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: Most children outgrow milk allergy
DEAR DR.PAUL: Our daughter is now 21 months old. She had
an allergic reaction to milk products when she was a baby. She
didn't develop any breathing problems or swelling from that incident.
But if we dab milk on her cheek, it will turn red, sometimes with
hives. We've been told most children grow out of this by the time
they are two years old. When should we start to introduce milk
products? Thank you.
PEDIATRICIAN DR.PAUL Answers: Cow's milk protein allergy
is the most common food allergy in young children. The cause
of the allergy is the body's reaction to the protein found in
the cow's milk. Almost all children outgrow milk allergy by
the first few years of life. Of course, this varies from child
to child.
The most common symptoms of cow's milk allergy include eczema
or skin rash, abdominal pain or cramps, vomiting or diarrhea
and in some cases, excessive crying.
Less commonly, some children may have a very serious allergic
reaction called anaphylaxis. This reaction usually occurs within
minutes after eating or drinking food to which they're allergic.
The most serious symptom of an anaphylactic reaction is the
swelling of the face, mouth and tongue leading to difficulty
breathing. If a child ever has these symptoms, medical help
should be sought immediately.
Untreated anaphylaxis can quickly become fatal. Fortunately,
anaphylaxis is rare. There are two very important reasons for
confirming that a child actually has a milk allergy. First,
cow's milk allergy is not the only cause of the symptoms described
above. These symptoms can be caused by other conditions, which
would need a different treatment.
The second reason is because of the danger of an anaphylactic
reaction. It's extremely important to know for certain if your
child has a cow's milk protein allergy because if she does,
you'll have to be very careful about making sure that all milk
and milk products are removed from the diet.
How the confirmation is made depends on the individual case.
The most reliable method is an allergy skin test or a blood
test (RAST).
In your situation, it sounds like your daughter is still allergic
(given that she gets a hive or reaction when milk touches her
skin). In a sense, this is like an informal skin test. Usually,
once the diagnosis is initially confirmed by an allergy test,
a child is re-tested every 6 to 12 months, depending on the
individual circumstances, until it becomes negative.
Once the test comes up negative, cow's milk protein can be started.
In the interim, all cow's milk protein foods (dairy products)
should be avoided, including "lactose free" cow's milk protein
preparations.
Most babies who develop cow's milk protein allergy, are bottle
fed, drinking cow's milk protein based infant formula such as
Similac, Enfalac, or SMA. Breastfed children are less likely
to develop food allergies of any sort which is one of the many
good reasons why breastfeeding is so strongly encouraged. Occasionally
though, breastfed children develop cow's milk allergy when they
react to the slight amount of cow's milk protein that's passed
along from their mother's diet into her breastmilk.
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replace the advice and care of your child's physician, nor is
it intended to be used for medical diagnosis or treatment. If
you suspect that your child has a medical condition, always
consult a physician.
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