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Learning to digest: How breast milk and mum’s diet can influence digestion in newborns… and what to eat for happy little tummies!

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By Osteopath, Melissa McDougall B.Clin.Sc. M.H.Sc. D.P.O. 

The digestive tract, like the skin and the respiratory system, is in constant direct interaction with the environment. The digestive tract functions to allow digestion and absorption of food, and just as importantly acts as a protective barrier against other substances from the environment.

 

The newborn baby has an immature digestive system.  Food break down, nutrient uptake and the protective function of the gut are all reduced in babies when compared older children or adults.  Just like rolling, crawling and walking, babies need time to learn how to digest.

 

 

Newborn babies have:

  • Immature function of the muscle controlling passage of food through the oesophagus (food tube) into stomach. (This muscle, when mature, acts to prevent reflux of contents back up the oesophagus)
  • Lower stomach acid production (This contributes to slower break down of fats, carbohydrates and especially protein)
  • Slower and uncoordinated stomach emptying into the intestine (This can lead to increased pressure in the stomach may contribute to reflux)
  • Increased absorption between cells in the intestinal wall (This results in decreased gut protection against environmental toxins and may contribute to food sensitivity)
  • Lower levels of digestive enzymes from the pancreas (This results in decreased nutrient breakdown for and therefore slower nutrient uptake)
  • Gradual establishment of immune function and healthy levels of good bacteria in the digestive tract (Immunity is stimulated by antigen (substances) ingested in breast milk)

BREAST FEEDBreastfeeding is well known to be the gold standard food choice for newborns. The unique composition of human breast milk contains about 45 to 50 % saturated fat, about 35% unsaturated and 15-20% polyunsaturated. Lauric acid and capric acid comprise about 20% of total saturated fatty acids found in breast milk. These fatty acids have potent antiviral, antibacterial, and parasiticidal (kills parasites) properties that support the immune system, offering the breast fed baby protection from illnesses, viruses, protozoa and  bacteria.  As we will see later, coconut oil can increase the levels of these fatty acids in breast milk.

Human breast milk also contains agents that positively affect the growth, development and function of the baby's intestinal wall, the immune system and nervous system of the digestive tract, and thus promote healthy gut maturation.

Unless you consume a very low-calorie diet or consistently eat from a single food group, the quality of your breast milk will stay about the same no matter what you eat. However, research suggests certain foods can act as irritants to the baby's developing digestive tract, and result in mild unsettledness.

As an osteopath, I see many cases of unsettledness, ‘colic’ and ‘reflux’ in babies and most respond very well to osteopathic treatment in just a few sessions. If the baby is showing a slow response, or no response to physical treatment, there is often a dietary factor that is maintaining the symptoms of unsettledness.

Because the baby's digestive tract is immature, variable amounts of a irritating food in the mothers diet can influence symptoms of unsettledness, colic and reflux, and these effects are most apparent in the first few months of life.

IRRITABLE BUBSo what are the most common food irritants in the maternal diet?

  • cow's milk
  • eggs
  • peanuts
  • tree nuts
  • wheat
  • soy
  • fish

Research suggests that exclusion of these foods from the maternal diet is associated with a reduction in distressed behavior among breastfed babies with 'colic' presenting in the first 6 weeks of life.

This does not mean that your baby is allergic to these foods, nor does it mean that you will never be able to eat them. It’s all about timing and your babies gut development.

If your are thinking about an exclusion diet, talk to your health care practitioner.  Exclusion diets should be implemented by a health care professional.  At growing bones we recommend exclusion diets span for 8 weeks, and mothers take at least a probiotic and omega supplement during this time. The aim of exclusion diets are to decrease inflammation and strengthen the gut biome, simply excluding foods for short periods does not achieve this.

The digestive system is a large and complex organ involved in nutrient uptake, waste removal and immunity.  Many digestive processes are poorly developed at birth and mature over weeks to years. Consequently, the baby's digestive tract can be more vulnerable to environmental factors (foods, pesticides, etc.) in the formative years.
Exactly how the mothers diet and breast milk components contribute to 'colic' or irritability in babies is unclear. Some theories include:

  • An immune reaction is stimulated by food 'antigens' in the gut (an antigen is any foreign substance that triggers an immune response in the body). Cow's milk,  egg,  peanut, and wheat antigens have been detected in human milk and immune reactions in the digestive tract of babies.
  • Other research suggests increased absorption between cells in the intestinal wall before full maturity may predispose babies to food sensitivity.
  • Increased levels of digestive tract hormones that regulate gut contractions and movement may also play a role. Hormones, the nervous system and immune system are in close feedback during development and influence each other. It is unclear whether food substances directly stimulate production of these hormones, or they are produced through immune responses.

Other foods have also been noted to effect the sensory (smell, taste) quality or other characteristics of breast milk.
These include:

  • garlic
  • chocolate
  • spices
  • chili
  • citrus fruit
  • garlic
  • gassy vegetables (cabbage, brussel sprouts, broccoli)

garlicThese foods do not always have a negative effect on digestive comfort in babies, For example, one study by the American Academy of Pediatrics found that infants attached to the breast for longer periods of time and sucked more when the milk smelled like garlic!

 

It is important to clarify that this article relates to infantile unsettledness in the first few months of life. Current evidence does not support a major role for maternal dietary restrictions during pregnancy or lactation for allergy avoidance in babies and children. Food allergy, similar to atopic dermatitis and asthma, is more likely to occur in infants with a family history of atopy (asthma, eczema etc).

Tips for promoting healthy, comfortable gut development in your baby in the first two months of life:

  • Identify if there is unsettledness. Is your baby more difficult to settle than your other children were?... more difficult than your friends children?
  • Is there any history of food allergy or atopy in your family? Do you feel sluggish after eating wheat? Are you always congested in your nose?...and more so when you eat dairy? Is there any history of asthma, eczema, dermatitis? Family patterns apply here too.
  • Get a diagnosis. You may see a GP, maternal and child health nurse, osteopath specialising in children, or paediatrician.
  • colici-bebelusiExplore treatment options.  In my experience as an osteopath, there is always an underlying reason to explain why babies are unsettled. These reasons are most commonly physical restrictions or mild dietary irritants, both are not serious, not permanent and treatable.
  • Keep a food diary. See if you can clearly identify a food that may be contributing to your baby's unsettledness before going on an exclusion diet.
  • Be kind to yourself, and take it easy. You are a great mother. Remove the pressure and do what you can each day for your baby. Eat cake sometimes and enjoy it! It is much better to eat stress free and happy, than be overly concerned in following a strict exclusion diet.

So what can mums eat for happy little breastfed bellies?
Some yummy, anti inflammatory food ideas for mum to enjoy during the first few months of breast feeding include:

  • Fresh fruit and veggies & raw salads (organic where possible)
  • Plant foods high in calcium: spinach, collards, kale, Swiss chard, lettuces, rhubarb, mustard and turnip greens.
  • Grains such as buckwheat, millet, brown rice (organic where possible)
  • Sunflower seeds, pepitas and sesame seeds (organic where possible)
  • 100powder_1_1Marine Phytoplankton. A great omega alternative, and the source of all omega in fish. This superfood includes all the amino acids (protein), essential fatty acids omega-3 DHA/EPA, vitamins (B 12 and folic acid) minerals, trace elements, unique anti-oxidants, electrolytes, nucleic acid, enzymes and co-enzymes. 100% pure and safe for breastfeeding. Available at Growing Bones.
  • Small amounts of sea vegetables. These contain loads of iodine, important for many organ systems and processes in the body. breastfeeding women have higher iodine requirements as they secrete more of this element in the urine. Sea vegetables also contain iron, magnesium, potassium, boron, silica, selenium, chromium, essential fatty acids, vitamins (including vitamin D) and water-soluble fibers. However if you have a sensitive thyroid, best speak to your doctor. While just enough iodine is good for the thyroid gland, too much can cause a slowing of thyroid activity.
  • Filtered water
  • Lean protein (can include lentils, legumes and lean meat)
  • LOV EARTH COCO OILRaw coconut oil and coconut products. Research suggests  that breastfeeding mothers who eat coconut oil and other coconut products, have significantly increased levels of lauric acid (three times the original level) and nearly double the amount of capric acid, creating milk rich in health promoting nutrients. A single meal of coconut oil can significantly affect the breast milk fatty acid compositions for 1 to 3 days with the maximum  increase occurring during the first 10 hours. Raw organic coconut oil, coconut paste and dried coconut are available at Growing Bones.

In light of all this information, it is important not to unnessarly restrict nutritious foods from a breastfeeding womans diet. Through this article we hope to educate mothers about the many dietary and osteopathic options to explore when looking to ease symptoms of infantile unsettledness, colic and reflux.

 

References:
Goldman, A,S. (2000). Modulation of the Gastrointestinal Tract of Infants by Human Milk. Interfaces and Interactions. An Evolutionary Perspective. J. Nutr.130(2):426S-431S

Boix-Ochoa, J., Canals, J. (1976). Maturation of the lower esophagus. J Pediatr Surg, 11(5): 748-756.

Carreiro, J.E. (2009). An osteopathic approach to children: Second edition.  China: Churchill LivingStone.

Cucchiara C, Staiano A, DiLorenzo C, DeLuca G, dellaRocca A, Auricchio S. (1988). Pathophysiology of gastroesophageal reflux and distal esophageal motility in children with gastroesophageal reflux disease. J Pediatr Gastroenterol Nutr 7(6): 830-836.

Francois, C.A.,Connor, S.L., Wander, R.C., and Connor, W.E., (1998). Acute effects of dietary fatty acids on the fatty acids of human milk. Am J Clin Nutr 67:301–8.

Greer, F.R., Sicherer, S.H., Burks, A.W., and the Committee on Nutrition and Section on Allergy and Immunology. (2008). Effects of Early Nutritional Interventions on the Development of Atopic Disease in Infants and Children: The Role of Maternal Dietary Restriction, Breastfeeding, Timing of Introduction of Complementary Foods, and Hydrolyzed Formulas. Pediatrics, 121(1):183 -191 doi: 10.1542/peds.2007-3022.

Hill, D.J., Roy, N., Heine, R.G., Hosking, C.S., Francis, D.E., Brown, J., Speirs, B., Sadowsky, J., Carlin, J.B. (2005). Effect of a Low-Allergen Maternal Diet on Colic Among Breastfed Infants: A Randomized, Controlled Trial. Pediatrics, 116(5):e709 -e715. doi: 10.1542/peds.2005-0147.

Hillemeier, A.C., Lange, R., McCallum, R.W., Seashore, J., Gryboski, J. (1981). Delayed gastric emptying in infants with gastroesophageal reflux. J Pediatr, 98(2):190-193.

Mennella, J.A., Beauchamp, G.K. (1991). Maternal diet alters the sensory qualities of human milk and the nursling's behavior. Pediatrics, 88(4):737-44.

Sreedharan, R., Mehta, D.I. (2004). Gastrointestinal Tract. Pediatrics, 113:1044 –1050.

Werlin, S.L., Dodds, W.J., Hogan, W.J., Arndorfer, R.C. (1980) Mechanisms of gastroesophageal reflux in children. J Pediatr, 97(2): 244-249.

About the Author

Melissa McDougall