A milk allergy is a reaction by your child's immune system to the protein in milk. Our immune systems normally respond to bacteria or viruses that attack the body. A food allergy occurs when the body's immune system mistakenly believes that a harmless substance (such as the proteins found in milk) is harmful. In order to protect the body, the immune system creates substances called antibodies to that food. The next time you eat that particular food, your immune system releases huge amounts of chemicals, such as histamines, to protect the body. This is what causes the symptoms.
Casein is the main protein found in milk. It is found in the solid part of milk (curd) when milk goes sour. Whey, the liquid that remains once the curd is removed, contains the rest of the proteins. Your child can be allergic to the proteins in curd, whey, or both.
In very young children, cow's milk is the leading cause of allergic reactions. Milk is one of the 8 foods that are responsible for most food allergies in children. The other foods include eggs, soy, peanuts, tree nuts (such as walnuts and cashews), wheat, fish, and shellfish. Most kids outgrow milk allergy by 2 or 3 years of age.
If you think your child is allergic to milk, dairy products or any other food, it is important to get a diagnosis from your healthcare provider or allergist.
Milk allergies are typically discovered very early in formula and breast-fed infants. If a mother drinks cow's milk, the milk protein also comes out in her breast milk. The symptoms seen in milk allergy depend on whether the child has a slow or a rapid reaction to milk. The slower reaction is more common and symptoms develop over time.
Symptoms that occur slowly (several hours and sometimes days):
Symptoms that occur rapidly (within seconds to hours) may include:
A milk allergy is not the same as lactose intolerance. Lactose intolerance affects only the digestive tract. It causes symptoms such as bloating, gas and diarrhea.
Although rare, it is possible to have an allergic reaction called anaphylactic shock. This is a serious reaction that is sudden, severe, and can involve the whole body. It can cause swelling of the mouth and throat, dangerously lower blood pressure, and trouble breathing. This type of reaction is a medical emergency. It is treated with epinephrine (a medicine that is given by injection). Usually parents or caregivers of children who have severe allergic reactions carry their own shot kits, just in case of emergency.
Pediatricians typically recommend soy-based formulas. These formulas contain soybean proteins, and most have added vitamins and minerals. The switch to soy formula helps for about half of babies allergic to milk. If the switch to soy doesn't help with your child's symptoms, the next step is to give your child a "hypoallergenic" formula. There are two types of hypoallergenic formulas:
Breast-feeding a baby with a milk allergy is sometimes recommended. If your baby is diagnosed with a milk allergy, you should avoid milk products in your diet. Keep taking prenatal vitamins and eat foods with lots of calcium and vitamin D. Talk with your healthcare provider about this.
The only treatment for a child with a milk allergy is to completely avoid milk and foods that contain milk products. Many processed foods and restaurant foods contain milk or milk products. You will need to change the way you shop and prepare foods. The first step is to learn to read labels and become familiar with ingredients that contain milk or dairy products. Always ask about ingredients if you are not sure. Study the lists below to learn more about foods and ingredients to watch out for.
Foods and ingredients that contain milk:
Reading labels to avoid allergens has become a lot easier. Foods that contain milk, eggs, fish, shellfish, peanuts, tree nuts, wheat, or soy products must list the food in plain language on the ingredient list. For example, casein (milk). These possible allergens must be listed even if they are part of a flavoring, coloring, or spice blend. There are still some things to watch out for when reading food labels:
It is very important for you to know less common names and scientific names for food ingredients.
Cross contamination occurs when a dairy food or something that has been used to process a dairy food comes in contact with your child's food. This can happen when eating out or at home.
To avoid this problem when dining out or buying food:
Your child can still have a healthy diet as well as continue to enjoy some kid favorites. The main nutrients found in milk are protein, calcium, vitamin D, and riboflavin. It is important to either take supplements or eat foods high in these nutrients.
There is a lot of protein in meat, poultry, pork, fish, beans, soy foods, legumes, nuts and seeds. Ask your provider about calcium and vitamin D supplements. Good sources of riboflavin are meat and eggs, whole-grain or enriched breads and cereals, and dark green leafy vegetables. Many foods (such as orange juice) are now supplemented with calcium and vitamin D. It is a good idea to have a registered dietitian check your child's diet to make sure your child is getting needed nutrients.
There are several brands of soy and rice milks that are enriched with calcium. These can be used for drinking and to pour on cereal. If milk is part of a recipe just to provide liquid, you can substitute water. Soy and rice milk, as well as fruit juice work well as substitutes when baking. Oils, milk-free margarines or soy butter can take the place of butter. Vegan products, available in the health food section of grocery stores, are another option. These products do not contain eggs or milk.
It is also helpful to get cookbooks for people with food allergies, such as the NEW-Food Allergy and Anaphylaxis Network (FAAN) Cookbook - Cooking Allergy-Free Everyday. Visit the Web site at http://foodallergy.org or call 800-929-4040 to order this cookbook and others. There are also Web sites where you can buy specialty foods online (such as http://www.allergygrocery.com).