Guest Blogger, Dr Trillitye Paullin from Free to Feed
The content is NOT intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your pediatrician or other qualified health provider with any questions you may have regarding a medical condition.
Dr Trill Talks Breastfeeding and Allergies
You suspect your breastfed infant has a food sensitivity through your diet and is reacting to proteins in your breast milk, now what? First, consult with your pediatrician and determine if referrals to an allergist or gastroenterologist are warranted. In conjunction with your medical team, the following steps can help guide your journey.
Does my baby have food intolerance/allergies?
· Excessively mucous stool
· Bloody stool
· Failure to thrive
· Airway restriction
It is important to understand that most infants will not present with every symptom, instead a combo of only a few. Since these range widely, it is important to consider other contributing factors such as lactation issues, teething, vaccines, or illness before taking action to fix a food problem that may not exist . The first line of defense when ruling out other factors is a lactation consultant!
This is not a one-size-fits-all issue. The best course of action is different for every mother, infant, and family situation. If baby's eczema or rash is very itchy to the point of causing injury, we recommended using a CozeeCoo to help prevent the scratching.
Regarding a breastfeeding mother's diet, we outline two possible courses of action: removing one food at a time or removing several common culprits at once. The reason why these two approaches are recommended are based on the pros and cons of each. When removing only one at a time, it is much easier to tell which is the offending food and it can be much easier on mom. Conversely, removing several foods at once can help baby recover faster from symptoms but it will take longer to deduce which items are the problem and such a restrictive diet can be difficult for mom.
Consideration 1: Symptoms
These decisions are often based on symptom severity. Milder symptoms can often be addressed by trialing individual protein elimination until identifying the culprit. Severe symptoms are best addressed by removing most possible culprits and slowly adding back one at a time after symptoms have subsided. For example, a family whose infant has reflux and mucousy stool may want to trial one at a time while a case of severe bloody stool, projectile vomiting, and constant colic may decide to take the second approach and remove several things at once then trial back foods once symptoms are more manageable.
Consideration 2: Dietary Ability
Everyone’s food situation is different. Mothers who plan to remove many food items at once need to consider their nutritional needs and the availability of alternative foods. A helpful outline on less-allergenic food substitutions with similar minerals and vitamins can be found here. Maternal malnutrition is a significant concern if mom cannot access or afford different foods to bridge the nutritional gap.
Consideration 3: Mental Health
There are two opposing maternal mental health considerations. On one hand, continued infant symptoms can be frustrating, depressing, and worrisome. On the other, excessively restrictive diets can be frustrating, depressing, and worrisome. See a theme here? It is vital that moms choose a path which is feasible for their long-term mental health. Breastfeeding is wonderful, but having happy parents is wonderful too. Awareness and loving support is key.
Elimination and Symptoms Timing
Breastfeeding and infant food allergies deserve more than a cookie-cutter response. Every situation is different and should be treated as such. Work with your medical team, consider using a CozeeCoo for scratching, keep a food log, and reach out to Free to Feed for additional support through the process. We offer one on one personal consults to help you navigate this space and understand the science behind what is happening for you and your little. You are doing an amazing job!
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