The myths around breastfeeding are innumerable and many focus on breastfeeding: take this or another food to increase milk production, avoid these other that produce gases, drink more or less fluids … Recently, several mothers have commented that they stopped drinking milk to avoid a possible intolerance to cow’s milk proteins in their babies.
What is true in here? Is an intolerance the same as an allergy? How to know if our baby suffers it? If we stop drinking milk, can we continue to produce breast milk? We solve all the doubts in this post.
What is a cow’s milk protein allergy?
It is one of the most frequent food allergies in children as it is one of the first foods to which they are exposed. An allergy to cow’s milk proteins is an abnormal reaction of our body when we drink milk or its derivatives. It is a reaction mediated by an immune mechanism, in which our body reacts to some milk proteins and this reaction occurs again if we drink it again.
And what is cow’s milk protein intolerance?
In the case of allergy to cow’s milk protein, we distinguish 2 types, depending on the mechanism by which the allergy occurs:
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mediated by immunoglobulin E (IgE): it often causes skin lesions and the reaction is very fast, almost immediately after drinking the milk (minutes to 2 hours)
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not mediated by immunoglobulin E: what we used to know as cow’s milk protein intolerance. Symptoms usually appear later (hours, days or weeks) after drinking milk and mainly affect the digestive system.
How do I know if my baby is allergic to cow’s milk proteins?
The symptoms of an allergy can be very varied and affect different organs: the skin (hives, dermatitis), the respiratory system (difficulty breathing, fatigue, cough) and the digestive system (vomiting, diarrhea, colic).
The “typical” allergy to cow’s milk proteins (IgE-mediated allergy) is easier to diagnose. As we have mentioned, lesions on the skin (spots, hives …) usually appear almost immediately after taking. In addition, respiratory or digestive symptoms may also appear. We have different complementary tests that help us diagnose it (we can determine the IgE against cow’s milk proteins in a blood test and / or perform skin tests).
The previously called intolerance to cow’s milk proteins (allergy not mediated by IgE), on the other hand, has a more difficult diagnosis. Symptoms are usually digestive: red bloody stools, vomiting, and diarrhea with little weight gain, including constipation, gastroesophageal reflux, or severe cramps. In this case, the diagnosis will be based on the symptoms and the exclusion-provocation test (see if the symptoms improve when cow’s milk is excluded from the diet and see if it reappears after reintroducing it).
If you have questions about whether your baby may be allergic to cow’s milk proteins, consult your pediatrician.
Are there cow’s milk proteins in breast milk?
Yes. If the mother drinks cow’s milk or derivatives, a small part of these proteins can pass into breast milk, mainly beta-lactoglobulin.
If as a mother I stop drinking milk in pregnancy and while breastfeeding, can it be beneficial for my baby?
This recent study compiles and analyzes the different evidences on the primary prevention of the main food allergies. There is no evidence that the restriction of cow’s milk and derivatives during pregnancy and lactation prevents the development of food allergies in the baby . It could even have the opposite effect; there are studies that suggest that a food restriction during breastfeeding could favor the sensitization and food allergy of the children.
In addition, both breastfeeding and pregnancy are periods with nutritional risk for the mother. If the mother must stop taking dairy for any reason, she should consult with her doctor to avoid possible nutritional deficits. There is also no evidence that the mother’s intake of vitamins and other nutritional supplements prevents the development of allergy to cow’s milk protein.
Can we prevent an allergy to cow’s milk proteins?
No effective food allergy prevention measure is currently known , according to different scientific societies in the 2018 Non-IgE-Mediated Allergy to Cow’s Milk Proteins Consensus Document. Some experts agree that the Exclusive breastfeeding for at least 4 months (it is recommended to keep it up to 6 months) can prevent the development of allergy to cow’s milk proteins.
There are some low-quality studies that suggest that the use of hydrolyzed formulas could prevent allergy to cow’s milk proteins in children at risk. However, the most recent systematic reviews and meta-analyzes, including the 2018 Cochrane review, do not find sufficient evidence to recommend the use of such formulas.
They conclude that no significant evidence was found to support short- or long-term feeding of hydrolyzed formula compared to formula with cow’s milk for the prevention of allergic diseases in infants who cannot be exclusively breastfed.
Other interventions, such as soymilk, taking pre and / or probiotics by the mother, have not been shown to be effective in preventing allergy to cow’s milk.
