Cows’ Milk Allergy in children

When infants and children are fed cows’ milk or any parts of it, this can trigger allergic reactions. By avoiding the ‘proteins’ in cows’ milk completely, the symptoms caused by this reaction can be eliminated.

Cows’ milk – and the proteins it contains - is often one of the first complementary foods to be introduced into the infant’s diet. Cows’ milk is also commonly consumed throughout childhood as part of a balanced diet. Cows’ milk allergy (CMA) is the most common food allergy in infants and young children – up to 1 in 20 of all children may suffer.

The symptoms caused by CMA can be varied and may affect several parts of the body.

How the body is affected:

• Skin – including rashes and eczema
• Digestion – including vomiting, diarrhoea, colic
• Breathing - including wheezing
• Excessive crying

 Allergic reactions can set in very rapidly (e.g. breathing problems, vomiting), but they can also be delayed or require more of the food (say a bottle of milk) to set them off.

• What’s an example of a delayed reaction? (click to expand) 

  An example of a delayed reaction would be a skin rash or diarrhoea which can take up to 3-5 days to appear after the food has been consumed.

In formula-fed infants and older children, avoiding whole cows’ milk proteins will be necessary to eliminate the symptoms of CMA. This may mean substitutes will need to be included in your child’s diet – your doctor or dietician is best placed to advise what’s best in each case.

If you are breastfeeding - it may be recommended that you avoid milk products – speak with a doctor or dietitian to ensure your diet remains adequate though before avoiding milk or dairy products.

If your baby is being bottle fed - there are alternative formulas containing ‘proteins’ which have been changed so that they are not like cows’ milk protein at all. Your doctor or dietitian will be able to recommend the best CMA management option for your child.

• What happens in the body? (click to expand)  

  We all have an immune system to protect us from infections. Our immune system attacks the viruses and bacteria that can make us ill. An allergic reaction is simply an overreaction of that system. With a food allergy, the body’s immune system mistakenly recognises common “proteins” that are present in the foods we eat as potentially harmful. An immune response is set in motion aimed at neutralising the “harmful protein” and is responsible for the symptoms experienced when a child or adult is allergic to that food.

• Can it happen in breast-fed babies? (click to expand)  

  Very rarely, babies who only receive breast milk can react to cows’ milk proteins. These proteins can be passed on through their mother’s milk if she has been consuming dairy products. In this situation, healthcare professionals recommend that breast-feeding is continued due to its benefits and the mother tries to eliminate cows’ milk protein from her diet.

• Why does CMA occur? (click to expand)  

  It is not clearly understood why some children’s immune systems try to ‘fight’ certain foods or the ‘proteins’ they contain.  In general, infants and young children are much more sensitive as their immune systems are still quite immature. Children coming from a family with an extensive history of allergy have a greater risk of developing food allergy than those with allergy-free relatives. However, even infants and children having no family history of allergy at all can have allergic symptoms.