Jump to content
  • Welcome to Celiac.com!

    You have found your celiac tribe! Join us and ask questions in our forum, share your story, and connect with others.




  • Celiac.com Sponsor (A1):



    Celiac.com Sponsor (A1-M):


  • Get Celiac.com Updates:
    Support Our Content
    eNewsletter
    Donate

Casien Intolerance?


TCA

Recommended Posts

TCA Contributor

I have been very active on this forum in years past, but motherhood has prevented me from spending hardly any time on the computer period lately. My 5 y/o son has been gluten-free for over 2 year now. the past few weeks, he has started getting sick again, having loose stools and lots of vomiting. He has probably vomited 2-4 days of every week for the past 4 weeks. At first I thought it was just a recurrent virus, but he just started vomiting again and I'm starting to get really concerned. My mommy instinct is telling me that dairy could be the culprit, but I have no particular reason to think that. His behavior has been worse lately. He's been very emotional and had a lot of outbursts. I don't know if it's related or what. I'm 99.9999999999% sure that it's not recurrent gluten exposure since I only cook gluten-free and we seldom eat out. I just thought I'd see if anyone else out there has seen anything similar and if so, was it related to another food issue?

Thanks!


Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):



Celiac.com Sponsor (A8-M):



Darn210 Enthusiast

I think you may be right . . . could be dairy. You might see if he responds to a lactose free diet first, though. Lactaid milk and chewable lactaid tablets with dairy products. My pediatrician says that lactose intolerance often starts around the age of 5 as that is historically/evolutionarily(is that even a word?) when children were weaned . . . and they didn't switch to cow's milk.

Mom23boys Contributor

I would go completely milk free rather than just lactose free. While digesting the sugar is a problem for many, it basically sticks to the tummy area. The casein is the protein that is associated with behavioral issues and can have a variety of issues like gluten.

  • 2 weeks later...
TCA Contributor

I took my son off of dairy in every form the day i started this post. He has improved and feels much better, thankfully. Now I'm trying to figure out what to feed the child. I have been dairy free before while breast feeding my daughter who had a milk allergy, so I have a pretty good grasp of what to avoid, but I'm having a hard time with understanding his sensitivity level. Could it be lactose, casein, or both? I took him to an allergist and everything was negative, but he said he thought it was a lactose issue. I know from being a part of this forum that casein also causes big problems similar to celiac. I don't know if I should try one or the other or just keep on being 100% dairy free. I also wonder if CC issues would be as serious with dairy as they are with gluten.

Any advice? I'd love to hear how casien or lactose impact other people's GI system and how they stay healthy.

thanks!

Ursa Major Collaborator

I would stay completely dairy free for a month, and then try lactose free milk for a couple of days. If his symptoms return, you will have your answer that he is casein intolerant. If he is fine, keep giving him lactose free dairy.

Mind you, it might take a little time for symptoms to return, in which case it would be casein after all.

But for now, casein free is the way to go.

Lizz7711 Apprentice
I took my son off of dairy in every form the day i started this post. He has improved and feels much better, thankfully. Now I'm trying to figure out what to feed the child. I have been dairy free before while breast feeding my daughter who had a milk allergy, so I have a pretty good grasp of what to avoid, but I'm having a hard time with understanding his sensitivity level. Could it be lactose, casein, or both? I took him to an allergist and everything was negative, but he said he thought it was a lactose issue. I know from being a part of this forum that casein also causes big problems similar to celiac. I don't know if I should try one or the other or just keep on being 100% dairy free. I also wonder if CC issues would be as serious with dairy as they are with gluten.

Any advice? I'd love to hear how casien or lactose impact other people's GI system and how they stay healthy.

thanks!

My daughter and I have been Gluten-free Casein-free for 3 months now. Enterolab testing showed sensitivity to gluten and casein (and soy and eggs). WE use rice milk for cereal, and just don't do cheese, ice cream (Rice Dream makes a good organic gluten free casein free "ice cream" flavor called "mudd pie"), yoghurt, or real butter. I'd also avoid candy with dyes in them as these were causing major behavioral issues for my daughter, especially red#40 and Yellow#5. Once you get used to just not having these foods, it gets easier. The only thing she misses is cheese. I miss the ease of yoghurt as a snack, but we just do other things like more fruit, gluten free pretzels/cookies, hummus, etc.

Our reactions to casein tend to be physical, whereas my daughter's reactions to gluten seems more behavioral. With casein, she'll get a headache. I'll get a headache, or joint pain, or extreme fatigue and brain fog, bloating , gas etc. also.

good luck,

Liz

TCA Contributor
My daughter and I have been Gluten-free Casein-free for 3 months now. Enterolab testing showed sensitivity to gluten and casein (and soy and eggs). WE use rice milk for cereal, and just don't do cheese, ice cream (Rice Dream makes a good organic gluten free casein free "ice cream" flavor called "mudd pie"), yoghurt, or real butter. I'd also avoid candy with dyes in them as these were causing major behavioral issues for my daughter, especially red#40 and Yellow#5. Once you get used to just not having these foods, it gets easier. The only thing she misses is cheese. I miss the ease of yoghurt as a snack, but we just do other things like more fruit, gluten free pretzels/cookies, hummus, etc.

Our reactions to casein tend to be physical, whereas my daughter's reactions to gluten seems more behavioral. With casein, she'll get a headache. I'll get a headache, or joint pain, or extreme fatigue and brain fog, bloating , gas etc. also.

good luck,

Liz

Thanks for the info. My son only ate cheese on pizza anyway and NO other dairy, so the main change has been in the way I cook. My biggest question is about how sensitive CF individuals tend to be. I know if I even touch gluten and touch his food, he will get violently ill, but I just don't know with casien or lactose. How sensitive are you and your daughter?

Thanks,

Tanya


Celiac.com Sponsor (A8):
Celiac.com Sponsor (A8):



Celiac.com Sponsor (A8-M):



Mom23boys Contributor
Thanks for the info. My son only ate cheese on pizza anyway and NO other dairy, so the main change has been in the way I cook. My biggest question is about how sensitive CF individuals tend to be. I know if I even touch gluten and touch his food, he will get violently ill, but I just don't know with casien or lactose. How sensitive are you and your daughter?

Thanks,

Tanya

Some can be very contact sensitive. It is one of those things you are going to test out yourself to find his sensitivity.

For pizza...we chop up a piece of bacon into little bits and cook some ground meat in there. It gives it the salt and greasy feeling you crave with cheese.

AliB Enthusiast

Have you looked at the Specific Carbohydrate Diet? It is fantastic for helping those with all sorts of problems, but particularly digestive.

I have noticed this a lot on the forum, that those who are on gluten-free seem to be ok for a while then get sick again. It's annoying 'cos you just get to the point where you think you have it sussed and you end up back at square one!

It seems that it is not always just gluten that is the problem, but carbohydrates in general, particularly complex ones, so for instance, honey would be ok because it is a mono-saccharide, but sugars and syrups are not, because they are more complex di- and poly-saccharides which the body struggles to digest - they don't feed us, but they feed the bad little blighters in our gut, encouraging them to get up to all sorts of nasty tricks!

I have been reading through the reviews in Lame Advertisement for Elaine Gottschall's book "Breaking the Vicious Cycle". Instead of the usual half dozen or so there are 188! And about 98% of them are totally positive. She gained degrees so that she could scientifically research this diet after her little daughter was cured by it. If you Google the book title it will take you to her website and if you select 'Beginners' it will give you the principles of the diet.

Apparently, whilst 20% of the population can tolerate carbs, the other 80% can't. I have realised that whilst gluten and dairy are part of my problem, they aren't the whole. I have bought the book and have already started the diet and so far it's been ok, but this is only the 2nd day so I can't yet show any personal testimony, but it does make a lot of sense.

Whilst it cuts out most carbs it is not quite as restrictive as you might think initially. Most feel though that they would rather restrict and be well, than eat what they want and be ill! It does cut out dairy although she does advocate probiotic yogurt, preferably home-made, in which the lactose and casein is pre-digested by the bacteria so is usually tolerated by those who are intolerant to basic dairy - I can and I am very dairy intolerant. It can be sweetened with honey and added to berries and fruit. There are loads of SCD recipes on the internet.

It is a struggle trying to pinpoint what the triggers are, isn't it. I think that is why this diet appeals, as it takes you back to basics and then you gradually introduce foods over a period of time. Some have found that after being on it for a while they are then able to tolerate some non diet foods occasionally.

I hope you manage to find some solution. It is worrying enough when it is yourself, but when it is your children you are so desperate for them.

AliB Enthusiast

Just out of interest the Pecanbread website which is the SCD primarily aimed at kids with autism and ASD (for which they are getting fantastic results!), but useful for anyone with stomach/digestive issues, has a great way for both children and adults of explaining what happens in the gut to the different carbohydrates and what they do. It is very interesting!

Here is the link (if the site will let me post it! If not, go to Pecanbread and look up SCD Science.

Open Original Shared Link

AliB Enthusiast

Sorry - oops, forgot the link. Open Original Shared Link

TCA Contributor

AliB,

It's funny you mention SCD. I had just read the book and was considering doing it as the next step if GFDF didn't work. Thankfully, it has worked so far, but I haven't forgotten about SCD if it does become necessary. I really do appreciate the advice. Another problem I have is the fact that he is sooooooo picky. He's down to just a handful of foods that he will eat, so it is a daily struggle to get healthy foods down him.

Mom23boys,

Thanks for the advice on pizza. I did something similar the other night and he ate it well. Thank God for bacon!!!!

AliB Enthusiast

I know exactly what you mean about picky - my youngest grandson is 4 and he has always been terribly picky, although I'm not sure he was so bad as a baby. He was diagnosed with ASD although he is actually quite bright and demonstrative, but has learning delay and is only in the 25th percentile for height.

For a long time he would only eat sausages and baked beans but will now eat a slightly better diet. The only veg he will eat though is potatoes, broccoli and carrots and that only from fairly recently. He never eats fruit unless forced, and then only under extreme duress! He may condescend to eat half a banana or a few grapes but will not touch strawberries or any other fruit, yet his older brother loves fruit! If he had his own way he would live on chocolate and chocolate cookies! He is addicted to carbs! Fine subject for the SCD if ever I saw one!

My daughter is selling her house and is hoping to move down with us shortly so I hope that between us we can get to grips with his diet. His older brother is getting stomach problems and D, but we are not sure if it is food related or stress-related from the impending move - he is only 6 and they aren't always very articulate about their feelings at that age! She is putting him on gluten-free to see if that helps so we will have to see.

I have noticed that some who have posted about their children have found that once they have been taken off gluten and/or dairy or whatever their particular antagonist/s are, they seem no longer to be picky and are happy to eat a much more varied diet.

AliB Enthusiast

I know exactly what you mean about picky - my youngest grandson is 4 and he has always been terribly picky, although I'm not sure he was so bad as a baby. He was diagnosed with ASD although he is actually quite bright and demonstrative, but has learning delay and is only in the 25th percentile for height.

For a long time he would only eat sausages and baked beans but will now eat a slightly better diet. The only veg he will eat though is potatoes, broccoli and carrots and that only from fairly recently. He never eats fruit unless forced, and then only under extreme duress! He may condescend to eat half a banana or a few grapes but will not touch strawberries or any other fruit, yet his older brother loves fruit! If he had his own way he would live on chocolate and chocolate cookies! He is addicted to carbs! Fine subject for the SCD if ever I saw one!

My daughter is selling her house and is hoping to move down with us shortly so I hope that between us we can get to grips with his diet. His older brother is getting stomach problems and D, but we are not sure if it is food related or stress-related from the impending move - he is only 6 and they aren't always very articulate about their feelings at that age! She is putting him on gluten-free to see if that helps so we will have to see.

I have noticed that some who have posted about their children have found that once they have been taken off gluten and/or dairy or whatever their particular antagonist/s are, they seem no longer to be picky and are happy to eat a much more varied diet.

AliB Enthusiast

Sorry about repeating the post twice - my broadband connection failed just as I was sending it, and thinking it hadn't gone, when it had reconnected, I sent it again! Ooops.

Lizz7711 Apprentice
Thanks for the info. My son only ate cheese on pizza anyway and NO other dairy, so the main change has been in the way I cook. My biggest question is about how sensitive CF individuals tend to be. I know if I even touch gluten and touch his food, he will get violently ill, but I just don't know with casien or lactose. How sensitive are you and your daughter?

Thanks,

Tanya

I'm actually still figuring that out. As time goes on, I know my self that I am becoming more and more sensitive to the point where if I were to have a glass of milk right now, i'd worry about anaphylaxis because lately when I have somewhat big amounts of casein, my throat gets tight and my whole head feels tight/pressured. However, that said, I still don't worry about a dab of butter once in awhile. I don' t intentionally eat anything with casein in it anymore aside from MAYBE preparing boxed cookies with some butter in the ingredients. My daughter on the other hand, has been still eating milk chocolate once in awhile also as well as nutella on gluten-free bread which has milk in it. No noticeable reaction to that. But yesterday at a friend's house she had 3 pieces of bread with nutella on it (she normally only has one), and last night in the middle of the night her legs were aching and this morning she had a bout of diarrhea and stomach pain. It seems to be a matter of how much exposure for us. If she has ice cream or cheese, she gets a headache fairly quickly.

Those are our experiences so far. Eveyone is different though...the longer you have it out of the diet, the more you will begin to sort out what his reactions are to the casein.

good luck!

Liz

TCA Contributor

Thanks ladies. I guess Cole must be pretty sensitive since he was only mostly getting what I baked with. The only food he will eat is gfdf pizza, bacon, gfdf pancakes, fruit, Gluten-free Casein-free cupcakes (mostly icing), kinnitoos, and occasionally some grilled meat. My daughter eats just about anything and I cook all the time, so it's not a matter of only being exposed to junk. It's very exasperating, but he's lost so much weight that for now we're just trying to get him to eat anything. We'll worry about being more nutritious later.

AliB - hope your grandson feels better soon!

Lizz7711 Apprentice
Thanks ladies. I guess Cole must be pretty sensitive since he was only mostly getting what I baked with. The only food he will eat is gfdf pizza, bacon, gfdf pancakes, fruit, Gluten-free Casein-free cupcakes (mostly icing), kinnitoos, and occasionally some grilled meat. My daughter eats just about anything and I cook all the time, so it's not a matter of only being exposed to junk. It's very exasperating, but he's lost so much weight that for now we're just trying to get him to eat anything. We'll worry about being more nutritious later.

AliB - hope your grandson feels better soon!

Are you checking ingredients for preservatives, food dyes, and artificial sweeteners and MSG? These can be major causes of behavioral issues. Also, if his intestines are damaged, some of the things you mentioned like bacon and red meat might be kinda tough on his system. But I know it can be hard if that's all a kid likes! I'd just be sure to get organic meats, nitrite free bacon etc if you're going to still give it to him. Will he eat things like hummus with cucumber or carrots?

anyway, hope he feels better and starts gaining some weight!

Liz

p.s. like the Romans verse :)

AliB Enthusiast

Elaine Gottschall in her book, Breaking the Vicious Cycle explains what happens when we eat carbs.

Mono-saccharides (single molecule carbs) like honey, fruits, some vegetables and well-fermented yogurt (where the lactose and casein is broken right down, unlike the commercial yogurts which are only short fermented), can cross the gut into the blood stream and be used for energy. They rarely, if ever cause any reaction.

Di-saccharides (twin molecule carbs) like sugar and milk due to damage to the gut causing a lack of enzymes from high over-consumption of the foods, cannot cross into the bloodstream and remain in the gut acting as food for the bad bacteria that not only ferment the carbs causing gas and bloating, but also produce acids that further the damage, setting the stage for different problems all over the body due to bacterial overgrowth and malabsorption issues.

Poly-saccharides (multiple molecule carbs) like grains and starches (wheat, rye, barley, oats, potatoes, and some beans, are even less able to be broken down and equally cause problems.

If our diets contain a high proportion of the di- and poly-saccharides then we will have problems. Lactase is apparently formed at the tip of the villi and will often be one of the first things to suffer as the gut becomes damaged. The more complex carbs we consume, the worse the problem gets.

Stopping gluten may be withdrawing a certain amount of the Poly's out of our diet and we may be able to carry on for a while, but the damage with continue - maybe not as bad as before and the gut may even recover to a certain extent, but the continuation of consumption of other carbs will continue to damage other areas of the gut and it will eventually succumb again to another intoleration.

It seems that the only proper way to help the gut heal properly is to completely withdraw all the problematic foods at the same time and allow the gut to heal completely and then, once that has happened, maybe some of these other carbs may be tolerated occasionally, rather than as an everyday consumption.

That is why the SCD makes such sense.

TCA Contributor

My husband hunts, so most of the meat we eat is organic. We live in the country, so organic is something that is a way of life. I hate feeding him the nitrites too and get the hormel natural bacon a lot to try to help that. As for artificial additives, most of those are cut out due to the other things he cannot eat, so he gets very little. I bake all of his bread, etc, so I know he's getting good stuff.

The problem with the carbs is the fact that he will eat absolutely no veggies - none. It is soooo frustrating because we have garden veggies on the table every night and it is a constant battle. We made him eat a carrot the other night and he threw up. I have figured out how to disguse eggplant as a pizza crust so he thinks he's eating pizza instead. But that is it. He does good with fruits, though. I read the book and understand SCD. We may have to go that route, but for now, GFDF seems to be working.

I appreciate all the help!

Lizz7711 Apprentice
My husband hunts, so most of the meat we eat is organic. We live in the country, so organic is something that is a way of life. I hate feeding him the nitrites too and get the hormel natural bacon a lot to try to help that. As for artificial additives, most of those are cut out due to the other things he cannot eat, so he gets very little. I bake all of his bread, etc, so I know he's getting good stuff.

The problem with the carbs is the fact that he will eat absolutely no veggies - none. It is soooo frustrating because we have garden veggies on the table every night and it is a constant battle. We made him eat a carrot the other night and he threw up. I have figured out how to disguse eggplant as a pizza crust so he thinks he's eating pizza instead. But that is it. He does good with fruits, though. I read the book and understand SCD. We may have to go that route, but for now, GFDF seems to be working.

I appreciate all the help!

One other trick to get veggies in is to get one of those hand-held mixers, cook lots of veggies with your spaghetti sauce and then grind it up in there. If you use a blender, just be sure to keep some extra spaghetti sauce separate to add to the mix as when you blend it it turns a different color and texture and he may figure it out!

same thing with soups, blend it up and he'll never know the veggies he's getting. My daughter likes split pea soup as well. Another one kids seem to like is potato leek (blended).

good luck and take care,

Liz

Archived

This topic is now archived and is closed to further replies.

  • Get Celiac.com Updates:
    Support Celiac.com:
    Donate

  • Celiac.com Sponsor (A17):
    Celiac.com Sponsor (A17):





    Celiac.com Sponsors (A17-M):




  • Recent Activity

    1. - Scott Adams replied to Jhona's topic in Introduce Yourself / Share Stuff
      35

      Does anyone here also have Afib

    2. - Jacki Espo replied to CDFAMILY's topic in Related Issues & Disorders
      5

      Covid caused reoccurrence of DH without eating gluten

    3. - Mari replied to tiffanygosci's topic in Coping with Celiac Disease
      1

      New Celiac Mama in My 30s

    4. - Mari replied to Jmartes71's topic in Coping with Celiac Disease
      2

      My only proof


  • Celiac.com Sponsor (A19):



  • Member Statistics

    • Total Members
      131,956
    • Most Online (within 30 mins)
      7,748

    Crismedin
    Newest Member
    Crismedin
    Joined

  • Celiac.com Sponsor (A20):


  • Forum Statistics

    • Total Topics
      121.5k
    • Total Posts
      1m

  • Celiac.com Sponsor (A22):





  • Celiac.com Sponsor (A21):



  • Upcoming Events

  • Posts

    • Scott Adams
      If black seed oil is working for his Afib, stick to it, but if not, I can say that ablation therapy is no big deal--my mother was out of the procedure in about 1 hour and went home that evening, and had zero negative effects from the treatment. PS - I would recommend that your husband get an Apple watch to monitor his Afib--there is an app and it will take readings 24/7 and give reports on how much of the time he's in it. Actual data like this should be what should guide his treatment.
    • Jacki Espo
      This happened to me as well. What’s weirder is that within a couple hours of taking paxlovid it subsided. I thought maybe I got glutened but after reading your post not so sure. 
    • Mari
      Hi Tiffany. Thank you for writing your dituation and  circumstancesin such detail and so well writte, too. I particularly noticed what you wrote about brain for and feeling like your brain is swelling and I know from my own experiences that's how it feel and your brain really does swell and you get migraines.    Way back when I was in my 20s I read a book by 2 MD allergist and they described their patient who came in complaining that her brain, inside her cranium, was swelling  and it happened when she smelled a certain chemical she used in her home. She kept coming back and insisting her brain actually swelled in her head. The Drs couldn't explain this problem so they, with her permission, performed an operation where they made a small opening through her cranium, exposed her to the chemical then watched as she brain did swell into the opening. The DRs were amazed but then were able to advise her to avoid chemicals that made her brain swell. I remember that because I occasionally had brain fog then but it was not a serious problem. I also realized that I was becoming more sensitive to chemicals I used in my work in medical laboratories. By my mid forties the brain fog and chemicals forced me to leave my  profession and move to a rural area with little pollution. I did not have migraines. I was told a little later that I had a more porous blood brain barrier than other people. Chemicals in the air would go up into my sinused and leak through the blood brain barrier into my brain. We have 2 arteries  in our neck that carry blood with the nutrients and oxygen into the brain. To remove the fluids and used blood from the brain there are only capillaries and no large veins to carry it away so all those fluids ooze out much more slowly than they came in and since the small capillaries can't take care of extra fluid it results in swelling in the face, especially around the eyes. My blood flow into my brain is different from most other people as I have an arterial ischema, adefectiveartery on one side.   I have to go forward about 20 or more years when I learned that I had glaucoma, an eye problem that causes blindness and more years until I learned I had celiac disease.  The eye Dr described my glaucoma as a very slow loss of vision that I wouldn't  notice until had noticeable loss of sight.  I could have my eye pressure checked regularly or it would be best to have the cataracts removed from both eyes. I kept putting off the surgery then just overnight lost most of the vision in my left eye. I thought at the I had been exposed to some chemical and found out a little later the person who livedbehind me was using some chemicals to build kayaks in a shed behind my house. I did not realize the signifance  of this until I started having appointments with a Dr. in a new building. New buildings give me brain fog, loss of balance and other problems I know about this time I experienced visual disturbances very similar to those experienced by people with migraines. I looked further online and read that people with glaucoma can suffer rapid loss of sight if they have silent migraines (no headache). The remedy for migraines is to identify and avoid the triggers. I already know most of my triggers - aromatic chemicals, some cleaning materials, gasoline and exhaust and mold toxins. I am very careful about using cleaning agents using mostly borax and baking powder. Anything that has any fragrance or smell I avoid. There is one brand of dishwashing detergent that I can use and several brands of  scouring powder. I hope you find some of this helpful and useful. I have not seen any evidence that Celiac Disease is involved with migraines or glaucoma. Please come back if you have questions or if what I wrote doesn't make senseto you. We sometimes haveto learn by experience and finding out why we have some problems. Take care.       The report did not mention migraines. 
    • Mari
      Hi Jmartes71 That is so much like my story! You probably know where Laytonville is and that's where I was living just before my 60th birthday when the new Dr. suggested I could have Celiacs. I didn't go on a gluten challange diet before having the Celiac panel blood test drawn. The results came back as equivical as one antibody level was very high but another, tissue transaminasewas normal. Itdid show I was  allergic to cows milk and I think hot peppers. I immediately went gluten free but did not go in for an endoscopy. I found an online lab online that would do the test to show if I had a main celiac gene (enterolab.com). The report came back that I had inherited a main celiac gene, DQ8, from one parent and a D!6 from the other parent. That combination is knows to sym[tons of celiac worse than just inheriting one main celiac gene. With my version of celiac disease I was mostly constipated but after going gluten-free I would have diarrhea the few times I was glutened either by cross contamination or eating some food containing gluten. I have stayed gluten-free for almost 20 years now and knew within a few days that it was right for me although my recovery has been slow.   When I go to see a  medical provide and tell them I have celiacs they don't believe me. The same when I tell them that I carry a main celiac gene, the DQ8. It is only when I tell them that I get diarrhea after eating gluten that they realize that I might have celiac disease. Then they will order th Vitamin B12 and D3 that I need to monitor as my B12 levels can go down very fast if I'm not taking enough of it. Medical providers haven't been much help in my recovery. They are not well trained in this problem. I really hope this helps ypu. Take care.      
    • knitty kitty
×
×
  • Create New...

Important Information

NOTICE: This site places This site places cookies on your device (Cookie settings). on your device. Continued use is acceptance of our Terms of Use, and Privacy Policy.