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Of all the food allergies in children, cow’s milk is the most common. There is a lot of protein in cow’s milk and that plays a key role when it comes to milk allergy and children. Also, there is a difference between a true milk allergy and a milk intolerance. I will explain a little about this as well as treatment ideas. In this article I will explain what causes a milk allergy, the classic signs and symptoms of a milk allergy, how prevention is best and substitutions for milk that you can use for your child.
What causes a milk allergy?
Cow’s milk is a nutrient rich liquid-food. So you might ask then, how is it that a child can be allergic to milk? Of all the nutrients in milk, protein makes up about 3.5%. The protein is made up of casein and whey. Casein is the part of protein that forms a large, insoluble curd that is harder to digest than the curd from whey which is very soft.
The body’s immune system recognizes and may react to the protein in cow’s milk making it one of the most common allergens. Allergies develop in approximately 2% to 7% of infants fed with cow’s milk formula.
So, in essence, a milk allergy is caused by an abnormal response to the body’s immune system reacting to the casein protein.
Signs and symptoms
First and foremost I want to say that signs and symptoms will differ from child to child and may occur anywhere from a few minutes to a few hours after your child drinks milk or eats a milk product.
Immediate signs and symptoms may include:
- Itching or tingling feeling around the mouth
- Swelling of the lips, tongue or throat
- Coughing or shortness of breath
Signs that may take a few hours to develop may include:
- Diarrhea or loose stools (blood may be in stool)
- Stomach cramps
- Runny nose
- Watery eyes
- Colic (infant or baby)
When should my child see a doctor?
If you notice that after your child consumes any milk or milk products (cheese, yogurt, butter, cream, ice cream, condensed milk, buttermilk, whey, ghee, and skim milk), he starts having any of the above signs and symptoms, call your child’s doctor (pediatrician) right away and have him seen. Your doctor will know how to evaluate him and most likely give you a list of foods to avoid along with an EpiPen for emergency purposes.
What is an EpiPen?
An EpiPen is a medication used in very serious allergic reactions. It acts quickly to reduce the swelling in the eyes, nose and throat which in turn improves breathing, heart rate and it brings blood pressure to an acceptable level.
EpiPen is a prescription drug and will be prescribed by your doctor.
Epinephrine is a chemical that our bodies naturally have to reduce swelling, improve heart function and improve blood pressure. That is the chemical that is used in the “EpiPen” and is an injection. It is important that you keep this with you at all times as you never know when a mishap will occur.
There are side effects from the EpiPen and they include pale skin, sweating, headache, dizziness, anxiety and nausea. Your child may or may not experience these side effects, but it is a good idea to know what they are in case they happen.
In some children, a severe reaction may occur and requires immediate attention and treatment. This severe reaction is called “anaphylaxis” and is characterized by a swollen airway (throat) making it difficult to breathe, facial flushing (the face turning red), itching and shock (blood pressure drops). This is a medical emergency and you need to call 911 or the emergency telephone number where you reside if in a country other than the U.S.A.
Anaphylaxis is treated immediately with an epinephrine shot (EpiPen or Adrenaclick or other brand as your doctor determines) so it is imperative you have an EpiPen on hand to give that emergency shot as soon as you see your child is in danger and get him or her to the emergency room at the hospital right away. Anaphylaxis can start very quickly and it is imperative you get your child help immediately!
Treatment for mild symptoms
The only way to treat a milk allergy is to avoid all milk and milk products. This can be difficult because milk is a common ingredient in many foods. However, some people can tolerate milk in baked goods and other processed foods. Talk to your doctor about this and ask for a list of foods to avoid along with foods that can substitute for missed nutrients such as calcium, vitamin D etc.
Antihistamines such as Benadryl may be of help if your child has mild symptoms of hives, rash or itching. Again, consult your child’s doctor for which antihistamine to give and what the dosage should be for your child.
Milk allergy or milk intolerance, there is a difference
There is a difference between a true milk allergy and a milk intolerance. A milk allergy involves the body’s immune system reacting to the protein “casein” found in milk and a milk intolerance is the body’s digestive system lacking an enzyme called “lactase” to break down milk’s sugars. Hence the name of this condition, lactose intolerance.
A few of the symptoms of milk intolerance are gas, bloating and diarrhea after consuming milk or milk products. In some cases there may be tummy pain or upset stomach (nausea). Unlike a milk allergy, milk intolerance is usually never a medical emergency.
It is rare for babies to be born with lactose intolerance, but it has happened. When a baby is born with this, it is because they received the genetic code for it from the parents. So, it is a hereditary trait. Premature infants can also have lactose intolerance because of an insufficient lactase level.
Your child’s doctor may do a couple of tests to see if your child has lactose intolerance (milk intolerance).
These tests are a hydrogen breath test and a lactose tolerance test:
The hydrogen breath test is when you drink a liquid that contains high levels of lactose and then your doctor measures the amountof hydrogen in your breath at regular intervals.
The lactose intolerance test is your doctor will have you drink a liquid with a high level of lactose and then 2 hours later, take a blood sample to measure the amount of glucose (sugar) in your bloodstream. If your glucose level doesn’t rise, it means your body isn’t properly digesting and absorbing the lactose-filled drink.
If your child has no other health conditions and is found to have lactose intolerance, then your doctor may be giving you this advice. To treat this disorder, you want to limit foods and drinks that have lactose. In other words, limit milk and other dairy products, eat and drink lactose-reduced ice cream and milk and add a liquid or powder lactase enzyme to milk to break down the lactose.
Infants and breast milk
If your infant is at risk for developing a milk allergy, breastfeeding is the best source of nutrition and should be done as long as it is possible. Click here to learn more about breastfeeding.
Additionally, if you are breastfeeding, make sure you do not consume any milk or milk products as it crosses the breast milk and is then consumed by your baby. Eat a well-balanced diet and follow the directions for milk allergy substitutes. Talk with a registered dietician for information about a healthy diet.
For the baby/infant who is allergic to milk, there are alternatives. If you find that you cannot breastfeed your infant, I have a few suggestions for you to check out and to inquire about with your pediatrician. See below:
For the toddler and child
There are lots of good milk substitutes for your child. Here are a few examples:
- Soy milk
- Rice milk
- Oat milk
- Almond milk
Soy milk is the best of these options because it has about the same amount of protein as cow’s milk. You may find that missing in other choices. Whichever one you choose, be sure it’s fortified with calcium and vitamin D.
Check the labels to make sure the product doesn’t include milk-based ingredients. Look for words like casein, whey, lactoferrin, lactoglobulin, lactalbumin, lactose, curds, diacetyl, ghee, lactulose, recaldent, and tagatose.
Milk that comes from an animal other than a cow, like goat’s milk, can also trigger an allergic reaction.
Here are some suggestions for you and your toddler for milk substitutions:
My final thoughts
I hope that you found this review on children with milk allergies and milk intolerance helpful and that it cleared up any questions you may have had about this subject. As always, I stress the importance of seeking the guidance of a physician and follow his or her advice. I highly recommend the products listed above for acceptable milk substitutes for yourself or your child. We have come a long way when it comes to medicine and nutrition in the 21st century!!
Questions or comments?
Please leave me your questions or comments in the comment section below and I will get back to you as quickly as I can.