There are two posts in the most recent digest about allergy---one
manifesting as blood in stools, and the other as eczema.
I have seen several babies similar to this lately, and it is a very frustrating
problem. I have learned to tailor the treatment plan to the motivation of
the mother. I prefer to try strict dietary elimination first, to alleviate the
babies symptoms, and then reintroduce one food at a time to find out
what the offending proteins are. But moms often balk at this
(understandably), so sometimes I will meet her half-way, and start
Pancrease as she eliminates a couple of the most common allergens from
her diet. Sometimes this helps, and sometimes it does not.
As for the two babies recently presented, it would appear they both have
allergies to multiple proteins. I would immediately start both moms on
pancrease as they continue their diets. Then if symptoms clear up for
several weeks (giving the gut a chance to heal) then they could start
reintroducing small amounts of one thing at a time, while still taking the
pancrease.
It is a lot to ask of a mother, so often these babies get put on elemental
formula.
And, yes, the milk previously pumped will contain the offending proteins.
But I would keep it in the freezer in case the baby out-grows the allergy,
and it could be used at a later date.
I have been wondering why this is such a common problem. While doing
research for a recent presentation, I found an article suggesting that
mothers of these babies often have environmental allergies, and have been
found to have low levels of IgA in their milk. The theory then is that the
baby would not receive adequate "coating" of the gut lining to protect it
from foreign proteins. So my personal theory is that mothers who were not
breastfed (most of us in America of childbearing age) and developed a
faulty immune system (allergies) and then insufficient quantities of IgA in
their milk, then set up the baby for food allergy in infancy.
The next piece of the puzzle for me is why/how do so many out-grow it???
Kathy Leeper, MD, IBCLC
Medical Director, MilkWorks-
a nonprofit breastfeeding support center in
Lincoln, NE
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