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.
Cows Milk Allergy Usually Resolves
Around 80% of children will outgrow their cows milk allergy by the age of three to five years. Your doctor should advise if further allergy testing and food allergen challenges are needed. These are usually performed in hospital clinics and supervised by a clinical immunology/allergy specialist.
ASCIA is the peak professional body of clinical immunology/allergy specialists in Australia and New Zealand.
ASCIA resources are based on published literature and expert review, however, they are not intended to replace medical advice. The content of ASCIA resources is not influenced by any commercial organisations.
For more information go to www.allergy.org.au
To donate to immunology/allergy research go to www.allergyimmunology.org.au/donate
Managing Your Childs Cows Milk Allergy
When your baby is diagnosed with a cows milk allergy, its only natural to feel worried. But once you know the cause of your babys symptoms, you can take positive steps to keep them healthy.
Your GP will discuss the options for management with you, and you may be referred to a dietician to look at the foods your baby is eating6.
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Milk Allergy Or Lactose Intolerance
Milk or dairy allergies and lactose intolerance are not related.
People with a milk or dairy allergy experience symptoms because their immune system reacts as though milk and other dairy products are a dangerous invader. This reaction can cause hives, an upset stomach, vomiting, bloody stools and even anaphylactic shock a life-threatening allergic response.
Individuals who are lactose intolerant cannot digest the sugar in milk because they have a deficiency of lactase, an enzyme produced by cells in the lining of the small intestine. Lactase is required to metabolize lactose. The lack of this enzyme which sometimes can just be temporary, due to infection causes symptoms such as abdominal gas, diarrhea or abdominal cramps.
If you suffer digestive problems after eating or drinking dairy products, try tracking your diet and noting how your body reacts to the items you consume. You may also try temporarily cutting dairy products milk, cheese and yogurt, for example from your diet and see if your symptoms improve. Report the results to your allergist, who can do testing typically, skin testing to confirm a diagnosis.
This page was reviewed for accuracy 3/21/2019.
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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Feeding And Milk Allergies
Managing a cows milk allergy involves removing all cows milk from your babys diet.
When introducing solid foods to a baby with a milk protein allergy, you’ll need to get familiar with reading food labels and ingredients, as milk can be found in unlikely places. Whilst this might seem overwhelming at first, keep in mind that food labelling laws are there to help you, and common allergens, like milk, must be declared on pre-packaged foods.
Is My Baby Lactose Intolerant
Image credit: flickr Jules Morgan CC BY 2.0
If your baby is sensitive to dairy products it is highly unlikely that the problem is lactose intolerance, although many people may tell you so.
See Is my baby lactose intolerant? for more information.
Although cows milk protein sensitivity and lactose intolerance are not the same thing, they can sometimes occur at the same time, since food allergy can cause secondary lactose intolerance.
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Cows Milk Allergy And Breastfeeding
Breast milk is the best form of nourishment for your baby, even if theyve been diagnosed with a cows milk allergy.
While cows milk protein can pass into breast milk from your diet, most babies with a cows milk allergy can tolerate it. In rare cases, babies do react to the cows milk in their mothers milk. If this happens, your healthcare professional or doctor may advise you to avoid all dairy products to see if this makes a difference to your babys symptoms.
Diagnosing A Cows Milk Allergy Or Lactose Intolerance
If you have discovered a possible milk allergy or intolerance in your child, speaking to your pediatrician is the first point of action. There are a number of reasons, including other common food allergies, that could be causing the side effects youre seeing.
Your Pediatrician may perform a skin test or observe your childs behaviour and symptoms to diagnose him or her appropriately. They will likely prescribe an elimination diet that may start with eliminating cows milk and other dairy products from your childs diet. If the signs of a cows milk allergy in your toddler or infant dont go away, your doctor may also recommend eliminating other common allergens such as soy and eggs.
With a breastfed infant, you will need to cut cows milk, dairy, and perhaps other foods from your diet so you dont pass them on. If you are formula feeding or your child is at the age where they are consuming real foods, youll be in charge of eliminating these products from their meals and supplementing them with a dairy-free formula and/or dairy-free milk.
Of course, if you are breastfeeding, and dont consume much cows milk, you may not notice a cows milk allergy or intolerance until your child reaches the age where they are old enough to drink cows milk on their own. If you begin to see dairy allergy symptoms in toddlers, or signs of an intolerance, swapping cows milk for a dairy-free alternative is essential.
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Milk Allergy In Babies
Milk allergies happen in 2 to 3 percent of children under age 3. Some risk factors for a cow’s milk allergy include having other allergies, having atopic dermatitis, and having a family history of milk allergy.
If your baby is allergic to cow’s milk, your doctor will have you switch to a specialty formula . If your baby is breastfed, you’ll need to eliminate milk and dairy from your diet for as long as you’re breastfeeding.
As your child grows, you’ll want to be careful to avoid giving them any food with milk in it, like yogurt, butter, cheese, ice cream, and powdered or condensed milk. All allergens must be clearly marked on food products, so read labels carefully.
Allergic reactions can happen within minutes of having cow’s milk, or they can take a couple of hours. Reactions can range from mild to severe.
If your child has a milk allergy, keep two epinephrine auto-injectors on hand in case they have a severe reaction. Even if they usually have a mild response, they could have a severe reaction one day and it’s best to be prepared.
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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Information On Specific Food Allergies & Elimination Diets
Elimination Diets
- Allergy Elimination Diet: More calcium info and lists of foods/ingredients to avoid while on an elimination diet .
- The Elimination Diet from AskDrSears.com
Various allergies
- The Food Allergy and Anaphylaxis Network FAANs mission is To raise public awareness, to provide advocacy and education, and to advance research on behalf of all those affected by food allergies and anaphylaxis. Tons of information here.
- Veggies Uniteyour online vegetarian resource guide, has lots of vegan recipes very useful if you are avoiding dairy, eggs, etc.
Cows milk products
- The No Milk Page. A list of links for people who must be cautious about consuming milk and milk byproducts.
Corn
- Avoiding Corn by Ephraim Vishniac. Information on determining whether you have a corn allergy and on corn-derived ingredients that should be avoided by those with corn allergy.
Food additives
- Food Intolerance Network by Sue Dengate, BA. Dip. Ed.
- Tartrazine info
Wheat
- Wheat allergy diet from Lucile Packard Childrens Hospital
Why Professional Advice Is Best
As weve already stated, a cows milk allergy can be difficult to diagnose given the variety of symptoms and potential causes. In fact, whilst the actual incidence of cows milk allergy is only 27.5%113, its estimated that up to 15% of babies may show symptoms that suggest a cows milk allergy might be at play.
As such, its important that you dont self-prescribe or make any significant changes to yours or your babys diet without the advice of a doctor.
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Cows Milk Allergy Is Uncommon
According to a special communication published in JAMA Pediatrics, while 14% of babies are reported to have cows milk allergy, only about 1% actually do have it.
As for the diet restrictions for breastfeeding mothers, the authors report that those are likely not necessary, even if there is an IgE-mediated allergy. So many mothers are putting their nutrition at risk, or stopping breastfeeding, for no good reason.
Its also worrisome that in 81% of the published guidelines on cows milk allergy, the authors of the guidelines reported a conflict of interest with formula manufacturers. This does not mean that the guidelines arent good or accurate, but its troubling that the formula manufacturers are supporting so much of the research.
If your baby has been diagnosed with cows milk allergy, and you have changed your babys diet or your own, dont stop these changes without talking to your childs doctor. But definitely talk to the doctor, and be sure that you understand exactly why your baby has the diagnosis and whether any further evaluation makes sense.
Follow me on Twitter @drClaire
About the Author
Claire McCarthy, MD, Senior Faculty Editor, Harvard Health Publishing
How Is Allergic Colitis Diagnosed
If your baby is extremely irritable and you notice vomiting and gassiness, it’s a good idea to make an appointment to see a pediatrician. The doctor will check for blood in your baby’s stool. This might be blood that can only be seen through a microscope. If blood is found, the symptoms are most likely caused by an allergic reaction.
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What If A Specific Food Appears To Be A Problem
If you think your baby is reacting to a particular food, then eliminate that food from your diet for 2-3 weeks to see if babys symptoms improve. If babys symptoms do improve, then this food may be a problem for your baby. Eliminating a food for less than 2-3 weeks may not be effectivecows milk protein, for example, can persist in moms body for 1½ 2 weeks, and it may be another 1½ 2 weeks before the protein is out of babys system.
Babys symptoms will usually begin to improve within 5-7 days of eliminating a problem food. Your baby may not improve immediately, however, especially if the reaction is to a food that has been a regular part of moms diet. Some babies seem to feel worse for about a week before symptoms begin to improve. Sometimes it takes several weeks to see an improvement.
One way to confirm that a particular food is a problem for your baby is to eat that food again to see whether baby has the same reaction. The more severe your babys original symptoms, the longer you may wish to wait before reintroducing it into your dietfor a very severe reaction you may not reintroduce the food at all. If you reintroduce a food and your baby does not have the same reaction as before, then baby is probably not sensitive to that food. If he does react in the same way, you will want to limit or avoid this food for a time until baby is older or in some cases until baby has weaned.
How Is A Milk Allergy Diagnosed In A Child
If you decide to take your child to the doctor in order to find out if he/she has a milk allergy, the doctor will start by asking you a number of questions about what is going on.
The doctor will ask for a description of symptoms before then examining your baby. To do this, the doctor may have to perform a blood test or take a stool sample.
In some instances, your doctor might even refer your child to an allergist that specializes in allergies.
From there, the allergist might carry out some skin tests. This is a simple test that wont cause your baby any harm.
For the skin test, a doctor or nurse will put a small bit of milk protein on your babys skin . If your child reacts to the allergen, the skill will start to look like a small insect bite.
If your baby is found to be allergic to milk, appropriate action and treatment will be provided.
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What Is The Milk Ladder
Your doctor or dietitian may recommend gradually reintroducing cow’s milk products into your baby’s diet when they are a year old. This process is often called the ‘milk ladder’ and involves introducing your baby to specific foods that contain cow’s milk. The process can be used in children who have had skin or gastrointestinal problems.
However, it is important not to attempt to reintroduce cow’s milk to your baby at home if they have previously suffered from breathing problems or floppiness after consuming dairy.
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 their 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.
Your child can usually eat:
- 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.
Your child should be careful about eating:
- milk ice-cream and milk desserts
- cream cheese, processed cheese and cheese spread
- instant mashed potato and vegetables with added milk or white sauces.
You or your child should check the ingredientsin:
- biscuits, cakes and cake mixes
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How Is A Milk Allergy In Infants Diagnosed
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 babys stool, a discussion your family’s history of allergies and/or a skin-prick test.
If your doc thinks your baby may have a milk allergy or intolerance, then youll probably be asked to eliminate milk from your diet or switch to a different formula to see whether your newborns symptoms improve.
After your baby has been cows-milk-free for about a week, the doctor may have you reintroduce cows milk to see whether your little one has a reaction to it.
Dietary Restrictions For Cows Milk Allergy Should Be Supervised
Exclusion and reintroduction of cow’s milk and other dairy foods should only be undertaken with advice from a medical specialist , particularly in cases of anaphylaxis. If long-term exclusion is required, an alternative source of calcium and protein is needed, to ensure adequate nutrition and growth.
Excluding foods from the diet during breastfeeding is rarely required, and if recommended, the maternal nutritional intake should be supervised, assessed and reviewed by a dietitian. Assessment and review by a dietitian is also recommended for babies and children who need to exclude cows milk and other dairy foods.
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