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What Causes Milk Allergy In Infants

Points De Repre Du Rdacteur

Cows Milk Protein Allergy in Infants – Dr. Aliza Solomon
  • Lallergie aux protéines du lait peur survenir durant lallaitement au biberon ou durant lallaitement maternel, habituellement avant lâge dun an. Les manifestations initiales peuvent être cutanées , mais elles peuvent aussi être dordre respiratoire, digestif ou nutritionnel. Certains nourrissons présentent dabord des pleurs irréductibles et refusent toute nourriture.

  • Lhistorique permet de soupçonner une allergie aux protéines du lait. Les investigations possibles incluent la provocation alimentaire, le prick-test, la mesure du taux sérique des anticorps IgE spécifiques et lépidermoréaction.

  • Le traitement cherchera principalement àéviter lallergène tout en maintenant un régime nourrissant et équilibré, pour le nourrisson comme pour la mère lallaitement au sein peut être poursuivi si la mère évite les allergènes. Le poids du bébé doit être étroitement surveillé.

  • Lallergie aux protéines du lait peut être traitée avec succès en soins primaires avec le soutien dune diététicienne les autres spécialistes ne devraient être consultés quen cas dallergie sévère ou déchec du traitement standard et quand des tests dallergie spécifiques sont indiqués.

Can You Randomly Be Allergic To Milk

In response to this question, Lactose intolerance will not happen as a result of exposure to the amino acid, and you will be able to develop it over time. Crohns disease is one such medical condition that may be responsible for lactose intolerance in some people. Some cases develop without a specific cause underlying them.

How Long Does Milk Protein Allergy Last In Babies

If you think your baby may have a milk protein allergy, its important to seek treatment as soon as possible to avoid severe illness later on. A small number of children may have long-term milk protein issues. But most outgrow the condition by the time they reach 18 months to 2 years old, Dr. Goldman says.

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General: Low Or No Weight Gain Or Failure To Thrive

Most infants double their birth weight by six months and triple it by 12 months. Each dot on a growth chart is a percentile. The dots form a growth curve that shows a pattern of growth relative to the population. A childs head circumference, weight, and height generally follow a consistent trend over time.

Sometimes though, slow weight gain may lead to a diagnosis of Failure to Thrive , which is one of the symptoms of a cow milk allergy. Slow weight gain is gaining weight more slowly than other children the same age and gender.

Many factors contribute to slow weight gain, and often several factors are at play. Food allergy reactions can cause problems digesting or absorbing food, leading to failure to thrive. For example, babies may not get the nutrition they need because of excessive diarrhea or vomiting. The body may not get all the nutrients needed, which can mean they cant grow as quickly as they should.

As always, ask your childs healthcare professional if you are concerned about your childs weight.

Should I Keep A Food Diary

Milk Allergy in Infants

If you are breastfeeding and see blood in the baby’s poop , you can record what YOU ate in the last 48 hours leading up to the event. If there has not been a diagnosis made yet, it will help identify the culprit proteins. If your baby has received a diagnosis and a symptom recurs, a food diary will help determine if the problem was accidentally eating dairy protein or if a new food protein is causing symptoms.

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How Common Is Milk Allergy In Babies

Milk allergy is not very common in babies. Only two to eight per cent of babies under the age of one year are allergic to milk. The allergy corrects itself in most cases by the time the baby is three years old, but it can last up to six to eight years in some cases. Rarely, the allergy continues up to adulthood.

Can Milk Allergy Also Cause Dairy Allergy

Yes. Milk allergy is not just allergy to liquid milk, but also to other milk or dairy products. Milk proteins are found in some non-dairy, packaged products. The following is the list of products to avoid when the baby has a milk allergy :

  • All dairy products including cheese, cottage cheese, butter, yogurt, ice cream, and milk desserts like custard
  • Foods containing casein, whey, and lactose
  • Creams and sour creams
  • Baked products, especially milk bread
  • Canned fish it often contains added milk proteins for better taste

Always check the labeling of the food you purchase to prevent accidental exposure to milk proteins.

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Are There Different Types Of Cow Milk Allergy

Yes. Cow milk allergy can be IgE mediated, non-IgE mediated or a mix of both.

IgE allergies are the classic allergies we think of when babies get hives/rashes and experience difficulty breathing after eating something. This allergy can be tested for with skin prick testing . These allergies are the ones that might need an epinephrine pen, steroid medicines, or Benadryl to manage. Reactions occur within minutes after drinking cow’s milk.

Non-IgE mediated cow milk allergy, on the other hand, is not driven by IgE but is considered a delayed hypersensitivity reaction. There is no risk of associated breathing problems or anaphylaxis with this type of allergy however, many babies experience vomiting and/or blood/mucus in the stool. It is called a delayed hypersensitivity reaction because the symptoms don’t occur immediately but can take up to 48 hours . The remainder of the talk will be about the non-IgE mediated cow milk allergy .

What Causes Milk Allergy In Babies

New guidelines will help babies with milk allergies

The causes of milk allergy are not known.

The physiology of the condition is that when food passes into the small intestine, the immune system mistakes it to be a foreign body and attacks it, causing an allergic reaction.

Genetics and environmental factors seem to be the fundamental cause of food allergies , while other factors increase an infants risk of developing milk allergy.

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What Are The Signs & Symptoms Of Hives

The hallmark red raised welts are the main sign of hives. The welts can:

  • have a pale center
  • change shape and location in a matter of hours
  • be tiny or as big as a dinner plate
  • itch, sting, or cause a burning sensation

Someone who also has angioedema might have puffiness, blotchy redness, swelling, or large bumps around the eyes, lips, hands, feet, genitals, or throat. Other symptoms can include nausea, vomiting, or belly pain.

Rarely, a person with hives and angioedema can also get anaphylactic shock. Signs of anaphylactic shock include breathing trouble, a drop in blood pressure, dizziness, or a loss of consciousness .

How Quickly Can Allergies Be Triggered Through Breast Milk

An allergic individual can react to trigger foods eaten directly almost immediately. But how long does it take for cows milk and other allergens in a mothers diet to affect her breastfed baby? Kelly Bonyata IBCLC says:

Excerpt from

Dairy and other Food Sensitivities in Breastfed Babies, Kelly Bonyata, 2020

Food reactions may occur within minutes, but symptoms in breastfed babies more commonly show up 4-24 hours after exposure. If baby has an acute reaction to a new food, or to a food that mom ate a large amount of, then he will probably be back to normal within a couple of hours. If baby is sensitive to a food that mom eats frequently, symptoms may be ongoing.

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How To Diagnose Formula Allergy

The doctor must be aware of all the signs that the baby is showing and also list any allergies running in the family if any. A child specialist or a pediatrician prescribes a few blood tests, allergy tests, and stool tests for a better examination if the baby develops a formula allergy.

Procedures that the doctor follows to diagnose formula allergy include:

Are There Other Types Of Reactions To Cows Milk

Milk Allergy In Babies: Symptoms And Treatment

Cows milk is made up of three main ingredients protein, sugar, and fat. In cows milk allergy, it is the proteins called casein and whey that usually cause the problem. However, the sugar in milk can also cause symptoms in some. This is referred to as Lactose Intolerance. It is important to understand the difference between lactose intolerance and cows milk allergy and to be aware that the management of lactose intolerance is very different from that of cows milk allergy. There are two types of lactose intolerance.

Primary Lactose Intolerance is the more common form and happens where there are reduced levels of the enzyme lactase in the digestive system. This enzyme is needed to break down lactose sugar found in milk, which the body can then absorb and use. As young children grow up and drink less milk, the amount of this enzyme gradually and naturally decreases. For some children, especially those from Asian or African ethnic backgrounds, this may mean that over time not all the lactose in the diet is broken down. Very gradually tummy symptoms begin to develop when lactose in milk is consumed. These symptoms may include bloating, tummy pains, wind and very loose poos all of which can also be seen in milk allergy. However, this does not usually happen until later in childhood and is very unlikely to occur in young babies, which is the group most likely to show symptoms of cows milk allergy.

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When To See A Doctor

Parents who do not know whether their child has lactose intolerance or milk allergy should ask their doctors. They should consult with their doctors immediately if their child has symptoms of an allergic reaction, including itching, hives, and abdominal pain. Additionally, they should seek immediate treatment if a person presents with symptoms of anaphylaxis, such as:

  • difficulty breathing
  • hives all over the body
  • swelling of face, tongue, and throat

People with a dairy allergy diagnosis should speak with their doctors about preparing an action plan if severe allergic reactions occur. Doctors may also take this time to demonstrate how to use injectable epinephrine.

Can Breastfed Babies Have Milk Allergies

Although it is much more likely that a baby would react to a food he was given directly such as infant formula or dairy produce an exclusively breastfed baby can have an allergy or intolerance to tiny traces of proteins from his mothers diet passing into breast milk. The most common food to trigger an allergic reaction through human milk is cows milk protein12. Less than 1% of exclusively breastfed babies are said to develop allergic reactions to cows milk proteins in their mothers milk3 compared to 1.9-4.9% infants who have CMPA generally4.

What other foods can cause allergies?

In addition to cows milk products, other common allergenic foods include peanut, tree nuts, egg, wheat, soy, sesame, fish and shellfish5 but any food might cause a sensitivity in an individual mother or baby.

What about lactose intolerance?

Lactose intolerance is not the same as CMPA, but a food allergy may cause symptoms of lactose intolerance due to damage to the babys gut affecting the digestion of lactose6 See Lactose Intolerance in Babies for more explanation.

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Causes Of Milk Allergies In Infants

The major cause of allergy from milk in infants is the administration of formula-based milk which contains cows milk protein. Other causes of allergies in infants include:

  • A family history of allergies
  • Giving formula-based supplements for breast milk too early to the baby
  • Some vaccines administered to the baby may also result in allergies
  • The condition at the time of birth, mode of birth, diet plan and nutrition, and changes to the microbiome can also influence allergies

Does My Child Have A Cow’s Milk Allergy

Interventions for Cows Milk Allergy in Children and Infants

What are the signs, symptoms and what to do next?

This factsheet has been written to help you understand and gain some advice on suspected cows milk allergy in babies and children. Cows milk allergy is one of the most common food allergies to affect babies and young children in the United Kingdom. While it mostly affects formula fed babies, breast fed babies can also be affected. Allergic symptoms can happen immediately after feeding or they can be delayed, as explained below.

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What Is Cows Milk Allergy

Cow’s milk allergy is one of the most common food allergies in infancy and early childhood. It is a hypersensitivity reaction to one or more bovine proteins found in cow milk and dairy products.

When a baby is allergic to cow’s milk, their immune system, which normally fights infections, overreacts to one or more bovine proteins in milk. As a result, every time the baby drinks milk or eats dairy products, the body thinks these proteins are harmful invaders this causes them to have a reaction.

CMA is sometimes confused with lactose intolerance. Both can cause problems after drinking milk or eating dairy products, but they are very different and unrelated.

CMA is a reaction to the PROTEIN in milk, while lactose intolerance is a reaction to the SUGAR in milk. Therefore, lactose-free milk would not be helpful for a baby with suspected CMA. Of note, lactose intolerance is typically not found in babies.

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
  • soups

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What To Feed A Baby With Milk Allergy

The following foods are excellent, nutritionally equivalent, substitutes for cow milk:

  • Soy-milk or almond milk formula: Soy-milk formula is manufactured from soy protein that is derived from soybean. Similarly, almond milk is made from the almonds. It is naturally free from milk proteins and thus an ideal alternative for babies with milk allergy. Soy formula is recommended for infants with a clinically-proven milk allergy .
  • Hydrolyzed formula: In this hypoallergenic formula, the milk protein is broken down into smaller amino acid chains that do not elicit an immune system response . The formula can be either partially-hydrolyzed or extensively-hydrolyzed. Consult your babys pediatrician before choosing a hypoallergenic formula.
  • Calcium-rich vegetables: Milk is a good source of calcium for growing babies. However, you can get adequate quantities of calcium from vegetables too. If your baby is a solid food eater, then you can introduce calcium-rich vegetables such as spinach, broccoli, kale, and even carrots in their diet . All green leafy vegetables and beans contain significant quantities of calcium . Most vegetables can be safely introduced to babies at the age of six months.
  • Meat and eggs: Meat contains several micronutrients while eggs are an excellent source of vitamins. Meat, except fish, is safe to introduce at the age of six months. Eggs and fish can be introduced once the infant is a year old .
  • How Is Milk Allergy In Infants Diagnosed

    Milk Allergy

    Milk allergy is diagnosed using the following two methods:

  • Suspected food elimination: After learning about the symptoms, the doctor will ask you to eliminate milk from the babys diet. If the existing symptoms improve and the baby does not display the symptoms again, then it can be concluded that the baby has a milk allergy.
  • Skin prick test: It is also called a percutaneous test. Here a small quantity of diluted allergen, milk protein in this case, is injected into the upper layers of the skin. If the infant is allergic to the substance, then they will display an itchy bump that would develop at the site of injection, thus indicating an allergy. The test is safe, but usually never performed on infants below the age of six months . Since the babies start having cow milk after the age of 12 months, this test can be performed on a baby older than a year.
  • Blood test: A blood test will check for the presence of immunoglobulin E antibodies, which are present in the case of food allergy. Blood test provides accurate diagnosis.
  • Treatment of milk allergy is often the biggest concern for the parents.

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    Foods: What’s Allowed And What’s Not


    • All milks
    • Yogurt, eggnog, milkshakes, malts
    • All beverages made with milk or milk products


    • Wheat, white, rye, corn, graham, gluten and soy breads made without milk or milk products
    • Graham cracker and rice wafers

    Not allowed:

    • Wheat, white or rye breads that contain milk
    • Biscuits, donuts, muffins, pancakes, waffles, zwieback, crackers, saltines that contain milk. There are now several mixes available that do not contain milk. Be sure to carefully read labels.
    • Most commercially prepared breads and rolls contain milk or milk products
    • French toast made with milk


    • Any cereal to which no milk or milk products have been added

    Not allowed:

    • Prepared and precooked cereals with milk solids, casein or other milk products added


    • Meringue, gelatin, popsicles, fruit ice, fruit whip and angel food cake
    • Cakes, cookies and pie crusts made without milk or milk products such as Vegan desserts

    Not allowed:

    • Cake, cookies, custard, pudding, cream desserts or sherbet containing milk products
    • Ice cream, cream pie
    • Scrambled with milk, creamed eggs or egg substitutes


    • Vegetable oil, meat fat, lard, bacon, shortening, milk-free gravy
    • Peanut butter
    • Salad dressing or mayonnaise containing milk, milk solids or milk products
    • Some butter substitutes and nondairy creamers


    • Fresh, frozen or canned fruits and juices

    Not allowed:

    • Any fruits served with milk, butter or cream such as whipped cream

    Meats, fish, poultry and cheese


    Not allowed:

    Not allowed:



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