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Allergies and the Breastfeeding Family
Modified from: NEW BEGINNINGS, Vol. 15 No. 4, July - August 1998, p. 100
Karen Zeretzke
Baton Rouge, Louisiana

Allergies today are more common than ever before--a one in five child now shows some degree of allergy by age 20. The incidence of allergies has increased tenfold over the past 20 years. This is partly due to increased exposure to known allergens (allergy-causing substances). It is also because physicians and allergy sufferers are more likely to recognize that certain symptoms or illnesses are caused by allergies (Lawrence 1994). Changes in the human diet from the days of hunter-gatherers eating seasonal foods to the year-round availability of most foods has, surprisingly, reduced the number of foods in a typical diet from around 200 to just about 20. Narrowing food choices in this manner increases exposure to these foods and predisposes people to food allergies.

The earlier and more often a food is ingested, the greater likelihood it has of becoming an allergen. Babies tend to be most allergic to the foods they have been offered first. While a baby is exclusively breastfed, he is only exposed to the foods his mother eats and secretes in her milk, so his exposure to potential allergens is minimized.

One long-term study of children who were breastfed showed that breastfeeding reduces food allergies at least through adolescence (Grasky 1982). Protection from allergies is one of the most important benefits of breastfeeding. The incidence of cow's milk allergies is up to seven times greater in babies who are fed artificial baby milk instead of human milk (Lawrence 1994).

Breastfeeding protects against allergies in two ways. The first and most obvious reason breastfed babies have fewer allergies is that they are exposed to fewer allergens in the first months of life. They are not given formula based cow's milk or soy products. Less exposure to these foods means less chance of allergy later on. The other reason breastfed babies have fewer allergies has to do with the development of the immune system. At birth, a baby's immune system is immature. Babies depend heavily on antibodies obtained from their mothers while in the womb. Their digestive systems are not ready for substances other than their mothers' milk. At about six weeks of age, Peyer's Patches in the intestines begin to produce immunoglobulins or antibodies. At six months of age, a baby has a functional, if immature, immune system that is capable of producing secretory immunoglobulin A (IgA), the antibody found in all body secretions that is the first line of defense against foreign substances.

In the meantime, a baby depends on mother's milk for protection. Fed from his mother's breast, a baby first receives Colostrum, the first milk, which is especially rich in antibodies, including IgA. The IgA "paints" a protective coating on the inside of a baby's intestines to prevent penetration by potential allergens. Mature milk continues to provide this protection-from-the-inside to help the baby remain healthy and allergy-free. Human milk and Colostrum also provide antibodies specifically designed to fight germs to which either the mother or baby has been exposed.

The tendency to be allergic is often inherited from a child's mother or father. Babies with a family history of allergy seem to have different immune responses than those without allergies.

How Allergies Occur

Allergies happen when a person's body perceives a normally harmless substance, such as pollen, mold, dust, or a particular food, as an invader. In its own defense, the body produces large amounts of the antibody immunoglobulin E (IgE). When the antibodies come in contact with the substance, the body perceives as dangerous, they attach themselves to tissue and blood cells. These cells then release powerful inflammatory chemicals, called mediators: histamines, prostaglandins, and leukotrienes. These in turn affect mucous glands, capillaries, and smooth muscles, causing the sufferer to experience allergic symptoms.
Symptoms are usually found in more than one body system and can be contradictory. Reactions to food most commonly cause symptoms in the gastrointestinal system, including spitting up, diarrhea (in a breastfed infant, this means stools are looser, more watery, and greater in number and volume than usual), cramping, constipation, gas, malabsorption of nutrients (which could result in poor weight gain), and colitis. The respiratory system, skin, eyes, and central nervous system may also be involved in allergic reactions to food. The table at the bottom gives an idea of what form allergic symptoms can take.
Parents often use behavior to help identify allergies in their child. How a child feels will be revealed in behavior. A child who does not feel well cannot behave well. A baby whose body chemistry is muddled by allergies will be confused and miserable.

Cow's Milk Tops the List

Lists of the foods most likely to trigger allergic responses differ from source to source and culture to culture, but cow's milk and dairy products top them all. There are more than 20 substances in cow's milk that have been shown to be human allergens (Stigler 1985). Colic and vomiting are often caused by cow's milk allergy. Eczema--dry, rough, red skin patches that can progress to open, weeping sores--is another common symptom among children allergic to cow's milk. Cow's milk has been found to cause sleeplessness in infants and toddlers. Dairy allergy has also been suggested as a cause of bed wetting in an older child.
When fed cow's milk-based formulas, some babies react simply because of the large amounts of cow's milk they receive. Feeding baby artificial baby milk is equivalent to an adult drinking seven quarts (almost eight liters) of milk a day! Allergies such as these are not accompanied by changes in the immune system-there is no rise in IgE levels-and they often subside spontaneously. Parents who are bottle-feeding keep switching brands of formula until they find one that works or until the baby outgrows the symptoms.

Early and occasional exposure to cow's milk proteins can sensitize a baby so that even tiny amounts of cow's milk may trigger a response: IgE levels rise and a severe reaction may occur. Thus, sensitive babies may react to cow's milk in their mothers' diet. Small amounts of cow's milk protein may appear in a mother's milk and provoke a response in her baby, even if the mother herself is not allergic to cow's milk. If there is a family history of milk allergies, a mother may prefer to avoid dairy products in her diet as well as not offering them directly to her baby. Severe reactions could otherwise occur.

Other common foods that cause allergic reactions are eggs, wheat, corn, pork, fish and shellfish, peanuts, tomatoes, onions, cabbage, berries, nuts, spices, citrus fruits and juices, and chocolate.

Avoiding foods that have been exposed to chemicals while being grown or raised, has helped some allergy sufferers. Other things to consider avoiding include additives, flavorings, preservatives, and colorings. In many places, cows, pigs, and chickens are fed antibiotics to produce healthy animals; these may cause or trigger allergies in very susceptible individuals. Coatings on vitamins or other medications can cause an allergic response, as can fluoride, iron, and some herbal preparations. Be sure no siblings or other family members are giving the baby a taste of anything--this is one time when sharing is not appropriate. Eating foods that are chilled or cold sets off reactions for some.

Sometimes mothers feel that because a food could be a potential allergen, it is best to avoid it entirely. If there is no history of allergy to these foods in the mother's or father's family, this may be an unnecessary precaution. Eating foods a mother enjoys will help her to find breastfeeding more satisfying. Mothers do not have to give up foods they love while breastfeeding. Only if a baby shows allergic symptoms should a mother consider avoiding certain foods

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