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Cow's Milk Allergy
cow's milk allergy affects about
1 in 30 babies during their first year
A condition that can show up in many different ways, cow’s milk allergy sometimes looks a lot like other common baby issues, such as colic, reflux, or loose stools. If your baby has eczema, cow’s milk allergy or other food allergies are more common.
an individual and a spectrum condition
Immediate reactions tend to be more severe and persisting, with eczema, rashes, and sometimes breathing difficulties. Medical attention is needed for those immediate reactions, and allergy testing can be helpful. Delayed reactions can occur soon, several hours or even days after having cow’s milk or products. These delayed reactions often affect the tummy and sometimes the skin. You might notice symptoms like loose, smelly, mucous or bloody stools, constipation, tummy pain, vomiting, reflux, or your baby may not want to feed. The wide range of symptoms can be bewildering to understand what’s happening for your baby. And symptoms of both types of reactions can be present, varying from mild to moderate, to severe and persisting. Tummy troubles in particular, causing discomfort, can make feeding more challenging and affect your baby’s growth.
lactose intolerance is a digestive issue, not a food allergy
It’s important to know that Cow’s Milk Allergy and Lactose Intolerance are two different conditions. They can look very similar but the causes and management are different. In Cow’s Milk Allergy, an immune response, symptoms will improve when milk proteins are completely removed from your baby’s diet. For breast feeding mums, whose baby has delayed reactions, maternal avoidance of dairy can be helpful, and nutritional support is often needed. For the severe and persistent immediate reactions, there is no benefit from maternal avoidance of dairy.
maternal dairy exclusion has no effect on lactose-content of breast milk
A maternal exclusion of dairy has no effect on the lactose content of breast milk, which remains steady, as a valuable component of gut health in infants. It helps colonise favourable microbes such as bifidobacteria in the gut; increases the absorption of key nutrients like iron and calcium and encourages lactase persistence – the enzyme needed to digest lactose. In young infants, high volume, lactose-rich fore milk is dominant. Frequent feeding is needed at this time, but it’s important to balance this up the high-volume fore milk, by feeding for long enough to get to the rich and creamy hind milk. This gives a balanced and nutritious feed. A relative lactose intolerance, with characteristic colic and frothy green stools can result from too much foremilk in young babies. This is a common feeding issue and can be managed easily by tweaks to the feeding routine.
active allergy management
A child’s symptoms can vary hugely, with mixed immediate or delayed reactions. Symptoms can show up in the gut, skin and respiratory tract, sometimes all three of those target organs. However, 90% of infants who present with delayed reactions to cow’s milk, are able to drink cow’s milk by age 1. Active allergy management means using careful planning with earlier weaning, dairy exclusion for 3-6 months, planned early introduction of other allergens, weaning to a dairy free diet, and a stepwise introduction of cow’s milk products from around 9 months of age.
lactose intolerance in older children
Lactose intolerance and cow’s milk allergy can certainly co-exist in infants, most likely associated with a nasty gut infection. This can temporarily limit or stop lactase enzyme activity, usually produced the sensitive lining of upper gastro-intestinal tract. It may also develop following illness or surgery that affects the gut lining. A lactose-free diet gives the intestines time to heal, and lactose can be slowly reintroduced, according to tolerance. There is another aspect to consider as children grow, and lactase enzyme activity can naturally reduce, as it often does in ethnic groups. Children of Asian, African, or Indian descent are more likely to lose lactase enzyme activity beyond childhood, and this is due to evolutionary practices, when children stopped drinking milk after early childhood.
my support
I offer personalised support for families managing cow’s milk allergy, helping you from diagnosis right through to safely reintroducing milk. I’ll take a detailed allergy-focused history, observe feeding where needed, and provide breastfeeding and nutritional advice to support both you and your baby during milk exclusion. I can guide you through early introduction of food allergens, and weaning onto a milk-free diet. I also can advise your GP on suitable changes to prescriptions for specialised formulas, and you on suitable milk-free products for your baby. My aim is to make the process clear, reassuring, and tailored to your baby’s needs. Take a look at the Cow’s Milk Allergy Management below.
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