Breast-feeding is currently recommended as the optimal source of nutrition for infants; however, it is known that some individuals can excrete enough food antigens in breast milk to result in allergic reactions in infants, especially those already highly sensitized. These reactions can include non‐immunoglobulin E (IgE) mediated reactions, such as atopic dermatitis or gastrointestinal symptoms, and IgE-mediated reactions, such as anaphylaxis, although rare. Food reactions in infants who are breast-fed is a unique challenge because identifying the culprit foods may be more difficult and special consideration must be taken in ensuring proper nutrition during periods of food avoidance for both the infant and mother. This article reviews what is currently known about food allergy in infants who are breast-fed as well as offers insights into a proposed evaluation.