Can my baby be allergic to cow's milk?

Cow's milk allergy, also known as cow's milk protein allergy, can occur when cow's milk causes symptoms in a child before weaning or if a child consumes foods containing cow's milk protein during or after weaning. Allergies usually appear within the first year of a child's life, but most children outgrow them.

How common is cow's milk allergy in babies?

It affects only 0.5% of exclusively breastfed babies and symptoms are usually mild to moderate. This is one of the reasons experts recommend exclusive breastfeeding for the first 4-6 months of a baby's life.

It is believed that children who have a family history of allergies are more likely to be allergic to cow's milk protein. The same goes for babies with eczema and asthma. Asthmatics can have severe reactions, especially if their lung disease is poorly controlled.

What causes an allergy to cow's milk?

An allergy occurs when the body's immune system mistakes a harmless substance for a foreign invader and attacks it as it attacks a bacterium or virus. This abnormal reaction releases chemicals, which in turn cause allergy-related symptoms.

Milk contains both caseins, and each contains several different proteins, each of which can cause an allergic reaction.

Cow's milk protein allergy can cause different types of reactions depending on the chemicals released, and allergies are classified according to the following causes:

IgE mediated reactions: The immune system releases histamine and other chemicals in response to cow's milk proteins. Symptoms usually appear within 20-30 minutes of protein intake, but may take up to 2 hours to appear.
Non-IgE-mediated reactions: T-lymphocytes are believed to be the cause of symptoms, which appear more gradually, 48 hours to one week after ingestion of cow's milk protein.
Mixed reactions IgE mediated and Non-IgE-mediated: this is a combination of reactions mediated by IgE and reactions not mediated by IgE.

Cow's milk allergy should not be confused with lactose intolerance, a condition in which the body cannot produce enough of the enzyme needed to digest the sugar found in milk.

What are the symptoms of cow's milk allergy?

Allergy to cow's milk protein can cause a wide range of symptoms, usually affecting the skin, gastrointestinal tract, and respiratory tract. Those that affect the respiratory tract often appear with other symptoms. These include:

IgE-mediated symptoms

Skin reactions: itching, redness of the skin, sudden itchy rash or swelling, most often on the lips, face and around the eyes
Gastrointestinal reactions: swelling of the lips, tongue or palate in the mouth, itching in the mouth, nausea, vomiting, colicky abdominal pain or diarrhea.
Respiratory reactions: itchy nose, sneezing, runny nose, nasal congestion, cough, wheezing or shortness of breath

Non-IgE-mediated symptoms

Skin reactions: itching, redness of the skin or eczema
Gastrointestinal reactions: acid reflux or gastroesophageal reflux disease, loose or frequent stools, blood or mucus in the stool, abdominal pain, colic, constipation, refusal to eat or aversion to it, redness in the perianal area, increased fatigue.
Respiratory reactions: cough, wheezing or shortness of breath

In rare cases, a child may experience an anaphylactic reaction, which requires emergency medical attention, as it can be fatal.

An allergy to cow's milk protein can sometimes lead to complications due to malabsorption or poor nutrition. The child may have chronic iron deficiency anemia or may not develop normally.

How is cow's milk allergy diagnosed?

If you suspect that your child may have a cow's milk protein allergy, make an appointment with a pediatrician who will ask about the child's family history to find out if other family members have cow's milk protein allergy, food allergies, asthma, eczema or allergies. . rhinitis. The doctor will want to know all about the symptoms and when they first appeared.

Before confirming the diagnosis of cow's milk allergy, it may be necessary to rule out other conditions that can cause similar symptoms.

If a doctor suspects an IgE-mediated cow's milk protein allergy, the child is usually referred to an allergist for a skin test and/or a blood test for antibodies to IgE. This is confirmed, cow's milk protein must be strictly avoided.

If a non- IgE-mediated cow's milk protein allergy is suspected, the doctor may not need to refer your child to a specialist unless there is concern about your child's growth or whether the symptoms are acute or severe. Your doctor may recommend that you try an elimination diet, in which cow's milk protein is removed from your child's diet for a set period of time and then reintroduced. If your child has an allergy, the symptoms will go away during the elimination period and then come back.

Beware of complementary or alternative food allergy tests such as hair analysis or applied kinesiology. There is no scientific evidence that they work, and a misdiagnosis of a food allergy or intolerance can lead to unnecessary product exclusions. Cutting out a lot of foods based on these tests can lead to nutritional deficiencies, which can interfere with your child's normal growth.

Can a child outgrow a cow's milk allergy?

Most children outgrow their cow's milk allergy.

Studies show that most children with non- IgE-mediated reactions outgrow cow's milk allergy by 3 years of age.

Studies show that in children with IgE-mediated reactions, about half of these children outgrow the cow's milk allergy by age 5. Evidence suggests that cow's milk protein allergy is more likely to persist in these children if they have asthma or allergic rhinitis, or if they have more severe reactions or antibody levels mediated by higher levels of milk-specific IgE However, it is rare for adults to be allergic to cow's milk.

Does my child need treatment?

If a cow's milk allergy is diagnosed, cow's milk protein should be eliminated from the child's diet.

For breastfeeding mothers, this means that dairy products should not be included in their own diet. Cut out milk, butter, cheese, yogurt and ice cream, as well as dairy products such as baked goods. Goat's and sheep's milk contain proteins similar to cow's milk, so these products are also banned. Dairy products can hide in processed foods under different chemical names, so check labels for:

Casein
Caseinates
Curd
Hydrolysed casein
Lactose
Lactoglobulin
Milk solids or milk sugar solids
Whey
Whey syrup sweetener

It's hard to get enough calcium and vitamin D if you don't eat dairy. Talk to your doctor about adding other calcium-rich foods to your diet or taking supplements.

If you are bottle-feeding, your doctor may recommend an allergy medication:

Highly hydrolyzed formulas: About 90% of infants with cow's milk protein allergy can tolerate highly hydrolyzed formulas. Although they are made from cow's milk, so their nutritional content is the same as regular infant formula, they are largely broken down into tiny pieces so the baby's immune system is less receptive to recognizing the protein.
Amino Acid Formulas: If your child has problems with hydrolyzed formulas or has severe symptoms, an amino acid formula may be recommended.

Don't assume that soy-based formula will be safe. It can also cause a reaction in children who are allergic to cow's milk.

You will also receive advice on how to wean your child off a no cow's milk diet. Because cow's milk contains many important nutrients, especially calcium, a pediatric dietitian can help make sure your child is getting enough of all the nutrients needed for healthy growth.

You should be given a management plan that will include not only how to feed your baby, but also treatment such as antihistamines or creams if the baby has eczema. Follow-up appointments must continue to ensure that your child is thriving.

Because children can outgrow a cow's milk allergy, your child should be retested as often as your doctor recommends to determine if there is a change in tolerance to cow's milk proteins.