Breastfeeding a baby with cows milk protein intolerance (CMPI) without giving up dairy

My second son was super unsettled. I remember it being one of the most difficult seasons of my life; looking after a screaming, unhappy baby and a toddler. I became suspicious that something I was eating was causing his discomfort. Apart from the constant crying, the only other symptom he had was constant nasal congestion (and significant cradle cap) – no blood in the stools, no rashes. I was quickly dismissed by doctors; told its normal for babies to cry.

Now I know that it was cows’ milk protein that was the issue! I want to share my story as someone who tried and failed to cut dairy from my diet (as a breastfeeding mother) and continued to breastfeed my son for over 2 years. Also to share what worked to lessen symptoms for my son (who is now ten years old, still eats dairy and admittedly still has issues with nasal congestion). I know this information is helpful to all the breastfeeding mothers and babies that I frequently work with who are navigating this path. There can be a temptation to wean to formula, but formula itself is derived from cows’ milk protein and special formulas are often expensive, taste terrible and may be hard to access.

Cows’ milk allergy (CMA) is taken more seriously by doctors, than cows’ milk protein intolerance (CMPI). CMPI causes discomfort and often the baby is reported to be “thriving” because they are gaining weight. Whereas, CMA has more serious consequences (eg low infant weight gain, skin rashes, hives). And what about lactose intolerance? Is that an issue in babies? Lactose is the sugar component of milk. It is plentiful in human milk too. Eliminating lactose from the diet will not eliminate lactose from breastmilk. It is very rare for babies to have primary lactose intolerance, it’s often not the lactose that’s the problem, but the protein (casein, whey).

There is a lot of misinformation and confusion, even among health professionals. Amidst this confusion, parents of babies with CMPI are unsupported by the medical system. The burden lies with the mother who suffers through those precious early days, her heart breaking over not being able to help her unhappy baby and often no one in the family getting much sleep. In my case, health professionals were quick to offer me treatment in the form of antidepressants, which I refused. With a background in mental health nursing, I knew it was a situational crisis – the answer lay in finding the root cause of my son’s discomfort (and now it’s a passion of mine to encourage all mothers to do this!).

When he was a few weeks old, I decided to trial cutting out dairy from my diet and failed miserably! I normally eat like a bird, so reducing a major food group left me feeling more tired, stressed and miserable than I was already (and hungry!). I would do fine for days then demolish a large bar of chocolate – feeling really guilty. I really craved my morning cup of tea (with milk – now I know barista oat milk is a great alternative). I do feel I am strong willed by nature, but not in this department. Joy Anderson* (Dietitian and IBCLC) who specialised in this area, makes mention that the more addicted you are to a food, the more likely it is to be the offending substance.

Time passed and the intensity of those first few months faded as his attention was directed more at the outside world and less on internal sensations. Still the nasal congestion didn’t go – he was a really snotty kid with frequent ear infections (often babies will grow out of their food sensitivities, but my sons stuck around). I was told by another doctor that he had hayfever. But it wasn’t an environmental sensitivity, it was food. My maternal gut instincts were confirmed, when at the age of six he told me “Mummy every time I drink milk, I get snotty”.

I am now reflecting on what has worked to reduce nasal congestion for my son over the years (he also found it unrealistic to give up dairy) as I currently implement this strategy in order to treat my dermatitis. If you are finding that dairy is contributing to your baby’s symptoms and are freaking out at the thought of giving it up. Here’s what I found in our case:

• A2 milk is a lifesaver! My son may get snotty but he is able to clear it. I feel regular milk causes inflammation (aswell as mucus) that makes nasal passages difficult to clear. A2 milk has a protein that is better tolerated by those who are sensitive to A1 protein (found in most milk products).
• Barista oat milk is an easy switch for hot beverages.
• Butter and cream are mostly fat, with a little bit of milk protein and may be tolerated.
• Avoid processed foods with milk products in them (e.g. milk solids, skim milk powder).
• Eat chocolate that is dairy free (e.g.dark chocolate or raw chocolate).
• Cheese and yoghurt can be less troublesome for sensitive folk (with my son its hit and miss). The addition of enzymes (in cheese) and the fermentation process (in yoghurt) change the structure of the protein making it easier to digest for some. Apparently the more aged a cheese is the better.

Cutting out dairy for 2-3 weeks is often first line strategy for suspected cows milk sensitivity. For some mothers it is easy, for others its impossible. Some mothers may be able to get away with a low dairy intake.

*This is my story of my journey and what I have learnt along the way but it may not work for everyone. For more support there are dietitians who work with breastfeeding dyads who can provide individualised advice.

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Please contact me if you suspect your baby has a cows milk sensitivity. As someone who has walked the path personally, and worked with lots of breastfeeding mothers with sensitive, unsettled babies, I can support you in working out the cause of your baby’s discomfort. Phone/zoom consults, clinic and home visits available.

Other resources:

• Food Sensitive Babies book by Joy Anderson*
• Facebook group –Breastfeeding mothers with allergic and food intolerant babies
• Kellymom article – Dairy and other Food Sensitivities in Breastfed Babies