Need help reading labels for dairy allergies? Click here.

Check out “Cody the Allergic Cow: A Children’s Story of Milk Allergies”, a children’s book that tells a beautifully illustrated story about a young cow learning to live with milk allergies. “Cody” helps children learn about milk allergies and how to recognize an allergic reaction. Find out more information here.

The milk allergy is one of the most common in young infants, with 2-3% of children under three years of age allergic to cow’s milk proteins.  It is standard procedure for a doctor to suggest not giving an infant cow’s milk until they are at least 12 months old.  Be careful of giving your child formulas with milk products in them, however, if milk allergy runs in your family.  Many infant formulas that claim to be milk free do in fact have derivatives of milk in them.

Chronic gastrointestinal distress, projectile vomiting and severe diarrhea are all symptoms of milk allergy.  Hives, swelling and other allergic reactions may accompany the reaction.  Breastfeeding is generally the best alternative if allergies run in your family.  If you have already started on formula, you could try a soy based formula or hydrolyzed protein formula instead.  Some of the soy formulas do have a significant amount of iron in them which may also be upsetting to your child. There have been conflicting studies linking soy formula to peanut allergies. It may be necessary to try out several formulas before finding a good match. Watch out for “lactose-free” labels, because that’s not necessarily an indication of a milk-free product.

Because of my son’s other allergies, and because my husband was allergic to milk as an infant, when my son was weaned from breastfeeding, we tried a soy formula.  It turned out that he was allergic to soy just slightly, so we ended up switching him to rice milk at 18 months old.  (Please note that rice milk is not high enough in protein to be considered an acceptable infant formula).  Upon his first allergy testing at 18 months old, we tested for milk allergies and he turned out to be negative!  All that work and no allergy to milk was ever there!

A mother of a child with severe milk allergies suggested these comments on eating out:  Avoid Mexican restaurants (too much chance a drop of grated cheese can cross-contaminate), Italian restaurants (same for parmesan cheese), Chinese (lactose seems to be in a lot of sauces), and breakfast places (too much milk and butter are used on griddles).

If your child is allergic to milk, don’t despair as some children do in fact grow out of their milk allergy.  The best action is to stay away from milk and milk products entirely.  The most common milk allergy symptom is vomiting after eating, according to an article in the Fall 2006 Allergy & Asthma Today magazine.

Hugh A. Sampson, M. D. wrote an article for “Food Allergy News” published by The Food Allergy & Anaphylaxis Network (FAAN) in June-July 2004 regarding Milk and Egg Allergies. In this article, he stated:

“Virtually all infants who develop cow’s milk allergy do so in the first year of life, with about 80% ‘outgrowing’ their milk allergy by their fifth birthday. About 60% of cow’s milk-allergic infants experience IgE-mediated reactions, or the more classical ‘immediate’ reactions affecting the skin (hives and eczema), gastrointestinal tract (crampy abdominal pain and vomiting), and the respiratory tract (nasal congestion, sneezing and wheezing). Nearly 25% of these milk-allergic infants retain their sensitivity into the second decade of life, and 35% go on to develop other food allergies.

According to research from Johns Hopkins Children’s Center published in Science Daily in December 2007, milk and egg allergies now appear to be more persistent and harder to outgrow:

“In what are believed to be the largest studies to date of children with milk and egg allergies, researchers followed more than 800 patients with milk allergy and nearly 900 with egg allergy over 13 years, finding that, contrary to popular belief, most of these allergies persist well into the school years and beyond. 

The bad news is that the prognosis for a child with a milk or egg allergy appears to be worse than it was 20 years ago, says lead investigator Robert Wood, M.D., head of Allergy & Immunology at Hopkins Children’s. Not only do more kids have allergies, but fewer of them outgrow their allergies, and those who do, do so later than before.

Researchers caution that their findings may reflect the fact that relatively more severe cases end up at Hopkins Children’s, but they believe there is a trend toward more severe, more persistent allergies.

The findings also give credence to what pediatricians have suspected for some time: More recently diagnosed food allergies, for still-unknown reasons, behave more unpredictably and more aggressively than cases diagnosed in the past. We may be dealing with a different kind of disease process than we did 20 years ago, Wood says. Why this is happening we just don’t know.

Earlier research suggested that three-quarters of children with milk allergy outgrew their condition by age 3, but the Johns Hopkins team found that just one-fifth of children in their studies outgrew their allergy by age 4, and only 42 percent outgrew it by age 8. By age 16, 79 percent were allergy-free.

Similar trends were seen in the egg-allergy group. Only 4 percent outgrew this allergy by age 4, 37 percent by age 10, and 68 percent by age 16.

The Hopkins Children’s team found that a child’s blood levels of milk and egg antibodies-the immune chemicals produced in response to allergens-were a reliable predictor of disease behavior: The higher the level of antibodies, the less likely it was that a child would outgrow the allergy any time soon. Pediatricians should use antibody test results when counseling parents about their child’s prognosis, researchers say.

One encouraging finding: Some children lost their allergies during adolescence, which is later than believed possible, suggesting that doctors should continue to test patients well into early adulthood to check if they may have lost their allergies.

Milk and egg allergies are the two most common food allergies in the United States, affecting 3 percent and 2 percent of children, respectively.

Reports on the two studies appear in the November and December issues of the Journal of Allergy and Clinical Immunology. Co-investigators in the two studies: Justin Skripak, M.D., Jessica Savage, M. D., Elizabeth Matsui, M.D., M.H.S, Kim Mudd, R.N., all of Hopkins Children’s.

The studies were funded in part by the National Institutes of Health and supported by the Eudowood Foundation, the Food Allergy Initiative and Julie and Neil Reinhard. Wood is a consultant for Dey Pharmaceuticals and has received support from Merck and Genentech.”

Non IgE-mediated milk allergy affects primarily the gastrointestinal tract resulting in a number of different allergic disorders: milk-induced enterocolitis syndrome, proctocolitis syndrome, allergic eosinophilic esophagitis, etc., that can lead to poor growth and failure to thrive.

There is also the chance that your child will test negative to dairy on an allergy test, yet still show symptoms of an allergy. In this case, the non-IgE milk-allergy may be at play, or lactose intolerance may be the culprit.

Lactose intolerance is not milk allergy. Instead, it is a problem in the digestive system caused from not producing enough of the lactase enzyme to break down the lactose sugar into simpler sugars. People who experience lactose intolerance have the crampy, abdominal pain that can turn into nausea and diarrhea. Lactose intolerance can be lifelong or temporary – especially following an intestinal illness, or even a round of antibiotics.

In the US, lactose intolerance is most common among Asian Americans, African Americans and Native American Indians.

Reading labels is a must for a milk-allergic child!  Milk is in so many processed foods that cooking from scratch may be a much safer alternative.

The Food Allergy Labeling Consumer Protection Act (FALCPA) was passed in 2004, requiring: labels to be marked such that a 7 year old could read and understand the ingredients, all allergens are declared even if they are in the spices or flavorings, and curtail the current widespread use of the ‘may contain statements.’ This act went into effect January 1, 2006.

Of course, milk is in virtually all cheeses, butter, creams and yogurt.  The lactose free milks do still have milk protein, so avoid them.  They are made such that the lactose-intolerant individual can digest them, but are not made for the milk-allergic.

Casein and whey are other names that milk can be called on a label.  There are other names that also indicate the presence of milk, and your allergist can provide for you a complete list of milk products and ingredients to avoid.

Lactose has also been used in medications to bulk up tiny medication particles. Inhalers such as Advair® Diskus®, Serevent® Diskus® and Foradil® Aerolizer® all contain lactose which can adversely affect the milk allergic. The 10 mg tablets of Singulair® also contains lactose, however the 4mg and 5mg versions do not. Many over the counter medications also contain lactose, including at one time Claritin and Benadryl in pill form, so make sure you read the label prior to purchase! Also, talk with your pharmacist should you have questions.

There are milk substitutes such as soy and rice milk. If neither of these is appealing, there is also Vance’s Dari Free milk which is made from potatoes. Additionally, Divvies is an online bakery with wonderful treats that are all dairy-free!