Early Symptoms of Allergies

Often the first symptom of food allergy that presents in the breastfed infant is gastro-intestinal upset (vomiting, reflux, gas, bloating, blood in stool, diarrhea or even constipation), possibly combined with eczema, and often the diagnosis of 'lactose intolerance' is given, along with the recommendation of a switch to formula, so I would like to cover that issue first.

Stool abnormalities can be attributed to numerous things in infancy, but primary lactose intolerance is not one of them. We are born with the ability to digest milk sugars with the enzyme, 'lactase'. As we age, and since mammals are not designed to consume milk into adulthood, some of us experience a loss of this enzyme and can therefore no longer digest milk sugar, leading to dairrhea, cramping, bloating, and excess gas. Damage to the intestines in infancy (due to illness, allergy, antibiotic use, etc) can lead to secondary lactase deficiency though, where the ability to break down lactose is temporarily inhibited, leading to symptoms described above. This is often labeled 'lactose intolerance' though, and since it actually isn't, ends up being treated improperly. Extending nursing sessions so the fatty hind milk is also ingested will help prevent an overload of lactose to the intestines, from baby's tummy emptying too quickly. For more information on lactose intolerance and secondary lactase deficiency, please visit the links below.

  • Is My Baby Lactose Intolerant?
  • Lactose Intolerance and the Breastfed Baby

    Breastfeeding an allergic infant presents a whole new set of dietary challenges for the breastfeeding mother. It is well documented that maternally consumed food proteins do pass into breast milk, and can cause initial sensitization, continued sensitization, and in extreme cases, even anaphylactic shock. Milk, eggs, peanut and wheat have previously been shown to pass into breast milk. The American Academy of Pediatrics guidelines recommend that mothers from allergic families eliminate peanuts and tree nuts (e.g., almonds, walnuts, etc.) and consider eliminating eggs, milk, fish, and perhaps other foods from their diets while nursing.1

    Can I eat the foods my baby is allergic to?

    No, it is best not to. One problem that sometimes occurs when a breastfeeding mother continues to consume her baby's allergens, is increased intestinal permeability. This could possibly worsen the present allergic state or contribute to new allergies, since whole proteins are absorbed, when without this damage, they normally wouldn't be.

    Experts in the allergy profession advocate complete avoidance of an allergen as offering the best chance for babies to outgrow their allergies. "It is generally agreed that treatment of FA should center on avoidance diets."2

    "In some cases, particularly in children, strict adherence to an elimination diet appears to promote the process of outgrowing a food allergy...Overall, approximately one-third of children and adults will eventually be free of their allergic reactions to foods after rigorously following appropriate diets free of the offending food allergens."3

    Should I stop breastfeeding?

    Absolutely not! Breastfeeding is very protective to the GI tract, and when a mother makes some modifications to her diet, allergic symptoms subside, while breast milk continues to offer protective benefits to the allergic infant. In addition to the highly protective benefits of breastmilk, a nursing mother can also boost the allergy preventive factors in her milk by taking certain probiotics. Lactobaccillus Rhamnosus (GG), is recommended as the strain of choice. A unique characteristic of this strain of probiotic is that it is able to survive the stomach acid and bile, and proceed intact to the intestines (important for having a positive impact on intestinal permeability).4 I recommend a dairy free variety.

    Some mothers may wonder, after reading food labels more carefully for the first time, 'but what can I eat?' Our family has been dairy, egg, fish/seafood, peanut and tree nut free for almost 4 years now. At first it was quite daunting, but after an adjustment period we did adapt quite well. Please visit the recipes section of my site as well as the section on allergen free products for some ideas and links to assist you in meal preparation.

    The LLL has a wonderful article titled 'Allergies and The Breastfeeding Family' that everyone visiting this page should read. Also, please see my page on food allergy prevention for additional information.

    Another helpful article titled 'Milk Allergies and The Breastfeeding Family' by Jessica Williams, may be helpful to some breastfeeding mothers.




    1 FAAN
    2Ann Allergy 1984 Dec;53(6 Pt 2):615-22
    3The American College of Allergy, Asthma & Immunology
    4Probiotics in primary prevention of atopic disease: a randomised placebo-controlled trial Marko Kalliomäki, Seppo Salminen, Heikki Arvilommi, Pentti Kero, Pertti Koskinen, Erika Isolauri, The Lancet, Volume 357, Number 9262 07 April 2001

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