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When Do Babies Outgrow Dairy Allergy

Likelihood Of Child Outgrowing Food Allergy Depends Of Type Severity Of Allergy

When can a baby get tested for dairy allergies?

Is it possible for children to outgrow food allergies?

Answer:

Some children may outgrow their food allergies. But the likelihood of that happening depends in large part on the type of food a child is allergic to, as well the severity of the allergy.

In people who have a food allergy, the body’s immune system mistakenly identifies a specific food or part of a food as something harmful. When that happens, the immune system releases into the body immunoglobulin E, or IgE, antibodies. The next time the IgE antibodies sense that food, they cause a variety of chemicals, including histamine, to be released into the bloodstream.

Those chemicals trigger the symptoms of the food allergy, such as hives, skin or throat swelling, gastrointestinal problems, or breathing problems. In some people, a food allergy may lead to a life-threatening reaction known as anaphylaxis. Symptoms of anaphylaxis can include the above symptoms as well as severe tightening of the airways , rapid pulse, drop in blood pressure, and/or loss of consciousness. Without emergency medical treatment including epinephrine, anaphylaxis may result in death.

It is possible to have an allergic reaction to almost any type of food. But some foods lead to allergies more frequently than others. Of the common food allergies, milk, egg, soy and wheat allergies are the ones children most often outgrow by the time they are in their late teens.

Nancy Ott, M.D., Pediatric Allergy and Immunology, Mayo Clinic, Rochester, Minn.

Identifying Infant Milk Allergy

Be sure to have your child evaluated by their pediatrician and/or an allergy specialist to ensure your child actually has a milk protein allergy. This is especially important because while 1% of babies have a true milk allergy, upwards of 14% of parents falsely assume their babies have this issue.

This often unsubstantiated worry that the mother’s milk is making their child ill can erode breastfeeding confidence and/or causes a huge, unnecessary disruption in the parent/infant diet.

According to researchers in a 2020 study, “Clinical trials do not provide consistent support for using maternal or infant cows milk exclusion to manage common symptoms in infants without proven CMA. We estimated that for more than 99% of infants with proven CMA, the breastmilk of a cows milkconsuming woman contains insufficient milk allergen to trigger an allergic reaction.”

So, don’t stop breastfeeding because of a suspected or confirmed allergy to cow’s milk protein, unless instructed to do so by your doctor. In fact, as mentioned above, even if your baby does have a milk allergy, you can usually still consume dairy and continue breastfeeding.

Once you eliminate these foods, you may see improvement in as little as a few days. But it can take two to three weeks to see results.

How Is A Milk Allergy In Babies Treated

If it turns out that your newborn is one of the 2 to 3 percent of babies who has a milk allergy, dont despair. Many children outgrow a milk allergy by the time they’re around 1 year old, and the majority of babies with milk allergies outgrow the condition by about age 3.

In the meantime, your child’s doctor may recommend the following:

  • If your baby is formula-fed: Your pediatrician will suggest switching to a different formula. Because many babies with milk allergies are also allergic to soy , the doctor may suggest a hypoallergenic formula with hydrolysate protein, which has milk proteins that are already partly broken down, so its less likely to cause a reaction.
  • If youre breastfeeding or exclusively pumping: 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 last thing you want to think about when dealing with a fussy newborn, but it may very well resolve the issue. If you do eliminate dairy, be sure to talk with your doctor about how to make sure youre still getting enough calcium and other nutrients in your diet.

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Alternative Milks For Babies

Soy protein formula

  • Tolerated by most babies with cow’s milk allergy.
  • Unsuitable for babies allergic to soy.
  • Usually only recommended in babies over six months old.

Cows milk based extensively hydrolysed formula

  • EHF has been treated with enzymes to break down most of the cows milk proteins and it is usually the formula of first choice in cows milk allergic babies.
  • EHF is not suitable for babies who have had anaphylaxis to cows milk.
  • Some EHF brands are available without prescription.
  • An amino acid based formula is usually prescribed if a baby reacts to EHF.
  • Partially hydrolysed formula is not a suitable formula for babies with cows milk allergy as enough allergenic protein is usually present to trigger an allergic reaction.

Rice protein basedformula

  • May be used as an alternative formula to EHF or soy protein formula and continued or changed based on specialist advice.
  • Available without prescription.
  • Should not be used in babies with food protein induced enterocolitis syndrome to rice.

Amino acid based formula

  • AAF is necessary in around one in ten babies with cow’s milk allergy.
  • AAF is usually prescribed when an EHF or soy protein formula is not tolerated.
  • AAF is tolerated by most babies with cow’s milk and soy allergies.

Rapid Onset Allergic Reactions To Cows Milk And Other Dairy Foods

Children Food Sensitivities

Rapid onset allergic reactions usually occur within 15 minutes and sometimes up to two hours after consuming cow’s milk or other dairy foods. Symptoms include one of more of the following:

  • Mild or moderate allergic reactions such as hives , swelling of the lips, face or eyes, stomach pain, vomiting and diarrhoea.
  • Severe allergic reactions include noisy breathing or wheeze, tongue swelling, throat swelling or tightness, hoarse voice, loss of consciousness and floppiness in babies or young children. Anaphylaxis should always be treated as a medical emergency, requiring immediate treatment with adrenaline and calling for an ambulance.

Diagnosis of allergic reactions is usually obvious if symptoms occur soon after consuming cows milk or other dairy foods. This can be confirmed by your doctor after taking a medical history and using allergy tests.

Allergy tests that measure allergen specific antibodies called Immunoglobulin E to cows milk are usually positive for rapid onset reactions. There is no place in the diagnosis of cows milk allergy by unproven tests such as IgG, Vega, kinesiology, Alcat or allergy elimination tests.

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What Are The Symptoms Of Allergic Colitis

While symptoms may not appear until a baby turns 6 months old, most babies show signs within the first two months of life. In most babies, the symptoms are mild, but occasionally may worsen.

A baby with allergic colitis may be extremely fussy, difficult to console, and develop flecks or streaks of blood in the stool. Some infants also have diarrhea and vomiting, and some may show other signs of allergies, such as nasal congestion or eczema. It’s important to remember that allergic colitis falls on a spectrum some babies are much more sensitive to milk protein than others.

Many babies go through a period of reflux in the first year of life, but babies with allergic colitis may have an especially hard time with reflux. Treating the colitis may lead to an improvement in the reflux, but some of the reflux maybe not be related to the allergy process.

Peanut And Tree Nut Allergies

Peanut and tree nut allergies are often studied together because about 40% of children are allergic to both. About 20% to 25% of children naturally outgrow their peanut allergies, whereas only 9% of children outgrow tree nut allergies.

In both cases, having lower IgE levels of smaller wheals on skin prick testing predicted a higher chance of outgrowing the allergy.

Even though peanut and tree nut allergies overlap, outgrowing a peanut allergy does not mean a child will outgrow their tree nut allergies. Each food has to be considered separately.

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Cows’ Milk Allergy In Babies

Cows’ milk allergy , 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 begin within minutes of having cows’ milk
  • delayed CMA where symptoms typically begin several hours, or even days, after having cows’ milk

Milk Allergy Or Lactose Intolerance

Is My Baby Lactose Intolerant?

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.

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Symptoms Of Milk Allergy

The most common symptoms of a cow’s milk sensitivity in a breastfed baby are stomach-related and may include bloody stool. These symptoms could make your baby very irritable or fussy.

The proteins in cow’s milk can cause gas in a baby’s stomach and intestines, which can lead to pain, vomiting, or diarrhea. A food allergy could also cause reflux, symptoms of colic, a rash or hives, swelling, a runny nose, wheezing, and bloody poop. If your child is in pain or has any of these symptoms, call the doctor. These symptoms can also be caused by a variety of other concerns, making it imperative to get a correct diagnosis.

When speaking with your healthcare provider, be as detailed as possible when you’re describing what’s going on with your baby. Keeping a food diary with the timing of symptoms can be helpful. The more information the doctor has , the easier it will be to narrow down the cause of your baby’s discomfort.

What Causes Cows Milk Allergy

An allergy happens when the body’s immune system mistakes a harmless substance — in the case of food, a protein — as a foreign invader and attacks it, much like it would attack bacteria or a virus. This abnormal response releases chemicals that in turn trigger the symptoms associated with an allergy.

Milk contains both casein and whey , and each of these has several different proteins, any of which can cause an allergic response.

A cows’ milk protein allergy can cause different kinds of reactions, depending on the chemicals released, and the allergy is categorized based on these causes:

  • Immunoglobulin E -mediated reactions: The immune system releases histamine and other chemicals in response to cows’ milk protein. The symptoms usually occur within 20 to 30 minutes of consuming the protein, but they can appear up to 2 hours later.
  • Non-immunoglobulin E-mediated reactions: T cells are thought to be the trigger for the symptoms, which appear more gradually, from 48 hours up to a week after consuming cows’ milk protein.
  • Mixed IgE and non-IgE reactions: This is a combination of immunoglobulin E-mediated reactions and non-immunoglobulin E-mediated reactions.

A cows milk allergy should not be confused with lactose intolerance, a condition in which the body cannot produce enough of the enzyme needed to digest a type of sugar found in milk.

Continued

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Treatment With A Dairy

If you do need to eliminate dairy, there are many substitutes for cow’s milk and milk products available. Just look for dairy-free on the labels at the grocery store. Since milk is a known allergen, it must be identified on food labels. Remember that milk can be found in many different products, including soups, salad dressing, and baked goods.

Keep in mind that even though a reaction to cow’s milk is the more common one, soy and nuts can also cause allergies in breastfed babies. Also, you’ll need to be careful that you consume enough calcium from non-dairy sources in order to meet your nutritional needs.

What’s The Difference Between Milk Allergies Vs Lactose Intolerance

Milk Allergy Vs Lactose Intolerance In Babies

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

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Signs Of Milk Allergy In Baby

There are many symptoms of milk allergy in infants, and the time frame for when these symptoms appear will vary. For a formula fed baby, adverse reactions can happen within minutes. Signs of a milk allergy in a breastfed baby will likely show up 4-24 hours after exposure. However, if the breastfeeding mom consumes dairy frequently, the symptoms will likely be ongoing.

What Is A Milk Protein Allergy

A milk protein allergy involves an immune response to ingesting milk protein. This response usually occurs right away after ingestion. A dairy intolerance or sensitivity differs from a true allergy in that an allergy triggers the immune system as well as digestive issues, while sensitivity to milk/dairy only causes digestive problems or discomfort.

Note that a cow’s milk allergy is not the same as lactose intolerance. A baby with an allergy to cow’s milk is reacting to the protein in dairy. Lactose is a type of sugar, not a protein. It’s very unusual for a newborn or infant to be sensitive to lactosean issue that is typically seen in adults or older children. For this reason, if your baby does have a milk allergy, lactose-free dairy products will still cause a reaction.

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Intolerance Vs Allergy: Whats The Difference

Milk protein allergy is the most common food allergy in infants.

But tummy troubles dont necessarily mean your baby has an allergy it could be an intolerance . Thats a common misunderstanding, Dr. Goldman says.

Sensitivity to dairy or soy. This is much more common than an actual allergy to milk and is what Dr. Goldman says she sees most often in her practice. Parents bring in an infant that is irritable and spitting up a lot, and they may see little flecks of blood in the stool.

This is frightening for new parents,but Dr. Goldman says you can easily resolve it by switching to a dairy- orsoy-free formula and avoiding dairy and soy yourself, if you are breastfeeding

Soy protein is similar to cow milk protein and often prompts a similar reaction in children who have this sensitivity, she says.

Milk protein allergy. An actual allergic reaction to milk protein is much less common. During an allergic reaction, an infants immune system sees milk proteins as a foreign material. It creates antibodies against the offending proteins, triggering the release of chemicals such as histamine.

With this cycle going on, your babyis likely irritable and may seem inconsolable. Symptoms may include:

  • Diarrhea
  • Vomiting or excessive spit ups
  • Blood in the stool
  • In severe cases, anaphylaxis, an emergency requiring immediate medical attention and a shot of epinephrine

Around 80% Of Children Outgrow Cow Milk Allergy

How can I know if my baby has a milk allergy?

Fortunately, the general consensus is that around 80% of children with cow milk allergy will outgrow it by 3-5 years of age5. Regular follow up by your medical specialist is important to re-test tolerance of cow milk protein.6

Now, compare that to the studies which show that about 20% and 10%, respectively, of young patients may outgrow peanut and tree nut allergies and approximately 8% of patients who outgrow a peanut allergy will later relapse, meaning the allergy comes back. Additionally, nut-related allergies are typically more severe and more likely to be fatal, which is quite scary!3

For example, if your little one has multiple food allergies, such as both CMA and tree nut allergies, he or she may outgrow the CMA while the tree nut allergy could still persist. Still, outgrowing an allergy to cow milk will expand their diet and improve the quality of life and available foods for your little one.

Now this may be good news/bad news for some families. The good news is that the chance of the cow milk allergy being outgrown is very good. Even if the child has the allergy into their teenage years, they are still likely to outgrow it. The bad news is that some infants with CMA may have it into their early teenage years, and a handful may never outgrow it.

Level of allergens in the blood and how it affects CMA

Our advice regarding the possibility of outgrowing Cow Milk Allergy

References

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