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ARTICLES
Milk Allergy:  The Facts

The following is a free brochure provided by the Allergy Asthma Information Association and published through a grant from the Dairy Farmers of Canada.

Milk allergy results from a hypersensitivity of the immune system to the proteins in cow's milk.  Symptoms can occur within minutes or hours of contact with milk and can range from mild to severe.  For a severe allergy, contact with cow's milk protein must be completely eliminated.  Fortunately, most children eventually "outgrow" this allergy.  Note that lactose intolerance is a completely different condition; see COMPARE! chart for specifics.

ALLERGY/ASTHMA INFORMATION ASSOCIATION (AAIA)
NATIONAL OFFICE:
Box 100, Toronto, Ontario M9W 5K9
Phone (416) 679-9521 or 1-800-611-7011  Fax: (416) 679-9524
Email:

Web site: http://www.aaia.ca

Regional Offices: AAIA BC/Yukon, AAIA Prairies/NWT/Nunavut, AAIA Ontario,
  AAIA Quebec, AAIA Atlantic



BREAST IS BEST
 Plan to breast-feed since it may lessen the chance or delay the onset of a milk allergy.  The nursing mother with a milk allergic infant may find it necessary to limit her own consumption of milk products.

WHEN BREAST-FEEDING IS NOT AN OPTION
Be cautious.  At this time there is no perfect milk substitute on the market ideal for everyone allergic to milk protein.  Some milk allergic children become allergic to soy and goat's milk protein.  The least allergenic substitutes seem to be formulas called "casein hydrolysates" -- Nutramigen, Pregestimil, Alimentum--made from pre-digested protein.  Expect help from your doctor to find a formula suitable for your baby.

SOLID FOOD: WHAT AND WHEN?
Take your time introducing solid food.  When the baby is 4 to 6 months old begin with iron-enriched, single grain infant cereals like rice or barley.  Slowly add pureed single vegetables, except corn, at the rate of one a week starting with a small spoonful.  Move on to pureed fruit, excluding citrus, introducing each in the same manner as vegetables.  Then pureed meat, start with chicken, turkey and lamb, the least likely to cause an allergic reaction.  After the meats, when the baby is at least 12 months, you can try cooked egg yolk which is less allergenic than the white.

DON'T KEEP IT A SECRET
Tell everyone who may have contact with your child about the allergy.  A letter from your doctor explaining the diagnosis may be helpful in convincing skeptics of its seriousness.  Carry prescribed medicines with you at all times and provide your child with a MedicAlert bracelet.  Have your allergist periodically reassess your child.  Remember the good news:  elimination of foods containing milk protein may help bring the allergy to a quick end.

COMPARE!


COW'S MILK ALLERGY
LACTOSE INTOLERANCE
 
cause
abnormal reaction of the immune system to milk proteins 
cause
not enough of the enzyme lactase needed by the digestive system to break down all the milk sugar lactose
age
usually starts in early infancy, rarely after 12 months of age
age
very rare in the first two years of life 
diagnosis
by a qualified medical practitioner based on a detailed history and...possible tests: 
*skin prick test   *blood tests * total IGE or RAST  *food challenge, open or double-blind (not done where this is a history of anaphylaxis)
diagnosis
by a qualified medical practitioner based on a detailed history and...possible test: 
*breath hydrogen excretion after a lactose challenge 
symptoms
can be immediate or delayed, affect 
digestion:
*nausea  *vomiting  *diarrhea  *stomach cramps 
skin:
*hives  *eczema  *swelling
airways:
*runny nose  *nasal congestion  *wheezing  *coughing
anaphylaxis:
rare, acute, sometimes overwhelming reaction of the immune system.  Can be life-threatening.
symptoms
affect digestion only: 
*diarrhea   *vomiting   *abdominal bloating 
*stomach cramps  *gas 
 
 
 
 
 
 
 

 

treatment
*eliminate foods containing cow's milk protein, a very small quantity of milk protein may bring on symptoms 
*breast-feed, if possible for as long as possible (mother may have to moderate her own intake of milk products) 
*use hypoallergenic infant formulas (test for tolerance)
treatment
*symptoms are generally dose-dependent, small amounts of lactose containing foods (ex. 125 mL milk) are often well tolerated 
*hard cheese and yogourt are well tolerated 
*use commercially available lactase (ex. Lactaid drops or pills) when eating lactose containing foods

Some foods that contain or may contain* milk protein:

  • baked goods*, (cake, bread, cookies, crackers, donuts, waffles, pancakes...)
  • butter
  • buttermilk
  • candy*
  • cheese
  • chocolate*
  • cream
  • cream soup
  • curds
  • custard
  • deli meats*
  • egg substitutes*
  • frozen yogourt
  • gravy*
  • ghee
  • Half & Half
  • hot dogs*
  • ice cream
  • kefir
  • margarine*
  • milk (whole, 2%, 1%, skim, condensed, evaporated, powdered, lactose reduced)
  • pizza
  • pudding
  • salad dressing*
  • sausages*
  • seasonings*
  • sherbet
  • sour cream
  • yogourt



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FICTION and FACT

FICTION:
No other animal drinks the milk of another species.  A milk allergy is proof that to do so is out of harmony with nature.

FACT:
A milk allergy results from a hypersensitivity of the immune system to the proteins in cow's milk possibly caused by a genetic predisposition.  Studies show that 2 to 3% of infants are milk allergic and most outgrow it within a couple of years.  If drinking milk was really "out of harmony with nature" one would expect the allergy incidence to be much greater.

FICTION:
Milk causes asthma.

FACT:
There is no evidence that dairy products can cause asthma.  A person with a milk allergy may develop asthma but there is no cause and effect relationship between the two.  Note, an allergic reaction to milk may trigger wheezing, especially in infants.

FICTION:
Milk causes a number of problems like constipation, ear infections and mucus secretion.

FACT:
Constipation is not related to what we eat but rather to what we don't eat.  More foods with fibre (whole grain breads and cereals; dried beans, peas and lentils; fruit and vegetables), more liquids and more exercise are good habits to adopt.
Ear infections are caused by germs.
The feeling of secreting a thick mucus may be linked to not drinking enough of all liquids, including milk.  1.5 to 2 litres of liquid a day is a good rule of thumb.
 
 

FIND A DIETITIAN
Concerned that your child is getting all the nutrients necessary for normal, healthy growth?  A call to the nutrition department at the local children's hospital, the local health unit, the provincial association or college of dietitians will help you find a qualified nutrition professional.  You can also contact Dietitians of Canada on-line at http://www.dietitians.ca.

This is an AAIA publication.  Support the goals and work of the AAIA by becoming a member!

Terms of Use: The information on this site does not constitute medical advice and is for your general information only. We cannot be held responsible for anything you could possibly do or say because of information on this site.   Consult your family physician or allergist for specific questions or concerns.

This article courtesy of the Allergy/Asthma Information Association at www.aaia.ca and the Calgary Allergy Network web site at calgaryallergy.ca. May be reproduced for educational, non-profit purposes.
If you enjoyed this article, help us keep writing them. Show your support by getting an AAIA membership.

 

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