In most cases, a new mom dealing with a fussy new-born has suspected that her suffering sweetheart must have a cow's milk allergy or intolerance, especially when well-intentioned friends and relatives are also blaming milk.
If you're breastfeeding or exclusively pumping, you may assume it’s the dairy in your diet that’s causing your little one to wail; if you’re formula feeding, you assume it’s the cow’s milk in the infant formula that’s causing the trouble.
Although it is one of the more common allergies in infants, milk allergies still only affect an estimated 2 to 3 percent of babies. Confusing the issue further is that many people are unaware of the differences between a milk allergy, an intolerance to milk and lactose intolerance.
To clear the confusion, here’s the breakdown on milk allergies and intolerance in breastfed and formula-fed babies.
What Is a Milk Allergy?
The infant formulas that are sold in stores are made from cow’s milk but have been adjusted to make the protein easier for infants to digest. Milk sugar (lactose) is added to equalize the concentration, and this ingredient is like that found in breast milk.
Vegetable oils and other essential fats are added to make the formula easily digestible. Other nutrients—vitamins and minerals such as iron, vitamin D, and calcium—are also added to baby formulas to meet the nutritional requirements for babies to grow.
Babies with milk allergies are allergic to the proteins in cow's milk—casein and whey. The condition is called cow's milk protein allergy (CMPA).
How Milk Allergies Affect Babies
A milk allergy (from cow's milk) is the most common food allergy in young children and infants. Many children outgrow the allergy, but some do not. Cow's milk allergy is also common among adults.
When a child has a milk allergy, the proteins in the milk stick to certain antibodies that are created by the immune system. The symptoms produced by the immune defences that cause the reaction can be mild or severe.
Cow's Milk Allergy Symptoms In Babies
If your baby’s allergic to cow’s milk, they’re likely to have a reaction to formula which is made from cows’ milk. Sometimes, but very rarely, your baby may react to your breast milk if you’ve recently consumed dairy products.
Symptoms to look out for include:
A red itchy rash (cow’s milk allergies and rashes on babies are very common).
Swelling of the lips, face and around the eyes.
Tummy ache.
Vomiting.
Colic.
Diarrhoea or constipation.
Hay fever-like symptoms (such as a runny, blocked nose).
Eczema.
You should consult your health visitor or doctor if your baby is affected in two separate areas of the body – for example, the stomach (vomiting) and skin (hives), and if they have more than one of the symptoms listed above.
Milk Allergy Or Milk Intolerance?
I some cases babies can either be allergic or intolerant to milk. Because some of the symptoms are similar, it can be difficult to diagnose. Not to mention confusing!
A milk allergy involves an immune reaction to one or more of the proteins present in milk, whereas an intolerance does not involve the immune system.
An intolerance is caused by an inability to deal with certain substances in milk, such as lactose. Lactose intolerance occurs when you don't produce any or enough of the enzyme lactase, which breaks down lactose. Undigested lactose causes uncomfortable symptoms like diarrhoea, bloating and wind.
What Are The Symptoms Of Lactose Intolerance In Babies? Symptoms of lactose intolerance in babies include:
Gas
Diarrhoea
Bloated stomach
Spitting up
Irritability, crying or other colic symptoms
Failure to thrive and gain weight
Recognising The Signs Of Milk Allergy And Intolerance In Babies From stomach cramps to sickness and diarrhoea, there are many similarities between the symptoms of a cows’ milk intolerance and a cows’ milk allergy. What’s more, the names of these conditions are often used interchangeably, and not always correctly.
Knowing how to recognise the difference can help get a quicker diagnosis and lead to an effective dietary management programme. If you're breastfeeding, this will be done by looking at your own diet and making any necessary changes. If your baby is formula fed, there are specialised formula milks to help with the dietary management of cow’s milk allergy symptoms.
Diagnosis and Treatment of Milk Allergies in Infants
Your child's doctor can find out if they are allergic to milk. They will ask you questions and examine your baby. They might also want to test samples of their blood or poop.
You might be referred to an allergist—a doctor who specializes in diagnosing and treating allergies. They will ask you detailed questions about your baby's eating habits and symptoms (including how long they have been happening).
An allergist might do an allergy skin testing to milk and, if necessary, an oral food challenge. For this test, the allergist will have your baby consume a small amount of milk or milk powder, then watch to see if there is a reaction.
The doctor might also use a blood test or skin prick test to look for immunoglobulin E antibodies. For this test, the doctor will place a sample of milk on your child's skin and then prick the area to allow the substance to enter the body. If there is a reaction within 10 to 20 minutes, it indicates an allergy. Sources:
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