Milk Allergy & Cow's Milk Protein Allergy

First, it is important to make the distinction between a milk allergy and lactose intolerance. While a milk allergy is an abnormal immune response to milk protein, lactose intolerance is an inability to digest milk sugar. Although an intolerance is not life threatening and is less serious than an allergy, it can adversely affect day-to-day life (abdominal pain, diarrhea).

Causes

In those with milk allergies, the immune system mistakenly identifies certain milk proteins as harmful. When such individuals are exposed to these proteins for the first time, their immune system produces antibodies. When they come into contact with milk proteins again, they produce even more antibodies and other chemical substances including histamines. Histamines, which play a major role in allergies, cause reactions throughout the body (reactions in the digestive and respiratory systems and skin reactions).

Milk allergy generally affects preschool children. It is the most common allergy in children. However, in the vast majority of cases, children outgrow cow milk allergies by the time they reach three or four years of age. Cross-reactivity with the milk of other ruminants such as goat or sheep should also be expected.

Symptoms

Symptoms, which differ from person to person, are often based on the severity of the allergy. Common immediate-type reactions (occur within two hours of having ingested a product) include:

• Anaphylactic shock (swelling of the airways) - which is rare
• Hives (red, itchy skin)
• Projectile vomiting

• Digestive problems (gastro-esophageal reflux, bloody stools, colic)
• Hives (red, itchy skin)

Children with milk allergies are more likely to develop other health problems such as reflux and other types of allergies.

Treatment

Once a milk allergy is confirmed, the best way to deal with it is to remove cow's milk from one's diet. This is known as an elimination diet. Symptoms can take up to 2 weeks to subside after removing allergenic foods.

For infants who are not being breastfed, several options are available. Changing commercial infant formulas should be done under medical supervision. A soy-based commercial infant formula may be used, however, infants allergic to cow's milk protein may also be allergic to soy protein. As for extensively hydrolyzed protein formulas (in which the proteins are broken down into smaller, less allergenic fragments) (e.g., Alimentum, Nutramigen), they are more expensive than regular formulas and are not entirely free of allergy risk. In more severe cases, a health care professional may recommend an amino acid-based formula (e.g., Neocate, Puramino). After some time, a gradual return to a standard milk-based diet may be possible, always under medical supervision.

If a problem is detected in an infant who is being breastfed, the nursing mother may have to follow an elimination diet that involves cutting cow's milk protein from her diet. Indeed, beef protein can be detected in breast milk. In this case, consultation with a dietician is recommended.

Prevention

Breastfeeding your infant remains the best way to protect them from developing allergies later. After 6 months of age, it is possible to begin to diversify your child's diet by adding nutrient-rich foods.

It should also be mentioned that reading product labels and ingredient lists is a good habit to get into. Milk and milk derivatives are found in a significant number of foods and can be present under different names. Here are a few examples of the names given to dairy products:

For more information:

• Allergyaware.ca (Educational community resources)
• Food Allergy Canada