Milk Allergy in Children

Common Milk Allergy in Infants

This is a prevalent issue in infants (under 1 year of age) and should be considered alongside the note on food allergy.

The milk allergy can manifest as an IgE allergy, a non-IgE allergy, or a combination of both. Immediate skin reactions occurring within 5 minutes, such as nettle rash (urticaria), swelling, and redness (erythema), are typically indicative of an IgE-mediated response.

Non-IgE allergies are more common and may present differently.

Treatment for both types involves avoiding the allergen (all dairy products) and substituting with a hypoallergenic milk. These specialised milks are pre-digested to break down allergens into component parts, mimicking the natural digestive process. Various palatable options of hypoallergenic milk are available.

A frequent presentation of milk allergy is colic and reflux, or gastroesophageal reflux disease (GERD). Symptoms include an unsettled baby, pulling legs up while crying, appearing hungry but reluctant to feed due to pain (resulting from acid reflux), vomiting, and arching the back during painful episodes. Correct diagnosis often leads to improvement with a dairy-free and hypoallergenic diet, along with anti-reflux medications.

In exclusively breastfed infants, identical symptoms can occur due to cow's milk allergy from maternal consumption of cow's milk proteins. Non-IgE milk allergy typically resolves by age one, although partial responses to dairy avoidance can occur due to acid-induced damage to the lower esophagus affecting stomach valve function.

A comprehensive medical history, physical examination, supervised dairy elimination, antacid therapy, and occasionally additional blood tests can aid in making a definitive diagnosis.