Elimination Diets in Lactation

Babies with Possible Reactions to Foods in Breast Milk

Most infant fussiness is normal for a young baby, and is not related to foods in mom’s diet. If your baby is sensitive to something you are eating, you will most likely notice other symptoms in addition to fussiness, such as lots of spitting up or vomiting, colic, rash, blood in the poop or congestion. In this case, you should be seeing your pediatrician right away. Fussiness without other symptoms which gets better with more frequent nursing is probably not related to foods moms are eating.

Elimination Diets

If you think your baby is reacting to a particular food, of you suspect that your baby has a food allergy, some moms think going on an "elimination diet." Some of the most likely suspects are cow’s milk products, soy and eggs. It is less clear whether wheat, tree nuts or corn can cause symptoms in breastfed babies.

There are 2 main ways of doing an "elimination diet."

1. Eliminate all at once:
   • Take out all cow’s milk products, soy and eggs from your diet.
   • Wait 2-4 weeks to see if baby improves. The food will clear from your milk in a few days, but baby’s gut may take longer to heal.
   • If baby improves, introduce one new type of food at a time, generally the one that you miss the most!
   • If baby doesn’t improve in 4 weeks, then it may not be food related, or you may need to look at other foods. Talk again to your pediatrician, and some families will see an allergist at this point.
2. Eliminate one food type at a time:
   • Take out one food type (milk products, soy or eggs) at a time.
   • Give each food 2-4 weeks, as above, before deciding whether it is causing baby’s symptoms.
   • If baby improves, you found the right one!
   • If baby doesn’t improve in 4 weeks, then try a different food category, or you may need to look at other foods. Talk again to your pediatrician, and some families will see an allergist at this point.

Staying Healthy

It is important to stay healthy while on an elimination diet. It can be hard to eat enough and eat healthy. Cow’s milk and soy substitutes can also be expensive. If you don’t think you can eat enough protein or calories, or the elimination diet causes a lot of stress, then it may not be for you. Talk to your or your baby’s provider.

Reintroducing Foods

If you have found a food baby is reacting to, you will want to talk to your pediatrician and/or an allergist to talk about when it is best to reintroduce that food into your diet, if at all. Many babies will outgrow cow’s milk protein intolerance by 12 months of age, and most have outgrown it by 4-6 years of age.