GAPS Diet Protocol... What the heck is GAPS?!

I won't lie... the GAPS diet is not like a traditional diet. If you're reading this, chances are you found it by searching for GAPS diet in google. There really aren't as many free resources available out there as one would hope. And for parents who are on an extremely limited budget, with a child who has a medical condition that GAPS has been indicated to help... free can make the difference between success and failure. I'm writing this because I've now spent the last 5 weeks on the GAPS full diet (you're about to learn what that means) and will be gearing up to do the introduction diet for GAPS (wait, shouldn't it be the other way around?)

If you are new to my blog, I will give a very brief background. My two year old daughter has Food Protein Induced Enterocolitis Syndrome. In the easiest way to explain it, she's allergic to food. Her body can react to any and all things she sticks in her mouth, or consumes in any way. Many children who have this, will eventually outgrow it. But it can be painful, difficult to manage, and indeed life threatening if not managed well. We were pointed toward the GAPS diet as a possible way to help "heal" my daughter's gut, and reverse some of the symptoms and sensitivities her body has to foods. My daughter does not have a mild version of FPIES... nor does she have it as bad as some others. Many children who have this syndrome are only "allergic" to less than a handful of foods. We have 10 known food allergies at this time, and all new foods are strictly introduced on a special trial schedule. It can be exhausting. And as any parent of a special needs child can attest, sometimes you're willing to try anything if it may help make it easier in the long run. 

In addition to that, I have struggled with my weight and weight related health issues for several years. The GAPS diet has been indicated to help with these issues as well. I figured, what do we have to lose?

5 weeks in, and I am down 10 lbs. But cheating on this diet is not like cheating on weight watchers, or some other weight loss diet. I caved yesterday and ate pizza at the office. I was sick all afternoon and all night long. My body had detoxed off of grains and sugars, and the pizza just didn't sit well at all. I could feel it this morning too. I am now convinced that GAPS has had a positive effect on my body. I am sleeping better, feeling better, and have seen a decrease in anxiety/depression and in my weight, and an increase in my energy. I have no financial steak in whether you do this diet or not, I can only say that modern medicine has not helped us up to this point, but GAPS has. If you're tired of dead end roads with the medical community, having pills thrown at you to alleviate symptoms but  not the cause of your illness, and you're ready to make a change... what have you got to lose?

Bear with me while I attempt to give you as much information as I can in regards to the practical application of starting the GAPS diet. If you want the history of the GAPS diet, the full details, or more information on it, there are other great resources out there. Dr. Campbell-McBride has her own website, and there are many other good sites for giving you pieces of the puzzle for figuring out the GAPS diet on your own. Everyone tells you to buy and read her book, but if you're like me, and you haven't yet done it but want to make steps in the right direction... then read on my friend.

GAPS DIET

Basic Info:

•  This diet is designed to eliminate grains, beans, sugars, and starches to allow the gut to heal and the body to start properly digesting and absorbing nutrients the way it was intended to do.
• GAPS diet is a temporary diet, and the length depends on what you’re intending to heal. Usually a couple of months to two years in length.
• Is recommended to help with healing of a whole host of autoimmune diseases. Can be used for diabetes, autism, FPIES, IBS, chrones disease, ADD/ADHD, dyslexia, dyspraxia, depression and anxiety, schizophrenia, 
• Starts with a 6 stage intro diet (the hardest part) where you progress based on symptoms.
•  “Die off” is where the body may revolt a bit and you experience an increase in symptoms as your body detoxes during the intro phase of the diet. Once symptoms start to subside, you move on to the next stage or phase of the diet.
• GAPS does require you to do your homework and some prep work prior to getting started. It is possible to start eliminating some of the harmful foods now, but you’ll want to source or make some of the essential foods ahead of time (bone broth, fermented veggies or dairy, organic eggs, grass fed meats, etc.)
• The entire diet recommends organic and grass fed versions as much as possible to avoid the meat/dairy/eggs being contaminated from modern feeding practices of animals (penned up without proper exercise to condition the meat properly, the lack of fresh grass which is high in essential vitamins that end up in the meat/dairy/eggs, etc.)
• Many people prefer to start with the “full GAPS diet” until they are comfortable with what is going to be expected, get the hang of the cooking, gather recipes and source needed products/ingredients. We did this, and I feel like it was the best way to transition for us. We purchased a bulk beef package from a butcher shop, and managed to get meat and bones for stock donated by local hunters (due to my daughter’s medical condition). After figuring what store brand versions were easily accessible, and what we liked (Bubbies vs. Olykraut) we were then able to determine what we wanted to ferment on our own (youtube and blogs are essential, anyone can learn to do it!) This diet doesn’t have to be expensive. It’s all in the planning. If you take the time to plan, make a binder, and write your game plan down (including recipes, what is require of you during each stage, etc.) then you can easily do this on a tight family budget.

GAPS INTRO DIET

Tips:

     -   A cup of broth should be taken with all meals if not already broth based

     -    Probiotic foods should be increased gradually starting from a spoon or two of the juice, working your way up to the veggies, and then up to eating the veggies at each meal for about a half cup a day

     -    Work your way up to two eggs per day

     -     Any nuts used to make nut butter should be rinsed/soaked/dehydrated first to remove phytic acid (this can help with reversing tooth decay!) and make it easier to digest while healing your gut

     -   Fruits are essentially your “sugar” on this diet. So moderation is key. Eat them as snacks, or when you’re not fully hungry to limit yourself from eating too much.

     -     Fruits should be fully ripe when eaten to get the maximum nutrition and benefit to your gut.

Stage 1

•           Broth/Soup made from bone, meat or fish
•           Boiled meat (from the making of stock)
•           Non fibrous veggies cooked in stock until soft (think soup)
•           Juice of fermented veggies added to slightly cooled stock when ready to eat (sauerkraut juice)
•           Dairy based ferments (think live plain yogurt or kefir)
•           Ginger, mint or chamomile tea with a little organic honey

Stage 2

•           All in stage 1
•          Organic Egg yolk in soup (if no issues with adding this into your diet, you can then have soft boiled eggs)
•           Ghee
•           Fermented fish
•           Increased quantities of probiotic foods from stage 1

Stage 3

•           Everything from previous two stages
•           Ripe avocado
•          “Pancakes” made from nut butter, eggs and winter squash
•           Scrambled eggs
•           Sauerkraut and fermented veggies

Stage 4

•           Everything from previous three stages
•           Roasted and grilled meats
•           Cold pressed olive oil (not to cook with, but as a sauce or dressing)
•          Nut based breads (almond flour, eggs, and any winter squash)
•           Fresh veggie juice (start with carrot juice, you can make it or buy it)
• Start with a few spoonfuls on an empty stomach and work your way up to 1 cup a day.
•  After you’ve worked your way up without added symptoms, you can add other veggies one at a time (cabbage, lettuce, mint, celery, etc.)

Stage 5

•           Everything from previous four stages
•           Cooked peeled apple (cook in a bit of ghee!)
•           Raw veggies
•    Start by introducing softer parts of lettuce/peeled cucumbers.
• Move on to carrots, onion, cabbage, tomatoes, etc. when softer veggies are consumed without further symptoms
• Avoid any starch based veggie! No potatoes, yams, sweet potatoes!
•          Juiced apples, mango or pineapple (avoid citrus fruits) added to your veggie juice!
•  Make sure fruits don’t make up more than 50% of the mix!

Stage 6

•           Everything from previous five stages
•          Add in raw apple and other raw fruits (avoid citrus)
•           Make homemade dried fruits (store bought contains added sugar and preservatives) to add into nut breads!

Once you’ve done the intro diet, you can move on to the full version of GAPS! Yeah, you survived it!

Disclaimer

Memoirs of a Nursing Mother disclaims any liability or warranties of any kind arising directly or indirectly from use of this blog.  It shall not be held liable or responsible for any misunderstanding or misuse of information contained in “Gut and Psychology Syndrome” or for any loss, damage, or injury caused or alleged to be caused directly or indirectly by any treatment, action, or application of any food, food source, or dietary supplement discussed. Use of the letters "GAPS" in this blog are used as an acronym for Gut And Psychology Syndrome. All information contained in this blog is intended to support the book “Gut and Psychology Syndrome” by Dr. Natasha Campbell-McBride. The information on this site is provided for general education purposes only. It is not intended to be a substitute for professional medical advice, diagnosis, or treatment. I am not a medical doctor and cannot give you medical advice or a diagnosis. Always seek the advice of your physician or health provider. Never disregard professional medical advice or delay seeking it because of something you have read on this blog. Always consult your health care provider before making dietary changes. Links to external sites contain information created and maintained by other individuals and organizations and are provided for your convenience. I do not control nor guarantee the accuracy, relevance, timeliness, or completeness of this information. Neither is it intended to endorse any view expressed nor reflect its importance by inclusion in this site.  The use of any information provided on this site is solely at your own risk. 

A Different Path

As much as we do not consider B's allergies to be a disability, in essence, they are the very definition of a disability, as they are a physical impairment that significantly limits her ability to eat. We are living with a child who has a disability. She is not disabled. She is not broken. She merely has a disability. (I hope that makes sense). If she doesn't outgrow her food allergies by the time she starts kindergarten, she will be eligible to go on a 504 plan. This frightens me so much. As the stigma of being disabled, being different, is a burden for any child attending school. Fears of "food bullying" keep me from looking forward to the future. Often times, I feel robbed of the life I dreamed of having with my daughter. That is not to say, that she isn't perfect in every way I could imagine. We are so very fortunate to have such an amazing daughter. But it is very different than what I envisioned when we planned for her.

Robert Frost's poem, The Road Not Taken has always been one of my favorite poems. I taught it to students while serving in the Peace Corps, and portions of the poem have always resonated with me. Sometimes in life, we are forced to take the road less traveled by. In the case of parenting a child with severe food allergies, this is certainly the case. I recently read a blog post that struck me to the core. I feel compelled to share it with you, in hopes that I can explain what it's like being a parent to a child with food allergies.

WELCOME TO HOLLAND

by

Emily Perl Kingsley.

c1987 by Emily Perl Kingsley. All rights reserved

I am often asked to describe the experience of raising a child with a disability - to try to help people who have not shared that unique experience to understand it, to imagine how it would feel. It's like this......

When you're going to have a baby, it's like planning a fabulous vacation trip - to Italy. You buy a bunch of guide books and make your wonderful plans. The Coliseum. The Michelangelo David. The gondolas in Venice. You may learn some handy phrases in Italian. It's all very exciting.

After months of eager anticipation, the day finally arrives. You pack your bags and off you go. Several hours later, the plane lands. The stewardess comes in and says, "Welcome to Holland."

"Holland?!?" you say. "What do you mean Holland?? I signed up for Italy! I'm supposed to be in Italy. All my life I've dreamed of going to Italy."

But there's been a change in the flight plan. They've landed in Holland and there you must stay.

The important thing is that they haven't taken you to a horrible, disgusting, filthy place, full of pestilence, famine and disease. It's just a different place.

So you must go out and buy new guide books. And you must learn a whole new language. And you will meet a whole new group of people you would never have met.

It's just a different place. It's slower-paced than Italy, less flashy than Italy. But after you've been there for a while and you catch your breath, you look around.... and you begin to notice that Holland has windmills....and Holland has tulips. Holland even has Rembrandts.

But everyone you know is busy coming and going from Italy... and they're all bragging about what a wonderful time they had there. And for the rest of your life, you will say "Yes, that's where I was supposed to go. That's what I had planned."

And the pain of that will never, ever, ever, ever go away... because the loss of that dream is a very very significant loss.

But... if you spend your life mourning the fact that you didn't get to Italy, you may never be free to enjoy the very special, the very lovely things ... about Holland.

A Long Time Coming... part 2

Now, I had heard the term GAPS diet mentioned in the FPIES circle before. I only knew that it was even more restrictive than paleo, and that it involved bone broth, in a belief that one could potentially repair the damage in the gut, and heal the body from FPIES... how very little I knew.

It turns out, GAPS is also recommended by the Weston A. Price Foundation (a non profit org "dedicated to restoring nutrient dense foods to the american diet through education, research and activism.") The Weston Price Foundation believes that it's possible to reverse damage to many parts of the body through dietary changes. In a nutshell, it believes that the whole body is connected, and by not feeding the body properly, that many of our modern health problems can be fixed by reverting to more traditional methods of eating. This means eliminating sugars and grains, eating grass fed meats, and eating a diet rich in vegetables, bone broth and probiotics. As it turns out, many FPIES parents have significantly benefited from the GAPS diet with their little ones. For us, it was worth the shot to attempt it. If not to reverse or prevent further damage to B's teeth, then to at least help her get through the stage of her life where FPIES is the star.

We have now been on the GAPS diet for 3 weeks. I am also eating on the GAPS diet. We did not do the intro diet, as she is over the age of 2, and the intro diet is so restrictive that switching cold turkey would have made it too difficult for us. Instead, we are doing a closer version to the full GAPS diet. We eliminated grains, sweeteners (except raw honey which is allowed), starchy vegetables (like potatoes, sweet potatoes, corn, etc.) We have switched her back to goats milk (off of almond milk), added in fermented foods (like sauerkraut), fermented dairy (like kefir), bone broth, grass fed butters and animal fats, and more non-starchy veggies (like squash!) We can't do coconut, so coconut oil had to be set aside, even though it's permissible on GAPS. Instead, we are using olive oil (with low heat cooking or raw) or ghee (clarified butter) or grass feed butter for anything we cook with higher temps.

In this time, B has seemed to be doing a little better. She's had a very coincidental language burst, coinciding with some other odd symptoms that could technically be her body detoxing on the GAPS diet. We did discover a 5th cavity in her mouth as well, and we think the dentist just didn't see it the first time around with her squirming around during her initial visit. The second dentist confirmed that without treatment that she will likely lose the teeth early, and that it could potentially cause nerve damage and damage to her permanent adult teeth. This hurt. My heart felt like it was breaking, and I felt nauseous to think we would have to undergo surgery at such a young age with so many significant risks (FPIES and both the long term/general side effects of anesthesia on toddlers).  We have scheduled the procedure for the 10th of September, and hope to come through it without issue. In the mean time, we will continue with GAPS and hope to prevent any further damage to her teeth, and prepare her body for the harsh conditions of surgery. If GAPS makes any improvement for her, I will try to start regularly updating this blog. I wish that there was a handbook for parents of children with FPIES. It would certainly make things a lot easier on all of us to consolidate our collective wisdom.

On a personal note, since I've started GAPS (as long as I don't cheat) I have lost 4 lbs in three weeks. With no other changes. I am sleeping better, have less intestinal distress, and more energy than usual. Perhaps it's physiological, but as a skeptical person by nature, I'm inclined to believe that it's having at least some positive effects on my health if nothing else.

A Long Time Coming... part 1

I think about updating this blog all the time. With everything we've been going through for the last 10 months, it feels like an entire lifetime since I've posted. This post has been a work in progress for months. Let me start from October (the last time I posted)...

In October, B started an actual daycare. Our in home nanny could no longer care for her, and needed to move on to a full time job. My husband and I were extremely worried about how she would do in a daycare setting. After all, it's not like she can avoid people and foods for the rest of her life. We knew that snack time, lunch time, and sticky fingers would pose a risk, and did our best to find a daycare that could work with us. We were very fortunate to have found a brand new in home daycare run by two sisters who were just coming out of careers as pediatric medical assistants. They found they loved playing with the children and making them smile, much more than weighing them and making them cry while holding them down for vaccinations. The sisters turned out to be miracle workers. I can not imagine how much different our life would be right now without this daycare. Within days of starting the daycare, B started napping easily... in a well lit room. As it turns out, she didn't need the black out curtains, or the box fan running to help lull her to sleep after all. The sisters were knowledgeable about food allergies, and prepared for the worst. They worked with us to allow us to bring all snacks, breast milk, and lunch in a cooler every day. They would ensure that her high chair was disinfected from any possible cross contamination, and that she would be the only one that slept in her bed. Cleaning products would be allergen free, hand soaps allergen free, and she would have her own designated bottles, cups and utensils.

As time went on, B grew more social, and looked forward to playing at daycare with the sisters. She started putting herself to sleep for nap time easily. This allowed us to make the transition from a nightly routine of patting her back to sleep for 30-90 minutes in the dark, to putting her to sleep in the pack and play at the beginning of the night. Our new routine began in February, as B transitioned out of her side-car crib, and into the pack and play at night at home. It went surprisingly well. After a day or two, she understood the routine had changed. We no longer had to wait up until 11pm or later for her to start crying before we finally could come to bed when I went in to "rescue" her and comfort her back to sleep. (We were always so afraid that going to bed we would wake her while getting in... so we would just wait up for the first time she inevitably woke up). This grew into her sleeping longer and longer at the beginning of the night. I would still bring her to bed with me once she woke, but we were all starting to get more sleep. A few times she even woke and put herself back to sleep! This felt like heaven after 22 months of constant night watch.

By her second birthday, she had finally slept through the night a handful of times. It gave my husband and I hope that she might start outgrowing some of her sleep issues. And it began the process of night weaning. After turning 2 in April, she was no longer nursing during the days. In October I finally stopped pumping at work. We successfully introduced goats milk, which alleviated the burden placed on me to nurse. In the spring, she had switched to drinking raw goats milk and almond milk without carrageenan in it during the days at daycare. Almond milk was a blessing, as it was easily $15-20 cheaper than raw goats milk per gallon.

Not everything was all roses though. We failed a salmon and an orange trial during that time, which meant that I had to eliminate those from my diet too. I wasn't doing a traditional elimination diet. Instead, I had been eating what I wanted, and only eliminating known fails as we encountered them. In May, we also lost shrimp, food dye and watermelon in one fell swoop. A birthday party for my nephew at my parents house put B in contact to all three on the same occasion. It was heartbreaking to jump to 10 failed foods. We were now at the point of which children start to begin outgrowing FPIES, and here we were losing 3 more foods. At this point, she could no longer have rice, turkey, coconut, cows milk, carrageenan, oranges, salmon, food dye, watermelon, or shellfish of any kind.

None the less, we chugged on, and at her annual follow up appointment with her allergist, we finally had the discussion about re trialing failed foods. The game plan is to retrail her foods in order of least symptomatic to most symptomatic, with one retrial per month pending no other failed foods in between. This would mean 10 months to retrial everything, as long as no new fails or old fails occurred again. This, is literally my worst nightmare. Intentionally give B something I know makes her sick? That doesn't sound like my idea of a good time. We had almost started to feel normal. Our new normal was getting easier. I was managing to make the same meal for each of us at dinner, and rotating through a diverse menu of foods that seemed to be healthy. Her sleep was getting better and better, and now we were getting more nights where she slept through than not! To be honest, retrials scare the hell out of me. But fear or not, we have to retrial at some point, and with her losing more and more foods, it was time to see if any of the old ones were starting to clear up. This was a good thing... it forced us to retrial salmon, which ended up being her first retrial pass! We were back down, with 9 to go.

Last month we had her first dentist appointment. Since B was a gummy bear up until that point last year, we figured 13 months with teeth meant it was time for a check up. What began as a regular appointment for a toddlers first check up, began the start of another major life change for us. We found that with the gradual switch to almond milk, and no other major sources of calcium, that B's teeth were starting to decay. She has 4 cavities on the back of her top front teeth. This in and of itself, is heartbreaking to any parent. My barely 2 year old child has cavities! We know it's not from excessive sugar or not brushing, as she doesn't get juice or sugar like most children. FPIES ensured that those would not be part of her childhood. Upon further research of cavities in toddlers, we discovered that toddlers who subsist on almond milk often have early tooth decay. Almond milk contains phytic acid, which blocks the bodies ability to absorb nutrients. So the "50% more calcium!" claim on the box is misleading if the other aspects of the milk keep you from benefiting from any added calcium.

The worst part is, the dentist wanted to do the fillings under anesthesia at the local children's hospital. Due to her age, and her FPIES, the complications of allergies makes it much harder for a dentist to treat such a small child with that many cavities. I won't lie, I had a full blown anxiety attack. I broke down, I cried, I felt like my heart was going to explode from racing so hard. The side effects and lasting impact of anesthesia in children under the age of 4 are significant. They can be long lasting, and cause significant issues with language and intelligence development. These were not things I was comfortable with.

In my quest to find an alternative, I scheduled a second opinion appointment with another pediatric dentist (out of our network) and started searching for ways to stop cavities in toddlers. It was then that I ran across the GAPS diet.