#What to do if you suspect your breastfed baby has a food allergy

When my oldest daughter was a baby, I noticed that each time I’d eat spicy food, she would cry and refuse to nurse. That’s when I learned that some foods mom eats elicit tastes in their milk that baby may not particularly like.

Some components in a breastfeeding mom’s diet do more than just affect the flavor, however. Breastfed babies can sometimes react to certain proteins that drift into mom’s milk from the food she eats. Symptoms of food-related allergies in breastfed babies may include wheezing, skin rashes, hives, vomiting and loose or bloody stools.

Figuring out if these symptoms are from something mom ate is the tricky part. Plenty of other medical conditions may also be the cause. Bloody stools can show up with viral infections, for instance.

Surprisingly, there is no best approach to determine if food allergy is the reason for symptoms, according to a recent review of this topic in the Journal of Allergy and Clinical Immunology.

Pediatric allergist Dr. Puja Sood Rajani and colleagues report that cow’s milk is the most likely cause of food-related allergies in exclusively breastfed babies. It’s therefore the first food moms are told to eliminate.

Milk is not always the culprit, however. Fish, eggs, soy, nuts, corn and wheat can also be prime suspects. And some infants have problems with more than one food.

Nutrition experts warn, too, that, in the quest to find the cause of baby’s symptoms, important sources of calcium and other essential nutrients can be stripped from the diet. So what’s a mom to do?

A medical work-up is the first step. Depending on symptoms and history, certain foods from mom’s diet may need to be eliminated for a trial period of time. Parents need to keep track of what mom eats and when baby’s symptoms occur. Signs of food allergy in breastfed babies can can occur immediately, or up to two days after mom has ingested a trigger food.

This can be a long process—especially if more than one food is involved—since foods should be eliminated one at a time. After a suspected food is eliminated, it may take two to four weeks before improvements. If a suspected food does not cause symptoms, it does not need to be removed permanently from mom’s diet, says Rajani and his team.

The good news is many infants outgrow food-related allergies. The goal, experts say, is not to unnecessarily eliminate nutrient-dense foods from a nursing mom’s diet. And remember that mom’s food is not always the cause of baby’s discomfort. A thoughtful step-by-step approach using medical tests as well as eliminating suspected foods when warranted is the best way to find answers.

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