Sunday, May 22, 2011

The staff of life, Part 1

Nothing smells quite as good as bread baking in the oven. I just had a delicious slice of homemade bread, made from wheatberries I ground myself, kind of as an experiment, but also as a reminder.

Back when my life was all diapers, playdates and naps, I first got caught up in the whole health food craze. Craze is really the best word for it; you don't have to go far on the internet or in the health food store to hear illogical ideas about which wholesome food is going to put your life in jeopardy next. Even before that, though, Kaiser had taught me about avoiding refined flour and sugar, so I was always out the outlook for a good loaf of bread which didn't contain white flour.

So when the opportunity presented itself to learn how to make bread from wheat in its purest form, I was all ears. My initial attempts to make bread yielded either flat or crumbly loaves. It was so frustrating. I borrowed a hand-crank grain mill from my mother-in-law, and I could grind about a half cup of flour in 5 minutes (I think -- it's been a while). Eventually, my entire operation would radically advance in technology with an electric grain mill and high-capacity mixer, allowing me to make five loaves of bread beginning from the grinding of the grain to their exit from the oven. I would make five loaves of bread once a week, and sometimes some of those loaves would become cinnamon rolls or pizza. Many times it was hard for us to not devour the first loaf right out of the oven.

The benefits of using freshly ground flour include the following:

1) Reduced cost. After the initial investment in equipment (of course), the cost for the wheat is about 27 cents per loaf, and a 50 lb bag of wheat yields about 83 loaves of bread. One pound of wheatberries yields about 4.5 cups of flour, and it takes 10-12 cups of flour to make 5 loaves of bread. These calculations are based on $22.12 for a 50 pound back of wheat, not including shipping.

2) Increased nutrition. Most of the nutritional benefits of eating wheat are from the germ, which is stripped from the grain in industrial milling because the germ oil goes rancid rapidly. The germ contains the full complex of B-vitamins, but according to the woman who taught me (and multiple internet sources), 90% of the nutrition has oxidized and been broken down within 72 hours of milling.

3) Reduced toxins. Have you ever read the label on a loaf of bread at the grocery store? I cannot even find a loaf of bread at my closest local grocery store, Safeway, which does not contain azodicarbonamide. In fact, even the breads baked in-house contain it because it is part of a dough conditioner that is put directly into the flour they use at the store. When I first discovered this, nearly eight years ago, there was very little information about it on the internet, except that it was an industrial foaming agent used in the manufacturing of plastics (like baby food jar seals), and had been banned in the United Kingdom. It is now banned for use in Europe and Australia.

So, I happily made my own bread, which contained just freshly ground wheatberries, water, yeast, honey, sea salt, Vitamin C and canola oil. We ate it at pretty much every meal. Grilled cheese sandwiches were an almost daily staple. Everett seemed able to tolerate cheese, even though milk and yogurt gave him digestive trouble.

In the early part of my pregnancy, I was very good about making bread weekly. Then, I developed sciatica, and it had been weeks, or perhaps even months, since I had made bread. We were eating out more and more, and during one trip to the chiropractor in Denver, we ate at my favorite restaurant (wide spaghetti and meatballs), and Everett and I both got a terrible case of food poisoning, which lasted nearly a week. I had been seeing a specialist during my pregnancy because I had polyhydramnios, which turned out not to be a result of a structural abnormality in the baby (thank goodness). After that week of food poisoning, however, I started losing amniotic fluid at a very steady rate.

I was placed on bedrest for a week at 30 weeks of pregnancy, and had visits to the maternal fetal specialist twice a week to monitor my amniotic fluid levels. I was told to drink at least 96 ounces of water per day, as well, and doing so didn't really seem to work, so I switched to an electrolyte beverage, and that did seem to work, with respect to the amniotic fluid. However, at 37 weeks, my blood pressure elevated again, and I was put on bedrest for that week, at the end of which, I had labor induced.

During one of my trips to the specialist, I had a friend watch Everett. She took him to McDonald's and got him some milk with his Happy Meal. When I came to pick him up, she was holding him in her lap, and he was crying in her lap. She explained that he just randomly became afraid in the Playland, and refused to play in there, crying and screaming. It was very much unlike him, and she was a close friend and neighbor who we saw very often, so he was comfortable with her. I took him home, and he was strange the whole evening. I actually had a high school friend come visit from out of town with her daughter, and he was totally bouncing off the walls (typically he was a pretty calm kid, though he had anxiety, he was not high energy). The entire evening he was loud, violent, his pupils were fully dilated, and his cheeks were bright red. I could not get him to listen to me or calm down at all. It must have made quite an impression on my friend (or my reaction to him did, because I really wasn't sure what to do), because I didn't hear from her again for several years. It was amazing to me that just drinking milk could cause him to have that kind of reaction. It had to have been the milk that caused the reaction; we ate at McDonald's at least once a week at that time, and had never had that kind of reaction before. That was my reasoning at the time, anyway.

In fact, before we eliminated milk from his diet, besides frequent illness I did have trouble getting him to acknowledge me, even though he was calm. He would kind of zone out and have a far away look in his eyes. Also, he frequently had bright red cheeks, and slept fitfully, waking if I wasn't right there next to him, and when he woke, he usually did so crying. He always sweat when he slept, leaving a moist spot where he lay his head.

After that episode at McDonald's, I was very concerned about him. I had him evaluated by the school district, and he was classified as having auditory, tactile, vestibular, oral, and visual sensory integration disorder. At 27 months of age, he knew all of his letter sounds, could count past 30. At that time, nine years ago, kids that young weren't getting Asperger's diagnoses (according to our family physician), but the school district Autism Team was entertaining the possibility. They came to see him at his gymnastics class and during a playdate, and ruled out Asperger's. Apparently, he was too social (even though it was difficult to get him to look me in the eye). According to the speech therapist, he had the vocabulary and speech of a seven year old, and she could see nothing wrong in that respect. However, she did suggest that we try removing gluten from his diet.

Okay, here it was again... gluten being a potential problem. But, I made bread every week, and according to traditional and historical wisdom, it was the staff of life! How could it be hurting our health? I would wait until absolutely necessary to make such a change. Instead, I would focus on eliminating all food chemicals from our diet after reading the book Fed Up with Food Intolerance by Sue Dengate (see also The Feingold Association).

Absolutely necessary came sooner than I thought it would. Lucy was born, and her reflux was worse than Everett's. It was not manageable with Mylicon (simethicone). I was already on a mostly dairy-free diet, but just even having a taste of dairy caused her to projectile vomit after nursing, and choke in the night. Soy would be a problem for her as well. I would try a trial without gluten, just for myself, for a couple of weeks.

The first time I had gluten, not only did Lucy's reflux return (she didn't even spit up once during the day when I avoided casein, soy and gluten), but my hands were achy, and I was so exhausted for the next 48 hours. Also, I would get pain in my right kidney, much like I had toward the end of my pregnancy with Lucy. So, there it was. I had to avoid gluten.

It was a lot easier to avoid gluten for Everett now that Lucy and I had such immediate and devastating side effects. The benefits that we saw from eliminating dairy with him just got better. His attention span increased, he was calmer, the wet spot from him sweating in the bed disappeared, and he stopped gagging at every meal. Many of his sensory integration issues (tactile, oral, auditory, vestibular, and visual) would disappear on a gluten-free, casein-free and salicylate (food-additive)-free diet.

Which of course, begged the question, WHY?!

Sunday, May 15, 2011

I met the enemy, and it was food (or so I thought)

We put our house up for sale on September 10, 2001, and moved back to Colorado a month later, even though our property did not sell for another month. In our apartment, I was the only other voice for his new ears during the day, so I read the first five Harry Potter novels out loud to Everett, while laying with him on the floor.

He somehow knew his father would be coming home around 5 o'clock, and would fuss in my arms until the front door cracked open, and a great smile would replace his consternation. Unless, of course, Erick had to use the restroom or have a drink of water before fully acknowledging this small person who had longed for him so intently. Mae, our bulldog, would jump around happily, performing what we called "The Rhino Dance" as her show of appreciation for Erick's return.

The week before Christmas, we moved into our first Colorado home (as adults). It was a "Spec Home" -- a brand new home which had been commissioned by another buyer. There was no landscaping in the back yard; and it was graded improperly, leaving a giant lake in the middle whenever there was any precipitation. The first time the tub in the guest bath was used on Christmas Eve, a missing solder joint in the soffit over the kitchen yielded a downpour onto the stove. The house had that new house smell, and I loved it, despite the surprises.

Slowly, we began to connect more to the community around us. It was more necessary than it had been in California or Ohio; something about having children made me need to make friends. Raising children in isolation was a challenge. Never before had I needed validation in the way I did as a new parent. I joined several mothers' groups in our area, and made a handful of good friends. I connected with two particular moms because their husbands worked with Erick.

One of these friends was really into health food. She was the kind of person who just when I thought I understood what she was doing, she was doing something new. When I first met her, she was baking fresh bread every week. It was absolutely heavenly, and made from fresh wheat berries that she ground in a mill in her home. We would buy a loaf here and there as her daughter was selling bread to make money to go to Disneyland with her step dancing group. She also coordinated a local food co-op through the Tucson Cooperative Warehouse, so I saw her very regularly. Eventually, I had to know how to make the bread myself.

I went to her house to learn to make bread the same day Everett had his first MMR vaccination. Before this day, he loved her and her kids. That day, he cried and fussed the whole time we were there. I kept wondering what happened to my sweet baby to make him so upset and scared. I ended up having to leave early to see if he would settle down for a nap. Things would not be the same from that day forward.

My baby was fussy. Erick called him "Little Ceasar." I was exhausted and lived for naptime. Through La Leche League, I would find Dr. William Sears' The Fussy Baby Book, and the chapter on Mother Burnout would be my salvation. The empathy I found in those pages would lead me to want to read every book Dr. Sears wrote, and much of the La Leche League Bibliography (where I first learned of Dr. Sears).

In the meantime, the advice there provided important coping mechanisms and the comfort of knowing I wasn't alone. There were other babies out there -- High Needs Babies -- who would be upset if their hands got dirty, or if they were overwhelmed by Wal-Mart, or if they were blinded stepping out into the sun without sunglasses, or if there was a slight breeze. I made close friends of mothers in similar positions. And it seemed they were everywhere.

After the MMR vaccination, he wasn't just more sensitive, he was constantly sick, after never having been sick. A mom who formula-fed her daughter actually remarked that she didn't see the benefit in breastfeeding since my son was constantly sick. He was sick for six months straight with nine different illnesses. We were constantly going to the doctor.

I was afraid to go anywhere after he caught rotavirus, which he had at 13 months of age for nearly four weeks straight. I have never seen so much vomit and diarrhea come out of one human being, and this particular human only weighed about 19 pounds. It would be this experience, when the on-call nurse told me that I was saving his life through breastfeeding him (most infants with rotavirus cannot digest formula or cow milk), that would convince me to continue to nurse him until he weaned himself. The nurse at the doctor's office, in response to my wondering where he would have picked up rotavirus, said, "It could have been anywhere -- even a shopping cart handle."

Again, I turned to Dr. Sears for help. I devoured his Family Nutrition Book -- the recommendations within largely agreed with what the Kaiser Permanente dietician had taught me two years earlier, with some important exceptions. Sears, in addition to recommending a diet very low in fat, high in grains and lean protein, would also recommend soy foods and very little sugar. I followed Dr. Sears' dietary recommendations to the letter.

Five months' worth of Clorox wipes and hand sanitizer later, I wrote to my local La Leche League Leader and asked what could be causing his frequent illness? "Perhaps a food allergy, like an allergy to dairy, eggs, corn, soy or wheat," was the reply. There it was. Again. Food as the Evil Villain.

My breadmaking friend lent me her copy of Is This Your Child? by Doris Rapp, MD, and the 2.5-inch thick tome convinced me it was time to entertain the idea of food allergies a little more seriously. So then, I bought Jonathan Brostoff's Food Allergies and Food Intolerances, and I was then convinced enough (Brostoff used citations) to do a food elimination trial. After reading a couple more books on the topic, I was a veritable expert.

Things did get dramatically better for Everett when we eliminated dairy at eighteen months of age. His sensitivities diminished greatly, and he stopped getting sick so easily. We replaced dairy with Dr. Sears' pet food, soy. Erick's mom gave me a copy of Nourishing Traditions by Sally Fallon around the time Everett was two years old. I read all the chapter introductions at that point, especially because she covered the topic of food allergies, but the cookbook contained a lot of ideas I considered strange and certainly lethal, if not plain disgusting (eating organ meat, making homemade stock, soaking legumes and grains, drinking raw milk, and, GASP! eating saturated fat). So, I would not reopen the cookbook for another three years (despite the fact that my own mother looked through it and said, "Wow! A cookbook with REAL FOOD in it! This is like the food my Grandma Edith would make!"). I guess I didn't consider it that strange, because around the same time, my food-savvy friend lent me a copy, so she had at least had a passing interest in it.

Nonetheless, we were eating fairly whole foods, and I was cooking most of the time. Things would become better enough that we would decide to have another baby.

Sunday, May 1, 2011

Longing for the familiar

Back in 2001, I hadn't babysat, held a baby, or maybe even seen one for about a decade. And now, here I was, fresh out of a job dealing with technical equipment, volatile chemicals, and scientific jargon, caring for my own.

I tried attending a couple of La Leche League (LLL) meetings, but my local group was led by several homeschooling women, all nursing toddlers. One was even nursing her preschooler, and though they were kind and welcoming and did not project any sort of judgment, that early on in my nursing relationship, I found the ideas of breastfeeding a non-infant and homeschooling foreign. Scary, even.

Everett's reflux continued. It was the source of much interrupted sleep. He slept on a wedge in a playpen/bassinet next to my bed. Even if he didn't wake up wanting to nurse, I frequently woke up worried that he had rolled to the bottom of the wedge or that he had stopped breathing. Ironically (or not), my coworker who had given birth a month before me had a parallel experience with her son: trouble initiating breastfeeding, oversupply, reflux and apnea issues. Her son even required an apnea machine, a machine that would alert her to lengthened episodes of non-breathing, for sleep. I could talk to her on the phone, but trying to get together was difficult for either of us, with babies who did not like to travel (she lived 20 miles away), and chronic sleep deprivation.

I can't remember why, but I had called the local Medela representative, and, as many new and lonely mothers do, shared my experience with reflux. The spitting up was much less if Everett took a bottle rather than nursing. I would get a clue to the cause of this when he was around three months, when his diapers suddenly had a foul odor (unusual for solely breastfed babies), and a strange olive green color.

As it turned out, this particular Medela representative had a child who had apnea and reflux as an infant. When we left the hospital with Everett after his sleep study, the doctor (who had angered Erick) said that if the reflux was not better by 3 or 4 months, surgery could be done to tighten the top sphincter on the stomach. The daughter of this Medela representative had that surgery, and the woman shared with me the difficulties that had arisen because of it. Her then six year old daughter was unable to burp or even vomit, resulting in severe discomfort. She advised me to simply give Everett a drop of Mylicon about 5 minutes into each feeding to help all the gas bubbles conglomerate into a single one to help with his reflux.

After researching the safety of simethicone (Mylicon), this advice would end up costing me a lot of money on generic simethicone, but saving me a lot of time in laundry, and easing Everett's pain tremendously. At that point in my life, short on sleep and support, what I needed most was a pill to make everything better, and that's what Mylicon provided.

The information given to me on my call to La Leche League was overwhelming. Nurse more often. Finish the first side first before moving to the next side. Prop the baby up while he is sleeping. Burp him religiously. Try burping in many positions. Express some milk before putting him to the breast. Try nursing in different positions (including laying on my side in bed and draping the baby over me so gravity was not aiding let-down). And finally, the information that undermined my trust in these lactation experts: try an elimination diet.

I tried all the other reflux management techniques LLL had suggested, and they were exhausting. Eventually, over the course of months, and in combination with the simethicone drops, they would serve to more equalize my supply with his demand. My cessation of pumping would also help. Also, I learned to pay attention to his cues better, and ignore the clock. Like my daughter would be three years later, he was very sleepy for the first three months, and did not give many hunger cues. I had attributed this to all the drugs I had during childbirth, but I did not have narcotics when I was in labor with my daughter, and she still experienced this time of mostly sleep. This was amplified when Everett had his two- and four-month vaccinations, which gave him a fever and made him sleep for twenty-four hours straight. Try as I might, I had great difficulty waking him to nurse, and it was such an endeavor that nursing every 3 to 4 hours worked just fine for me. After three months, though, he was awake more often, and more likely to want to nurse more often than every 3 to 4 hours.

We had a follow-up from the sleep study with a gastroenterologist around 4 months of age. By coincidence, Everett had not passed a stool for several weeks, and I was concerned. This gastroenterologist said that it was normal for a breastfed baby to go as long as 28 days without passing a stool, which eased my mind.

Over time I would learn just how important it was to nurse "early and often." I would learn that the upper limit of a woman's milk supply was determined by the amount she nursed in the first five days after the baby's birth. My breastfeeding experience in those first five days was not at all natural, but my sessions with the surrogate baby (breast pump) apparently drove the upper limit of my supply up plenty. Supply was never an issue.

I would also learn that what is stored in the breast is foremilk, the "skim" part of the breastmilk. It is high in lactose and low in fat. The longer between nursing sessions, the more foremilk will be present in the breast. This foremilk is much harder to digest than the rich, fatty hindmilk which is made on demand after the foremilk in each breast is exhausted. Considering that an infant's stomach is about the size of his fist, and I was expressing about five fluid ounces per side during a pumping session, it's unlikely Everett was getting much hindmilk during that period of time. And that is how the foul-smelling green stools happened, ladies and gentlemen.

My mind kept drifting to the suggestion of food allergies (I would later learn these are called intolerances), with the most likely one being dairy. Really? I thrived on dairy. I was not a water-drinker; I washed everything down with a glass of milk. Running out of milk in college was the most likely reason I would request a ride to the grocery store from a friend. I attributed my lack of cavities to my milk consumption. How could such a health promoting food be the cause of so many problems for my son and I? This made no sense to me at all. I felt that viewing foods as trouble was a road fraught with peril, as is the wise and common response of many people who first hear the recommendation for a food elimination trial.

I had landed right on Mars, complete with little men who pooped green, cried to communicate, and didn't honor my body's need to sleep like a log for eight hours uninterrupted. Health-promoting foods were potentially danger-ridden. This was all strange for Erick, too, and in watching how quickly everything was changing, how quickly Everett was growing, we decided to move back to Colorado and share the experience with people who would care -- our family. We would leave Mars and go back to the familiar.