Signs of Food Allergy in Babies
My name is Zoe Williams, I’m a mum of two children and a food allergy blogger at My Allergy Kitchen. I was delighted to be asked to write a guest blog by my Hypnobirthing teacher Jacqueline. I did Hypnobirthing classes when I was pregnant with my second child and had a much more positive birth experience than with my first. Things didn’t go exactly as planned (do they ever where babies are involved?!) but I still felt calm and in control. This stood me in good stead as we had a tricky first year due to my daughter’s multiple food allergies.
Food allergies are hitting the headlines on a regular basis these days, and for good reason. The rate of food allergies has risen hugely in recent years, along with all types of allergic disorders. In the UK, almost 1 in 12 children suffer from a diagnosed food allergy. In babies and young children, the most common food allergy is milk. Allergies tend to run in families. There is a higher chance of a baby having a food allergy if either parent or a sibling has any allergies themselves, or eczema or asthma.
Food allergies in babies can be difficult to diagnose, for a number of reasons. Firstly, babies can’t tell us how they are feeling. Secondly, many of the symptoms of food allergy in babies are experienced by all babies now and then, and may overlap with other conditions. Thirdly, the majority of GPs have received no training in how to manage allergic conditions. And finally, allergy testing isn’t suitable for everyone, nor is it completely reliable, so it can be difficult to get a clear answer.
What is a food allergy?
Food allergies happen when the immune system mistakenly reacts to a food protein as if it is dangerous. There are two categories of allergic reaction: immediate and delayed. Immediate reactions are known as IgE-mediated and can start within minutes or up to two hours after eating or coming into contact with the food. Delayed reactions are known as non-IgE mediated and usually appear within 2-72 hours of eating the food, but can build up over several days or weeks. Some babies may have a mixture of both types of reaction. Food allergies can affect babies whether they are breast fed or bottle fed, or a combination. Some food proteins may pass through into breastmilk and can sometimes cause a reaction.
Food allergy symptoms
Milder immediate reactions can include hives, wheezing, coughing, swelling in the face, runny or blocked nose, sneezing, itchy eyes, stomach pains, vomiting, diarrhoea and eczema flare ups. If left untreated, babies may not gain weight. A severe immediate reaction is known as anaphylaxis. An anaphylactic reaction can include the symptoms above. However, it affects multiple organs in the body and also includes difficulty breathing, changes in heart rate and a drop in blood pressure, which can lead to collapse. This is a medical emergency – call 999 and ask for an ambulance if you think your baby is having this type of reaction. Anaphylaxis is thankfully rare but can be fatal if not treated immediately with epinephrine.
Delayed reactions can show up in many different ways. Gastrointestinal symptoms are common. Delayed reactions are not the same as a food intolerance. They still involve an immune system reaction, whereas a food intolerance is caused by an inability to digest a particular food. Many healthy babies have these symptoms at some time due to illness, teething, growth spurts etc. However, if your baby suffers from several of these symptoms over a long period of time, it may be due to a food allergy:
- Excessive crying and fussiness – also known as colic.
- Excessive wind or trapped wind – babies may draw their knees up in pain, or strain to pass wind.
- Constipation – in breastfed babies their poo may still be runny, but they may seem to find it hard to pass their poo. Again, they may be pulling their knees up or straining.
- Diarrhoea – this is hard to spot in a breastfed baby as their poo is usually runny anyway, but if they are filling their nappy very frequently it may be classed as diarrhoea. Poos may also be ‘explosive’, requiring a change of clothes.
- Green poo – green poo can be caused by milk passing through the body too quickly and not being fully digested.
- Mucousy/bloody poo – mucus or blood may be present in the poo due to the body’s immune response trying to fight against the allergens in their milk.
- Reflux/vomiting – it is normal for babies to bring up a small amount of milk after a feed but if they are often bringing up larger amounts or even a whole feed this is not normal. In extreme cases babies may projectile vomit.
- Eczema/skin rashes/nappy rash
- Frequent feeding or overfeeding – breastfed babies feed for comfort as well as hunger. If they have stomach ache and feel uncomfortable they may feed more often than usual. In some cases, this can also lead to excessive weight gain.
- Refusing feeds – confusingly, this can also be a symptom if baby associates feeding with pain and discomfort. In this case baby may be slow to gain weight.
- Difficulty sleeping – babies may have difficulty settling to sleep, or may only be able to sleep in a caregiver’s arms, in a sling, or in a reclined position such as a car seat or pushchair. They may also wake excessively and struggle to settle back to sleep.
Getting a diagnosis
If you suspect that your baby may have a food allergy, speak to your GP for advice. It is important to get medical support with diagnosis. You need to be sure what is causing your baby’s symptoms. If you are exclusively breastfeeding, your GP may advise you to try an exclusion diet to see if your baby’s symptoms improve. You may also be offered hypoallergenic formula. Babies with immediate reactions should also be referred for allergy testing. Unfortunately, there are no tests for delayed reactions. If a food allergy is confirmed, you may need to see a dietician, paediatrician or allergy specialist for additional support.
Getting a diagnosis for food allergy can take time. Be persistent if your GP is dismissive or seek a second opinion. Having evidence to show them can be helpful, such as a food and symptoms diary, videos of your baby’s behaviour, or photos of their nappies. However, once you have worked out which food your baby is reacting to and eliminated it, they will begin to feel better much quickly.
Zoe T. Williams is passionate about supporting families with food allergies, having two daughters and a husband with multiple food allergies and intolerances. Right now, she is busy in the kitchen concocting new allergy-friendly recipes for her blog, My Allergy Kitchen. Her book, The Busy Parent’s Guide to Food Allergies is out now on Amazon and aims to take allergy parents from overwhelmed to empowered in easy bite-size chapters. She also runs the local group East Kent Allergy Mums.