How Is Cma Treated
If your baby is diagnosed with CMA, you need to cut out cows’ milk, dairy products and any foods with cows’ milk-containing ingredients from their diet. Some infants and children with cows’ milk allergy can have dairy especially where it is a minor ingredient in a well-cooked food your doctor or dietitian can help decide if this is true for your child.If your baby is formula fed, you need to give them a non-dairy infant formula. There are 3 main types of non-dairy infant formula: soy-based formula, extensively hydrolysed formula and amino acid formula . The type of infant formula that is best for your baby depends on their age and the type of CMA they have. Ask your doctor or dietitian for advice on which infant formula to try.Read more about infant formula for cow milk allergy.
What Should I Do
Ask the healthcare team! The ideal way they confirm the symptoms of a cow milk allergy is to:
- Remove cow milk from the diet, and
- Re-introduce cow milk, often under a doctors supervision.
Many doctors wont go past step 1 if signs improve. However, step 2 is the best way to confirm a food allergy. If you add cow milk back to the diet and symptoms reappear, CMA can be diagnosed.
Babies allergic with symptoms of a cow milk allergy who require formula need one thats hypoallergenic, like Neocate® Syneo® Infant. Neocate is safe for babies with food allergies because it contains amino acids, building blocks of protein. Amino acids cant trigger an allergic reaction the way proteins or peptides in other formulas can.
If you suspect CMA, ask your childs doctor for a thorough evaluation. Bring this information with you and ask your doctor if your baby might benefit from Neocate. For more on CMA, check out the following resources:
Treatment And Management: Lactose Intolerance In Older Children And Teenagers
If your older or teenage child is diagnosed with lactose intolerance, you can reduce the amount of lactose in her diet. But you dont need to get rid of products with lactose completely, especially if your child eats only small amounts of them with other foods during the day.
The following food and diet tips can help.
These foods are OK:
- cheeses with very low lactose content brie, camembert, cheddar, colby, edam, fetta, gouda, havarti, mozzarella, parmesan, halloumi, Swiss and Tilstat
- yoghurt the bacteria in yoghurt breaks down the lactose so its usually fine for your child to eat
- calcium-fortified soy products soy yoghurt, soy milk, soy ice-cream and soy cheese
- lactose-free cows milk
- butter and cream these contain only small amounts of lactose and are usually fine to eat
- bread, cereals, fruit, vegetables, meat and other protein foods
- full-fat milk the fat in full-fat milk gives your childs body longer to digest lactose.
Watch out for these foods:
- milk ice-cream and milk desserts
- cream cheese, processed cheese and cheese spread
- muesli bars
- instant mashed potato and vegetables with added milk or white sauces.
Check the ingredients in these foods:
- biscuits, cakes and cake mixes
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How Is Lactose Intolerance Diagnosed
To diagnose lactose intolerance, doctors ask about a child’s symptoms and diet. They might test the breath for hydrogen levels before and after the child drinks lactose. Normally very little hydrogen gas is detectable in the breath. But undigested lactose in the colon breaks down and makes various gases, including hydrogen.
If your child has a hydrogen breath test, they’ll blow into a tube for a beginning sample. Then they’ll swallow a drink with lactose in it, wait a while, and breathe into the tube again. Your child will blow into the tube every half hour for 2 hours to measure hydrogen levels. The levels should go up over time if your child has lactose intolerance.
Doctors also can find out if someone can digest lactose by testing for the presence of lactase with an endoscopy. During this procedure, doctors view the inside of the intestines by inserting a long tube with a light and a tiny camera on the end into the mouth.
A doctor can then take tissue samples and pictures of the inside of the gut. The amount of lactase enzyme can be measured in one of these tissue samples.
What Formula To Give To A Baby Whos Allergic To Cow’s Milk
Keep in mind that even small amounts of milk can cause a reaction in a baby with CMA. If your babys pediatrician confirms she has lactose intolerance or sensitivity, ask about switching her to a formula like Similac Pro-Sensitive® or Similac Pro-Total Comfort. If it is confirmed that your little one has CMA, you can ask about switching to Similac® Alimentum®.
Shop now to find a Similac® formula thats right for your baby.
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What Happens In Lactose Intolerance
Normally, when we eat something with lactose, an enzyme in the small intestine called lactase breaks it down into simple sugars. The bloodstream absorbs these simple sugars, which are turned into energy.
In lactose intolerance, the body doesn’t make enough lactase to break down lactose. Instead, undigested lactose sits in the gut and gets broken down by bacteria, causing gas, bloating, stomach cramps, and diarrhea.
Lactose intolerance is fairly common. Kids and teens are less likely to have it, but many people become lactose intolerant in adulthood. Some health care providers view lactose intolerance as a normal human condition and not a disease or serious health problem.
Besides age, people can become lactose intolerant due to:
- Ethnic background. People of Asian, African, Native American, and Hispanic backgrounds are more likely to develop lactose intolerance at a young age.
- Other problems with the digestive tract. People who have inflammation of their upper small intestine, such as celiac disease or Crohn’s disease, have less of the lactase enzyme.
- Medicines. Some antibiotics can trigger temporary lactose intolerance by affecting how the intestine makes lactase.
- Infection. After having diarrhea, some people have a temporary lactose intolerance that usually gets better after a few days or weeks.
Will Your Baby Outgrow An Allergy
Even if your doctor recommends you eliminate dairy, you don’t necessarily have to stay away from dairy for as long as you breastfeed. Once you’ve eliminated all the dairy and your child is feeling better, under the direct supervision of your doctor, you can wait a few weeks or months, then slowly reintroduce some dairy products back into your diet.
If your baby starts to react, you can stop the dairy once again. With your doctor’s go-ahead, you can keep trying to add back dairy every few weeks or so, and as your baby gets older, they may be able to tolerate it more and more, as it’s quite common for children to grow out of their milk allergy.
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General: Excess Fussiness Sleeplessness Or Colic
Every baby cries, but crying continuously and inconsolably for extended periods is unusual. You might hear someone say a baby who cries a lot has colic. Some doctors find colic controversial, but excess crying comes from somewhere, often with insomnia. Doctors also often downplay fussiness, which can delay diagnosing CMA. We hear this from parents all too often!
When should you suspect that crying is excessive and something serious is happening? The going adage is to talk to the doctor if it happens in threes. That is: if your baby cries for 3+ hours in a day, for 3+ days in a week, for over 3 weeks. That can signal gastrointestinal pain, which could result from CMA.
Extreme fussiness can also come with reflux, a rash, or other factors. Keep this in mind when asking your childs doctor about the possibility of CMA.
Digestive: Frequent Vomiting Reflux Or Spitting Up
Babies often spit up , but anything beyond the occasional post-meal spit-up should be examined by a doctor. Many infants who spit up dont seem bothered by it and maintain a healthy weight we call them happy spitters. For other infants, spitting up may represent something more concerning like gastroesophageal reflux disease or vomiting. It can lead to low or no weight gain.
In infants, frequent reflux or vomiting can be related to CMA. Almost 50% of infants with reflux may be diagnosed with CMA. In those cases, taking cow milk out of the diet should help resolve reflux. Read more information on reflux and vomiting in infancy. violent vomiting a few hours after feeding is the hallmark sign.)
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What Should I Avoid Feeding My Baby Who Has Cma
If your child has CMA, its important to avoid milk in all forms. You may not be able to tell if a food contains milk just from the name of its ingredients. Ingredients like galactose, ghee, and casein, for example, all contain milk.
The USDAs food allergen label law requires a food label to state if it contains a Top 8 allergen, such as milk. This will be identified in the ingredient list or as an allergen statement. Learn more about the Top 8 Food Allergies.
Avoid all milk-containing foods and ingredients. Though this list is not complete, here are some to look out for:
- Butter, butter fat, butter acid, and butter ester
- Sour cream and sour cream solids
- Sour milk solids
How Does A Lactose Intolerance Affect Breastfeeding And Formula Feeding
If diagnostic testing confirms a lactose intolerance, dont immediately panic and stop breastfeeding. Whether youre able to continue breastfeeding depends on the type of lactase deficiency.
For example, if your baby develops a lactose intolerance after a viral illness, the general recommendation is to continue breastfeeding. Breast milk can give their immune system a boost and help heal their gut.
If your infant has developmental lactase deficiency due to a premature birth, this condition only lasts a few weeks or months. So your baby may eventually drink milk-based formula or breast milk with no problem, although youll need to use lactose-free infant formula in the meantime.
But breastfeeding isnt an option if your baby has a congenital lactase deficiency. The lactose in your breast milk can cause severe diarrhea and lead to dehydration and electrolyte loss. Youll need to feed your baby with lactose-free infant formula.
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Milk Intolerance In Babies And Children
Some babies and children have a reaction when they drink cow’s milk or formula made from cow’s milk. This could be due to 2 things: a lactose intolerance or an allergy to milk. If your child has one of these conditions, you will have to alter their diet to cut down on milk or avoid it altogether.
- wheezing or difficulty breathing
- they are pale and floppy or unconscious
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What’s The Difference Between Milk Allergies Vs Lactose Intolerance
With a milk allergy in infants, a babys immune system reacts negatively to the proteins in cows milk. Breastfed babies are reacting to the dairy his mother has eaten , while formula-fed babies are reacting to the cows milk proteins in the formula. In either case, a baby’s immune system sees the cows milk proteins as foreign substances.
Milk intolerance, on the other hand, has nothing to do with cows milk proteins or the immune system, and instead has to do with the digestive system. Your child might have loose stools or blood in stool hours or days later.
Congenital lactose intolerance is an extremely rare metabolic condition that also impacts the digestive system. Lactose intolerance more commonly develops in older kids and adults. The few babies with lactose intolerance will usually fare much better on a formula with little or no lactose.
- Irritability, crying or other colic symptoms
- Failure to thrive and gain weight
Treatments For Milk Allergy
Once your child is confirmed to have a milk allergy, the first step in treatment is avoiding milk and dairy products.
Your childs doctor can give you detailed information on how to read food labels to help you identify and avoid milk protein.
No matter how careful you are, there may be times when your child accidentally ingests milk protein and has a reaction. When that happens, you can treat the symptoms with antihistamines or epinephrine.
If more than one body system is involved in the allergic reaction for example the throat and skin it is recommended to use epinephrine. Epinephrine comes in a variety of forms, including auto-injectors such as Epi-Pen, Auvi-Q and other generic forms.
If your childs reaction is mild and only involves a few hives, an over-the-counter or prescription strength antihistamine can ease their symptoms. Your childs doctor can help you decide which option is best for your child in each circumstance.
Children with milk allergies should carry epinephrine with them, or it should be readily available at places where they routinely spend time, such as school, daycare and home.
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What Is Cows’ Milk Allergy
Cows’ milk allergy occurs when your babys immune system reacts to the protein in cows’ milk. The body’s immune system fights off harmful bugs and infections. The immune system of babies with CMA identifies the protein in cows’ milk as being harmful. This produces an allergic response, which can present as a wide range of symptoms . Cows’ milk contains 2 types of protein casein and whey . Your baby may be allergic to one or both of these proteins.
Suspected Immediate Allergic Reaction
If immediate cows milk allergy is suspected your GP is likely to arrange a referral to a childrens specialist allergy service for allergy testing and further management. The two tests which help diagnose IgE reactions are a skin prick test and a specific IgE antibody blood test . Usually the information from the allergy-focused history and the tests will be enough to confirm the diagnosis. However, if information and/ or results of the tests are not clear, then an oral milk challenge may be needed to confirm or exclude whether there is an IgE mediated cows milk allergy.
The referral process and waiting times to see a specialist will depend on where you live, and the allergy service and resources in your area. Allergy UKs Helpline on 01322 619 898 can help signpost you to an approved NHS or Private allergy clinic. If you choose not to be seen through the NHS you have the choice to pay to see a private allergy doctor. Whilst waiting for an NHS or private appointment, your GP or Healthcare Professional should advise you on the dietary changes that you will need to start immediately.
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Treatment Of Milk Allergy In Babies
The treatment involves cutting down the source of allergy completely from your babys diet. In case of cow milk allergy, you must stop giving this milk and look for alternatives. For formula milk allergies, your pediatrician will recommend specially formulated milk powders to add to your babys diet. In both cases, you must follow the doctors advice strictly. Your pediatrician may also recommend a dietitian who will recommend a further course of action
If your infant develops serious reactions, the allergist might give your baby an epinephrine injection. Its a life-saving drug to save the infant from severe reactions.
You must get your baby evaluated for allergies once every 6 to 12 months based on your doctors recommendations to see if your baby is able to get rid of the allergies.
Dairy Allergy And Formula
If your baby breastfeeds and takes formula, a cow’s milk-based formula can cause milk allergy symptoms. Milk allergy is actually more prevalent in formula-fed babies. If formula is the cause, you may need to change the brand you use. Soy formula is an option, but it can also cause allergies in about 10% to 15% of infants who are allergic to the cow’s milk protein. A hypoallergenic formula may be used instead.
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What Should I Do If I Suspect That My Child Has Symptoms Of Cows Milk Allergy
The key message: Do not delay in seeking advice from your GP or Health Visitor. They will be able to assess whether the symptoms may be due to milk allergy or there is another cause.
They will listen to your concerns and take an allergy focused history . It may be necessary for the doctor to carry out a physical examination. To get the best from your appointment, it may be useful to write down the answers to the questions below before attending and take them with you for discussion.
- What signs and symptoms have you noticed and are concerned about?
- When did the symptoms first start?
- How long do they last?
- Have you started weaning yet? Any other food eaten, amount and form .
- How has your baby been fed: breast milk, formula, or mixed fed ?
- Do you know or suspect a food is triggering the symptoms?
- How quickly or slowly did the symptoms appear?
- Do such symptoms appear each time the suspected food is given?
- How much of the suspected food does your child need to eat for symptoms to appear?
- Are there any existing allergic conditions or family history of such allergy? .
- Have you tried any medication or dietary changes?
In addition, if you think your child may be showing delayed symptoms, consider keeping a food and symptom diary of all the food eaten and symptoms seen. Listing medications and taking photos or videos of rashes, swelling etc. may also be helpful.