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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 warning 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-onset or a rapid-onset
reaction to milk. The slower reaction is more common and symptoms
develop over time.
Symptoms that occur rapidly (within seconds to hours) may include:
Symptoms that occur slowly (several hours and sometimes days):
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 are supplemented with vitamins
and minerals making them nutritionally equal to milk-based formulas.
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.
As a mother, avoiding milk products in your diet may have a
protective effect against allergy. If you decide to avoid cow's
milk, you should take calcium plus vitamin D supplements. Talk with
your healthcare provider about whether or not you should
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.
Milk products are a primary source of calcium, riboflavin, and
vitamin D. It is important to either take supplements or substitute
foods high in these nutrients. It is a good idea to have a
registered dietitian evaluate your child's diet to make sure your
child is getting adequate nutrition.
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 nutritionally complete diet as well as
continue to enjoy some kid favorites. The primary nutrients found in
milk are protein, calcium, vitamin D, and riboflavin. 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.
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.allergygrocer.com).