What do you give a 1 year old with milk allergy
Treatment depends on the extent of your child’s intolerance. Some children with lactose intolerance may be capable to own little amounts of dairy products without having symptoms.
Your kid may be referred to a dietitian for specialist advice.
Read more about treatment for lactose intolerance in children.
How does cow’s milk protein allergy occur?
Cow’s milk protein can be present in breast milk if the mom has cow’s milk in her diet, and it is also in cow’s milk protein formula.
Reactions can be either immunoglobulin E (IgE) mediated or non-IgE mediated.
These reactions are generally rapid in onset and happen when the milk protein (the allergen) binds to a milk-specific IgE on the surface of mast cells (on skin and in the blood) that recognise the protein as harmful. In response to this, IgE initiates a process of intracellular signalling, leading to the release of histamine and other inflammatory markers that produce local tissue responses characteristic of an allergic reaction (see Table 1).
IgE-mediated reactions happen most commonly in formula-fed children or at the onset of mixed feeding.
|Mild-to-moderate IgE-mediated symptoms||
|Severe IgE-mediated symptoms||Rare||Persistent symptoms||Significant respiratory and/or cardiovascular symptoms|
|If anaphylaxis occurs, call 999|
Diagnosis of non-IgE-mediated milk allergy is more challenging because there is no temporal relationship with ingestion.
The symptoms are also commonly seen in children who do not own CMPA. Symptoms can appear after a couple of hours but can also be delayed for up to 72 hours post-ingestion of cow’s milk protein; the kid may be formula fed, exclusively breastfed, or it may happen at the onset of mixed feeding. Symptoms tend to intensify with increasing exposure to the allergen; therefore, they are seen to build up over a period of time following recurrent exposure through feeding (see Table 2).
Evidence from the UK shows that the majority of children presenting with suspected CMPA drop into a ‘mild-to-moderate’ clinical expression of non-IgE-mediated allergy.
|Mild-to-moderate non-IgE-mediated symptoms||
|Severe non-IgE-mediated symptoms||
Symptoms of cows’ milk allergy
Cows’ milk allergy can cause a wide range of symptoms, including:
- digestive problems – such as stomach ache, vomiting, colic, diarrhoea or constipation
- skin reactions – such as a red itchy rash or swelling of the lips, face and around the eyes
- hay fever-like symptoms – such as a runny or blocked nose
- eczema that does not improve with treatment
Occasionally CMA can cause severe allergic symptoms that come on suddenly, such as swelling in the mouth or throat, wheezing, cough, shortness of breath, and difficult, noisy breathing.
A severe allergic reaction, or anaphylaxis, is a medical emergency – call 999 or go immediately to your local hospital A&E department.
Sheet final reviewed: 12 July 2019
Next review due: 12 July 2022
Eating Away From Home
Cross-contamination can happen in restaurants when milk or milk products get into a food product. The staff might use the same surfaces and utensils (like knives, cutting boards, or pans) to prepare both dairy products and other foods.
This is particularly common in fast-food restaurants, so some people discover it safer to avoid these restaurants altogether.
Buffet-style restaurants also pose a cross-contamination risk, with cheeses and salad dressings dripping over non-dairy food platters. When eating at restaurants, it may be best 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 might own been used to fry something else that contains milk.
When your kid eats in a restaurant or at a friend’s home, discover out how foods are cooked and exactly what’s in them. It can be hard to enquire a lot of questions about cooking methods, and to believe the information you get.
If you can’t be certain that a food is milk-free, it’s best to bring safe food from home.
Also talk to the staff at school about cross-contamination risks for foods in the cafeteria. It may be best to pack lunches at home so you can control what’s in them.
If your kid will be eating at a restaurant, take these precautions:
- Carry a personalized "chef card" for your kid, which can be given to the kitchen staff.
The card details your child’s allergies for food preparers. Food allergy websites provide printable chef card forms in numerous diverse languages.
- Tell the restaurant wait staff that your kid has a milk allergy.
- Don’t eat at a restaurant if the manager or owner seems uncomfortable about your requests for a safe meal.
en españolAlergia a la leche en bebés
Milk from other animals (such as sheep, goats, and buffalo) are not excellent alternatives for those with a cow’s milk allergy because the proteins are similar.
But numerous other milk-free alternatives are available, including ones that are fortified with calcium and vitamin D.
The allergist can tell you which milk substitute is best for your child.
If Your Kid Has an Allergic Reaction
If your kid has symptoms of an allergic reaction, follow the food allergy action plan your doctor gave you.
If your kid has symptoms of a serious reaction (like swelling of the mouth or throat or difficulty breathing, or symptoms involving two diverse parts of the body, love hives with vomiting):
- Give the epinephrine auto-injector correct away. Every second counts in an allergic reaction.
- Then,call 911 or take your kid to the emergency room.
Your kid needs to be under medical supervision because, even if the worst seems to own passed, a second wave of serious symptoms can happen.
What Else Should I Know?
To prevent allergic reactions to milk, your kid must avoid any foods that contain milk, milk products, or milk proteins. Read food labels to see if a food contains milk.
Milk may be found in unexpected places, such as processed meats, canned tuna, and baked goods, so it’s significant to read labels on every foods, even ones that are not dairy foods.
Makers of foods sold in the United States must state in understandable language whether foods contain any of the top eight most common allergens, including milk.
The label should list "milk" in the ingredient list or tell "Contains milk" after the list. For detailed information about foods to avoid, visit Food Allergy Research & Education (FARE).
Some foods glance OK from the ingredient list, but while being made they can come in contact with a food your kid is allergic to.
This is called cross-contamination. Glance for advisory statements such as "May contain milk," "Processed in a facility that also processes milk," or "Manufactured on equipment also used for milk." These are cross-contamination warnings, but manufacturers are not required to list them.
You can contact the company directly to see if a product contains milk. Check the company’s website for this information or email a company representative.
Food makers sometimes change ingredients, so always read the food labels.
What Happens in a Milk Allergy?
When someone is allergic to milk, the body’s immune system, which normally fights infections, overreacts to proteins in the milk.
Every time the person drinks or eats milk or other dairy products, the body thinks these proteins are harmful invaders and releases chemicals love .
This can cause symptoms such as:
- throat tightness
- trouble breathing
- itchy, watery, or swollen eyes
- a drop in blood pressure, causing lightheadedness or loss of consciousness
Allergic reactions to milk can differ. Sometimes the same person can react differently at diverse times. Milk allergy can cause a severe reaction called anaphylaxis, even if a previous reaction was mild. Anaphylaxis might start with some of the same symptoms as a less severe reaction, but can quickly get worse.
The person may own trouble breathing or pass out.
More than one part of the body might be involved. If it isn’t treated, anaphylaxis can be life-threatening.
What Is a Milk Allergy?
When a baby is allergic to milk, it means that his or herimmune system, which normally fights infections, overreacts to proteins in cow’s milk. Every time the kid has milk, the body thinks these proteins are harmful invaders and works hard to fight them. This causes an allergic reaction in which the body releases chemicals love .
Cow’s milk is in most baby formulas. Babies with a milk allergy often show their first symptoms days to weeks after they first get cow milk-based formula.
Breastfed infants own a lower risk of having a milk allergy than formula-fed babies.
People of any age can own a milk allergy, but it’s more common in young children. Numerous kids outgrow it, but some don’t.
If your baby has a milk allergy, hold two epinephrine auto-injectors on hand in case of a severe reaction (called anaphylaxis). An epinephrine auto-injector is an easy-to-use prescription medicine that comes in a container about the size of a large pen.
Your doctor will show you how to use it.
How Is an Allergic Reaction to Milk Treated?
If your kid has been diagnosed with a milk allergy (or any helpful of serious food allergy), hold two epinephrine auto-injectors available in case of an emergency.
An epinephrine auto-injector is a prescription medicine that comes in a little, easy-to-carry container. It’s simple to use. Your doctor will show you how. Kids who are ancient enough can be taught how to give themselves the injection.
If they carry the epinephrine, it should be nearby, not left in a locker or in the nurse’s office.
Every second counts in an allergic reaction. If your kid starts having serious allergic symptoms, love swelling of the mouth or throat or trouble breathing, give the epinephrine auto-injector correct away. Also give the epinephrine auto-injector correct away if your child’s symptoms involve two diverse parts of the body, love hives with vomiting. Then call 911 or take your kid to the emergency room.
Your kid needs to be under medical supervision because even if the worst seems to own passed, a second wave of serious symptoms can happen.
It’s also a excellent thought to carry an over-the-counter (OTC) antihistamine for your kid, as this can assist treat mild allergy symptoms. Use after — not as a replacement for — the epinephrine shot during life-threatening reactions.
How Is a Milk Allergy Diagnosed?
If you ponder your baby is allergic to milk, call your baby’s doctor. He or she will enquire you questions and talk to you about what’s going on.
After the doctor examines your baby, some stool tests and blood tests might be ordered. The doctor may refer you to an allergist (a doctor who specializes in treating allergies).
The allergist might do skin testing.
In skin testing, the doctor or nurse will put a tiny bit of milk protein on the skin, then make a little scratch on the skin. If your kid reacts to the allergen, the skin will swell a little in that area love an insect bite.
If the allergist finds that your baby is at risk for a serious allergic reaction, epinephrine auto-injectors will be prescribed.
Sheet final reviewed: 12 July 2019
Next review due: 12 July 2022
What Is Milk Allergy?
Milk allergy is the most common food allergy in young kids, affecting about 2%–3% of those younger than 3 years ancient.
Numerous kids outgrow it, but some are allergic for a lifetime.
A milk allergy can cause a range of symptoms, from mild to severe.
Allergy to milk is sometimes confused with lactose intolerance. Both can cause problems after drinking milk, but they are extremely diverse and unrelated. Lactose intolerance is annoying and can cause discomfort, but it is not life-threatening. Milk allergy, though, can make someone suddenly and severely ill, and can be life-threatening. That’s why milk and other dairy products must be completely avoided if your kid has a milk allergy.
If you’re not certain if your kid has an intolerance or an allergy, speak with your doctor.
What Are the Signs & Symptoms of a Milk Allergy?
In children who show symptoms shortly after they own milk, an allergic reaction can cause:
- stomach upset
- throat tightness
- trouble breathing
- itchy, watery, or swollen eyes
- a drop in blood pressure causing lightheadedness or loss of consciousness
The severity of allergic reactions to milk can vary.
The same kid can react differently with each exposure. This means that even though one reaction was mild, the next could be more severe and even life-threatening.
Children also can have:
- an intolerance to milk in which symptoms — such as loose stools, blood in the stool, refusal to eat, or irritability or colic — appear hours to days later
- lactose intolerance, which is when the body has trouble digesting milk
If you’re not certain if your kid has an intolerance versus an allergy, talk to your doctor.
Avoiding a Milk Allergy Reaction
If You’re Breastfeeding
If your breastfed baby has a milk allergy, talk to the allergist before changing your diet.
If You’re Formula Feeding
If you’re formula feeding, your doctor may advise you to switch to an extensively hydrolyzed formulaor an amino acid-based formula in which the proteins are broken below into particles so that the formula is less likely to trigger an allergic reaction.
You also might see "partially hydrolyzed" formulas, but these aren’t truly hypoallergenic and can lead to a significant allergic reaction.
If you’re concerned about a milk allergy, it’s always best to talk with your child’s doctor and work together to select a formula that’s safe for your baby.
Do not attempt to make your own formula.
Commercial formulas are approved by the U.S. Food and Drug istration (FDA) and created through a extremely specialized process that cannot be duplicated at home.
Other types of milk that might be safe for an older kid with a milk allergyare not safe for infants.
If you own any questions or concerns, talk with your child’s doctor.
You may own heard that cow’s milk should not be given to babies younger than 1 year ancient. This is because cow’s milk doesn’t provide enough of certain nutrients. Also, it’s hard for your baby to digest the protein and fat in cow’s milk.
It is safe though, to give cow’s milk to children after they’re 1 year old.
A kid who is 1 or 2 years ancient should only drink whole milk. This is because the fat in whole milk is needed for your child’s developing brain. After 2 years ancient, children can drink low-fat milk or even skim milk if they are overweight.
Some children own problems from drinking cow’s milk. For instance, a milk allergy may cause:
- Nausea and vomiting
- Belly pain or cramping
A severe allergy can cause bleeding in the intestines that can lead to anemia. But only about 1% to 3% of children under 1 year ancient own a milk allergy. It is even less common in children who are older than 1 to 3 years.
Lactose intoleranceoccurs when the little intestine does not make enough of the enzyme lactase.
A kid who is lactose intolerant can’t digest lactose. This is a type of sugar found in milk and other dairy products. The condition can cause bloating and diarrhea.
If your kid has one of these problems, your health care provider may recommend soy milk. But numerous children who are allergic to milk are also allergic to soy.
Children generally outgrow allergies or intolerances by the time they are 1 year ancient. But having one food allergy increases the risk for having other types of allergies.
If your kid can’t own dairy or soy, talk to your provider about other food options that will assist your kid get enough protein and calcium.
The US Department of Agriculture recommends the following daily amounts of dairy for children and teens:
- Four through 8 years old: 2½ cups (600 milliliters)
- Two through 3 years old: 2 cups (480 milliliters)
- Nine through 18 years old: 3 cups (720 milliliters)
One cup (240 milliliters) of dairy equals:
- Eight ounces (240 milliliters) of yogurt
- One cup (240 milliliters) of milk
- Two ounces (56 grams) of processed American cheese
- One cup (240 milliliters) of pudding made with milk
Milk and children; Cow’s milk allergy — children; Lactose intolerance — children
Nowak-Wegrzyn A, Burks AW, Sampson HA.
Reactions to foods. In: Adkinson NF, Bochner BS, Burks AW, et al, eds. Middleton’s Allergy: Principles and Practice. 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap 81.
Parks EP, Shaikhkhalil A, Groleau V, Wendel D, Stallings VA. Feeding healthy infants, children, and adolescents. In: Kliegman RM, Stanton BF, St. Geme JW, Schor NF, eds. Nelson Textbook of Pediatrics. 20th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 45.
United States Department of Agriculture. ChooseMyPlate.gov website. Dairy. www.choosemyplate.gov/dairy.
Updated November 3, 2017. Accessed October 6, 2017.
Updated by: Neil K. Kaneshiro, MD, MHA, Clinical Professor of Pediatrics, University of Washington School of Medicine, Seattle, WA. Also reviewed by David Zieve, MD, MHA, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.
Source: Hero Images Inc. / Alamy Stock Photo
Allergy is an adverse overreaction by the immune system to a harmless substance. A food allergy occurs when specific components of a food (typically proteins) are recognised by allergen-specific antibodies or cells, eliciting specific immunological reactions that result in characteristic symptoms.
Food allergy is an significant public health problem that affects both adults and children.
Cow’s milk protein allergy (CMPA) is the abnormal response to proteins found in cow’s milk or products containing milk proteins.
The reported prevalence of CMPA varies owing to possible misinterpretations of presumed reactions to milk and diagnostic criteria, and is often overestimated. A pan-European study using the gold standard food challenge test for diagnosis confirmed CMPA in around 1% of children aged up to two years.
Identification of CMPA can be hard because the typical symptoms are not specific to CMPA alone, and instead are common in children (e.g. skin rashes, reflux, colic and diarrhoea). If left untreated, CMPA can lead to faltering growth, persistent unpleasant symptoms and in rare instances can be life-threatening. Furthermore, CMPA is often confused with lactose intolerance, making diagnosis even more difficult,.
Lactose is a component of milk and dairy products; an intolerance may happen when lactase, the enzyme required to break lactose into glucose and galactose, is lacking. This malabsorption leads to gastrointestinal side effects (e.g. bloating, diarrhoea and flatulence), but lactose intolerance is highly unlikely in a kid aged under three years unless they own a history of a gastrointestinal infection.
This article provides an overview of how pharmacists, pharmacy teams and other healthcare professionals can assist to identify a kid with possible CMPA, ensuring a timely diagnosis and initiation of the most appropriate management plan.
Further information can be found in the Milk Allergy in Primary Care (MAP) guideline.
Could it be lactose intolerance?
Lactose intolerance is another type of reaction to milk, when the body cannot digest lactose, a natural sugar found in milk.
However, this is not an allergy.
Lactose intolerance can be temporary – for example, it can come on for a few days or weeks after a tummy bug.
Symptoms of lactose intolerance include:
- stomach rumbling and pains
Cows’ milk allergy in babies
Cows’ milk allergy (CMA), also called cows’ milk protein allergy, is one of the most common childhood food allergies. It is estimated to affect around 7% of babies under 1, though most children grow out of it by the age of 5.
CMA typically develops when cows’ milk is first introduced into your baby’s diet either in formula or when your baby starts eating solids.
More rarely, it can affect babies who are exclusively breastfed because of cows’ milk from the mother’s diet passing to the baby through breast milk.
There are 2 main types of CMA:
- immediate CMA – where symptoms typically start within minutes of having cows’ milk
- delayed CMA – where symptoms typically start several hours, or even days, after having cows’ milk
Treatment for CMA
If your baby is diagnosed with CMA, you’ll be offered advice by your GP or an allergy specialist on how to manage their allergy.
You may also be referred to a dietitian.
Treatment involves removing every cows’ milk from your child’s diet for a period of time.
If your baby is formula-fed, your GP can prescribe special baby formula.
Do not give your kid any other type of milk without first getting medical advice.
If your baby is exclusively breastfed, the mom will be advised to avoid every cows’ milk products.
Your kid should be assessed every 6 to 12 months to see if they own grown out of their allergy.
Read more about cows’ milk allergy.