food sensitivities and breastfeeding
I have been working with breastfeeding mothers for over 35 years. In that period of time, I have seen more and more moms struggle with babies who have intolerances to something in their mother’s diets. I have often wondered why this is so, and the reasons I can come up with are merely speculative, not “evidenced based”, but nonetheless still quite plausible. I believe that there are probably multiple factors (as with anything!) and the problem is often multifaceted. So why do I think more babies have a sensitivity?
1) Increased use of antibiotics… Moms didn’t used to get antibiotics in labor for the treatment of Group B strep. (I won’t get into whether or not this is necessary- that’s a discussion for another time). If you have a long labor, this is MANY doses of strong antibiotics which change the gut flora. If you have a c/section, you are also given antibiotics as a routine part of the surgery. If you have a uterine infection, urinary tract infection or breast infection postpartum, you will also receive antibiotics. The “microbiome” of the gut is altered with the medication, and while antibiotics kill bad bacteria like Group B strep, they also kill good bacteria which create a healthy environment in the gut.
2) Additives in our food…preservatives, dyes, chemicals etc. all lead to an altered microbiome and affect our health overall, but especially our digestive health. Moms who have a “leaky gut” (intestines that are more permeable which allows the proteins to leach into the bloodstream) are more prone to having babies with sensitivities because the culprit foods are more available to the baby from the mother’s bloodstream into her milk.
3) Poor nutrition in general…highly processed foods, diets high in sugar, GMO’s- also contribute to a leaky gut and poor health in the mother. Many mothers also eat foods that they are sensitive to, but ignore the symptoms that go along with that (“oh, I just have a tendency for gassiness, congestion, eczema” etc etc). I have worked with so many moms that find that they feel so much better when they eliminate foods from their diet for their babies, and then realize that they themselves had a problem with that food. The mother’s sensitivity and antibodies are shared with her baby.
4) Increased awareness of this problem… Thanks to the internet and mothers being more educated in general about the potential for food intolerances in their babies, we are more aware of the issue. Years ago, moms were simply told that their babies had “colic” and left to deal with a miserable baby for months to come. Unfortunately, there are still some pediatricians who will tell moms this, but more and more I am hearing them suggest that moms eliminate certain foods from their diets, and many doctors even test babies stool for blood which indicates significant irritation. Colic is not a real affliction, it simply describes a baby who cries a lot. Babies cry for a reason…and when you identify the reason, the “colic” goes away!
So, what are the signs that your baby might have an intolerance to something in your diet?
1) Increased fussiness- usually it takes a week or two (or sometimes longer) for a baby to start to react to something in mom’s diet. That’s because it takes a number of exposures for them to start to build the intolerance. I always use the analogy of bee stings to explain- you can have a bee sting or two and not have a reaction, but if you step on a hive and get many stings at once, then you have an allergic reaction. It’s the increased exposure that’s like the straw that breaks the camel’s back.
2) Gassiness, spittiness, reflux, congestion, “rattly” breathing
3) Rash- telltale sign is a red ring around the anus. Many babies also get rashes on their face, their trunk, and eczema like patches on their arms and legs.
4) Green, mucousy, watery, stinky poop. Green poop means rapid transit through the gut due to an irritant. Mucous is due to irritation of the gut lining (mucous membranes on overdrive). While breastfed babies typically have liquidy poop, watery is not normal and it should have a not- unpleasant buttermilk like smell. If it’s a stinky offensive smell, (this goes for their gas too) then something is bothering them.
5) Discomfort at the breast- babies should be calm and comforted while nursing. If they are grunting, scrunching up their legs, fussing and pulling at the breast while feeding, that’s another sign that something in your diet is troublesome.
Some babies have many of the symptoms, while others only have one or two.
What are the most common culprits?
Dairy, soy, eggs, and nuts are the ones I see most often. (dairy being by far the most common- you have a human baby, not a baby cow. Human babies are not meant to digest cow’s milk protein) Less commonly seen irritants are gluten and corn. Things like tomatoes and other acidic foods can exacerbate reflux symptoms, but are not sensitivities like the other foods. Many moms find they can eat foods like that in moderation, but the true intolerances need to be completely eliminated.
It can take 2-3 weeks to see improvement in your baby’s symptoms. While the culprit foods will be gone from your milk much sooner, it can take awhile for your baby’s system to settle down. Don’t abandon ship too quickly. Also be sure to have every bit of the problem food eliminated- even the smallest amount still present in your diet can keep your baby’s symptoms activated. That means reading all labels and being aware of sneaky places that the ingredient might be present. (for example, many breads contain non-fat dry milk powder. This doesn’t mean you can’t have bread, it just means you need to read the label to avoid that brands that have it). Casein and whey are dairy derivatives, so look out for that in your labels. Fortunately, allergy labeling has gotten easier to decipher since most foods will simply say “contains dairy (or whatever)” at the bottom of the list of ingredients.
Be careful of eating out or eating at friend’s houses while first eliminating foods and trying to interpret what the problem is. People will often tell you that what they’re serving is dairy-free, but they don’t stop to think that the bread crumbs they used have cheese in them, or the butter they cooked the chicken in is dairy. Once you’ve eliminated the problem food from your diet and your baby’s symptoms are improved, little indiscretions like that won’t be a big problem, (maybe just one funky poop or a gassy night), but while you’re trying to settle your baby's system, even a small amount can keep them activated.
Unfortunately, some babies can have more than one sensitivity. It can take some time to do your detective work and figure out exactly what the problems are. It can be frustrating and make you feel quite helpless when you watch your baby struggle with discomfort. Many moms feel like they are hurting their baby with their milk. It’s not your milk, it’s what’s in your diet that’s the problem. Babies are ALWAYS better off with breastmilk. Formula is cow’s milk protein. So if you chose to switch to formula because of a concern about your breastmilk causing your baby distress, you would most likely end up with a hypoallergenic formula, which is VERY expensive, and not very good tasting or smelling! (and doesn’t contain ANY of the benefits of breastmilk!)
When will your baby outgrow the intolerance? It depends on the baby. Some kids outgrow it pretty quickly and other more sensitive babies take longer. But if you avoid exposing the problem food to them through your milk, they will eventually outgrow it. If you just chalked up your baby’s symptoms to “colic” and didn’t change your diet, they would most likely go on to have a problem with it long-term due to the continued exposure. While it’s definitely a sacrifice on mom’s part, it’s certainly worth it to have a more comfortable baby! Sometimes you inadvertently challenge the baby by mistakenly eating the problem food by accident, or you may choose to purposely try it to see if they still have an issue. Either way, you will know if you still need to avoid the food, or if you can now put it back into your diet. I have seen literally hundreds of babies with food sensitivities and many, many dedicated mamas who sacrifice lots of yummy foods for the sake of their babies. Fortunately with the increased incidence of food allergies, there are many more alternatives available. Ben and Jerry’s and Haagen-daz even make dairy free alternatives now!
If you suspect your baby might have a sensitivity, talk to a Lactation Consultant about it. They can help you troubleshoot and make it easier to figure out. It’s definitely a process, but a process well worth it. I’ve heard so many moms say, “It’s like I have a different baby!”. What a wonderful thing that is!
