Breastfeeding and Allergies: A Dietitian and a Mom’s Perspective

While I have been plugging away these past few years writing blogs about food I always wanted to delve into writing a lifestyle blog. It appears I didn’t feel like I had a lot to say until I had my own little guy! Having a baby certainly changed the way I practice dietetics and I find myself gravitating much more towards baby, children and family nutrition.
I was so excited when I became pregnant and friends started adding me to mom groups on Facebook. There were mom groups, play groups, Breast Feeding Support groups and Baby Led Weaning groups. I loved these groups but I quickly saw a trend. Worried momma’s getting online and sharing their baby’s issues with other mom’s in the hope of getting advice…but sometimes this advice was medical in nature and certainly not something they were quailifed to give and often incorrect. This lead me to take 2 actions. Firstly, I started my own Baby Led Weaning Workshop so I could help mom’s navigate the tricky world of online information and provide real, evidence based information about when baby was ready to start solids, what foods should be offered first, how these foods should be prepared and how to offer them. The Second thing that came from this experience was seeking out medical help more readily myself.
I hit my first roadblock when baby was about 6 weeks old. My little guy was spiting up SO MUCH. I mean it went from the occasional spit up to me wondering if I should call a priest to perform an exorcism…it was BAD! SO many mom’s had also written about this experience on the mom groups. Their solution, which was suggested by other mom’s in some cases and their family doctor’s in others, was to give up dairy, soy and gluten. Being a Dietitian I knew that this was uneccesary and also detrimental to Mom’s nutrition. You need all the energy, protein and especially calcium you can get when you are breastfeeding! Aside from this, cutting out these foods is completely unnecessary because only true allergens can cross the breast milk. Baby might appear to be fussy after you eat certain things but there is little that crosses through the breast milk besides drugs (including alcohol, caffeine and marijuana) and these allergens. Don’t get me wrong, true milk allergies are common but before you go cutting dairy from you diet it’s extremely important to explore other possibilities.
Let me bring this back around to my little guy. First I sought out a lactation consultant. My nipples had tears in them and I had developed a case of mastitis along with the issues my baby was experiencing. I so desperately wanted to continue breastfeeding but the pain was unbearable. It turned out he had a shallow latch and was taking in too much air when he fed (thus increasing the amount of gas and discomfort in his stomach). Second, I bought him into the children’s hospital. He was gaining great, almost a pound a week, but there was something to this spitting up. He did it so often and so much. The Peaditrician saw him, examined him, took the time to ask me specific questions and told me something that made COMEPLETE sense (he even drew a diagram!). We all may know (or might not know, hey, everyday is a new experience) that baby’s muscle tone is not fully developed for the first few months and that is why their movements are uncoordinated and jerky. BUT did you know that the throat musculature is the same!? Reflux in babies is extremely common and most often caused by immature muscles in the throat. There is a ring of muscle fibers whose job is to prevent food at the top of the stomach from moving back up into the esophagus This valve is meant to be only one way. If this muscle does not close well, which it often does not in new babies, food can leak back into the esophagus. This is called gastroesophageal reflux.
Did I blow your mind? I mean I knew it couldn’t just be the food but this made complete sense to me. I was so relieved. I have Celiac Disease myself and having to restrict my diet any more than I already have was a stressful thought to me.
So what did this doctor suggest? He told me after each feed to make sure baby was sitting up for 30 minutes or so. Lying baby flat increases the chance that milk will move back up the stomach and into the throat if the valve isn’t closing properly. Keeping baby upright helps them digest better and prevents this backflow from happening. He also suggested to keep baby still for 30 minutes. So no joslting, bouncing, or sitting up quickly. Again this is to let milk settle and prevent a backflow issue. Lastly, he prescribed reflux medication. As I am not always a fan of medication, I decided to try his other suggestions first before resorting to that. I will add though, he told me that the medication would do nothing to STOP the spitting up, only relieve any discomfort that my baby was feeling from the acidic juices coming back into the throat.
I practiced this advice for a couple of days and I saw great results. My baby still spit up but it would only be 2-3 times per week and if I moved him too quickly after a feed. It was nothing like the previous multiple times per day. I did end up giving him the medication a couple times, but only when he appeared to be particulay uncomfortable. With the improvement of his latch breastfeeding also became more enjoyable and I finally started to heal.
I am not a pediatrician and I’m not saying you should follow my advice…what I’m saying is that I’m a Dietitian and I knew that I shouldn’t cut food out of my diet so I consulted with a Paediatrician. Sure enough there was an alternate solution to my problem. The moral of this story is to seek out the right professional for the job. Mom’s are great and offer great advice, but you want to make sure you are looking out for your health as well as your babies. I always love the saying “you can’t pour from an empty cup” and you can’t. Now if your baby does have a true milk allergy then you should certainly consult with a Dietitian so they can help you decipher which foods you need to avoid as well as helping you incorporate other sources of calcium into your diet AND your baby’s when it comes to introducing solids.
When it came to introducing solids I offered all the allergenic foods first at 6 months and one at a time. Health Canada now suggests offering these foods sooner (at 6 months opposed to a year) as research shows it can prevent allergies. My little guy had egg, peanut butter, gluten, soy and the list goes on. I had Benedryl and a phone on hand but he was a-ok. But wait…didn’t I say I had Celiac and didn’t I just admit I gave my baby gluten? Yes I did both and yes he is at in increased chance of having celiac, but only 15%. There is a huge psychological component in children who have food allergies and cannot participate in regular activities like other children. So even though there is some chance my baby might have Celiac, ruling out this possibility so he can have a normal childhood and go to a birthday party and eat cake like all the other children is so much more important for his mental health. Its not just the nutritional component we worry about either.
Mom’s, I am just sharing my experience as a mom and a Dietitian so that another perspective is offered. It isn’t easy to cut foods from your diet, especially if you are exhausted and caring for a small life. Your Nutrition can suffer, your mental health can suffer and so can your baby’s. So always seek other alternatives. Cutting food out might seem like the lesser of some evils but it isn’t. Often there are other things going on in the background and if you don’t solve the underlying issue, you might not be able to solve the problem in entirety. At the end of the day everyone will be much more happy if they can eat whatever they want.