Food Sensitivity In Breastfed Babies
Breastfeeding and food allergies are not usually closely linked and breastfed babies are not usually affected by what the mother consumes. In fact, most studies have claimed that breastfeeding your child can help avoid any food allergies.
There is an unfortunate few, however, that start to see food intolerance or allergy signs in their babies who are breastfed, usually just after feeding.
Why Does This Occur
Doctors believe gluten pass through into breast milk for a reason: to “train” a baby’s young immune system to cope with them.
In most cases, this works like it’s intended to work, and babies’ immune systems learn not to worry about these proteins. But in a few babies, it might backfire, leading to allergies and possibly even to the beginning stages of celiac disease.
The vast majority of young children aren’t diagnosed with celiac disease until they’ve begun gluten-containing solid foods, such as bread and crackers. But there are certainly a few babies and toddlers whose mothers find they seem to react to their breast milk, and in some of those cases, the mothers have solved the problem by eliminating allergens from their own dietsmost commonly cow’s milk, but sometimes gluten, as well.
Newborn Food Allergy Symptoms
An allergy is different to an intolerance allergies are much more serious but less common than intolerances. Allergies will cause more severe symptoms and can at times be life-threatening.
Food allergies in breastfed infants, while not common, can cause both emotional and physical distress. Newborns can experience allergy symptoms after drinking breast milk that contains traces of allergens.
If your infant has any of the following symptoms after feeding, they most likely are having an allergic reaction to a food product that you have consumed.
These symptoms will require medical attention:
- Hives or welts
- Stuffy, itchy nose
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Milk Allergy In Infants
If your baby seems extra fussy, gassy, barfy, snorty or rashy you may wonder, Can babies be allergic to breastmilk? The answer? No, the natural breastmilk proteins are so mild that they just dont provoke allergies in babies. However, heres the big BUT. Babies can be allergic to foods that you eattiny bits of which can sneak into your milk!
How do we know infants dont get breastmilk allergies? In 1983, Swedish scientists proved that even colicky babies are totally fine with their moms milk, however, they can be allergic to proteins that pass through the moms intestines into her bloodstream and then into her milk.
And, those foreign invaders can sometimes create major hassles. About 10% of colic is caused by a baby food allergymost often the common allergenic foods, like dairy, soy, citrus, eggs, nuts, etc.or food sensitivitylike caffeine in coffee, chocolate, tea, cola, Chinese herbs or decongestant medicine.
The Composition Of Breast Milk
One of the reasons that studies of breastfeeding and allergic disease remain inconclusive could be the complexity of interaction between breast milk, the infant intestinal milieu, and the developing immune system. Some elements in breast milk may protect the infant from developing allergies, whereas others may act in an opposing way .
Table 1
Factors in breast milk that are being evaluated as inducing or protecting against food allergies
The components of breast milk have immunomodulatory activity, including antigens , cytokines, immunoglobulins, polyunsaturated fatty acids, and chemokines It is known that secretory IgA is passed from mother to infant through breast milk or colostrum. s-IgA may confer passive protection to the infant immune system. Low levels of s-IgA in breast milk are associated with an increased risk of cow’s milk allergy in infants. Lower s-IgA levels to ovalbumin have been shown in colostrum and mature milk of allergic mothers compared to mothers without allergy, although the presence of these antibodies was not predictive of allergies in their infants .
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Can Peanut Allergy Pass Through Breast Milk
Both major peanut allergens Ara h 1 and Ara h 2 were detected. Conclusions Peanut protein is secreted into breast milk of lactating women following maternal dietary ingestion. Exposure to peanut protein during breastfeeding is a route of occult exposure that may result in sensitization of at-risk infants.
A Personal Story About Baby Allergies
When my husband was a baby, he stopped breathing twice.
His parents were terrified.
Both times, it was after he was exposed to milk.
So when I had my daughter, I knew that giving her dairy wasnt an option. However I drank it and breastfed and she didnt seem to have a problem with that.
My daughter also had eczema .
When she turned 5 months old, my pediatrician suggested introducing peanut butter to her. His theory was that exposure young could help prevent allergies in the future. He also refused to test her allergies because often there are false positives.
So I gave her a tiny bit of peanut butter. She swelled up, almost stopped breathing, and we spent the following 2 nights in the Emergency Room.
It was terrifying.
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Case Study: Infant Immune Study
Data on breastfeeding and infant wheeze were collected from birth to 1 year from 243 mothers as part of the Infant Immune Study in Tucson, AZ, USA . Breast milk samples obtained at 11 days postpartum and assayed by ELISA for concentrations of TGF-1, IL-10, TNF-, and soluble form of CD14 as well as cytokine dose and its relationship with wheeze were assessed. An increasing duration of breastfeeding was associated with decreased prevalence of wheeze . A higher TGF-1 dose was associated with less wheeze at 1 year, showing a linear trend with wheeze when considered as a dose . The risk of wheeze decreased with increasing dose of TGF-1 when adjusted for sex, gestational age, maternal smoking, exposure to other children, maternal education, and maternal asthma. The dose of TGF-1 from breast milk had a significant relationship with infant wheeze at 1 year. Because wheeze is a risk factor for asthma in childhood, this relationship is significant.
Fig. 4
Percent with ever wheeze at 1 year of age by tertiles of cytokine dose: 2 analysis. Reproduced with permission from Oddy et al. .
Breastfeeding Cannot Not Train Food Tolerance
Although breastfeeding does support a healthy immune system and healthy gut microbiome, studies comparing food allergy rates in breastfed and formula fed infants shows no difference.
Studies dating back to the 1970s all the way through today show that there isnt a difference in allergy rates between children who are breastfed, given cows milk formula, or soy formula.
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What You Should Eat
You can have a well-balanced diet even without eating any dairy. You can get plenty of protein from fish, beef, chicken, eggs, nuts and beans. You can use calcium-fortified soy milk, rice milk, almond milk, coconut milk, hemp milk, or fortified orange juice to supply you with 1,000 mg of calcium each day, or you can take a calcium supplement.
You will also want to continue taking a multivitamin. Be sure to read the labels on your vitamins and any medications that you are taking. They may also contain hidden allergens.
It can take a month or more for your babys symptoms to improve. If your baby shows no signs of improvement or his symptoms get worse after a month of the dairy-free diet, you may need to eliminate other foods such as wheat, eggs, soy, peanuts or nuts.
Sometimes babies are allergic to more than one food. You may need to stay on this restricted diet the entire time you are breastfeeding, or until your infant is 1 year old. Many babies outgrow their food allergies by their first birthday.
Breast milk provides important health benefits for your baby including protection from infections and higher IQ scores, and a reduction in chronic diseases such as diabetes and obesity.
Next Steps
Most Common Food Allergens In Infants
The most common food allergens in infants are milk, dairy, eggs, peanuts, tree nuts, fish, shellfish, soy, soy products and wheat. Eliminating some or all of the most common food allergens could improve babys health dramatically if she is experiencing food allergy symptoms. However, the list of offending foods restricts moms diet to the point where she may suffer ill health effects. It is best to contact an allergist if you feel your infant may have food allergies and create a plan of action to test foods. A typical plan starts out with mom removing all potentially offending foods from her diet. She then adds one food into her diet at a time and records the reactions of her infant.
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Breastfeeding And Childhood Illness
Breastfeeding has numerous health benefits for the mother and child . Exclusive breastfeeding for the first 6 months of an infant’s life, with continued breastfeeding for up to 2 years or longer, is recognized as normal and the gold standard for infant feeding . This is because human maternal milk is uniquely suited to the human infant, and its nutritional composition and non-nutritive bioactive factors promote healthy development and ultimately survival. Breast milk contains immune factors such as IgA antibodies protecting against many health problems in infancy, such as necrotizing enterocolitis, overweight and obesity, diabetes, infections, and allergic disease , as well as reducing the risk of diseases later in life .
In the past 30 years, the evidence for global breastfeeding recommendations has evolved remarkably. Epidemiological studies combined with growing insights from epigenetics, stem cell research, and the developmental origins of health and disease hypotheses offer strong and solid support to the concept that breast milk is best for human infants. Never before in science history has so much been known about the complex significance of breastfeeding for mothers and their children.
Against this background of breast milk significance, there is evidence that breastfeeding may protect against the development of asthma and allergic disease in children although this has been controversial since it was first observed more than eight decades ago .
Baby Food Allergy Treatment
If you suspect that your baby has an allergy, there isnt a specific way to tell what theyre reacting to. While dairy is the most common allergen, it isnt always the culprit.
A family history of food allergies might help determine the cause. If a family member is allergic to a certain food, theres a higher chance the baby will be too.
Theres debate about whether or not to prevent eating common allergens late in pregnancy and early breastfeeding. Some experts think that exposure in the womb and through breast milk will improve outcomes. Others believe that it could sensitize them to the allergen and cause a problem.
The research isnt clear, so its probably best to eat a normal diet UNLESS you notice a reaction in your baby.
One way to prevent food allergies is to breastfeed exclusively for 6 months. When your baby is 6 months old, their GI tract becomes mature. Before that time, it can allow small proteins through . Breast milk encourages healing and is easily digested. So if you are concerned about allergies, its a great option to just breastfeed your baby exclusively!
How To Determine What Baby Is Allergic To
The best way to figure out what your baby is allergic to is to cut the food out of your diet. It takes 1-2 weeks for the food to be completely out of your breast milk and sometimes babies seem worse before getting better.
Keeping a journal of what foods you eat and how your baby acts might help you figure out what the problem food is.
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Common Foods That Cause Allergies
Any food could potentially cause an allergy. The following foods, though, are those that most commonly cause allergies.
- Dairy
- Eggs
- Soy
- Wheat
The challenge is discovering which foods your baby is allergic to. Allergy testing in young infants is often not reliable. One way to determine which foods are a problem for your baby is to keep a food diary of the foods you eat along with a record of your babys symptoms. You may see a pattern develop of worsening symptoms whenever you eat certain foods.
Which Medication Should I Take
Now that you know a little bit about all your options of medications that reduce allergy symptoms, you might be feeling a little overwhelmed with your choices.
It may be tempting to stick to the L1 drugs as they are rated as the safest options, but many parents need higher rated medications to find relief.
Its important to note that L3 medications arent necessarily more dangerous than L1 or L2 drugs, just that theres not a lot of published information available. Drugs that have been better studied in breastfeeding parents tend to get dropped down in rating.
The only person that can tell you which drug you should take is your care provider, and luckily now you have some information to navigate that conversation better.
The specific details regarding each specific medication was gathered from Dr Hales Medication and Mothers Milk .
Having allergies is not a reason to wean, and breastfeeding is not a reason to suffer. There are many options available, and hopefully, one will provide you with relief this allergy season.
Shondra Mattos, IBCLC owns Mattos Lactation, located in Seaside, CA. For more information about her and the services she offers, please visit
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Keep Breastfeeding If You Suspect Allergies
The best thing you can do if you suspect your baby has allergies is continue breastfeeding!
Breast milk contains nucleotides, glutamine, lactoferrin and countless other beneficial nutrients! The components of breast milk are healing and promote your babys stomach development. It also contains antibodies to help your babys body defences. Secretory IgA is an antibody that coats your babys intestines and helps prevent proteins from passing through and causing allergies.
Basically, breast milk has the perfect combination of nutrients and protects your baby from being susceptible to allergies.
Formula is the nest best thing to breast milk but it is full of harder-to digest ingredients. Thats why formula-fed baby poop smells worse than breastfed baby poop. Additionally, most formulas are made with either cows milk or soy- two of the most common allergens!
An option is hydrolyzed formula, but babies tend to reject it because of the taste. Its also very expensive.
The best option is usually to continue breastfeeding and alter your diet.
If your baby has eczema, you can try adding fish oil into your diet! In this study, when a mom supplemented with fish oil her babys eczema disappeared. Then, she stopped taking the oil and the eczema returned. When she started taking it again, the eczema disappeared again!
Healthy fats are essential for skin health and renewal so while eczema is a sign of allergies simply adding fish oil might solve the problem!
What Does A Food Allergy Look Like
An allergic reaction to a food that is normally harmless happens because the immune system is overacting to the substance. It is trying to attack and defend itself. The substance is often a food protein. The immune systems deregulated reaction to the allergen produces what we call an allergic reaction.
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Milk Allergy Symptoms In Babies
Allergies are an overreaction of the immune system as it tries to protect us from foreign proteins. In older kids and adults, the fight between your body and say, cat dander or pollen, takes place up high, causing a runny nose or sneezing. But with infants, the allergy battleground is in the intestines. Here are the most common symptoms of milk allergies in infants.
- A lot of spitting up
- Vomiting
- Signs of abdominal pain
- Slimy diarrhea or blood in stools
- Hives
- Eczema Scaly skin rash
- Coughing or wheezing
- Watery eyes, runny nose or stuffy nose
- Swelling
So What Are The Most Common Allergens
Substances from foods in your diet appear in your milk anywhere from one to 24 hours after eating, with the average being about four to six hours. Your digestion depends on a number of factors, such the type and amount of food, and your individual metabolism. Other factors that may determine how much the foods affect your baby include how old your baby is , and how many times a day he is nursing.
Before limiting any foods from your diet, think about what else baby is ingesting. Has he already started solids? Is he taking vitamin and mineral supplements or Vitamin D drops? Has he had any juice or formula? It could be that something baby ingested directly is causing the problem, and not necessarily something that go to him through moms milk.
The most common substance to cause problems for baby via moms milk is cows milk protein found not only in milk but also in other dairy products, including casein and whey. Other protein foods are also common offenders, including eggs, wheat, soy, pork, fish and shellfish, peanuts, nuts, and pork. Additional sources of allergy can be found in corn, tomatoes, onions, cabbage, berries, spices, citrus fruits and juices, and chocolate.
If you or your partner has a family history of food allergies, it might be a good idea to limit the offending foods from the start just as a precaution, though the research on this is contradictory.
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Can I Breastfeed While I Have Allergies
You definitely can breastfeed while you have allergies, including if you have topical symptoms such as a rash or hives.
Sometimes telling the difference between a cold and allergies is a challenge because they share many of the same symptoms.
Rest assured, even if you have a cold or flu, you can still breastfeed while youre symptomatic, and weaning is not necessary.
