Ravina Sewani

Milk allergy, also known as Cow Milk’s Protein Allergy (CMPA) is an immune response triggered against the proteins present in the milk which the body perceives as a threat and mounts a reaction.Even though milk allergy is one of the top food allergies, your little one is less likely to develop a severe reaction. Symptoms:<ul><li>Nasal congestion, runny nose, sneezing or dry cough</li><li>Eczema (a dry, itchy rash) or hives (reddish, swollen, itchy areas on the skin)</li><li>Redness of the skin around the mouth or eyes</li><li>Itchy mouth, ear canal or lip swelling, odd taste in the mouth</li><li>Nausea or vomiting, diarrhoea or stomach pain</li><li>Severe reactions include loss of consciousness, chest pain, turning pale, shortness of breath, trouble swallowing, or anaphylaxis.</li></ul> Diagnosis:<ul><li>Always get your child diagnosed by a healthcare expert and never on your own. Never self-assume that your child has peanut allergy. Commercial home test kits for self-diagnosis are not recommended as they may not be of the required standards.</li><li>Your child’s paediatrician may recommend that your child undertake tests like skin prick test, blood test or food/drug challenge. It is important that these tests are performed under medical supervision as these tests might trigger an allergic reaction. Along with these tests, your child’s paediatrician will also examine your child's medical/family history, existing conditions like asthma and eczema.</li></ul> Cow Milk Protein Allergy can be present in two forms:Breast-fed children can develop CMPA before they turn 6 months, and rarely after they are a year old. Most children either outgrow this allergy and some learn to tolerate this. Children with eczema, asthma or hay fever have a higher likelihood of developing CMPA. Children develop CMPA due to one of these reasons – formula milk containing cow milk’s proteins, breastfeeding mother consuming cow milk, or a child consuming cow milk. Cow milk's allergy can be present in two forms:<ul><li>An 'immediate response' from minutes to hours and a 'delayed' type onset over hours to days. The “delayed” type is more common in children.</li><li>Fortunately, most children outgrow cow milk’s allergy in their early childhood.</li><li>Keep in mind that well-boiled or heated milk does not alter the structure of CMP or make it any less allergic.</li></ul> To alleviate CMPA, breastfeeding mother should cut off products containing CMP from her diet until the child is weaned off from breastfeeding completely. For formula milk, your child’s doctor may prescribe hydrolysed formula that breaks the proteins.Majority of the children with CMPA can tolerate baked food due to the process of different ingredients binding together. A doctor may advise you to introduce baked-milk under medical supervision to improve your child's CMPA. If your child is able to tolerate it, a 'milk ladder' may then be recommended. A milk ladder is a structured approach to reintroduce milk protein products and is tailor-made for each child. Please make sure to inform your child's school, caregivers, or places frequently visited by your child's milk allergy and the possible alternatives in the diet. Milk allergy and lactose intolerance:<ul><li>Milk allergy is completely different from milk intolerance.</li><li>Milk (lactose) intolerance triggers abdominal symptoms like diarrhoea, gas, or cramps due to the absence/deficiency of an enzyme called Lactase that helps in digestion of milk sugar called 'Lactose'. Lactose intolerance can occur at any age but more commonly seen in babies and young children following infections, medications, or inflammatory bowel conditions.</li></ul> Alternative to cow’s milk:<ul><li>Consult your child’s paediatrician before selecting any alternative of milk for your child.</li><li>Milk from other mammals like sheep, goats, buffalo may also cause allergic reactions as they share similar proteins with cow's milk at varying levels.</li><li>Amino Acid-based Formulas (AAF) are recommended for children with a severe sensitivity to milk proteins.</li><li>It is not recommended to give other types of milk like rice milk, almond milk, soy milk to babies as it is not safe to use in children during weaning period.</li><li>Formula based on soy proteins may be advised for infants over 6 months of age.</li></ul> Foods to avoid:<ul><li>If your child has CMPA, it is recommended to avoid milk proteins. As milk proteins may be found in the following food/food products, you must identify the variants too.</li><li>Dairy products like yogurt or curd, pudding, cheese, cottage cheese, sour cream, cream, custard, butter, ghee, whey, etc.</li><li>Certain food or drugs containing casein or its variants, lactose, lactulose, lactalbumin, lactoalbumin phosphate, lactaglobulin, lactoferrin also have cow's milk proteins.</li></ul> Other potential sources are:<ul><li>Chocolate, candies, nougat</li><li>Ice creams</li><li>Bakery products</li><li>Some medications/supplements</li><li>Artificial butter flavour</li></ul> Cow milk’s ladder:<ul><li>Milk Ladder is a guide to gradually introduce cow milk proteins in children who have milk allergy. This is basically a reintroduction.</li><li>The first step of the ladder is to introduce baked products, progressing to less-treated milk products. It ends with a more allergenic form of cow's milk protein.</li><li>It is observed that few children can tolerate baked or well-heated milk.</li><li>The milk ladder may have eggs, soy or wheat. If your child is allergic to any other food, it is advisable to consult your child’s paediatrician for alternate options.</li></ul>

Milk allergy is one of the most common food allergies.

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