In my lactation practice I am seeing more and more babies with food sensitivities (allergy and intolerances). In Australia, ten percent of babies have food allergies 1, also these numbers don’t include intolerances (non IgE mediated reactions). Unfortunately, many mothers and their uncomfortable babies are dismissed by the medical system, especially if they are gaining weight (or “thriving” – not my definition of thriving!). What tends to get ignored, is the impact on both mum and baby’s wellbeing and enjoyment of breastfeeding.
These are all signs and symptoms of food sensitivity that I have seen in babies:
- nasal congestion
- cradle cap
- low weight gain
- unusual bowel motions (excessive number of stools or mucus or blood in stools)
- vomiting /reflux after feeding
- excessive hiccups or gas
- high-needs baby
- constant sucking
- difficulty getting baby to sleep
- attachment difficulty / shallow latch / twisting away from the breast
- breast refusal
- tight jaw muscles
Food allergens cause irritation to the gut lining, causing inflammation and discomfort. This can lead to babies taking smaller feeds at the breast, fussing and sometimes refusing to feed much at all, leading to low weight gain. Low weight gain can also be caused by impaired nutrient absorption in the bowels. Other babies gain lots of weight because they have an increased need to feed for comfort.
Before trialling an elimination diet, it is a good idea to see a lactation consultant (IBCLC) or someone who is experienced in this area. An IBCLC will do a full assessment ruling out other possible causes of discomfort or breastfeeding problems (eg. lactose overload, supply issues, tongue tie). A doctor can do a thorough check to rule out medical issues such as UTI, GORD etc. Bodywork can play a role. As a craniosacral therapist I can treat unresolved physical and emotional tensions in the body that may be contributing to unsettled behaviour.
After other causes have been ruled out, the first step is to trial a dairy elimination diet for 2-3 weeks. Cow’s milk protein is the most common cause of food allergy and intolerance in babies. Some mums choose to eliminate soy as well, as many babies who are sensitive to cow’s milk protein are sensitive to soy too. If babies are sensitive to dairy, mothers should see improvement after 3-4 days of starting the elimination diet. Stools may take longer to return to a normal consistency. Parents will have to carefully read ingredient lists on packets of processed foods to ensure there is no hidden dairy. Removing cow’s milk from mother’s diet often makes a significant difference. For some mothers this is an easy venture, for others (myself included) it was near impossible. Accidental slip-ups can happen and often there are other foods causing reactions. In these cases I refer mums to a dietitian experienced with helping breastfeeding families. Mothers who need to continue any long-term elimination diet, including dairy-free, should also have their diet checked by a dietitian.
Other factors to keep in mind that can negatively impact bowel function in babies include maternal or infant antibiotics, and the oral rotavirus vaccine (that babies receive at 2 & 4 months). Discuss these medical treatments with your doctor if you have a food sensitive baby. Exclusively breastfed babies are protected from rotavirus through breastfeeding and the vaccine is non-compulsory.
As a mother of a breastfed baby who was sensitive to cow’s milk protein I know the impact food sensitivities can have on breastfeeding, emotional wellbeing and sleep. Parents may be tempted to switch to formula, but breastmilk is still the milk of choice for these babies, providing good bacteria (probiotics), a large range of prebiotics to develop a healthy microbiome, many protective factors, stem cells and gentle exposure to other potential allergens. Most formula is derived from cow’s milk protein, though there are specialised formulas for babies allergic to cow’s milk protein. These are often expensive and taste terrible. There may also be the temptation to enrol in sleep school or hire a sleep consultant, though food sensitive babies do tend to fail sleep school! This also doesn’t help remove the cause of the baby’s distress.
It is a difficult road caring for and breastfeeding, these babies. There is a lot of self-doubt (feeling you are getting parenting or breastfeeding wrong) and an overriding feeling of helplessness. Parents need support and empathy, not to be dismissed or given advice to space feeds or switch to formula.
Here’s my tips to get through the day with a food sensitive baby:
- Keep on boobing!
- Don’t worry about routines, forming bad habits, or feeding too much.
- Do what ever is easiest for you in each moment.
Remember this too shall pass.
- *Article inspired by Robyn Noble’s webinar – Recognising Allergies in Breastfed Babies.
Resources for mothers:
- Breastfeeding mothers with allergic and food intolerant babies Facebook group
- Food Sensitive Babies book by Joy Anderson (Australian dietician and IBCLC)
- Breastfeeding and Food Sensitivities article
- Crying Babies and Food: In the Early Years ebook
- Cow’s Milk Protein Intolerance article
- Breastfeeding Works! Even With Allergies book by Robyn Noble