Hello Linda!

Linda:
>I seem to be seeing/hearing about increased numbers of infants who develop
>severe GER and/or GI bleeding due to true allergy (as evidenced by
>eosinophilia) while breastfeeding.  Sometimes having the mom go off dairy
>(the most common offender, I think) helps, but I've had kids who react to
>unusual things in mom's diet (one reacted to white potato--we discovered this
>through trial & error & her RAST to potato was positive).

We in Finland have a lot of experience about food allergies in babies
and young children. One reason is that our MDs view food allergy and
intolerances little differently than in USA. According to the research
and real life it seems now that rash/hives (atopic skin) in children
under 2 years of age might be a food intolerance/allergy more often than
it was thought to be.

As with breastfeeding and babys symptoms: earlier MDs used to think that
it was rare that those tiny amounts of proteins in mothers milk could
affect a nursing allergic baby. Now it seems that about 70% of allergic
nurslings react to the food ingredients their mothers eat. Most common
allergens in young children in Europe are cow milk, egg and whey, barley,
rye and oat (childrens food allergies has nothing to do with celiac disease so
a baby can react to oat too). But many of us who breastfeed our highly
allergic babies see how our babies react also to many other foods we eat.
My daughter didnt tolerate white potatoe during her first 1,5 years.

Our experience is that a child can be allergic to anything. The mother
has to find out what are the ingredients that cause allergic symptoms in
nursing child by carefully experimenting with her diet. The mother
eliminates ingredients one by one until the child is not having any
symptoms (or only very mild). This takes a lot of patience and
persistence. Many mothers cant do this if their children are very
allergic and some babies just are too allergic to breastfeed (their
symptoms are too severe and a mother doesnt have time to do this diet
adjusting).

Our experience is also that if a mother can find a suitable diet the
children usually start to tolerate more foods after a couple of months
strict diet. 1) Mother finds a diet so that her nursing baby is
symptom-free and grows normally. 2) Suitable solid foods are found for
the baby if she is over 4-6 months. 3) Mother and baby find more ingredients
to eat according babys healing timetable.

>Some of these kids just don't gain weight/do well until they are taken
>off breast and put on Neocate.

Some very breastfeeding oriented mothers have started to give Neocate
blended in babys solid food for example in pureed pear and the
babys weight gain have been better after that and they could have
continued to breastfeed. They are the ones who have found a suitable
diet. We dont recommend breastfeeding if the mother havent found a
diet and the child has allergic symptoms. Only mild symptoms are tolerable
so the child can heal and out-grow her allergies/intolerances.

>Is there any good way to identify the problematic protein(s) in the
>mom's diet so that we could treat the kids with maternal dietary
>restriction and not unduly restrict the maternal diet?

There are no reliable test to young children and babies because of
their immature immunological system. In Finland only elimination and
challenge are regarded as reliable with young children. The test may
not show anything but baby gets diarrhea and colic from cows milk,
so she has CMA. (In Europe we call other than eosinofil reactions as
allergy.)

But according our experince: a mother can breastfeed if she likes
by avoiding babys allergens also a very allergic baby/child. I have
been on diet almost two years now and my still nursing daughter is
recovering slowly (but tolerates more foods than some children whose
mothers quit breastfeeding and started Neocate/Nutri-Junior).

Best wishes,
Pia Ruohotie
RN, breastfeeding counsellor and bf support group leader,
mother of two daughters
From Finland, Europe

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