Babies can have food intolerances and allergies just like adults. Unlike adults, infant allergies and food intolerances are hard to identify. It causes trauma to the babies as well as stress to the parents. One of the most common allergies which infant's face is breast milk allergy. Well, for some mothers it sounds weird but for mothers who have experienced it, it sounds like a nightmare. Breast milk is supposed to be the most nutritious food a baby can get. How can babies become allergic to it? Is it even true or just another myth? Let us first understand what breast milk allergy in babies is all about.
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Types of breast milk allergy in babies:
When we talk of breast milk allergy in babies, there are two distinct types of allergies that can arise:
#1. Allergy to breast milk itself caused due to improper metabolism.
#2. Allergy to breast milk due to the presence of allergens passed into the milk from the mother.
Let us understand more about both types of allergy.
Allergy to breast milk itself caused due to improper metabolism:
Medically, this condition is known as Methylmalonic Acidemia (MMA). It is a very rare inherited condition, in which the digestive enzymes do not function properly. It is one type of organic acid disorder, which is caused by defective genes.
Infants with this condition, have problems breaking down and using the proteins and fatty acids from the food they eat. A number of enzymes are required in our body to break down and digest the proteins. When one or more of these enzymes are not working properly or missing in the body, a certain type of protein doesn’t get broken down into amino acids (the simplest form of proteins), which are easily absorbed by the body.
This results in accumulation of undigested proteins and fats in the body of the infants. Harmful substances like glycine, methylmalonic acid etc. build up in the blood and in urine causing serious problems to health, growth, and learning. This condition can affect both males and females equally.
How to identify if your baby has MMA?
The symptoms of MMA can begin anytime within a few days of birth to few months. The typical signs of MMA are:
- Sleeping frequently
- Weak muscle tone
- Breathing problems
- Low immunity
- Increased bruising and bleeding
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How to Treat MMA:
There are different forms of MMA, as there are a number of enzymes involved in protein ingestion. Many types of MMA are treated with Vitamin B12 injections and some forms require changes in diet and food habits. Your pediatrician will be the best person to recommend suitable treatment.
What happens if MMA is left untreated?
Newborn babies can display symptoms in the first few days of birth. Some babies become symptomatic later in infancy or may not display symptoms throughout their lives. MMA, if left untreated can cause bouts of a severe illness called metabolic crises. This is a serious health condition signified by low blood sugar and toxicity in the blood due to undigested proteins.
Symptoms of metabolic crises are poor appetite, vomiting, lethargy, and loss of muscle tone.
If metabolic crises is not treated, a baby may develop:
- Breathing problems
- May clip into a coma, which can be fatal.
MMA can cause brain and nerve damage, which can affect intellectual abilities and involuntary muscle movements. MMA, if untreated in infants can be fatal.
Due to the high fatality rate in infants with this disorder, many countries have made MMA screening as one of the newborn’s mandatory screening tests.
Allergy to breast milk due to the presence of allergens passed into the milk from the mother:
Babies usually exhibit an allergic reaction to food that was given directly such as formulas, grains, vegetables, and fruits. But sometimes, babies exhibit allergic reaction towards components present in the mother’s milk.
Most babies don’t have any problem with what the mother eats. Nursing mothers are always advised to eat nutritious food and heed to their bodies on the time and quantity of food consumption. However, there is nothing like a “list of foods that nursing mothers should avoid” which would help mothers to avoid allergenic foods. Each baby is unique and may or may not have an allergic reaction to the same food.
Symptoms of allergy towards components in breastmilk:
Your baby might exhibit all or some of the below-listed symptoms if it is having an allergic reaction to the components of certain foods in your breast milk:
- Excessive fussiness
- Excessive spitting up
- Persistent congestion
- Green stools with mucus or blood
Common Food allergens for infants:
The most common allergy-causing substance is the protein found in cow’s milk. Other allergens include nuts, soy, eggs, bananas, wheat, fish, seafood etc.
The allergens in these foods will be passed on to the baby through the breastmilk, causing an allergic reaction in the babies.
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How quickly are allergies triggered by breast milk?
We all know that the quantity of the compounds, which may cause allergy, passed to the baby through breastmilk is very less. But for the small infants, even little quantities are enough to trigger allergic reactions. So, it is not an easy task to know if your baby has an allergic reaction or any other health issue because the symptoms of allergy show up 4-24 hours after exposure to the allergens.
If your baby’s allergic reaction is to a new food you consumed, the symptoms should subside within a few hours. However, if your little one is allergic to something that you consume regularly, the symptoms will be persistent.
Image Source: Livestrong
How can you figure out which substance is causing allergy in your child?
Identifying the allergic reaction in infants is a tough job but the task of identifying the allergen in a breastfeeding baby is a herculean task. However, you can try some of the below steps to zero down the allergen.
#1. Maintain food diary
Make a note of everything you and your baby eat every day. Note the date and time of the allergic symptoms exhibited by your baby. You can compare the foods consumed with the symptoms and find out the culprit.
#2. Elimination diet
In this method, you have to first start avoiding a common allergen one at a time, let’s say wheat. Avoid all sources of wheat including bread, cookies, cakes, pasta etc. Read the labels of any processed food you want to consume for traces of wheat.
If your baby is allergic to wheat, the symptoms will subside in 2-3 days but the symptoms will take at least 2 weeks to vanish completely. However, if your baby is not allergic to wheat, you can try the same process with another common allergen such as cow’s milk. Repeat the same steps until you identify the allergen.
#3. Rotation diet
This method is a structured way of eating biologically related foods one day and then avoiding those foods for several days. Usually, in this, a group of foods is allowed to be consumed on a particular day, and then you have to watch out for allergy symptoms for you and your baby. For example, seafood including fish, prawns, lobsters can be consumed once in a day and should be avoided for several days. You have to watch out for all possible allergy symptoms before you start consuming seafood again.
#4. Allergy test
This is the last option if you are unable to identify the allergen. A doctor will take a blood sample from your baby and subject it to various tests to identify the allergen. You and your baby have to eliminate the substance from your diet.
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How to treat the allergy caused by the components in the breast milk
Prevention is always better than cure. It is best to avoid the allergens altogether. However, most infants outgrow their allergies.
Some doctors prescribe infant probiotics hoping for better digestion. However, there is no research that probiotics would help in controlling allergies or that a better digestion leads to prevention of allergies.
Breast milk allergy in babies is not as common as many people make it sound. If your child is not well, it can mean an infection or an allergic reaction, as both present similar symptoms. Let the pediatrician diagnose if it is an allergy or an infection and avoid making guesses.
If your baby is diagnosed with an allergy to breast milk because of improper metabolism i.e. MMA, consult your pediatrician to understand more about the condition and get an appropriate treatment plan for it. You have to give additional care to your child until their adolescence so that they don’t get affected by metabolic crises. Check with your doctor if you can continue to breastfeed or should you switch to alternatives like formula feeds, soy milk etc.
If your baby is diagnosed as being allergic to certain substances in your breast milk, try to figure out the allergen using the methods mentioned above. But an allergic reaction should never make you stop breastfeeding your child as it is still the richest source of nutrients to your child. If you are advised to avoid the food causing the allergy, speak to a dietitian to understand how you can compensate for the nutrients you might lose if you avoid that particular food.
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