Allergies and the Breastfeeding Family
Karen Zeretzke
Baton Rouge, Louisiana, USA
From: LEAVEN, Vol. 33 No. 4, August-September 1997, pp. 75-77
We provide articles from our publications from previous years for reference for our Leaders and members. Readers are cautioned to remember that research and medical information change over time.
Breastfeeding serves as both
a preventive measure and a cure for allergic disease.
One in five children shows some
degree of allergy by age 20, according to Ruth Lawrence in Breastfeeding:
A Guide for the Medical Profession. So it's not surprising that Leaders
are frequently called upon to answer questions about allergies.
Lawrence also reports that the
incidence of allergies has increased tenfold over the last 20 years. The
increase may be due to better recognition of allergic symptoms as well as
the increased incidence of exposure to known allergens. Increased longevity
has helped us recognize the connection between allergy and many chronic
illnesses.
The change in man's diet from
his hunter-gatherer days when he ate foods seasonally to 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 way
increases exposure to these foods and predisposes people to 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 first foods
they have been offered.
A study by Saarinen and Kajosaari
showed that breastfeeding reduces food allergies-at least through adolescence.
Protection from allergic disorders and resistance to infection are the most
often cited immunologic benefits of breastfeeding. Symptoms of cow's milk
allergies are up to seven times more common in babies who are fed manufactured
baby milk instead of human milk, according to Lawrence.
At birth, a baby has no functional
immune system of his own; he depends entirely on antibodies from his mother's
placenta, colostrum and milk. By about six weeks of age, Peyer's Patches
in the intestines begin operating, assisting baby's immunities by producing
immunoglobulins. By six months of age, a baby has a functional, although
immature, immune system and secretory immunoglobulin A (IgA) is produced.
Fed from his mother's breast,
a baby first receives colostrum, a pre-milk fluid rich in antibodies that
begins "painting" the insides of a baby's intestines preventing
penetration by potential antigens. Mature milk continues this protective
help. It provides antibodies specific to challenges that both mother and
baby may be exposed to.
At a higher risk are children
with a family (paternal or maternal) history of allergies. These babies
seem to have a defective immunoglobulin E (IgE) system with increased IgE
levels and lower T-cell counts, according to Riordan and Auerbach in Breastfeeding
and Human Lactation. IgE and T-cells are important components of the
body's allergy response.
Allergy Formation
An allergy is formed when a normally
harmless substance, such as pollen, mold, dust or a food, is perceived by
the body as an invader. In its own defense, the body produces large amounts
of an antibody, immunoglobulin E or IgE. Antibodies attach themselves to
tissue and blood cells when they come in contact with the substance the
body perceives as dangerous. This signals these cells to release powerful
inflammatory chemicals called mediators: histamines, prostaglandins and
leukotrienes. The mediators affect mucous glands, capillaries and smooth
muscles, causing the sufferer allergic symptoms.
Symptoms are usually found concurrently
in more than one system in the body and can be downright contradictory.
Reactions most commonly cause symptoms in the gastrointestinal system. Symptoms
may include spitting up, diarrhea (which in a breastfed infant means that
the stool is looser, more watery and greater in number and volume than usual),
cramping, constipation, gas, malabsorption of nutrients (resulting in poor
weight gain), and colitis. The respiratory system, skin, eyes and central
nervous system may also be involved.
Behavior is often a clue to allergies
in child. It is an observable tip of an imaginary iceberg that rests on
how the child thinks, which is influenced by how the child feels and is
based in part on his individual body chemistry. If allergies muddle the
body chemistry, it may affect how the child feels, thinks and acts.
Cow's Milk Tops List
Lists of foods that trigger allergic
responses differ from source to source but cow's milk and dairy products
top them all. According to Stigler in his article "Preventive Dietary
Management: Prenatal, Neonatal and in Infancy," there are more than
20 substances in cow's milk that have been shown to be human allergens.
Colic and vomiting are often
caused by cow's milk allergy. Eczema-dry, rough, red skin patches that can
progress to open, weeping sores-plagues many allergic children. Cow's milk
has also been found to cause sleeplessness in infants and toddlers.
When fed artificial baby milk,
babies react to the large amount of cow's milk they receive. When a typical
baby is fed manufactured baby milk it's as if an adult consumed seven quarts
(almost eight liters) of milk a day!
Breast milk protects against
allergies by coating the insides of the intestines and making leakage of
foreign substances into the gut difficult. The baby is only exposed to what
the mother eats and secretes in her milk, thus lessening the absorption
of these foods.
When a breastfed baby is exposed
to an allergen, small amounts of the offending substance may trigger a response:
IgE levels rise and a severe reaction may occur. Early and occasional exposure
to cow's milk proteins sensitizes a baby so that even tiny amounts of cow's
milk may act as booster doses in provoking an allergic response. In families
demonstrating milk allergies, a mother should avoid such foods and not offer
them to baby. Severe, perhaps even life-threatening reactions could occur.
Research by Gruskay has shown
soy-based artificial milks demonstrate little or no advantage over cow's
milk-based based baby milks.
Other common foods which cause
reactions are wheat, corn, pork, fish and shellfish, peanuts, tomatoes,
onions, cabbage, berries, nuts, spices, citrus fruits and juices, and chocolate.
Sometimes mothers feel that because
a food could be a potential allergen, it best to avoid it entirely. If there
is no history of allergy to these foods in mother's or father's family,
this may be an unnecessary precaution. Eating foods a mother enjoys will
help her find breastfeeding more satisfying. Only if a baby shows allergic
symptoms should a mother consider avoiding certain foods.
A Detective Game
Since there is no cure for allergies,
the best, easiest and least-expensive treatment for sufferers is simply
to avoid the allergens. Finding the allergens can be a difficult process
but worth the effort.
For a breastfed baby, this might
involve keeping a record of foods eaten by the mother along with notes on
the baby's symptoms and behavior. In time, it is usually possible to determine
which foods cause the baby distress.
The mother then may develop an
eating plan for herself that eliminates suspected foods. If doing so makes
for a happier baby, the mother can then challenge the baby by eating some
of the suspected food. A reaction from the baby confirms his sensitivity,
and his mother may well choose to limit or avoid the suspected food.
Rotation Diets
Many mothers have found that
following a rotation diet allows inclusion of most foods, even those to
which the baby has reacted, says Stigler. Rotation diets allow a food to
be completely eliminated from the mother's body before she ingests it again.
By waiting three to seven days before eating the food again, the mother
can usually include that food in her diet. The stronger the baby's reaction
to the food, the longer the mother should wait before exposing the baby
to it again. Trial and error will permit the mother to make the best choice
for her circumstances.
Interestingly, foods that cause
problems in babies often bother their mothers as well but more subtly; they
may be unaware of their sensitivity until the elimination finds both mother
and baby much happier. Ironically, foods that a mother consumes and eats
on a daily basis often fall into this category.
Eczema on the mother's nipples
may be caused by a food her baby or toddler is eating or medications he
may be taking. Residuals of that substance in his mouth may cause reactions
on the mother's skin.
Additional Options
Other treatment options for allergy
include medication, immunotherapy and allergy tests. These can be particularly
helpful when the allergen is one not easily avoided, such as pollen, dust
and environmental allergens.
Changing the child's environment
by stripping his room to the bare walls and floor will often help an allergic
child; the results have been likened to a military- barracks look. No curtains,
bedspreads, fluffy quilts, dust ruffles, carpeting, rugs, shutters, slatted
blinds, upholstered furniture, stuffed animals (except those which are hypoallergenic
on both the outside and the inside), or furred or feathered pets.
Roll-up shades may be used on
the windows; pillows should be synthetic; blankets cotton or synthetic and
washed weekly; mattress and box springs should be encased in plastic and
furniture should be plain wood or plastic. The closet should hold only the
clothes for the current season and nothing should be stored under the bed.
Heating/air conditioning vents could be covered in muslin "shower caps"
for easy removal and washing. Walls, woodwork and furniture should be scrubbed
at least every three months. If a vaporizer is used, it must be kept scrupulously
clean. Some families have found air cleaning machines worth the investment.
Some families have been helped
by changing to unscented soaps and laundry detergents and avoiding other
products with additives, such as hair sprays, deodorants, disposable diapers,
wipes and other personal products. Avoiding fumes and odors where possible,
such as gas (car fuel and stove/heating fuel), paint, pesticides, chemicals,
exhausts, hay and other dried harvest products, insulation materials and
new carpeting, may also help.
Eating foods that are chilled
or cold sets off reactions for some. Selecting foods that have been exposed
to few chemicals while being grown or raised has helped some allergy sufferers.
This includes additives, flavorings, preservatives and colorings. In some
places, cows and chickens are fed antibiotics to produce healthy animals;
these may cause or trigger allergies in susceptible individuals.
Coatings on vitamins or other
medications have often been causative as well, as have fluoride, iron and
some herbal preparations.
If the baby with suspected allergies
is not the only child in the household, be sure that older siblings do not
give him a taste of anything—this is one time when sharing is not appropriate.
Prevention for Subsequent Children
Once a family has experienced
an allergic child, they are most concerned with avoiding allergies or mitigating
them for subsequent children. Studies by Chandra and others have shown that
avoidance during pregnancy and lactation of foods to which any family members
show sensitivity will produce far fewer instances of allergy in later children.
Avoidance of large amounts of any food during pregnancy will lessen the
likelihood of infant allergies to that food.
Recently, reports have been published
indicating an increased incidence of peanut allergies in young children.
Some doctors are recommending that peanuts and peanut butter be limited
during pregnancy and lactation and that babies not be given peanuts or peanut
butter until three years of age. These precautions would be most important
in families with a history of allergy.
If milk is one of the foods to
be avoided, a pregnant mother needs to get adequate calcium from sources
other than dairy foods, either through her diet or a calcium supplement.
Lawrence recommends reagent-quality powdered calcium carbonate. Dark green
vegetables, egg yolks, carrots, sardines, oatmeal, salmon, shellfish and
cabbage are other dietary sources.
Mothers who are practicing food
avoidance during pregnancy seem to have less incidence of pre-eclampsia,
swelling and yeast infections, says Stigler. They also have less trouble
with runny noses during pregnancy. These benefits may reward mothers for
giving up foods they enjoy.
Pregnant mothers may also wish
to stay inside during high pollen counts. Research shows that during high
hay fever periods, there is a seasonal clustering of more miscarriages,
late-pregnancy bleeding, extreme swelling and ectopic pregnancies; and ten
days after an elevated ragweed count, hospitals admit more women with toxemia
of pregnancy, says a study by Mabray quoted in Stigler's article.
Stigler feels frequent hiccoughs
by a baby in utero may indicate allergies: the hiccoughs are caused by exposure
to an antigen. Questioning women of the author's acquaintance revealed that
this proved quite true.
Although discovering allergies
and taking steps to reduce exposure may be tedious and difficult, the results
are rewarding. The change in a child from a whiny, aggressive, rash-prone,
doesn't-know-what-he-wants, non-sleeper to a pleasant, clear-skinned, easygoing
child who sleeps well is extraordinary. Once parents have seen this "child
they had never met," they are willing to do what it takes to keep him
that way.
Why protect against allergies by breastfeeding?
- Protection from allergies
is one of the most cited advantages of breastfeeding (Neifert 1993).
- One-third of all pediatric office visits are due to allergies (Lawrence 1994).
- One-third of all chronic conditions
under age 17 are due to allergies (Lawrence 1994).
- One-third of all school absences are due to asthma (Lawrence 1994).
Generally more than one body system is involved in an allergic reaction. Gastrointestinal symptoms are most common.
Gastrointestinal
System: Vomiting, spitting up Diarrhea Blood in stools Colic
Occult bleeding Cramping Constipation Gas Malabsorption (and resulting
poor weight gain) Colitis Protein and iron-losing enteropathy Neonatal
thrombocytopenia (low levels of platelets in the blood)
Respiratory
System: Runny nose Sneezing Coughing Rattling Asthma Red, itchy
nose (allergic salute) Pulmonary disorders Bronchitis Congestion,
prolonged cold-like symptoms Recurrent nosebleed Mouth breathing
Stridor (noisy breathing)
Eyes:
Swollen eyelids Red eyes Dark circles under eyes Constant tearing
of eyes Gelatin-like fluid in eyes
|
Skin:
Dermatitis Urticaria (hives) Rash Sore bottom Redness around rectum
Itching Flushed cheeks Excessive pallor Eczema
Central Nervous
System: Irritability Fussiness Sleeplessness Light sleeper Restlessness
Prolonged drowsiness
Other Symptoms:
Ear infections Hiccoughs Poor weight gain Excessive drooling (also
a teething symptom) Excessive sweating Aching in legs and other
muscles Short attention span Poor school performance Hard to live
with Depression Spots on tongue Failure-to-thrive Swelling of lips,
tongue, throat Life-threatening drop in blood pressure
|
References
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THE WOMANLY ART OF BREASTFEEDING
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Gruskay, F. Comparison of breast,
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Jandl, A. Allergies. NEW BEGINNINGS, Mar-Apr 1996; 40-41.
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Shircliff, S. Bottoms up. NEW BEGINNINGS. Mar-Apr 1995; 43-44.
Sutin, K. Eliminating foods worked
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Crook, W. You and Allergy.
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Host, A, Husby, S., and Osterballe,
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Last updated Friday, October 13, 2006 by njb.
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