Cow’s Milk Allergy in Children

Cow’s milk allergy is the most common food allergy in young children affecting around 2%–3% of those younger than 3 years old. The onset of cow’s milk allergy is closely related to the introduction of cow’s milk based infant formula.

Fortunately, many children will outgrow their allergy by the age of one and most children have outgrown their allergy by the age of three. However some children will have their allergy for a lifetime.

What’s the difference between allergy and intolerance?

Allergy to milk is sometimes confused with lactose intolerance. Both can cause problems after drinking milk, but they are very different and unrelated. Milk allergy, can make someone become suddenly and severely ill, and can be life-threatening, whereas lactose intolerance can cause discomfort and often limited to digestive problems. Lactose intolerance is also not life-threatening.

What Happens in a Milk Allergy?

When someone is allergic to milk, the body’s immune system, which normally fights infections, overreacts to the protein in the milk. Every time the person drinks or eats milk or other dairy products, the body thinks these proteins are harmful invaders and releases chemicals like histamine. This can cause symptoms such as:

  • Wheezing
  • Trouble breathing
  • Coughing
  • Hoarseness
  • Throat tightness
  • Stomach ache
  • Vomiting and Nausea
  • Diarrhoea
  • Itchy, watery, or swollen eyes
  • Hives
  • a drop in blood pressure, causing light headedness or loss of consciousness

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Severe milk allergy

In this case, an allergic reaction to milk can develop after consuming tiny amounts. Therefore a strict avoidance of all traces of milk and all dairy products is the only way to deal with this type of allergy. Emergency adrenaline (epinephrine) should be prescribed and kept nearby at all times.

Mild to moderate milk allergy

Small traces of milk products in cooked foods can be eaten without causing a reaction. It’s advisable to avoid milk, cream, cheese, yoghurt and ice cream as these could still cause a reaction.

Very mild milk allergy

Small amounts of processed dairy products (e.g. yoghurt and cheese) can be tolerated. These children are likely to outgrow their milk allergy at an early age.

Reactions through touch and smell

Food doesn’t always have to be eaten to cause a reaction. When milk comes into contact with the skin, irritation and hives can occur as a result. Reactions can even occur if food gets into the body through a cut in the skin, or by contact on the lips or the eyes. It’s not uncommon for very sensitive patients to show symptoms of an allergic reaction when they smell the food, such as the cheese on a pizza. These are not normally severe unless the exposure involves extremely high concentrations. Generally reactions caused by smell tend to involve minor symptoms (e.g. itchy eyes, runny nose and sore throat.

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Treating symptoms and allergy

Most people with milk allergy find that antihistamines (e.g. loratadine, cetirizine) are usually sufficient to treat their symptoms. However if you have experienced breathing difficulties or anaphylaxis has been diagnosed, then you should carry adrenaline (epinephrine) auto injector at all times (e.g. EpiPen or Anapen). – NHS Website

In order to prevent allergic reactions to milk, your child must avoid any foods that contain milk, milk products, or milk proteins. It’s important to read food labels to see if a food contains milk. Milk may be found in unexpected places, such as processed meats, canned tuna, and baked goods, so it’s important to read labels on all foods, even ones that are not dairy.

Alternatives to milk

A fully hydrolysed infant formula is the feed of choice and should be used. Although rare, there are infants who cannot tolerate this and require an elemental formula. Soy milk may be suitable for babies over the age of six months, although some milk allergic children may also react to soy.

Milk from other animals (such as sheep, goats, and buffalo) are not good alternatives for those with a cow’s milk allergy because the proteins are similar. When offering children milk-free alternatives such as nut and oat milks, ensure you buy the ones that are fortified with calcium, vitamin D and iodine. Before giving your child a milk-free alternative please check with your healthcare professional or allergist that the milk alternative is appropriate for your child.

If you expect your child has a dairy allergy or perhaps intolerance please seek advice from a registered healthcare professional like myself.

If you would like more information or would like to seek advice please contact me via my contact page to book an appointment.

Phoebe x