baby drinking from bottle
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What is Cows’ Milk Allergy?

Cows’ milk allergy -- also known as cows’ milk protein allergy -- occurs when your baby's immune system mistakenly thinks proteins in milk and milk protein-containing products are a threat to the body, and responds to this. The proteins may be in formula, or in breastmilk from the foods the mum has consumed.

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Signs to Watch For

Cows' milk allergy is the most common food allergy in children under 3 and affects around 7% of babies and young children in the U.K. Babies and children are at higher risk of getting cows' milk allergy if allergy runs in the family. Many children who react to cows' milk protein will also react to the proteins in sheep's and goats' milk too. Symptoms may include:

  • Swelling of the lips, face, and around the eyes
  • Itchy rash or lumps on the body (urticaria)
  • Cough
  • Wheezing
  • Vomiting
  • Diarrhoea
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milk on babys face
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Spotting Delayed Reactions

It's also possible for your baby to have a delayed allergic reaction to milk or milk products. In these cases, symptoms emerge more slowly and may include:

  • Posseting (vomiting milk)
  • Colic 
  • Constipation
  • Diarrhoea
  • Food refusal
  • Eczema
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Recognising Serious Reactions

Rarely, cows’ milk allergy can trigger a life-threatening reaction known as anaphylaxis. Symptoms develop soon after consumption of milk or milk protein-containing products. Seek help straight away if your child has any of these signs:

  • Hives or skin swelling
  • Wheezing or difficulty breathing
  • Swelling of lips, mouth, throat, or tongue
  • Floppy body and limbs
  • Unresponsiveness

Anaphylaxis can develop quickly and be life-threatening, so call 999 immediately.

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Diagnosing Cows’ Milk Allergy

Your child may be referred to a specialist at an allergy clinic, where tests may include:

  • Blood tests
  • A skin prick test

A supervised elimination of cows' milk from the diet may be recommended, and a doctor may recommend putting cows' milk back into the diet later. A delayed allergic reaction can be harder to diagnose, so a dietitian may suggest a special diet. Tests such as hair analysis, vega tests, and applied kinesiology can’t diagnose any allergy, so the NHS doesn’t recommend them.

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Foods to Avoid

If your baby is allergic to cows' milk proteins, foods to cut out of the diet include:

  • Milk, yoghurt, fromage frais, cream, butter, margarine, ghee, cheese
  • Ice cream, milk drinks, milk powder, quark, condensed milk

Milk is in lots of food products, so check labels for ingredients like:

  • Milk sugar, lactose, milk solids, milk protein, modified milk
  • Casein, caseinates, whey protein, hydrolysed whey, whey solids
  • Lactose, lactalbumin
  • Hydrolysed caseinates
  • Skimmed milk powder, non-fat milk solids, butter fat

Foods containing milk must highlight the word in bold on the ingredients list.

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Lactose Intolerance

Some symptoms may appear to be cows’ milk allergy but are actually signs of lactose intolerance, when natural milk sugar can't be broken down. Lactose intolerance is uncommon in babies. It causes wind, diarrhoea, stomach cramps, and bloating.

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Colic or Allergy?

The symptoms of colic and cows' milk allergy can be similar and easily confused. Also bear in mind that cows' milk allergy can trigger colic. If your baby has cows' milk allergy, you may see classic, colic symptoms like intense crying, clenched fists, an arched back, and allergy symptoms like:

  • Eczema
  • Diarrhoea
  • Vomiting

If in doubt, seek medical advice for a correct diagnosis.

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Breastfeeding and Cows’ Milk Allergy

If you're a breastfeeding mum, a healthy, varied diet is best for you and your baby. But you may start noticing reactions in your baby after you've eaten dairy. Cows' milk proteins pass into your milk  and are linked with discomfort in babies with cows’ milk allergy. Signs may include:

  • Crying a lot
  • Discomfort after feeds
  • Sleep problems
  • Tummy upsets, diarrhoea, or constipation
  • Cold-like symptoms, wheezing
  • Itchy, red eyes
  • Dry skin or a sore bottom
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Amending Mum's Diet

If you think your breastfed baby is reacting to milk products that you have eaten, talk to your GP. It may be recommended that you avoid dairy for at least 2-3 weeks to see if your baby gets better. If dairy is the culprit, your baby's symptoms should improve within a week to several weeks. You don't always have to give up dairy altogether. Talk with your GP, who may recommend getting help from a registered dietitian.

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Fixing the Formula

Your doctor may suggest using another type of formula if your baby shows signs of allergy to cows' milk protein. This may involve an extensively hydrolysed (eHF) milk formula, where milk proteins are broken down into more digestable parts, which makes them less likely to trigger allergy symptoms. Amino-acid based formulas may be recommended if a child has difficulty with extensively hydrolysed milk formula or has severe symptoms.

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Playtime Hazards

Be extra vigilant with your baby who has cows' milk allergy during playtime with other children. It's easy for icecreams to melt into paddling pools or sand, so keep an eye open for exposure to milk products this way, and always let nursery staff or babysitters know about allergies and how to care for your infant if you are away from them.

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Getting Help

To help your doctor help you, you may want to consider a symptoms diary. It should note:

  • When and where reactions happen
  • Types of foods that trigger reactions
  • What kind of reactions occur, such as a rash or wheezing
  • How long symptoms last
  • What seems to relieve reactions
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doctor and baby
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Managing Cows’ Milk Allergy

The best way to manage cows’ milk allergy in babies is to make sure they avoid cows’ milk proteins completely. If you're breastfeeding, consult your GP to decide whether to cut down or eliminate dairy products from your diet. If you are bottle-feeding, cows’ milk substitutes include:

  • Extensively hydrolysed formulas
  • Amino acid-based formulas.

Your GP can help. More complex cases, like multiple allergies, an uncertain diagnosis, severe reactions, or stunted growth, can be referred to a specialist.

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The Outlook

Fortunately, most children grow out of cows' milk allergy by the time they’re 5 years old, but some people still have an allergic reaction when they're adults. Don't try to go it alone and cut essential foods out of your child's diet. Talk to your GP, who can refer you to a registered dietitian who can advise on how to make sure your child has a nutritious diet whilst excluding the food group being monitored.

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Sources | Medically Reviewed on 05/16/2019 Reviewed by Rob Hicks, MD on May 16, 2019

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Cows' Milk Allergy.

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Reviewed by Rob Hicks, MD on May 16, 2019

This tool does not provide medical advice. See additional information.

THIS TOOL DOES NOT PROVIDE MEDICAL ADVICE. It is intended for general informational purposes only and does not address individual circumstances. It is not a substitute for professional medical advice, diagnosis or treatment and should not be relied on to make decisions about your health. Never ignore professional medical advice in seeking treatment because of something you have read on the WebMD Site. If you think you may have a medical emergency, immediately call your doctor or dial 911.

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