean they don’t exist. It helps to have bodywork before undergoing a tongue tie release. Cranio is a form of bodywork that can address other issues that may mimic the symptoms of tongue tie such as, cranial nerve dysfunction, tight fascia or general nervous system activation. If a couple of cranio treatments improves breastfeeding then the tongue tie procedure may be avoided; if it doesn’t, then the parent can feel confident that the procedure is necessary. It is also recommended to schedule a cranio treatment within 48 hrs of the tongue tie release, to optimise function and to reset the nervous system.

4. Your newborn has difficulty latching to the breast

Newborn babies have natural instincts to latch themselves to the breast after birth, if they can’t then there is usually a good reason for it. Often the mum feels like she is doing something wrong, but it is actually because the baby is in pain, tense, stressed or medicated from birth. Perhaps there is a tongue tie or tight jaw muscles? Cranial nerve function can be impeded due to compression of cranial bones which can affect tongue function and sensation. The earlier cranio treatment is given the better in these circumstances.

5. Your baby cries a lot

Babies cry to communicate and once that need is met usually stop crying. If your baby cries inconsolably or with a high pitch then they may need some cranio support. Some babies have musculoskeletal pain or discomfort from birth. Others have a strong need to tell their birth story through memory crying. I have successfully treated babies who have cried excessively since birth. Cranio provides deep listening as well as addressing any physical tensions and may help get to the root cause of their suffering.

6. Baby has a head preference/torticollis or breastfeeding is painful on one side

This gorgeous little guy needed a few cranio sessions for torticollis that was affecting latch at the breast and also causing him discomfort.

Babies with a stiff neck tend to have trouble with positioning and latch. Tight inutero environments and/or asynclitic positions during birth may impact the neck/shoulders and jaw and other parts of the body. This can cause breastfeeding difficulties which tend to be slow to resolve on their own. Cranio helps the body let go of these restrictions and then breastfeeding often becomes easier.

Birth is a formative experience. Its impact is imprinted in the tissues of the body and can influence the health and wellbeing of the person from infant to adulthood. Early cranio treatment can prevent future difficulties such as headaches, anxiety and more.

As the twig is bent, so grows the tree

Alexander Pope

Often an hour or so of skin to skin after birth helps the mum and baby to integrate the birth experience and let go of any held tensions; sometime this doesn’t happen, sometimes it does – but bub needs more support.

Contact me to book your baby in for a treatment.

Photos used with parents permission*

Antenatal lactation consults

Occasionally I am asked to do an antenatal breastfeeding consult. This is a great idea for all women planning to breastfeed, but particularly for mothers having subsequent babies with a history of difficult breastfeeding issues; those that did not breastfeed for as long as they had planned. There is also a huge benefit of this personalised care for women with specific medical problems who suspect there may be supply issues, Having the right information and resources up front can help to optimise milk supply and breastfeeding success.

Forming a relationship with a lactation consultant beforehand makes it that bit easier to obtain help post-partum. Mums can be overwhelmed, exhausted and in pain and can be shocked to find out that there is not a lot of support within the system. This varies depending on place of birth or whether there is a free lactation clinic within the bounds of their locality. Child health nurses do their best but are often time poor and their breastfeeding education varies from individual to individual. Dads/ partners are often the ones to call private lactation consultants when they have reached a dead-end of support for their partners. For this reason it is often recommended that partners also attend breastfeeding education consults so they have the information and tips to provide support.

Having a basic understanding of the physiology of breastfeeding and what to expect from a breastfeeding newborn can make a huge difference to stress levels of new parents. Some private health funds do cover antenatal lactation consults. For a slightly cheaper option the Australian Breastfeeding Association does some great group classes on weekends – I used to teach these myself. Unfortunately you cannot rely on many hospital based breastfeeding classes – the information is minimal and sub par (please correct me if things have improved since I had kids).

If this sounds like it would be helpful, please get in touch to set yourself up for a smoother breastfeeding experience – $130 for 1.5hr consult.

Low-cost baby cranio clinic

Here are the new dates for the next three months.

I am offering a monthly clinic for babies to receive biodynamic craniosacral therapy – by donation. All babies should have the opportunity to receive cranio, regardless of their parents’ financial situation. This is a great opportunity for your baby to experience this gentle therapy. Read below for more details….

Photo by Pixabay on Pexels.com

Who:

Pre-crawling babies (babies who have not received cranio before will be prioritised)

What:

Cranio is a light touch form of bodywork that is non-manipulative. Jenny uses a listening touch to calm babies nervous system, sparking a biological process, unique to each individual, to release held tensions, stresses and trauma from the body. Babies often find it to be deeply relaxing. Parents often report that baby is calmer, easier to settle and more comfortable in their body.

Why:

Cranio may help:

  • breastfeeding difficulties
  • fussy, hard to soothe, irritable babies
  • babies who have had an assisted birth (vaccuum /forceps/ C-section)
  • babies who experienced a fast birth or excessively long birth
  • babies who vomit frequently
  • newborns who do not wake for feeds
  • babies with digestive or sleep issues
  • premature babies or babies who have been separated from their mother.

When:

  • Thursday 22nd October – 9.30 – 2.30
  • Thursday 26th November – 9.30 -2.30
  • Thursday 17th December – 9.30 – 2.30

Where:

Pregnancy and Breastfeeding Clinic – 74 Nollamara Ave, Nollamara.

Cost:

Donation based – suggestion at least $10. (*usual cost $60). If you find the treatment to be helpful for your baby, I would appreciate a facebook review.


Places are limited and by appointment only. So book early through the website or phone 0435 309 397.

Cranio for babies with a head preference

I recently had the privilege of working of with two babies who had a head preference and cranio was very helpful in increasing range of motion and infant comfort.

One little boy had significant torticollis from inutero positioning. This prevented him from latching well to the breast. His mum was “amazed” by the improvements. She herself booked in for a few sessions of cranio, it was so interesting to see the same constrictions show up in her body too. Baby shows much more progress when you help to release the jaw/neck tightness in mum.

Another baby I worked with over three sessions had significant neck tension and discomfort, which we suspected was from an external cephalic version (ECV). He was in a breech position and was assisted to turn head down while inutero by health professionals. His mother noted how painful the procedure was for her as she felt his head when it hit her pelvis. For the baby this can be a disorienting experience and, by the sounds of it for this baby, painful too as his head came into contact with her pelvic bones. He was extremely unsettled since birth. After two treatments, he was noticeably more comfortable in his body, sleeping better & crying less.

It is important to note that mums also need to be involved in treatment. It still astounds me to feel the same constriction patterns arise in the mums body. Often full healing is not possible until the tight jaw/shoulders/neck resolve in mums body. Mums and babies are so connected and often mirror each other body patterns.

Cranio is such a gentle and sensitve way to approach these kinds of injuries. Often if touch is the cause of the injury (despite best intentions), then the spacious empathic listening touch of a craniosacral therapist is the perfect way to create a sense of safety around touch in order for the body to release tensions and trauma.

For best results book a birth trauma package – three treatments spaced one week apart (including at least one mum and bub treatment).

Insufficient Glandular Tissue as a cause of low supply

This week I worked with two mothers who were struggling with low supply due to insuffient glandular tissue (IGT). They didn’t feel their milk come in, they had minimal breast growth during pregnancy and they were needing to top up with almost full feeds of formula. Noone had mentioned to them the possiblity of IGT.

IGT is not well known among health professionals working with mothers and babies, or other mums. They are often given well meaning advice that does not work and may feel as though they are doing something wrong or failing their baby. They are not! Unfortunately there is not a lot of research behind this heartbreaking condition. Diana Cassar-Uhl (IBCLC) has contributed to the field of knowledge through research and written a fantastic book. We do know that the glandular tissue, where milk is made and stored, is underdeveloped, but not necessarily why. It can be hormonal or due to circumstances surrounding periods of breast development (inutero and during the teenage years). Mums may make as little as a few drops of milk or up to 3/4 of the milk, but despite their best efforts to increase supply need to supplement with formula (or donor milk).

It is often not until they consult with an IBCLC that they understand the reasons behind their milk supply struggles and then get to set realistic expectations around increasing supply or to make peace with their breastfeeding journey. Understanding their body and its limitations clears any doubt or confusion. IBCLC’s do have tools up their sleeve to support mums to work out exactly how much milk they make and tools to support supplementing at the breast. Ultimately the diagnosis can be healing in and of itself.

If this resonates please seek the emotional support and knowledge of an IBCLC.

For a more detailed discussion of IGT see this resource.

Sleepy Newborns

Did you know that cranio can help to wake up sleepy babies? I have worked with many babies whose mothers have plenty of milk but they are unable to stay awake long enough to drink it. This is a frustrating situation. Relying on a breast pump and topping up with a bottle is a full time job and also runs the risk of bottle preference (where baby gets used to a constant flow of milk).

You can lead a horse to water but you can’t make them drink

Sometimes there is a tongue tie that is causing the baby to tire when breastfeeding.

Sometimes they are born too early. This includes babies induced. Being born at 38 weeks may be considered 2-4 weeks early for that particular baby.

Sometimes there has been a medicated birth and the baby has not fully integrated the medication / anaesthesia into their system. Anaesthesia or opioid medication has a dissociative effect on the nervous system. It is helpful because there is a temporary separation from a painful experience but on a more subtle level, there is a separation from the body.

This is where cranio comes in. I have treated sleepy babies who are not yet fully present in their bodies due to a medicated birth – one session of cranio can bring them out of a dissociative state and into the present moment – it breaks the pattern in the nervous system. This is why cranio is also helpful for anyone who has recently undergone surgery.

*I say all this with no judgement. I, too, have had a highly medicated, induced birth. My son was too sleepy to breastfeed when he was born and his first feed was a bottle of formula. I didn’t know about cranio back then (or expressing colostrum) and wish I was able to arrange this gentle treatment for my son.

All Good Things…

After 4.5 years at Baby Steps Health Centre, I have made the decision to leave so that I can focus fully on building Flow Cranio & Lactation. I have thoroughly enjoyed my time working there and am grateful to the team for their support and expertise.

But all good things must come to an end.

If you first met me through Baby Steps please let your friends and family know to book me for lactation support through my business rather than the clinic.

If you, or your baby, have benefited from my lactation or cranio support – please tell your family or friends or other mothers at mothers group. Or consider writing a google or Facebook review.

Thanks for your support xx