The most common causes of food allergy in children during infancy are seen in milk and egg whites. Milk allergy can be seen in 1-3% of babies. What is meant by milk allergy is the reaction of the body's immune system to milk other than breast milk. Since cow's milk is generally used, it is also defined as cow's milk allergy.

The most common causes of food allergy in children during infancy are seen in milk and egg whites. Milk allergy can be seen in 1-3% of babies. What is meant by milk allergy is the reaction of the body’s immune system to milk other than breast milk. Since cow’s milk is generally used, it is also defined as cow’s milk allergy. In addition to cow’s milk, the milk of mammals such as sheep, goat, horse, bison or buffalo can also cause allergies. Because the proteins that cause allergies are also found in others.

Breast milk usually does not cause allergies. If she uses other milks, these proteins can be passed to the baby with her own milk, and it may cause allergies in the baby. It can be understood as an allergy to breast milk. In such cases, it is recommended that the mother also stop breastfeeding.

The picture of sensitivity to cow’s milk is divided into two groups as non-allergic sensitivity and allergic sensitivity. Non-allergic sensitivity occurs due to sensitivity to lactic acid in cow’s milk, and this condition is called lactose intolerance. Milk allergy, on the other hand, is IgE-mediated in most of the children and may occur with atopic structure together with urticaria, atopic dermatitis, allergic rhinitis and/or asthma.

A distinction should be made between milk allergy and lactose intolerance.

When milk is drunk, symptoms occur due to the inability to digest the lactic acid in milk. People with lactose intolerance experience the following symptoms, which sometimes begin within 3 minutes, sometimes within half an hour, and can last from 2 hours to 72 hours:

  • Increased bowel movements
  • Gas
  • Weakness
  • Diarrhea
  • Abdominal cramps
  • Feeling of fullness in the abdomen
  • Nausea
  • Edema status
  • Amorphous defecation
  • Swelling

Lactose intolerance is determined by diagnosis with its own methods. You can find detailed information in our article What is lactose intolerance.

What are the symptoms of milk allergy?

These are the symptoms that start to appear soon after your baby drinks milk and can be seen at different levels in babies. Consult your doctor if you suspect a milk allergy. Babies with a milk allergy may experience the following symptoms:

  • Wheezing, coughing or shortness of breath
  • Redness, itching or tingling sensation around the lips or mouth
  • Swelling of the lips or tongue
  • Bloody and mucous poo
  • Noisy poop
  • Unrest
  • Crying spells
  • Not gaining weight
  • Gas pain
  • Inability to fall asleep
  • Non-passing host
  • Hives and eczema
  • Rash that doesn’t go away
  • Digestive problems such as constipation, diarrhea

Milk allergy can also cause anaphylaxis. Anaphylaxis is a severe and life-threatening condition. The baby is likely to have anaphylaxis, with difficulty breathing, swelling of the throat and tongue, and redness and bruising of the face and skin. Urgent medical attention is required. In any case of doubt, immediately call 112 emergency services.

Avoiding milk and dairy products is the primary treatment for milk allergy. Fortunately, most children outgrow their milk allergy. Those who are not growing may need to continue to avoid dairy products.

Why does milk allergy occur?

Find many proteins in cow’s milk that can cause allergies. The two main groups of these are whey proteins and casein fractions. Casenins are substances that give milk a milky appearance. Caseins make up 80% of the proteins in cow’s milk. 70% of these are alpha-s1-casein and beta-casein. Cow’s milk contains less whey proteins and 50% of them are beta-lactoglobulins.

Major whey proteins in cow’s milk:

  • Alpha-lactoalbumin
  • Beta-lactoglobulin
  • Bovine serum albumin

Cow’s milk also contains bovine immunoglobulins and can sometimes cause allergies.

The main caseins in cow’s milk are:

  • Alpha-s1 casein
  • Alpha-s2 casein
  • Beta casein
  • Kappa casein
  • Gamma casein

Casein allergy is mostly caused by Alpha and Kappa caseins.

It is thought that goat’s milk is the most common cause of milk allergy. There was not much difference in allergic reaction between boiling cow’s milk and using it raw.

How does a milk allergy occur?

Failure of the body to react to any allergen is called tolerance, and its reaction is called sensitivity. The balance between these two changes according to your body’s predisposition to allergy, your genetic structure, the nature of the antigen, the amount of the substance taken, the frequency of exposure to the antigen, your age at first exposure to the antigen, and your immunological status. Another factor is whether breast milk transfers these antigens to the baby in infants.

When your baby takes cow’s milk, the proteins in the milk are recognized by the tissue cells on the surface of the internal organs of your baby’s mouth. The immune system cells are notified. This is called a cell-associated reaction. T cells in the immune system attack by collecting some other immune cells, if there are those who have an allergy record from the proteins in milk.

IgE antibodies have a role in rapidly developing allergic reactions in the early period (in the first 2 hours) from the first moment. When the IgE antibody detects the allergen protein, it binds to it and also binds to cells such as mast cells that initiate the allergy. Thus, an allergic reaction is initiated. This condition is called an IgE-related reaction. Thus, skin urticaria or angioedema, runny nose, nasal congestion, wheezing, asthma, allergic reactions in the mouth, nausea, vomiting, diarrhea, hypotension, anaphylaxis and shock may develop.

Milk allergy symptoms by cause

We can group milk allergy symptoms according to their causes as follows:

1.IgE-related reactions

I- Systemic reaction associated with IgE ( Anaphylaxis)

  1. Acute onset reactions
  2. Late onset reactions

II- IgE mediated gastrointestinal reactions

  1. Oral allergy syndrome
  2. Sudden onset gastrointestinal reactions

III- IgE mediated respiratory reactions

  1. Asthma and rhinitis secondary to milk intake
  2. Asthma and rhinitis secondary to milk inhalation

IV- IgE mediated skin reactions

  1. Acute onset reactions
  • Acute urticaria or angioedema
  • Contact urticaria

2.Late onset reactions Atopic dermatitis.

2. Non-IgE-related reactions

  1. Nausea, bloating, intestinal disturbances and diarrhea

3. Cell-related reactions (Allergic dermatitis, etc.)

4. Mixed reactions related to both cell and IgE

I- Atopic dermatitis

  1. Acute onset reactions
  2. Late onset reactions

II- Non-IgE mediated gastrointestinal reactions

  1. Gastroesophageal reflux disease
  2. Cricopharyngeal spasm
  3. Pyloric stenosis
  4. Allergic eosinophilic esophagitis
  5. Cow’s milk protein-induced gastroenteritis and proctocolitis
  6. Constipation
  7. Colic

III- Non-IgE mediated respiratory reactions

  • Heiner syndrome

How is a milk allergy diagnosed?

If milk is removed from your diet, your symptoms regress, and if your symptoms recur when you add milk to your diet again, a situation that increases the suspicion of milk allergy occurs. In this process, your doctor may ask you to write down all the foods you consume for a certain period of time and the symptoms that develop after taking them. This symptom diary will make it easier for the physician to make a decision.

An allergy prick test to your skin or IgE antibodies specific to some allergen proteins in your blood can be measured. These tests alone may not be enough to make a decision. The classic diagnostic method in cow’s milk allergy is elimination, provocation and re-elimination diet.

How does milk allergy progress?

Cow’s milk allergy starts in the newborn period and tends to improve in childhood, peaking towards the end of the first year.

How is milk allergy treated?

The first thing to do in the treatment of cow’s milk allergy is to remove cow’s milk from your baby’s diet. Along with cow’s milk, cow’s milk products contain the same proteins. Expressions of artificial butter yolk, butter, all kinds of milk, milk powder, skimmed milk, evaporated milk, goat’s milk, sheep’s milk, casein, caseinate cheese, cream, lactalbumin, lactalbumin phosphate, lactoglobulin, lactulose, whey, yogurt on food packages Foods containing cow’s milk protein should not be given.

Since there are protein similarities between cow’s milk and the milk of other mammals, it should not be given because there is a high possibility of allergy development in other milks. Cross-reactions are common, especially between cow’s milk and sheep’s and goat’s milk. It should not be forgotten that the content of any milk taken may be mixed milk.

Hypoallergic formulas can be used in those who are allergic to cow’s milk. In mothers with breastfed babies, removing milk and dairy products from the mother’s diet and giving calcium support will reduce allergic reactions in the baby. Babies who cannot take breast milk should be fed with hypoallergic forums. It is not recommended to give soy-based infant formulas and formulas to infants in the first 6 months.