Most of us know several “allergic” children, some of these children requiring EpiPens in case of accidental exposure. It is concerning being a parent of one of these children (as I am), and also hard on other parents, who need to remember not to send certain foods to school / child care to avoid harm. Cow’s milk allergy (CMA) is one of the most common allergies in kids, affecting 2% of infants. However, the good news is that around 80% outgrow it before they start school.
Other kids are “intolerant” to cow’s milk protein (CMP), the incidence of which is unknown but almost certainly higher than CMA. The difference between allergy and intolerance can be somewhat confusing. A simple explanation of the difference is that food allergy involves an immune system response and food intolerance does not involve an immune system response.
Allergic reactions can be caused by food, pollens, moulds, house dust, and animal hair, and are often noticed within minutes to hours. Symptoms include eczema, hives, asthma, face swelling, vomiting, diarrhoea, or in severe cases, anaphylaxis. Food Intolerance responses can also be quick; some however can take up to 48 hours or even several days to show. Symptoms of cow’s milk protein intolerance (CMPI) can include bloating, constipation, diarrhoea, reflux, sweating, headache / migraine, and eczema.
CMA can be diagnosed through skin prick tests done by an allergist, or RAST tests through a blood test, and requires removal of all cow’s milk sources from the child’s diet, and that of their mother if being breastfed. CMPI is harder to diagnose: as for CMA, foods containing cow’s milk protein are removed from the child’s (and breastfeeding mother’s) diet, and then reintroduced via food (for child and breastfeeding mother) as a “challenge” when the child is symptom-free. If a flaring of symptoms occurs, CMPI may be diagnosed. Some “intolerant” children can tolerate small amounts of CMP, whereas others cannot. Likewise, some mother’s might be lucky enough to still be able to enjoy some CMP while breastfeeding a CMP intolerant infant, depending on the child’s level of sensitivity.
a2 Milk and goat’s milk should not be used by those allergic to cow’s milk, however, I have had some patients with CMPI who are able to tolerate a2 Milk. All children (and breastfeeding mums) eliminating CMP should see an Accredited Practising Dietitian to ensure they are adequately replacing the nutrients like calcium and protein that they would otherwise enjoy from CMP. It is important to seek the opinion of a qualified medical practitioner such as your GP or paediatrician to get a referral to see an Accredited Practising Dietitian if you suspect either food allergy or intolerance.
Common food allergies
Egg, wheat, dairy, soy, tree nuts (especially cashews), peanuts, sesame seeds, shellfish, fish
Common food intolerances
Tomatoes, berries, spreads like honey and jam, wheat, dairy, foods with additives such as artificial colours and flavours, antioxidants, preservatives
Ingredient listings that indicate the presence of dairy: