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Thread: Can a baby be "allergic" to breastmilk?

  1. #1

    Default Can a baby be "allergic" to breastmilk?

    My daughter is 3.5 months old. I've been dairy/soy free for 5 weeks due to mucous/blood in her stool ( I was dairy/soy free for 14 months while I nursed my son so this isn't a surprise/issue for me). The blood has gotten worse lately so we went to see a pediatric g.i. specialist. The Dr. told me that my daughter is likely allergic to my breastmilk. I asked if she meant she's allergic to food I'm eating being passed through my milk. The dr. said, no, she's likely allergic to my actual milk because since we're mammals there is whey and casein in our milk and some babies can't process that. I said that sounded really rare and she said my daughter is one of the rare ones. Is this even a possibility? I called the IBCLC I've worked with and she said she's never heard of it but is researching it.
    The dr. said she wanted to do a scope of her colon and if the damage was too bad I'd have to stop nursing immediately and switch to hypoallergenic formula. We did the scope, the damage wasn't too bad so I'm "allowed" to nurse for two more weeks and see how things go from there. I just want as much information I can get to make the most informed decisions I can!

  2. #2
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    Default Re: Can a baby be "allergic" to breastmilk?

    Here is the Academy of Breastfeeding Medicine's "Clinical Protocol #24: Allergic Proctocolitis in the Exclusively Breastfed Infant"; You might already be familiar with this document if your first experienced allergies, though? I would really hope that if your doctor is advising that baby is allergic to your breastmilk itself that the doctor is familiar with this protocol, and could provide you with other peer-reviewed research and support for the assertion. I'm no doctor, so I have no idea what's out there, but I would hope the specialist is providing you with evidence, resources, and research to help explain the assessment.

    http://www.bfmed.org/Media/Files/Pro...ish_120211.pdf

  3. #3
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    Default Re: Can a baby be "allergic" to breastmilk?

    I am not an expert by any means. but my understanding is some babies cannot process lactose. But yes this is an exceedingly rare condition and probably would have been noticeably making baby very, very ill long before now.

    My understanding also is that blood in stool is not always considered a problem. Is baby gaining normally and otherwise healthy?

    There is no possibility the blood is in your milk? Blood in stool can happen where mom has bleeding in the milk ducts for some reason, but it is typically more temporary I would suspect.

    Was the GI specialist someone you went to on your own or were you referred? Is there a possibility of getting another medical opinion?

    Any discussion that the problem might be another possible allergen? Was there any improvement at all when you stopped consuming dairy and soy?

    Here is info about allergic proctocolitis in the breastfed infant from the Academy of Breastfeeding Medicine. This is written by and for doctors. I am not sure how helpful this will be as baby is already under the care of GI specialist. But it will give you more information if you have not see it yet. http://www.bfmed.org/Media/Files/Pro...ish_120211.pdf

    Here is one thing I strongly suggest.
    IF you decide to go ahead with the formula, ask the doctor when improvement can be expected. And pump your milk with a good pump while baby has formula, often enough to maintain a normal milk production. Also, make sure baby is fed in a breastfeeding supportive way- basically this means using a special positioning for both bottle and baby, and helping baby control the feeding by encouraging regular pauses. this is called paced bottle feeding and I can link more info about it later if you want.

    That way, if things do not improve on the formula, or you discover this was not the right approach for any reason, you have the option of bringing baby back to the breast. Will anyone apologize if weaning off breastmilk does no good, but baby has been prematurely weaned, causing possible health issues for both of you?
    Last edited by @llli*maddieb; November 21st, 2014 at 02:48 PM.

  4. #4
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    Default Re: Can a baby be "allergic" to breastmilk?

    (So, my baby is asleep in the Ergo, and I have a hard time turning down an opportunity to internet sleuth.)

    Yes, it is possible for babies to be allergic to breastmilk (and ALL lactose) itself. This condition is known as Congenital Lactase Deficiency, Congenital Alactasia, or Disaccharide Intolerance II.

    In disaccharide intolerance II, cellobiose intolerance would be expected as well as that for lactose. Sucrose, maltose, and starch are well tolerated. In a breastfed infant who developed watery diarrhea on the third day of life, Levin et al. (1970) demonstrated absent lactase in a specimen of duodenal mucosa which was histologically normal and showed normal maltase isomaltase and sucrase activities. Convincing direct demonstration of absent lactase in biopsies obtained in infancy has been achieved only twice before, according to the authors. A sister of the proband was probably identically affected.

    Savilahti et al. (1983) reported 16 Finnish cases (10 male, 6 female) discovered during the previous 17 years. In each case the mother noted watery diarrhea, generally after the first feed of breast milk but at the latest by age 10 days. The 16 cases included 4 pairs of sibs. With the virtual disappearance of diarrhea as a cause of death in the first year of life, the authors believed that every case of congenital lactase deficiency in their population was discovered. Segregation analysis, assuming complete ascertainment, showed agreement with the number expected. The Finnish collection of 16 patients was especially impressive in light of the fact that only 18 cases had been reported elsewhere. The late consequences of this genetic disorder were not fully known. Affected persons might have less atherosclerosis than the average because they avoid dairy products, just as persons with fructose intolerance (229600) have fewer dental caries.
    The above quote is from this source, which supplies more information and genetic markers for this VERY rare condition (how rare? see above: "The Finnish collection of 16 patients was especially impressive in light of the fact that only 18 cases had been reported elsewhere."): http://www.omim.org/entry/223000

    So, I really doubt the above rare condition is what is going on with your 3.5 month old, and thus is probably not really helpful, but I thought I'd just provide it in case it is, or in case someone else stumbles across this thread in the future.

    This protocol, from the College of Family Physicians of Canada, may also be informative: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2553152/ . It is not about the above rare genetic disorder, but about recommendations for diagnosis and management of milk protein allergy, and is worth a look.

    This section seems to touch on a question suggested by maddieb:

    The timing of clinical response to protein elimination depends on the symptoms observed and the manner of infant feeding.
    - In formula-fed infants, esophagitis and behavioural symptoms should respond within 72 hours.
    - Other non–IgE-mediated symptoms should start to improve within 7 days.
    - Colitis can take up to 3 weeks to heal; ongoing bloody stools can persist even when patients are improving generally.
    - Advise breastfeeding mothers that a 7-day washout of milk proteins is required when instituting a restricted diet, delaying the expected clinical response.
    Last edited by @llli*erin.in.middletown; November 21st, 2014 at 03:27 PM. Reason: added other link an description

  5. #5

    Default Re: Can a baby be "allergic" to breastmilk?

    I've heard of the rare case of a baby being allergic to lactose (mostly in my internet searching when my son had issues because many moms confuse milk protein allergy/intolerance with lactose allergy/intolerance). I don't think this is her issue, thankfully, but very interesting!

  6. #6
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    Default Re: Can a baby be "allergic" to breastmilk?

    We're not doctors and we can't tell you to ignore medical advice. But I think that this is a situation in which you should be exceedingly skeptical. As the PPs have pointed out, it's vanishingly rare for a baby to be unable to digest breastmilk. Congenital lactase deficiency is not, by definition, an allergy, but rather a gastrointestinal disorder. Unless you're Finnish, it's almost surely not a problem for your baby.

    Can you give us the rundown on your baby? It would be helpful to know birthweight, lowest weight, and weight at each checkup. It would also be good if you could tell us how often (on average) the baby nurses, how nursing feels, the frequency/quantity of blood in the baby's poop (are we talking occasional streaks or specks or large blobs?), and any other symptoms you're seeing in the baby (e.g. eczema, asthma).

  7. #7

    Default Re: Can a baby be "allergic" to breastmilk?

    I've never seen blood when I pump (I work full time so I pump 6x a day during the week, and I already rent a hospital grade pump bc I can just keep up with her demand since I've never responded well to the pump!) If (hopefully not!) I decide to try formula I will definitely pump and save for whatever duration until we're sure what our plan is. She does have a small anal fissure (probably from pooping constantly) which is definitely causing some of the blood, but the gi seems to think not all of the blood. She is gaining ok, she's slowed down considerably but still gaining 2 to 3 ounces a week and she looks great, alert, coos, usually content, sleeps well. Our ped referred us to the g.i. since we weren't seeing improvement. This isn't the same g.i. I saw with my son, that dr. is unavailable for a few weeks and we wanted to get in asap. I might consider setting up an appointment with her and if the issue resolves itself by then I could always cancel. Thanks for the link. I wish I'd thought to ask about research when I was there...I was just so overwhelmed when she said I might have to stop nursing completely! I'm not sure if this dr fully understands the importance of nursing, both health and emotional aspects, for my daughter and I. I'm especially frustrated because we receive care at a world class institution that is supposed to be baby friendly and at the cutting edge of medicine. I didn't feel like that was the case when I left today!

  8. #8

    Default Re: Can a baby be "allergic" to breastmilk?

    Reading the line about blood stools persisting makes me feel better. Both her ped and her gi suggested I'm not keeping a strict enough diet bc we keep seeing blood.

  9. #9
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    Default Re: Can a baby be "allergic" to breastmilk?

    Intestinal irritation can persist well beyond the point at which the irritant is removed from the baby's diet. Healing doesn't happen overnight!

  10. #10
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    Default Re: Can a baby be "allergic" to breastmilk?

    https://m.facebook.com/DrJackNewman/...01628756577912
    This is a theory on bloody stools from Dr Jack Newman. It may be worth an email to him for his opinion which you could take to the GI.

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