Cow's milk allergy (or IgE-mediated cow's milk allergy) is an immediate allergic reaction to the proteins found in cow's milk. Approximately 2% of babies in Australia will have a cow's milk allergy. Cow's milk allergy can be tricky to manage as milk is found in many different foods.
Signs and symptoms of IgE-mediated cow's milk protein allergy develop within minutes of exposure.
IgE-mediated cow's milk protein allergy is reproducible — symptoms occur on each exposure.
Any child with a suspicion of an immediate cow's milk allergy should be seen by a paediatric allergist for assessment and management.
IgE-mediated cow's milk allergy is diagnosed based on a history of symptoms with exposure. Sometimes allergy testing such as skin prick testing or blood tests may be recommended by your doctor.
IgE-mediated cow's milk allergy is managed by avoiding cow's milk and having an Action Plan in place in case of accidental exposure. Non-dairy alternative milks and formulas should be used in place of cow's milk to ensure your child receives enough calcium in their diet.
Important: Goat's milk should be avoided as it is very similar to cow's milk. Lactose-free products are not suitable for people with cow's milk protein allergy.
Next step: If you suspect your child has a cow's milk allergy, talk to your GP about seeing a paediatric allergist.
Non-IgE-mediated cow's milk allergy is a gut-based allergy. Cow's milk protein is the most common trigger of two related conditions: food protein-induced proctocolitis (affecting the large intestine) and food protein-induced enterocolitis (affecting the small bowel).
Usually occurs in the first few weeks of life. Symptoms include frequent or watery bowel movements containing blood or mucus. Babies are typically growing well.
Symptoms include diarrhoea, abdominal pain, vomiting, poor weight gain, and growth concerns. Babies may often be unsettled and irritable.
Skin prick testing and blood tests are not useful in diagnosing non-IgE-mediated cow's milk allergy. If other causes have been excluded, a trial of removing cow's milk and reintroducing it once symptoms have resolved may be recommended.
Non-IgE-mediated cow's milk allergy usually resolves in infancy. Your allergist will explain how to reintroduce cow's milk into your child's diet as they grow older.
Next step: If you suspect your child has a cow's milk allergy, talk to your GP about seeing a paediatric allergist.
Lactose intolerance is an intolerance to the sugar in cow's milk, which is called lactose. When you eat lactose, an enzyme called lactase is needed to break it down into smaller sugars that can be absorbed by the gut. Some people stop making enough lactase to easily digest lactose. This can occur as you get older and is more common in certain populations.
Symptom severity may be related to how much lactose was consumed. There is no risk of developing anaphylaxis with lactose intolerance.
Lactose intolerance cannot be diagnosed with skin prick testing or blood tests. Usually, reproducible symptoms following lactose consumption are enough to suggest the diagnosis.
Lactose intolerance can be managed by drinking and eating lactose-free dairy products, or by using lactase enzyme supplementation (i.e., Lacteeze tablets or drops). Usually, small amounts of lactose are tolerated.
Good news: Children with lactose intolerance generally do not need to see an allergist.