Infant Allergies: Is My Baby Allergic to Breast Milk?

Breastfeeding issues

My child is currently one and a half months old.
He was fed a combination of formula and breast milk since birth.
However, on the night of his 18th day, he started passing a small amount of bloody stools, and during the night, he even had several instances of bright red blood in his stool.
He was subsequently hospitalized for 11 days, and the doctor diagnosed him with a formula allergy.
After being on a fasting diet for five days in the hospital, he began drinking extensively hydrolyzed formula.
By the eighth day, he started having breast milk once a day without any issues, and he was discharged on the 11th day.
However, shortly after returning home, he had bloody stools again.
I called the ward, and the nurse suggested temporarily stopping breast milk.
When I followed up with the doctor, he also recommended pausing breast milk for a week.
Starting from March 10, I gradually reintroduced breast milk, beginning with one feeding a day, then increasing to two feedings after a few days.
By March 18, he was having three feedings a day, but today his stool has changed again.
Previously, when he was on the extensively hydrolyzed formula, his stools were dark green, occurring about once every two days or once a day.
Today, however, he had five bowel movements, varying in frequency, with colors ranging from yellow to brown, and one of them was very watery.
I had been eating confinement meals that did not include shellfish, and I personally have a milk allergy, so I did not consume any milk.
Could this indicate that he is allergic to breast milk? Additionally, can we switch from extensively hydrolyzed formula to partially hydrolyzed formula in the future? Thank you, doctor.

Niming, 30~39 year old female. Ask Date: 2016/03/19

Dr. Xiao Kaiwen reply Pediatrics

Breast milk is essentially the most natural and least allergenic milk for infants, and there should be no babies who are "allergic to breast milk." The severity of cow's milk protein allergy can vary from mild to severe; for those with milder cases, partially hydrolyzed formula may be suitable, but it ultimately depends on individual trials.

Reply Date: 2016/03/19

More Info

Understanding infant allergies, particularly in relation to breast milk and formula, can be quite complex. Your situation highlights a critical aspect of infant nutrition and allergy management.
From your description, it seems that your baby experienced gastrointestinal distress, specifically blood in the stool, which led to a hospitalization and a diagnosis of formula allergy. This is not uncommon in infants, as their digestive systems are still developing, and they can be sensitive to certain proteins found in both breast milk and formula.
The fact that your baby was able to tolerate extensively hydrolyzed formula (which breaks down proteins into smaller, less allergenic pieces) without issues during hospitalization suggests that the formula proteins were likely the initial trigger for the allergic reaction. However, the reappearance of blood in the stool after reintroducing breast milk raises the question of whether your baby might also be reacting to something in your breast milk.

Breast milk is generally considered the best source of nutrition for infants, but it can also contain proteins that some babies may be allergic to, especially if the mother consumes dairy or other allergenic foods. Since you mentioned that you have a milk allergy, it's possible that traces of dairy proteins could still be present in your breast milk, depending on your diet.
The recommendation to temporarily suspend breastfeeding was likely made to determine if the breast milk was contributing to your baby's symptoms. If the blood in the stool resolves during this period, it could indicate that your baby is sensitive to something in your milk. When reintroducing breast milk, it’s advisable to do so gradually, as you are currently doing, monitoring for any adverse reactions.

Regarding your question about transitioning from extensively hydrolyzed formula to partially hydrolyzed formula, this should be approached with caution. Partially hydrolyzed formulas contain larger protein molecules compared to extensively hydrolyzed formulas, which may not be suitable for infants with a history of allergies or sensitivities. It’s essential to consult with your pediatrician or a pediatric allergist before making this change. They can provide personalized guidance based on your baby's specific health needs and allergy history.

In summary, your baby’s symptoms could be indicative of an allergy to proteins in either the formula or breast milk. It’s crucial to work closely with healthcare professionals to monitor your baby’s reactions and adjust feeding practices accordingly. Keeping a detailed food diary, noting any changes in your diet and your baby's symptoms, can also be beneficial in identifying potential triggers.
In the meantime, ensure that your baby is receiving adequate nutrition, whether through hydrolyzed formula or breast milk, and continue to communicate openly with your healthcare team about any concerns or changes in your baby’s health.

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