You may be hearing more and more about food allergies these days. Whether you know your little one has one or you're trying to figure out what's going on, your pediatrician should be your first stop for information. Check out these articles then message Dotti for an individualized appointment with one of our Registered Dietitians to learn more.

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Know about food allergies

What is a food allergy?

So, what is a food allergy? Food allergies happen when the body’s immune system reacts negatively to proteins found in a food and creates symptoms like gastrointestinal problems including abdominal pain, vomiting, colic and diarrhea. Your baby also might have respiratory symptoms such as runny nose, cough, sneezing, and breathing difficulties, or skin irritations—like rashes or hives. This article will help you understand food allergies and possible ways to help reduce risks.

You may be able to reduce your baby’s risk of developing allergies by waiting until at least 4 months before introducing food. Breastfeeding during that time is especially protective. When its time for solid foods, including potential allergens is OK for most babies, as long as the foods are developmentally appropriate. Be sure to ask your doctor about food allergens and introducing foods.


In unusual cases, babies may become sensitized to very small amounts of food proteins that are carried in breastmilk. If you suspect your baby is having an allergic reaction to your breastmilk, have a talk with your baby’s doctor to discuss symptoms and removing the likely triggers from your diet.


So, is it an allergy or an intolerance?

We know the difference is confusing. Food allergy reactions have more to do with the immune system and may happen quickly—within minutes or hours after eating—and can include symptoms such as hives, pale skin, vomiting, diarrhea and breathing problems. Reactions can happen even when only a very small amount of food is eaten, touched or even inhaled. The most common foods causing allergies in the US are peanuts, treenuts, milk, egg, wheat, soy, fish and shellfish. 

Food intolerances are reactions to foods inside the digestive system (and don’t involve the immune system). Lactose (a sugar found in milk) intolerance is an example of a food intolerance in adults. Usually, small amounts of the problem food can be eaten before symptoms appear. Some symptoms might be gas, stomachaches, bloating and diarrhea.

The only way to know what your baby is experiencing is to talk with their doctor and discuss your concerns.

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Understanding cow milk allergy

Understanding your baby’s cow’s milk protein allergy

Cow’s milk protein allergy is the most common food allergy in infants and young children 0–2 years of age.

Cow’s milk protein allergy usually shows up before baby’s first birthday. Good news is, most children may outgrow it.

Cow’s milk protein allergy happens when a baby’s immune system reacts to the proteins in cow’s milk. Formula-fed babies react to the milk protein in the formula. Breastfed babies react to the cow's milk protein in Mom's diet that are passed through her breastmilk. In both cases, the body’s immune system treats this protein as a foreign substance and tries to fight them by releasing natural chemicals, such as histamines, which cause the allergic symptoms that your baby may be experiencing.


What to watch for

Symptoms of cow’s milk protein allergy can vary, and they can affect different organ systems in the body. This can make it difficult to pinpoint a cause. Also keep in mind that every case is unique, so it helps to be aware of all the possible symptoms. Get in touch with your baby's pediatrician if you suspect your child has cow's milk protein allergy.


Talk to your baby's doctor if you should see any of these areas of concern.

Common symptoms of cow’s milk protein allergy

Organ system involved Symptoms
Digestive system Frequent spit-up, vomiting, diarrhea, constipation, blood in stool, anemia.
Skin Atopic dermatitis (allergic skin rash), hives, swelling of lips or eyelids.
Respiratory system (not related to a respiratory system infection) Runny nose, ear infections, chronic cough, asthma, wheezing, congestion… particularly if these conditions are chronic.
General Your baby may be fussy, cry inconsolably or have a hard time getting to sleep very often. You also may notice that your baby isn’t gaining the appropriate amount of weight.


These symptoms happen within minutes or hours after your baby has been fed formula or exposed to milk protein through other products or even mom's breastmilk. Severe symptoms like hives, difficulty breathing, and facial swelling can happen within the first half hour.


Will she always have a milk allergy?

The good news is cow’s milk protein allergy is one of the allergies children often outgrow. This usually happens by the time they are between 2 and 5 years old, and 80% of children will be cow’s milk protein allergy-free by their 16th birthday. Allergies to eggs, soy and wheat are also often outgrown; however, allergies to peanuts, tree nuts, fish or shellfish may be life long.

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Develop food allergies

How babies develop food allergies

With all of the talk out there about food allergies, of course you're concerned and want to understand more. Here's what you should know about how babies develop an allergy to certain foods.

Most grown ups' immune cells are found inside the digestive tract, but babies' digestive systems are still developing every day. That's why food allergies are more common in infants than other age groups.


Here’s how it works:


  1. A food allergy develops when a baby’s immune system becomes “sensitized” to an allergen or protein in a certain food. This may happen the first time the baby is exposed to the food, but can also come later.
  2. Once sensitized, the baby‘s body makes antibodies—little proteins that “lock” onto foreign invaders—that are ready to react to that food the next time it’s eaten.
  3. These antibodies then trigger immune cells to make histamine, a chemical that causes allergy symptoms—rash, wheezing, diarrhea, etc.


Feeding choices may be able to lower your baby’s chances of developing a food allergy. That's why experts suggest having your baby drink only breastmilk for at least the first 4 to 6 months of life and waiting until they're at least 4 months old to start appropriate solid foods.


Atopic dermatitis


The most common symptom of food allergy in babies is atopic dermatitis (AD), a type of skin rash or eczema that most often appears on the face, scalp, limbs and knees. The number of infants with AD has gone up 2 to 3 times over the past 30 years, and nearly 1 in 5 infants will develop AD by 6 months of age. While any baby may develop AD, if the baby's parents or siblings have ever had symptoms of allergies such as hay fever, asthma or AD, or if the parents or siblings have diagnosed food allergies, then they may be at increased risk.


Cow’s milk protein allergy


Cow’s milk protein allergy affects as many as 2–7% of babies. Baby formula is the most common culprit, but babies can also react to the cow’s milk protein that Mom has in her diet, which can be passed through to her breastmilk.

If you think your baby may have a food allergy, talk to your pediatrician as soon as possible to see if allergy testing might be a good idea. They will usually suggest a change to a hypoallergenic formula prior to any additional testing.

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Allergies and solids

Watching for allergies when starting solids

It's no fun for you or your little one, but as your Supported Sitter starts to try new foods, you may discover that they have a food allergy or sensitivity. Reactions to foods may be common during infancy, although only 8% of children 1-18 years have a food allergy. Here's a little info to make figuring things out a bit easier.
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Breastfeeding cow milk allergy

Breastfeeding baby with cow’s milk protein allergy

Your baby's digestive system is super sensitive to the things they eat. There’s a chance cow’s milk protein can pass from your diet through your breastmilk and cause an allergic reaction. Cow’s milk protein allergy is rare in breastfed babies, with only about 1% of babies affected, but if you're baby is one in a hundred you'll need to take a few steps to keep them healthy and unaffected.

Body Copy

The most common symptoms of cow’s milk protein allergy include atopic dermatitis (an allergic skin rash, sometimes called eczema) or digestive problems such as vomiting or diarrhea. These symptoms usually start two to six weeks after birth, though they can appear even sooner.


It’s great that you’re breastfeeding. So don’t be discouraged if your baby has a cow’s milk protein allergy. The good news is you can continue to give them the best nutrition with breastmilk by cutting cow’s milk protein from your own diet.


Breastfeeding has many benefits for babies with allergies:


  • Only small amounts of cow’s milk protein are found in human milk.
  • Breastmilk contains probiotics and antibodies, which support a healthy immune system.
  • Breastfed babies tend to have more “good” bacteria in their digestive systems compared to formula-fed babies.


How you can help your baby


If the doctor thinks your baby has cow’s milk protein allergy, they might advise you to cut out all foods containing cow’s milk from your diet. You could see their symptoms clear within six to eight days, though it may take a couple of weeks for your breastmilk to be completely clear of the proteins. Since dairy foods are a major source of Calcium and Vitamin D in your diet, you might need to take supplements to make sure you get the nutrition you need.


If your baby has severe symptoms that include anaphylaxis (a severe allergic reaction that can be life-threatening) or growth failure, then your baby’s pediatrician may suggest an amino acid formula, which is a hypoallergenic formula for special conditions. You can always pump your breastmilk to keep your milk supply up until your baby’s physician says it’s okay to begin breastfeeding again.

Reading food labels


Read ingredient statements on food labels carefully to make sure you're avoiding all sources of it. Cow’s milk is a major food allergen that must be clearly labeled on any food packaged in the U.S. if it’s an ingredient.


Cow's milk can hide in unexpected places. Get help finding it.


If your baby definitely has a cow’s milk protein allergy and you’ve done your best to cut out all milk and dairy from your diet, but they still have symptoms, visit a dietitian. It may be helpful to keep a food diary for a few days, so the dietitian can help uncover hidden sources of cow’s milk.

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aah with an allergy

Nutrition for babies with food allergies

Starting a baby on solids can make any parent a little anxious, even without food allergies. For babies with cow’s milk protein allergy, you may also worry if your child will have other allergies. Children that already have at least one food allergy are at risk for others, so careful planning is important. That’s why it’s a good idea to work with your baby’s doctor or dietitian to plan the best approach for starting solids. Having a plan in place will give you the confidence you need to be able to relax and enjoy the journey.
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Nutrition for toddlers

Nutrition for Toddlers with food allergies

About 8% of children (1-18 years old) have a food allergy. The most common food allergies are milk, eggs, peanut, tree nuts, soy, wheat, fish and shellfish. The only treatment approach for food allergies is to avoid the food altogether.
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Did you know?
Experts do not recommend restricting baby foods with potential allergens after 4-6 months of age when served in a developmentally appropriate form.


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