Frequently Asked Questions: Pregnancy, breastfeeding and infant feeding

Will changing my diet during pregnancy or breastfeeding prevent my baby from developing allergies?

Avoiding the common allergy causing foods including peanut, egg, fish, soy and cow’s milk when you are pregnant or breastfeeding has not been shown to reduce the chance of the baby developing allergies but has been shown to increase the likelihood of lower weight gain by babies.

Therefore, restricted diets during pregnancy or breastfeeding are not recommended for allergy prevention.

REMEMBER: Smoking during pregnancy can lead to significant health problems for your baby including an increased chance of asthma and should be avoided.

If my baby is allergic to a food, should I avoid eating or drinking this food if I am breastfeeding?

Breastfeeding mothers do not need to avoid eating or drinking the food their baby is allergic to unless their baby is reacting to the food in breastmilk, or they have been advised by their doctor to avoid the food.

Removing foods from the mother’s diet unnecessarily puts the mother’s nutritional health at risk, particularly when removing food groups such as milk (dairy) and wheat or removing multiple foods. Mother’s avoiding foods such as milk (dairy), wheat or multiple foods should see a dietitian to make sure they are getting all the nutrition they need.

Will taking fish oil supplements or eating fish prevent allergy?

For pregnant and breastfeeding mums, eating oily fish such as: salmon, mackerel, sardines, trout and herring, 3 times a week may help.

Some research shows that consuming the omega-3 fatty acids found in oily fish during pregnancy and breastfeeding may help prevent eczema in early life. There is no evidence that consuming fish oil supplements prevents allergy.

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Are probiotics useful in preventing allergies?

Probiotics are good bacteria. We usually think of bacteria as germs that make us sick, but research has shown that probiotics are a good type of bacteria and good for your health.

At this stage, researchers are not sure if probiotics can help to reduce the chance of your baby developing allergies.

There is some research that shows that probiotics taken during pregnancy and breastfeeding may help to reduce the rate of eczema in the baby.  However, the type of probiotic and the amount needed is still not clear.

Are there any foods I should not feed to my baby when starting solid foods?

Solid foods should be commenced when your baby is ready at around 6 months of age, and not before 4 months. You should not avoid any foods to prevent allergy.

If you think your baby has an allergy to a certain food, talk to your doctor before giving your baby that food. If there are foods you are not able to feed your baby due to allergy, talk to your doctor and possibly a dietitian.

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How often should I feed my baby allergy causing foods once introduced?

Once you have fed your baby the common allergy causing foods, it is important to continue to include these foods in your baby’s meals, about twice a week. This is important to help prevent your baby possibly developing an allergy after eating the food. If you feed your baby the common allergy causing foods, but your baby does not continue to eat the foods, they could develop a food allergy if they have not eaten the food for some time. There is no clear research to tell us exactly how much of the allergy causing foods your baby needs to eat to prevent food allergy, so it is recommended that you choose small amounts (for example, 1 teaspoon) to start with and increase the amount as your baby grows and eats more.

As it is important to continue to feed your baby the common allergy causing foods once introduced, you should only feed them the foods that you are able to continue to feed them. Your baby will eventually be eating family foods, so if your family does not eat a particular food, you may choose not to introduce that particular food to your baby, knowing that they are not likely to continue eating it once they are able to eat family meals. You may wish to discuss this with your doctor or an allergy dietitian.

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What should I do if my baby already has food allergies?

If your baby has had what could be an allergic reaction or is allergic to a particular food, do not feed your baby that food. However, it is important to feed your baby the common allergy causing foods that your baby is not allergic to, to prevent them from developing other food allergies.

It is important that you have discussed your baby’s food allergy with a doctor so that you have any medications required or prescribed by your child’s doctor.

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What should I do if other members of the family have food allergies?

If other members of the family have food allergies, it is still important to introduce that food to your baby, while keeping the family member with food allergy safe.

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Does cooking the food remove the allergen?

Cooking some foods such as baking egg and milk, may make some foods less likely to cause allergic reactions.  However, this is not always the case, so the decision to give a child a food they are allergic to in a cooked form, should only be made by a clinical immunology/allergy specialist.

If a clinical immunology/allergy specialist thinks a child who is allergic to egg or milk is likely to be able to eat baked milk or baked egg without having an allergic reaction, the child will usually have an oral food challenge to confirm this. Oral food challenges may be done in a hospital setting where medical assistance and facilities are available, as severe reactions can, and do, occur.

Many people allergic to food products cannot eat them whether they are cooked or uncooked, and they should follow the advice of their treating specialist.

If I can't breastfeed, which formula is useful in preventing allergies?

If you are not able to breastfeed or your baby needs supplementary feeding (commonly known as ‘top ups ’or complementary feeds), commercial infant formula may be used until 12 months of age.

Current research does not support the use of partially hydrolysed formulas (usually labelled ‘HA’ or Hypoallergenic) or extensively hydrolysed formulas to prevent eczema, food allergy, asthma or hay fever (allergic rhinitis) in babies or toddlers.

What formula should I use if my baby has a cow’s milk allergy?

If your baby has a cow’s milk allergy, regular infant formula should not be given to your baby and your doctor will recommend an alternative such as soy infant formula, hydrolysed rice formula or a prescription only specialised infant formula depending on your child’s age and medical history.

Children allergic to cow’s milk should avoid all dairy products unless their clinical immunology/allergy specialist advises otherwise.

Most children allergic to cow’s milk will also react to other animal milks such as goat and sheep milk and horse milk, so they should be avoided.

“A2 milk” (from specially bred cows) is claimed to have a number of health promoting properties, but this milk is also not suitable for children with cow’s milk allergy and should not be given.

Partially hydrolysed cow’s milk-based formula (usually labelled ‘HA’ or hypoallergenic) is also not suitable for children with cow’s milk allergy.

Lactose free infant formula is not suitable for babies with cow’s milk allergy.

Are all reactions to cow’s milk due to allergy?

Some reactions to cow’s milk may be due to lactose intolerance, which is caused by the lack of the enzyme lactase, which helps to digest the milk sugar lactose.

Symptoms include diarrhoea, vomiting, stomach pain and gas, which are similar to some of the symptoms of cow’s milk allergy.

Lactose intolerance is uncomfortable but not life-threatening and does not cause symptoms of food allergy such as hives, swelling or anaphylaxis.

Is soy milk or goat's milk better at preventing allergies over cow's milk formula?

No. Research has shown that using soy milk or goats milk formula instead of cow’s milk formula does not reduce the chance of your baby developing an allergy.