Cow's milk allergy

Cow’s milk allergy

Cow milk allergy means that you are allergic to one or more proteins found in the milk. Allergy is most common in children younger than one year. Most often the allergy goes away before the child starts school. Some have left the allergy as adults. The treatment is to avoid diets containing cow’s milk.

Cow’s milk allergy is most common in children younger than one year. You may have cow’s milk allergy as an adult, but it is unusual.

Symptoms of cow’s milk allergy

It is common for the allergy to be detected when the baby stops breastfeeding and instead starts with breast milk replacer or fever. Breast milk replacement is also called breast milk replacement. Some children may react the first time they receive breast milk replacement.

It is unusual, but children who are breastfeeding can develop symptoms of cow’s milk allergy by reacting to small amounts of milk protein transmitted with breast milk. This applies if the breastfeeding person eats milk products. 

Usually with several symptoms at the same time

Most people with cow’s milk allergy have several different symptoms at the same time. It is most common to get symptoms from the skin, stomach and intestines. Children with cow’s milk allergy may temporarily become more sensitive to milk during an infection. 

These skin symptoms are common:

  • eczema
  • hives .

These symptoms from the stomach and intestines are common:

  • vomiting
  • diarrhea
  • stomach ache
  • constipation
  • no appetite
  • the child does not gain weight properly
  • blood in the stool .

The child may also have red and itchy eyes. It can sometimes be due to direct contact, that is, the child has got milk on his hands and then scratches his eye. It can also be a symptom of an allergic reaction after the baby has consumed milk.

Symptoms of severe cow’s milk allergy

The child may also get respiratory symptoms. It is not as common as skin, stomach and mouth symptoms. 

Examples of respiratory symptoms in children with cow’s milk allergy:

  • coryza
  • cough
  • asthma
  • difficult to breathe .

Symptoms from the respiratory tract can be signs of severe cow’s milk allergy and it is therefore important to seek care.

Symptoms of cow’s milk allergy in nursing infants

Children who are breastfeeding receive small amounts of cow’s milk through breast milk. The child can therefore get symptoms without having milked himself, but it is unusual.

Symptoms of cow’s milk allergy in children who are breastfeeding can be  eczema ,  blood in the stool  and the child screaming a lot, similar to  colic .

When and where should I seek care?

If you think your child has a cow’s milk allergy, contact a childcare center or email a health center .

Contact a health care center if the child has been diagnosed with cow’s milk allergy and does not feel better despite not receiving milk products.

Call on emergency telephone number for medical advice. Then you can get help to assess symptoms or help with where you can seek care.

If it’s in a hurry

Call on emergency if the child has a severe allergic reaction and is difficult to breathe, gets very tired, gets severe vomiting. It also applies if they become pale and seem taken. 

Investigations

The only sure way to check if a person has cow’s milk allergy is to remove all milk products from the diet and see if the trouble goes away. It’s called elimination. How long the elimination should last is determined together with a doctor.

Most children get rid of their troubles after a few days to a week with a dairy-free diet. Therefore, it is usually sufficient to exclude milk products for two to four weeks to find out if the problems are due to allergies. It can take longer if the baby has stomach problems which causes them to lose weight.

After a while provocation is made

After the elimination, the child should test using milk products again. It’s called provocation. If the problems then return, the diagnosis of cow’s milk protein allergy is made.

Most children with milk allergy quickly regain their troubles when they get milk products again. In some cases, the child only gets back the trouble after having consumed a larger amount of milk for an extended period of time.

The provocation should be done in the hospital if the child has had a serious reaction. This applies if the child has symptoms of the respiratory tract, but also if the child has been generally affected, had repeated vomiting or if the child has had widespread hives.

It is common to wait a few years before a provocation is made if the child has had severe allergic reactions that are clearly due to milk. 

Cow milk ALLERGY TEST

Sometimes the child may have a blood test. This is done to check for IgE antibodies to cow’s milk protein in the blood. It may be helpful for the physician to make a diagnosis, but it is not always possible to rely on the results of the test. If the allergy test is positive and the child gets rid of the trouble of excluding milk products, they are likely to be allergic to cow’s milk protein.

Sometimes a dot test is done. It shows if the child has IgE antibodies in tissues, such as the skin.

Children under one year may have allergic symptoms before there is enough IgE antibodies to show up in a blood test. The body’s immune system can also form antibodies to milk protein without causing any symptoms.

It is common for the child to have IgE antibodies in the blood or tissues for a while after the allergy has healed.

Allergy tests can only show if the child has IgE-mediated allergy

The blood test and the dot test show only if children have IgE antibodies to milk protein. There are milk allergies that cannot be measured by blood tests or dot tests. It is called non-IgE-mediated milk allergy. Since the allergy test only shows if the child has IgE-mediated allergy, the child often has to make a provocation regardless of what the allergy test shows.

Regular examinations and provocations about the child have cow’s milk allergy

Children who have cow’s milk allergy need to be examined regularly to find out if the allergy has healed and if the child is growing properly. You should also have regular contact with a dietician to plan the food. It is especially important if several foods have been removed from the child’s diet.

Provocation every six months if the child has mild to moderate symptoms

Children who have been diagnosed with cow’s milk allergy and who have mild to moderate symptoms may undergo a provocation approximately every six months. This applies up to the age of three. When the child gets older, provocations are made once a year.

Children who have severe allergies may make provocations less common

Children who have severe cow’s milk allergy are usually examined by pediatricians once a year. This also applies if the child has allergies to several other foods. Together with your doctor, you decide when and how any provocation should be done.  

Treatment

The treatment consists of avoiding cow’s milk and products made from cow’s milk such as butter, cheese, yogurt, cream and ice cream.

Do not replace cow’s milk with milk from other animals such as goats or sheep. The proteins in goat’s milk and sheep’s milk are similar to the proteins in cow’s milk and can cause allergic reactions.

Get help from a dietician

There may be cow’s milk protein in many foods, for example in sausages, liver pies and in some bread. Milk in cooked food can sometimes be hidden under another name, such as whey or casein. Take the help of a dietitian when the baby should start eating a dairy-free diet. They can advise on nutritious and dairy-free diets.

Important with a completely dairy-free diet in the beginning

It is important that the baby’s diet is completely milk-free at first. After a while, you can decide together with the child’s doctor to try to have a small number of milk products in foods that are cooked. Boiled milk products may be less allergenic than untreated milk.

When the child begins to tolerate milk, it is common for them to do so step by step. This means that they can first tolerate a small amount of milk products in cooked food and eventually tolerate an increasing amount.  

Breast-feeding

If you are breast-feeding a child with a milk allergy, you only need to remove milk from your diet if the child only eats breast milk and has clear problems.

Formula feeding

Milk is the basis of the usual breast milk replacements and supplements that children usually get. There are dairy-free breast milk substitutes and foals that the child can get if they are allergic. In most cow’s milk free breast milk replacements, milk proteins have been broken down so that they are no longer allergenic.

When the child starts eating more regular food, they can get cow’s milk-free products from grocery stores as a supplement. It can, for example, be gruel and porridge.

Milk-free breast milk replacement at pharmacy

At pharmacies, there are milk-free breast milk replacements to buy. They provide the same nutrition as those containing cow’s milk. If you have a small child who has been diagnosed with cow’s milk allergy, you can get milk-free breast milk replacement printed on the prescription. It is called a food guide. With a food guide, you can buy the milk-free compensation at pharmacies at a discounted price.

Older children may need supplementation

Older children who do not want to drink dairy-free infant formulas, or yeast, may need extra lime. This also applies to older children and adults who drink milk-free drinks such as soy drinks, oatmeal, and rice milk as they do not always contain enough lime.

Lime supplements are taken in the form of tablets. In this case, children who are between six months and six years need about 500 milligrams of extra lime a day, and older children need 750 to 1000 milligrams of extra lime a day.

Some do not need extra lime because they get enough of themselves through the food or through lime-enriched products that are available in grocery stores.  

Extra supplements of fat and vitamin D

Children who do not drink cow’s milk may sometimes also need supplements of fat and vitamin D.

Avoid certain herbal drinks

Do not give soy-based products, such as soybeans, to children younger than 10 months. This is because the child can then have an allergy to soy.

The National Food Agency recommends not to give rice cakes and rice drinks to children younger than six years. This is because rice can contain arsenic that is harmful to children. 

What happens in the body?

In an allergy, the body’s immune system overreacts to a substance that is not really dangerous. The over-reaction can cause the body to react with some or all of the symptoms described in the text above. The substances that the immune system responds to in case of an allergy are called allergens and these are usually proteins. In cow’s milk allergy, one or more proteins in the milk are not tolerated.

Different types of cow’s milk allergy

There are two types of cow milk allergy, both of which are equally common. In so-called IgE-mediated allergy, the body forms much of a certain type of antibody to protein in milk. It is called immunoglobulin E. In this type of cow’s milk allergy, symptoms usually come within an hour. It is common to get stomach upset, diarrhea, vomiting or skin rashes.

The second type of cow’s milk allergy is called non-IgE-mediated allergy. In this type of cow’s milk allergy, the first symptoms usually come to a few hours after the baby has consumed milk, but sometimes the symptoms can last up to a few or a few days. It is common to get symptoms from the stomach and from the skin.

What is the cause of cow’s milk allergy?

It is not known why some people get cow’s milk allergy. The risk is greater if one of the biological parents or a sibling is allergic.

Allergy and intolerance are not the same things

Intolerance to different foods can cause similar symptoms as allergies. In the case of intolerance, it is not the immune system that responds but the reaction proceeds in another way. The most common form of intolerance is  lactose intolerance, which means that the intestine cannot break down milk sugar. Lactose intolerance never produces severe symptoms and is very uncommon in children under the age of six. 

Can I prevent cow’s milk allergy?

It is not possible to prevent or reduce the risk of cows’ milk allergy. 

Cow’s milk allergy in adults

You may have cow’s milk allergy when you are an adult but it is very uncommon. Most adults who are allergic to milk have been there since they were children. People who have an IgE-mediated milk allergy when they become adults often have a more severe allergy.

Adults who are diagnosed with non-IgE-mediated allergy often have gastric symptoms. For example, it can be a problem with swallowing, stomach pain, diarrhea, and constipation. Most have had symptoms for a long time. Some have also had cow’s milk allergy as a child but who went over and then come back. 

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