Milk allergy is an immune reaction to one of the many proteins in animal milk. The most common form seen worldwide is allergy to cow’s milk and called as cow’s milk protein allergy (CMPA). Cow’s milk protein allergy (CMPA) is most often caused by the casein protein in cow's milk.
How is a cow’s milk protein allergy different from lactose intolerance?
A milk allergy is sometimes confused with lactose intolerance because they often share symptoms. Lactose intolerance is caused by deficiency of the enzyme lactase, which is required to break down lactose, the sugar found in cow’s milk. Cow’s milk protein allergy (CMPA) is a true food allergy caused by an allergic reaction to the protein in cow’s milk.
What are the different types of cow’s milk protein allergy in children?
Children with suspected Cow’s milk protein allergy can be of two types. IgE mediated Cow’s milk protein allergy (CMPA) cause immediate symptoms (within minutes to an hour) such as wheezing, rash, lip-swelling, vomiting, diarrhea and anaphylaxis. Children with non-IgE mediated milk allergy causes delayed symptoms such as rash, atopic eczema, blood in stools, recurrent vomitings, GERD, long standing diarrhea.
What tests are required for a proper diagnosis of cow’s milk protein allergy?
Children with IgE type of CMPA can be diagnosed by a skin prick test to cow’s milk extract or fresh cow’s milk. Alternately we can also do a blood test called as immunocap.
Children who have a non IgE type of cow’s milk protein allergy do not have a specific skin prick test for blood test which can be used for a diagnosis. In these children improvement in symptoms after elimination of cow’s milk for the period of 4 weeks followed by a milk challenge helps to diagnose cow’s milk protein allergy.
By what age a child grows out of cow’s milk protein allergy?
Most children outgrow milk allergy between 2-6 years of age. Some children can continue to achieve tolerance well into adolescence. In 10 percent cases milk allergy can persist into adulthood.
My child has cow’s milk protein allergy. What alternate milk formulae should I use?
Children with cow’s milk protein allergy should not be given milk or any milk products like curd, cheese, paneer, etc. Breast feeding should be continued. Replacement milk recommended is extensively hydrolyzed formulae which is available commercially. Soy formula can be tried in children with cow’s milk protein allergy if they are more than 6 months of age. Soy formulas are cheaper in price and more palatable. Goat milk, sheep milk, or camel milk should not be used in children with cow’s milk protein allergy as the child can also be allergic to these milk. In addition the proper hygiene of these sources is usually not known.