Breastfeeding comes with a lot of questions: Is the baby latching correctly? Are you making enough milk? Are your nipples supposed to feel like this? Navigating the mysteries of breastfeeding only gets more complicated when you suspect your baby may be sensitive to your milk. Fortunately, you can test to see if your baby has a food sensitivity to your breast milk.
It’s important to note that your baby is probably not actually reacting to the milk itself; instead, "the baby is sensitive to a protein that has passed into the milk and can be removed from mom's diet,” certified lactation consultant Danielle Downs Spradlin tells Romper. “True allergy to human milk is a metabolic disorder that can be fatal. It is discovered during the newborn metabolic screen done after birth.” So basically, allergy and sensitivity aren't the same thing. "Allergy is typically when there is an extreme reaction — extreme rash, eczema, vomiting, and rarely, anaphylaxis," certified lactation consultant Leigh Anne O'Connor tells Romper.
If your little one seems especially gassy or fussy after nursing, they may be experiencing a food sensitivity; you can think of this as your feeling a little weird after eating a double scoop of ice cream, which doesn't mean necessarily you have a milk allergy. “The baby may not be allergic or sensitive to the breast milk, per se. [Instead] they could be reacting to a food their parent is eating,” O'Connor tells Romper. Other signs of a food sensitivity in a newborn are digestive problems including blood in the stool, skin rashes, excessive crying, and possibly even cold-like symptoms. And even if your child is displaying many of the signs, “it's best to work with a pediatric allergist and your lactation consultant when you suspect a food allergy,” Downs Spradlin says. “The majority of self-diagnosed food allergy families I've worked with discovered they did not have a food allergy. There are many other feeding challenges that can mimic [an] allergy.”
While your general inclination may be to shield your infant from anything that’s causing them discomfort, The Academy of Breastfeeding Medicine actually recommends continuing to breastfeed if you suspect a food allergy.
“They do not recommend a formula test,” Downs Spradlin says. “ If it's truly a food allergy, most babies will have marked improvement within days of an elimination diet.”
A breastfeeding elimination diet is much like what it sounds, and it's a great way (perhaps the only way) to truly test if your baby has a sensitivity to something in your breast milk. To do this, the breastfeeding parent slowly and one-by-one removes known allergens — cow’s milk products, soy, wheat, corn, eggs, and peanuts are some of the most common, per Kelly Mom — from their diet, then monitors how the baby reacts to these changes. Downs Spradlin adds that while a baby’s full healing from a food exposure may take weeks, parents will usually begin to see results within a week or less, and therefore, she says, “months long diet tests are tedious and unhelpful.”
To speed up the process, “the parent can keep a food journal and see if certain foods cause certain reactions [or] behaviors in the baby,” O’Connor says. She adds that you may need to use a bit of trial and error before you see results, and it’s a good idea to look at your family’s history of food sensitivity, at least as a starting point. Peanut "is the most prevalent allergen, followed by milk and then shellfish" in food allergic children, according to the American Academy of Allergy, Asthma, & Immunology. Plus, “most babies eventually outgrow their allergy to cow’s milk, although food allergies to other substances may be lifelong,” as per Healthy Children.
So if you suspect that your baby is sensitive to your breast milk, remember it's not actually the milk itself, and the problem can most likely be easily resolved by eliminating an offending food from your diet. And don't worry, you can still have your favorite foods again after you wean your little one. Just think of all the pizza that awaits.
Danielle Downs Spradlin, IBCLC
Leigh Anne O'Connor, IBCLC
The Academy of Breastfeeding Medicine (2011). ABM Clinical Protocol #24: Allergic Proctocolitis in the Exclusively Breastfed Infant. Breastfeeding Medicine Vol. 6 No.6. https://doi.org/10.1089/bfm.2011.9977