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An Allergic Reaction to Infant Formula? Allergy Symptoms to Look For in Babies

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By Chris Telden


If food allergies run in either parent's family, you may be concerned that your baby is displaying symptoms of an allergy to infant formula. Although allergies to baby formula are uncommon--the U.S. Department of Agriculture puts the number of babies who develop an allergy to milk protein, the base of most infant formula, at less than 3 percent of U.S. infants--some babies do develop them. Half of those that have allergic reactions to milk-based baby formula are also allergic to soy, which is the other main food base of infant formula. If your baby does have signs of an allergy to milk formula, talk to your baby's doctor. There are hypoallergenic formula options that may help. Here are some symptoms of infant formula allergy to look for. Oh--and if it turns out your baby is having an allergic reaction to infant formula, don't stress it--within a few years, most children grow out of infant cow's milk allergies.

Skin Rash--a Symptom of a Possible Allergy

In babies, an allergic reaction to infant formula often occurs on the skin.  Look for

  • hives
  • eczema (flaky, dry patches on the skin)
  • ring around the rectum that diaper rash cream doesn't help
  • other rash


Poll: Does Your Baby Tolerate Hypoallergenic Formula or Soy-Based Formula?

If your baby is on a special infant formula due to allergies, how is he or she doing?

  • My baby is on a soy-based formula and tolerates it just fine.
  • My baby is on a soy-based formula and I don't know how well my baby's tolerating it.
  • My baby is on a soy-based formula and is not tolerating it very well.
  • My baby is on a hypoallergenic formula and tolerates it just fine.
  • My baby is on a hypoallergenic formula and I don't know how well my baby's tolerating it.
  • My baby is on a hypoallergenic formula and is not tolerating it very well.
  • My baby is still on a cow's-milk-based formula and usually tolerates it just fine, but I'm concerned about some symptoms.
  • My baby is still on a cow's-milk-based formula and I'm afraid my baby's not tolerating it very well.
  • Other (Please leave a comment.)
See results without voting

Baby Vomiting After Formula? May Be an Allergy

Expect your baby to spit up sometimes, particularly in the early months.  Babies have immature digestive tracts and normally spit up occasionally.  But take note if your baby is:

  • having repeated vomiting episodes
  • having episodes of forceful vomiting (projectile vomiting)
  • spitting up formula a lot, an indication that your baby may have excessive reflux

Baby Has Diarrhea? Constipation? These Could Be Allergy Symptoms

Your baby's stools may indicate an allergy to cow's milk protein or soy.  Note if the stools:

  • smell foul
  • are unusually hard (constipation)
  • are unusually loose (diarrhea)
  • are frequently loose (diarrhea occurring multiple times in a day for several days) - CALL THE DOCTOR
  • blood in the stool - CALL THE DOCTOR

Note: it's normal for a baby's poop to change appearance and smell when you switch from breast milk to infant formula.

Tummy Hurts? Could Be an Allergy Symptom

Abdominal discomfort--that is, tummy pain--can be a sign of an allergy to infant formula.  Watch for these symptoms:

  • Your baby fusses, cries, and squirms during or after a feeding
  • Your baby cries a lot, seems gassy, or shows other signs of colic

The symptoms may, however, not be indicative of a baby formula allergy at all, but again be due to the baby's immature digestive tract or some other problem.

Note: Lactose intolerance, while possible, is actually quite uncommon in babies, according to the U.S. Dept. of Agriculture.


Breathing Difficulties Could Suggest a Baby Formula Allergy

An allergic reaction to milk protein may be indicated by these symptoms if they present when your baby does not have a cold virus:

  • nasal congestion
  • wheezing / asthma
  • shortness of breath
  • throat mucus
  • nose mucus
  • other breathing problems or abnormalities of the respiratory passages


Baby Losing Weight? Gaining excessively?

As a result of other symptoms, in particular excessive vomiting or frequent diarrhea, your baby's growth may slow down.

Watch for this sign of a possible food allergy. If you suspect failure to thrive, don't hesitate--talk to your baby's pediatrician right away.

Also let your physician know if you're concerned your baby is gaining too much weight--not so your doctor can put your baby on a diet, but to see if there is an underlying allergy or condition.

Baby Not Sleeping Well?

An infant formula allergy can manifest itself in part in discomfort that may keep a baby from sleeping soundly.

If your baby shows any of the above symptoms and you are concerned that she is allergic to infant formula or might have another health problem, talk to her pediatrician.

Don't let this article serve as medical advice--it's just meant as a guideline to help you know what to look for if you're concerned about a possible allergic reaction to infant formula.

Have You Had Experience With Infant Allergies? Comment Here.

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OTmommy profile image

OTmommy  says:
5 weeks ago

Great hub, and so thorough! Both of my children have extensive food allergies including dairy and soy. I chose to exclusively breastfeed after I tried formula once, and my daughter had an anaphylatic reaction to Nutramagin, a hypoallergenic hydrolyzed formula, that still contains the milk protein casein. Now as a toddler, my son drinks a hemp beverage or rice milk. I make sure my kids get calcium in other ways since they can't consume dairy products. Although food allergies are not super common, they are scary to the parents and caregivers!

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Research on Infant Allergy to Formula

  • Casein hydrolysate formula-induced liver dysfunction in a neonate with non-immunoglobulin E-mediated cow's milk allergy.

    Related Articles Casein hydrolysate formula-induced liver dysfunction in a neonate with non-immunoglobulin E-mediated cow's milk allergy. J Investig Allergol Clin Immunol. 2008;18(1):67-70 Authors: Yada K, Yoshida K, Sakurai Y, Kimura M, Yasuhara H, Tanaka I, Yoshioka A A 10-day-old male neonate was admitted with bilious vomiting and gross hematochezia. Peripheral eosinophilia, delayed positive skin prick test to artificial milk, and elevated eosinophil cationic protein levels suggested cow's milk allergy. Fluid infusion with prohibition of oral intake improved the digestive symptoms. Breast-feeding was resumed on hospital day 3 and only casein hydrolysate formula was fed from day 7 onward. Nevertheless, eosinophilia and elevated transaminase levels developed on day 14. Liver dysfunction associated with casein hydrolysate formula was suspected and the infant was transferred to soy formula. Eosinophil counts decreased and transaminase levels were normalized on day 19. A cow's milk protein-specific lymphocyte proliferation test was positive for alpha-casein, beta-lactoglobulin, and bovine serum albumin, indicating sensitization of T cells to cow's milk proteins. These observations suggest that careful attention should be paid to liver dysfunction in non-immunoglobulin E-mediated cow's milk allergy, even when hypoallergenic formula is used. PMID: 18361106 [PubMed - indexed for MEDLINE]

  • A hydrolysed rice-based formula is tolerated by children with cow's milk allergy: a multi-centre study.

    Related Articles A hydrolysed rice-based formula is tolerated by children with cow's milk allergy: a multi-centre study. Clin Exp Allergy. 2006 Mar;36(3):311-6 Authors: Fiocchi A, Restani P, Bernardini R, Lucarelli S, Lombardi G, Magazzù G, Marseglia GL, Pittschieler K, Tripodi S, Troncone R, Ranzini C BACKGROUND: Children allergic to cow's milk are fed a soy- or a hydrolysed cow's milk-based substitute. Neither can rule out a sensitization risk. Previous studies have shown that hydrolysed rice is tolerated by animals and children with multiple food hypersensitivities. OBJECTIVE: A prospective clinical assessment of tolerance to a rice-based hydrolysed formula was carried out in children allergic to cow's milk. Patients and methods One hundred children (42 girls and 58 boys, mean age 3.17+/-2.93 years, median 2.20, range 0.18-14.6 years) with a history of immediate reactions to cow's milk and confirmed at double-blind, placebo-controlled food challenge (DBPCFC) when not contraindicated were assessed for clinical tolerance to cow's milk proteins. Their allergy work-up included skin prick tests with whole milk, alpha-lactalbumin (ALA), beta-lactoglobulin (BLG) and total caseins, and specific IgE determinations using CAP technology were performed against whole milk, ALA, BLG and casein. Sensitization to rice and rice-based hydrolysed formula was similarly investigated. Patients' sera were evaluated at immunoblotting for specific IgE to cow's milk proteins, rice and rice-based hydrolysed formula. DBPCFC was carried out with increasing doses of a rice-based hydrolysed formula. RESULTS: All patients were sensitized to cow's milk and/or at least one cow's milk protein fraction. Eighty-seven out of 99 were positive to cow's milk and/or a cow's milk protein fraction at skin prick test. Positive (>0.35 kUA/L) specific IgE determinations were found for cow's milk and/or milk fractions (92/95), rice (21/91) and hydrolysed rice infant formula (4/91). At immunoblotting, sera from 96 children were positive to alpha-casein (n=54), beta-casein (n=38), ALA (n=57), BLG (n=37) and bovine serum albumin (n=61). Similarly, although patients' sera often contained specific IgE against rice proteins at CAP (21/91) and immunoblotting (70/96), only six very weakly positive responses were observed against rice-based hydrolysed formula. All DBPCFC with rice-based hydrolysed formula were negative. CONCLUSIONS: Rice-based hydrolysed formula is a possible alternative not only for children with multiple allergies, but also for children with cow's milk allergy. PMID: 16499641 [PubMed - indexed for MEDLINE]

  • Feeding a soy formula to children with cow's milk allergy: the development of immunoglobulin E-mediated allergy to soy and peanuts.

    Related Articles Feeding a soy formula to children with cow's milk allergy: the development of immunoglobulin E-mediated allergy to soy and peanuts. Pediatr Allergy Immunol. 2005 Dec;16(8):641-6 Authors: Klemola T, Kalimo K, Poussa T, Juntunen-Backman K, Korpela R, Valovirta E, Vanto T Peanut allergy has been associated with the intake of soy milk or a soy formula. We studied the development of immunoglobulin E antibodies specific to soy and peanuts and of allergic reactions caused by peanuts, in children with confirmed cow's milk (CM) allergy fed either a soy formula or an extensively hydrolyzed formula (EHF). One hundred and seventy infants with documented CM allergy (CMA) were randomly assigned to receive either a soy formula or an EHF. The children were followed to the age of 4 yr. Peanut-specific immunoglobulin E was measured at the age of 4. A detailed history of the occurrence of allergic reactions caused by peanuts was recorded by the parents. Soy-specific immunoglobulin E antibodies were measured at the time of diagnosis and at the ages of 1, 2 and 4 yr. Immunoglobulin E antibodies to soy (> or =0.35 kU/l) were found in 22 of 70 children fed the soy formula, and in 14 of 70 of the children fed the EHF (p = 0.082). In an open challenge with soy at the age of 4, no immediate reactions were observed. One of 72 children from the soy group had a delayed reaction. immunoglobulin E antibodies to peanuts (> or =0.35 kU/l) were found in 21 of 70 children fed the soy formula and 17 of 69 infants fed the EHF (p = 0.717). The incidence of reported peanut allergy in the soy group was two of 72 (3%) and four of 76 (5%) in the EHF group (p = 0.68). Development of immunoglobulin E-associated allergy to soy and peanuts was rare in our study group of milk allergic children. The use of a soy formula during the first 2 yr of life did not increase the risk of development of peanut-specific immunoglobulin E antibodies or of clinical peanut allergy. PMID: 16343085 [PubMed - indexed for MEDLINE]

  • Z-score of weight for age of infants with atopic dermatitis and cow's milk allergy fed with a rice-hydrolysate formula during the first two years of life.

    Related Articles Z-score of weight for age of infants with atopic dermatitis and cow's milk allergy fed with a rice-hydrolysate formula during the first two years of life. Acta Paediatr Suppl. 2005 Oct;94(449):115-9 Authors: Savino F, Castagno E, Monti G, Serraino P, Peltran A, Oggero R, Fanaro S, Vigi V, Silvestro L BACKGROUND: Recently, rice-based formulas have been widely used in hypoallergenic diets, but data on nutritional values are scarce. Aim: To evaluate the growth of infants fed with a rice-based hydrolysate formula, compared to those infants fed with a soy formula or an extensively hydrolysed casein formula, in the first 2 y of life. METHODS: A total of 88 infants were enrolled between March 2002 and March 2004. Fifty-eight infants with atopic dermatitis (AD) and cow's milk allergy (CMA), confirmed by open challenge, were enrolled as study group: 15 were fed with a rice-based hydrolysate formula (RHF), 17 with a soy-based formula (SF) and 26 with an extensively hydrolysed casein formula (eHCF). Thirty infants with AD without cow's milk allergy were recruited as a control group (CG) and fed with a free diet. Weight was recorded on enrolment and at 3-monthly intervals in the first year of life, and at 6-monthly intervals in the second year. Infants were weighed naked, before feeding, by means of an electronic integrating scale. The z-scores of weight for age were calculated. Statistics: One-way analysis of variance and Student's t-test were used for statistical comparison. Significance was set at p<0.05. RESULTS: No significant differences between the RHF, SF and eHCF groups were observed for the z-score of weight for age during the first 2 y of life, but a significantly lower difference was seen in the RHF group compared to the control group in the intervals 9 mo-1 y (p=0.025) and 1-1.5 y (p=0.020) of age. In contrast, the SF and eHCF groups were comparable to the control group, but the eHCF group was significantly lower (p=0) in the first trimester of life. CONCLUSION: Even if our findings show no significant difference between RHF and control, low weight observed in infants fed with RHF raises doubts about the nutritional adequacy of rice-hydrolysate formulas. PMID: 16214777 [PubMed - indexed for MEDLINE]

  • Formula feeding during cow's milk allergy.

    Related Articles Formula feeding during cow's milk allergy. Minerva Pediatr. 2003 Jun;55(3):209-16 Authors: Dupont C, De Boissieu D Cow's milk allergy (CMA) is an immunologically mediated reaction to cow's milk proteins, which affects infant and young children. Cow milk elimination requires either breast-feeding, with or without elimination diet in mother or the use of specific formulas, based on cow's milk protein extensively hydrolyzed, which fit 90-95% of children with cow's milk allergy. In others, still reactive to allergic remnants in hydrolysates, an amino acid based formula is the optimal option. The good tolerance of soy formulas in a reasonable proportion of children with cow's milk allergy make them useful, including as a 1(st)-choice alternative, except probably for those below the age of 6 months. Any elimination diet in children is at risk of nutritional deficiency so that a constant monitoring of the growth parameters should be kept in those children. PMID: 12900707 [PubMed - indexed for MEDLINE]

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