Cow’s milk allergy is a common condition in infants and young children. The severity of the condition varies but it is important that parents keep an eye out for warning signs. By learning more about this condition and what it entails, parents can take the necessary steps towards providing their child with the right treatment, leading to a full recovery.

Cow’s milk allergy can develop early in life from the moment an infant comes into contact with cow’s milk. Even though only three to six per cent of all children suffer from this condition, parents should consistently observe their child’s diet, especially since the symptoms of cow’s milk allergy might not be apparent at first. Children can have an allergic reaction not only to the cow’s milk they drink, but also to cow’s milk in other food, shampoo, soap, or lotion.

The symptoms of cow’s milk allergy are divided into two categories – severe and mild. Mild symptoms can last a day or a few days, depending on how frequently the child comes into contact with cow’s milk. These mild symptoms can include:

•  Vomiting the milk he or she consumes. While vomiting or “spitting up” is a common occurrence in infants, it can point towards cow’s milk allergy if the symptom persist and if the baby only reacts this way to cow’s milk, not to mother’s milk.
•  Diarrhoea
•  Blood in stool
•  Rash
•  Snoring
•  Irritation and frustration when it is time to drink milk
•  Weight loss or inability to gain weight
• Most of the children who display severe allergic reactions to cow’s milk have parents with a history of high allergic levels, or high levels of immunoglobulin E (IGE). These severe symptoms can include:
•  Asthma attacks
•  Hives
•  Fainting
•  Low blood pressure
•  Seizures
•  Suffocation, shortness of breath or inability to breathe normally

In some cases, children can start becoming allergic after a severe case of diarrhoea. When there is trauma to the intestine, the body becomes more susceptible to proteins, therefore increasing the chance of the child developing an allergic reaction to cow’s milk.

A cow’s milk allergy is different from lactose intolerance.

Lactose is a form of enzyme that exists in almost all types of milk, such as cow’s milk, mother’s milk, and goat’s milk. A person should not consume more than 500cc of lactose per day, as the intestine cannot digest any more than that. If a child is allergic to lactose or has consumed too much of it, he or she can exhibit the following symptoms:

•  Flatulence
•  Gas
•  Diarrhoea
•  Constipation
•  Vomiting

A child can be allergic to lactose, but not to cow’s milk. If so, he or she can only drink cow’s milk which has no lactose. If parents suspect that their child might be suffering from lactose intolerance instead of cow’s milk allergy, the child can undergo a skin test or a lactose tolerance test, which can help diagnose the condition.

If your child is starting to show symptoms of cow’s milk allergy, remove milk from their diet. Do not let your child come into contact with any shampoo, lotion, or cream with milk. After the symptoms have subsided, the child can undergo a “skin prick test” at the hospital. The test introduces a small amount of the allergen into the skin. If the child is allergic to the substance, the skin surrounding the area will exhibit an allergic reaction.

If the test comes back negative, it is still advisable not to let your child drink cow’s milk for another month. Then, the child can come back for another test.

This time, the test starts with the consumption of one drop of cow’s milk. The child can drink another one millilitre of milk 15 minutes later, if there’s no allergic reaction, and the amount will be increased until it reaches 30 millilitres. The test can help determine the severity of the child’s condition.

Once the diagnosis has been made, the doctor will assist you and your child in further treatment and recovery.

PROFESSOR BOOSBA VIVATVAKIN is an expert in Paediatric Gastroenterology and Hepatology at Samitivej International Children’s Hospital, Sukhumvit Campus. Call (02) 022 2236-7.