The Basics of Milk Allergy
by Gloria Shanks, Atlantic Regional Coordinator
Milk allergy results from a hypersensitivity of the immune system to the proteins in cow's milk. Symptoms can occur within minutes or hours of contact with milk and can range from mild to severe. For a severe allergy, contact with cow's milk protein must be completely eliminated. Fortunately, most children eventually "outgrow" this allergy. Studies show that 2 to 3% of infants are allergic to milk and most outgrow it within a couple of years. Milk allergy in children usually begins in early infancy, rarely after twelve months.
Lactose intolerance is a completely different condition than milk allergy and is not an allergy. Lactose intolerance is caused by not having enough of the enzyme lactase, which is needed by the digestive system to breakdown all the milk sugar lactose. Symptoms of lactose intolerance affect the digestive system.
In recent years some alternative practitioners have been recommending avoidance of milk and dairy products to combat a variety of aliments, but this has nothing to do with allergy to milk and is generally not based on scientific evidence. There is no evidence that consumption of dairy products can cause asthma. A person with a milk allergy could develop asthma but this does not imply a cause and effect relationship between the two. (Note: an allergic reaction to milk may trigger wheezing, especially in infants.)
Symptoms of milk allergy can be immediate or delayed and in the digestive system can cause nausea, vomiting, diarrhea or stomach cramps. On the skin, milk allergy can exhibit as hives, eczema or swelling and in the airways as a runny nose, nasal congestion, wheezing or coughing. Some people allergic to milk are at risk of anaphylaxis, a life-threatening allergy, affecting multiple body systems.
Once a milk allergy develops the only way to avoid reactions is to completely eliminate foods containing cow's milk protein from the diet. A very small quantity of milk protein may bring on symptoms. Breast-feeding, if possible, is advised for as long as possible. (Some mothers may have to moderate their own intake of milk products if advised to do so by the allergist.)
At this time there is no perfect milk substitute on the market that is ideal for everyone allergic to milk protein. Hypoallergenic infant formulas, which have modified milk proteins, may be tolerated by some infants (test for tolerance with physician's help) while others will need a formula that is entirely milk-free. Soy based formulas are sometimes used but some milk allergic children may become allergic to soy. Parents should seek professional advice from their physician to find a formula suitable for a milk allergic baby.
If your child has a milk allergy, tell everyone who may have contact with your child about the allergy. A letter from your physician explaining the diagnosis may be helpful in convincing sceptics of its seriousness. Carry prescribed medications (e.g., Epi-Pen®) with you at all times and provide your child with a MedicAlert® bracelet. Have your allergist periodically reassess your child. Remember the good news: elimination of foods containing milk protein may help bring an end to the allergy.
Check labels carefully and call food manufacturers to verify the ingredients since milk proteins do not have to be fully disclosed under present regulations.
Some food ingredients that indicate the presence of milk protein:
- calcium caseinate
- sodium caseinate
For more information on milk allergy please refer to the AAIA brochure Milk Allergy: The Facts, which is available on line at www.aaia.ca or can be ordered from your regional office.
from Allergy & Asthma News, Issue 3 2004