We Asked the Expert: What You Need to Know About Milk Allergy {Sponsored Post}

{NMB has partnered with The Allergy, Asthma, & Sinus Center for this sponsored post. As anyone living in Middle Tennessee knows, allergies are a part of our daily life. Especially in light of the increased number of food allergies among children, we knew that the information provided here would be important to all parents.}

Food allergy is a serious medical condition, and the number of incidences diagnosed each year is climbing. In fact, the diagnosis of food allergy has increased by about 50 percent over the past 15 years. The most common food allergies are peanut, tree nut, milk, egg, wheat, soy, fish, and shellfish. One of the more common allergies found in infants and toddlers is cow’s milk. It represents a major dietary staple in young children, and reactions to milk can make mealtimes challenging for parents.

Reactions to milk generally fall into one of three categories:

1. A true milk allergy is the most common food allergy in infants. According to Food Allergy Research & Education (FARE), milk allergy affects 2.5 percent of children under three years of age. This allergy may present with hives or may progress to a severe reaction called anaphylaxis. Anaphylaxis may manifest as swelling (usually affecting the face, lips or throat), breathing difficulties, vomiting, or diarrhea. It can be potentially fatal. These symptoms almost always occur within two hours after eating or drinking milk-based products. The reaction is triggered by allergic antibodies (IgE) that recognize specific proteins in milk. With continued exposure to milk, the reaction typically worsens. Fortunately, most children will eventually outgrow a milk allergy; however, recent studies are indicating that children are hanging onto this allergy longer than previously thought. Research done by Dr. Robert Wood at Johns Hopkins University School of Medicine found that only 19 percent of four year olds have outgrown a milk allergy. By age 16, almost 80 percent have outgrown it. It also appears that children who can eat baked milk products—such as muffins—are more likely to outgrow their allergy.

2. The second type of reaction to milk is a Cow Milk Protein Allergy (CMPA) or Allergic Colitis. Although it has the word “allergy” in the name, it is not a true allergic reaction and does not cause anaphylaxis. CMPA usually starts in the first year of life with bloody stools and fussiness and is due to an irritant reaction in the lining of the bowel triggered by the milk protein. Many of these babies are also sensitive to soy milk. This almost always resolves by the time the child turns one.

3. Lactose intolerance represents the third most common type of reaction to milk products. It is due to either the absence of or, more commonly, the decreased function of the enzyme that breaks down the milk sugar—lactose. If this sugar is not broken down, it will draw fluid into the bowel, which results in bloating, diarrhea, and gas. These symptoms, although uncomfortable, will not become life threatening.

Treatment of all three conditions involves various degrees of avoidance. True milk allergy avoidance needs to be strict, but patients with lactose intolerance may be able to tolerate small amounts of milk products. Because a milk allergy can be life threatening, milk allergic patients must always have emergency treatment available. This treatment includes an antihistamine (such as Benadryl) for mild symptoms and epinephrine for more severe symptoms. Two epinephrine auto-injectors (Epi-pen and Auvi-Q) are currently available.

Hopefully, this helps clear up some of the confusion surrounding “milk allergy!”

Dr. Megan Partridge Stauffer is a board certified allergist with The Allergy, Asthma & Sinus Center. She received her medical degree from Eastern Virginia Medical School, Norfolk. She completed her residency in Pediatrics at Johns Hopkins Hospital in Baltimore, Maryland and her fellowship in Allergy and Immunology at Medical College of Georgia, Augusta. She is board certified in Allergy and Immunology and is a Fellow of the American Academy of Allergy, Asthma and Immunology (FAAAAI) and the American College of Allergy, Asthma and Immunology (FACAAI). Dr. Stauffer enjoys spending time with her family, foreign travel, and medical mission work and is also an active member of her church.