Cow milk allergy

January 2017

Sensitivity and allergy to cow's milk is the most common allergy in infancy with the incidence being reported between 1.8% and 7.5%.
Over 50% of children with food allergy are allergic to many foods, like cow's milk, eggs, peanuts.

The start and disappearance of allergy to cow's milk protein


  • Normal shop bought formula contains cow's milk protein as does breast milk if you are eating and drinking dairy products. Allergy to cow's milk is nearly almost immediate at the first exposure of drinking either the formula or breast milk.
  • Cow's milk allergy usually disappears in 90% of the cases by the age of 3 if you stop feeding the infant cow's milk and all products containing allergenic proteins.
  • Approximately half of babies and children that have a cow's milk allergy may go on to develop an allergy to something else and between 40% - 80% will develop asthma and 30% allergic rhinitis.

The symptoms of protein allergy to cow's milk


Severe reactions occur within minutes of exposure, intermediate reactions within 24 hours after exposure and late responders can develop symptoms from 1 to 5 days.

Gastrointestinal Features


Other events

  • Skin rashes - allergy type rash called urticaria, eczema, may also occur.
  • Asthma including wheezing, angioedema, or anaphylaxis can happen, but rarely do.

Hospitalisation


Hospitalisation is often necessary especially in the newborn. A correct diagnosis is essential as the above symptoms can be attributed to other causes. It is also important that the appropriate dietary modifications are made.

Foods containing cow's milk proteins



The allergenic proteins are in
  • Fresh milk or long life milk
  • Powdered Milk
  • Formula, even "hypoallergenic" types
  • Cheese
  • Yoghurts
  • Dairy desserts
  • Butter
  • Cream
  • Pastries
  • Ready made and powdered sauces
  • Mayonnaise
  • Bread
  • Rusks
  • Some ready made meals ... INCOMPLETE LIST

Important advice

Making a full allergy assessment


Your child will be under the care of a specialist in allergies, some times called an immunologist. A number of tests will be carried out to confirm if there is an allergy to the protein in cow's milk and to evaluate its severity. Blood tests, patch test and skin prick tests may be performed and in some cases when looking for food allergies and oral food challenge test.

Beware of soy, sheep and goats milk

  • Be wary of soy milk, sheep or goats that have cross allergies to proteins from cow's milk: 30% of children allergic to cow's milk are also to soy protein and 70% of them are to proteins of goat milk.
  • The department of health and the British Dietetic Association do not advocate soy formula for babies under 6 months. You must see a dietician who will decide and recommend the appropriate formula to use.
  • Check that the shampoos and creams that you use for the baby child does not contain proteins from cow's milk.

Take the advice of a dietician


Dietician's are highly specialised and will advise you on what formulas are safe to use and when weaning types of foods required as a diet without milk can cause a deficiency in calcium and protein

Listen to the advice of your specialist


Follow the advice of your specialist and avoid hearsay and advice from others that are not qualified in this area, because each child is different and advice can vary from one baby to another.

Treatment

Do not consume cow's milk in any form


Do not consume cow's milk in any form is the treatment for an allergy to cow milk proteins: this approach requires above all the expertise of an allergist/immunologist.
Avoiding cow's milk will require a prescription of substitute products.

Hydrolysed Milks

  • Protein hydrolysate formulas are suitable for 90% of children and are used for several years as alternatives to cow's milk.
  • Sometimes these hydrolysate formulas can cause allergies. In this case, a formula made of amino acids is given as it ensures higher safety, provides effective nutrition and promotes growth of the baby.
  • Your dietician and specialist doctors will advice you.

The reintroduction of cow's milk

  • In 90% cases, children will grow out of their allergy and may achieve tolerance to cow's milk from 18 months or later by the age of 5.
  • Depending of the severity of the allergy will depend on when cow's milk is reintroduced. Repeat blood and patch testing and cow's milk oral challenge will be carried out in hospital
  • In case of failure, further attempts to reintroduce cow's milk should happen at approximately 6 monthly intervals.

Related


Allergie au lait de vache - Symptômes et traitement
Allergie au lait de vache - Symptômes et traitement
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