Cows' milk allergy affects a small percentage of babies born each year. Many outgrow the allergy as their small bodies develop, but some may have the problem for life. Some of us are under the misapprehension that the allergy does not affect breastfed babies: this is untrue. While CMA is less prevalent among breastfed babies, it does occur more often than we realize.
Whether a baby is fed with the breast or a bottle, the symptoms are the same. A baby may be colicky, suffer diarrhoea, constipation, reflux after feeds, vomiting (more than posseting, which is very common in a newborn) and even skin rashes or breathing difficulties in the most different of reactions. Breastfed babies are known to have sloppier dirty nappies than their bottle-fed counterparts, so diarrhoea may be a little less obvious, especially to a first time breastfeeding mother or a first time parent who is not sure what is normal.
Cows' milk allergy is often confirmed by an appointment with a dietician who will ask a few questions and may require a feeding diary with notes regarding when symptoms occur in order to determine what baby is taking from you, as well as if there is a correlation . Usually, diagnosis is confirmed in one appointment and blood tests are rarely taken without baby sufferers from 'instant' reactions such as swilling, wheezing or rashes on contact with milk.
The advice given to breastfeeding mothers is usually to continue with breast milk due to its immense benefits to the infant, particularly during the first six months where it should be a child's sole source of nutrition. However, you will need to adjust your own diet in order to reduce the amount of cows' milk protein that you consume. Products containing milk in any form should be avoided, and substituted where possible. Cows' milk protein can be quite sneaky and goes by many different names, including casein, whey, betalactoglobulin, whole milk, milk powder, skimmed milk, and hydrolysed whey protein. Your dietician may be able to provide you with a full list.
Typically, this is sufficient to manage the problem until weaning age. However, sometimes babies can be very sensitive and may need to swap onto an advanced medical nutrition supplement in the form of specialist formula milk. If you are concerned your dietary changes are not controlling your child's allergy, consult with the dietician.
Weaning is an exciting time, and just because your child can not have milk does not mean they are limited to boring foods. Opt for simple purees which consist sole of fruit, vegetables or a mixture of both in the beginning, introducing one new flavor at a time. When introducing new foods, as you would with any child, you should keep an eye out for a reaction. It might be a good idea to keep a food diary initially. Sometimes, children with one allergy can have multiple that you will discover as time passes.
Once you have tried out a few different foods, you can try little meals or combinations of foods. Many of the meals you can buy in pouches or jars are suitable for children with milk allergy, but you should always check the ingredients before feeding anything to your child. Have a look online for dairy free recipes and try making some of your own delicious baby foods. If recipes do require you do use milk, use expressed breast milk where you can.
When they reach one year of age, it is common for your doctor or dietician to encourage you to reintroduce milk into their diet. This can be done either at home (in the case of less severe reactions) or as a challenge in a supervised environment like a hospital (usually for the more severe reactions. some may have the problem for life.