What is Milk Allergy ?

Milk allergy is immunologically mediated reaction to milk which occurs within minutes to hours after taking milk. Even a small amount of food is sufficient to trigger allergy symptoms. In some individuals, a food allergy can cause severe allergy symptoms or even a life-threatening reaction called anaphylaxis.

Milk allergy is one of the most common allergies in children. Among the several types of milk cow’s milk allergy is the most common however goat milk, buffalo milk, sheep milk and other mammals milk can cause reaction.

Sources of Milk

Sources of allergy causing milk proteins are mainly found in dairy products, including:

• Whole milk, low-fat milk ,butter milk, skimed milk
• Cheese and anything that contains cheese
• Ice cream, gelato
• Butter
• Yogurt

Milk in different forms are used in several ingredient in processed foods, including baked goods and processed meats. Few hidden sources of milk include:

• Whey
• Casein
• Protein powders
• Hydrolysates
• Artificial cheese flavor and butter flavor
• Candies, such as chocolate, nougat and caramel
• Ingredients with prefix “lact” — such as lactose and lactate

Symptoms of Milk Allergy

The most common symptoms include:

• Tingling sensation or itching in and around the mouth
• Swelling of the lips, tongue, face, throat or other parts of the body
• Hives, itching or eczema
• Cough, wheezing or trouble breathing
•  Nasal congestion
• Abdominal pain, nausea, vomiting, diarrhea
• Dizziness, lightheadedness or fainting
• Anaphylaxis

Causes of Milk Allergy

In Cow’s Milk Allergy, our immune system recognize cow’s milk as a harmful substance and react against it. After a sensitization phase, when cow’s milk is introduced for second time the body produces huge number of immunoglobulin E (IgE) antibodies to neutralize the protein (allergen) in cow’s milk. Cross linking reaction lead to degranulation of mast cell releasing large number of powerful chemical mediators including histamine and other chemicals leading to sign and symptoms of allergic inflammation.

Cow’s milk contain two main proteins which are responsible for allergic reactions. These include:

• Casein, found in the solid part (curd) of milk that curdles
• Whey, found in the liquid part of milk that remains after milk curdles

Diagnosis of Milk Allergy

Till date there is no ideal test for milk allergy. A physician should consider the following:

• Symptoms. Tell your physician /allergist, the symptoms you are experiencing.
• Family history of allergies. Tell your physician whether other family members are suffering from any form of allergic disorders.
• A physical examination. To find out any urticarial lesion in the body and to exclude other cause of similar symptoms.
• A skin prick test. A skin prick test using food allergen can be performed. Expertise in this regard is necessary to perform skin test. A positive prick test is only indicate the people is sensitized to particular food allergen tested.
• A blood test. A blood test can be performed to measure the allergen-specific immunoglobulin E (IgE).
• Elimination diet.
• Oral food challenge.

Treatment of Milk Allergy

Avoidance is the best preventive measure.

However an individual may unknowingly come in contact with the food and lead to allergic reaction.

For mild to moderate allergic reaction:  over-the-counter or prescribed antihistamines are helpful.

For severe allergic reaction: If there is severe reaction or anaphylaxis one must inject adrenaline/ epinephrine in appropriate dosage. If someone has adrenaline autoinjector then he can use it otherwise one have to attend nearest hospital as early as possible. One must carry his adrenaline autoinjector all the time if an allergist prescribed it.

Prevention of Milk Allergy

If you have food allergy, then follow these steps:

• Know what you’re eating and drinking. Always read the food labels.
• If you have already had a severe reaction/anaphylaxis, wear a medical alert bracelet or necklace that lets others know that you have a food allergy.
• Have an action plan ready. Always have your epinephrine /adrenaline autoinjector with you.
• Be careful while eating at restaurants.
• Plan your meals and snacks before leaving home.

If your child has a food allergy, you must follow few steps to ensure your child is safe:

• Always notify key people about the child’s food allergy.
• Explain food allergy symptoms to persons who spend time with the child.
• Have a written action plan.
• Have your child wear a medical alert bracelet or necklace.

Food Allergy Mimickers

Common conditions that mimic food allergy include:

• Lactase deficiency / lactose intolerance
• Food poisoning
• Celiac disease. sometimes called to as a gluten allergy
• Sensitivity to food additives.eg sulfites used in dried fruit, canned goods
• Histamine toxicity from certain not refrigerated fish

Read in-depth of Milk Allergy

To read details click on Read More

Point to be remembered in managing Food Allergy

Avoidance of the offending food is the best way to prevent food allergy. One must know the causative food to which he is allergic. A person with food allergy must be cautious when eating in  restaurants and in social events.

If you have  food allergy, then follow these steps:

• Know what you’re eating and drinking. Always read the food labels while you eating something.
• If you have already had a severe reaction/anaphylaxis, wear a medical alert bracelet or necklace that will alert others and you have a food allergy.
• Have an action plan ready. Always have a action plan of your food allergy.
• Have an Epinephrine / Adrenaline Autoinjector with you.
• Be careful while eating at restaurants.
• Plan your meals and snacks before leaving home.

If your child has food allergy, you must follow few steps to ensure your child is safe:

• Always notify key people about the child’s food allergy. Inform your child care providers, school personnel, parents of your child’s friends and other adults who regularly interact with your child. Tell them that food allergy may be life threatening and may require urgent intervention to save life of the child.
• Explain food allergy symptoms to persons who spend time with the child.
• Have a written action plan.This plan should include the appropriate management strategies to care the child in case of food allergy and in emergency case of anaphylaxis.  Give one copy to school authority.
• Have your child wear a medical alert bracelet or necklace to display that he/she has Food Allergy.

In-depth reading about of Milk Allergy

What is Milk Allergy?

Food allergy is immunologically mediated reaction to certain foods which occurs within minutes to hours after taking food. Even a small amount of food is sufficient to trigger allergy symptoms. In some individuals, a food allergy can cause severe allergy symptoms or even a life-threatening reaction called anaphylaxis.

Milk allergy is one of the most common allergies in children. Among the several types of milk cow’s milk allergy is the most common however goat milk, buffalo milk, sheep milk and other mammals milk can cause reaction.

Sometimes few people develop indigestion, gaseous distention of abdomen or diarrhea after taking some food but it may not be due to food allergy but another condition called food intolerance. This reaction is not immunologically mediated and it is less severe than allergy.

Sources of Milk

Sources of allergy causing milk proteins are mainly found in dairy products, including:

• Whole milk, low-fat milk ,butter milk, skimed milk
• Cheese and anything that contains cheese
• Ice cream, gelato
• Butter
• Yogurt

Milk in different forms are used in several ingredient in processed foods, including baked goods and processed meats. Few hidden sources of milk include:

• Whey
• Casein
• Protein powders
• Hydrolysates
• Artificial cheese flavor and butter flavor
• Candies, such as chocolate, nougat and caramel
• Ingredients with prefix “lact” — such as lactose and lactate

Symptoms of Milk Allergy

Symptoms of milk allergy can ranges from mild allergic reaction to severe allergic reaction or even life-threatening reaction called anaphylaxis. Usually, milk allergy symptoms develop within a few minutes to two hours after eating the offending food.

The most common symptoms include:

• Tingling sensation or itching in and around the mouth
• Swelling of the lips, tongue, face, throat or other parts of the body
• Hives, itching or eczema
• Cough, wheezing or trouble breathing
•  Nasal congestion
• Abdominal pain, nausea, vomiting, diarrhea
• Dizziness, lightheadedness or fainting

Anaphylaxis

In few individual, a milk allergy can cause anaphylaxis. Life-threatening signs and symptoms of anaphylaxis include:

• Respiratory distress
• A swollen throat or the sensation of a lump in your throat
• Shock with a severe drop in blood pressure
• Rapid pulse
• Dizziness, lightheadedness or loss of consciousness

Anaphylaxis is a medical emergency treatment. Emergency treatment with intramuscular epinephrine/adrenaline is crucial for the survival of patients. Anaphylaxis if untreated can lead to coma or even death.

Causes of Milk Allergy

In Cow’s Milk Allergy, our immune system recognize cow’s milk as a harmful substance and react against it. After a sensitization phase, when cow’s milk is introduced for second time the body produces huge number of immunoglobulin E (IgE) antibodies to neutralize the protein (allergen) in cow’s milk. Cross linking reaction lead to degranulation of mast cell releasing large number of powerful chemical mediators including histamine and other chemicals leading to sign and symptoms of allergic inflammation.

Cow’s milk contain two main proteins which are responsible for allergic reactions. These include:

• Casein, found in the solid part (curd) of milk that curdles
• Whey, found in the liquid part of milk that remains after milk curdles

An individual can have allergy to one or both of the proteins. Less commonly, people allergic to cow’s milk are also allergic to soy milk.

Risk factor for milk allergy include:

• Family history of Allergy.  your family members are suffering from some form of allergies like asthma, eczema, urticaria, allergic rhinitis then you are at risk of developing food allergy.
• If you are suffering from food allergy to one of the food items. If you’re already allergic to one food, then you are at risk of developing food allergy to other foods.
• Age. Overall food allergies are more common in children. Your food allergy may disappear when you grow older. In most of the cases of food allergy to eggs, milk, soy and wheat in children may resolved automatically when they grow older. But an allergy to shellfish and nuts may remain lifelong.
• Asthma. Asthma and food allergy can occur together. In such patient, both food allergy and asthma symptoms are more likely to be severe.

Diagnosis of Milk Allergy

Till date there is no ideal test for milk allergy. A physician should consider the following:

• Symptoms. Tell your physician /allergist, the symptoms you are experiencing. Tell your allergist about the possible food items, eating of which lead to start of your symptoms. Inform him when this symptoms start occurring, how much time the symptoms last and how you get relief.
• Family history of allergies. Tell your physician whether other family members are suffering from any form of allergic disorders.
• A physical examination. To find out any urticarial lesion in the body and to exclude other cause of similar symptoms.
• A skin prick test. A skin prick test using food allergen can be performed. Expertise in this regard is necessary to perform a skin test. A positive prick test only indicates the people is sensitization.
• A blood test. A blood test can performed to measure the allergen-specific immunoglobulin E (IgE).
• Elimination diet. This can be done by first eliminating the suspected food items for 2-4 weeks then reintroducing the food items one by one to see when the symptoms return back. However, an elimination diet cannot distinguish true food allergy from food sensitivity. Another thing one must be kept in mind that if a person is already experienced severe allergic reaction or anaphylaxis, one must not do an elimination diet as it may be disastrous.
• Oral food challenge. Here the physician will give you a small but gradually increasing amount of milk or milk  containing product to see whether the symptoms are occurring or not. One must be kept in mind that if a person is already experienced severe allergic reaction or anaphylaxis, one must not do oral food challenge test as it can be disastrous.

Treatment of Milk Allergy

Avoidance is the best preventive measure. However, an individual may unknowingly come in contact with the food and lead to an allergic reaction.

For mild to moderate allergic reaction:  over-the-counter or prescribed antihistamines are helpful.

For severe allergic reaction: If there is severe reaction or anaphylaxis one must inject adrenaline/ epinephrine in an appropriate dosage. If someone has adrenaline autoinjector then he can use it otherwise one has to attend the nearest hospital as early as possible. One must carry his adrenaline autoinjector all the time if an allergist prescribed it.

How to Prevent Milk Allergy

Avoidance of the  milk and milk products are the best way to prevent milk allergy. One must know the causative food to which he is allergic. A person with a food allergy must be cautious when eating in a restaurant and in social events.

If you have a food allergy, then follow these steps:

• Know what you’re eating and drinking. Always read the food labels.
• If you have already had a severe reaction/anaphylaxis, wear a medical alert bracelet or necklace that lets others know that you have a food allergy.
• Have an action plan ready. Always have your epinephrine /adrenaline autoinjector with you.
• Be careful while eating at restaurants.
• Plan your meals and snacks before leaving home.

If your child has a food allergy, you must follow few steps to ensure your child is safe:

• Always notify key people about the child’s food allergy.  Inform your child care providers, school personnel, parents of your child’s friends and other adults who regularly interact with your child. Emphasize that food allergy may be life-threatening and may require urgent intervention.
• Explain food allergy symptoms to persons who spend time with the child.
• Have a written action plan. This plan should include the appropriate management strategies to care for the child in case of food allergy. One copy of the plan must be given to school authority.
• Have your child wear a medical alert bracelet or necklace.

Lifestyle and home remedies

Avoidance of the offending food in the utmost importance in food allergy.

• Don’t assume offending food in any form. Always check food labels while you eating outside especially in restaurants and in social events.
• If you are in doubt then don’t eat. One must keep in mind that even a very small amount of food particle can trigger symptoms of food allergy or may trigger anaphylaxis. So if you are in doubt then it is better to avoid the food.
• Involve caregivers of the child. If your child has a food allergy, then you have to inform the school staff and other care givers of the child so that they can manage the child in case of any symptoms of food allergy.
• Hand washing/ clean kitchen room.

Alternative medicine

Limited use. Research needs to be conducted. Some people, however, claim few improvements of symptoms.

Common conditions that mimic food allergy include:

• Lactase deficiency / lactose intolerance
• Food poisoning
• Celiac disease. sometimes called to as a gluten allergy
• Sensitivity to food additives.eg sulfites used in dried fruit, canned goods
• Histamine toxicity from certain not refrigerated fish

Complications of milk allergy include:

Children who are allergic to milk are more likely to develop certain other health problems, including:

• Allergies to other foods — such as eggs, soy, peanuts or even beef
• Hay fever — a common reaction to pet dander, dust mites, grass pollen and other substances

Milk Alternatives for Infants

• Breast-feeding

  is the best nutritional source of infant. If your baby is allergic to milk continue breast-feeding for as long as possible.

• Hypoallergenic formulas 

are specially produced formula where milk proteins, such as casein or whey are broken down (hydrolyzed) by enzymes.  They are of two types , partially hydrolyzed or extensively hydrolyzed depending upon the level of processing. Some of hypoallergenic formulas contain amino acid instead of milk. Amino acid based formulas are the least likely to cause any allergic reaction.

• Soy-based formulas

  are based on soy protein instead of milk. Soy formulas are fortified to be nutritionally complete, but some children with a milk allergy also develop an allergy to soy.

If your child is suffering from cows milk allergy and if the child is breast feed then you should stop taking cows milk as cows milk protein can secreted in breast milk  and can cause allergic reaction to baby. You may need to exclude from your diet all products that contain milk.

If you or your child is on a milk-free diet, your doctor or dietitian can help you plan nutritionally balanced meals. Your child may need to take supplements to replace calcium and nutrients found in milk, such as vitamin D and riboflavin.

Food intolerance

• A food intolerance is a condition which is not allergy but it mimic the sign symptoms of allergy such as nausea, vomiting, cramping and diarrhea.
• Depending on the type of food intolerance you have, you may be able to eat small amounts of offending foods without a reaction. By contrast, if you have a true food allergy, even a tiny amount of food may trigger an allergic reaction.
• Sometimes an individual may not be intolerant to food itself but maybe intolerance to the ingredients to prepare the food.

Cow’s Milk Protein Allergy (CMPA) vs Cow’s Milk Protein Intolerance (CMPI):

CMPA is a form of allergic reaction to protein present in the cows mild and it is immunologically mediated reaction. CMPI is not allergy and it is not immunologically mediated. In CMPI Milk protein cause local injury to gut leading symptoms ranging from diarrhea, blood in stool, abdominal colic etc. There is another condition called lactose intolerance which is due to deficiency of enzyme lactase. Lactase isan important enzyme in the small intestines which break lactose into glucose and galactose. This condition may mimic CMPA and CMPI.