1Overview

Babies either drink breast milk or formula milk during the first years of life. These are the sources of nutrition of infants until they can eat solid foods. However, some children have a milk allergy, which makes them hypersensitive to some of the chemicals present in milk and dairy products.

About 2 to 3 percent of children who are younger than three years old is allergic to milk. Even though some experts believe that many of those children will eventually outgrow the allergy by the time they turn 3, some studies had shown that less than 20 percent of these children had outgrown the allergy when they turned four years old. About 80 percent are more likely to outgrow the allergy before they turn 16 years old.

Milk allergy is one of the most common food allergies in children. It is characterized by the abnormal response of the body’s immune system to milk and other products that contain milk. The usual culprit is cow’s milk, but there are some cases that milk from sheep, buffalo, goats and other mammals can also spur an allergic reaction.

Though this condition is generally mild, it may still lead to serious health consequences like anaphylaxis, a potentially-fatal reaction. Sensitivity to cow’s milk may vary from one person to another. Some individuals may have a severe reaction while others may just have mild reactions.

Difference Between Milk Allergy And Lactose Intolerance

Milk allergy is not the same as lactose intolerance. A good allergy is a result of the overreaction of the immune system to a chemical or substance in food.

Once the person or baby consume milk, it will trigger an allergic reaction that includes various symptoms from mild to severe ones. A milk allergy like any other food allergies is potentially-fatal.

On the other hand, lactose intolerance does not involve the immune system. Individuals with lactose intolerance have a missing enzyme called lactase, which is responsible for breaking down lactose, a type of sugar found in milk and other dairy products. When people who have lactose intolerance ingest milk, they are unable to digest it, leading to diarrhea, bloating, cramps and nausea. This type of condition is not life-threatening.

2Symptoms

After the ingestion of milk, the immediate signs and symptoms you can observe the child include:

Skin:

  • Rashes (eczema)
  • Hives (red and itchy bumps on the skin)
  • Edema

Nose, Throat, and Lungs

  • Runny nose
  • Sneezing
  • Itchy and watery eyes
  • Shortness of breath
  • Wheezing
  • Coughing

Stomach Problems

When To See A Doctor?

Anaphylaxis is a potentially-fatal condition, and it is advised to bring the child to the hospital when you observe that he or she has difficulty breathing.

3Causes

Immune System Malfunction

All food allergies have one thing in common; they’re caused by the immune system identifying certain milk proteins as harmful, stimulating the production of antibodies called immunoglobulin E (IgE) into the bloodstream to neutralize the protein or allergen. When a baby is again exposed to the milk proteins, the body recognizes them, and the immune system releases histamine, causing various signs and symptoms of allergy.

Milk Proteins

There are two proteins in cow’s milk that have the potential to trigger an allergic reaction – casein, and whey. Casein is mainly found in the curd of the milk, which is the solid part and whey, which is found in the liquid part of the milk.

4Risk Factors

There are some factors that may increase the likelihood of an infant to develop milk allergy:

Eczema or Atopic Dermatitis

 Many children have atopic dermatitis or eczema, which is a chronic inflammation of the skin. They are at an increased risk of developing a food allergy, including milk.

Other Allergies

Children who are allergic to milk proteins are also allergic to other food. However, milk allergy is the first to develop since it’s the first food introduced to infants before other foods.

Genetics

 Children who have parents, siblings or relatives with milk allergy, other allergies and atopic dermatitis are more likely to develop these conditions.

Age

 Young children, including infants, are more likely to develop milk allergy since their digestive system are not yet mature enough, and they have underdeveloped immune systems. However, as the child grows older, these allergies tend to disappear.

Complications

Infants and children who are allergic to milk may develop other health problems like:

  • Hay Fever – an allergic reaction to pollen, pet dander, dust mites and other allergens
  • Allergy to other food like peanuts, beef, chicken, eggs, and soy

5Diagnosis

To diagnose a milk allergy, the doctor or allergist will take a very detailed history of the present medical illness such as what the person ate, the symptoms present and how long did the symptoms last. There are other ways to determine if the symptoms were that of milk allergy.

Allergy Tests

Allergy tests such as a blood test or a skin-prick test aim to look for the presence of immunoglobulin E (IgE) antibodies in the blood. These antibodies are present whenever the person has been exposed to a substance or chemical which he or she is sensitive to. When these antibodies are present, they stimulate the release of chemicals responsible for the allergy symptoms.

Skin-Prick Test – This test is done through the application of a liquid containing milk or milk protein on the forearm or back. The doctor or health care professional will prick a small and sterile probe into the skin. When rashes or weals appear on the skin within 15 to 20 minutes, then that signals an allergy.

Blood Test  – In the blood test, a blood sample is extracted from the patient and examined for the presence of IgE antibodies. A new type of blood test known as a component test, however, the allergist will identify the risk of the patient for a serious reaction by determining the allergies to the two proteins in milk – casein, and whey.

Oral Food Challenge – An oral food challenge is done only under medical supervision. The patient will be asked to eat a small amount of substance that has milk in it. The doctor will observe if an allergy will develop.

6Treatment

As the famous adage goes, “Prevention is better than cure,” hence, the best way to manage milk allergy is to avoid drinking milk or consuming products that have milk in them.

Avoid Milk And Items Containing Milk Products

Avoidance of milk or items containing milk products is now the only way to manage milk allergy. Individuals who have this type of allergy and even the parents of babies with the allergy should always read the labels of the food they’re buying very carefully.

Medicines

Antihistamines ­– The doctor will prescribe antihistamines to reduce the effects and symptoms of milk allergy. However, this medicine should only be prescribed by a licensed doctor, especially if it will be used in infants.

Epinephrine – An epinephrine auto-injector is a device used in severe and potentially-fatal allergic reactions. However, only a doctor should prescribe this medicine. Usually, this is the last resort during severe anaphylactic reactions.

Epinephrine is safe with the risks of anaphylactic reactions outweighing any risks of administering the medication. However, it is used with caution in older adults, children and those with heart disease. In most cases, if the patient is brought to the emergency room of the hospital, health care practitioners are the ones who inject this drug.

Steroids – Doctors may give steroids like cortisone in the emergency room. It will help reduce inflammation after a severe allergic reaction.

Asthma Medications ­– Short-acting bronchodilators, also dubbed as rescue inhalers, may be used to relieve breathing problems after epinephrine has been given in the emergency room.

7Prevention

Food allergy like that of milk can be prevented through the following measures:

  • Strictly avoid milk and products that have milk in them such as dairy products, cakes, some pastries, and others.
  • Work with your doctor to create a food allergy and anaphylaxis emergency care plan.
  • Always wear a medical identification such as jewelry or bracelets at all times.
  • Prevent anaphylaxis by carrying your medicines wherever you go.
  • Take your medicine as prescribed by the doctor whenever you notice the first signs of an allergic reaction.

Food Products And Drinks To Avoid:

  • Milk in all forms –  formula milk, fresh milk, cow’s milk and others.
  • Butter, butter oil, butter fat
  • Buttermilk
  • Casein
  • Cheese and cottage cheese
  • Curds
  • Cream
  • Ghee
  • Milk protein hydrolysate
  • Pudding
  • Rennet Casein
  • Sour cream
  • All forms of whey
  • Yogurt
  • Sometimes milk is also found in baked goods, artificial butter flavor, lactic acid starter culture, margarine, and nougat
  • Cakes and other pastries
  • Some candies, chocolates, caramel candies, and other products that use milk as one ingredient.
  • Unexpected sources of milk – deli meat slicers, canned tuna that contain casein, soy or rice-based dairy products which are produced on equipment shared with milk
  • Some meats
  • People with milk allergy are also advised to avoid milk from other animals like goats, wherein the protein is similar to that of cow’s milk.