Babies can be very unsettled for many reasons.
Sometimes it’s food related, many times it’s not.
We have known for a long time that foods the mother eats can affect the make-up of her breastmilk. We know that flavours from your diet go through breastmilk,1 but food proteins2 and other food chemicals3 do as well.
If your baby is allergic or intolerant to traces of foods from your diet, then they may have adverse reactions.4
This is different to lactose intolerance, as lactose is a major part of breastmilk and is made in the breast; it doesn’t come from your diet. However, a baby may develop secondary lactose intolerance as a result of allergy or intolerance to foods coming through the breastmilk. For more information, see the Lactose intolerance and the breastfed baby article.
Can you reduce the risk of allergy?
If you have a family history of allergy, try to exclusively breastfeed your baby for around 6 months (at least the first 4 months) to reduce the risk that they will become allergic to foods.5 There is not enough evidence for you to avoid foods in pregnancy or breastfeeding to reduce the risk of your baby becoming allergic. Unless your baby is already reacting, then don't restrict your diet.6
Your baby should start solids at around 6 months, mainly because babies need a new source of iron and zinc in their diet.7 With regard to allergies, it is thought to be best to begin the major allergenic foods as soon as possible after starting solids and before 12 months, as long as your baby is not already showing reactions to the particular food.8 These foods include cows’ milk, soy, wheat, eggs, nuts and fish. It is also best for your baby to keep breastfeeding as new foods are begun as a way to possibly reduce the risk of allergy.9
Could it be something other than food?
Babies can be very unsettled for many reasons. It may be something other than food. Before changing your diet to try to prevent your baby’s symptoms, consider if they could be unsettled due to:
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lactose overload from too much milk
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medical conditions, including reflux disease although this can be also associated with food allergy or intolerance, especially to cows' milk.10
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normal newborn baby behaviour, such as cluster feeding and fussy periods.
Does your baby have any other symptoms as well, like a rash or odd-looking poos? Have your baby checked by your doctor in case there is anything medical that is causing your baby to be unsettled. It could be something as different as an ear or throat infection and nothing to do with your diet.
If you have ruled out these causes and would like to check if it is your diet, it is important to consult a health professional before changing your diet. Particularly when you are breastfeeding, you need good nutrition and if you start cutting out foods, you will need to make up for what you are missing by eating different foods.
A dietitian who deals with food allergy and intolerances would be the best type of health professional to guide you. You don’t need a doctor's referral to see a dietitian, but your doctor may be able to recommend one. Or find one listed in the Dietitians Association of Australia. Many dieticians do remote consulting as well as face-to-face.
What is food allergy?
There are different types of food sensitivity in babies, including food allergy and food intolerance. The term 'allergy' usually refers to reactions that involve the immune system. In this case, a small amount of an allergen (in this case food) can trigger a major reaction.
Allergic type reactions may occur soon after a feed, such as with vomiting, reflux or a rash. Or they may occur hours or days later, such as blood in the bowel motions or eczema. The most common foods causing these reactions are the same major allergens listed above (cows’ milk, soy, wheat, eggs, nuts, fish).
What is food intolerance?
Reactions caused by food intolerance do not involve the immune system and may be quite delayed. They may appear 24 to 48 hours or more after your baby was exposed to the food. There is also a ‘dose-effect’, where a small amount won’t cause a reaction but a larger amount may, so a more graded effect.
A baby with food intolerance reacts to food chemicals coming through the breastmilk from their mother’s diet.3 These include food additives and natural food chemicals found in everyday healthy foods. These are often the substances in foods that give them flavour. Babies can also react to some staple foods, such as dairy products, soy and some grains.
In breastfed babies, allergy and intolerance can look similar
Although food-intolerance reactions do not involve the immune system, as allergy does, the symptoms in breastfed babies may be similar. The symptoms of both food allergy and food intolerance commonly include:
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colic/wind in the bowel
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gastro-oesophageal reflux
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green, mucousy bowel motions
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eczema
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a wakeful baby who appears to be in pain.
Some babies possibly have both food allergy and food intolerance.
Starting solids if your baby is allergic or intolerant
If you find your baby reacts to foods in your diet, you may need to be extra careful when starting solids. Reactions after eating foods directly can be more serious than when the baby was reacting through breastmilk. If you think your baby is having allergic reactions, it is vital to consult your doctor before starting the more risky foods listed above. As well as advice about your diet, a dietician can also help with advice on solids for your baby.
By Joy Anderson BSc (Nutrition) PostgradDipDiet IBCLC ABA breastfeeding counsellor
The information on this website does not replace advice from your health care provider.
© Australian Breastfeeding Association April 2022
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