Will My Baby Outgrow This…and How Will I Know?
Most babies outgrow Allergic Proctocolitis by their first birthday, and nearly all can tolerate all food proteins by age 2. When your baby is at least 9 months old, and has been on the elimination diet for at least 6 months, you can try a food challenge (see below).
How to Conduct a Food Challenge
When your baby is at least 9 months old, and has been on the elimination diet for at least 6 months, you can try a food challenge. Talk to your doctor about the best way to do this. In most cases of AP, the breastfeeding mother can safely eat some food, nurse, and watch for any reaction in the next 72 hours. Some nursing mothers prefer to give their baby a little bit of a problem food instead. That way they do not have to wonder how long the protein will stay in their breast milk. If your baby takes formula, you could offer soy or dairy formula, but giving the baby a taste of a problem food will most likely provide a smaller dose of protein than giving formula would.
Keep in mind that cooking, heating, and fermenting foods breaks down the proteins, so these foods may be less allergenic than raw or whole foods. For example, dairy in processed foods, cheeses, and yogurt may not be as big a problem as milk or ice cream. Start with a small amount of yogurt, hard cheese, or baked products. If there is no reaction, slowly progress to other foods.
If your baby clearly reacts to the reintroduced foods, go back on the elimination diet and try again in a month or so.
Note: If your baby has had a positive allergy test, or if you or your doctor have any concerns about a serious allergic reaction, then any food challenge should be done in a medical facility.
All babies should avoid solids until 4-6 months of age. When your baby is developmentally ready for you to introduce solids, use the same diet you have been following. (If your baby taking formula, use the elimination diet (LINK) on this site to guide what you feed him or her when introducing solids). Be aware that some jarred baby foods have dairy ingredients. Read all labels carefully!
Your health care provider may suggest that you introduce certain foods (like peanuts or eggs) a little later than is typically recommended.
We’re Weaning. What now?
It is ideal to continue breastfeeding until at least 1 year of age for your health and your baby’s health – Center for Disease Control Recommendations
If your baby is under 1 year of age, you will need to wean to formula. Babies with milk allergy can wean to soy formula. Babies with milk and soy allergy must wean to extensively hydrolyzed formula (eHF). The proteins in eHF have been partially broken down to make them easier to digest and less likely to cause AP symptoms. Very sensitive babies will need an amino acid formula, where the proteins are already broken down completely. Note: These formulae are expensive, and not always well received by the infant.
If your baby is over 1 year of age, wean to the elimination diet, and get advice on any supplements (such as Calcium) your baby may need.
If your baby passed a food challenge, congratulations! Follow regular advice for weaning.
What Does This Mean for the Future?
Good news! Your baby will outgrow Allergic Proctocolitis, and there is no indication that he or she will have any greater risk of future allergies or digestive diseases than any other baby. As your child grows, if you notice frequent belly aches and constipation, cutting back on or eliminating dairy may help.