At Better Milky Days discovering our baby had multiple allergies felt like a death sentence, but through my exposure as a neonatal nurse and all my friends with babies, allergies felt like a common occurrence. So can we breastfeed a baby with allergies? Read on to find out what the research has to say.
Breast milk is high in protective factors that are perfectly suited to the baby’s immature gut the moment they are born1. Breast milk begins the process of immune protection and closure against whole foreign proteins in the gut. It is recognised and recommended that the baby be exclusively breastfed for 4 to 6 months to support their immune development and support them through atopic reactions should they be predisposed to this4.
There are other risk factors for a baby to develop allergies, and exclusively breastfeeding alone will not prevent allergies in the baby that is at higher risk3. However, exclusive breastfeeding may delay the onset and reduce the severity of allergies. Overall studies have shown that breastmilk can be protective against food allergies, but study methodology has been inconsistent and rarely able to comprise a group of women that exclusively breastfed from birth, as well as considering the mother’s breastfeeding history as an infant, her own allergies and environmental impacts etc4. Exclusive Breastfeeding may delay the onset and reduce the severity of allergies.
Cows Milk Protein Allergy (CMPA) is the most common food allergy seen in babies. Foreign proteins can pass through to the baby’s bloodstream when contained in the mother’s milk5. It is recommended that the mother exclude milk products from her diet (once diagnosed as CMPA), to prevent the milk proteins from passing through to the baby5. The mother does not initiate the allergy in her child, it has to be acquired4. In the case of CMPA, giving formula soon after birth, when the baby’s gut is the most immature, is shown to cause CMPA in the ‘at risk’ infant of atopic disease, even if the baby is exclusively breastfed after4. Specialised formulas do not prevent babies from allergies, and there is no evidence that goats milk or soy based infant formulas are of any added benefit, as they too contain foreign proteins5.
IgG and IgE mediators are situated in the gut and these are part of the body’s defence system that detect and recognise potential pathogens. An allergy will develop after exposure to a particular antigen or allergen4. Breastfeeding is shown to provide potential benefit in protecting the infant from food allergens, atopic dermatitis and asthma2. Atopic disease is typically IgE-mediated allergic reactions that trigger a histamine release, denoted by a rash, vomiting, anaphylaxis and wheezing4.
For the infant ‘at risk’ of atopic disease (inherited factors etc), breastfeeding is shown to be most beneficial4. Eliminating potential proteins in the mother’s diet may be necessary whilst breastfeeding to prevent reactions in the baby, but the mother should seek support from a dietician or skilled specialist during this adjustment4.
NB: It is not recommended or shown to be preventative of allergies for the pregnant woman to exclude typical allergens from her diet whilst the baby is in vitro4.
I hope you can take some comfort in knowing that you have in no way caused your baby to have allergies. But please feel empowered to continue breastfeeding if you feel you can. Restrictive diets are not suggested lightly, so it's important to find out if your baby has a true allergy. We have carefully considered all our recipes to be vegan and wheat free to account for so many mother's seeking support with allergy babies.
1 Lauwers and Swisher 2016, “Counselling the Nursing Mother”, Jones and Bartlett Learning, Sixth Edition
2 Slade, HB, Schwartz, SA1987 Sep “Mucosal immunity: the immunology of breast milk.” J Allergy Clin Immunol.;80(3 Pt 1):348-58. doi: 10.1016/0091-6749(87)90041-8. PMID: 3305665; PMCID: PMC7133196.
3 Lawrence and Lawrence 2011, Breastfeeding, A Guide for the Medical Profession, Seventh Edition, Elsevier Mosby.
4 Brodribb 2006, Breastfeeding Management, Third Edition, Australian Breastfeeding Association
5 Day, J 2011, Breastfeeding …Naturally, Australian Breastfeeding Association, Third Edition, East Malvern