Elimination Diets and Breastfeeding

We often hear from moms of infants with cow milk allergy who would like to continue breastfeeding their infant. It’s very rare that an infant will be truly allergic to the breast milk: usually the infant reacts to one or more foods in the mother’s diet that affect breast milk contents. For this reason, many clinicians might suggest that a mom try to follow an elimination diet to continue breastfeeding. Other times, they will recommend Neocate Infant DHA/ARA as an appropriate replacement for breast milk. We always suggest that you check with your little one’s healthcare team and follow their advice, but below are some links to information you may find helpful.

Elimination Diet Basics

The general idea behind an elimination diet is that certain foods are strictly eliminated. This includes removing “whole” foods, like cow milk, and specific ingredients. For example, a mom whose infant has cow milk allergy may need to screen ingredient lists for anything derived from dairy. This video, featuring members of our team, explains the basics behind an elimination diet, such as eliminating dairy and soy ingredients. Your healthcare team can provide more detailed instructions on what foods you should eliminate and what ingredients to look out for.

Beyond the Basics

For some nursing infants, an elimination diet that removes common allergens like dairy and soy from mom’s diet may only provide minimal symptom improvement. If that’s the case for you, please seek advice from your healthcare team. For some families, the team may suggest a diet that restricts more foods, which they may refer to as a “total elimination diet.” You can read about one mom’s experience with the total elimination diet here. This previous blog post suggests some other websites that may be helpful to you.

But if a more strict approach like the total elimination diet still doesn’t completely help, is there still an option to breastfeed? If you are truly committed to breastfeeding, we have heard of moms who drink an elemental formula themselves so that they haven’t got ANY food in their diet that the infant could react to. You can read about my two-day experience of nothing but Neocate here. And two days is nothing: there are many teens and even adults who depend on Neocate every day to help meet their nutrition needs safely.

Elimination Diet Caution

For many moms who try an elimination diet, there is often a need to eliminate more than just dairy and soy. This can lead to a diet that is restricted in one or more nutrients, which could pose a risk to both mom and her baby. Please read this previous blog post to make sure you’re aware of some potential risks. While the article discusses a scenario in which a child is on an elimination diet, some of the key principles hold for a nursing mom (and her baby) as well. One option may be for mom to consume Neocate Junior as a safe, supplemental source of nutrition: I’d recommend the Vanilla with prebiotic fiber!

What experience can you share with other moms who are considering an elimination diet?

– Rob McCandlish, RDN

Published: 01/31/2013
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