Food Elimination While Breastfeeding

Food elimination refers to a lactating parent cutting out a food from their own diet in the hopes it will help relieve their baby’s distressing symptoms. Do not start an elimination diet on your own. Always talk to your baby’s healthcare provider first. An elimination diet should only be tried when a medical professional suspects a true food allergy or sensitivity based on specific symptoms.

The Big Picture on Food Elimination

Many common baby behaviors — spitting up, fussiness, gassy tummies, loose stools, and even occasional flecks of blood in the diaper — are a normal part of infancy. These symptoms are often distressing to parents who want to find reasons for the symptoms and ways to help their babies. These symptoms are usually not caused by something in the parent’s diet and are often benign, temporary and resolve on their own. Unnecessary food elimination can cause stress because of the need to change one’s diet, despite not helping their baby.

When Might an Elimination Diet be Recommended?

Your baby’s doctor may suggest trying an elimination diet if your baby has:

• Significant blood or mucus in the stool (not just a streak or fleck)
• Severe eczema that is not responding to standard skin treatments
• Persistent vomiting (not just normal spit-up) with poor weight gain
• More than one concerning symptom (for example, skin rash plus bloody stools plus vomiting)
• Symptoms that have a clear, repeatable pattern related to your eating a specific food

An elimination diet is NOT recommended for:

• Normal spit-up (“happy spitter”)
• Typical and intermittent baby fussiness
• Colic (a predictable 2–3-hour period of daily fussiness)
• Normal variations in stool color or consistency
• General gassiness
• As a “just in case” measure

How Do You Do a Food Elimination Diet?

Your baby’s healthcare provider will help decide what food to eliminate first. Dairy (cow’s milk products) is typically the first food to eliminate.

Under the guidance of your baby’s healthcare provider, a food elimination diet consists of the following steps:

• STEP 1: Eliminate all sources of the suspected food from your diet. Even small amounts can matter, so read labels carefully.
• STEP 2: Monitor your baby’s symptoms. Keeping a simple log of your baby’s symptoms (fussiness, stools, skin, spit-up) can help you track any changes. If your baby’s symptoms are going to improve, you should start to see changes within 72–96 hours, with continued improvement over the following days to weeks.
• STEP 3: If your baby’s symptoms have not improved, the food you removed is very unlikely to be the cause, and you should add it back into your diet.
• STEP 4: If your baby’s symptoms did improve, add the food back into your diet after 2-4 weeks and monitor for a return of the same symptoms that prompted the elimination in the first place (symptoms would return within 48-72 hours). This step is the best way to know if your baby truly has a food allergy or sensitivity.