Signs of Food Allergy in Babies

All types of allergies, including food allergy, are on the rise around the world.  The most common food allergy in babies is to cow’s milk protein, which affects 3-7% of infants worldwide, according to CMPA Support, and the NHS states that milk, eggs, wheat, soya and peanuts are the most common childhood food allergies in the UK.  However any kind of food could cause an allergic reaction.   Allergic reactions to food can be immediate or delayed.  Severe allergic reactions can be fatal and require urgent medical attention.  In babies, delayed food allergy reactions can cause a lot of pain and discomfort, but it can be difficult to diagnose a baby’s food allergy because they cannot tell you how they are feeling, and because the symptoms overlap with a lot of other conditions.  A delayed food allergy is not the same as a food intolerance because it still involves the immune system, whereas an intolerance is due to the inability to digest a particular food.

Here are some of the symptoms of delayed food allergy in babies, whether breast or formula fed. The symptoms may occur hours or even a day or two after the mother consumes the food the baby is allergic to.  The symptoms of immediate food allergy are more obvious and occur immediately after the baby feeds.

  • Colic or excessive crying and fussiness.  The official definition of colic is 3 or more hours of crying in a day, 3 more more days a week.  Colic is just a word that means crying that we don’t know the reason for.
  • Excessive wind, or trapped wind.  Your baby may be drawing their knees up in pain or straining to pass wind.
  • Constipation.  In a breastfed baby their poo may still be runny, but they may seem to find it hard work to pass their poo.  Again, they may be pulling their knees up or straining.
  • Diarrhoea.  This is hard to spot in a breastfed baby as their poo is usually runny anyway, but if they are pooing very frequently it may be classed as diarrhoea.  Poos may also be ‘explosive’, requiring a change of clothes.
  • Green and/or mucousy/bloody poo.  Green poo can be cause by milk passing through the body too quickly and not being fully digested.  Mucous or blood may be present in the poo due to the body’s immune response trying to fight against the allergens in the milk.
  • Reflux/vomiting.  It is normal for babies to bring up a small amount of milk after a feed but if they are often bringing up larger amounts or even a whole feed this is not normal.  In extreme cases babies may projectile vomit.
  • Eczema/skin rashes/nappy rash.
  • Frequent feeding or overfeeding – breastfed babies feed for comfort as well as hunger.  If they have stomach ache and feel uncomfortable they may feed more often than usual.  This can also lead to excessive weight gain.
  • Refusing feeds – confusingly, this can also be a symptom if baby associates feeding with pain and discomfort.  In this case baby may be slow to gain weight.
  • Nasal congestion or cold-like symptoms.
  • Difficulty sleeping.  Babies may have difficulty settling to sleep, or may be uncomfortable sleeping on their back and only be able to sleep in a caregiver’s arms, in a sling, or in a reclined position such as a car seat or pushchair.  They also wake excessively, although night waking is normal in infants.

My youngest daughter has multiple food allergies, which are all non-IgE (delayed) reactions.  She was exclusively breastfed and her symptoms started at birth.  She had terrible colic and gastrointestinal symptoms.  She cried for hours (the worst day I remember she cried for 6 hours).  She seemed snotty and congested even though she didn’t have a cold.  She vomited a lot, even before my milk came in and I was still producing colostrum – even in hospital, my husband had to go out and buy extra clothes as she had thrown up over all of the clothes I had packed within about an hour, including 2 sets of spare clothes.  She was very uncomfortable and would struggle for to poo, drawing her knees up to her chest.  We even resorted to holding her over a potty, elimination communication style, to try and help her.  She struggled to sleep and would only sleep in a sling with constant movement.  She fed very frequently, and didn’t lose weight after birth (which is normal) but instead shot up from the 25th to 75th centile in 2 weeks.  I was very lucky that one of my friends, who happens to be a breastfeeding peer supporter, told me that 95% of babies with colic were cured when the mother eliminated cow’s milk from her diet and the babies were given probiotics.  I cut cow’s milk out of my diet and she improved within days (although it took us a full year to figure out the rest of her allergies). We now suspect that my older daughter’s colic may have been due to the same reasons.

My advice would be to trust your instincts.  If you think your baby may have a food allergy speak to your health visitor or doctor.  Unfortunately not all health professionals are clued up about food allergies and you may find it helpful to read the NICE Guidelines which explains what should happen if a food allergy is suspected and also to print the MAP Guideline and take it to appointments.  I will also be writing a follow-up post soon about how to do an exclusion diet if you suspect your baby has a food allergy.

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