We see a large number of allergic breastfed babies in our breastfeeding
clinic. It has long been one of our interest areas, so we have been very
keen to see what answers the relevant literature holds. There have been
thousands of research articles and case histories to base practitioners'
management upon.

This means that there really is no excuse for anyone to still be holding the
view that it is possible for babies to be allergic to breast milk. Alicia,
you put all of your points extremely well, and you were absolutely right
about the difference in allergenic potential of the different
lactoglobulins. With this huge mass of literature incriminating cow milk
protein as the main culprit in these cases, we automatically advise mothers
to withdraw ALL cow milk products from their diets and to continue to fully
breastfeed. About 75% of the babies lose all their symptoms once this is
done. We have seen allergies manifesting in an amazing number of ways, some
quite subtle. Allergies can affect any part of the body's physiological
systems - skin, central nervous system, digestive tract etc. With the babies
whose symptoms do not abate, we refer them to a specialist nutritionist who
sorts out allergy problems with great insight AND advises mothers that the
best food for these babies is breast milk!

Hydrolysed milks have the disadvantages already mentioned by Alicia, but
will also continue to cause allergy symptoms in severely allergic babies
because there are traces of cow milk protein which remain unhydrolysed after
processing. We have had cases where these babies have been merely
supplemented with no more than 60ml a day of hydrolysate (as well as their
breast milk) and have continued to bleed from the bowel, have apnoea
episodes etc until the hydrolysate was stopped.

Robyn Noble and Anne Bovey, Brisbane, Australia