Lorna C. Aliperti, APRN, IBCLC

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Colic, Reflux, and Allergy

Colic, Reflux, Constipation and Allergy in the Breastfed Baby

If you or your baby’s dad have hay fever or other allergies, your baby has a 25- 50% chance of developing some type of allergy. Recent studies have indicated that infant colic, gastroesophageal reflux, and constipation can all be caused or aggravated by cow’s milk allergy–or intolerance, as it is called since it is cell-mediated and has a slower onset than reactions which involve IGE antibodies. In addition, Dr. Hugh Sampson (who has been involved in developing a peanut allergy vaccine) has found that early satiety as well as reflux can be a cause of failure to thrive among babies who are intolerant to foods in the mother’s diet. Reflux can cause babies to undereat because they associate feeding with the pain they feel afterwards, or overeat because sucking keeps the contents of the stomach down and because milk is a natural antacid. Infants who are intolerant to foods the mother is ingesting may even refuse to nurse.

Research has shown that 50-70% of breastfeeding infants with such conditions respond favorably to the removal of cow’s milk products from the maternal diet. Since frequency of exposure is related to the development of allergies, the average US dairy consumption of 666 pounds per person per year (USDA, 1999) may be one of the reasons dairy is frequently the culprit in infant allergies.

In addition, the American Academy of Pediatrics has stated that from 20-60% of babies with gastrointestinal problems due to cow’s milk allergy will also be intolerant to soy milk. (Pediatrics, Vol. 106 (2) 346-349). The majority of infants outgrow such allergies by the age of three, but this can be a long time if you are the parent of an uncomfortable, unhappy baby.

Since cow’s milk or dairy proteins appear in much of what we eat, it can seem daunting to try to eliminate them. Milk is in any product mentioning whey, casein, lacto-, etc. as an ingredient.

Some suggestions:


Rice milk (WestSoy is a good brand)is a good-tasting protein and calcium fortified drink which is both soy and dairy free—many prefer the vanilla flavor. Some milk free items (always double-check labels) : Soy Garden margarine, Arnold’s stoneground whole-wheat bread. Trader Joe’s is a good source of dairy free products. They carry Chicken Taquitos and Shrimp Stir Fry–both great quick meals. Also delicious is Sharon’s coconut sorbet. They also have a line of vegan cookies which are dairy free. Chocolate Emporium and Chocolate Decadence sell dairy free chocolate.

What CAN you eat?

Breakfast: Cheerios or other dairy free cereal with rice milk and fruit. Orange juice fortified with calcium is a good beverage. Eggs and bacon, the old standby, are good.
Lunch: A salad or sandwich with chicken, beef, turkey, etc. Fruit and other vegetables. V-8 or tomato juice is good for you.
Dinner: Potatoes or rice, a meat or fish entrée, salad and a fresh vegetable. A dessert can be fresh fruit or sorbet.
Snacks: Dried fruits and nuts, rice crackers or cakes, nut butters. Cut up vegetables (buy cut up since you have no time) with a hummus or salsa dip.

Many moms with babies who are reacting to foods they eat may believe formula will help their baby be more comfortable, but this is often not true. More than 10% of cow’s milk allergic babies also react to hypoallergenic formulas (Nutramigen, Alimentum and Pregestimil).

The elimination diet is sometimes used when a baby seems to be having a problem with something in the mom’s milk but she doesn’t know which food or foods are causing the problem. The idea is to eat only non-allergenic foods for approximately two weeks or so until symptoms improve and then gradually reintroduce foods–no more often than one every three to four days–to see if the baby reacts. One of the most frequently used is the Diet by Dr. Sears. Another, the  Failsafe Diet, for those concerned about chemical additives as well, is becoming more popular. I have had success in my practice with a diet which includes only natural, whole foods. In one form or another, this diet keeps reappearing as a recommendation for a number of problems–autism, autoimmune disease among others. A discussion of this diet can be found in this article by a family physician: Introduction to the Paleolithic Diet. Recipes and menu suggestions may be found at PaleoFood. Whatever else happens, you’ll definitely lose weight while on these diets.