Clinical Commonalities

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Free to Feed has conducted nearly 200 interviews with women who have experienced infant food intolerances while breastfeeding.  These personal accounts indicate several commonalities.  Typically, the child will present with one or more symptoms such as colic, failure to thrive, eczema, gastrointestinal complications, or reflux which is not originally attributed to food allergies.  Misdiagnosis is common at this stage due to the inability to effectively test allergies in children under one year and the wide range of symptoms. 

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As symptoms increase in severity, pediatricians and/or parents may suggest potential food intolerance.  This is typically followed by a hypoallergenic formula recommendation.  Understandably, medical professionals are unable to give parents specific culprits to avoid in order to continue breastfeeding, so switching to a controlled feeding method is a rational decision.  However, human milk has been scientifically proven to be fair superior to formula when it is an option.  Many mothers strongly desire to continue their breastfeeding journey and extend the benefits for both her child and her.  Several interviewed parents pointed to issues such as bottle aversion, hypoallergenic formula reactions, and formula refusal as additional factors involved in continuing breastfeeding through intolerances. 

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Behind the Scenes Sleuths

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Mothers who decide to continue breastfeeding begin the arduous task of removing food groups which could be eliciting a response, also known as an elimination diet.  The only solution for these mothers is an attempted food diary.  This is meant to closely examine her food intake and can quickly spiral until she is only consuming a few items. 

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Several women annotate ingested foods and subsequent reactions with the hopes of narrowing down potential culprits.  This is inadequate because not all dietary proteins enter human milk.  In one study, only 11 of 23 lactating women who consumed 50 grams of roasted peanuts had detectable levels of the major peanut allergens Ara h 1 and Ara h 2 [1].  Scientists also found that in 16 women given an egg-containing muffin once daily, 25% of them did not excrete ovalbumin at any timepoint through the 23-day study [2].  Similarly, 54 of 80 human milk samples contained gliadin following the ingestion of a test meal with 20 grams of gluten [3].  These findings support the frustrating dietary journaling process which is fraught with false negatives when mothers ingest a protein that does not cause a reaction one time and does the next. 

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Total Elimination: As Severe as it Sounds

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Incredibly strict maternal consumption is also referred to as a total elimination diet (TED) by this community.  Many women we have spoken to have reduced their intake down to as few as 5 foods.  A common example of this may be chicken, mangos, coconut oil, spinach, and sweet potatoes on rotation every day, all day.  Extreme dieting while chasing adverse infant reactions affects maternal nutritional and mental health which should be a larger talking point in this space.

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The past year of working with lactating mothers has also found that dietary logs are inadequate due to hidden allergens.  Often, when digging deeper into the mother’s intake, we discover a culprit found in a seemingly benign supplement, beverage, or seasoning.  Without a method to directly test human milk, mothers will often continue to methodically cut out whole food groups without realizing that the true problem is going undetected.  Answering the question of what is contained in human milk can help zero in on where it originates.  

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Takeaways

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Our research shows the incredible need for a solution.  Our solution is a testing mechanism which would allow mothers to detect allergens at any time in the comfort of their own homes.  This, in conjunction with a user-friendly app, will allow parents to collaborate with medical professionals and feel supported through the tedious process of breastfeeding a child with food allergies. 

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1. Vadas, Peter, et al. "Detection of peanut allergens in breast milk of lactating women." Jama 285.13 (2001): 1746-1748. 

2. Palmer, D. J., M. S. Gold, and M. Makrides. "Effect of maternal egg consumption on breast milk ovalbumin concentration." Clinical & Experimental Allergy 38.7 (2008): 1186-1191.

3. Troncone, R., et al. "Passage of Gliadin Into Human Breast Milk." Pediatric Research 20.7 (1986): 696.