Food Allergies in Breastfed Infants
6 to 8% of infants in the first 3 years of life suffer from food allergies.
Approximately 1/3 of infants with eczema have a food allergy.
Top Symptoms Associated with Food Allergy
An infant with food allergies can exhibit one or more of the following symptoms:
- Refusal to breastfeed or fussy nursing behavior
- Poor weight gain
- Vomiting or excessive spitting up
- Poor sleeping patterns
- Chronic skin problems such as hives or eczema (atopic dermatitis)
Common Foods Associated with Allergies
Studies have shown foods ingested by the mother can be detected in her breast milk.
Peanuts, cow’s milk, soy, wheat, eggs, fish and shellfish are the most common food allergies. However, almost any food has the potential to trigger an allergic reaction. Cultural difference in food ingestion affects the likelihood that a certain food will cause allergy. For example, there is a high prevalence of shellfish allergy among Scandinavians, of rice allergy among the Japanese, and of sesame allergy among the Israelis.
When a breastfed infant is diagnosed with a food allergy the infant and nursing mother must totally avoid the identified food allergen to see improvement.
Can a mother still breastfeed an infant with a food allergy?
The majority of mothers of babies with food allergies can continue to breastfeed.
Our goal is to work with the nursing mom to allow her to continue breastfeeding.
Once a food is identified through an extensive history, limited food skin tests and/or ImmunoCAP blood testing, our allergists will help to develop a plan for food allergen avoidance. We will help the infant’s mom in adjusting her diet, teach her how to become a proficient label reader while ensuring nutritional issues are met for the infant and mother.
Can food allergies be outgrown?
Strict adherence to an elimination diet appears to promote the process of outgrowing a food allergy. The majority of children with allergies to eggs, cow’s milk, and soy will eventually outgrow their allergy although it may take a longer time than originally thought. Unfortunately, allergies to peanuts, tree nuts, fish, and shellfish are generally considered life-long allergies. In rare cases, these allergies are outgrown but careful testing and an oral food challenge conducted in the office is required.
Patients who are cautious and comply with their allergist’s recommendations can bring food allergy under control.
Can food allergies, such as peanut allergy, be prevented?
A recent study, Learning Early About Peanut Allergy (LEAP), published in the New England Journal of Medicine showed that early oral introduction of peanuts could prevent peanut allergy in high-risk infants who are not yet allergic to peanuts. This is a change from the former recommendation of avoiding peanut as a strategy to prevent peanut allergy.
High-risk infants include:
- Infants with eczema
- Infants with egg allergy
- Infants with a family history of food allergies
The LEAP study findings suggest that early and sustained consumption of peanut products was associated with a substantial and significant decrease in the development of peanut allergy in high-risk infants. Conversely, peanut avoidance was associated with a greater frequency of clinical peanut allergy than was peanut consumption.
Based on this study, high-risk infants should be evaluated prior to having peanuts introduced into their diets. Our allergists will take a history, perform peanut testing by skin test and assess peanut IgE blood levels. Our physicians will then determine whether peanuts can be safely introduced into the infant’s diet via a controlled in-office oral peanut challenge.
Contact our office to schedule an appointment to address questions or concerns about food allergies.