Milk allergy can involve many organ systems such as skin, respiratory, gastrointestinal and cardiovascular. In some cases multiple systems can react simultaneously causing a life threatening anaphylactic reaction.

Skin symptoms may include hives, flare up of eczema, swelling of eyes, lips, or mouth (angioedema).

Respiratory symptoms may be sneezing, runny nose, nasal blockage, wheezing, chest tightness, shortness of breath, or throat tightness.

Gastrointestinal symptoms may include vomiting, diarrhea, abdominal cramps or bloody stools in infants.

Cardiovascular symptoms may manifest by pale skin, faintness/dizziness, rapid heart rate, drop in blood pressure. Symptoms of a life threatening anaphylaxis reaction may include loss of consciousness, cessation of breathing or a stopped heart.

Milk allergy is caused by the immune system overreacting to the milk and causing various symptoms.

An adverse reaction to a food not caused by the immune system is called food intolerance. A common example of food intolerance is lactose intolerance. When there is a deficiency of the lactase enzyme in the intestine, patients develop cramps, bloating, or diarrhea symptoms. These symptoms mimic food allergy but it is not.

Milk allergy is managed by strict avoidance of milk and keeping injectable epinephrine and antihistamine available for accidental exposure.

Q: How prevalent is cow’s milk allergy?
About 2.5% of newborn babies are allergic to cow’s milk.

Q: Do babies outgrow cow’s milk allergy?
Most infants outgrow cow’s milk allergy by 3 years of age.

Q: How soon after ingestion do the symptoms occur?
Symptoms usually appear 30 minutes to 2 hours after the ingestion of food.

Q: How is milk allergy detected?
This is done based on the history, physical examination followed by a positive allergy test to the food trigger. Most allergist perform skin tests for allergies. Blood tests can also detect food allergies.

Q: Is it ok to eat milk containing cookie or cake if you have milk allergy?
Some patients with milk allergy can tolerate small amounts of milk proteins in cooked or baked form.

Q: Is nursing safe in infants with cow’s milk allergy?
Food allergens ingested by the mother can be secreted in the breast milk. So nursing is safe if mother avoids milk and milk products.

Q: Can goat milk be used in children with cow’s milk allergy?
Up to 90% of the children will have allergy to goat milk if they are allergic to cow’s milk. So goat milk should be avoided.

Q: What can be a substitute for cow’s milk if you are allergic?
Soy based formula or soymilk, Rice milk can be substituted after appropriate testing and with guidance from your physician.

Q: When can milk be reintroduced?
Since different children outgrow their milk allergy at different ages, this has to be assessed by the allergist based on the test results and the history of accidental ingestion.