The milk allergy is one of the most common in young infants, with 2-3% of children under three years of age allergic to cow’s milk proteins.  It is standard procedure for a doctor to suggest not giving an infant cow’s milk until they are at least 12 months old.  Be careful of giving your child formulas with milk products in them, however, if milk allergy runs in your family.  Many infant formulas that claim to be milk free do in fact have derivatives of milk in them.

Chronic gastrointestinal distress, projectile vomiting and severe diarrhea are all symptoms of milk allergy.  Hives, swelling and other allergic reactions may accompany the reaction.  Breastfeeding is generally the best alternative if allergies run in your family.  If you have already started on formula, try a soy based formula instead.  Some of the soy formulas do have a significant amount of iron in them which may also be upsetting to your child.  It may be necessary to try out several formulas before finding a good match. Watch out for “lactose-free” labels, because that’s not necessarily an indication of a milk-free product.

Because of my son’s other allergies, and because my husband was allergic to milk as an infant, when my son was weaned from breastfeeding, we tried a soy formula.  It turned out that he was allergic to soy just slightly, so we ended up switching him to rice milk.  (Please note that rice milk is not high enough in protein to be considered an acceptable infant formula).  Upon his first allergy testing at 18 months old, we tested for milk allergies and he turned out to be negative!  All that work and no allergy to milk was ever there!

A mother of a child with severe milk allergies suggested these comments on eating out:  Avoid Mexican restaurants (too much chance a drop of grated cheese can cross-contaminate), Italian restaurants (same for parmesan cheese), Chinese (lactose seems to be in a lot of sauces), and breakfast places (too much milk and butter are used on griddles).

If your child is allergic to milk, don’t despair as some children do in fact grow out of their milk allergy.  The best action is to stay away from milk and milk products entirely.  The most common milk allergy symptom is vomiting after eating, according to an article in the Fall 2006 Allergy & Asthma Today magazine.

Hugh A. Sampson, M. D. wrote an article for “Food Allergy News” published by The Food Allergy & Anaphylaxis Network (FAAN) in June-July 2004 regarding Milk and Egg Allergies. In this article, he stated:

“Virtually all infants who develop cow’s milk allergy do so in the first year of life, with about 80% ‘outgrowing’ their milk allergy by their fifth birthday. About 60% of cow’s milk-allergic infants experience IgE-mediated reactions, or the more classical ‘immediate’ reactions affecting the skin (hives and eczema), gastrointestinal tract (crampy abdominal pain and vomiting), and the respiratory tract (nasal congestion, sneezing and wheezing). Nearly 25% of these milk-allergic infants retain their sensitivity into the second decade of life, and 35% go on to develop other food allergies.

Non IgE-mediated milk allergy affects primarily the gastrointestinal tract resulting in a number of different allergic disorders: milk-induced enterocolitis syndrome, proctocolitis syndrome, allergic eosinophilic esophagitis, etc., that can lead to poor growth and failure to thrive.”

There is also the chance that your child will test negative to dairy on an allergy test, yet still show symptoms of an allergy. In this case, the non-IgE milk-allergy may be at play, or lactose intolerance may be the culprit.

Lactose intolerance is not milk allergy. Instead, it is a problem in the digestive system caused from not producing enough of the lactase enzyme to break down the lactose sugar into simpler sugars. People who experience lactose intolerance have the crampy, abdominal pain that can turn into nausea and diarrhea. Lactose intolerance can be lifelong or temporary – especially following an intestinal illness, or even a round of antibiotics.

In the US, lactose intolerance is most common among Asian Americans, African Americans and Native American Indians.

Reading labels is a must for a milk-allergic child!  Milk is in so many processed foods that cooking from scratch may be a much safer alternative.

The Food Allergy Labeling Consumer Protection Act (FALCPA) was passed in 2004, requiring: labels to be marked such that a 7 year old could read and understand the ingredients, all allergens are declared even if they are in the spices or flavorings, and curtail the current widespread use of the ‘may contain statements.’ This act went into effect January 1, 2006.

For more information on this important law, please see:

http://www.foodallergy.org/Advocacy/labeling.html

Of course, milk is in virtually all cheeses, butter, creams and yogurt.  The lactose free milks do still have milk protein, so avoid them.  They are made such that the lactose-intolerant individual can digest them, but are not made for the milk-allergic.

Casein and whey are other names that milk can be called on a label.  There are other names that also indicate the presence of milk, and your allergist can provide for you a complete list of milk products and ingredients to avoid.

Lactose has also been used in medications to bulk up tiny medication particles. Inhalers such as Advair® Diskus®, Serevent® Diskus® and Foradil® Aerolizer® all contain lactose which can adversely affect the milk allergic. The 10 mg tablets of Singulair® also contains lactose, however the 4mg and 5mg versions do not. Many over the counter medications also contain lactose, so make sure you read the label prior to purchase! Also, talk with your pharmacist should you have questions.

There are milk substitutes such as soy and rice milk. If neither of these is appealing, there is also Vance’s Dari Free milk which is made from potatoes. The Web site: www.GoDairyFree.org has an abundance of information about living milk free.

Books for the Dairy Allergic:

	"Cody the Allergic Cow" By Nicole Smith "Cody" helps children learn about milk allergies and how to recognize an allergic reaction. Beautiful illustrations and a simple text make this book a must-have for your child, friends, grandparents and classrooms. This is the second book by Nicole Smith, and illustrated by Maggie Nichols.
	Abby the Alley Cat - Staying Safe from Dairy" (Paperback) by Myronie McKee  and Sam McKee “Abby” is one of the few children’s books on milk allergies, and it has a nice message all in rhyme. It’s very reminiscent of the Dr. Seuss tale, “Green Eggs and Ham.” The illustrations aren’t great, but the book will get the point across to milk allergic children.
	Go Dairy Free: The Guide and Cookbook for Milk Allergies, Lactose Intolerance, and Casein-Free Living by Alisa Marie Fleming This book is in conjunction with Alisa Fleming’s website: GoDairyFree.org which is a great resource for the dairy allergic. The book has recipes, lifestyle suggestions and great info for all who need to avoid dairy.
	The Milk Free Kitchen : Living Well Without Dairy Products   by Beth Kidder A recommended book from other parents of milk allergic children.
	What's to Eat? The Milk-Free, Egg-Free, Nut-Free Food Allergy Cookbook by Linda Marienhoff Coss An easy-to-use, comprehensive cookbook for those who must eliminate dairy products, eggs, and nuts from their diet.
	What Else is to Eat? The Dairy-, Egg-, and Nut-Free Food Allergy Cookbook (Paperback) by Linda Marienhoff Coss With an emphasis on fast and easy cooking, the book includes recipes for baked goods, soups and salads, main dishes, side dishes, and breakfast foods all based almost entirely on normal, easy-to-find ingredients.