What formula to feed baby with milk allergy
Treatment depends on the extent of your child’s intolerance. Some children with lactose intolerance may be capable to own little amounts of dairy products without having symptoms.
Your kid may be referred to a dietitian for specialist advice.
Read more about treatment for lactose intolerance in children.
Treatment for CMA
If your baby is diagnosed with CMA, you’ll be offered advice by your GP or an allergy specialist on how to manage their allergy. You may also be referred to a dietitian.
Treatment involves removing every cows’ milk from your child’s diet for a period of time.
If your baby is formula-fed, your GP can prescribe special baby formula.
Do not give your kid any other type of milk without first getting medical advice.
If your baby is exclusively breastfed, the mom will be advised to avoid every cows’ milk products.
Your kid should be assessed every 6 to 12 months to see if they own grown out of their allergy.
Read more about cows’ milk allergy.
Could it be lactose intolerance?
Lactose intolerance is another type of reaction to milk, when the body cannot digest lactose, a natural sugar found in milk.
However, this is not an allergy.
Lactose intolerance can be temporary – for example, it can come on for a few days or weeks after a tummy bug.
Symptoms of lactose intolerance include:
- stomach rumbling and pains
Signs and symptoms
Food allergies can own rapid-onset (from minutes up to 2 hours), delayed-onset (up to 48 hours or even 1 week), or combinations of both, depending on the mechanisms involved.
The difference depends on the types of white blood cells involved.
B cells, a subset of white blood cells, rapidly synthesize and secrete immunoglobulin E (IgE), a class of antibody which bind to antigens, i.e., the foreign proteins. Thus, immediate reactions are described as IgE-mediated. The delayed reactions involve non-IgE-mediated immune mechanisms initiated by B cells, T cells, and other white blood cells. Unlike with IgE reactions, there are no specific biomarker molecules circulating in the blood, and so, confirmation is by removing the suspect food from the diet and see if the symptoms resolve.
IgE-mediated symptoms include: rash, hives, itching of the mouth, lips, tongue, throat, eyes, skin, or other areas, swelling of the lips, tongue, eyelids, or the whole face, difficulty swallowing, runny or congested nose, hoarse voice, wheezing, shortness of breath, diarrhea, abdominal pain, lightheadedness, fainting, nausea and vomiting.
Symptoms of allergies vary from person to person and may also vary from incident to incident. Serious harm regarding allergies can start when the respiratory tract or blood circulation is affected. The previous can be indicated by wheezing, a blocked airway and cyanosis, the latter by feeble pulse, pale skin, and fainting.
When these symptoms happen, the allergic reaction is called anaphylaxis. Anaphylaxis occurs when IgE antibodies are involved, and areas of the body that are not in direct contact with the food become affected and show severe symptoms. Untreated, this can proceed to vasodilation, a low blood pressure situation called anaphylactic shock, and extremely rarely, death.
For milk allergy, non-IgE-mediated responses are more common than IgE-mediated. The presence of certain symptoms, such as angioedema or atopic eczema, is more likely related to IgE-mediated allergies, whereas non-IgE-mediated reactions manifest as gastrointestinal symptoms, without skin or respiratory symptoms. Within non-IgE cow’s milk allergy, clinicians distinguish among food protein-induced enterocolitis syndrome (FPIES), food protein-induced allergic proctocolitis (FPIAP) and food protein-induced enteropathy (FPE).
Common trigger foods for every are cow’s milk and soy foods (including soy baby formula). FPIAP is considered to be at the milder finish of the spectrum, and is characterized by intermittent bloody stools. FPE is identified by chronic diarrhea which will resolve when the offending food is removed from the infant’s diet. FPIES can be severe, characterized by persistent vomiting, 1 to 4 hours after an allergen-containing food is ingested, to the point of lethargy.
Watery and sometimes bloody diarrhea can develop 5 to 10 hours after the triggering meal, to the point of dehydration and low blood pressure. Infants reacting to cow’s milk may also react to soy formula, and vice versa. International consensus guidelines own been established for the diagnosis and treatment of FPIES.
Symptoms of cows’ milk allergy
Cows’ milk allergy can cause a wide range of symptoms, including:
- hay fever-like symptoms – such as a runny or blocked nose
- digestive problems – such as stomach ache, vomiting, colic, diarrhoea or constipation
- skin reactions – such as a red itchy rash or swelling of the lips, face and around the eyes
- eczema that does not improve with treatment
Occasionally CMA can cause severe allergic symptoms that come on suddenly, such as swelling in the mouth or throat, wheezing, cough, shortness of breath, and difficult, noisy breathing.
A severe allergic reaction, or anaphylaxis, is a medical emergency – call or go immediately to your local hospital A&E department.
Sheet final reviewed: 12 July
Next review due: 12 July
Not to be confused with Lactose intolerance.
Milk allergy is an adverse immune reaction to one or more proteins in cow’s milk.
When allergy symptoms happen, they can happen rapidly or own a gradual onset. The previous may include anaphylaxis, a potentially life-threatening condition which requires treatment with epinephrine among other measures. The latter can take hours to days to appear, with symptoms including atopic dermatitis, inflammation of the esophagus, enteropathy involving the little intestine and proctocolitis involving the rectum and colon.
In the United States, 90% of allergic responses to foods are caused by eight foods, with cow’s milk being the most common. Recognition that a little number of foods are responsible for the majority of food allergies has led to requirements to prominently list these common allergens, including dairy, on food labels. One function of the immune system is to defend against infections by recognizing foreign proteins, but it should not over-react to food proteins.
Heating milk proteins can cause them to become denatured, meaning to lose their 3-dimensional configuration, and thus lose allergenicity; for this reason dairy-containing baked goods may be tolerated while unused milk triggers an allergic reaction.
Management is by avoiding eating any dairy foods or foods that contain dairy ingredients. In people with rapid reactions (IgE-mediated milk allergy), the dose capable of provoking an allergic response can be as low as a few milligrams, so recommendations are to avoid dairy strictly. The declaration of the presence of trace amounts of milk or dairy in foods is not mandatory in any country, with the exception of Brazil.
Milk allergy affects between 2% and 3% of babies and young children. To reduce risk, recommendations are that babies should be exclusively breastfed for at least four months, preferably six months, before introducing cow’s milk.
If there is a family history of dairy allergy, then soy baby formula can be considered, but about 10 to 15% of babies allergic to cow’s milk will also react to soy. The majority of children outgrow milk allergy, but for about % the condition persists into adulthood.Oral immunotherapy is being researched, but it is of unclear benefit.
Cows’ milk allergy in babies
Cows’ milk allergy (CMA), also called cows’ milk protein allergy, is one of the most common childhood food allergies.
It is estimated to affect around 7% of babies under 1, though most children grow out of it by the age of 5.
CMA typically develops when cows’ milk is first introduced into your baby’s diet either in formula or when your baby starts eating solids.
More rarely, it can affect babies who are exclusively breastfed because of cows’ milk from the mother’s diet passing to the baby through breast milk.
There are 2 main types of CMA:
- immediate CMA – where symptoms typically start within minutes of having cows’ milk
- delayed CMA – where symptoms typically start several hours, or even days, after having cows’ milk