Cow’s milk allergy

Very few adults are allergic to cow’s milk. People who are allergic to cow’s milk can also be allergic to milk from other animals such as goats, sheep and buffalo. Some people experience symptoms immediately, but in others, the symptoms can take time to develop.

If you think you, or someone in your care, have a cow’s milk allergy, visit your doctor for a diagnosis.

To manage a cow’s milk allergy, all food containing milk must be avoided (under strict medical supervision). Exclusion and reintroduction of cow’s milk and other dairy foods should only be undertaken with advice from a medical specialist (and in many cases, a dietitian), particularly in cases of anaphylaxis.

If long-term exclusion is required, an alternative source of calcium and protein is needed, to ensure adequate nutrition and growth. Do not change your child’s diet without consulting a doctor or your child could suffer from nutritional deficiencies. can be life threatening.

If you, or someone in your care, have a severe allergic reaction (anaphylaxis), call 911 for an ambulance.

Do not stand or walk

Administer adrenaline (epinephrine) via injector (EpiPen® or Anapen®), if available. Milk allergy is most commonly caused by an allergy to cow’s milk, although some people are allergic to milk from other animals such as goats, sheep and buffalo. reacts to triggers, also known as allergens.

Your immune system produces antibodies that detect the allergen, causing inflammatory reactions and the release of chemicals, including histamine, which cause allergic symptoms. In the case of milk, the triggers are milk proteins including whey and casein. You or your child may be allergic to either one of these proteins, or both.

Some people can have a physical reaction to milk that is not due to an allergy.

If you lack an enzyme called lactase, which breaks down the milk sugar lactose, you can experience symptoms that seem similar to an allergy ( and is different from milk allergy, because it does not involve your immune system reacting to a trigger.

Some people also experience excess thick mucus in their throat after eating or drinking dairy products, but this is not caused by an allergy. The American Society of Clinical Immunology and Allergy (ASCIA) advises that this mucus production is not a health risk. Symptoms of a cow’s milk allergy can appear within minutes or several days of consuming cow’s milk or dairy products.

The severity of the symptoms will depend on the person and the amount of cow’s milk they consume. Symptoms that can appear within minutes of having a small amount of milk include:

• diarrhoea. If your child is prone to a severe allergic reaction to milk
• these symptoms can also appear very rapidly

Symptoms that can appear within hours include: rashes or eczema. Symptoms that can appear within days include: Cow’s milk is one of the most common foods to cause severe allergic reactions. is life threatening.

Symptoms of a severe allergic reaction include:

• If you or someone your care have a severe allergic reaction (anaphylaxis)
• call 911 for an ambulance

Do not stand or walk

Administer adrenaline (epinephrine) via injector (EpiPen® or Anapen®), if available. Further adrenaline may be given if there is no response after 5 minutes. Give adrenaline first, then asthma reliever puffer, if required.

Keep a diary that describes your symptoms or your child’s symptoms and when and where they occur. Your diary could include information about whether the symptoms occur: after you have taken a particular medication, either prescription or over the counter from a pharmacy or supermarket If you or your child have allergic symptoms, visit your family doctor who will ask some questions about your reactions.

You can also discuss your record of your symptoms

To diagnose your allergy, your doctor may refer you to a clinical immunology/allergy specialist.

If your symptoms appear rapidly after eating or drinking milk or dairy products, the allergy may be easier to diagnose, whereas symptoms that take longer to appear make diagnosis more difficult. using a number of methods depending on the type of potential allergy.

To test for an allergy, the allergist may: ask you to temporarily avoid all milk or products containing milk (elimination diet), then follow up with the introduction of milk back into your diet (food challenge) under strict medical supervision. They can be costly and could lead to dangerous avoidance of certain foods.

The American Society of Clinical Immunology and Allergy (ASCIA) recommends that you do not use certain methods to have potential allergies tested, including: Vega testing.

If you or your child have been diagnosed with milk allergy, treatment involves total avoidance of milk or products containing milk.

This can be difficult to achieve

The American Society of Clinical Immunology and Allergy (ASCIA) advises that children who are allergic to cow’s milk are often allergic to goat’s milk, and so substitution with a milk of animal origin may not be possible.

To avoid milk and milk products, read food labels and avoid foods that contain milk or milk products such as: yoghurt.

Eliminate milk and milk products from your baby or young child’s diet only under strict medical supervision.

Your doctor will need to advise on replacement sources of , which are especially important nutrients for children.

Replacement formulas for babies also needs to be carefully supervised

For example, some children with cow’s milk allergy will not be able to tolerate soy milk products.

If you are at risk of a severe allergic reaction (anaphylaxis), carry an adrenaline injector such as an EpiPen® or Anapen®, an and a means of calling for medical assistance, such as a mobile telephone. are: Lay the person flat – do not allow them to stand or walk. Administer adrenaline with an injector into the outer mid-thigh.

Always dial 911 to call an ambulance in a medical emergency. Further doses of adrenaline may be given if there is no response after 5 minutes. Give adrenaline first, then asthma reliever puffer, if required.

If you are at risk of a severe allergic reaction (anaphylaxis) make sure you: Have an ASCIA Action Plan for Anaphylaxis. Carry an adrenaline injector (such as an EpiPen® or Anapen®) to treat a severe allergic reaction. Consider wearing medical identification jewellery – this increases the likelihood that adrenaline will be administered in an emergency.

Avoid medication (where possible) that may increase the severity of allergic reaction or complicate its treatment such as beta blockers.

Avoid the food which causes your allergic reaction

Tell food staff about your allergy when eating out.

Seek medical advice from a doctor or clinical immunology/allergy specialist

Adrenaline injectors are also available over the counter from a pharmacy.

About cow’s milk allergy An allergy to cow’s milk and related dairy products affects one in 50 in babies and is different to lactose intolerance Symptoms of milk allergy vary and range from mild reactions to a severe allergic reaction (anaphylaxis) Food allergies Causes of cow’s milk allergy In all allergies , the immune system More research Some reactions to milk are not caused by allergies diarrhoea , vomiting, stomach pain and gas ).

This is called lactose intolerance Symptoms of cow’s milk allergy raised red bumps of skin – hives (urticaria) itchy, red, weeping or crusty rash of the skin – dermatitis or eczema swelling of the face wheeze or persistent cough vomiting vomiting diarrhoea eczema diarrhoea asthma Severe allergic reaction – anaphylaxis Severe allergic reaction (anaphylaxis) difficult or noisy breathing swelling of the tongue swelling or tightness of the throat difficulty talking or hoarse voice wheeze or persistent cough persistent dizziness or collapse paleness and floppiness in young children Keep a record of your symptoms inside your home, outside or both for a short time or longer at night, during the day or when you wake up after you have had a particular food or drink after you have taken a herbal medicine Diagnosis of cow’s milk allergy Allergists can test for allergies do a skin prick test do a blood test A number of methods claim to test for allergies but have not been medically or scientifically proven cytotoxic food testing electrodermal testing hair analysis iridology kinesiology pulse testing reflexology Always speak with your doctor if you are thinking of using a complementary medicine or therapy Treatment for cow’s milk allergy butter buttermilk casein and caseinate cheese chocolate cow’s or goat’s milk – including ‘A2 milk’ cream crème fraiche ghee ice cream margarines that contain milk products milk powder nougat whey ASCIA has more information about dietary avoidance of cow’s milk for food allergy calcium and protein Emergency treatment for severe allergic reactions (anaphylaxis) American Society of Clinical Immunology and Allergy (ASCIA) Action Plan for Anaphylaxis Emergency responses for a severe allergic reaction Where to get help In an emergency, always call 911 Emergency department of your nearest hospital Your GP (doctor) NURSE-ON-CALL (616) 555-0024 – for health information and advice (24 hours, 7 days) St John Ambulance United States (616) 555-0400 American Society of Clinical Immunology and Allergy (ASICA) Cow’s milk allergy Locate a specialist Allergy and Anaphylaxis United States .

Key Points

• Some people experience symptoms immediately, but in others, the symptoms can take time to develop
• is needed into the causes, diagnosis and treatment of food allergy
• American Society of Clinical Immunology and Allergy (ASCIA) advises that this mucus production is not a health risk
• Symptoms of a cow’s milk allergy can appear within minutes or several days of consuming cow’s milk or dairy products
• severity of the symptoms will depend on the person and the amount of cow’s milk they consume