February 17, 2021

By Andrea Tran RN, BSN, MA, IBCLC

If you are concerned that something you are eating is causing a problem for your baby, you may think you need to wean. However, eliminating the offending food may be all you need to do.

A food sensitivity or allergy in the breastfed baby can present itself in several different ways. You will need to be a detective when it comes to uncovering the likely culprit.

What is the difference between a food sensitivity and a food allergy?

There is some overlap in the symptoms of both allergy and intolerance. There are some critical distinctions between the two terms.

A true allergy causes a reaction from a person’s immune system. True food allergies in exclusively breastfed babies are rare, only occurring in 2-3% of infants.

A food intolerance results in a response from an individual’s digestive system.

To determine if a symptom is an allergy may require allergy testing.

What are the symptoms of a food allergy?

• Hives
• Itching
• Swelling
• Eczema
• Vomiting
• Diarrhea
• Blood in the stool

The most severe allergic response is called anaphylaxis. An anaphylactic reaction can be life-threatening. Anaphylaxis can cause difficulty breathing, swelling of the throat or tongue, dizziness, loss of consciousness, and death.

Anaphylaxis can be treated with epinephrine.

Exclusive breastfeeding for six months is associated with a lower incidence of food allergies as well as the severity of allergies that do occur.

What are the symptoms of a food sensitivity?

• Nausea
• Vomiting
• Diarrhea
• Gas
• Bloating
• Excessive fussiness and crying
• Rash
• Runny nose that never seems to go away

What are the most common foods that can cause an issue?

Any food has the potential to cause an allergy or intolerance. Certain foods cause problems more often than others.

These are the top ten foods that cause issues most frequently.

• Dairy products
• Soy
• Wheat
• Eggs
• Peanuts
• Tree nuts
• Fish
• Shellfish
• Sesame
• Citrus

How do I determine what food is causing a problem?

The simplest way to see if a food is causing your baby’s symptoms is to do a diet elimination.
Doing a diet diary for a few days can help you see if you are consuming any of the most common foods that can cause a reaction.

If you stop eating a particular type of food and your child’s symptoms improve or go away, then you have discovered what is causing the problem.

Patience is required when doing diet elimination. You should not consume the food or food group for a full two weeks to see if there is an improvement.

Some babies will show improvement sooner than two weeks.

It is also possible that more than one food is contributing to your baby’s symptoms. If you see some improvement but not complete resolution of symptoms you should eliminate another food from the list. Working with a lactation consultant may help.

When doing a diet elimination, it is critical to read all labels. You will want to learn all the different ways that dairy and soy products can be identified in any processed food you eat.

• Milk products - milk powder, butter, cream, cheese, yogurt
• Butterfat
• Casein
• Whey
• Lactoglobulin
  Some unexpected foods where dairy products have been found include powdered green food, tuna. You can also find milk products in vitamins and medications.

When a baby has an intolerance to dairy, it is usually caused by the cow’s milk protein. While it is common for adults to be lactose intolerant, it is exceptionally rare for an infant to be lactose intolerant.

Can a baby outgrow food sensitivities and allergies?

Infants can outgrow food sensitivities and allergies. It is not uncommon with a dairy intolerance.

To see if your baby has outgrown the sensitivity or allergy, you can reintroduce the food after six months and see if the previous symptoms return. If it were a true allergy, you would want to work with your child’s health care provider and decide if it is safe to try to reintroduce a food.

Food sensitivities and allergies in the breastfed baby can present a challenge to your nursing experience. However, most of the time, you will be able to continue breastfeeding with a few tweaks to your diet.

Sources:

Food Intolerance Versus Food Allergy. (2020, September 28). American Academy of Allergy Asthma and Immunology. https://www.aaaai.org/conditions-and-treatments/library/allergy-library/food-intolerance

Common Allergens. (n.d.). Food Allergy Research and Education. Retrieved January 21, 2021, from https://www.foodallergy.org/living-food-allergies/food-allergy-essentials/common-allergens

Infant Allergies and Food Sensitivities. (2009, November 2). Healthy Children. https://www.healthychildren.org/English/ages-stages/baby/breastfeeding/Pages/Infant-Allergies-and-Food-Sensitivities.aspx

Bunik, M., Chantry, C. J., Howard, C. R., Lawrence, R. A., Marinelli, K. A., Noble, L., ... & Taylor, J. S. (2011). ABM clinical protocol# 24: allergic proctocolitis in the exclusively breastfed infant. Breastfeeding Medicine, 6(6), 435-440.

Andrea Tran RN, BSN, MA, IBCLC is a freelance writer who has been helping moms and babies breastfeed for over twenty-five years. She is married and the mother of three adult children.