What If Dairy Elimination Doesnt Make My Baby Better
Cows milk protein is the most popular child allergy, but its certainly not the only one. Eggs, peanuts, soy, wheat, tree nuts, fish and shellfish are other common allergies. If youre breastfeeding and a dairy-elimination diet didnt help your baby , your baby might have another allergy. Trying a hypoallergenic formula can at least indicate if babys food intake is the issue. If you notice improvements during a formula trial, you can then decide if you want to continue with formula, or try to identify the allergy through food testing and continue breastfeeding.
Suspected Delayed Allergic Reaction
If delayed cows milk allergy is suspected, skin prick testing and/or blood tests are not helpful. The diagnosis for delayed allergy needs to be confirmed or excluded by starting a trial elimination of all cows milk protein either from you babys diet in the case of a formula fed baby or from your own diet if you are exclusively breast feeding. Those babies who are formula fed need to be prescribed a special low allergy formula .
If it appears that your baby has reacted to cows milk protein coming through in your breast milk, you will need to eliminate all cows milk and all products containing cows milk from your own diet. This trial elimination diet will need to be guided by your GP or healthcare professional. If you are still exclusively breast feeding, your doctor may well wish to refer you to a dietitian to ensure that both your on-going nutritional needs and those of your baby are being met.
In the less common case where the suspected allergy symptoms are considered severe, your doctor will still need to advise starting this elimination diet. However if a clear improvement should be seen in the symptoms your doctor should not be advising any reintroduction of cows milk protein at home to confirm the diagnosis. The diet should be continued and the need for early referral to a childrens specialist allergy service for ongoing assessment and care should be discussed and made as soon as possible.
Food Challenges For Babies With Cma
When your toddler has been on a cows milk protein-free diet for some time and is at least 912 months old, your doctor may request an oral food challenge a process where food is eaten slowly, in gradually increasing amounts, under a doctors supervision to see if they have outgrown a cows milk allergy. You may have done this before when your doctor was assessing your baby for cows milk allergy.
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What You Should Eat
You can have a well-balanced diet even without eating any dairy. You can get plenty of protein from fish, beef, chicken, eggs, nuts and beans. You can use calcium-fortified soy milk, rice milk, almond milk, coconut milk, hemp milk, or fortified orange juice to supply you with 1,000 mg of calcium each day, or you can take a calcium supplement.
You will also want to continue taking a multivitamin. Be sure to read the labels on your vitamins and any medications that you are taking. They may also contain hidden allergens.
It can take a month or more for your babys symptoms to improve. If your baby shows no signs of improvement or his symptoms get worse after a month of the dairy-free diet, you may need to eliminate other foods such as wheat, eggs, soy, peanuts or nuts.
Sometimes babies are allergic to more than one food. You may need to stay on this restricted diet the entire time you are breastfeeding, or until your infant is 1 year old. Many babies outgrow their food allergies by their first birthday.
Breast milk provides important health benefits for your baby including protection from infections and higher IQ scores, and a reduction in chronic diseases such as diabetes and obesity.
Next Steps
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The Good News About Outgrowing Cow Milk Allergy
Many children do outgrow their allergies however, it may depend on what the child is allergic to and the type of allergy they have. Most importantly, keep in mind that all children are different!
Children with cow milk allergy may be more likely to outgrow their allergies than their peanut or tree nut allergy buddies. One research study showed that 80% of kids diagnosed with a CMA will outgrow their allergy by 16 years of age1. More specifically, other research studies have found that about 45-50% of children outgrow CMA by one year, 60-75% by two years and 85-90% by three years.2,3
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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
Hypoallergenic Formulas From Birth To Two Years
Extensively hydrolysed formulas
These formulas contain proteins that have been broken down into smaller segments so they are less likely to cause an allergic reaction. It is important to discuss the best option with your healthcare professional. Examples include:
- extensively hydrolysed formulas based on casein
- extensively hydrolysed formulas based on whey . Some of these may contain prebiotics that promote the growth of good bacteria in the gut and lactose, which improves the taste but may not be suitable for all babies.
Amino acid formulas
These formulas are based on the individual building blocks that make up a protein and are tolerated by most babies with a cow’s milk allergy. Amino Acid formulas are recommended when an extensively hydrolysed formula has either not been tolerated or is not an appropriate first choice.
Soya based formulas
These formulas are not suitable as a first-line alternative for infants under six months of age. In infants over six months of age, your dietitian can advise whether a soya formula is suitable.
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Outgrowing True Milk Allergy
Studies over the past decade, in contrast to earlier studies, suggest that outgrowing milk allergy may not be as common as previously thought, and also occurs later in childhood than was expected.
A 2007 study found based on the most accurate definition of milk allergy found that the percentages of previously allergic children who could tolerate milk at various ages were:
- 19% by age four
- 79% by age 16
When Do Babies Return To A Normal Diet
Most babies grow out of cows milk allergy and can return to a normal diet, consuming cows milk without allergic reactions.
Although cows milk allergy is the most common food allergy in under 3 year olds, the good news is that more than three-quarters of babies with cows milk allergy grow out of it later on in early childhood. When a baby has grown out of cows milk allergy they can consume cows milk without allergic reactions – in other words, they can return to a normal diet.
Most babies with cows milk allergy will be able to consume cows milk without allergic reactions by the time they reach 35 years of age. For uncomplicated non-IgE-mediated cows milk allergy, the majority of babies will return to a normal diet by 3 years of age. For IgE-mediated cows milk allergy, the average age that a baby will be able to return to a normal diet is when they reach 5 years old.
If your baby is diagnosed with cows milk allergy, a healthcare professional will advise you when and how to test whether they have started to grow out of their allergy. In the meantime, suitable dietary changes would be advised by a healthcare professional to manage the allergy.
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What Is Lactose Intolerance
Your child may have a different type of reaction to cows’ milk, or formula made from it, called lactose intolerance. This is when their body can’t digest lactose, which is a type of natural sugar found in milk.
About 70% of people in the world have lactose intolerance. It’s more common among people from Asian, African, and Hispanic ethnic groups.
Babies and young children can also become temporarily intolerant to lactose after they’ve had a tummy bug or another condition.
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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Milk Protein Allergy: What Are My Formula Options
Cows milk protein allergy is one of the most common food allergies in infants1 and it often presents with diverse and non-specific symptoms, making it challenging to diagnose. Up to half of all babies with CMPA will outgrow it after just 1 year, over three quarters will outgrow CMPA after 3 years, and nearly all babies with CMPA. CMA Breastfeeding . Milk protein allergy. Cows Milk Allergy. Or MSPI . Whatever you want to call it. They all mean the same thing. What it means is that your babys immature digestive system has a difficult time digesting the proteins found in dairy milk and soy The good news: About 80 percent of children outgrow the milk protein allergy by the time they are 16. Diagnosis and Treatment To diagnose a cows milk allergy, your doctor will talk with you about your childs medical and family history and symptoms
Cow’s Milk Allergy In Infants
Cow’s milk is an important source of energy, protein, vitamins and minerals for the growing child. If your child is allergic to cow’s milk, it is very important to replace it with a milk alternative that will provide the same nutrition.
A wide range of cow’s milk alternatives are available on prescription for younger children and over-the-counter for older children.
It is important that you discuss the available options with your childs doctor, health visitor or dietitian to ensure they get the best choice for them.
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What To Expect From Your Lactose Intolerant Babys Poop
Loose, watery stools – diarrhoea, are common in babies with lactose intolerance. But loose poos can mean other things, too. So if your baby starts having runnier poo than usual, this doesnt necessarily mean that they’re lactose intolerant.
Remember that its not unusual for newborn babies to have the odd runny poo. Every baby is different when it comes to their pooing habits, both in terms of frequency and consistency, not to mention smell. Once you get to know their particular toilet habits, youll know whats normal, and whats not so normal, for your baby.
How Common Is Cows Milk Allergy In Infants
Only 0.5% of exclusively breastfed babies are affected, and the symptoms are usually mild or moderate. This is one reason breastfeeding exclusively is recommended by experts for the first 4 to 6 months of a baby’s life.
It is thought that infants who have a family history of allergy are more likely to have a cows milk protein allergy. The same goes for infants with eczema and asthma. Those with asthma can have severe reactions, especially if their lung disease is poorly controlled.
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If Your Child Has An Allergic Reaction
If your child has symptoms of an allergic reaction, follow the food allergy action plan your doctor gave you.
If your child has symptoms of a serious reaction :
- Give the epinephrine auto-injector right away. Every second counts in an allergic reaction.
- Then, or take your child to the emergency room. Your child needs to be under medical supervision because, even if the worst seems to have passed, a second wave of serious symptoms can happen.
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
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When A Child May Outgrow A Milk Allergy
Although serious, a milk allergy diagnosed in infants is most often not permanent. In fact, many babies outgrow a milk allergy by the time they are one years old, and most children outgrow a milk allergy by three years old. Some may not outgrow a milk allergy until five years old, and other children wont outgrow it at all.
To know if your child has outgrown a milk allergy, revisit your doctor. They may perform some of the same tests used to diagnose the milk allergy to confirm the diagnosis. These could include an allergy skin test, blood and stool tests, and/or an oral test. During an oral test, your doctor would have your child consume milk under observation and wait a few hours to see if they exhibit any symptoms.
Milk allergies in babies are serious and the symptoms can be severe so always consult your doctor before reintroducing milk and dairy products into your childs diet.
How To Treat A Milk Allergy Or Lactose Intolerance
Unfortunately, a milk allergy cannot be treated. However, like other toddler seasonal allergies, symptoms can be completely abated as long as the allergen is avoided. Today, all food makers are required to clearly state on package labels whether foods contain milk or milk-based products, making our job as parents to protect our children from potentially harmful ingredients much easier.
Early on in your childs life, avoiding milk and dairy will be completely up to you. If you are still breastfeeding, your doctor will have you eliminate dairy from your diet and may suggest removing other potential allergens from your diet as well. As you wean your child, you may want to choose a fortified formula to help supplement their diet with essential nutrients. At this time, its critical to choose a dairy-free option. Consult your pediatrician to find the best option for your child with allergies.
As your child grows, continue to feed them a dairy-free diet. Your child will be able to get everything they need from nutritious whole foods even with dairy out of the mix. Withhold giving your child any cows milk or dairy products until your pediatrician suggests it may be safe and then do so only under careful observation.
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Can An Infant Outgrow Cows Milk Allergy
Most children will outgrow cows milk allergy.
Studies show that most children with non-IgE-mediated reactions will outgrow cows milk allergy by the time they are 3 years old.
For children with IgE-mediated reactions, studies show that about half of these children will outgrow cows milk allergy by the time they are 5 years old. Evidence suggests that a cows’ milk protein allergy is more likely to persist in these children if they have asthma or allergic rhinitis, or if they have more severe reactions or higher milk-specific IgE antibody levels. Even so, its rare for adults to have a cows milk allergy.
What About Lactose Intolerance
A lactose intolerance is actually quite different from a milk allergy. A lactose intolerance is a digestive system issue, but a milk allergy is a response from the immune system. Lactose intolerance is defined as the inability to digest the naturally occurring sugar in milk, lactose. While a milk allergy onsets early in life and is typically outgrown, a lactose intolerance onsets later in childhood or adolescence and typically progresses as levels of lactase, the enzyme needed to properly digest lactose, naturally decline. In some rare cases, babies are born without lactase and thus are lactose intolerant from birth.
In other cases, lactose intolerance may be a symptom of something else. For instance, if your child experienced an infection or was diagnosed with celiac disease , his or her digestive tract may be irritated and unable to digest lactose for the time being. As your childs digestive tract heals from damage or irritation, though, they will likely become tolerant of lactose again.
Signs of lactose intolerance in kids include abdominal pain, cramps, gas, diarrhea, and bloating. While less severe than milk allergy symptoms, these symptoms can cause extreme discomfort and should be addressed.
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