The Why & How of Sarah’s Elimination Diet

The Why & How of Sarah’s Elimination Diet

Many of you perked up your ears when I mentioned my daughter’s elimination diet here. I promised you I’d tell you more later. Today’s the day.

The backstory

My oldest daughter, Sarah, was sensitive to milk when she was born, and tested positive for a milk allergy. Our pediatrician told us it was likely she’d grow out of it, and until a couple of years ago, we thought that she had. But to make a long story short, Sarah started experiencing symptoms again at age 6.

At our doctor’s suggestion, we first eliminated dairy, and then gluten, with great results. We finally figured out that soy and seed oils (like canola) were trouble. Sarah had been off gluten, dairy, soy, and seed oils since February of last year, and her symptoms had disappeared.

How we knew it was time to try an elimination diet

Sarah’s symptoms started up again over the holidays. I thought we were keeping to the plan, but we ate out a lot during the holidays, and it’s very easy to accidentally consume gluten, dairy, or soy when we’re out and about. I chalked it up to that. But the New Year came and went, and we were still dealing with symptoms. A lot. Even though I was cooking at home and I was positive that her food was “safe.”

Our pediatrician had told me before that if we ever had any questions about her trigger foods, we should try an elimination diet. Suddenly, we had a lot of questions. It was time. We started on short notice because we were at the end of our rope. Sarah was miserable; I was miserable for her. So I pulled out the notes I had from my chat with the pediatrician:

elimination diet list

Based on these lists, we dove in. I was in the middle of my Whole 30, so our fridge was already stocked with fresh, whole foods. (LINK)

How an elimination diet works

An elimination diet works by removing all problematic foods from the patient’s diet. After a two-week period, those foods are added back in, one at a time, one new food every four days. With this slow, systematic approach, it’s much easier to see which foods are causing problems.

The elimination diet was surprisingly difficult. My family eats very little gluten, dairy, or soy. I’m used to navigating food allergies, and I think I’m pretty good at it. But this extra layer of complexity threw me.

food list

Sarah helped brainstorm “safe” foods on the first day of her elimination diet. 

On day 2, I added lime (citrus, one of the nasty nine) to guacamole without thinking twice about it. On day 3, I cross-contaminated her food with an eggy spoon, thinking it wouldn’t be a big deal. (It was a big deal.) I’d hand her almonds for snack and she’d laugh at me, saying, “Mama, I can’t eat those.” Despite these slip-ups, we made it through–and by the end of the two weeks, her symptoms were gone.

The question I get asked the most is, “how did you keep your daughter on the plan?” Sarah has been 100% on board with all the changes we’ve made over the past few years. She’s old enough to understood cause and effect, and she wanted to avoid the effects. (She’s a better label-reader than I am.)

Where we are now

Now we have a fairly lengthy list of foods Sarah doesn’t eat. 99% of the time, she avoids those foods and she feels great. But about once a month she’ll feel terrible after a day of eating food that ought to be perfectly fine. My suspicions are on the olive oil, because much of it is known to be contaminated with cheaper canola oil. But I really don’t know. We haven’t actually tested all the foods we eliminated from her diet back in January.

Sarah’s hesitant to add potentially troublesome foods back in, because she doesn’t want to suffer the symptoms if she turns out to be sensitive to them. Sarah and I add a long talk with our pediatrician about this last month, and everyone agrees that it’s okay to wait to add those foods back in until Sarah wants to. Even if that day never comes. Right now, I have two big things on my mind when it comes to my family and food allergies:

1. If it’s worth trying a GAPS protocol, and

2. How we’re going to survive summer travel without anyone bursting into tears at the dinner table.

We’ll see what happens. Wish me luck—I’ll need it.  Hearing others’ experiences played a crucial role in figuring out what the issues were for our daughter. If you’ve had any experience with trigger foods or an elimination diet, would you share them in comments?  

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  1. Plop says:

    My little brother has milk and citric acid intolerance. We found out during a trip in the USA that pills (called ‘Lactoferment’ in my country) exist. Since the stomach can’t process milk fat, these pills add the enzymes required for processing. One version is to be taken just before consuming milk and the other one is on a daily basis.

    He usually doesn’t consume much milk, but it’s SO amazing that he finally can eat nice milky food from time to time ! Totally worth it.

      • Plop says:

        I got really good at reading ingredients in several languages. I feel you for gluten, it’s also seems to be really inconvenient. Good luck !

    • Nancy B. says:

      Those pills only work if you have a reaction to lactose (milk sugar). If your reaction is to casein and other milk proteins, the pills won’t help. Fortunately, a lot of people react only to the lactose portion.

  2. melyssa says:

    Our son, who is now 5, has/had severe food allergies. He seems to have grown out of nearly all, but sometimes it’s hard to tell because he’s so darn tough! He’s used to not feeling 100%, I think, and sometimes he can’t say exactly what’s wrong. We’ve been lazy with them lately, just avoiding peanuts, and allowing the other trigger foods in in small amounts. Our pediatrician said there is an allergy “trifecta.” That is, food allergies that morph into other allergies (now we’re dealing with such bad seasonal stuff that his cough made him sound like a smoker) that usually morphs into asthma. Sigh. Poor little dude. And poor little Sarah!

    • Anne says:

      Oh, that allergy trifecta sounds terrible! Poor little guy. I hope you find a way to manage the symptoms that brings everyone some relief.

  3. Michelle says:

    I’ve had a cranky baby since she was born in December. For the longest time we thought it was just colic, but after some experimenting, I’ve realized it’s food dyes and coloring (darn that caramel color that comes even in caffeine-free soda). So, I indulge in the occasional 7Up and when I have a candy craving reach for chocolate chips since they’re not colored.

    I’m wondering if food sensitivities might follow this one, so it’s helpful to read about other people’s experiences. Best of luck with Sarah’s diet, sounds like you’ve hit a pretty good place for now!

    • Anne says:

      Wow, I’m thinking tracking down food dyes must have been pretty tough. That takes some serious detective work!

      Three of my four babies had milk issues when they were young. Eliminating milk (and then wheat) from their diets (and from mine, when I was breastfeeding) made for MUCH happier kiddos. In hindsight, I regret that neither my pediatrician nor I thought to get my firstborn off dairy during his first year. I still wonder if that would have made a difference–he was pretty unhappy that first year. 🙁

  4. Jaimie says:

    I can’t imagine. Neither me or my siblings (or my husband) really has any food allergies… although I do get (sometimes really bad) indigestion from eating most take-out/fast-food pizzas, and most non-homemade Chinese food. My mom thinks it’s the MSG, and after having the same symptoms with pizza in our college cafeteria (as well as the hot dogs; I only ate those ONCE), I think that might be it. So I mostly avoid those, except for the rare times I crave Pizza Hut, and then I just deal with the consequences later, lol.

  5. Karlyne says:

    What were Sarah’s symptoms? I know that an elimination diet only works, as hers has, when the “subject” is highly motivated! Did she have hives or stomach issues or…?

    • Anne says:

      Karlyne, her symptoms vary a bit, but the consistent two were headaches and tummyaches. Not regular stomaches, but curled-up-on-the-couch-like-a-woman-in-labor tummyaches. 🙁

      I didn’t know those two things were frequent symptoms of food allergies/sensitivities (especially the headaches) so it took longer than I would have liked to figure out the root cause.

      • Interesting. I’ve been having AWFUL headaches lately. I chalked it up to my terrible seasonal allergies, they’re always dreadful this time of year, but the headaches haven’t been responding to claritin as usual.

        So then I just figured I’d blame it on pregnancy, since that seems to cause all sorts of things… but perhaps it’s something I’ve been eating…? My eating habits have changed a bit due to food aversions. Will have to ponder this.

      • Karlyne says:

        I skimmed an article the other day about how parents are reporting more kids’ allergies than they used to. I was in a hurry and automatically annoyed when the “report” said that it’s probably because they go to the doctor more and that it’s probably not really allergies, anyway, so I didn’t save it. But not a word was said about how our food supply has changed and so our diets have, too! Not a word about the fact that these parents (who just might know their kids!) could have valid concerns.
        I think how “nice” it is that our kids don’t have to suffer measles, whooping cough and other common old childhood diseases, but I wonder what these kids who suffer day in and day out with what could be called “environmental diseases” would choose…

        • Carrie says:

          My kids DID have whooping cough two months ago.

          Incidentally there is some evidence that eliminating these acute illnesses may be playing a role in the increase in food allergies.

          Not that I would want to go back to my grandmother’s generation…. although her food supply was much healthier. She’s 95 and still kicking. My grandfather died at 94 and was ambulatory up until the final year or two. I think one of the reasons food allergies are on the increase are because our food is so tampered with. Wheat allergies are way up because the wheat that grew 50 years ago is not the same as wheat today, it has far more gluten. And gluten is added to SO many foods.

          • Anne says:

            Interesting. I hadn’t heard that about eliminating illnesses like whooping cough playing an increase in the role of food allergies.

            I did just finish reading Michael Pollan’s new book Cooked, and he explores the connection between our bacteria-free, nutrient-bereft food and the explosion of allergies, asthma, staph infections, and metabolic syndrome in detail. Really interesting stuff, and it makes me want to roll in the mud and down some sauerkraut, pronto.

          • Karlyne says:

            I know that whooping cough is considered debilitating at best and deadly at worst, but I had it, too, when I was 6. I remember it as vaguely nasty, but then that was the same year I had chicken pox, measles and about every other disease known to man at that time, so what was a few weeks of wheezing to complain about? (I’m sure my mother had worse memories of that time than I did!)
            And, Anne, I’ve been rolling in the mud — well, actually trying to pull up bindweed out of my potato boxes — and you’ve reminded me that I need to go make some sauerkraut…

          • Karlyne says:

            Carrie, I just had to giggle over your grandmother being 95, but you wouldn’t want to go back to her time. I guess longevity isn’t everything, is it?

  6. I am so impressed with your daughter’s maturity, and your ability to stick with a plan regarding food. I am completely unaware of my body and it’s intolerances. I hope your daughter’s situation regulates itself.

    Also, I’m a little unnerved about the canola oil contaminating olive oil.

    • Anne says:

      I’m impressed with her, too. I’m not sure how we could have pulled this off without her cooperation. But I’m so glad we were able to because it’s made a world of difference for all involved.

      About the canola oil: I KNOW!!

  7. Wow, I think this officially classifies you as a warrior mom! I can’t imagine how hard this would be, both emotionally and logistically. At least you’re not fighting Sarah on it, though. It’s great that she’s so motivated. Poor thing! Good luck this summer!

  8. Tim says:

    My wife has a lot of food restrictions, and I can eat anything moving slow on the plate enough for me to grab it. Family nutrition is a complicated thing. I hope you are able to find Sarah a ton of stuff she loves to eat and that her body won’t beat her up over.


    P.S. One of your regulars, Jaimie, is doing a guest post for me tomorrow!

  9. Krystal DL says:

    My 7yo son has had dairy allergies since birth. The doctor is hopeful that he will outgrow it, but so far hasn’t. It’s hard for most people to understand the difference between a food “intolerance” and a food “allergy”. We are huge food label readers. He will not eat any food that cannot be proven “safe” by a food label. It’s especially difficult with breads. Some restaurants are not very helpful. We’ve had a restaurant meltdown or two in the past. He usually ends up not eating anything. He also has severe seasonally allergies. This spring has been especially horrible. So I feel for you!! I can only imagine the difficulty of having to do an elimination diet!! Good luck with your summer travels. Hopefully you will be able to find out before hand what eating establishments have “safe” foods.

  10. Nadine says:

    Hm, that is intense! I have similar symptoms to Sarah, and now I’m wondering if it’s related to eating. I’ve always chalked it up to stress, but maybe there is a food solution.
    So you went through a GP as opposed to a naturopath? What was your reason for that? Or a dietician?

    • Anne says:

      Nadine, my philosophy is it can’t hurt to try. 🙂

      When kids are young, they see their pediatrician all the time, so the food allergy discussion is one we’ve been having for years with the kids’ doctors. If I were a grown-up in the Pacific Northwest, a naturopath would make a lot of sense. I have friends in that area who have felt tons better after seeing naturopaths and/or holistic MDs up closer to where you live, but those specialists are harder to find in the Upper South. 🙂

  11. Nancy B. says:

    I have lupus and Sjogren’s, two autoimmune diseases. Over the last 5 years, I have tried many eating regimes. First, eliminating gluten, dairy, and soy helped immensely. Some of my joint damage actually reversed. I tried vegan grain-free (which I enjoyed a lot, but didn’t benefit from much). When I switched to paleo, my health improved another notch upwards. Then I did the autoimmune paleo (AIP) which is basically, lots of all veggies except nightshades (tomato, white potato, eggplant, peppers), protein from fish and meat (no eggs), and fruits in moderation. My AI symptoms practically disappeared. It’s hard to maintain – I’m always getting tripped up by black pepper at restaurants. But after several years on it, I’m much more resilient. I’m not healed concerning these foods, but I can eat them once in awhile without feeling bad. I hope Sarah finds that to be true, as well. Incidentally, my husband also went on this diet as I do most of the cooking, and lost 50 pounds in less than a year, which helped his health as well! It’s really awesome that Sarah is able to take charge of her health and improve how she feels. It’s so empowering to be able to do that. And to have that attitude so early in life. In spite of my relative deprivation (we do eat very well), I feel fortunate that there is something I can do to control how I feel.

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