How to differentiate milk allergy and milk intolerance?

Almost all infants are fussy at times. But some are excessively fussy because they have an allergy to the protein in cow’s milk, which is the basis for most commercial baby formulas.

A person of any age can have a milk allergy, but it’s more common among infants (about 2% to 3% of babies), though most outgrow it.

If you think that your child has a milk allergy, talk with your doctor about testing and alternatives to milk-based formulas and dairy products.

A milk allergy occurs when the immune system mistakenly sees the milk protein as something the body should fight off. This starts an allergic reaction, which can cause an infant to be fussy and irritable, and cause an upset stomach and other symptoms. Most kids who are allergic to cow’s milk also react to goat’s milk and sheep’s milk, and some of them are also allergic to the protein in soy milk.

Infants who are breastfed have a lower risk of developing a milk allergy than those who are formula fed. But researchers don’t fully understand why some develop a milk allergy and others don’t, though it’s believed that in many cases, the allergy is genetic.

 

MILK ALLERGY VS. MILK INTOLERANCE

Milk allergy: With a milk allergy in infants, a baby’s immune system reacts negatively to the proteins in cow’s milk. If the baby is breastfed, he’s reacting to the dairy his mother has eaten (the milk proteins pass through breast milk), and if the baby is formula-fed, he’s reacting to the cow’s milk proteins in the formula. In either case, the immune system sees the cow’s milk proteins as foreign substances, and in its efforts to fend off the invaders, the body releases histamine and other chemicals, which cause allergic symptoms in the body. Symptoms of milk allergies in babies include:

• Frequent spitting up
• Vomiting
• Signs of abdominal pain, or colic-like symptoms, such as excessive crying and irritability (especially after feedings)
• Diarrhea
• Blood in stool
• Lack of weight gain
• Hives
• A scaly skin rash
• Coughing or wheezing
• Watery eyes and stuffy nose
• Trouble breathing and swelling (especially of mouth and throat), or even anaphylaxis (which is a life-threatening allergic reaction)

 

Milk intolerance: Milk intolerance, on the other hand, has nothing to do with cow’s milk proteins or the immune system. Instead, it involves the digestive system, and it occurs when a formula-fed or breastfed baby can’t digest the sugar in milk (called lactose). That’s why milk intolerance is also called lactose intolerance. Congenital lactose intolerance (milk intolerance in babies from birth) is an extremely rare metabolic condition. Lactose intolerance more commonly develops in older kids and adults. The few babies with lactose intolerance will usually fare much better on a formula with little or no lactose. Symptoms of lactose intolerance in babies include:

 

• Gas
• Diarrhea
• Bloated stomach
• Spitting up
• Infant eczema
• Irritability, crying, or other colic symptoms
• Failure to thrive and gain weight

 

Once allergy has been confirmed either by your GP or specialist, you should be offered advice on how to manage your baby’s allergy to cows’ milk protein. This may include advice from a dietitian on alternatives to cows’ milk formulas, how to avoid cows’ milk in processed foods and advice on avoiding foods that contain cows’ milk in your own diet if you are breastfeeding.

 

They will also be able to help you put together a management plan so that you know what to do, both for feeding your baby and for any medical treatments that may be necessary, such as antihistamines or creams for babies with eczema. You will probably be given follow-up appointments so that your baby can be monitored regularly, as they get older, to make sure that they are thriving well and not missing any nutrients. This may be at the allergy clinic but it is very likely that you will be referred back to your GP or health visitor.