06 June 2009

Introducing Foods

I've decided to hereby completely ignore the photocopied brochure Global Baby's pediatrician gave me regarding the introduction of foods and follow the English-language book from the US instead.

When I follow the US guidelines, Global Baby does just fine. He spits up maybe once or twice a week. When I decide to try a new food using the Swiss schedule, clothing changes tend to happen!

It astounds me at how different the two schedules are! Are babies really that different?

Let's go back and talk about Global Baby's lactose intolerance. In the US there are many options available for babies who are lactose intolerant. In Switzerland, we could not find a single formula that worked for him. Once I started reading labels, I discovered why. It is virtually impossible to find formula that doesn't have some lactose in it. Even the soy formulas had lactose added!

And when we were still in the US and Nicholas was having difficulties, the US pediatrician told us to try the lactose-free formula first. Worked like a charm and Global Baby instantly stopped having stomach problems. The pediatrician said lactose-intolerance is quite common, especially in babies under 6 months old. That is the one they usually start with when a baby is having discomfort.

However, the Swiss pediatrician said lactose-intolerance was extremely unlikely. He would be more likely to have a milk protein allergy.

Complete opposite of the US theory. I suppose it's possible, given Swiss cuisine, that Swiss children are simply not allowed the luxury of lactose intolerance. But is it also possible they are far less likely to have it?

So I've been wondering. Is there some kind of genetic link to this and that is why the advice is so diverse? Is it possible that babies of some ethnic heritage have more problems with certain foods than others?

When we first considered adoption we looked at the various options, international and US domestic. One article intended for parents adopting from Asia said that Asian children are quite likely to have lactose intolerance and therefore should be watched closely when given dairy products. So, I guess it is possible.

Or is it that Swiss children simply have more stomach discomfort and vomiting and that it is considered within the norm.

What have been the experiences of other expat parents in Europe?


G in Berlin said...

It's a fact that lactose intolerance is an ethnically related trait. In the US, when friends adopted Asian children, it was the first thing they were warned of. Here in Germany, they also allow infants to eat popcorn and nuts and honey: my ped said nut allergies were unknown. Well, perhaps so, because Germany is pretty homogenous genetically. But honey is a botulism hazard for infants and that has nothing to do with genetics. So, even though I love my ped, I make certain to do my own research. (After all, Germans also believe in homeopathy, a ridiculously crank belief).
Stick to the US feeding schedule- they updated it recently, too. And I started with fruits. not vegetables- what matters is when you start- in the 5-6 month range usually, and no cow's milk until after 12 months. Good Luck!

Jennifer said...

I believe native americans and african americans are also more likely to be lactose intolerant; there is something genetic to it.

I do not think Swiss parents just sit back and let their kids experience discomfort and vomiting and say, eh whatever. In my experience Swiss (and German) parents are very particular about what their kids eat and hate to see their children in discomfort as much as everybody else. That's why the Mutterberaterin appointment are always booked solid, at least in my neighborhood.

Pointless Drivel said...

I must say, this is the first time I recall hearing of the lactose issue with Asian children. We have one from China and one from Korea, and, as you might expect, many friends and acquaintences with Asian children, as well, and it just never comes up.

Of course, it's entirely possible we were warned, but I wasn't paying attention.

I've also heard the peanut allergy is much more prevelant in North America than other parts of the world, so I suspect there is a strong cultural element.

Global Librarian said...

PD - I know you were told at least once. Because I mentioned it to you and you said, "Huh, didn't know that." From all the articles I saw when we were researching adoption, I am quite certain the agency provided you with the information at some stage as well. You just weren't paying attention.

Jennifer - I didn't mean to say that Swiss parents callously allow their children to cry and be in pain. I just wonder if culturally, there may be a difference between how much crying and spitting up is considered normal.

For instance, with just a little spitting up and a few minutes of crying per day, our US pediatrician was already helping us determine the cause and resolve it. The Swiss pediatrician said it was completely normal up until Global Baby began projectile vomiting so violent that he would actually hit walls and ceilings!

Of course, it may also be that with all the cultures and genetic pools intermingling in the US, pediatricians have learned to be far more cautious about such things. Switzerland is very homogenous and perhaps as a result there are conditions they simply do not see.

By the way, it's only a very small part of his genetic composition, but Global Baby's biological great-grandmother was a member of the Cherokee Nation (she was 1/2 Cherokee). Perhaps that is where the lactose-intolerance comes from?

Pointless Drivel said...

The Ways and Means Committee said the same thing. We were warned, but, since it didn't affect us, I effectively put it out of mind.

On the serious side, in reference to the peanut allergy and, by extension, other subjects: The WMC recently found an article in one of her medical journals theorizing the increase in allergies and other similar sensitivities stems from lack of exposure, not the other way around.

In essence, the authors proposed the fear of peanut allergies among a very small percentage of children led to the over-reaction of recommending no exposure at all. Kids stopped slowly building immunities, and the natural reaction that was nearly unnoticeable at a younger age became a potentially dangerous reaction a few years later.

By the same token, it has been shown children who spend time in day care early in life have much lower instances of asthma when they are older.

Marcy said...

I think so much of the "standards" decided on for babies are based on little research and even less proof, and that's part of why advice varies so much. Just look at peanut recommendations-- we used to think late exposure helped, now we're finding the opposite may be true? How good can these studies be if they outright contradict each other like this?

I also remember being very amused by the very, very different recommendations for what I could/not eat as a pregnant women when looking at US vs Swiss standards. The US has a list a mile long of what you can't eat. It Europe it was basically no undercooked meat, and no salad greens (which aren't seen as much of a threat in the US).

It also does seem reasonable that there could be genetic differences. There also sometimes seem to be diagnoses that pass in and out of "vogue." Gas used to be blamed for everything. Now most fussy babies apparently have acid reflux. In another few years they will likely have a different popular diagnosis altogether.

When D was 4 months and started struggling with a milk allergy, our pedi gave us meds for acid reflux to help with the spitting up. The medicine was a PILL. THAT NEEDED TO BE DISSOLVED. FOR BABIES. He said that was the ONLY reflux medicine available in Switzerland (or at least Geneva).

Clearly many things about children and medicine make little sense.

G in Berlin said...

It's actually a very interesting topic. The incidences of peanut allergy are ethnically related and it has been shown that groups that eat peanuts during pregnancy (eg Indian food) have lower incidence of peanut allergy. I ate a lot of different foods when pregnant, but there are also no incidences of nut allergy in my family, so I had little fear. I think the studies you are referencing re asthma actually said a diryt (you know, normal) house and exposure to pets decreased later incidence of asthma.
I also think that when you look at what food are contraindicated, you need to look at groups: I avoided sushi my first prenancy and my second was just picky as to exposure. I would bet that Switzerland isn't too concerned about mercury levels in river fish, because I would think that would not be a problem to the Swiss. And toxoplasmosis is a standard check in France and ignored in the US (where I had a real toxo scare). the only solid study I rely on is when to start solid foods and milk products: it was a very good study.
I actually thought colic was now considered a neuro overreaction to excess stimuli that goes away as the brain cn handle it: that is, there's nothing one cn do but live through it.

Pointless Drivel said...

I've avoided sushi my entire life, and there's never been even a remote chance of getting pregnant.

The medical establishment, at least in the US, continually contradict themselves, and they go to extremes. Fats, wine, coffee. All things that have been good and bad, depending on what theory is picked up by the media.

It is as if they are so afraid of lawsuits, they will tout whatever the current research indicates, so they can at least cover themselves if they wind up in court.

Hey! I just blamed both lawyers and the news media! Excellent!

G in Berlin said...

PD, we disagree. I think the medical establishment is pretty stable. I think everything you mentioned is the basis of fad doctors and the media.
Also, Germans are more litigious than Americans. Hard to believe, isn't it, after reading general media accounts:).

Global Librarian said...

That's all just plain confusing. Now I don't know whether to try peanut butter when Global Baby is a year old or not. His birthmother is allergic to nuts, as are other members of his birth family. She definitely didn't eat peanuts while she was pregnant with him!

Am I doomed to never have peanut butter in the house again? How will I survive?

CanadianSwiss said...

Both your post and the comments were very interesting. I don't have children myself, however, I do believe that the ethnic background has a strong influence on what allergies/intolerances might develop. If you look at the oriental cooking, nuts are used in many meals, as is fish in Japan for example, and you'll find very few of these allergies in children growing up there.

As for the dread of no having peanut butter that you love so much in the house, isn't there a simple test that can be made on Global Baby before you try it?

Anyway, I hope you find the right answer/best solution for you and GB.

Dr Spouse said...

On the peanut thing, there are some recent studies in the Uk with allergic children that introduce them gradually in tiny, tiny amounts (don't try this at home) and the children stop being allergic.

I think they are also stopping the no-peanuts advice here, though I've pointlessly avoided peanuts in all my pregnancies because Mr Spouse is allergic to everything (except peanuts).

Anonymous said...

Disclaimer: The medical opinions and information provided by Pointless Drivel do not necessarily reflect the opinions of the nurse practitioner residing in his home.

Anonymous said...

Pointless Drivel forgets about the time he said, "hey, why do we have soy milk in the fridge". CD

dj said...

I've come here from Dr. Spouse, where I have arrived from Niobe. I live in Romania, so not so far from Switzerland. From what I've found out, it's the protein in cow milk that's an allergen. Lactose is, actually, a form of sugar very easily digested, especially formulated (by nature) for babies. Babies and children need sugars to grow up, and the first sugar at their disposition is lactose. So, the HA formulas are less allergenics. But, of course, this is just what's worked for mines, and I mainly learned this from my paeditrician (specialty gastroenterology) and french magazines.

Anonymous said...

Dropping in a bit late on all this. (GL, I actually got here from a comment you made on a librarian blog, what an interesting coincidence that we are both a-moms as well as librarians!)
We adopted our daughter from China at 14 months. I'm not sure our agency warned us about lactose intolerance among Asians - I rather doubt it, as the social worker said that my 98% Black high school was "diverse"! Sheesh! Diverse is not a code word for "not white"! Anyway, I didn't need to be told because I already knew this. I'm having a bit of trouble understanding how someone could think to adopt from China and not have been exposed to Asians and stuff... Anyway.

Our daughter was 14 months when we adopted her, supposedly mostly on milk-based formula mixed with rice cereal and fed through a nipple with a big slit in the top. She also ate noodles and green beans, and "cake" (fish? soy? chocolate?), reportedly. We kept using the bottle in the mornings for quite some time, for the attachment benefits. Once we stopped adding the rice cereal, she spit up a LOT. Our US ped was pretty unconcerned, unlike yours. I tried a few things, but it didn't seem to be a lactose problem. In fact soy seemed to make it worse (and reportedly is a worse allergen than lactose, sigh, who can figure these things out). My best theory was that she just drank too fast because she was used to thicker stuff. Interestingly, she's now 5, and no signs of lactose problems yet - and we eat a fair amount of cheese and she likes cow milk. I expect she will develop some degree of intolerance, but perhaps the use of milk now will make it less of a problem? Who knows?

Here are a couple of links on the very interesting peanut allergy study that showed Israeli children who were exposed early on to peanuts (apparently it is a major ingredient in a first food there) had much less allergy than Jewish children in the UK who did not eat peanuts early.

I gave my daughter peanut butter soon after bringing her home. I figured she'd been exposed to peanuts in China in her foster family. Unfortunately I did it at a park. I say unfortunately because the other moms completely freaked out like I was some sort of devil mom. One said she had her daughter at the pediatrician the first time she gave her pb - hello? allergy doesn't work that way - rarely a strong reaction on very first exposure. Of course I'm already an outcast around here because I vaccinate. Don't get me started.

One more thing on peanut allergy. Apparently dry roasted peanuts like we have in the US are MUCH more allergenic than boiled ones like they usually eat in China and South America and Africa. Apparently there's a whole 'nother allergen or something if you dry roast them. So if you do decide to try early exposure, use boiled peanuts.

Good luck!
Andrea the loud librarian
(and long-winded)