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It is my absolute pleasure to introduce you to my long time friend and dietitian Miriam Raleigh, a registered dietitian based in Australia. She’ll be taking us through the low FODMAP diet and how you can try it as early as the weaning phase if you suspect that your baby has difficulty digesting certain foods.
Tune into this week’s episode to learn about FODMAPs.
What are FODMAPs?
FODMAPs are a group of short chain carbohydrates that your child’s gut may have difficulty digesting. They can be poorly absorbed in the small part of the bowel (small intestines). Unabsorbed, they remain in the small intestine where bacteria ferments these to produce gas.
F . Fermentable
O . Oligosaccharides (fructans and galactans)
D Disaccharides (lactose)
M . Monosaccharides (fructose)
And
P . Polyols (sugar alcohols)
FODMAPs are usually absorbed in the small intestine and fermented in the large part of the bowel.
Some children’s bodies may not handle FODMAPs well and can suffer from IBS-like symptoms such as constipation, diarrhoea, bloating, flatulence and abdominal pain or discomfort.
If you are wondering whether a low FODMAP diet could work for your child, it’s really important to speak to your child’s GP or gastroenterologist first.
They can organise a set of tests first though these are not always necessary to start the diet.
FODMAP myths
A low FODMAP diet isn’t a lifestyle choice. When you work with a paediatric dietitian, your child’s dietitian will guide you through a 4-6 week exclusion phase. Your child will be asked to follow a diet low in FODMAPs.
Miriam Raleigh explains that it’s best not to rely on Dr Google for the list of low FODMAP foods.
You can read a lot about FODMAPs but you’ll quickly get fed up with the amount of inaccurate data published online.
Whilst the internet gets noisier, save your sanity and hours of searching in the dark by speaking to your dietitian who can provide you with a list of accurate resources to help you navigate through this artificial but effective diet.
Power hour education sessions with an expert can help streamline your thoughts, answer any burning questions and help you design a purposeful yet nutritionally balanced low FODMAP diet for the exclusion diet phase.
Example of FODMAPs
Fructans (also known as fructo-oligo-saccharides) or FOS are chains of the sugar fructose of different lengths.
Galactans are known as galacto-oligo-saccharides (GOS) which are chains of the sugar galactose.
FODMAP vegetables and foods that are high in fructans or GOS include:
- wheat and rye based foods such as bread, pasta, breakfast cereals.
- vegetables like onion, garlic, legumes (chickpeas and lentils), leeks
- fruit such as apples, nectarine, watermelon
- some nuts and seeds
- processed foods where FOS has been added as a prebiotic
What is lactose?
Lactose is the main type of carbohydrate found in milk and dairy products.
A lactose breath test can be organised by your child’s doctor if you suspect lactose malabsorption.
During the elimination phase, switching from regular cow’s milk to the lactose free range may just do the trick.
This is not a dairy free diet. If you identify that lactose is problematic and drives your child’s loose stools, don’t worry as they may still be able to enjoy small amounts of regular milk, cheese and yoghurt.
FODMAP fruit: foods high in fructose
Nearly all fruit and vegetables contain fructose but for a happier gut, only the fruit high in fructose is reduced during the elimination phase.
These only need to be restricted if your child has a fructose malabsorption.
You’ll be relieved to know that vegetables with excess fructose are asparagus and artichokes which children don’t tend to eat in large quantities.
As part of the low FODMAP trial, it’s still important that children meet their daily quota of five servings of fruit and vegetables per day.
Your dietitian may suggest restricting fruit with excess fructose such as:
- apples
- pears
- dried fruit
- fruit juice
Don’t despair, there’s plenty on the list that your child can still enjoy such as bananas, berries and clementines.
When you work with a children’s dietitian you’ll find that diet can still be carefully balanced with sufficient calories from the major food groups such as carbohydrates, fat, protein, fruit and vegetables.
If necessary the diet may be topped up with a suitable vitamin and mineral supplement but the emphasis will be on encouraging children to get their daily dose of goodness through whole grains and veggie inspired dishes.
What are sugar polyols?
These are sugar alcohols such as sorbitol, mannitol and xylitol.
They can be found naturally in fruit and vegetables such as apples, some types of pear and cauliflower.
Some foods can be artificially sweetened with the above, therefore always check food labels of low-calorie or sugar-free packaged food items.
Why is the low FODMAP diet not a long-term solution for children’s gut symptoms?
The goal of the diet is to identify which of the FODMAP sugars are troublesome for your child’s gut.
When you identify which FODMAP group are the problem during the reintroduction phase, your dietitian will help you identify how much of these your child can eat without experiencing symptoms of constipation or diarrhoea.
Monash the founders of the FODMAP diet emphasise how important it is to reintroduce high FODMAP foods back into the diet to promote the growth of good bacteria.
This is because some high FODMAPSs are also prebiotics and a source of fibres. These foods are therefore crucial for feeding and nurturing the overall composition of your child’s gut microbiota.
For breakfast ideas see 10 Delicious Low Fodmap Breakfast Recipes.
The Bottomline
The low FODMAPs diet is more commonly used as a diet therapy for adults with IBS.
Roughly 1 out of 10 children suffer from IBS.
Relief from symptoms such as persisting constipation and diarrhoea of unknown cause in children may be solved through a low FODMAP diet trial, within just two weeks of starting the diet.
The diet should never be started at home. Please speak to your child’s doctor or dietitian for further help and advice.
Let Me Help
Would you like to meet a children’s dietitian who has successfully helped families solve their nutrition problems from around the world?
Whether you are worried about picky eating, food allergy or need help with suspected IBS for your child, I’ll help you manage these with confidence.
For bookings and enquiries email me on bahee@ukkidsnutrition.com or book a free 15-minute call to discuss how I can help you.