Dear Lactnetters - I have been following the thread on possible "allergy" to
human breastmilk and came across this article that reinforces relating to a
foreign protein in the mother's milk. I accessed it through mdconsult.
Sincerely, Toby Gish RN, BA, IBCLC
Immunology and Allergy Clinics of North America
Volume 19 • Number 3 • August 1999
Copyright © 1999 W. B. Saunders Company
553
Food Allergy: Current Knowledge and Future Directions
DIETARY PROTEIN ENTEROPATHY
".........The breastfed infant, a unique feature of this syndrome, is
usually managed with continued nursing on a maternally restricted diet. By
process of elimination and rechallenge with maternal dietary proteins, cow's
milk is the offending antigen in more than 50% of cases. Indeed, in a
16-year experience in 95 breastfed infants with proctitis, the implicated
protein was cow's milk in 62 infants, egg in 18, corn in 6, and soy in 3,
with multiple antigens in only 5.
In 11 of the 95 infants, bleeding persisted despite rigorous efforts to
identify an offending protein in the nursing mother's diet. To document the
syndrome, seven cleared on hydrolyzed casein formula, whereas four cleared
only with use of an L-amino acid formula. Of note, these four also were
somewhat older, had longer duration of symptoms before intervention, and
also had eczema. Ten of these eleven infants resumed and continued
breastfeeding even in the face of ongoing low-grade bleeding. An additional
11 nursing mothers could not maintain a strict elimination of the offending
protein. These 21 infants were followed for more than 6 months with no
significant progression of inflammatory concern, although six became mildly
anemic despite iron supplementation. All of the breastfed infants, as with
the formula-fed infants, tolerated an unrestricted diet by 1 year of age.
In 1921, Shannon demonstrated that maternal dietary protein was transported
antigenically intact through human breast milk. [46] More recent
investigations confirm the presence of bovine beta-lactoglobulin throughout
lactation. [3] [27] [29] The ability of microgram doses to induce
anaphylaxis in a breastfed infant has also been shown. [26]
.........................."
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