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Breastfeeding and Food Allergies

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Breast milk has protective components that help protect infants against allergies. The Academy of Breastfeeding Medicine states, "infants fed human milk appear to have a lower incidence of allergic reactions to cow’s milk protein than those fed cow’s milk–based formula." Since breastfeeding is the best nutrition for infants and has many protective benefits, breastfeeding is highly encouraged.

Severe allergic reactions are rare in breastfed babies. Mild allergic reactions may be seen and typically present with eczema and/or gastrointestinal symptoms (such as gassiness, constipation, diarrhea, nausea and/or vomiting). Other symptoms of food allergies may include hives, congestion, running nose, wheezing, irritability, and/or swollen lips, mouth or throat. Symptoms usually appear within hours or days after exposure to the offending food. Severe reactions (which are rare) can present with labored breathing and/or loss of consciousness. THIS IS A MEDICAL EMERGENCY!

Proteins in mother's milk are responsible for the majority of allergic responses in breastfed infants with cow's milk proteins being the #1 offenderIf your baby has a milk protein allergy, avoid milk and milk products in your diet. The most common symptom of a milk protein allergy is bloody stools which typically develops between 2 - 6 weeks of life (although some babies may present with symptoms earlier). Other signs and symptoms of milk protein allergy include:
  • Excessive crying
  • Blood streaked stool
  • Diarrhea and/or vomiting
  • Poor growth
Other foods can induce allergic responses. These include the following: 
  • Berries
  • Citrus fruits
  • Cocoa
  • Corn
  • Egg whites
  • Fish
  • Milk or milk products
  • Shellfish-shrimp, lobster, crabs, etc.
  • Soy
  • Strawberries
  • Tomatoes
  • Tree nuts
  • Wheat
Cow's milk protein, eggs, peanuts, tree nuts, wheat, soy, fish and shellfish account for the majority of food allergies in children. Many times, elimination of the offending food(s) in mom's diet can help alleviate the allergic symptoms within 3-4 days. However, some moms may need to continue to eliminate the offending food(s) for another 2-4 weeks before improvement in symptoms can be seen. 
To find the culprit of the allergic response, eliminate one food or food group at a time and look for signs of improvement in your child. Since milk protein allergies are the most likely offender, eliminating milk and milk products is usually the best place to start. Be sure to read labels and avoid ingredients such as casein, whey, and lactoglobulin. Usually symptoms will improve within 3-4 days, but it can take up to 4 weeks. If symptoms have not improved by the 4th week, reintroduce the eliminated food (since it is most likely not the cause of the allergic response) and eliminate another food or food group and monitor child for signs of improvement.
Keeping a food journey may be helpful in pinpointing the source of the food allergy. Once your child's symptoms have resolved, you can begin to introduce one food per week back into your diet.  Continue to monitor your child for allergic reactions as you reintroduce foods. If symptoms reoccur, the Academy of Breastfeeding Medicine suggests eliminating the offending food from you and your child's diet until your child is 9-12 months of age and 6 months has elapsed since the "time of diagnosis."
Be sure to keep your pediatrician informed of your activities and your child's progress during this process so that he/she can continue to monitor your child's growth and development. A pediatric allergist, lactation consultant and/or a dietician can be great resources during this time.
Academy of Breastfeeding Medicine (2011). Clinical Protocol #24: Allergic Proctocolitis in the Exclusively Breastfed Infant. Breastfeeding Medicine; Volume 6, Number 6. 
Texas Department of State Health Services Nutritional Services and Texas Association of Local WIC Directors. Principles of Lactation Management. Attended May 2010.
Walker, M (2011). Breastfeeding Management for the Clinician (2 edition). Boston: Jones and Bartlett Publishers.

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