Dr. Allan Greene answers the question, Should I stop breastfeeding because of my baby's allergy to cow's milk?


I have an 8-week-old son who started producing green stool with bits of blood about three weeks ago. The pediatrician said that he tested positive for hemoccult and that it was caused by colitis and eczema, resulting from an allergy to cow's milk. He told me to stop breastfeeding and only use Nutramigen. But when I spoke with La Leche League, they said that dairy is out of your system in seven days, so I returned to breastfeeding a week after giving up dairy. But the doctor still disagrees. What do you think?


    One of the most common reasons for hemoccult positive stools at that age is an allergy to cow's milk protein in dairy products. And dairy in mom's diet can come through in the breast milk (dairy is the most common cause, but enough soy, peanut, and eggs can also go through breast milk to cause allergic reactions).

    LLL is right that the offending agents are usually gone from the breast milk within seven days of removing them from mom's diet -- often even sooner. Most babies do get better while breastfeeding if their mothers give up cow's milk, but there are a few who do not. If your baby doesn't get better, I would try eliminating all four of the most common allergens from your diet (milk, soy, peanuts, and eggs) and would not stop nursing unless your baby were anemic and/or hypoproteinemic. Even then, I would recommend seeing a pediatric GI doc before stopping nursing for this.

    Many doctors are not aware of this, but even though Nutramigen is a great hypoallergenic hydrolysate formula, it does contain traces of milk. In my experience, those who react to traces of milk in dairy-free breast milk will also react to Nutramigen (within a few weeks, if not at first) and would ultimately need a formula called Neocate, which contains none.

    In short, the advantages of nursing far outweigh a tiny bit of inflammation and blood loss in an otherwise growing baby. I wouldn't stop nursing for that.

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