What to Feed Your Infant or Toddler If They Have Food Allergies

Infants can develop food intolerances or allergies. A small subset of infants fed human milk (either by breast or bottle) can show symptoms due to food proteins the mother or lactating person eats passing through into the human milk. Formula-fed infants can show symptoms due to not tolerating the food proteins (milk or soy) in infant formula. Babies should ideally drink human milk or formula for at least the first year of life.

Food Allergy

A food allergy occurs when the body’s immune system sees a certain food as harmful and reacts by causing one or more symptoms. This is known as an allergic reaction.

Foods that cause allergic reactions are called allergens. Even a small amount of an allergen can cause a reaction. Allergic reactions usually occur after your child eats a food they are allergic to.

There are two types of food allergies: IgE mediated and non-IgE mediated.

Symptoms from IgE mediated food allergies usually occur within two hours of feeding and can present as:

• Rash
• Hives
• Vomiting
• Severe allergic reaction (anaphylaxis)

This is the “classic” type of food allergy that causes symptoms like hives and swelling. An IgE-mediated food allergy can get worse over time. Some food allergies are more likely than others to be outgrown as children age. When a child is diagnosed with this type of allergy, your health care provider should provide you with an epinephrine auto-injector to treat severe allergic reactions.

Symptoms from non-IgE mediated food allergies are usually delayed after feeding and may present as:

• Bloody, mucousy stools
• Colic, reflux, more severe spitting up
• Vomiting
• Diarrhea

Most symptoms of non-IgE mediated food allergies involve the digestive tract. Types of non-IgE mediated food allergies include:

• Eosinophilic [EE-oh-sin-oh-FILL-ick] esophagitis (EoE) – an allergic swallowing disorder caused by an inflamed esophagus (part of the throat)
• Food protein-induced enterocolitis syndrome (FPIES) [eff-PIES] – inflammation in the small intestine and colon (large intestine)
• Allergic proctocolitis [prahk-toe-koh-LIE-tis] – inflammation in the lower intestine caused by an allergy to cow’s milk or soy proteins found in formula or breast milk

The symptoms of non-IgE mediated food allergies usually go away when the food allergen is removed from the infant’s diet.