Top 9 Things You Should Know About Milk Allergy in Children

When an allergy occurs, children can show symptoms in various parts of the body, ranging from mild to severe. The digestive system, skin, and respiratory system are most commonly affected. Symptoms can vary and are often non-specific, making them easy to overlook, especially in young children:

• Digestive system: Infants may have reduced feeding, spitting up milk, crying, or blood in the stool. Older children may experience diarrhea, constipation, stomach pain, blood in stool, or difficulty swallowing. Prolonged symptoms can lead to pale skin due to iron deficiency anemia and poor weight gain.
• Skin symptoms: One of the most common signs, children may develop red, raised patches on their skin, accompanied by intense itching. In severe cases, swelling around the eyes and lips may occur.
• Respiratory symptoms: Children may have itchy noses, runny noses, and dry coughing. In severe allergic reactions, difficulty breathing and cyanosis (bluish skin) can occur.
• Nausea and milk vomiting: While it's normal for infants to spit up small amounts of milk, if vomiting occurs outside feeding times, parents should consult a doctor. Symptoms of reflux, such as vomiting and difficulty swallowing, may indicate an allergy.
• Fussiness and crying: If a child suddenly experiences prolonged crying, it may be due to stomach pain from an allergic reaction to milk protein in formula.

Milk allergy symptoms can vary in severity and may appear at different times depending on the child's body. In some cases, the symptoms are mild and affect only a few areas, such as hives on the skin or a sore throat. However, in more severe cases, children may experience anaphylaxis, with signs such as seizures, intense stomach pain, cyanosis, limp body, and unconsciousness. These life-threatening symptoms require immediate medical attention.

The body's immune system may mistakenly recognize milk proteins as harmful, triggering the production of IgE antibodies to neutralize these proteins.

If these milk proteins re-enter the body in the future, the immune system will quickly identify them through the IgE antibodies, activating the immune response. This leads to the release of histamine and other chemical mediators, resulting in an allergic reaction that can range from mild to severe symptoms.

Milk allergies are very common, leading many people to underestimate the importance of proper treatment. In some cases, the condition can become severe and even life-threatening. The following groups are at higher risk of developing milk allergies:

• Children are more likely to develop milk allergies than adults. The risk decreases as the digestive system matures.
• Children with a history of allergies to any triggers are at increased risk for milk allergy.
• Children with chronic atopic dermatitis (eczema) are more likely to develop a milk allergy.
• Family history: The risk of milk allergy in children is higher if there is a family history of milk allergy or other allergic conditions such as food allergies, eczema, hives, or asthma.

If a child has a strong reaction to formula milk, which is mainly due to the child's hypersensitivity, the best way to reduce this issue is to exclusively breastfeed in the early stages.

If breastfeeding is not an option, formula milk can be introduced. However, it is important to start with small amounts to observe if the child is allergic to the formula. If no reaction occurs, parents can gradually increase the amount in subsequent feedings.

Note: Children allergic to cow's milk are also likely to be allergic to other foods, such as goat's milk or soy milk. During the weaning period, parents should be mindful of this and consult with an allergy specialist to develop a suitable diet plan for the child.

Additionally, parents may consider allergy testing for their child, which includes skin prick tests and blood tests. Failing to diagnose a milk allergy can impact the child's physical development and long-term health.

Clinical symptoms, medical history, and allergy history: After gathering information, doctors will use it to guide their diagnosis and recommend appropriate tests to confirm the allergy.

Allergy tests that should be conducted:

• Skin prick test: If the test area becomes swollen and red within 15-20 minutes, this indicates an allergic reaction to milk.
• Blood test: This is used to detect IgE antibodies, which are produced when the body is exposed to allergens.

Component testing: This is a new blood test where patients are tested for specific milk proteins, such as casein, whey, and lactalbumin. This helps determine the risk of allergy to particular milk components.

Food challenge test: This should only be performed in a fully equipped emergency setting.

There is no guaranteed method to prevent food allergies, but reactions can be avoided by steering clear of trigger foods. Parents may want to consider using advanced formulas, such as partially or fully hydrolyzed protein formulas, designed to be gentler on infants' bodies.

Alternative Milk Options for Infants

For babies with milk allergies, breastfeeding or using hypoallergenic formulas can help prevent allergic reactions.

• Breastfeeding is the best nutrition for your baby. It's recommended to breastfeed for as long as possible, especially if your infant is at high risk for milk allergies.
• Hypoallergenic formula is made by breaking down (hydrolyzing) milk proteins such as casein or whey using enzymes. The formula may undergo additional treatments like heat and filtration. Depending on the processing level, the formulas are categorized as partially or extensively hydrolyzed, or they may be called elemental formulas.

Some hypoallergenic formulas don't contain milk at all, but instead use amino acids. These amino acid-based formulas are less likely to cause allergic reactions than extensively hydrolyzed formulas.

• Soy-based formula is made from soy protein instead of milk. While soy formula is nutritionally complete, some children allergic to milk may also have soy allergies.

If you're breastfeeding and your baby has a milk allergy, the milk proteins passing through your breast milk could trigger an allergic reaction. You may need to eliminate all dairy from your diet. Consult your doctor if you suspect your baby has a milk allergy and shows signs of allergy after breastfeeding.

If you or your child are on a dairy-free diet, a doctor or nutritionist can help create a balanced meal plan. You may need to take supplements to replace calcium and other nutrients found in milk, such as vitamin D and riboflavin.

An allergy is the body's immune system response to a foreign substance (in this case, proteins found in milk). This means that when a child consumes milk, their immune system mistakenly identifies the proteins as harmful invaders and triggers a defense response, causing milk allergy symptoms.

Similarly, children may have difficulty digesting proteins in infant formula, leading to allergic reactions that may result in malnutrition and weakness. The severity of the reaction can be determined by the type of symptoms the baby exhibits. Generally, children who are allergic to cow's milk protein may also react to proteins in goat and sheep milk.

Milk allergy can affect individuals of all ages, but it is most common in children under the age of 1 (approximately 2-3% of infants). Some children may continue to experience this condition as they grow older.

When a child is allergic to milk, their immune system overreacts to the proteins in milk. When the child drinks milk, their immune system mistakes the proteins for harmful foreign substances and begins to fight them off.

Children typically show signs of a milk allergy within the first week of consuming milk. Babies who are breastfed generally have a lower risk of developing milk allergies compared to those who consume formula. However, even breastfed babies may experience an allergic reaction if the mother’s diet contains similar ingredients while nursing.

Milk allergy differs from lactose intolerance, where the body is unable to digest milk. Some children may react immediately after consuming milk, while others might experience symptoms hours or even days later. Parents should seek medical attention immediately if their child exhibits severe symptoms of anaphylaxis, such as seizures, unconsciousness, intense abdominal pain, or cyanosis.

It is estimated that 10-30% of infants and children under 1 year old are allergic to formula milk. By the age of 1, the number of children with milk allergies starts to decrease, and by 3 years old, around 75% of children no longer suffer from milk allergies. However, in some cases, the allergy may persist throughout life.

Despite ongoing research, scientists have not yet pinpointed the exact cause of milk allergies in infants. However, numerous studies suggest that genetic factors may play a role. If a parent experienced a milk allergy in childhood, there is a 50-80% chance that their child may inherit a similar condition.

Additionally, the development of allergic conditions depends on factors such as the child’s constitution, environmental exposures, and daily diet. Milk allergy symptoms in children are typically a combination of various signs, which may worsen if the child continues to consume the allergenic milk formula.