29 Sep Breastfeeding & Elimination Diets: Do you Actually Have to Give up Dairy?
“Should I eliminate dairy products while breastfeeding?” is a common concern from breastfeeding parents.
New parents often worry that their baby’s fussiness after feedings is a sign of an allergy or sensitivity to something that the parent is eating. Unusual diapers, gassiness, and lots of spit-up can also trigger this concern.
If you do a quick Google search or text a few friends, the first response is usually “Did you try cutting out dairy?” Your pediatrician might say the same.
So does this mean you actually have to eliminate dairy? Spoiler alert: you probably don’t.
How to Know if You Need to Eliminate Dairy
While dairy issues are a common concern, it’s actually a pretty uncommon allergy, only affecting about 1% of infants. Recent research suggests that cow’s milk protein allergies are typically overdiagnosed (and part of this is formula companies’ financial interests at work – yikes!).
Even so, it can be stressful and scary if your infant seems distressed after feedings or is having seemingly strange GI symptoms.
So how do we know if it’s necessary to try an elimination diet? Here are some questions to ask yourself.
1) Is my baby’s fussiness “normal”?
First, check if your infant is experiencing general fussiness or if there’s more to it. Some degree of fussiness without other symptoms is typical for infants and not a cause for concern. Even though babies are tiny, their needs are great!
2) Are the symptoms actually related to nursing?
If your baby seems truly fussier than normal, breastfeeding issues might be the root cause. Gassiness, excess spit-up, green-colored stools, and other signs can all stem from nursing challenges. For example, your baby may have gas from swallowing extra air thanks to a shallow latch, or be gulping in response to a heavy letdown. If you’re in this situation, see an IBCLC (International Board Certified Lactation Consultant) for assessment to rule out any issues here
3) Are there other troubling symptoms, too?
If you’ve ruled out nursing issues and you still see fussiness coupled with colic (persistent inconsolable crying), rashes or eczema, a persistent cough, or frequent spitting up, it now makes sense to suspect dairy as a culprit. Your baby may have an issue called Cow’s Milk Protein Allergy (CMPA).
What is Cow’s Milk Protein Allergy?
With CMPA, a breastfed infant is reacting negatively to the protein in cow’s milk that a mother has consumed. Take note that this is different from “lactose intolerance,” which is a reaction to the sugar found in milk. With CMPA, your baby’s immune system sees the protein as a “threat,” leading to an allergic reaction. Milk proteins secreted from breast milk induce an inflammatory response in the colon that can cause pain, bloody stool, and eczema-like reactions on the skin.
If your pediatrician suspects your infant may have this allergy, they may conduct a stool test to check for blood specks.
You Have to Eliminate Dairy: Now What?
If you’ve ruled out breastfeeding issues and your pediatrician suspects CMPA, the best practice is to follow a dairy elimination diet for at least 3 weeks.
This involves a total elimination of any dairy or dairy-containing products from your diet. While we tend to think of dairy being in products like cow’s milk, yogurt, butter, ice cream, and cheese, there are also a bunch of products that contain “hidden dairy.” In other words, these products sneakily contain dairy when we wouldn’t expect them to.
Make sure to always check the label of your salad dressings and dips, granola, chocolate, canned tuna, protein bars, and pre-made soups. Keywords to look out for on the ingredient list include “milk” “milk protein” “milk solids” “casein” or “whey.”
Many parents worry that without dairy, they won’t be able to meet their calcium, vitamin D, or protein needs. Fortunately, all the beneficial nutrients found in dairy products are also found in a variety of other delicious foods!
- Soymilk and peanut milk are rich in protein and unsaturated fats, so those are a great substitute for cow’s milk
- Avocado is a creamy and delicious substitute for cheese on a sandwich or with eggs in the morning!
- Foods like broccoli are rich in calcium and delicious when roasted or steamed!
- Vitamin D is super important for helping your body absorb calcium. Luckily eggs, fatty fish (like tuna and salmon), and some fortified cereals will help you reach your Vitamin D needs!
If you and your pediatrician make a plan to retry dairy, you may slowly reintroduce dairy after a few weeks and check if the symptoms return. But if your baby was having severe symptoms, it may be best to stay on a dairy-free diet until your infant weans.
More Resources for Eating Dairy-Free
Dairy-Free Cookbook by Jane Zukin, published by Prima Publishing & Communications, ISBN 0914629883.
http://nomilkmall.com/ → Comprehensive List of Dairy Free Items
Written by: Natalie Vallone, BS Candidate at NYU / @nutritionbynatalie_
Medically reviewed by: Grace Goodwin Dwyer, MS, MA, RD, LDN, CLC