Is My Breast Feeding Baby Allergic To Dairy?
McKenzie Pediatrics, P.C.
Most babies have no problem with anything that mom eats. Most moms can eat whatever they want, when they want it, with the exception of spicy foods, and no more than one alcoholic beverage per day. Caffeinated beverages should also be kept to a minimum. Otherwise, there is no list of “foods that every nursing mom should avoid”.
However, between 5 to 10 percent of babies are dairy allergic, which means that they are allergic to the protein casein that is the predominant protein in dairy products. The predominant protein in breast milk is the whey protein (remember “curds and whey”?). However, when a mom consumes dairy products, more casein protein is used in making her milk.
Most infant fussiness is normal for a young baby, and is not related to foods in a mom’s diet. However, a baby that is allergic to dairy products is often noted not only to be fussy for much of the day, but also to have excessive spitting up or vomiting, heartburn, eczema (especially on the face and upper chest), bloody diarrhea, and/or persistent congestion. Parents might also note that the baby is excessively gassy, and suffers significant recurrent abdominal discomfort, although this alone is NOT usually a sign of a dairy allergy.
Dairy allergies are often genetic. It is likely that either mom or dad was allergic to dairy as an infant. Thankfully, most babies who are allergic to dairy outgrow the allergy, often by the first birthday, and almost always by the third birthday.
Children who are allergic to dairy are not usually allergic to other foods. However, about 1 in 3 dairy-allergic children are also allergic to soy, and 1 in 10 are allergic to egg and/or wheat.
If you are breast feeding, and you or your doctor suspects that your baby is allergic to dairy, the best “test” is to eliminate dairy products from your diet for two weeks to see if your baby’s symptoms improve. Sometimes, symptoms will improve even within a few days, but it is important to do a full two-week trial of eliminating dairy before moving on to other possibilities for your baby’s symptoms.
If your baby’s symptoms clearly improve within the two week trial, it is okay to reintroduce one dairy product in your diet each day to see if the baby’s symptoms return. For many babies, their dairy allergy is mild enough to allow mom to eat a single dairy product each day.
However, some babies are so allergic to dairy that even one thing in mom’s diet sets off a return of symptoms in the baby. If your baby’s allergy to dairy via breast milk is moderate or severe, it is best to wait at least 6 months before trying again to reintroduce dairy.
Keep in mind that a dairy allergy is NOT the same thing as lactose intolerance, which is not having enough of the enzyme lactase in the gut to break down milk sugar, or lactose. Babies and older children with lactose intolerance may have gassiness, cramps, and even diarrhea after eating dairy products, but they do NOT have eczema, vomiting, heartburn, or eczema.
Therefore, if your baby might be allergic to dairy, it will NOT help to switch to lactose-free dairy products. The problem is the cow’s milk proteins, not the lactose. Cooking dairy products will also not help to eliminate the proteins.
When you eliminate dairy products from your diet, you will need to avoid eating cheese, cottage cheese, yogurt, sour cream, ice cream, cream, cream soups, buttermilk, and butter, and you will need to avoid drinking milk. Goat’s milk also is high in casein, and is best avoided.
Margarine is okay to use in place of butter. And buy non-dairy creamer for your coffee. It is generally not necessary to worry about tiny amounts of dairy that might be in baked goods, but as for desserts certainly avoid cheesecake, custard, and pudding!
Acceptable substitutes for dairy include soy milk (Silk™ brand and Organic Valley™ brand soy milks, found in the refrigerator case, tend to be the best, especially the “light” versions lightly sweetened with vanilla), soy yogurts, soy cheeses, and soy ice cream (Tofutti™ brand and Soy Dream™ brand tend to be the best varieties).
However, it must be kept in mind that 1 in 3 babies who are dairy allergic will also be soy allergic. If your baby’s symptoms are not resolving after two weeks off dairy and on soy, discuss this with your baby’s doctor.
If your baby is highly allergic to dairy, and you cannot consume dairy products for many months, it is important that you find other ways to add calcium into your diet. Your baby will not need a calcium supplement, as studies have shown that breastfed babies get plenty of calcium even when a mom doesn’t eat dairy.
Good sources of dietary calcium include:
- Dark greens: broccoli, spinach, collards, kale, turnips, bok choy, parsley, mustard greens, and dandelion greens
- Tofu and other soy products
- Beans: chickpeas (garbanzo beans), navy beans, pinto beans (e.g. refried beans)
- Nuts & Seeds: sesame seeds, sunflower seeds, almonds, hazelnuts, cashews, nut butters, tahini (Sesame paste), walnuts
- Sea Vegetables: nori, kombu, wakame, agar-agar
- Grains: tapioca, quinoa, whole wheat tortillas
- Seafood: shrimp, salmon, mackerel, sardines
- Drinks: calcium-fortified orange juice/Sunny Delight™/soy milk/almond milk/rice milk