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Milk Allergy

Cow’s milk allergy is the most common allergy among infants and young children.1,2 A milk allergy, like every allergy, is when your immune system mistakenly identifies one or both of these proteins as harmful.  When you ingest these proteins, your immune system responds and releases histamines, which then cause your allergic symptoms.

Between 2–3% of children younger than age 3 are allergic to milk.1 Nearly all infants who develop an allergy to milk do so in their first year of life, but about 80% are likely to outgrow their milk allergy.3 But this research also suggests that children are outgrowing their milk allergy more slowly than before, with many children still allergic beyond age 5.3

Since the majority of children do outgrow their milk allergy, periodic re-evaluation—including testing—is recommended.

However, children who have high levels of cow’s milk antibodies in their blood are most likely to have a milk allergy for life.3 A simple blood test that measures these antibodies can help your healthcare professional determine whether or not your child is likely to outgrow their milk allergy.    

milk allergy graph

Milk allergy symptoms

Allergic reactions to cow’s milk vary from person to person. Your reaction can occur from just minutes to hours later after ingesting something that contains milk. Reactions can also range from mild to severe, including the life-threatening reaction anaphylaxis. 

Common signs and symptoms of milk allergy can include:    

  • Mild wheezing or coughing
  • Vomiting
  • Skin rashes/hives 
  • Digestive symptoms (e.g. stomach pain, diarrhea, nausea)
  • Bloody stools (especially in infants)

Infants and children who are allergic to milk are more likely to have eczema (atopic dermatitis) and other allergies.4,5

Common milk allergy triggers

Avoiding milk is much more complicated than just leaving the cheese off of your burger. Milk can be a hidden ingredient in many foods—which is why it’s important to read the label or ask before buying or eating any food. Ingredients in packaged foods can change at any time—and without warning—so always read labels carefully. 

Milk can be found in a variety of foods including:    

  • Dairy products like cheese, cream, butter, yogurt and ice cream
  • Breads and pastries
  • Manufactured foods including baking mixes, potato chips, canned soups and chicken broth
  • Candy
  • Processed meat like ham, sausages, pates
  • Hydrolyzed milk baby formula

Other cross-reactive symptoms:

There is a high degree of cross-reactivity between cow's milk and the milk from other mammals. Cross-reactivity is when the proteins in one food are similar
to the proteins in another and your body's immune system sees them as the same. So, people who are allergic to cow’s milk are often advised to also avoid milk from other domestic animals like sheep, goats and buffalo. In studies, the risk of an allergic reaction to goat's milk or sheep's milk in a person with a cow’s milk allergy is about 90%.6

Learn more about cross-reactivity 

Milk Allergy vs Lactose Intolerance

Milk allergy is often confused with lactose intolerance because you can have the same digestive symptoms, like bloating, gas or diarrhea, with both. While a milk allergy is an immune system reaction to milk protein, with lactose intolerance the body can’t digest lactose (milk sugar). Lactose intolerance doesn’t cause an immune system reaction, so although it can cause discomfort, it’s not life-threatening.

If you suffer digestive problems after eating or drinking milk or dairy products, talk to your healthcare professional about a simple blood test. There are several good reasons why a blood test should be considered: Testing is easy to perform and can help determine whether the symptoms are actually due to a milk allergy or not.

Baked milk breakthrough

When milk is thoroughly heated or cooked, the proteins change shape and for some people this could mean that their immune system will no longer overreact to the protein. In fact, studies have shown that 75% of children with a milk allergy can actually tolerate baked foods containing milk, like a muffin or cake.7,8 This means some people with a milk allergy can go to a birthday party and taste the cake, as opposed to skipping the cake (or the party) completely. A simple blood test can help your healthcare professional determine if you’re a good candidate for an oral food challenge to see if you’re likely to tolerate baked milk.    

Am I allergic?

Many people are so used to living with—or being embarrassed by—their uncomfortable symptoms that they’ve never considered asking for help. Or you might think how often your baby spits up is normal. So, how do you know if these symptoms are caused by a milk allergy? If you think you or a loved one may have a milk allergy, don’t try to manage the problem on your own.

A simple blood test - together with your medical history- can help identify underlying allergen triggers, if you have an allergy. Knowing if you’re allergic and what you’re allergic to can help you get relief. Be sure to consult your healthcare professional.

Learn more about testing 

References
  1. Lifschitz, C and Szajewska H. Cow’s milk allergy: evidence-based diagnosis and management for the practitioner.  Eur J Pediatr 2015; 174:141-15..
  2. Sampson, HA. 9. Food Allergy. J Allergy Clin Immunol;2003; 111(2Suppl): S540-7.
  3. Johns Hopkins Medicine, Milk And Egg Allergies Harder To Outgrow https://www.sciencedaily.com/releases/2007/12/071215205437.htm. Accessed August 2017.
  4. Spergel JM, et al. Food Allergy in Infants With Atopic Dermatitis: Limitations of Food-Specific IgE Measurements. Pediatrics; 2015 Dec;136(6):e1530-8.
  5. Novembre E, Vierucci A. Milk allergy/intolerance and atopic dermatitis in infancy and childhood. Allergy. 2001;56 Suppl 67:105-8.
  6. Rangel, A et al. Lactose intolerance and cow’s milk protein allergy. Food Sci. Technol, Campinas, 36(2): 179-187, Abr.-Jun. 2016.
  7. Nowak-Wegrzyn A, et al. Tolerance to extensively heated milk in children with cow’s milk allergy. J Allergy Clin Immunol. 2008;122:342-7.
  8. Caubet JC, et al. Utility of casein-specific IgE levels in predicting reactivity to baked milk. J Allergy Clin Immunol. 2013;131:222-4.