Autism and Malnutrition: The Milk Connection

by Linda Carlton

To understand autism we can begin this journey from what we have learned about how seemingly insignificant dietary changes can affect newborn primates. In October 1975, three Japanese scientists raised a group of infant primates. By artificial nursing, these primates were fed a casein powdered milk formula. When they modified the infant formula to reduce the content of protein and increased the lactose to supplement the appropriate number of calories, the primate infants developed abnormal behaviors such as stereotype rocking, fear, aggression, head banging and other autistic-like behaviors. Completely unaware of what they had discovered, the scientists had induced autism in a clinical setting.

Now, they were aware that by reducing the protein content they caused the infants to become malnourished. They also observed that without human contact some infants were much more impaired. They learned that the infants that received the standard solution were reared successfully. At that time they concluded that a protein deficiency had caused a decline in physical and mental growth. Subsequent studies have supported this, whereby protein deficiency does cause developmental delay.

Autism Versus Developmental Delay

But it is important to know which symptoms are truly autistic and which are that of developmental delay. These disorders are often used interchangeably, but they are very different. For example, hand flapping is an autistic symptom, but it is not a common characteristic of developmental delay. In developmental delay children are often slow to learn, and will quickly fall behind their peers. The symptoms of these primates were more than just symptoms of developmental delay--they were symptoms of autism.

The most important information we have about these infant primates is that the researchers had also increased the lactose content in their diet. If the quantity of protein matched that of the quantity of lactose, this might not have occurred, or it might also have occurred if they had been fed too much protein. The standard formula given to the infant primates that were reared successfully were given the same amount of lactose, and what would have been the normal amount of protein for these size mammals.

Lactose and Autism

Lactose is the key to unraveling what happened to these infants. Bacteria use lactose, or milk sugar, as a nutrient base. Bifidobacteria and clostridia use lactose, and they often describe these strains of bacteria as lactose-fermenting bacteria. One difference in Bifidobacteria and Clostridia is that only one can produce significant amounts of ammonia, only one can damage the intestines. Milk oligosaccharides contain lactose; they are fermented in the infant colon where they selectively stimulate the growth of Bifidobacteria. Clostridia are competitors of Bifidobacteria, and Clostridia produce ammonia. Ammonia and only ammonia produced from bacteria could have caused the aberrant behaviors.

The infant primates had developed symptoms of autism because there was protein restriction, milk proteins needed for ammonia detoxification, and not necessarily just casein. They were fed lactose and lactose ferments ammonia, producing bacteria. They were unable to detoxify on a protein-deficient diet. It is a simple formula:

Protein + Lactose = Normal Development
Low protein + High Lactose = Autism

But protein malnutrition does not equal autism nor does lactose feeding equal autism. However,

Protein malnutrition + high-lactose feeding + (the unknown factor) = Autism

There has to be an unknown factor for this to occur, a combination of things that all relate to one another. The unknown factor can be found by testing these three variables. We have to review other information that we have on children with autism to give us the correct answer to the unknown factor.

A low-protein diet offsets a nitrogen balance to detoxify ammonia, whereas lactose feeding ferments bacteria. The only variable that could account for the unknown factor is ammonia. In autism, there are signs of ammonia detoxification, for example when GABA and nitric oxide are increased. So instead of developing overt ammonia toxicity, they are able to detoxify this excess ammonia. As encouraging as this sounds it still depletes cellular energy. Many parents can recall 'staring spells' as the first behavioral change in a child prior to autistic regression. This can be the first sign of increased blood ammonia.

Other symptoms found in children with only minimal increases in blood ammonia were:

Developmental regression
Loss of acquired speech
Stereotype hand movements
Myoclonic seizures
Generalized epileptic discharges
Repetitive behaviors
Sensory dysfunction
Auditory and visual hallucinations

Finegold and his colleagues have published three studies on children with autism. The first study was with the use of antibiotics. The second study of stool specimens indicated a vast overpopulation of Clostridia in children with autism. Many physicians use antibiotics for treatment of elevated blood ammonia to kill the ammonia-producing bacteria. Antibiotics have produced dramatic effects in children with autism, however this treatment did inevitably fail. Experiments with fermented foods after antibiotic treatments have been somewhat successful in preventing relapsing Clostridial infections.

Live Bacteria to Temper Immune Response

As many of us already know, treatment with probiotic supplements at most show only minor, if any, improvement in autistic symptoms. These can sometimes take weeks or even months to take affect or may never have any effect. The reason for this is that when probiotic bacteria are dried and then rehydrated, even with prebiotic assistance it takes time for these bacteria to reestablish a colony. When live bacteria are frozen they can re-colonize within 24 hours at room temperature, but when bacteria are heat-killed they induce an immune response and their ability to re-colonize is remote. Each time we consume foods with heat-killed bacteria it produces an immune response.

Every time we receive a vaccination with heat-killed bacteria or a heat-killed virus, it produces a similar immune response. Live bacteria such as that of lactic acid bacteria can temper these immune responses. The infant primates were fed heat-treated formulas, Clostridia is an opportunist infection, looking for a chance to colonize. However, Clostridia is also a natural inhabitant of the colon. The problem here with heat-treated foods is that you might as well say they are sterile. If you are feeding sterile foods, they don't contain bacteria that can form a colony. So in order to colonize bacteria you have to consume foods with live bacteria or an opportunist will take that invitation.

Breast-fed babies are colonized naturally by Bifidobacteria. Babies fed formula develop much more harmful fecal environments. Preterm infants are especially at risk for Clostridrial infections because there is usually a delay in breast feeding. In older children generally pathogenic Clostridial infections develop after antibiotic treatment, which can destroy the beneficial bacteria derived from the mother.

Impaired Digestion and Pasteurized Milk

Pasteurized milk causes the impaired digestion of casein and other proteins found in milk. Malnutrition is caused by either an insufficient diet or an impaired utilization of foods. Malabsorption is the impairment of intestinal absorption of nutrients. Some children with protein-calorie deficiency had abnormal intestinal fat absorption, and because of this they had an increased uptake of serotonin in the plasma. One scientific study found hyperserotoninaemia in 70 percent of their autistic patients. It should come as no surprise that serotonin uptake inhibitors have had some success in treating autistic children. The medical literature supports the realization that protein deficiency causes developmental delay and even mild increases in ammonia causes oddities in behavior.

Some methods of ammonia detoxification have been suggested with the use of lactulose, oral lactulose and the drug Tributyrate, which can scavenge excess ammonia. Lactulose can cause extreme irritability in children, and perhaps its use with autistic children was abandoned due to these circumstances.

Impacted Colons and Pasteurized Milk

Children with autism frequently have impacted colons. Clostridia is notorious for reducing the quantity of water in the colon. Hard dry stools can cause irritability once stool-softening products are started. These stools might only be removed by using an enema prior to beginning any stool-softening treatment. Once the bowels have been cleared of extremely hard, dry stools, then treatment with stool softeners can begin.

What we have to consider is the matter of colonizing bacteria. A healthy colon in a normal infant contains a significant supply of Bifidobacteira. Pasteurized milk simply putrefies in the colon and hinders the passage of fecal matter. Pasteurized milk contains heat-killed bacteria and is unable to reflourish the colon with host-friendly bacteria--unless contaminated, it is sterile.

When milk proteins are damaged by heat processing it renders them indigestible. Raw milk does not cause constipation. Constipation is caused by the loss of moisture. Lactose and lactulose add moisture back to the colon, but clostridia can quickly dry up the feces. Raw milk is easily digestible by infants, for as long as babies have been born mothers have been feeding their young casein and other milk proteins. Clostridia can feed on unabsorbed lactose from the diet. Lactose is completely hydrolyzed in cheeses made with bifidobacteria.

Autism and Casein-Free Diets

Science cannot support the presumption that a casein-free diet reduces autistic symptoms. All the literature on casein restriction indicates this only causes a developmental delay. If an improvement is seen on a casein-free diet, it is only because of the removal of free lactose, and the removal of constipating foods.

The very worst thing that you can do to a child coping with mercury is to wean them off of breast or raw milk. Weaning causes the hair and blood mercury levels to suddenly drop, and it is re-routed to the colon for excretion. If the child is constipated, it could mean real problems.

Now we know three Japanese researchers were able to induce autism in a clinical setting, with a low-protein, high-lactose, sterilized formula. The belief that infant-mother separation or the refrigerator mother causes autistic symptoms continued for many years. Understanding what happened to these infant primates could have changed the course of medical history. Unfortunately, two new theories of what causes autistic symptoms have followed.

Treating Autistic Symptoms

To treat the symptoms of autism, we have to feed our children foods that they can digest, foods that do not cause constipation, foods that will give them back the bacterial environment to temper these inflammatory conditions. And most importantly return to proper nitrogen-ammonia balance.

Treatment should begin with a healthy diet, high in quality protein foods such as eggs, meat, milk and cheese and balanced essential oils. Raw goat's or raw cow's milk may be given. If not well tolerated, then cultured raw milk/kefir can be used. Oral, inexpensive butyrate may be given to both clean the colon and to detoxify ammonia from the liver and bowels.

To finalize, there are still the issues of treating malabsorption, the impairment of intestinal absorption of nutrients and abnormal intestinal fat absorption. To begin nutritional rehabilitation for your child you will need some help navigating through the complicated process. Dr. Patricia Kane has treated thousands of children with autism over the past 25 years who have not only had malnutrition, but also abnormal intestinal fat absorption. Restoration of digestive function is critical to absorbing dietary essential fatty acids and stabilizing the nutrient base.

Japanese scientists in 1975 documented the development of autistic symptoms and revealed how diet can induce these symptoms. In 2004 we now have the tools to eradicate the symptoms of autism.