Let’s paint a picture: mom breastfeeds baby.  Baby spits up and seems a little fussier than normal for the next hour.  Mom decides to give up dairy, caffeine, and broccoli.  Sound familiar? 

Deciphering a baby’s behavior can be challenging enough, and the thought of a food allergy at work has led to many a coffee and bowls of ice cream passed upon, sometimes unnecessarily. While allergies are becoming increasingly more common and are a serious health concern for some, it’s important to know what to look for in babies and toddlers, and what do it when you do actually suspect something.  Dr. Purvi Parikh, an adult and pediatric allergist and immunologist with Allergy & Asthma Network, explains. 

Allergy vs Intolerance: Two Very Different Things
“An allergy is when your immune system is involved in the reaction, and can be dangerous as your immune system forms antibodies against a particular food, ”explains Dr. Parikh. “If exposed, it can cause a life threatening reaction, whereas an intolerance is more like a side effect of a food that most people experience, but is not necessary to avoid the food,” she continues.  “Often intolerance is dose-dependent, meaning someone can eat a food in some forms but not all.  Or, it can be an issue with digestion or breakdown. For example, lactose intolerance  is due to a lack of an enzyme to break down milk.  This is very different from a  milk allergy, which in some patients can be life threatening.” 

Signs To Look For
An all-too-common breastfeeding stress the idea that certain food that a mother is consuming aren’t “agreeing” with their baby.  Know this: fussiness alone is not usually a sign of a food intolerance or allergy.  Babies are, by nature, fussy.  According to Dr, Parikh, the fussiness would need to be accompanied by one of more other signs, like rashes, coughing, congestion, wheezing, trouble breathing, vomiting, diarrhea, blood in stools, or even loss of consciousness to become a red flag for an allergy or intolerance.

Once a baby starts on solid food, the cycle starts again.  If a baby nurses without problem, it doesn’t always mean they are in the clear.  “It usually takes repeat exposures to a food to develop an allergy so it may develop after nursing,” Dr. Parikh explains.  Once a baby starts on solids, the same signals apply as with breastfeeding: rashes, coughing, congestion, wheezing, trouble breathing, loss of consciousness, vomiting, diarrhea, blood in stools are all signs of food allergy.

Suspect Something? Here’s What To Do (Spoiler Alert: It doesn’t involve self-self-diagnosing over Google.)
If a parent is concerned their baby might have an allergy or intolerance, “they should see a board certified allergist and get the appropriate work up,” encourages Dr. Parikh.  “It is important to know if it is true allergy or not as that can be life threatening,” she continues.  “Further, there is a lot of ‘allergy’ testing that is not evidence based, and may misguide you. Thus, a  trained specialist can make sure you have the correct diagnosis.”