It’s 4am. The silence of the night is interrupted by the cry of a baby, followed by hasty footsteps and the sweet song of a woman. She lays him down on the changing table, speaking soothingly as tears stream down the child’s face as if in a desperate attempt to run away. When the diaper comes off there is a gasp and so is the mother.
“There was blood in the diaper,” she told Gulf News, recalling that night.
For Egyptian expat Nourhan Tarek, the pregnancy came when she least expected it, after three miscarriages and a failed in vitro fertilization (IVF). She says: “Doctors said my miscarriages were mainly due to genetic abnormalities and something wrong with the cells in the embryos, they are not dividing properly. And that’s why they terminated. I got pregnant but it didn’t turn into a live birth – it always ended in a miscarriage.
She tried for two years and then quit, giving her body time to rest. “This pregnancy happened very spontaneously one year after the IVF cycle, without any effort. It was a surprise. I was scared every time I went to the doctor, I thought it was over now. I was surprised to find the heartbeat. And I was surprised to find that the heartbeat continued on my second visit. And on my third visit. Every time I went there, I expected him to say, “It’s over.” But it continued, and it was easy.
“Looking back,” she laughs, “pregnancy was the easy part.” At the end of her term, she had to undergo an emergency caesarean section, which she believes could explain her daughter’s food intolerances.
Can caesareans cause food allergies?
May be. According to a study that observed more than one million children born between 2001 and 2012 in Sweden, children who had a caesarean section had a 21% higher risk of developing food allergies than those born vaginally. The results of the article were published in “The Journal of Allergy and Clinical Immunology”.
“I was very, very persistent about breastfeeding even though she couldn’t latch on and the milk was delayed – for about three days there was no milk. At the hospital, they told us that we had to give her formula milk because [if she loses weight] she will have hypoglycemia; his blood sugar will be very low. So we introduced her to formula – it was cow’s milk,” she recalls.
In the days that followed, a mixture of formula and breast milk was given to the child. “She was not doing very well, she was losing weight; we don’t really know until now if it’s because of allergies or because my milk wasn’t enough, but we had to supplement with formula because she wasn’t gaining weight. Then the doctor said, “we need to know how much she was getting,” so I had to pump to see how much she was getting. I moved on to that and of course after I got the bottle it refused to lock again,” says Tarek.
Babies tend to lose weight in their first two weeks of life, but losing more than 10% can lead to problems with temperature regulation. Young Tarek, who weighed 2.78 kilos at birth, continued to take formula milk in an effort to regain her birth weight. Reflux and colic were all attributed to general growth phases. Especially since she also had jaundice, which meant she needed more nutrition and more food. As his weight increased, the family was relieved; their baby was finally fine. And they went to Egypt.
It was during this visit, one sleepy night, that the concerned mother discovered blood in the diaper. It was like a switch had flipped in her head, she said. “I saw the blood and started making the connections; her poo still had mucus in it and it was more on the green side, but I hadn’t linked it to allergies before,” she says. “I had a friend who had a baby three or four years ago, and she was going through the exact same thing, food intolerances.”
Get a diagnosis
“I immediately stopped the formula – I remember it was 4am and I had to call a pharmacy as she was hungry for her next feed and by then I had seen the blood. I knew my milk was contaminated so I couldn’t give her the milk I couldn’t give her the formula Because I’m a pharmacist I know the name of the food insensitivity brand so I bought it for her. I took her to the doctor in the morning and once he saw the picture of her poo he said to me, “It’s most likely a food allergy and a cow’s milk allergy” . That’s where it all began.
How common is lactose intolerance?
“In general, babies are lactose intolerant in the first weeks of life because their body has not produced the enzyme ‘lactase’ to digest lactose, which will eventually be produced as the baby grows. grows. The baby does not necessarily have symptoms as well. If the baby is lactose intolerant for a longer period of time, it may mean that the baby’s intestinal lining has been damaged due to medications like antibiotics ingested by the baby or the mother. Highly processed foods and even formula can make the baby lactose intolerant, which can affect long-term immunity,” says lactation consultant Aysha Bint Abrar.
“I had to eliminate dairy products at first. The first few days I was very, very scared, I knew some babies had multiple allergies, it’s not just cow’s milk protein, so I basically eliminated everything. I only ate a few things – chicken, dates, coconut milk and a few vegetables – and stuck to it for maybe two weeks. It was then that she began to get better, to gain weight, the blood in the stool stopped. Things completely changed because I was on this restricted diet. I stopped my supplements because they were also gelatin; however, I started having bone pain. When I went to see a pediatrician, he told me: “Everything is back to normal, she is fine, she is gaining weight”. He said, ‘There’s no need to do that [giving up supplements] …take your supplements and keep trying new foods,” she says.
So Tarek started introducing one food a week and monitoring the symptoms.
“I made meat. The day I started the meat I saw her having a rash on her face and when I stopped the meat the rashes disappeared. I started testing with seafood – prawns – which gave him a really bad allergy. His allergies are not immediate, so after three days [of shrimp] she started vomiting profusely. I stopped the prawns. I tested corn, no symptoms. I tested the rice, so the symptoms. Bread and gluten, no symptoms. However, even though she has no symptoms, her calprotectin is high, so I started reducing some items. The doctors said, “Let’s just try to eliminate the gluten, that’s the most suspicious.” So again I am gluten free. But then his calprotectin is still high, in fact it’s rising, so something else must be the cause – maybe the rice, I’m not sure. Now I’m back to my very, very restrictive diet because I still can’t find what the problem was.
What is Calprotectin?
Calprotectin.co.uk explains: “Calprotectin is a protein biomarker found in faeces in intestinal inflammation.
“A few days ago, I saw blood in the diaper again,” she sighs. “We are still struggling to understand.
“I’m tired, I’m so tired. But that’s okay. She has a few difficult days of colic and pain. But other than that, she’s a happy kid. So that’s the most important thing. For food, it’s fine. I do not care. Because it’s my baby… The only thing is that sometimes some days I struggle, I want to find something nutritious to keep pumping my milk. So I can feed her.
Take food on a trip
Tarek has learned to adapt to his new reality. “I can’t eat out at all, I have to read every label to make sure there’s nothing wrong or there’s no hidden allergen. All my meals are prepared at home. And when I go out with friends or whatever, I bring my tea or my packet of herbal drinks or something and a box of cucumber and vegetables,” she explains.
Tarek is a full-time working mum – and with that comes mum guilt by the mountain full. “Sometimes I feel like I don’t wear it enough. I don’t hold her enough because I have to pump someone else to hold her. So I have to ask my maid or my husband to hold her while I finish pumping and it would have been easier if I could just hold her more,” she says, adding that she hates pumping more than the dietary restrictions.
“I think maybe if I breastfed directly it would have been easier…expressing is a lot of work. And I’m glued to the machine. The pumping isn’t very smooth,” she says, listing issues such as blocked ducts and problems with milk production.
For now, Tarek is taking it one day at a time and hoping his five-month-old will pull through.
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