Thursday, September 26, 2013

Breast Milk Allergy: Breastfeeding Myth Busted!

     The breastmilk allergy myth was further perpetuated on the TODAY show's #bornTODAY series this morning causing me to have to speak out against irresponsible and incomplete journalism. 
The Myth: Some babies are allergic to their mother's milk.
The Facts: Human milk is the most natural physiological substance that baby can ingest which is why breast milk can be used as a "clear liquid" if a baby is ill with a stomach virus and it is also why breast milk does not sting when placed in the eye as a remedy for conjunctivitis.  
     If a baby shows sensitivities related to feeding, it is usually a foreign protein that has been consumed by the mother and entered into mother's milk, and not the breast milk. The remedy for this is to remove the offending food from mother's diet for 3-4 weeks.  One example is dairy.  Dairy is difficult to digest and can take 10 days to two weeks to leave the mother's system and another 10 days to two weeks to leave the nursing baby's system making the process take 3-4 weeks.  This lapse in time is no reason to wean because as any formula feeding mother can attest, it may take much longer than that to find a formula your baby can tolerate.

Here are some references to help bust the breastmilk allergy myth!

Hudson, I. et al. A low allergen diet is a significant intervention in infantile colic: results of a community-based study. J Allergy Clin Immunol 1995; 96:886-92.

Mohrbacher, N., Stock, J. BREASTFEEDING ANSWER BOOK. Schaumburg, Illinois: LLLI, 1997; 97-99.

Salmon, M. Breast Milk: Nature's Perfect Formula. Demarest, New Jersey: Techkits, 1994; 32-3.


Newman, Jack: Pitman, Teresa, The Ultimate Breastfeeding Book of Answers, 2003; 150

Tanya Roberts
Lactation Connection

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4 comments:

  1. I'm the mom who was interviewed for that segment - also an author, blogger, and creator of the #ISupportYou movement. I was annoyed that they whittled my story down to the soundbyte of "her baby was allergic to breastmilk" because that is completely oversimplifying the story. We faced many obstacles - latching issues, nerve damage, jaundice, more than 12% weight loss in an already growth-restricted infant - the milk allergy was just the final straw.

    I have to disagree with your labeling this a "myth", however. In my personal case, I was vegan. There was no dairy in my diet, and I became religious about reading labels about 1 week into my son's life, so I promise you there was no dairy coming through my milk 6 weeks out when we finally switched to hypoallergenic formula. I do believe he may have been suffering from foremilk/hindmilk imbalance as well, but he is still intolerant of dairy to this day- so who knows.

    However, there is little research that actually proves infants can't react to human milk, despite what is commonly believed - it's mostly conjecture based on admittedly solid logic, but conjecture just the same. But regardless, I feel that telling mothers this is a "myth" is not only doing a disservice to those dealing with a frustrating situation, but also denies mothers' own experiences. There are a fair number of women on my blog who also cut out ALL allergens and had babies still reacting months later. Your references are not actual research studies save for one, which is not about breastmilk as an allergen but rather examines low-allergen diets and colic. I agree with you that unexplained statements like the Today Show made are problematic, but I also think we need to give mothers the benefit of the doubt: sometimes, despite all efforts, elimination diets just don't work. Whether the baby is reacting to some unknown protein passing through maternal diet or the breastmilk itself is rather beside the point - the end result is a baby who is getting sick on breastmilk.

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    1. Thank you for your comments! We welcome you to a conversation on breastfeeding and specifically on "breast milk allergy". Let me start by saying that as a lactation advocate, I do not sit in judgment of moms who choose formula. I am especially sympathetic to good moms like you who tried your best to breastfeed. As a matter of fact, 25 years ago when I had my first child I wanted to breastfeed. I was a teacher and coach with long hours who was having to return to work when my son was just 4 1/2 weeks old. I asked my doctor if I could breastfeed for that period of time. He did say yes, but gave me no further information such as how to deal with the engorgement I would experience from trying to wean so quickly; better yet if only he had told me that I could rent a hospital grade breast pump. This child unlike my next two who were exclusively breastfed had allergies and ADHD that I attribute to the formula. So as you can see, I was angry that I had not been given information and therefore see it as my job to inform mothers. Again, I do not sit in judgement of your choice to formula feed. You did the best you could with the information you were given. I am just sad that you were told that your child was allergic to your breast milk. How difficult that must have been for you to hear!
      The truth is your baby cannot be allergic to the breastmilk itself because breastmilk is made from blood. Blood nourishes the infant in utero through the umbilical cord. If the fetus was allergic to this blood, it would not have been a viable pregnancy. Having said that, there are substances that can create colic in infants that are transmitted through the breastmilk. Eliminating these can be a challenge, and frustrating to the new mother especially if she is given incorrect information. Dairy was given as an example in my post, but is certainly not the only culprit. And in your case could not have been the problem. I will post a link to an article by Dr Sears which speaks to TLD or transient lactase deficiency. Gluten is also reported to pass thorough the breastmilk as are many other allergens.
      None of us have all the answers and that there is still much to be learned within the medical community which is why it is called "practicing medicine". We just do the best we can with the information we are given which is why I stand behind stating that the term "breastmilk allergy" is a myth. If we label something so complicated with an incorrect term, moms do not look for the real cause which is the allergen within the breastmilk. Fortunately many of these are able to be overcome as the infants digestive system matures.
      So my response to your assertion that I should not have used the word "myth" is that the journalists and your doctor should not have used the incorrect term "breast milk allergy". After all, I think we are both after the same thing which is encouraging and informing mothers so that they can make informed choices. Best wishes!

      References:
      http://www.askdrsears.com/topics/fussy-baby/coping-colic/transient-lactase-deficiency-treatable-cause-colic
      https://www.nbci.ca/index.php?option=com_content&view=article&id=13:colic-in-the-breastfed-baby&catid=5:information&Itemid=17
      http://www.ncbi.nlm.nih.gov/pubmed/9867098
      http://pediatrics.aappublications.org/content/116/5/e709.long

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    2. Interesting point about breastmilk being made from blood - I will definitely have to look into that.

      Just wanted to clarify one thing - no doctor ever used the term "breast milk allergy" and I wouldn't use that term, either. That was a term the producers of the Today Show segment chose to use after reviewing the footage from my interview, where I have a lengthy explanation of why "being allergic to breastmilk" is a commonly misunderstood phenomenon and what the research actually says about this. I did extensive research into this for my book ("Bottled Up:; University of California Press, 2012) so I tend to run off at the mouth a bit when the topic comes up. :)

      I do want to point you in the direction of one particular study that I found quite interesting while researching this issue:
      http://www.ncbi.nlm.nih.gov/pubmed/17970780

      It was small study, to be sure, but I think the methodology was quite sound - and they did find human reaction to human milk protein in a lab setting. Now that I think about it, though, I have feeling these were non-maternal breastmilk samples...which would obviously make a huge difference. Have to dig through my files and find the full text! I wonder if there's an alternative "truth" here - that babies cannot be allergic to their mother's own breastmilk, but can be allergic to human milk in general - which would have major implications for donor milk/milk sharing scenarios.

      Regardless - I really appreciate your willingness to discuss this with me, and I agree that we are both after the same thing. Best wishes to you, as well!

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    3. Here's another similar study - interesting discussion in this one...

      http://www.ncbi.nlm.nih.gov/pubmed/22092935

      "The present study shows that CMA infants possess specific IgE antibodies that recognize endogenous human milk proteins. We show that the presence of IgE specific to endogenous human milk proteins could be due to a high degree of sequence homology between the known bovine milk epitopes and the corresponding amino acid sequence on human milk proteins. These human milk-specific IgE antibodies were capable of mediator release in a functional assay in infants with high cow’s milk-specific IgE levels. Such functional studies are necessary, although not sufficient, to support the presence of clinical reactivity. There was only a trend towards detection of a polyclonal IgE response to human milk peptides in those infants who continued to have symptoms despite a maternal cow’s milk avoidance diet. However, a few such infants exhibited remarkably strong IgE binding to human milk peptides together with evidence that such autoreactive antibodies had functional properties in vitro. Our findings suggest that these antibodies could be clinically relevant in breastfed infants whose symptoms (eczema) cleared only after weaning. Similar antibodies were incapable of inducing mediator release (suggesting low-affinity antibodies) in infants who successfully responded to maternal milk restriction. Consequently, the role of these IgE antibodies in infants responding to maternal restriction and in older children with CMA remains unclear."
      "

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