Ah, dairy. As you stroll down the grocery store aisles, you're hard-pressed to find something that doesn't contain milk products. Unfortunately for breastfeeding moms with dairy-based diets, cow's milk is the most common allergen affecting infants. What are some of the signs and symptoms? How do you deal with a baby who is milk allergic or intolerant? Let's start with the good news...It does not mean that you have to give up breastfeeding. Here is everything you need to know from diagnosis to making the transition from dairy-laden to dairy-free.
What is it about cow's milk that is so allergenic?
Certain proteins in cow's milk have high allergic potential. Lactoglobulin, casein, bovine serum albumin, and lactalbumin act as allergens. Before the age of six to nine months, the lining of the intestines is absorbent to proteins, so a baby with this allergy will respond quickly. In addition, at this stage, the baby's secretory IgA, which essentially coats the intestinal lining and binds sensitizing proteins to itself, is not fully functioning yet.
What are some symptoms of cow's milk allergy?
Babies with this allergy typically show signs of gastrointestinal distress. Vomiting, diarrhea, colic and bloody stool are some symptoms. Many mothers will describe their baby as "screaming all day" or "pulling up their legs in pain." Even when gas is passed or the baby stools, the pain remains. It is also possible that the baby will display respiratory problems such as a runny nose, cough, or wheezing. Others may notice skin conditions such as atopic dermatitis or urticaria. If your baby has any of the above, keep a journal of the appearance of symptoms to discuss with your pediatrician, pediatric allergist, or pediatric gastroenterologist, as a diagnosis may be difficult to ascertain with such varied signs.
I want to continue breastfeeding. How should I handle this?
Even though it may seem against the grain, breastfeeding is still the best source of nutrition for your baby. Speak with your pediatrician or pediatric allergist about eliminating foods from your diet. It will take some work on your part. But once you figure out your new "system," your baby will respond well. Keep in mind that clearing this protein out of your body and the baby's will take about a week to 10 days, so be patient and know that happy days are coming. It is also important to note that the baby will respond negatively to the tiniest amount of milk protein. So if your diet has been dairy-free for many days, but you just indulged in one Godiva truffle ("Come on! It was the smallest thing I've ever seen!"), your little one will most probably suffer the consequences later.
Here is your non-shopping list:
- Acidophilus milk
- Lactic acid
- Malted milk
- Potassium caseinate
- Sodium caseinate
Watch out for that fine print!
Be aware that foods containing "artificial butter flavor," "caramel color", "non-dairy substitutes" (believe it or not, they often contain dairy!), or anything that doesn't describe what "flavorings" or "seasonings" means, may contain milk. In addition, milk may be hiding out in canned fish (such as tuna), many processed meats and deli meats, nutritional supplements and medications.
It is critical that you see your pediatrician or a pediatric allergist as soon as possible if your baby is displaying any symptoms listed above. The sooner you both eliminate the allergen from your diets, the happier you'll both be.
Riordan J, Auerbach KG. Breastfeeding and Human Lactation. Jones and Bartlett.