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Dear Jo, I know there is much information and many opinions on this topic. Milk Soy Protein Intolerance or MSPI is a condition where diet is extremely important. Breast feeding mothers need to eliminate all sources of milk and soy from the diet. A baby with MSPI will have some similar symptoms to reflux. In addition, there may be mucousy or bloody stools, skin rashes or eczema.   There is another group of babies who look like they have reflux (cry, fuss, poor sleep and eating) but actually have severe food allergies. Often there is a family history. These babies will benefit from elimination of certain food from the diet. Some of these babies are later diagnosed with Eosinophilic Esophagitis, a condition related to reflux.   In between are babies with plain old reflux. Some breastfeeding moms find that certain foods are associated with a change in vomiting and fussiness. Nursing mothers often try to eliminate the most common allergy causing food, even if there isn't a diagnosed food allergy. These foods are: wheat, dairy, nuts, fish, soy. Others take out the high acid foods like tomato, orange and coffee. I do not know of a specific study that found a benefit to removing certain foods except for milk/soy. Perhaps someone else would like to provide additional information on this important topic.   When I talk with breastfeeding moms, I hear a lot of stories about careful elimination of food and food groups from the diet. It makes me feel nervous that key nutrients will be taken out of both the mother's diet and the baby's diet. Further, it is a lot of effort to find substitutions when foods are eliminated. When a mom is down to rice, chicken and water, I get very worried. Often, mothers tell me that eliminating foods doesn't make a huge difference.   I think the confusion comes in when you have those rare babies who truely have significant food allergies or intolerances from birth. It can be like an on off switch when you eliminate the food that is causing the irritation.    Good for you for nursing your baby! Certainly breastfeeding is highly beneficial and is thought to be easily digested by a baby with reflux.   I hope this helps!   Jan Gambino The Reflux Mom
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