What do i give my 1 year old who has a milk allergy

Often, symptoms experienced with CMPA are common presentations that may not own any association with CMPA. Generally, CMPA should be suspected in children presenting with one or more of the signs and symptoms listed (see Table 1 and Table 2), and particularly for those with persistent symptoms involving diverse organ systems. CMPA should also be suspected in children with symptoms that do not reply adequately to usual management and a referral should be made to the GP for further investigation[6].

Questioning parents and carers about their child’s symptoms will aid diagnosis (see Box 1).

Box 1: Questions to enquire parents to determine the possibility of cow’s milk protein allergy

  1. How quickly do symptoms develop after feeding?
  2. What are the signs and symptoms?
  3. Do the same symptoms happen each time your kid eats/drinks a specific food?
  4. Is there a family history of allergy, especially in parents or siblings?
  5. How often do they happen? Are they the same every time?
  6. How ancient was your kid when you first noticed the symptoms?
  7. Do you suspect a specific food is involved — either in your child’s diet or the mother’s diet if the kid is breastfed?

    If so, how much of the suspected food does your kid need to eat for symptoms to appear?


Diagnosing a milk allergy in infants

If your baby has symptoms of either a milk allergy or milk intolerance, see your pediatrician. He or she will probably check for both with a physical exam, an examination of your baby’s stool, a discussion your family’s history of allergies and/or a skin-prick test.

If your doc thinks your baby may own a milk allergy or intolerance, then you’ll probably be asked to eliminate milk from your diet (if you’re breastfeeding) or switch to a diverse formula (more on that below) to see whether your newborn’s symptoms improve.

After your baby has been cow’s-milk-free for about a week, the doctor may own you reintroduce cow’s milk to see whether your baby has a reaction to it.


Milk allergies vs. milk intolerance

Milk allergy: With a milk allergy in infants, a baby’s immune system reacts negatively to the proteins in cow’s milk. Breastfed babies are reacting to the dairy his mom has eaten (the milk proteins pass through breast milk), while formula-fed babies are reacting to the cow’s milk proteins in the formula.

In either case, a baby’s immune system sees the cow’s milk proteins as foreign substances. In its efforts to fend off the invaders, the body releases histamine and other chemicals, which cause allergic symptoms in the body. Symptoms of milk allergies in babies include:

  1. Diarrhea
  2. Vomiting
  3. Coughing or wheezing
  4. Watery eyes and stuffy nose
  5. Trouble breathing or a bluish skin color
  6. Frequent spitting up
  7. Blood in stool
  8. Signs of abdominal pain, or colic-like symptoms, such as excessive crying and irritability (especially after feedings)
  9. Hives
  10. A scaly skin rash
  11. Swelling (especially of the mouth and throat)

Milk intolerance: Milk intolerance, on the other hand, has nothing to do with cow’s milk proteins or the immune system.

Instead, it involves the digestive system. It occurs when a formula-fed or breastfed baby can’t digest the sugar in milk (called lactose). That’s why milk intolerance is also called lactose intolerance. Congenital lactose intolerance (milk intolerance in babies from birth) is an extremely rare metabolic condition.

What do i give my 1 year ancient who has a milk allergy

Lactose intolerance more commonly develops in older kids and adults. The few babies with lactose intolerance will generally fare much better on a formula with little or no lactose. Symptoms of lactose intolerance in babies include:

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  1. Diarrhea
  2. Gas
  3. Irritability, crying or other colic symptoms
  4. Spitting up
  5. Bloated stomach
  6. Failure to thrive and acquire weight


Treating a milk allergy in infants

If it turns out that your newborn is one of the 2 to 3 percent of babies who has a milk allergy, don’t despair.

Numerous children outgrow a milk allergy by the time they’re around 1 year ancient, and the majority of babies with milk allergies outgrow the condition by about age 3. In the meantime:

  1. If your baby is formula-fed, your pediatrician will propose switching to a diverse formula. Because numerous babies with milk allergies are also allergic to soy (and to goat’s milk), the doctor may propose a hypoallergenic formula with hydrolysate protein, which has milk proteins that are already partly broken below, so it’s less likely to cause a reaction.
  2. If you’re breastfeeding, your pediatrician will likely recommend that you ditch dairy in your diet to see whether that makes a difference to your baby.

    Of course making a major change to your diet is probably the final thing you desire to ponder about when dealing with a fussy newborn, but it may extremely well resolve the issue. If you do eliminate dairy, be certain to talk with your doctor about how to make sureyou’re still getting enough calcium and other nutrients in your diet.

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect the First Year.

Health information on this site is based on peer-reviewed medical journals and highly respected health organizations and institutions including ACOG (American College of Obstetricians and Gynecologists), CDC (Centers for Disease Control and Prevention) and AAP (American Academy of Pediatrics), as well as the What to Expect books by Heidi Murkoff.

What Happens in a Milk Allergy?

When someone is allergic to milk, the body’s immune system, which normally fights infections, overreacts to proteins in the milk. Every time the person drinks or eats milk or other dairy products, the body thinks these proteins are harmful invaders and releases chemicals love .

This can cause symptoms such as:

  1. throat tightness
  2. trouble breathing
  3. itchy, watery, or swollen eyes
  4. hives
  5. swelling
  6. wheezing
  7. hoarseness
  8. coughing
  9. stomachache
  10. diarrhea
  11. vomiting
  12. a drop in blood pressure, causing lightheadedness or loss of consciousness

Allergic reactions to milk can differ. Sometimes the same person can react differently at diverse times. Milk allergy can cause a severe reaction called anaphylaxis, even if a previous reaction was mild.

Anaphylaxis might start with some of the same symptoms as a less severe reaction, but can quickly get worse. The person may own trouble breathing or pass out. More than one part of the body might be involved. If it isn’t treated, anaphylaxis can be life-threatening.

Treating a milk allergy in infants

If it turns out that your newborn is one of the 2 to 3 percent of babies who has a milk allergy, don’t despair. Numerous children outgrow a milk allergy by the time they’re around 1 year ancient, and the majority of babies with milk allergies outgrow the condition by about age 3.

In the meantime:

  1. If your baby is formula-fed, your pediatrician will propose switching to a diverse formula. Because numerous babies with milk allergies are also allergic to soy (and to goat’s milk), the doctor may propose a hypoallergenic formula with hydrolysate protein, which has milk proteins that are already partly broken below, so it’s less likely to cause a reaction.
  2. If you’re breastfeeding, your pediatrician will likely recommend that you ditch dairy in your diet to see whether that makes a difference to your baby. Of course making a major change to your diet is probably the final thing you desire to ponder about when dealing with a fussy newborn, but it may extremely well resolve the issue.

    If you do eliminate dairy, be certain to talk with your doctor about how to make sureyou’re still getting enough calcium and other nutrients in your diet.

From the What to Expect editorial team and Heidi Murkoff, author of What to Expect the First Year. Health information on this site is based on peer-reviewed medical journals and highly respected health organizations and institutions including ACOG (American College of Obstetricians and Gynecologists), CDC (Centers for Disease Control and Prevention) and AAP (American Academy of Pediatrics), as well as the What to Expect books by Heidi Murkoff.

What Is Milk Allergy?

Milk allergy is the most common food allergy in young kids, affecting about 2%–3% of those younger than 3 years ancient.

Numerous kids outgrow it, but some are allergic for a lifetime.

A milk allergy can cause a range of symptoms, from mild to severe.

Allergy to milk is sometimes confused with lactose intolerance. Both can cause problems after drinking milk, but they are extremely diverse and unrelated.

What do i give my 1 year ancient who has a milk allergy

Lactose intolerance is annoying and can cause discomfort, but it is not life-threatening. Milk allergy, though, can make someone suddenly and severely ill, and can be life-threatening. That’s why milk and other dairy products must be completely avoided if your kid has a milk allergy.

If you’re not certain if your kid has an intolerance or an allergy, speak with your doctor.

Milk Alternatives

Milk from other animals (such as sheep, goats, and buffalo) are not excellent alternatives for those with a cow’s milk allergy because the proteins are similar.

But numerous other milk-free alternatives are available, including ones that are fortified with calcium and vitamin D.

What do i give my 1 year ancient who has a milk allergy

The allergist can tell you which milk substitute is best for your child.

What Else Should I Know?

To prevent allergic reactions to milk, your kid must avoid any foods that contain milk, milk products, or milk proteins. Read food labels to see if a food contains milk.

Milk may be found in unexpected places, such as processed meats, canned tuna, and baked goods, so it’s significant to read labels on every foods, even ones that are not dairy foods.

Makers of foods sold in the United States must state in understandable language whether foods contain any of the top eight most common allergens, including milk.

The label should list "milk" in the ingredient list or tell "Contains milk" after the list. For detailed information about foods to avoid, visit Food Allergy Research & Education (FARE).

Some foods glance OK from the ingredient list, but while being made they can come in contact with a food your kid is allergic to. This is called cross-contamination. Glance for advisory statements such as "May contain milk," "Processed in a facility that also processes milk," or "Manufactured on equipment also used for milk." These are cross-contamination warnings, but manufacturers are not required to list them.

You can contact the company directly to see if a product contains milk.

Check the company’s website for this information or email a company representative.

Food makers sometimes change ingredients, so always read the food labels.

How Is an Allergic Reaction to Milk Treated?

If your kid has been diagnosed with a milk allergy (or any helpful of serious food allergy), hold two epinephrine auto-injectors available in case of an emergency.

An epinephrine auto-injector is a prescription medicine that comes in a little, easy-to-carry container.

It’s simple to use. Your doctor will show you how. Kids who are ancient enough can be taught how to give themselves the injection. If they carry the epinephrine, it should be nearby, not left in a locker or in the nurse’s office.

Every second counts in an allergic reaction. If your kid starts having serious allergic symptoms, love swelling of the mouth or throat or trouble breathing, give the epinephrine auto-injector correct away. Also give the epinephrine auto-injector correct away if your child’s symptoms involve two diverse parts of the body, love hives with vomiting.

Then call or take your kid to the emergency room. Your kid needs to be under medical supervision because even if the worst seems to own passed, a second wave of serious symptoms can happen.

It’s also a excellent thought to carry an over-the-counter (OTC) antihistamine for your kid, as this can assist treat mild allergy symptoms. Use after — not as a replacement for — the epinephrine shot during life-threatening reactions.

Eating Away From Home

Cross-contamination can happen in restaurants when milk or milk products get into a food product. The staff might use the same surfaces and utensils (like knives, cutting boards, or pans) to prepare both dairy products and other foods.

This is particularly common in fast-food restaurants, so some people discover it safer to avoid these restaurants altogether.

Buffet-style restaurants also pose a cross-contamination risk, with cheeses and salad dressings dripping over non-dairy food platters. When eating at restaurants, it may be best to avoid fried foods or foods with batter on them. Even if the batter doesn’t contain milk products, the oil used to fry the foods might own been used to fry something else that contains milk.

When your kid eats in a restaurant or at a friend’s home, discover out how foods are cooked and exactly what’s in them.

It can be hard to enquire a lot of questions about cooking methods, and to believe the information you get. If you can’t be certain that a food is milk-free, it’s best to bring safe food from home.

Also talk to the staff at school about cross-contamination risks for foods in the cafeteria. It may be best to pack lunches at home so you can control what’s in them.

If your kid will be eating at a restaurant, take these precautions:

  1. Tell the restaurant wait staff that your kid has a milk allergy.
  2. Carry a personalized "chef card" for your kid, which can be given to the kitchen staff. The card details your child’s allergies for food preparers.

    Food allergy websites provide printable chef card forms in numerous diverse languages.

  3. Don’t eat at a restaurant if the manager or owner seems uncomfortable about your requests for a safe meal.

You may own heard that cow’s milk should not be given to babies younger than 1 year ancient. This is because cow’s milk doesn’t provide enough of certain nutrients.

What do i give my 1 year ancient who has a milk allergy

Also, it’s hard for your baby to digest the protein and fat in cow’s milk. It is safe though, to give cow’s milk to children after they’re 1 year old.

A kid who is 1 or 2 years ancient should only drink whole milk. This is because the fat in whole milk is needed for your child’s developing brain. After 2 years ancient, children can drink low-fat milk or even skim milk if they are overweight.

Some children own problems from drinking cow’s milk. For instance, a milk allergy may cause:

  1. Belly pain or cramping
  2. Nausea and vomiting
  3. Diarrhea

A severe allergy can cause bleeding in the intestines that can lead to anemia.

But only about 1% to 3% of children under 1 year ancient own a milk allergy. It is even less common in children who are older than 1 to 3 years.

Lactose intoleranceoccurs when the little intestine does not make enough of the enzyme lactase. A kid who is lactose intolerant can’t digest lactose. This is a type of sugar found in milk and other dairy products. The condition can cause bloating and diarrhea.

If your kid has one of these problems, your health care provider may recommend soy milk.

What do i give my 1 year ancient who has a milk allergy

But numerous children who are allergic to milk are also allergic to soy.

Children generally outgrow allergies or intolerances by the time they are 1 year ancient. But having one food allergy increases the risk for having other types of allergies.

If your kid can’t own dairy or soy, talk to your provider about other food options that will assist your kid get enough protein and calcium.

The US Department of Agriculture recommends the following daily amounts of dairy for children and teens:

  1. Two through 3 years old: 2 cups ( milliliters)
  2. Four through 8 years old: 2½ cups ( milliliters)
  3. Nine through 18 years old: 3 cups ( milliliters)

One cup ( milliliters) of dairy equals:

  1. Eight ounces ( milliliters) of yogurt
  2. One cup ( milliliters) of milk
  3. Two ounces (56 grams) of processed American cheese
  4. One cup ( milliliters) of pudding made with milk

Milk and children; Cow’s milk allergy — children; Lactose intolerance — children

Nowak-Wegrzyn A, Burks AW, Sampson HA.

Reactions to foods. In: Adkinson NF, Bochner BS, Burks AW, et al, eds. Middleton’s Allergy: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; chap

Parks EP, Shaikhkhalil A, Groleau V, Wendel D, Stallings VA. Feeding healthy infants, children, and adolescents. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier Saunders; chap

United States Department of Agriculture. website. Dairy. Updated November 3, Accessed October 6,

Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA.

Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.

Source: Hero Images Inc. / Alamy Stock Photo

Allergy is an adverse overreaction by the immune system to a harmless substance. A food allergy occurs when specific components of a food (typically proteins) are recognised by allergen-specific antibodies or cells, eliciting specific immunological reactions that result in characteristic symptoms[1]. Food allergy is an significant public health problem that affects both adults and children[1].

Cow’s milk protein allergy (CMPA) is the abnormal response to proteins found in cow’s milk or products containing milk proteins.

The reported prevalence of CMPA varies owing to possible misinterpretations of presumed reactions to milk and diagnostic criteria, and is often overestimated. A pan-European study using the gold standard food challenge test for diagnosis confirmed CMPA in around 1% of children aged up to two years[2].

Identification of CMPA can be hard because the typical symptoms are not specific to CMPA alone, and instead are common in children (e.g. skin rashes, reflux, colic and diarrhoea). If left untreated, CMPA can lead to faltering growth, persistent unpleasant symptoms and in rare instances can be life-threatening.

Furthermore, CMPA is often confused with lactose intolerance, making diagnosis even more difficult[3],[4]. Lactose is a component of milk and dairy products; an intolerance may happen when lactase, the enzyme required to break lactose into glucose and galactose, is lacking. This malabsorption leads to gastrointestinal side effects (e.g. bloating, diarrhoea and flatulence), but lactose intolerance is highly unlikely in a kid aged under three years unless they own a history of a gastrointestinal infection[5].

This article provides an overview of how pharmacists, pharmacy teams and other healthcare professionals can assist to identify a kid with possible CMPA, ensuring a timely diagnosis and initiation of the most appropriate management plan.

Further information can be found in the Milk Allergy in Primary Care (MAP) guideline[6].


How does cow’s milk protein allergy occur?

Cow’s milk protein can be present in breast milk if the mom has cow’s milk in her diet, and it is also in cow’s milk protein formula. Reactions can be either immunoglobulin E (IgE) mediated or non-IgE mediated.

IgE-mediated reactions

These reactions are generally rapid in onset and happen when the milk protein (the allergen) binds to a milk-specific IgE on the surface of mast cells (on skin and in the blood) that recognise the protein as harmful.

In response to this, IgE initiates a process of intracellular signalling, leading to the release of histamine and other inflammatory markers that produce local tissue responses characteristic of an allergic reaction (see Table 1).

IgE-mediated reactions happen most commonly in formula-fed children or at the onset of mixed feeding[6].

Gastrointestinal  Skin  Respiratory
Mild-to-moderate IgE-mediated symptoms
  1. Vomiting
  2. Diarrhoea
  3. Abdominal pain/colic
  1. Erythema (flushing)
  2. Acute pruritus (itching)
  3. Angioedema (swelling) 
  4. Urticaria (hives)
  5. Acute ‘flaring’ of atopic eczema  
  1. Acute rhinitis and/or conjunctivitis 
Severe IgE-mediated symptoms  Rare Persistent symptoms  Significant respiratory and/or cardiovascular symptoms
If anaphylaxis occurs, call

Non-IgE-mediated reactions

Diagnosis of non-IgE-mediated milk allergy is more challenging because there is no temporal relationship with ingestion.

The symptoms are also commonly seen in children who do not own CMPA. Symptoms can appear after a couple of hours but can also be delayed for up to 72 hours post-ingestion of cow’s milk protein; the kid may be formula fed, exclusively breastfed, or it may happen at the onset of mixed feeding. Symptoms tend to intensify with increasing exposure to the allergen; therefore, they are seen to build up over a period of time following recurrent exposure through feeding (see Table 2).

Evidence from the UK shows that the majority of children presenting with suspected CMPA drop into a ‘mild-to-moderate’ clinical expression of non-IgE-mediated allergy[7].

Gastrointestinal  Skin 
Mild-to-moderate non-IgE-mediated symptoms 
  1. Vomiting, reflux or gastro-oesophageal reflux disease
  2. Irritability or colic
  3. Abdominal discomfort, painful flatulence
  4. Diarrhoea (i.e.

    loose or frequent stools) or constipation (especially soft stools with excessive straining) 

  5. Food refusal or aversion 
  6. Blood and/or mucus in stools in an otherwise healthy child
  1. Pruritus (itching)
  2. Erythema (flushing)
  3. Moderate persistent atopic dermatitis
Severe non-IgE-mediated symptoms 
  1. Abdominal pain
  2. Diarrhoea
  3. Significant blood and/or mucus in stools
  4. Irregular or uncomfortable stools
  5. Food refusal or food aversion
  6. Vomiting
  7. +/- faltering growth
  1. Severe atopic dermatitis
  2. +/- faltering growth


Risk factors

Children who own other confirmed food allergies or own comorbidities (e.g.

eczema) are more likely to own CMPA. There is also an increased likelihood if there is a family history of atopy, such as allergies or asthma[5],[7].


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