Caring for an Infant With a 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 reacts with a range of symptoms . The proteins may be in formula or in breast milk.

A cows milk allergy is the most common food allergy in children under 3 and affects around 8% of children in the U.S. Babies and children are at higher risk of having an allergy to cows milk if other family members do. Some children who have an allergy to cows milk also react to the proteins in sheep and goat milk. Symptoms may include:

• Swelling of the lips, face, and around the eyes
• Itchy rash or lumps on the body (hives)
• Cough
• Wheezing
• Vomiting
• Diarrhea

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:

• Spitting up
• Colic 
• Constipation
• Diarrhea
• Refusing to eat
• Eczema

Though it's rare, a cow's 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, so call 911immediately.

Your child may be referred to an allergy specialist who might order blood and skin prick tests to determine if they have an allergy to cows milk. Eliminating dairy from the diet may be recommended at first. It is possible for your baby to have a delayed reaction to cows milk..

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

• Milk, yogurt,  cheese, butter, cream, ghee
• Ice cream, milk drinks, 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, hydrolyzed whey, whey solids
• Lactose, lactalbumin
• Hydrolyzed caseinates
• Nonfat milk solids, butterfat

Some symptoms may appear to be a 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 gas, diarrhea, stomach cramps, and bloating.

The symptoms of colic and a cow's milk allergy can be similar. Along with colicky symptoms like persistent crying, clenched fists and an arched back, your baby may have symptoms like: 

• Eczema
• Diarrhea
• Vomiting

Call your child's pediatrician if you are worried. 

If you are breastfeeding your child,  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 who have an allergy to cows milk. Signs may include:

• Crying a lot
• Discomfort after eating
• Sleep problems
• Diarrhea or constipation
• Wheezing
• Itchy, red eyes
• Dry skin
• Diaper rash

If you think your breastfed baby is reacting to milk products that you have eaten, talk to their pediatrician. They might recommend 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 to your doctor about how to maintain a balanced diet.

Your doctor may suggest using another type of formula if your baby shows signs of allergy to cows milk. Some baby formulas are less likely to trigger allergy symptoms. 

 Keep an eye on your toddler, who may find melted ice cream on the playground too interesting to ignore. Let family members, friends,  nursery staff, and babysitters know about allergies and how to care for your baby if you are away from them.

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

Most children grow out of cows milk allergy by the time they reach age 5. To make sure they are getting the nutrition they need in the meantime, talk to their pediatrician.