Along
with wheat,
milk
is among the top allergens for children if not the leading allergy for babies
under one year old. As
with all allergies, milk allergy is a case of mistaken identity by the immune
system; in this case, it mistakes the proteins in milk as foreign invaders and
releases histamines to vanquish the attackers.
Symptoms
can range from mild to severe and may affect the digestive tract (vomiting,
diarrhea, cramps, gas, abdominal pain), the respiratory tract (coughing,
sneezing, wheezing or shortness of breath, runny nose, watery/itchy eyes), or the
skin and soft tissue (eczema, hives, red rash, or swelling of the face, mouth,
throat, tongue, or lips).
Most
people with a milk allergy must avoid not only cow’s milk but sheep and goat’s
milk as well, since the proteins in these milks are all similar and will cause
an allergic reaction.
Although there are multiple proteins
in cow's milk that can cause allergic reactions, casein (80% of milk protein) and
whey (the other 20%) are the two main components. Casein is the curd that forms
when milk is left to sour and the watery part (after the curd is removed) is
the whey. Who knows, maybe “Mary, Mary
quite contrary, eating her curds and whey” might have been feeling contrary due
to milk allergy!
Side
note: There is a subset of people who are allergic to and cannot tolerate milk
but can safely ingest other dairy products if baked (subjected to high heat) in
a dessert or food.
Appearance of Milk Allergy
As
with many food allergies, milk allergy is seen more commonly in children than
in adults. Between 2-5 percent of infants develop milk allergy but many outgrow
this; however, statistics about the percentage of children that outgrow milk
allergy are all over the map. A Johns Hopkins study, cited on allergicchild.com,
reported that just 20 percent of children in its studies outgrew their milk
allergy by age 4 and 42 percent by age 8. By age 16, almost 80 percent were
allergy-free.
If
your baby exhibits reactions to milk-based formula or to dairy foods as he/she
gets older, consult a physician to determine if milk allergy is the culprit. Symptoms
may include rash, upset stomach, lack of weight gain, or breathing problems.
If
your baby tests positive for milk allergy there are two ways to treat it
depending on the baby’s food source: eliminate milk proteins from nursing
mothers’ diets or switch to a formula-fed baby to an amino-acid-based formula
which is non-allergenic. Older babies and toddlers who cannot tolerate cow’s
milk might do fine drinking goat’s milk, sheep’s milk, or soy milk (these
alternatives are available in many grocery and health food stores).
Another
side note: It has been observed that milk allergy symptoms may change over time
from affecting one bodily system to another (for example, to move from
digestive symptoms to respiratory symptoms).
Lactose Intolerance is Different
Although
the symptoms may appear similar in some cases, having a milk allergy is not the
same as being lactose intolerant, which is very specific to lactose, the sugar
found in dairy products. People who are lactose intolerant lack the lactase enzyme
to properly digest this sugar. This causes digestive distress such as stomach
aches, gas, or diarrhea. It does not affect other systems.
What
to Eat, What to Avoid
There are
obvious milk-based foods to avoid—butter, all types of cheeses, yogurt, cream
(heavy cream, light cream, sour cream, ice cream), pudding, and custard.
And there are many foods that contain cow’s milk protein, such as: candies,
gum, and chocolates; cake mix and baked goods; coffee creamers, malted milk,
margarine, salad dressings, cereals, sherbet, canned and processed meats, and mashed
potatoes. Check all labels!
There are also many processed foods
with hidden milk in them, often in the form of whey or casein—even in
“non-dairy” products. Be sure to check labels very carefully or contact the
manufacturer about ingredients if this is a concern. These ingredients contain
milk proteins:
- Casein, caseinates (sodium caseinate)
- Whey, whey solids, whey products
- Curds
- Cream
- Ghee (clarified butter)
- Buttermilk solids
- Milk solids
- Lactalbumin, lactalbumin phosphate
- Lactose, lactoglobulin, lactoferrin, lactulose
- Rennet
- Hydrolysates
- Artificial butter or cheese flavor
Dairy Substitutes
Just
because you or your child suffers from a dairy allergy, don’t let that stand in
your way of enjoying food and life! In a prior
blog post we talked about dairy substitutes for cow’s milk which
can be used in baking and cooking, as a beverage, over cereal, and are popular
in alternatives to traditional ice cream. Many people eat pizzas with soy-based
cheeses, use almond milk in their coffee, or love coconut milk-based frozen
desserts. What are your favorites?