Cow's milk allergy is said to occur in 2 - 8% of infants. About 5 -15% of infants have a reaction to the cow's milk protein, but not all of these are allergic reactions.
For example, lactose intolerance is not an allergy as such, but children do have a reaction to cow's milk. Read more about lactose intolerance.
Allergic reactions to cow's milk may be:
This page answers the following questions:
The first thing is a good story (history) of a reaction after having cow's milk.
If your infant has had an immediate reaction, then skin prick tests, or blood tests (such as CAP, EAST, RAST) will usually be helpful. These tests detect IgE mediated allergies.
In other cases, milk and dairy products may need to be eliminated from the diet in a trial of treatment. If the symptoms resolve and then return when milk is reintroduced into the diet, this is diagnostic for allergy - called Elimination/Reintroduction. If your child has had a severe reaction to milk products, then reintroduction should be done under medical supervision.
Some centers offer patch testing, which may be useful in detecting non IgE mediated allergies.
Cow's milk will need to be excluded from your baby's diet. This can be difficult and you may need the help of a dietician. As cow's milk is in all dairy products, cow's milk allergy is sometimes called dairy allergy.
Some breast-fed babies will get symptoms if their mother has cow's milk (dairy) products in her diet. In these cases, the mother will need to exclude dairy products from her diet.
Foods to be avoided in cow's milk allergy include:
If you can continue breast feeding, that will be best for your baby. If not, alternatives to cow's milk include:
No. Goat's milk and cow's milk share similar proteins so children who are allergic to one will be allergic to the other. Goat's milk, sheep's milk, and rice milk are not suitable alternatives in cow's milk allergic children.
Sometimes a baby will seem to prefer a goat's milk formula to a cow's milk formula. This is not due to a milk allergy. It's merely a preference.
Some cow's milk allergic children will tolerate yoghurt or cheese and have no problem at all with cookies with milk as an ingredient. This is because heating changes the shape of the protein and this can make it less likely to cause an allergic reaction.
Once your child has been symptom free for at least six months, you could try a small piece of cookie (that has milk as an ingredient) - if your child tolerates it, then you can give cookies freely. You could then try yoghurt or cheese as the same may apply. Some children will show a reaction to cookies, yoghurt and cheese and you will just have to keep these out of the diet for a bit longer - you could try again in about 6 months. Remember leave about 2 weeks between trying a new food.
This is not necessary in most cases so keep breast feeding your baby as breast milk is best. Cow's milk allergy is less likely in breast fed infants.
If your baby has symptoms of cow's milk protein allergy, then you should exclude dairy products and eggs from your diet - you need to continue this for at least 2 weeks, but probably for 4 weeks, to see if there is an improvement. If there is improvement, one food per week can be introduced into your diet until you know what food is causing your baby's problems and then you can just avoid that food.
If you need to continue to eliminate milk from your diet, you may need a calcium supplement.
If and when you do wean your baby, you should use an extensively hydrolysed formula (or soy if your baby is over 6 months of age but as mentioned above about 50% of babies allergic to milk will be allergic to soy).
Most children grow out of their cow's milk allergy by age 3 years. Once your child is over 12 months old and has been without dairy products in the diet for at least 6 months, you could try introducing some dairy products into the diet - you might want to start with yoghurt or cheese as these are sometimes tolerated better than actual milk.
If your child had a severe reaction to the milk in the first place, like anaphylaxis, then you should have the milk challenge under medical supervision - do not try re-introducing milk at home.
Some children grow out of the dairy allergy but develop other allergic diseases, like asthma as they grow older.
Symptoms that relate to the respiratory system, such as runny nose and mucus, usually are a result of what we breath not what we eat. Any symptoms of mucus after ingesting milk are not dangerous and in infants are more likely to be the result of a respiratory tract infection rather than an allergy.
In most cases of eczema, there will not be any allergy. However, in some infants, particularly young babies with severe eczema, allergy may be a factor. In these cases, skin prick tests may be positive and even if they are not, it may be worthwhile trying an elimination diet (no dairy, including cow's milk) for 4 weeks to see if there is improvement. If no improvement occurs, cow's milk is unlikely to be contributing to the eczema. This type of elimination diet is best supervised by your doctor or a dietician.
No, there is no evidence that delaying the introduction of milk or other dairy products will make any difference to whether your child develops eczema or asthma or allergy.
Unless your child has shown a clear allergic reaction to milk and dairy, there is no advantage in delaying introduction of it, so give it at the usual time. This is even when there is a history of allergy, eczema or asthma in your family.
There is also no evidence that giving a hydrolysed formula to your baby when there is a family history of allergy will prevent your baby getting allergy, therefore we do not advise this.
Lactose intolerance occurs because the body lacks an enzyme, lactase, that is necessary to digest the milk sugar, lactose. People with lactose intolerance will get diarrhea, vomiting and tummy pains - these symptoms are similar to cow's milk allergy, but do not involve the skin. Although the symptoms are a nuisance, lactose intolerance is not dangerous.
If you have lactose intolerance, you can usually manage to eat small amounts of cow's milk. Other dairy products, such as yoghurt and cheese, are usually well tolerated because they have easier to digest milk sugars.
The diagnosis is made on a stool test which shows sugars (reducing substances) in the stool or a breath hydrogen test. Treatment is reducing or avoiding products containing lactose (milk sugar) - so reducing or avoiding dairy products. Infants require a lactose-free formula.
Last reviewed 18 March 2016
|We comply with the HONcode standard for trustworthy health