Nothing at All to Sneeze At
By Denise Syed
Breastfeeding is a special gift mothers and babies share. The joy of breastfeeding, however, can be cut short if a mother suspects that her child is having an allergic reaction. What causes an allergic reaction, and what are the symptoms? Does breastfeeding help or hinder an allergic baby? What are the treatments for an allergic baby? And, finally, are allergy symptoms during infancy a precursor to a lifelong battle of allergy suffering? Happily, breastfeeding is not part of the problem but rather part of the solution.
Allergic reactions occur when the body responds to what it perceives as an invasion of a foreign substance (e.g., dust, mold, or a particular food particle). In defense, the body produces large amounts of the antibody Immunoglobulin E (IgE) and has an immunological response to counter the intrusion. The result of that process, as any allergy sufferer knows, can be a host of symptoms ranging from bothersome (runny nose, watery eyes, and congestion) to life threatening (anaphylaxis).
Breast milk contains antibodies from the mother which help in preventing allergic reactions in children.
Allergic reactions in infants—even those who are exclusively breastfed—can occur. A baby’s symptoms may include stomach upset and diarrhea, rashes or hives, and the trademark runny nose and eyes. However, the symptoms of an allergic reaction might be limited to something as subtle as restlessness or difficulty sleeping. Rachel’s son, fully breastfed since birth has always had “mucusy green bowel movements, rashy cheeks and scales behind his ears. He sometimes has red rashes on the skin on the insides of his knees as well. He has never slept well.”
Allergic reactions in infants who are exclusively breastfed might be mistaken by some mothers (and some physicians) as an allergic reaction to the breast milk itself. Rest assured, this is most often not the case. According to lactation consultant Kathy Koch, “It is not possible for a child to be allergic to his or her mother’s milk. It is possible for a child to be allergic to something in the mother’s milk—that is, something the mother has consumed.” (A rare metablolic condition exists that interferes with a baby’s ability to appropriately digest a mother’s milk, but even this does not necessarily preclude breastfeeding.)
Consequently, the mother is the one who typically has to change her diet in order to reduce the allergic symptoms that her child may be suffering. The most common allergens that impact a baby are cow’s milk, soy protein and egg white. Other common allergens include meat, fish, peanuts, onions, cabbage, berries, tomatoes and chocolate. A rotation diet is a noninvasive measure that allows the nursing mother to pinpoint her baby’s particular allergens and modify her own diet in a way that will, hopefully, eliminate the infant’s allergic reactions.
During the rotation diet, a mother picks a suspect food and eliminates it from her diet altogether for a period of five to seven days. If her baby’s symptoms disappear when the food product is no longer present in her breast milk, then it is reasonable to surmise that she has targeted the allergen. By eliminating it, at least temporarily, that particular food from her diet, the nursing mother can help her baby considerably. If the first food elimination does not eradicate the baby’s symptoms, the mother will take another suspect food and eliminate that from her diet. The rotation diet proceeds until the baby’s allergic symptoms dissipate.
It is neither particularly helpful nor practical for a nursing mother to eliminate all potential allergens from her diet as soon as she suspect that her baby is having an allergic reaction. According to gastroenterologist Dr. Maryelle Vonlanthen, “Most infants with allergy symptoms will improve after the elimination of cow’s milk from the mother’s diet. It is not necessary to use elimination of multiple foods as a first line of therapy.” By eliminating all potential allergens immediately, on the other hand, the mother drastically reduces her own diet and does not identify the cause of her child’s problem.
Sometimes the introduction or elimination of a new food into the mother’s diet will have dramatic results for a baby. That does not necessarily mean that the mother is forever banned from that food. Similarly, a baby who is unable to tolerate a particular food in infancy or early childhood will not necessarily be allergic to that food as an adult or even an adolescent. However, severity of reaction is a realistic barometer during the rotation diet. A serious reaction requires a longer abstinence.
The benefit of continued breastfeeding during an allergy scare cannot be overemphasized, however. “Breastfeeding is the cornerstone of allergy prevention,” says pediatrician Dr. Kathi J. Kemper. Breast milk contains immunoglobulins that assist in preventing the onset of allergic reactions in infants. Additionally, breast milk contains antibodies from the mother which help in preventing allergic reactions in children. Furthermore, the alternative of providing commercial formula to allergic babies is counterproductive. Infant formulas are based primarily on cow’s milk—one of the leading allergens for nursing mothers and their breastfed babies. Substituting a soy-based formula may also be of little value, because soy is also a common allergen.
Breastfeeding provides numerous health benefits to a growing baby. As nursing mothers will attest, it is also a special opportunity for mutual adoration and nurturing between a mother and a baby. A baby with allergy symptoms should not be immediately taken away from the breast. Rather, breastfeeding—with the assistance of a systematic rotation diet—can help identify and ameliorate symptoms and can assist in preventing long-term allergy problems for the child in the future. Breastfeeding mothers of children who have allergies can feel confident that their breast milk is optimal for their baby.