A true milk protein allergy usually appears in the first year of life, when an infant’s digestive system is still quite immature.
Milk allergy symptoms may appear anywhere from a few minutes to a few hours after the child consumes a milk product, but the most severe symptoms usually occur within half an hour. The most common symptoms are:
- Gastrointestinal/stomach upset
- Vomiting and/or diarrhea.
Less common symptoms include blood in the stool.
In babies, if the milk allergy affects their respiratory system, they also may have chronic nasal stuffiness, a runny nose, cough, wheezing, or difficulty in breathing. The allergy also can cause eczema, hives, swelling, itching, or a rash around the mouth and on the chin due to contact with milk.
If you suspect your baby has an allergy to milk, tell your pediatrician, and be sure to mention whether there’s a family history of allergy. Take your child to the doctor’s office or emergency room immediately if he
- Has difficulty breathing
- Turns blue
- Is extremely pale or weak
- Has generalized hives
- Develops swelling in the head and neck region
- Has bloody diarrhea
If your breastfed infant develops a milk allergy, your pediatrician may recommend that you follow a milk-free diet yourself. (You should take an extra calcium supplement in addition to the prenatal vitamin that you are already taking.) As you wean your baby, delay feeding him cow’s milk as long as possible, and give it very cautiously at first, at the direction of your doctor.
Infants with milk allergy should be given alternatives like soy formula or elemental formula, according to your pediatrician’s guidelines. Ask your doctor to recommend a brand of hypoallergenic formula made with extensive hydrolysate protein, which is processed in a way to avoid allergic reactions. He can not only offer guidance on which formulas to select, but also where to buy them (they’re not available in all stores).
Infants over one year old
If your pediatrician suspects that a milk allergy is present, first he will try eliminating milk and milk products completely for a period of time to see if there is any improvement. If there is, your child may then be given a milk trial—that is, a controlled introduction of milk to the diet. This will reveal whether the symptoms decrease or disappear when milk is avoided and if they reappear when it’s introduced again. This trial of milk should be carried out cautiously and under the supervision of a doctor; don’t experiment by trying to introduce milk on your own—talk with your pediatrician. Infants who are allergic to milk can become sick quickly, even if exposed to only a small amount.
A young child over the age of one year who has a milk allergy will need to avoid cheese, yogurt, ice cream, and any food that contains milk. She will need a milk substitute like soy milk; if she’s also sensitive to soy protein (some children are allergic to both soy and milk), your doctor can suggest still another milk substitute.
Your pediatrician can use several appropriate medications to treat a reaction to milk; these include antihistamines and antiasthma medication (if wheezing is among your child’s allergy symptoms). However, the main “treatment” is to eliminate milk and milk products from your child’s diet. Most children eventually will outgrow the allergy by ages two to five years; this allergy seldom lasts until adolescence.
By the way, be sure to tell all of your child’s caregivers (including babysitters and those in child care settings) of your child’s milk allergy so he is not given milk by mistake.
As mentioned earlier, breastfeeding a baby is the best way to prevent a milk allergy from developing in a newborn. Particularly if anyone in your immediate family is allergy-prone, you should plan to breastfeed your baby; research has shown that breastfeeding for at least four months (some recommend exclusive breastfeeding to six months or longer) can prevent or delay the development of allergies to cow’s milk. When you eventually introduce other foods to your baby, you’ll want to do it gradually (a new one at one- or two-week intervals), watching for the signs of allergy.
If you cannot breastfeed, ask your pediatrician to guide you in selecting an appropriate formula (as discussed above).