Cow’s milk allergy is an atypical response of the immune system to milk and milk-containing products. It is among the most common food allergies that infants and young children have. It is among the top most common food allergies in adults. Cow's milk is the common cause of milk allergy. However, milk from other sources like sheep, goats, buffalo, and other mammals can also cause an allergic reaction.
An allergic reaction usually occurs immediately after your child consumes milk. The symptoms can be mild or severe and may include wheezing, vomiting, hives, and digestive problems. It can also cause anaphylaxis — a serious and life-threatening allergic reaction.
Approximately 2.5% of children under 3 years old are allergic to milk and about 70% of children with cow milk allergy can tolerate baked cow milk. Baked milk refers to any milk that has been heated for a long period, this alters the structure of the proteins and can cause cow milk allergy. Young children who are allergic to fresh milk but can eat baked milk without reacting to it are more likely to outgrow their milk allergy much earlier than those who only respond to baked milk.
Avoiding milk and products containing milk is the primary treatment for milk allergy. Most times, many children outgrow milk allergy. However, those who don't outgrow it may need to continue to avoid the use of milk-containing products.
What causes Cow's milk allergy?
Cow's milk allergy occurs when your child's immune system reacts to the protein found in milk. The immune system identifies the protein as harmful, and then, triggers the production of immunoglobulin E (IgE) antibodies to neutralize it. When next your child’s body comes in contact with these proteins, the antibodies recognize them and signal the immune system to release histamine and other chemicals, which activate a range of allergic reactions.
There are two major proteins in cow's milk which can cause an allergic reaction:
Casein is found in the solid part (curd) of milk that curdles and
Whey, which is found in the liquid part of milk that remains after it curdles
Your child can be allergic to any of the milk proteins or both. These proteins may be hard to avoid because they can also be found in some processed foods.
Symptoms of Cow's Milk Allergy
The symptoms of cow's milk allergy differ from person to person, occurring a few minutes to a few hours after your child drinks milk or eats milk products.
The immediate signs and symptoms may include:
- Urticaria (hives)
- Wheezing, noisy breathing, or hoarseness
- An itching or a tingling sensation felt around the lips or mouth
- Swelling of the lips, tongue, throat, face or eyes
- Coughing or shortness of breath
- Vomiting or diarrhea
- Changes in consciousness in infants or young children
The delayed Signs and symptoms include:
- Loose stools or bloody diarrhea
- Abdominal cramps or stomach pain
- Runny nose
- Watery eyes
- Colic, in babies
- An increase in eczema
Anaphylaxis
Milk allergy can cause anaphylaxis.
It is a severe and life-threatening allergic reaction that narrows the airways and can block breathing. Among the usual foods that can cause this reaction, milk is known to be the third most common — after peanuts and tree nuts.
If your child reacts to milk, let your child’s pediatrician know, no matter how mild the reaction may be. Tests can help confirm the allergy, to help you avoid future and potentially worse reactions.
Anaphylaxis is a medical emergency that needs immediate treatment using an epinephrine (adrenaline) shot and a fast visit to the emergency room.
Signs and symptoms that develop soon after milk consumption include:
- Constriction of airways, including a swollen throat that makes it very hard to breathe
- Facial flushing
- Itching
- Shock, with low blood pressure
What Are Its Risk Factors?
Some of these factors may increase the risk of your child developing a cow’s milk allergy:
Family history: The risk of a child having a food allergy increases greatly if one or both parents have a food allergy or another kind of allergy or any allergic disease —like hay fever, hives, asthma, or eczema.
Age: Cow’s milk allergy is generally common in children. But as they get older, their digestive systems mature, and their bodies are less likely to react to milk.
Other allergies: Most children allergic to milk also have other allergies. Milk allergy may occur before other allergies.
Atopic dermatitis: Children having atopic dermatitis — a common, chronic inflammation of the skin — are much more likely to have a food allergy.
What Are the Complications of Cow's milk allergy?
Children who are allergic to milk are much more likely to have other health problems, which include:
Nutritional deficiencies: Because of feeding problems, and dietary restrictions, children with cow’s milk allergy may have a very slow growth, including vitamin and mineral deficiencies.
Poor quality of life: There are a lot of common, and sometimes unexpected, foods that contain milk, including some salad dressings. If your child is prone to having frequent allergic reactions, avoiding giving him foods containing milk may increase your stress or anxiety levels as a parent when it comes to making food choices.
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How is Cow’s Milk Allergy Treated?
If your child is allergic to milk, you need to completely remove any milk and milk products from their diet. Adhere to your child's pediatrician's instructions and read food labels carefully. You may also need to avoid milk from other animals, such as goats, sheep, and buffalo.
Watch out for other words used to describe milk on food labels, such as butter, buttermilk, cream, curd, ghee, milk, cheese, ice cream, gelato, dairy, milk solids, whey, yogurt, candies, protein powders, casein, and caseinates.
In children who have allergic reactions when taking milk, using breastmilk and hypoallergenic formula can prevent such reactions. Hypoallergenic formulas are produced using enzymes to break down or hydrolyze milk proteins, such as casein or whey.
If your baby is formula-fed, you can use extensively hydrolyzed formula (EHF) or amino acid-based formula (AAF). If your baby is 6 months old and above, you can also use soy protein formula (unless they are also allergic to soy). Avoid using formula made from cow's milk, goat's milk, sheep's milk, HA or A2 milk, or lactose-free formulas.
When eating out, ask how the food was prepared. Does it have melted butter on it? Was it dipped in milk before cooking?
If your child is at risk of a serious allergic reaction, you may be advised to carry an adrenaline autoinjector to be used as a first aid in the event of anaphylaxis, or your child can wear a medical alert bracelet or necklace to signify that he has a food allergy, when there has been a previous event of a severe reaction.
If your child is on a milk-free diet, your child’s pediatrician or dietitian can help you carve out a nutritionally balanced meal plan. If your child is over one, you can give soy milk, calcium-enriched rice, oat, or nut milk. Or, they can be given supplements to replace calcium and nutrients found in milk, such as riboflavin and vitamin D.
Can You Still Breastfeed Your Baby Who Has a Milk Allergy?
Breastfeeding is the best nutritional source for your baby. It is recommended to breastfeed for as long as possible, especially if your baby is at high risk of developing a milk allergy.
If you're breastfeeding and your baby is allergic to milk, cow's milk proteins that are passed through your breast milk may cause an allergic reaction. In some cases, you may need to exclude from your diet all milk and dairy products, but in other cases, you may be able to eat your regular diet. Talk to your child's pediatrician if you know — or suspect — that your child has a milk allergy and develops the symptoms right after breastfeeding.
Will my Child Outgrow a Cow’s Milk Allergy?
More than 75% of children eventually outgrow a milk allergy. For some, the allergy is most likely to continue when there are high cow’s milk antibodies in their blood.
Blood tests that measure these antibodies can help determine whether or not a child is likely to outgrow a milk allergy.
Ingestion of baked forms of cow milk may help lead to tolerance or resolution of the allergy with time. Ensure to speak to your doctor about a formal baked milk challenge before doing it at home.
Is it Milk Allergy or Lactose Intolerance?
Milk allergies and lactose intolerance are unrelated.
Children with milk allergies experience symptoms because their immune system reacts as though milk and other milk products are dangerous invaders. This response can cause hives, stomach pain, vomiting, bloody stools, and even anaphylactic shock — a life-threatening allergic reaction.
Children who are lactose intolerant cannot digest the sugar in milk (lactose) because they have a deficiency of the enzyme lactase, which is produced by cells in the lining of the small intestine. Lactase is needed to metabolize lactose. The lack of this enzyme — which sometimes can just be temporary, due to an infection — causes symptoms such as bloating, diarrhea, or abdominal cramps.
If your child suffers digestive problems after eating or drinking milk products, try tracking their diet and noting how they react to the foods they consume. You can also try removing milk products — milk, cheese, and yogurt, for example — temporarily from their diet and see if the symptoms improve. You can see your child’s pediatrician, who can confirm a diagnosis and advise you on what to do.
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Disclaimer
The information on this blog is just for educational purposes only.
It should not be used as a replacement for the medical care and advise of your child’s pediatrician.
Always consult your pharmacist before giving your child any drug.
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