Maternal Diets and Infant Health

Today, we look at the effect of maternal diets on infant health. Did you know that you can treat the cause of infant reflux with maternal cow’s milk elimination? Here’s our first story.

There has been a longstanding problem among zookeepers of the gorilla. Latin name: Gorilla, gorilla, gorilla.

The problem is that they were throwing up all the time. We’ve never seen wild gorillas barfing, but it had “unfortunately been accepted as” routine by many zoos. What were they feeding them? Well, you know they’re big strong animals; so, they made sure to feed them lots of protein; ya know, cottage cheese, meat, eggs, milk—until a zoo in Germany got this radical idea to try giving them their natural diet. And? “The change…following the alterations to the diet was astonishing.” I mean before, the poor silverback was “regurgitating and vomiting during most of the day.” But by the third day eating what they were supposed to eat, he and the rest were all miraculously cured. Even just “removing milk from captive gorilla diets” led to significant improvements. Cow’s “[m]ilk was historically considered an essential item in the captive gorilla diet,” but they showed that “removal of milk from the captive gorilla diet may reduce [such] undesirable behaviors…and may be a step toward better approximating [their] natural diet.” I mean, giving an animal milk after weaning? Giving an adult animal milk? Milk is for babies! And then giving milk from a bovine to a primate? What were these crazy zookeepers thinking? Doesn’t make any sense!

Reminds me of this landmark study. Eighty-one children presenting with reflux, gastroesophageal reflux disease; so, they were given drugs, and two-thirds got better, but 27 kids still did not. So, they tried eliminating cow’s milk from their diets, and within one month, all 27 were cured. 

“Symptoms of acid regurgitation, heartburn, or both, occur at least once a week in 10–20% of adults [in] the western world”—and, in about up to 25 percent of all infants. Now, it’s normal for babies to spit up occasionally—that’s not what we’re talking about. It can actually get quite serious. Up to a quarter of infants “present with regurgitation severe enough for parents to seek medical help,” and it may just be that they’re sensitive to cow’s milk. “The symptoms of [cow’s milk protein allergy] overlap…or may coexist or complicate GERD” or reflux. Even if there’s no formal dairy allergy per se, there appears to be some kind of cow’s milk “hypersensitivity” among many infants and children with severe reflux.

There are all sorts of invasive tests you can do, like stick pH probes down the poor baby’s throat, but probably “the most practical test in routine [pediatric] practice” is just a trial of a cow’s milk protein-elimination diet for two to four weeks in infants with reflux.

The gold standard is what’s called an “elimination and re-challenge protocol,” where you see “full resolution of symptoms via a strict elimination, followed by recurrence [of the symptoms] on reintroduction of cow’s milk protein.” And, when you do that, take 200 or so infants diagnosed with reflux and then not only put them on a cow’s milk-free diet, but then do the challenge tests. Eighty-five of the 204 infants with reflux were actually suffering from a cow’s milk allergy, or at least hypersensitivity or something.

What we think is happening is that our immune system attacks the bovine proteins as understandably foreign, triggering an inflammatory response, which like irritates the nerves lining your digestive tract, and that results in abnormalities in the rhythmic contractions of the stomach, triggering the regurgitation. And, we’re not just talking about formula-fed infants. Cow’s milk protein allergy “can occur in exclusively breastfed infants, as intact cow’s milk proteins can be secreted in breast milk.” If the mom drinks milk, or eats eggs, it can get into her baby. “Cow’s milk protein and other [foreign] proteins [can] pass into human breast milk. So, “Breast-fed infants with regurgitation and vomiting may therefore benefit from a trial of withdrawal of cow’s milk and eggs from the maternal diet.”

And indeed, that is now the consensus recommendation of both the North American and European Society for Pediatric Gastroenterology, Hepatology, and Nutrition. Anytime you see reflux, let’s first try “a therapeutic trial” of either a cow’s milk protein–free formula, or, “for infants who are breastfed, a maternal strict [cow’s milk protein] elimination diet.” And so, then we can potentially treat the cause “without using unnecessary medications,” and certainly before you start considering performing any anti-reflux surgery on the poor kid.

In our next story, we look at how cow’s milk proteins can pass through breast milk—which may explain why maternal dairy-free diets are so effective in treating infant colic.

Colic affects up to 40% of young infants. Characterized by prolonged periods of inconsolable crying, the condition is often dismissed as trivial by the medical profession, but should be treated seriously. It can contribute to postpartum depression, interfere with breastfeeding, and even lead to the death of the infant at the hands of a parent from shaken baby syndrome.

They’re not just crybabies. Colic is pain. The medical profession has a scandalous history, not just denying pain relief to infants, but routinely performing surgery on infants with minimal or no anesthesia, into the 1980s. One famous case in 1985 was little Jeffrey Lawson, who underwent open heart surgery fully awake and conscious; they just gave him a drug to paralyze him so he wouldn’t squirm. But, like a horror movie, he couldn’t move, but could feel everything. This wasn’t some rogue surgeon; torturing babies was standard operating procedure in the 80s. Not the 1880s, mind you, the 1980s.

The liaison between the American Academy of Pediatrics and the Society of Anesthesiologists commented that the use of paralyzing agents was a standard and time-honored technique. The profession has a history of infant pain denial. They didn’t think babies could feel pain.

Even today, most physicians don’t use painkillers or even local anesthesia for circumcisions, for example—a procedure so traumatic that babies show stronger pain responses to vaccinations, even months later.

The pain of colic is thought to be caused by gastrointestinal discomfort, like intestinal cramping. In my videos on irritable bowel and relaxing the colon before a colonoscopy, I explored the role of peppermint oil in reducing intestinal spasms. So, might it help with colic? 

A few drops of a peppermint leaf solution appeared to cut the number of colicky episodes in half, and reduced daily crying from three hours to two hours, working just as well as the leading over-the-counter drug for colic, called simethicone. The problem is that simethicone has been shown to have no benefit for colic. So, saying peppermint is as good as useless isn’t exactly a ringing endorsement. And, the American Academy of Pediatrics warns about the use of peppermint oil in infants.

One study found an herbal tea preparation to be helpful, but parents have been cautioned not to use them. Not only might tea interfere with breastfeeding continuity, but there is a lack of adequate industry regulation. For example, star anise tea is commonly used for colic. Chinese star anise is regarded as safe and nontoxic, but Japanese star anise is poisonous. They look identical, but Japanese star anise contains a potent neurotoxin, and it has been found contaminating star anise tea in the U.S. So, we shouldn’t give it to kids.

There’s even a report of toxicity from a supposed homeopathic dose of belladonna, also known as deadly nightshade, that evidently wasn’t homeopathic enough. Just because it’s homeopathic doesn’t necessarily mean it’s safe.

It’s no better when doctors prescribe it, though. The drugs used for colic are made from belladonna, too. The drugs may work, but should not be used because of their serious side effects.

What about just good old-fashioned burping? Burping after feeding is, after all, commonly advised by pediatricians, nurses, and parenting websites to promote expulsion of gases that accumulate during feeding, with the aim of decreasing discomfort and crying episodes. But, scientific evidence for the efficacy of burping was lacking—until this 2014 randomized, controlled trial for the prevention of colic and regurgitation (also known as spitting up) in healthy infants. So, what did they find? Useless for colic, and made the regurgitation worse. Burped babies spit up twice as many times as un-burped babies! 

So, what’s an effective treatment? The elimination of cows’ milk protein—thinking colic may be some sort of allergic response. Decades ago, it was shown that infants fed cows’ milk developed antibody responses to the bovine proteins, which may explain why colic can improve after changing from a cows’ milk formula to either a hypoallergenic hydrolyzed protein formula, or a soy-based formula.

Now, breast-fed infants have similar rates of colic as formula-fed infants. But, that might be because breast milk from milk-drinking mothers contains cows’ milk proteins. We know cows’ milk proteins can pass through breast milk and cause certain serious allergic reactions, but what about colic? 

Based on studies of formula-fed infants, colic was already a well-known symptom of intolerance to cows’ milk protein back in the 70s. So, thinking colic in breastfed infants may be caused by cows’ milk proteins transmitted from mother to infant via breast milk, they tried a dairy-free diet for breastfeeding mothers whose infants had colic.

Of 19 infants, the colic disappeared promptly from 13. And, in 12 of those 13, they were able to show that they could bring back the colic by challenging the mothers with a little dairy. For example, baby boy develops colic that almost completely disappears within a day of mom eliminating cows’ milk, and then promptly comes back when mom went back on dairy. The researchers conclude that the treatment for infantile colic in breastfed infants is a diet free of cows’ milk for the mother—a recommendation that continues to this day.

Finally today, we look at how spirulina supplements with toxins from blue-green algae raise safety concerns for nursing mothers.

On his first day of life, an infant is hospitalized with seizures. The researchers concluded that his mother’s daily spirulina use, starting in the fourth month of pregnancy, was likely to blame. I’ve talked previously about the liver and nerve toxins present in many spirulina supplements, but the supplement companies swear up and down that spirulina doesn’t produce these toxins—and they may be right.

But if spirulina doesn’t produce toxins, how is it that toxins have repeatedly been found in spirulina supplements? It appears to be contamination of spirulina with toxin-producing blue-green algae.

So, for example, if you look at the new U.S. “Pharmacopeia Safety Evaluation of Spirulina,” they conclude “the available evidence does not indicate a serious risk…or other public health concern when [spirulina is] properly identified, formulated, and used.” Ah, but that’s the catch. You collect spirulina in some open lake, and you have no idea what other algae are going to crop up.

The researchers report all sorts of adverse reactions in people taking spirulina products, but they attribute these issues to non-spirulina algae toxin contaminants within spirulina supplements, known to be toxic to the liver and cancer-causing. So, unless there’s third-party testing of each batch, which no company could presumably afford to do, I continue to encourage people to avoid spirulina products.