What about elimination diets?

This blog is always handwritten from my perspective and my clinical experiences — no AI slop found here!

Maternal diet eliminations are a common recommendation when a breastfed baby presents with negative symptoms like blood in their stool, oozing eczema, screamy reflux, copious spit up, the list goes on and on. While an elimination is, in my opinion, a very big deal for a breastfeeding dyad, it is only half of the big picture. If a baby IS reacting to maternal diet (which is not always the case but that’s not what this post is about….) the reaction begins with maternal intestinal permeability or “leaky gut”. (The gut is a simple word to describe the entire digestive system.) Our guts are designed to be tightly sealed with a thin layer of protective membrane to keep all ingested foods and everything related to digestion in the gut, rather than leaking through the gut walls and entering the bloodstream.

There’s a common misconception that only proteins can enter the bloodstream through the parents gut and that is what causes the reactions for breastfed babies but that is a very over simplified version of events. Rather than focusing on food proteins as the source of their baby’s reaction to maternal diet, I urge parents to research and read about Lipopolysaccharide (LPS) — LPS is an interesting phenomena within the gut as it’s presence both causes and results from leaky gut. LPS is released from gut dysbiosis and literally breaks down the tight cellular junctions that protects and seals the gut as well as causing downstream effects of systemic inflammation.

(Too much about the potential/eventual effects of persistent systemic inflammation for this post!)

The more the maternal gut wall is broken down, the more LPS is released into the blood stream, the more inflammation is present in the maternal bloodstream, the more the infant’s exposure to inflammatory LPS through mother’s milk, the more infant inflammation and reactivity is possible, the more the infant’s gut wall is broken down.

If this makes sense to you, it should also make sense that “just” finding and eliminating a single food culprit does not solve the big circular cause and effect of leaky gut and constant exposure to inflammation inducing LPS. The highly reactive infant often presenst with reduced symptoms with maternal diet elimination but the magic happens when actual healing is supported to improve the lifelong health trajectory of mom and baby.

My philosophy is that elimination of trigger foods with addition of healing foods and healing lifestyle changes is the holistic care sweet spot for reactive babies. And that, my gentle reader, is where the holistic IBCLC comes into the picture.

The purpose of this article is to show that a simple elimination is simply not enough to promote health through breastfeeding when food reactivity is present. Everyone’s bandwidth for diet and lifestyle changes are different; everyone’s values regarding food and lifestyle are different and everyone’s health history is different. This is not easy work, but it is necessary work and it is a privilege to be trusted to support lifelong holistic health!

1. Gut Microbiota, Intestinal Permeability, and Systemic Inflammation: A Narrative Review.

Internal and Emergency Medicine. 2024. Di Vincenzo F, Del Gaudio A, Petito V, Lopetuso LR, Scaldaferri F.

2. .Role of Metabolic Endotoxemia in Systemic Inflammation and Potential Interventions.

Frontiers in Immunology. 2020. Mohammad S, Thiemermann C.

3. Impaired Intestinal Barrier and Tissue Bacteria: Pathomechanisms for Metabolic Diseases.

Frontiers in Endocrinology. 2021. Massier L, Blüher M, Kovacs P, Chakaroun RM.

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