The "Big Eight" Educational Series - Dairy Allergy
The Allergy Free Shop exists to provide parents and caretakers with allergen-free foods and products for those with food allergies and sensitivities. We also strive to provide resources that help to provide guidance to those just beginning their education about specific food allergies affecting their children.
Prevalence
Dairy 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 now 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, especially 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, 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. There have been conflicting studies linking soy formula to peanut allergies. 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.
It should also be noted that 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 African Americans, Asians and Native Americans.
Prognosis
If your child is allergic to milk, don’t despair, as most children do in fact grow out of their milk allergy. Virtually all infants who develop a cow’s milk allergy do so in the first year of life, with almost 80% "outgrowing" their milk allergy by the age of 16. The bad news, however, is that the prognosis for a child with milk allergy appears to be worse than it was 20 years ago. Now only do kids have more allergies, but a growing number do not outgrow their allergies, and those who do, do so later than before. Doctors have found that a child’s blood levels of milk (and egg) antibodies - the immune chemicals produced in response to allergens - were a reliable predictor of disease behaviors. The higher the level of antibodies, the less likely it was that a child would outgrow the allergy any time soon.
But until tests confirm this, or more likely - accidental ingestion with no adverse reaction whatsoever - it is certainly best to stay away from milk and milk products entirely. 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., which can lead to poor growth and failure to thrive. There is a chance 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.
More recently diagnosed food allergies, for still-unknown reasons, behave more unpredictably and more aggressively than cases diagnosed in the past. Some doctors believe we may be dealing with a different kind of disease process than we did 20 years ago. Why this is happening is an unknown at this point.
Avoiding Milk Products
Reading labels is a must for a milk-allergic child! The Food Allergy Labeling Consumer Protection Act (FALCPA) was passed in 2004, requiring that labels be marked such that a 7 year old could read and understand the ingredients and that all allergens be declared even if they are in the spices or flavoring. 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. Stick with milk substitutes, such as soy and rice milk.
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.
Some other advice on eating at restaurants: you may want to avoid Mexican restaurants (too great a chance that grated cheese can cross-contaminate), Italian restaurants (same for parmesan cheese), Chinese (lactose is in many of the sauces), and breakfast restaurants (milk and butter are often used on the griddles).
Also be on the lookout for lactose in many popular inhalers, used in these medications to bulk up tiny medication particles. Other medicines (such as 10 mg tablets of Singulair) contain lactose which can adversely affect the milk allergic. Many over the counter medications also contain lactose, so make sure you read the label prior to purchase! Talk with your pharmacist should you have questions.
Allergy Free Shop offers a wide variety of foods that are Dairy Free. Some of our best sellers are Enjoy Life's Boom Choco Boom dairy-free chocolate bars, Vance's Dari Free chocolate powder, and Home Free dairy-free chocolate chip cookies. You can view our entire stock of over 700 Dairy Free foods and beverages here.
Our goal is to provide you with a wide variety of allergy-free products for you and your children, a place where you can find EVERYTHING that you need in one place. And with ongoing vigilance, and armed with an understanding of your child's or loved one’s food allergy, you CAN avoid exposure and reactions to Milk allergens!
Hugh A. Sampson, M. D., "Food Allergy News", The Food Allergy & Anaphylaxis Network (FAAN), June 2004.
Johns Hopkins Children's Center, Science Daily, December 2007.
Justin Skripak, M.D., Jessica Savage, M. D., Elizabeth Matsui, M.D., Journal of Allergy and Clinical Immunology, November and December 2008.
Prevalence
Dairy 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 now 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, especially 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, 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. There have been conflicting studies linking soy formula to peanut allergies. 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.
It should also be noted that 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 African Americans, Asians and Native Americans.
Prognosis
If your child is allergic to milk, don’t despair, as most children do in fact grow out of their milk allergy. Virtually all infants who develop a cow’s milk allergy do so in the first year of life, with almost 80% "outgrowing" their milk allergy by the age of 16. The bad news, however, is that the prognosis for a child with milk allergy appears to be worse than it was 20 years ago. Now only do kids have more allergies, but a growing number do not outgrow their allergies, and those who do, do so later than before. Doctors have found that a child’s blood levels of milk (and egg) antibodies - the immune chemicals produced in response to allergens - were a reliable predictor of disease behaviors. The higher the level of antibodies, the less likely it was that a child would outgrow the allergy any time soon.
But until tests confirm this, or more likely - accidental ingestion with no adverse reaction whatsoever - it is certainly best to stay away from milk and milk products entirely. 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., which can lead to poor growth and failure to thrive. There is a chance 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.
More recently diagnosed food allergies, for still-unknown reasons, behave more unpredictably and more aggressively than cases diagnosed in the past. Some doctors believe we may be dealing with a different kind of disease process than we did 20 years ago. Why this is happening is an unknown at this point.
Avoiding Milk Products
Reading labels is a must for a milk-allergic child! The Food Allergy Labeling Consumer Protection Act (FALCPA) was passed in 2004, requiring that labels be marked such that a 7 year old could read and understand the ingredients and that all allergens be declared even if they are in the spices or flavoring. 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. Stick with milk substitutes, such as soy and rice milk.
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.
Some other advice on eating at restaurants: you may want to avoid Mexican restaurants (too great a chance that grated cheese can cross-contaminate), Italian restaurants (same for parmesan cheese), Chinese (lactose is in many of the sauces), and breakfast restaurants (milk and butter are often used on the griddles).
Also be on the lookout for lactose in many popular inhalers, used in these medications to bulk up tiny medication particles. Other medicines (such as 10 mg tablets of Singulair) contain lactose which can adversely affect the milk allergic. Many over the counter medications also contain lactose, so make sure you read the label prior to purchase! Talk with your pharmacist should you have questions.
Allergy Free Shop offers a wide variety of foods that are Dairy Free. Some of our best sellers are Enjoy Life's Boom Choco Boom dairy-free chocolate bars, Vance's Dari Free chocolate powder, and Home Free dairy-free chocolate chip cookies. You can view our entire stock of over 700 Dairy Free foods and beverages here.
Our goal is to provide you with a wide variety of allergy-free products for you and your children, a place where you can find EVERYTHING that you need in one place. And with ongoing vigilance, and armed with an understanding of your child's or loved one’s food allergy, you CAN avoid exposure and reactions to Milk allergens!
Hugh A. Sampson, M. D., "Food Allergy News", The Food Allergy & Anaphylaxis Network (FAAN), June 2004.
Johns Hopkins Children's Center, Science Daily, December 2007.
Justin Skripak, M.D., Jessica Savage, M. D., Elizabeth Matsui, M.D., Journal of Allergy and Clinical Immunology, November and December 2008.
Labels: allergens, allergic reaction, allergy free, big eight, dairy allergy, food allergy, ingredients
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