The myths about breastfeeding are innumerable and many focus on breastfeeding: take this or another food to increase milk production, avoid these others that produce gas, drink more or less fluids ... Recently several mothers have commented having stopped drinking milk to avoid 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? If we stop drinking milk, can we continue to produce breast milk? We solve all doubts in this post.
What is 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. 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 take it again.
And what is cow's milk protein intolerance?
In the case of cow's milk protein allergy we distinguish 2 types, depending on the mechanism by which the allergy occurs:
Immunoglobulin E (IgE) mediated: skin lesions often occur and the reaction is very rapid, almost immediately after drinking milk (minutes to 2 hours)
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 the milk and mainly affect the digestive system.
In Babies and more Allergy to cow's milk proteins, mediated by IgE and not mediated by IgE: differences, symptoms and prognosis How do I know if my baby is allergic to cow's milk proteins?
The symptoms of an allergy can vary widely and affect different organs: the skin (hives, dermatitis), the respiratory system (difficulty breathing, fatigue, cough) and the digestive system (vomiting, diarrhea, cramping).
The "typical" allergy to cow's milk proteins (IgE-mediated allergy) is easier to diagnose. As we have said, skin lesions (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 IgE against cow's milk proteins in a blood test and / or perform skin tests).
The so-called cow's milk protein intolerance (non-IgE-mediated allergy), on the other hand, has a more difficult diagnosis. Symptoms are usually digestive: bowel movements with red blood, vomiting and diarrhea with little weight gain, including constipation, gastroesophageal reflux or severe cramping. In this case, the diagnosis will be based on the clinic and on the exclusion-provocation test (see if the symptoms improve by excluding cow's milk from the diet and see if they reappear after reintroducing it).
If you have doubts 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 betalactoglobulin.
If as a mother I stop drinking milk during pregnancy and 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 restriction of cow's milk and derivatives during pregnancy and lactation prevents the occurrence of food allergy 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 children.
In addition, both breastfeeding and pregnancy are periods with nutritional risk for the mother. If the mother should stop taking dairy products for any reason, she should consult her doctor to avoid possible nutritional deficits. There is no evidence either that the intake of vitamins and other nutritional supplements by the mother prevents the development of cow's milk protein allergy.
In Babies and more Healthy eating during breastfeeding: what you should knowCan we prevent an allergy to cow's milk proteins?
No effective prevention of food allergy is currently known, according to different scientific societies in the consensus document on cow's milk allergy not mediated by IgE of 2018. Some experts agree that Exclusive breastfeeding at least 4 months (it is advisable to keep it up to 6 months) can prevent the development of cow's milk protein allergy.
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 with hydrolyzed formula milk compared to formula milk with cow's milk for the prevention of allergic diseases in infants who cannot receive exclusive breastfeeding.
Other interventions, such as soy milk, pre-and / or probiotic taking by the mother have also not proven effective in preventing cow's milk allergy.
