Cow's milk allergy
An infant's milk allergy comes up frequently among questions asked by parents. Most often it is an allergy to cow's milk proteins. Below we explain what this allergy is all aboutwhat symptoms it gives and what its diagnosis and treatment looks like.
Cow's milk is one of the most allergenic foods. Among infants and young children, the prevalence of food allergy is about 6-8% of the population. Other foods that are often allergenic include chicken eggs, soybeans, wheat, nuts, fish and shellfish. However, the most common of these allergens in the first year of life is allergy to milk proteins cow. According to various sources, its incidence is estimated at 2-7%.
What is an allergy to cow's milk proteins?
Expert advises
Food allergy, including allergy to cow's milk protein, it is an unwanted reaction of the body as a result of the body's immune response to a particular food. This response may be related to IgE class antibodies - then we call such an IgE-dependent reaction or with other immune mechanisms and then we talk about IgE-independent mechanisms. It happens that both mechanisms may reveal themselves in one patient - then we are talking about the so-called mixed response.
What are the symptoms of an allergy to cows' milk proteins?
They can appear at any age, but most often appear in infancy. They mainly affect the digestive system, skin and respiratory system. Due to the severity of symptoms, we can distinguish mild or moderate forms, severe forms and, fortunately, rare violent forms, i.e. severe anaphylaxis.
- In mild or moderate form allergies to cow's milk proteins there may be skin lesions of the type of atopic dermatitis, general symptoms - such as child anxiety, intestinal colic, vomiting, regurgitation, stool disorders - both diarrhea and constipation, blood in the stool may appear, iron deficiency anemia.
- Heavy character allergy to cow's milk proteins in an infant these are much more severe symptoms like those mentioned above. Skin lesions may take the form of severe atopic dermatitis, there is a lack of appetite or even refusal to eat, due to severe vomiting, regurgitation (causing the so-called downpouring) or diarrhea, the physical development of the infant is impaired. Respiratory symptoms may appear - acute laryngeal edema, bronchial obstruction, asthma. Gradual but constant blood loss in stools leads to severe anemia.
- Anaphylaxis or shock - this is the most severe form - violent symptoms appear even after a small amount of allergenic food - i.e. cow's milk.
Who may be allergic to cows' milk proteins?
The presence of atopic diseases in the immediate family increases the risk of allergy symptoms. If both parents have the same atopic diseases, the risk is 50-80%, only one parent - 20-40%, and siblings - 25-35%. But if there is no allergy in the immediate family, there is also a risk of it developing in the child - it is estimated at 5-15%.
How soon can undesirable illnesses develop after eating food containing cow's milk?
In the case of IgE-dependent allergy, they may be almost immediate - i.e. about 30 minutes after eating food containing cow's milk proteins, in the case of IgE-independent allergy it is the so-called delayed reaction - symptoms appear within hours or days after consuming cow's milk proteins. Sometimes the reaction may be mixed, i.e. some symptoms will appear quite quickly, but then others will appear.
What could be the immediate symptoms of a cow's milk allergy?
Expert advises
The most dangerous are anaphylaxis, i.e. shock, acute urticaria, acute angioedema, wheezing caused by bronchospasm, vomiting, dry cough, laryngeal edema, and oral allergy syndrome.
How is an allergy to cow's milk proteins diagnosed?
The most important thing is the medical history - that is, a detailed conversation between the doctor and the parent and an analysis of the child's symptoms. It should be established whether they are food-dependent, if they disappear after excluding milk from the child's diet, or if they come back after re-administering it. You can also perform a blood test to determine specific IgE antibodies or skin tests. The presence of clinical symptoms, confirmed by serological tests or skin tests, allows for a certain diagnosis of allergy to cow's milk proteins. However, if the interview is not convincing enough, the same goes for additional tests - a cow's milk provocation test is performed. A positive result of such a test confirms the diagnosis of cow's milk allergy. It is then necessary to introduce a dairy-free diet, i.e. completely exclude cow's milk from the child's diet.
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Chief Specialist for issuing opinions on utility products for children at the Institute of Mother and Child in the years 2004-06.2022
How to feed an infant allergic to cow's milk proteins?
If a toddler is fed with mum's food, she stops drinking milk, i.e. switches to a dairy-free diet and can continue to feed the child. In the case of mild severity of allergy symptoms, it may also be recommended to reduce the amount of milk in the diet of a nursing woman. The mixture must be changed when feeding with formula. It is replaced with a protein hydrolyzate with a high degree of protein hydrolysis, popularly known as a milk replacer. If we get an improvement after a diet change, this confirms our diagnosis. The duration of the diet is decided by the doctor - usually it is several months, but sometimes a provocation test is made earlier in order to verify the diagnosis of allergy to cow's milk proteins. With very severe symptoms and no improvement after the preparation used, it is advisable to use the so-called elemental mixture, i.e. a completely hydrolyzed preparation. The use of milk replacers is necessary in the infancy period, i.e. up to 12 months of age. After that, we have the opportunity to compose the diet differently, and thus the further use of milk substitutes is not always necessary.
What if your diet does not help?
What to do if the allergy persists despite the diet? In such a case, it is necessary to consider whether an allergy to cow's milk proteins has been correctly diagnosed. Other diagnoses should be taken into account and further diagnosis performed in order to make the correct diagnosis and treatment of the child. It is necessary to consult a doctor again.
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