Breastfeeding allergies and intolerances

Signs and symptoms to watch for if you suspect your baby has a food allergy or intolerance

After a feeding, you’d typically expect your baby to feel full, content and happy. But what if you’re noticing some unusual symptoms? When you’re nursing or pumping, traces of the foods and drinks you consume make their way into your breast milk. If your little one is experiencing excessive fussiness, digestive discomfort, rashes and other symptoms, it may be a sign of a food allergy or intolerance. No need to panic though! We’ve gathered important info on allergies and intolerances to help you recognize any potential issues and find solutions. It’s possible to have a happy, healthy breastfeeding journey—allergies or not.

Signs and symptoms

A point of distinction: there is a difference between an “allergy” and an “intolerance.” Out of every one hundred babies who are exclusively breastfed only two to three babies show signs of an allergic reaction. Reactions can range from uncomfortable to severe—or in rare cases, life-threatening. Signs to look out for:

• Skin rashes, such as eczema or hives
• Diarrhea or frequent bowel movements
• Excessive gas
• Abdominal discomfort
• Constipation
• Mucus or blood in the stool
• Vomiting or reflux (spitting up or “silent” reflux) 
• Severe colic/extreme fussiness
• Difficulty breathing

True allergic reactions typically come on very quickly and are more severe, such as vomiting, wheezing, swelling, hives and blood in the stool. A reaction connected to intolerance is usually slower to appear, such as irritability, reflux, eczema, gagging and stooling issues. Allergies and intolerances are also different from a food sensitivity, which might show up as general fussiness or less severe symptoms after a mom eats spicy or “gassy” foods. Mild symptoms—such as shorter periods of fussiness, gas or spitting up—can be “normal,” as babies’ digestive systems often need some time to fully develop. It’s when the symptoms become more extreme or upsetting to them that you may suspect a true allergy or intolerance.

Common baby food allergies

The top eight allergens for babies and young children include cow’s milk, soy, eggs, fish, peanuts, tree nuts (like almonds, cashews and walnuts), shellfish (including lobster, crab and shrimp) and wheat. Among children, the most common allergen is cow’s milk protein (dairy). The proteins in cow’s milk and soy are fairly similar, so some babies who have trouble digesting dairy will also react to soy. Many babies who have a dairy intolerance will outgrow it by age 1, while those with a dairy allergy will often outgrow it by the time they’re 5 years old.

What you should do

Depending on the severity of symptoms, start by calling your pediatrician or talk to him or her at an upcoming appointment. Keep track of symptoms by writing down foods you eat and any notable reactions. The pediatrician may perform a Hemoccult test on a dirty diaper to check for traces of microscopic blood, an indicator of an allergy or intolerance. Your baby may also be referred to a pediatric gastroenterologist (GI) or allergist. While this might sound serious, these doctors are experts on little ones’ digestive systems and can help pinpoint what’s going on and find solutions fast. If you’re breastfeeding or pumping, you don’t have to stop. The doctor might suggest that you completely eliminate an allergen from your diet, either starting with a common one or with the one you suspect your baby is reacting to. Check ingredient labels for “hidden” sources of the allergen (you’d be shocked which foods contain small amounts of dairy!). Ask lots of questions about ingredients and food preparation when dining out. It can take some time—even a few weeks—to clear your system of an allergen, but you should see some improvement in your baby’s symptoms within a week or two. If you have stored breast milk that contains the allergen, your baby may no longer be able to drink it (major bummer, we know!). In that case, breast milk donation may be an option, or you could choose to keep the milk frozen in case he or she outgrows the intolerance in the future. If you supplement with formula, you’ll want to use a hypoallergenic or amino acid-based one, depending on whether your baby has an intolerance or a true allergy. It’s really tough when your baby isn’t feeling well. But armed with this information, you’ll be more educated on the signs and symptoms of an allergy and more empowered to ask questions and find relief for your baby. At Ashland Breast Pumps, we’re a team of moms who work to support all moms, especially when it comes to breastfeeding. We understand that allergies and intolerances can make the journey more challenging—one that feels like a total rollercoaster or a crazy guessing game as you figure things out. We’re here to help by providing insurance-covered breast pumps—and reassuring you that it will get better.