Breastmilk: is it making my baby irritable?

Breastmilk is considered the superior food for your baby and exclusive breastfeeding is recommended for the first 4-6months of your baby’s life. This is because the milk provides not only the essential nutrients required for growth, but helps the immune system to fight illness and infections and protects against disease later in life.

Breastfeeding however can lead to irritability in your baby, with at least one unsettled period occurring normally during any one day. Of these babies only 5% will have an organic or medical cause for their unsettled symptoms.

A question often asked by mothers is whether their own diet plays a role in the development of these symptoms. This week explores the common problems associated with breastfeeding which include reflux disease, food allergy and lactose intolerance.

Infant reflux and regurgitation affects 40% of babies less than 3 months of age. Reflux occurs when gastric contents travel back up into the oesophagus, irritating the surrounding organs and causing a severe burning sensation in the baby’s chest. A mistake often made here is that once reflux is suspected, mothers tend to blame breastfeeding as being the cause and convert to formula feeding immediately. This isn’t the case; your breastmilk plays no role in the development of the symptoms. In fact, the symptoms generally tend to resolve as your baby grows and reaches 6-10months of age and spends more time in an upright position5,6. Positional changes whilst breastfeeding and aiming for smaller and more frequent feeds will also help with these symptoms.

Lactose intolerance is a condition whereby the body is unable to digest lactose properly. This will affect your baby by causing large amounts of loose green stools and gas due to the abnormal digestion by bacteria of milk in the large bowel, as well as abdominal discomfort. The condition develops from damage to the lining of their intestine, caused from either a food allergy or following a viral gastroenteritis illness where the enzymes and lining have disappeared with the diarrhoea symptoms. Symptoms tend to persist until the gut lining has had time to heal after the virus or foods causing the allergy are avoided completely. Lactose intolerance is also not an inherited condition; so if you or any other family members suffer from it, this will not place your baby at risk of developing the condition.

Food allergies although not common, can also be a cause for the irritable baby. Common food allergies include cows milk, eggs, nuts, sesame seeds, soy, wheat and seafood proteins. Your baby will experience symptoms similar to above, with stomach pain, diarrhoea, constipation, reflux, mouth ulcers, rashes and irritable behaviour. Although controversial, current research states that there is not enough evidence to support that mothers should avoid potential allergenic foods in their diet to prevent food allergies developing in their baby. These food groups do NOT need to be avoided, and in addition, delaying the introduction of solid foods will not protect your baby from developing atopic disease later on. It also places both you and your baby at risk of deficiency in important nutrients1.

Of the food allergies, cow’s milk protein allergy is a little different. It is the most common food allergy seen amongst infants, occurring in 0.5% or 1 in 200 babies. It presents similar to lactose intolerance; hence is often confused and missed as a diagnosis. The allergy is diagnosed through a strict elimination diet involving omitting cows milk and other dairy products from the diet, or giving hypoallergenic formula instead if a formula fed baby. Cow’s milk is not suitable for infants under 12 months of age due to the difficulties in digesting the milk, and by avoiding it during their first 12 months of life will help prevent developing the allergy.

If you are concerned your baby is at high risk of developing a food allergy, then tips you can adopt to explore this further include:

  • Slow introduction of new foods when your baby is ready for solids, for example introducing a new one to your baby every 2-3 days
  • Introducing only one new food at time to allow for clear identification of any reactions and tolerance
  • Breastmilk or formula should remain the main source of milk until at least 12 months of age
  • Advice from a dietitian to ensure that the elimination diet doesn’t rid too much goodness from your diet

Feeding time can be unsettling for your baby however breastmilk mustn’t be blamed until other causes are explored.


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