Today's topic that we're talking to Dr. Tina Feeley about
is allergies and intolerances.
So can you tell us what the difference is
between an allergy and an intolerance.
Tina: Absolutely.
It's a great question.
So an allergy is something that is going to cause
issues in your body that can be potentially life-threatening
but also harmful to your body, in general,
especially over a long period of time.
So there is different types of allergies,
they're the food allergies you think of,
where you need your EpiPen, where it causes the
hives, and the wheezing, and the vomiting, diarrhea,
and just a lot of almost instant reaction
within like a half hour to an hour of eating that food.
And then there's other allergies like
celiac disease or milk protein allergy
that can cause your body to have bloody poop,
and to not be able to digest food well and things like that.
So they are things that cause you to have ultimate
harm to yourself.
An intolerance is something that makes you feel
kind of lousy, but it doesn't actually cause any
damaging effects to you in general, beside the fact
that you feel kind of lousy but it won't cause
ultimate harm or potentially kill you or things like that.
So those are kind of the major differences just from
how we separate them in terms of how we think and then
the ultimate difference comes down to biology,
which we don't need to get into right now.
But it comes down to the actual reactions that are
happening within your body when you're exposed
to the foods, as well.
Amanda: Right.
And so what are the most common allergies and intolerances
that you see in children and babies?
Tina: Yes, so it really depends on the age.
So by and large, in the newborn period until a baby eats
solid foods, the number one allergy is usually
milk protein allergy.
So milk protein allergy is something, that,
the baby actually has an allergy to the milk,
but it's not an allergy that you think of with getting
hives and trouble breathing and things like that.
It actually affects your gut, and the major symptom with it
that we use to diagnose is having bloody stool.
So having bloody poop, but also they're generally
vomiting, refusing bottles, very fussy, uncomfortable,
but the major hallmark is the bloody poop.
With that also sometimes babies that have milk protein
allergy also have a soy allergy because the soy protein
and milk proteins are very similar to each other,
so they can kind of mimic each other, so some parents
will switch from a milk formula to a soy formula
and not see any difference, and that's the reason
'cause they could kind of be similar allergies in that.
Once the baby gets older, when they're starting solid food,
then we think also, they could still have the milk protein
allergy, but we could also think of allergies,
the typical allergies you think of that cause the
wheezing, and the hives, and things like that.
Those allergens are typically peanuts, tree nuts,
so tree nuts are things like almonds, pecans and like that,
shellfish, finfish, dairy, eggs, wheat and soy.
And then in terms of intolerances, the two that I think
we talk about most common are lactose intolerance.
That is actually, it's different than the milk protein
allergy, lactose intolerance means that you have trouble
breaking down the sugar in the milk itself,
and that we generally don't see in babies.
That's usually more toddlers and above.
Usually not, you don't see it before the age of 2 typically.
And then also, there's right now a lot of talk about
gluten intolerance, as well.
Again not something we typically see with babies
but it's usually older children.
Amanda: Right.
How do you know if a baby has an allergy or an intolerance?
What are some of the signs that you would typically see?
Tina: So this is definitely something where,
especially when it comes to like milk protein allergy,
or if you're concerned that you're child is having
issue with dairy or milk protein, I would say
go to your pediatrician, or go to your doctor
right away and talk about it because it can actually be,
especially in the newborns and younger infants,
it can be kind of tricky to hash out what is
an allergy versus what is an intolerance.
Part of that is because a good amount of babies with reflux
will actually respond to a milk-free diet.
So it's not that they are actually having a milk protein
allergy, it might be the milk protein,
more like intolerance, but it's making the reflux worse,
so although it's not having those harmful effects
of like what we're talking about before, like a true
allergy where it can cause you to have ultimate harm
in your body, and baby not gain weight and things like that,
it can make them fussy and irritable and make the reflux
worse, so sometimes we'll actually recommend a
milk-free formula or a milk-free, or mom to go on
a dairy-free diet if she's nursing.
For the reflux, that's not actually a milk protein allergy.
So in terms of, that's why I say definitely,
if you're concerned about it, definitely go to your doctor
so that we can kind of discuss your specific baby
and their specific symptoms because it can be
a little bit of an overlap in that age group.
But the hallmark, again, of a milk protein allergy
would definitely be if they are vomiting after each feed,
and vomiting, I mean like very profusely,
not just spit up and moving around.
I mean, you know, forceful vomiting.
If they're having any bloody stool but
those are definitely hallmarks of a milk protein allergy
but sometimes there's a little bit of interaction between
the two, it definitely takes a little more discussion
with you and your doctor to hash out what's what.
Amanda: And this is something that I see commonly around
some of my own friends, is that other mothers have suggested
going off milk or changing the baby from
cow's milk formula, is this something,
this is something that
should really only be recommended by a pediatrician
or a doctor rather than just hear from friends?
Tina: Absolutely, absolutely.
I can't emphasize that enough.
If you're going to make any changes to your baby's diet,
then I would definitely recommend talking to your
doctor, talk to your pediatrician, talk to your GP
about it prior to making that change,
because A, especially, so with my own daughter had reflux
that was responsive to a milk-free diet,
and I can tell you as a nursing mom, a dairy-free diet
is not easy to do
So before you put yourself through that, you might wanna
also make sure that that's something that would be helpful,
but also any time you make a change to your baby's diet,
it's going to ultimately change what they'll take in the
future, when you're gonna introduce different solids
to them, and I would definitely recommend talking to your
doctor before making any dietary changes
because it can be really eye-opening depending, again
there's a lot of overlap between things and what works
for one baby might not work for another, so
depending on the specifics of the situation.
Amanda: I couldn't agree more, definitely.
And so can allergies or intolerances ever be confused
with anything else?
Tina: Definitely.
So a lot of times, especially around the six week mark,
parents will come and talk about their baby being really
fussy, and so allergies and intolerances can definitely be
confused with reflux, but around the six week mark,
it also could just be colic, which generally around
the four to six week time, baby end up stooling less,
so parents will think that they're constipated,
even though a lot of times, the stooling patterns can be
completely normal for a four to six week old.
Also colicky babies, we don't really know what causes colic,
but sometimes parents will come and say,
"It must be the milk."
And they've come in at six weeks and they've tried
eight different formulas and nothing's making any
difference, and they've tried each one for a couple days
here or there, and it's not making a difference
and it turns out that it's actually because of colic,
which is frustrating, because there's not much you can do
for it, but at least it's reassuring that you don't have
to take something out of their diet and things like that.
There are definitely overlap between multiple diagnoses
especially in the younger babies, and again just
a fussy infant, in general, can often be
attributed to multiple different things, but oftentimes
it gets attributed to problems with the formula,
problems with the milk, problems with reflux or constipation
and it may not be any of them.
Amanda: It may be that they need more sleep, for example.
I know a lot of babies get diagnosed with colic
when it's actually just that they have
only had three 20-minute sleeps throughout the day,
that they just need to sleep.
They're fussy because they need to sleep
Tina: Absolutely, absolutely.
Amanda: Yeah, definitely.
Okay, well thank you so much for chatting about allergies
and intolerances, it's been really informative.
Thank you very much, Tina.
Tina: Thank you.