Are you ready to meet your next level? Click here to book your free discovery call
Cow's Milk Allergy
cow's milk allergy affects about
1 in 30 babies during their first year
A spectrum condition that shows up in many different ways in infancy, cow’s milk allergy sometimes looks a lot like other common baby issues, such as colic, reflux, or loose stools. If your baby has eczema, cow’s milk allergy or other food allergies are more common.
an individual and a spectrum condition
Immediate or IgE reactions tend to be more severe and persisting, with eczema, rashes, and sometimes breathing difficulties. Medical attention is needed for those immediate reactions, and allergy testing can be helpful. Delayed or non-IgE reactions can occur several hours or even days after having cow’s milk or products, and this changes with any infants age. These delayed reactions affect the gut and sometimes the skin. You might notice symptoms like loose, smelly, mucous or bloody stools, constipation, tummy pain, vomiting, reflux, or your baby may not want to feed. The wide range of symptoms can be bewildering to understand what’s happening for your baby. And symptoms of both immediate and delayed reactions can also be present. Symptoms vary from mild to moderate, to severe and persisting. Tummy troubles in particular, causing discomfort, can make feeding more challenging and affect your baby’s growth.
lactose intolerance is a digestive issue, not a food allergy
It’s important to know that Cow’s Milk Allergy and Lactose Intolerance are two very different conditions, but the gut symptoms can look very similar. Again these two conditions can co-exist. Cow’s Milk Allergy is an immune response, and symptoms will improve when milk proteins are completely removed from your baby’s diet. For breast feeding mums, whose baby has non-IgE delayed reactions, maternal avoidance of dairy can be helpful, with calcium (and Vitamin D) supplementation needed. For the severe and persistent immediate IgE reactions, there is no benefit from maternal avoidance of dairy. Lactose is the milk sugar presenting all mammal milks including human breast milk. It is digested in the upper gut with the enzyme lactase. It does not initiate an allergic response.
maternal dairy exclusion has no effect on lactose-content of breast milk
A maternal exclusion of dairy has no effect on the lactose content of breast milk, which remains steady, as a valuable component of gut health in infants. It helps colonise favourable microbes such as bifidobacteria in the gut; increases the absorption of key nutrients like iron and calcium and encourages lactase persistence – the enzyme needed to digest lactose. In young infants, high volume, lactose-rich fore milk is dominant, and frequent feeding is needed at this time. It’s is also important to balance up this high-volume fore milk, by feeding for long enough at each breast to initiate the protein, fat and nutrient rich hind milk, giving a balanced and nutritious feed. A relative lactose intolerance, with characteristic colic and frothy green stools can result from too much fore milk in young babies, by switching breast for small feeds. Restarting the next feed on the same breast can both give better access to this hind milk, and stimulate more breast milk supply. This is a common feeding issue and can be managed relatively easily by tweaks to the feeding routine.
active allergy management
Symptoms of cow's milk allergy can vary hugely, with mixed immediate or delayed reactions. Symptoms can show up in the gut, skin and respiratory tract, and sometimes all three of those organs. However, 90% of infants who present with delayed reactions are able to start drinking cow’s milk around age one with appropriate dietary management. Active allergy management means using careful planning with weaning to a dairy free diet, early introduction of allergens including egg and peanut butter, strict dairy exclusion for 3-6 months, and a stepwise introduction of cow’s milk products using a ladder approach from 9-12 months of age, depending on age at diagnosis.
lactose intolerance in older children
Lactose intolerance and cow’s milk allergy can co-exist in infants, most likely when symptoms are associated with a nasty gut infection. This can temporarily limit or stop lactase enzyme activity, usually produced the sensitive lining of upper gastro-intestinal tract. Lactose intolerance may also develop following illness or surgery that affects the gut lining. A lactose-free diet gives the intestines time to heal, with lactase enzyme activity usually being restored with healing. Lactose can then be slowly reintroduced, according to tolerance around 2-6 weeks after infection surgery. Lactase enzyme activity typically declines with age, and ethnicity is an additional factor. Children of Asian, African and Indian descent are more likely to loose lactase enzyme activity throughout childhood, due to evolutionary practices, when (breast) milk drinking ceased in earlier childhood.
my support
I offer personalised support for families managing cow’s milk allergy, from diagnosis to safely reintroducing cow's milk. I’ll take a detailed allergy-focused history, observe feeding when needed, and provide breastfeeding and nutritional advice to support both you and baby during milk exclusion. Guiding you through early introduction of food allergens, and weaning onto a milk-free diet. Sometimes changes to specialised formula prescriptions are needed, and we explore suitable milk-free products for your baby. My aim is to make the process clear, reassuring, and tailored to your baby’s needs. Take a look at the Cow’s Milk Allergy Management below.
Book Your Free Discovery Call