I have a milk allergy what can i eat

The symptoms of lactose intolerance can be similar to several other conditions, so it’s significant to see your GP for a diagnosis before removing milk and dairy products from your diet.

For example, the symptoms above can also be caused by:

  1. irritable bowel syndrome (IBS) – a long-term disorder that affects the digestive system
  2. milk protein intolerance – an adverse reaction to the protein in milk from cows (not the same as a milk allergy)

If your GP thinks you have lactose intolerance, they may propose avoiding foods and drinks containing lactose for 2 weeks to see if your symptoms improve.


What is the difference between an allergy and intolerance?

The terms 'food allergy' and 'food intolerance' are often used interchangeably, although they actually refer to extremely diverse conditions.

A true food 'allergy' is a reaction which involves the immune system and can cause a range of symptoms extremely quickly. In some cases, an allergic reaction to a food can be severe and even life-threatening. In contrast, an 'intolerance' is generally less severe,does not involve the immune system, and symptoms are often delayed.


Complications of lactose intolerance

Milk and other dairy products contain calcium, protein and vitamins, such as A, B12 and D.

Lactose also helps your body absorb a number of other minerals, such as magnesium and zinc.

These vitamins and minerals are significant for the development of strong, healthy bones.

If you’re lactose intolerant, getting the correct quantity of significant vitamins and minerals can prove hard.

This may lead to unhealthy weight loss and put you at increased risk of developing the following conditions:

  1. osteoporosis – where your bones become thin and feeble, and your risk of breaking a bone is increased
  2. osteopenia – where you own a extremely low bone-mineral density; left untreated, it can develop into osteoporosis
  3. malnutrition – when the food you eat does not give you the nutrients essential for a healthy functioning body; this means wounds can take longer to heal and you may start to feel tired or depressed

If you’re concerned that dietary restrictions are putting you at risk of complications, you may discover it helpful to consult a dietitian.

They can advise you on your diet and whether you require food supplements.

Your GP should be capable to refer you to an NHS dietitian free of charge. Or you can contact a private dietitian.

The British Dietetic Association has information on how to discover a private dietitian.

Sheet final reviewed: 25 February 2019
Next review due: 25 February 2022

What Happens With a Milk Allergy?

Food allergies involve the body’s immune system, which normally fights infection. When someone is allergic to a specific food, the immune system overreacts to proteins in that food.

People who are allergic to cow’s milk react to one or more of the proteins in it.

Curd, the substance that forms chunks in sour milk, contains 80% of milk’s proteins, including several called caseins (pronounced: KAY-seenz). Whey (pronounced: WAY), the watery part of milk, holds the other 20%. A person may be allergic to proteins in either or both parts of milk.

Every time the person eats these proteins, the body thinks they are harmful invaders. The immune system responds by kicking into high gear to fend off the «invader.» This causes an allergic reaction, in which chemicals love histamine are released in the body.

The release of these chemicals can cause someone to own the following problems:

  1. red spots
  2. wheezing
  3. swelling
  4. diarrhea
  5. vomiting
  6. coughing
  7. hoarseness
  8. throat tightness
  9. stomachache
  10. itchy, watery, or swollen eyes
  11. hives
  12. trouble breathing
  13. a drop in blood pressure

Milk allergy is love most food allergy reactions: It generally happens within minutes to hours after eating foods that contain milk proteins.

Although it’s not common, milk allergies can cause a severe reaction called anaphylaxis.

I own a milk allergy what can i eat

Anaphylaxis may start with some of the same symptoms as a less severe reaction, but then quickly worsen. A person might own trouble breathing, feel lightheaded, or pass out. If it’s not treated, anaphylaxis can be life-threatening.

Milk allergy is often confused with lactose intolerance because people can own the same kinds of things happening to them (like stomach pains or bloating, for example) with both conditions. But they’re not related:

  1. Milk allergy is a problem involving the immune system.
  2. Lactose intolerance involves the digestive system (which doesn’t produce enough of the enzyme needed to break below the sugar in milk).

Complications of lactose intolerance

Milk and other dairy products contain calcium, protein and vitamins, such as A, B12 and D.

Lactose also helps your body absorb a number of other minerals, such as magnesium and zinc.

These vitamins and minerals are significant for the development of strong, healthy bones.

If you’re lactose intolerant, getting the correct quantity of significant vitamins and minerals can prove hard.

This may lead to unhealthy weight loss and put you at increased risk of developing the following conditions:

  1. osteoporosis – where your bones become thin and feeble, and your risk of breaking a bone is increased
  2. osteopenia – where you own a extremely low bone-mineral density; left untreated, it can develop into osteoporosis
  3. malnutrition – when the food you eat does not give you the nutrients essential for a healthy functioning body; this means wounds can take longer to heal and you may start to feel tired or depressed

If you’re concerned that dietary restrictions are putting you at risk of complications, you may discover it helpful to consult a dietitian.

They can advise you on your diet and whether you require food supplements.

Your GP should be capable to refer you to an NHS dietitian free of charge. Or you can contact a private dietitian.

The British Dietetic Association has information on how to discover a private dietitian.

Sheet final reviewed: 25 February 2019
Next review due: 25 February 2022

Methodology

The NICE guideline was written to direct the diagnosis of every food allergies. CMA is however, the most clinically complicated individual food allergy and therefore causes significant challenges in both recognising the numerous differing clinical presentations and also the varying approaches to management, both at primary care and specialist level.

A subgroup of the clinicians on the NICE guideline development group (CV, JW, ATF, TB) felt that there was therefore a specific need to extend this into a more practical guideline for cow’s milk allergy for UK Primary Care use. This need was further emphasized by the publication of international and European guidelines on cow’s milk allergy[2, 7–9]. This subgroup, with the additional expertise of a paediatric gastro-enterologist (NS) has produced a UK Primary Care Guideline in the form of practical algorithms.

Prior to the development of this Primary Care Guideline, the group discussed significant questions that they wanted to address and which clear, practical messages they wanted to convey to UK primary care.

These were:

  1. To provide guidance on formula choice in the initial diagnosis of CMA based on the current international guidelines.

  2. How to distinguish between:

  3. 1)

    IgE-mediated and non-IgE-mediated presentations of CMA.

  4. 2)

    Severe and mild to moderate clinical expressions of CMA.

  5. Give guidance about the ongoing management of mild to moderate non-IgE-mediated CMA in primary care.

A literature search was conducted to ensure that every major food allergies and cow’s milk allergy guidelines published in the past five years were included.

These included the World Allergy Organisation’s Guidelines on Cow’s Milk Allergy[2], the NIAID Food Allergy Guidelines from the US[10], the UK NICE Guideline on Food Allergy in Children and Young People[6], the ESPGHAN guidelines on the diagnosis and management of cow’s milk allergy[7]and the Australian consensus statement on the diagnosis and management of cow’s milk allergy[11]. Every these papers were informed by extensive systematic reviews of the literature and the group (CV, TB, JW, NS, ATF), felt that they were rigorous enough to build this proposed additional practical guideline on.

It is intended to complement the NICE Food Allergy Guideline.

How Can Doctors Tell It’s a Milk Allergy?

If your doctor suspects you might own a milk allergy, he or she will probably refer you to an allergist or allergy specialist for more testing. The allergy specialist will enquire you questions — love how often you own the reaction, the time it takes between eating a specific food and the start of the symptoms, and whether any family members own allergies or conditions love eczema and asthma.

The allergy specialist may do a skin test on you. This involves placing liquid extracts of milk protein on your forearm or back, pricking the skin a tiny bit, and waiting to see if a reddish, raised spot forms, indicating an allergic reaction.

You may need to stop taking anti-allergy medications (such as over-the-counter antihistamines) or prescription medicine 5 to 7 days before the skin test because they can affect the results.

Most freezing medicines and some antidepressants also may affect skin testing. Check with the allergist’s office if you are unsure about what medications need to be stopped and for how long.

The doctor also might take a blood sample and send it to a lab, where it will be mixed with some of the suspected allergen and checked for IgE antibodies.

These types of tests are used for diagnosing what doctors call a fast-onset type of milk allergy.

But for people whose allergic reactions to milk develop more slowly, skin and blood tests are not as helpful.

In these cases, doctors attempt to diagnose the person using a food challenge. The person is told not to eat or drink anything made with milk for a period of time — generally a few weeks. Then, during the challenge, the person eats foods containing milk under a doctor’s shut supervision. If symptoms come back after eating milk products, it’s a beautiful certain bet the person has a milk allergy.

Common allergy

Cow's milk allergy is one of the most common food allergies in children, affecting between two and 7.5 percent of infants under one, although some grow out of it by the age of five.

I own a milk allergy what can i eat

Symptoms include an itchy rash or swelling, stomach ache, vomiting, colic, diarrhea or constipation, and a runny nose. Symptoms can appear almost immediately or up to 72 hours after consuming cow's milk protein. This makes it hard to diagnose.

A large problem affecting infants can be gastrointestinal bleeding resulting from cow's milk allergy. Blood loss often occurs in such little quantities that it goes unnoticed but over time can cause iron-deficiency anemia.

Scientists propose that blood loss associated with cow's milk consumption during infancy may affect 40 percent of otherwise healthy infants.

Exactly how cow's milk causes blood loss from the intestines is unclear but it's generally agreed that it is probably an adverse immune (allergic) reaction.

However, because healthy infants lose some blood anyway and cow's milk-induced bleeding is clinically silent and shows no other symptoms, it's hard to tell how numerous more infants than the widely accepted figure of less than 10 percent may actually be allergic to cow's milk.

Not excellent for kids

Regardless of these problems, it's simply not a excellent thought to give cow's milk to children at every as it contains virtually no iron but does contain potent inhibitors, reducing the body's ability to absorb iron from other foods in the diet.

The high protein, sodium, potassium, phosphorus, and chloride content of cow's milk present what is called a 'high renal solute load'.

Unabsorbed solutes from the diet must be excreted by the kidneys and this can put a strain on immature kidneys, forcing them to draw water from the body thus increasing the risk of dehydration. This is why most health bodies tell that cow's milk should not be given to children under 12 months of age.

Diagnosis of Cow’s milk allergy

Non-IgE -Mediated CMA

There are no validated tests for the diagnosis of non-IgE CMA, apart from the planned avoidance of cow’s milk and cow’s milk containing foods, followed by reintroduction as a home challenge to confirm the diagnosis[17].

Home reintroduction/challenges may not be acceptable in children with severe forms of non-IgE- mediated cow’s milk allergy, and these children should be referred to secondary/tertiary care[6].

History taking

Taking an allergy focused history forms the cornerstone of the diagnosis of food allergies including CMA and the UK NICE guideline[6] recommends that questions should be asked regarding:

  1. Details of previous management, including any medication and the perceived response to any management.

  2. Any family history of atopic disease in parents or siblings.

  3. Presenting symptoms and signs that may be indicating possible CMA.

  4. The infant’s feeding history.

  5. Any personal history of early atopic disease.

  6. Was there any attempt to change the diet and what was the outcome?

An EAACI task force also dealt with the significant questions that should be asked during an allergy focused diet history, and will be available later this year.

Following on from these questions is the significant step to attempt to differentiate between possible IgE and non-IgE -mediated allergies (Figure 2) and which “tests” to do.

IgE-Mediated CMA

For the diagnosis of IgE-mediated CMA, the use of skin prick tests (SPT) or specific serum IgE tests are recommended, but these should only be performed by those capable to interpret the tests[16].

It is significant to understand that a positive SPT or specific serum IgE test merely indicates sensitisation and does not confirm clinical allergy. However, a positive test coupled with a clear history of a reaction should generally be sufficient to confirm a diagnosis. Although a diagnostic oral food challenge (after a short period of cow’s milk avoidance) may not be required in most of these cases, if such a challenge is conducted, it may need to be performed in a supervised setting in the majority of cases.

Liasion with or referral to a local paediatric allergy team is recommended (see Figure 3).

The role of dietary interventions in the diagnosis of IgE and non-IgE-mediated CMA

Maternal avoidance of cow’s milk in the case of breast fed infants, or choosing an appropriate formula for bottle fed/partially bottle fed infants are crucial steps in the diagnosis of CMA. Mothers excluding cow’s milk from their diet should be supplemented with calcium and vitamin D[18] (Figure 2).

Choosing the most appropriate formula (Figure 3, Figure 4; Table 1) for the baby based on the clinical presentation is debated with clear differences between countries.

This choice is really a clinical decision which should be based on clinical presentation and the nutritional composition and residual allergenicity of the proposed hypoallergenic formula.

The problem clinicians face is that it may appear there is a large body of evidence about alternatives to cow’s milk formulae, but most of the research is of low quality and there are a relatively little number of studies about each type of formula. There are extremely few studies comparing the diverse formulae in RCTs head to head and the clinical profiles of the patients who improved and did not improve are often extremely poorly described.

This puts the physician and dietitian in a extremely hard position when choosing the most appropriate formula for a specific clinical presentation. In some cases choosing a soya or an extensively hydrolysed formula (eHF), which the baby may also react to, may lead to a untrue negative diagnosis. Alternatively, choosing an amino acid formula (AAF) when not indicated increases the cost burden of managing CMA and may affect development of tolerance (albeit the data is extremely preliminary at this time)[19, 20].

Table 1 summarises the current international guidelines on the use of hypo-allergenic formulae in the diagnosis and management of CMA.

It is accepted that the majority of children with CMA will improve on an extensively hydrolysed formula. It is therefore not surprising that in general, the guidelines propose the use of an AAF, as a first line treatment, only for more severe presentations of CMA such as a history of anaphylaxis, Heiner Syndrome, Eosinophilic Eosophagitis and severe gastro-intestinal and/or skin presentations, generally in association with faltering growth. They recommend the use of an eHF for every other clinical presentations.

Unfortunately, apart from the ESPGHAN guidelines[21], none of the guidelines[2, 6, 10, 11, 22] discuss the use of formulae in two significant patient groups, namely those with multiple food allergies, and those infants who do not reply to maternal avoidance of cow’s milk (and other suspected allergens) despite a excellent clinical suspicion that these infants may be reacting to residual allergens.

These cases own been reviewed by Hill et al.[23], Niggeman et al.[24] and Van den Plas et al.[8] with data suggesting that these groups may benefit from an AAF.

I own a milk allergy what can i eat

The systematic review by Hill et al.[23] further suggested that those infants presenting with symptoms of CMA whilst exclusively breast fed, who may need a top-up formula or a replacement of breast milk may also benefit from an AAF.

The use of soya formula in the diagnosis and management of CMA is also debated, with clear differences between the Australian consensus panel[11] and the ESPGHAN[7]/AAP[22, 25] guidelines. ESPGHAN and AAP acknowledge that only about 10-14% of infants with IgE- mediated CMA will also react to soya, but that this figure is much higher in infants with non-IgE- mediated CMA (25–60%).

The two societies therefore recommend that cow’s-milk-based hypoallergenic formulae should ideally be chosen rather than soya formula in the management of CMA. In addition, soya formula contains phytate which may affect nutrient absorption and isoflavonoids in amounts that make soya milk unsuitable for use in every infants under six months of age. Soya can however be used in infants older than 6 months if eHF is not accepted or tolerated, if these hypoallergenic formulae are too expensive, or if there are strong parental preferences (e.g.

I own a milk allergy what can i eat

vegan diet).

In addition, there own been some questions raised regarding the use of hypoallergenic formulae containing lactose in the diagnosis and management of infants and young children with CMA. ESPGHAN[7] advises that adverse reactions to lactose in children with CMA is not reported in the literature and finish avoidance of lactose is not needed in the majority of cases, apart from those children who own an enteropathy with severe diarrhoea where there is a secondary lactose intolerance.

I own a milk allergy what can i eat

Two randomised trials suggested that rice based hydrolysed formula is well tolerated by infants with CMA[26, 27] although there are some concerns about the effect of these formulae on weight gain[28].

Therefore, to summarise the above discussion, taking into account the lack of excellent quality studies in this field:

  1. eHF is recommended as a first line of choice for infants with mild to moderate presentations of CMA e.g. colic, reflux, diarrhoea, vomiting, eczema in the absence of faltering growth.

    eHF containing whey may not be suitable as a first line of treatment of those infants with possible secondary lactose intolerance[7].

  2. Breast-feeding is always the preferred way to feed any baby. In any case where there is a need to exclude cow’s milk from the maternal diet and a top-up formula is needed, we propose in agreement with Hill et al.[23] an amino acid based formula as the B-lactoglobulin levels and peptide sizes of cow’s milk protein in breast milk and those of eHF are similar to the ranges of B-lactoglobulin seen in breast milk[29–33].

  3. AAF is recommended as a first line of treatment for those infants with a history of anaphylaxis to cow’s milk, Heiner Syndrome, Eosinophilic Eosophagitis and severe gastro-intestinal and/or skin presentations, particularly in association with faltering growth.

  4. Soya formula can be used in infants over 6 months of age who do not tolerate the eHF, particularly if they are suffering from IgE mediated CMA in the absence of sensitisation to soya.

Lactose intolerance and cow's milk allergy often get mixed up.

Lactose intolerance is caused by a lack of an enzyme that helps you to digest the sugar in milk.

I own a milk allergy what can i eat

Cow’s milk allergy, on the other hand, is an adverse immune reaction to proteins found in milk. They are completely unrelated conditions except that they share a common cause – cow’s milk and dairy products.

After returning from the Beagle expedition in 1836, Charles Darwin wrote: "I own had a bad spell. Vomiting every day for eleven days, and some days after every meal."

Darwin struggled for more than 40 years with endless bouts of vomiting, stomach cramps, headaches, severe tiredness, skin problems, and depression. Researchers now ponder that he had lactose intolerance, and his case is a excellent example of how easily it can be missed or misdiagnosed.

What is lactose?

Lactose is the sugar in mammal's milk. In order to release its energy, it must be broken below into its constituent simple sugars – glucose and galactose – so they can be absorbed. This task falls to an enzyme called lactase, produced by cells lining our little intestines

If your body doesn't produce this enzyme, then lactose travels to the large intestine where it is fermented by gut bacteria, producing hydrogen and a range of potential toxins.

Lactase and weaning

Everyone naturally produces lactase when they are babies – without it we couldn't drink our mother's milk. However, every mammals and the vast majority of people stop producing it soon after weaning – for us, around the age of two. This is the normal state for most people – around 70 percent of the world's population, in fact.

In Northern Central Europe, lactose intolerance affects between two and 20 percent of people, rising to 40 percent in Mediterranean countries – most common in Italy where it affects 56-70 percent in some regions.

Highest rates are seen in Africa, where it affects 65-75 percent of people, and Asia, where more than 90 percent of people are lactose intolerant.

Lactase persistence

So why are some people capable to digest lactose after weaning and others not?

'Lactase persistence' originates from a genetic mutation that occurred among a little number of European and African pastoral tribes within the final 5,000-10,000 years – in evolutionary terms, this is extremely recent history.

It provided a selective advantage to populations using dairy products, enabling them to live endless enough to own children. The average life expectancy was probably little more than 25 years, but this meant the ability to digest lactose could be passed on to subsequent generations.

Descendants of these people are still capable to consume cow's milk without suffering the symptoms of lactose intolerance. It doesn't mean, however, that it's excellent for them.

Cow's milk allergy

Cow's milk allergy is extremely diverse to lactose intolerance.

An allergic reaction is when the body's immune system launches an inappropriate response to substances mistakenly perceived as a threat.

Common triggers include latex, detergent, dust, pollen or certain proteins in food. In cow's milk, it is the protein casein that causes most problems, but whey protein can also trigger a reaction in some people.

General symptoms include inflammation, sneezing, runny nose, itchy eyes, and so on, giving rise to the classic allergies – asthma, eczema, hay fever, and urticaria (skin rash or hives).

Because cow's milk allergy is linked to numerous conditions – including asthma and eczema – it's always useful to consider it when treating them.

The calcium myth

It's a myth that people who avoid dairy miss out on calcium – there are numerous excellent non-dairy sources, including green leafy vegetables (spinach is a relatively poor source as it contains oxalate which binds calcium), dried fruits, nuts and seeds, calcium-set tofu and calcium-fortified soy milk. Remember, 70 percent of the world's population don't do dairy – so you're not alone.

Dairy consumption in the UK is in decline as the market for plant-based milks, vegan cheese, yogurt, and other alternatives is booming.

Whether you are lactose intolerant, allergic to cow's milk protein, or simply desire to cut out dairy for health reasons, the animals or the environment, there's never been a better time to go dairy-free.

Going vegan has never been easier, there are vegan foods labeled as such in every major supermarket. Discover out how simple it is on Viva!'s website here 

So numerous foods are made with milk and milk products these days that people with milk allergies own to pay attention to what’s in just about everything they eat. And a milk allergy is not the same as lactose intolerance — some people with food allergies can become suddenly and severely ill if they eat or even come in contact with the food they’re allergic to.

Some foods that contain milk are obvious, love pizza.

But others, love baked goods, might not be so obvious. Plus, teens need calcium and vitamin D, which milk has lots of, because their bones are still growing.

So what should a person who’s allergic to milk do? Read on to discover out.

Prevalence of CMA

Population based studies report that the prevalence of Cow’s Milk Allergy (CMA) ranges from 1.9 – 4.9% in young children[2]. UK data from 2008 indicated 2.3% of 1–3 year olds suffer from CMA, the majority of these presenting with non-IgE-mediated CMA[3].

A meta-analysis by Rona et al.[4] reported that Cow’s milk (CM) is one of the most common foods which is responsible for allergic reactions in European children. In general, the prognosis for CMA is excellent, with up to 80-90% of children developing tolerance before three years of age[12]. However, CMA may persist up to school age and may be associated with the later development of other allergic diseases such as asthma, rhinoconjunctivitis, and atopic dermatitis[13], as well as other disease manifestations such as recurrent abdominal pain[14]. It is also well-known that perceived prevalence may be much higher[4, 12] than that confirmed by appropriate tests.

Cow’s milk formula or cow’s milk containing foods frolic an significant role in the nutritional intake of children particularly in early infancy. Onset after infancy has also been uncommonly reported[3].

Ditching lactose

The treatment for lactose intolerance is straightforward: avoid lactose. It means cutting out every cow's milk, and other dairy foods and checking labels as lactose is added to numerous unlikely foods, including bread, breakfast cereals, salad cream, mayonnaise, biscuits, chocolate, cake, crisps, instant soup and some processed meats, such as sliced ham.

The expression 'lactose' will not necessarily be listed on food labels so glance out for things love dried milk or whey powder.

Lactose is also used as a filler in numerous types of medication and while this may not trigger symptoms in most people with lactose intolerance, it can cause problems in some. Check with your doctor and request lactose-free tablets.

Avoiding cow's milk

The only dependable treatment for cow's milk allergy is to avoid every cow's milk and dairy products, including milk, milk powder, milky drinks, cheese, butter, margarine, yogurt, cream, and ice-cream.

Products with hidden milk content should also be avoided – glance out for: casein, caseinates, hydrolyzed casein, skimmed milk, skimmed milk powder, milk solids, non-fat milk, whey, and milk solids.

People with cow's milk allergy face a similar problem as those avoiding lactose – milk-based ingredients can be hard to avoid as they are commonly used in the production of so numerous foods. It can seem a daunting prospect, having to read the ingredients labels, but most supermarkets now produce product 'free-from' lists, and numerous own their own-label range.

There are even iPhone apps available now to assist you identify ingredients by scanning the product bar code. Soya ice creams, spreads and yogurts, and dairy-free cheeses are just some 'free-from' examples.

What is lactose intolerance?

This is 'lactose intolerance', and most symptoms result from the production of gases and toxins by these gut bacteria. Symptoms include a bloated and painful stomach, wind, diarrhea, and, on some occasions, nausea and vomiting.

Other symptoms can include muscle and joint pain, headaches, dizziness, lethargy, difficulty with short-term memory, mouth ulcers, allergies, irregular heartbeat, sore throat, increased need to pass urine, acne, and depression.

Even more worrying is that the toxins produced by bacteria may frolic a key role in diseases such as diabetes, rheumatoid arthritis, multiple sclerosis, and some cancers.

The diverse manifestations of CMA

According to the UK NICE guideline[6], food allergy can manifest as a number of diverse clinical presentations, mainly affecting the skin, gastro-intestinal tract and respiratory systems.

The NICE guideline[6] emphasises that food allergies should be particularly considered 1) in infants where there is a family history of allergic disease (but the absence of a family history of allergy does not exclude the possibility of becoming allergic), 2) in infants where symptoms are persistent and affecting diverse organ systems and 3) in infants who own been treated for moderate to severe atopic eczema, gastro-oesophageal reflux disease (GORD) or other persisting gastrointestinal symptoms (including ‘colic’ , loose stools, constipation), but own not responded to the usual initial therapeutic interventions.

In Figure 2 of the algorithms, we own divided IgE and non-IgE-mediated CMA into “mild-moderate presentations” and “severe presentations” to aid in the diagnostic process, management of CMA and appropriate onward referral.

Therefore, most importantly, Figure 2 gives a clear message about which infants can be safely diagnosed and managed in UK primary care without any onward referral to secondary or tertiary care.

Developing allergies

Although a lot of food allergies start in childhood, you can develop them as an adult, too. Cow's milk allergy in adults is relatively rare, but symptoms tend to be much more severe than in children when they do happen, with reactions being triggered by amounts as low as 0.3 milligrams of cow's milk protein.

The most severe type of allergic reaction (anaphylactic shock) may involve difficulty in breathing, a drop in blood pressure, and ultimately heart failure and death.

Occasionally, cow's milk allergy can cause severe symptoms that come on suddenly, such as swelling in the mouth or throat, wheezing, coughing, shortness of breath, and difficulty breathing. In such cases, immediate medical assist must be sought.

Nomenclature

The first step in making the correct diagnosis and managing infants and children with cow’s milk allergy is to own a excellent understanding of the immune mechanisms involved. According to the European Academy for Allergy and Clinical Immunology (EAACI) and the World Allergy Organisation (WAO)[15], a hypersensitivity reaction to cow’s milk can be referred to as cow’s milk allergy if it involves the immune system.

I own a milk allergy what can i eat

Non-allergic cow’s milk hypersensitivity (lactose intolerance) on the other hand, does not involve the immune system. Cow’s milk allergy is further divided into IgE-mediated cow’s milk allergy and non-IgE-mediated cow’s milk allergy[7]. There is however clinical overlap between some presentations of cow’s milk allergy as indicated by the US food allergy guidelines[10].

How Is It Treated?

To treat a milk allergy, the person who is allergic needs to completely avoid any foods that contain milk or milk products.

Avoiding milk involves more than just leaving the cheese off your sandwich.

If you are allergic to milk, you need to read food labels carefully and not eat anything that you’re not certain about. It’s a excellent thought to work with a registered dietitian to develop an eating plan that provides every the nutrients you need while avoiding things you can’t eat.

If you own a severe milk allergy — or any helpful of serious allergy — your doctor may desire you to carry a shot of epinephrine (pronounced: eh-peh-NEH-frin) with you in case of an emergency.

Epinephrine comes in an easy-to-carry container about the size of a large marker. It’s simple to use — your doctor will show you how.

If you accidentally eat something with milk in it and start having serious allergic symptoms — love swelling inside your mouth, chest pain, or difficulty breathing — give yourself the shot correct away to counteract the reaction while you’re waiting for medical assist. Always call for emergency assist (911) when using epinephrine.

You should make certain your school and even excellent friends’ houses hold injectable epinephrine on hand, too.

Keeping epinephrine with youat every times should be just part of your action plan for living with a milk allergy. It’s also a excellent thought to carry an over-the-counter antihistamine, which can assist ease allergy symptoms in some people. But antihistamines should be used in addition to the epinephrine, not as a replacement for the shot.

If you’ve had to take an epinephrine shot because of an allergic reaction, go immediately to a medical facility or hospital emergency room so they can give you additional treatment if you need it.

Sometimes, anaphylactic reactions are followed bya second wave of symptoms a fewhours later. So you might need to be watched in a clinic or hospital for 4 to 8 hours following the reaction.

Living With a Milk Allergy

It can be challenging to eliminate milk from your diet, but it’s not impossible. Because most people don’t get enough calcium in their diets even if they do drink milk, numerous other foods are now enriched with calcium, such as juices, cereals, and rice and soy beverages. But before you eat or drink anything calcium-enriched, make certain it’s also dairy-free.

Milk and milk products can lurk in strange places, such as processed lunchmeats, margarine, baked goods, artificial butter flavor, and non-dairy products.

Chocolate is another product that may contain dairy — so be certain to check the label before you eat it.

Manufacturers of foods sold in the United States must list on their labels whether a food contains any of the most common allergens. This means that you should be capable to discover the expression «milk» stated plainly in the ingredients list, in parentheses in the ingredients list, or somewhere on the label with a statement like: «Contains milk.»

It is optional, however, for food manufacturers to use «may contain» statements. The U.S. Food and Drug istration does not control whether companies can tell things love «Processed in a facility that also processes milk products» or «May contain milk.» So call the manufacturer to be certain if you see statements love this on a food label.

New labeling requirements make it a little easier than reading the ingredients list — instead of needing to know that the ingredient «hydrolyzed casein» comes from milk protein, you should be capable to tell at a glance which foods to avoid.

But it’s still a excellent thought to get to know the «code words» for milk products when you see them in the ingredients of a food.

Some ingredients and foods that contain milk are:

  1. non-dairy creamers
  2. casein, calcium casein, casein hydrolysate, magenesium casein, potassium casein, rennet casein, sodium casein
  3. lactalbumin, lactoalbumin phosphate, lactaglobulin, lactose, lactoferrin, lactulose
  4. butter, butter flavoring (such as diacetyl), butter fat, butter oil, ghee
  5. dairy products love cheese, yogurt, milk, pudding, sour cream, and cottage cheese
  6. whey, whey hydrolysate

Vegan foods are made without animal products, such as eggs or milk.

You can purchase vegan products at health food stores. Be careful to read the labels of soy cheeses, though. They may tell «milk-free» but could contain milk protein.

For your sweet tooth, soy- or rice-based frozen desserts, sorbets, and puddings are excellent substitutes for ice cream (as endless as you’re not allergic to soy), as are ice pops. For baking, milk substitutes work as well as milk and some come out better.

I own a milk allergy what can i eat

Dairy-free margarine works as well as butter for recipes and spreading on your bagel.

Try to avoid fried foods or foods with batter on them. Even if the batter doesn’t contain milk products, the oil used to fry the foods may own been used to fry something that contains milk.

People are generally understanding when it comes to food allergies — nobody wants to risk your health. When dining out, tell the waitstaff about anything you’re allergic to. Order the simplest foods and enquire the waitstaff detailed questions about menu items. At a friend’s home, explain your situation and don’t be embarrassed to enquire questions if you’re staying for a meal.

Having a milk allergy doesn’t mean you can’t still enjoy eating.

In fact, some people ponder that some of the milk substitutes — love vanilla soy milk — taste better than regular cow’s milk. As with any specialized diet, you’ll probably discover that avoiding milk gives you the chance to explore and discover some grand foods that you’d never own found otherwise!

Dairy-free diet

Discovering that you are intolerant or allergic to dairy products can seem hard to start with. Luckily,with a little knowledge it can be a lot easier to store and eat dairy-free than you might first imagine. Let us start by separating dairy allergy and intolerance as they are two distinctly diverse disorders.


Is it an allergy?

Lactose intolerance is not the same as a milk or dairy allergy.

Food allergies are caused by your immune system reacting to a certain type of food. This causes symptoms such as a rash, wheezing and itching.

If you’re allergic to something, even a tiny particle can be enough to trigger a reaction, while most people with lactose intolerance can still consume little amounts of lactose without experiencing any problems, although this varies from person to person.


Treating lactose intolerance

There’s no cure for lactose intolerance, but cutting below on food and drink containing lactose generally helps to control the symptoms.

Lactose-free products include:

  1. soya milks, yoghurts and some cheeses
  2. lactose-free cows’ milk
  3. rice, oat, almond, hazelnut, coconut, quinoa and potato milks

Your GP may also recommend calcium and vitamin D supplements.

You may be advised to take lactase substitutes, which are drops or tablets you can take with your meals or drinks to improve your digestion of lactose.


Symptoms of lactose intolerance

Symptoms of lactose intolerance usually develop within a few hours of consuming food or drink that contains lactose.

They may include:

  1. stomach rumbling
  2. farting
  3. stomach cramps and pains
  4. a bloated stomach
  5. diarrhoea
  6. feeling ill

The severity of your symptoms and when they appear depends on the quantity of lactose you own consumed.

Some people may still be capable to drink a little glass of milk without triggering any symptoms, while others may not even be capable to own milk in their tea or coffee.


What causes lactose intolerance?

The body digests lactose using a substance called lactase. This breaks below lactose into 2 sugars called glucose and galactose, which can be easily absorbed into the bloodstream.

People with lactose intolerance do not produce enough lactase, so lactose stays in the digestive system, where it’s fermented by bacteria.

This leads to the production of various gases, which cause the symptoms associated with lactose intolerance.

Depending on the underlying reason why the body’s not producing enough lactase, lactose intolerance may be temporary or permanent.

Most cases that develop in adults are inherited and tend to be lifelong, but cases in young children are often caused by an infection in the digestive system and may only final for a few weeks.

Who’s affected

In the UK, lactose intolerance is more common in people of Asian or African-Caribbean descent.

Lactose intolerance can develop at any age. Numerous cases first develop in people aged 20 to 40, although babies and young children can also be affected.


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