In last week’s blog post, I wrote about my daughter’s colic and constant fussiness and how it led me to look for a root cause related to my breastfeeding diet. After discussing it with a nurse at my pediatrician’s office, who thought my daughter might have a cow’s milk protein intolerance, I gave up all dairy and caffeine.
This was not at all easy for me. There were already so many things I had “given up” since becoming a mother: sleep, alcohol, working out, personal space, and long showers, to name a few. Now I was going to add COFFEE (the only thing keeping me awake) and dairy to that list?? It seemed impossible.
But like countless strong mothers before me, I put on my big-girl pants and did it. Why? Because my baby’s painful screams – and my helplessness and feelings of inadequacy – were more painful than the thought of a few months without my nightly treat of chocolate chip ice cream.
If you’re breastfeeding and your baby seems unusually fussy and uncomfortable, how will you know whether it’s caused from dairy in your breast milk? What is a cow’s milk protein intolerance anyway? And what are the long-term implications for your baby? Let’s start at the beginning.
What is a cow’s milk protein intolerance?
Biologically, humans aren’t supposed to consume milk from any animal except humans. We’re also the only species that consumes milk past infancy and childhood. Thousands of years ago, we didn’t. But as dairy became more prevalent during the agricultural revolution, in European countries in particular, people began to consume more dairy. Our bodies started to adjust to be able to tolerate the proteins found in cow’s milk. Over time, the genes of certain cultures of people have actually changed to accommodate dairy products in our diet – or at least, many of us have. For newborn babies, it can still take some time to become tolerant of the proteins found in cow’s milk.
Cow’s milk contains two primary types of proteins: A1 and A2. They are genetic variants of one another that differ in structure by one amino acid. The A1 protein has been shown to cause gastrointestinal issues and inflammation in the gut. So, when we talk about a cow’s milk protein allergy or intolerance, we’re referring to an intolerance of the A1 protein.
One more thing to discuss: the difference between cow’s milk protein intolerance and lactose intolerance. They are NOT the same thing. The former is intolerance to the A1 protein, and the latter is intolerance to lactose, which is a sugar found in milk. Lactose intolerance is usually not something you grow out of and continues into adulthood, whereas most children outgrow a cow’s milk protein intolerance. It’s also important to note that if you suspect your baby has a cow’s milk protein intolerance and you try switching to lactose-free milk, it won’t help your baby’s symptoms.
How will you know if your baby has a cow’s milk protein intolerance?
If you’re breastfeeding and you suspect dairy in your diet might be bothering your baby, the best test is to eliminate dairy from your diet for a week or two to see if there’s a difference in your baby’s demeanor. But, before we get that far, let’s talk about the signs that your baby might have a cow’s milk protein intolerance.
5 Signs Your Breastfed Baby Has a Cow’s Milk Protein Intolerance
1. She’s fussy…like, REALLY fussy. She screams bloody and murder and seems to be crying out in pain a good chunk of the day.
2. Her fussiness gets worse after you’ve fed her (within 2 hours).
3. She spits up frequently (after every time she eats) or vomits.
4. She has a nasal-y sound coming from her nose, kind of like she’s congested.
5. She doesn’t sleep well. We’re talking very short windows of sleep, day or night (like 15 minutes at a time).
If your baby exhibits all or most of these signs, the best next step is to eliminate dairy from your diet to test your assumption.
Ok, here’s the hard part. Make a list of all dairy items you typically consume; things like:
--Half ‘n half
It’s helpful to make a list because sometimes you don’t even think about the fact that something you’re eating has dairy in it. When you actually write it down, though, you’re more likely to catch everything.
One thing to note: Eggs are NOT dairy. This may seem obvious to some of you, since eggs come from a chicken and not a cow, but I got confused for a minute myself because eggs are in the dairy section at the grocery store. Anyway, eggs are ok to eat, as long as you don’t use milk or cheese for scrambled eggs.
Now, plan out what you’re going to eat instead of these items. For example, Coffeemate doesn’t have dairy in it (weird – and slightly alarming? – I know), so if you typically take milk or half ‘n half in your coffee, you could replace it with Coffeemate. If you have a sweet tooth like I do and need some sugary snacks around, you could eat sweet fruit (grapes are my favorite) or cookies that don’t have dairy in them (shortbread cookies, for example). Just check the label on the back of the boxes to make sure there isn’t any dairy ingredients listed.
Eliminate all dairy for one to two weeks and take note of your baby’s demeanor. Is she settling down? Spitting up less? Sleeping a little bit better? I saw a noticeable in both of my girls within a few days of eliminating diary, but it could take up to two weeks, depending on how much dairy you have in your system and how intolerant your baby is.
If you’ve eliminated all dairy and your baby is doing better, but you’re really having a hard time going without a certain thing in your diet, you COULD try to incorporate just that one thing back into your diet to see if she’ll tolerate it. Not all babies need all dairy eliminated, so if you’re willing to experiment a bit, you might find that you can eat butter, but not milk or cheese. I used to experiment just a little bit by eating buttered toast or something small, and my girls would instantly start spitting up. Although it was disappointing to be reminded that I had to follow such a strict diet, I at least felt validated that it was, in fact, dairy that was causing my baby’s discomfort.
The transition back to cow’s milk
One of my biggest fears about my daughters having a cow’s milk protein intolerance was what it meant for the long term. Would they never be able to tolerate dairy? Would we forever have to live a life without cheese and ice cream?
The good news is that for the vast majority of babies, the answer is no. Your baby simply needs some more time for her gut to develop a tolerance to cow’s milk protein. There are two transitions to discuss: your transition to incorporate dairy back into your breastfeeding diet, and your baby’s transition to cow’s milk.
I was able to start incorporating dairy back into diet around 6 months with my first daughter, and closer to 8 or 9 months with my second daughter. I can recall trying to eat ice cream when my second daughter was 7 months old, and like clockwork, she would start spitting up two hours after I ate it (she never spit up otherwise). That’s how I knew she wasn’t ready. But, she did come around eventually.
Obviously, you can’t test out your baby’s tolerance to cow’s milk until 12 months old. My oldest daughter started on cow’s milk at 12 months with no problems. My youngest daughter needed a bit more time, though. She was very fussy when we started her on cow’s milk, so we switched her to soy milk. That worked for a bit, but then she started getting really fussy again and had a lot of gas. My sister called me one day and said she had just seen a commercial for something called A2 milk, which removed the A1 protein (the one that causes tummy issues) from cow’s milk. SCORE! We ran out and got some that day, and it was a lifesaver for us. It tastes exactly like regular milk, so my daughter loved it, and her tummy problems were solved. Our bank accounts suffered a bit, though. It’s expensive stuff! But, it was worth it, and she transitioned to regular whole milk by 21 months old.
Although a cow’s milk protein intolerance is not something you want your baby to have, it’s not as scary as it might seem. Determining what the problem is and understanding what’s involved to get your baby to a healthy place is half the battle. Take heart that it’s a temporary problem and one that your little one will likely outgrow by two years old. In the meantime, you’ll have a healthier, happier baby.
About Katie Stansberry
Katie Stansberry is a work-from-home mom of two sweet girls and the creator of Breastfeeding Bliss. After struggling at the beginning of her breastfeeding journey, she wanted to create a happy place where breastfeeding moms could find practical tips, positive inspiration, and the newest and best breastfeeding products. On her "Back to Bliss" breastfeeding blog, she shares her personal stories and tips for making breastfeeding an easier and more enjoyable experience.