Intolerance-allergy to cow’s milk proteins

allergy to cow's milk proteins it is a food allergy. An allergy is any immune reaction mediated by immunoglobulin E. The child creates antibodies against the food and when taking it, a reaction occurs that causes allergic symptoms. There must be a direct relationship between the ingestion of milk or milk derivatives and the appearance of symptoms.

It is called cow's milk protein intolerance when the immune mechanism causing symptoms not dependent on immunoglobulin E; They usually have digestive symptoms that do not affect the child's growth or good weight gain.

The protein in cow's milk is one of the first foods that the baby has contact with.

Causes

To understand allergy to milk proteins It must first explain how our immune system works.

The human body tries to eliminate everything that it perceives as alien or strange. This is how we defend ourselves against viruses or bacteria that cause disease. Food is tolerated by the body and, under normal conditions, it is not treated as foreign agents that must be eliminated. Cow's milk protein intolerance is a failure of 'tolerance' to proteins contained in milk. Symptoms do not appear until the child begins to drink milk.

There are cases of breastfed children who have symptoms of allergy to cow's milk proteins. This is due to the fact that the mother is drinking milk and its proteins are capable of reaching the breast, being secreted by the mother's milk. In all these cases, the baby is genetically predisposed to suffer from this food allergy.

There is a genetic predisposition to suffer from food allergy, especially if there is family history of allergies or atopy, or, if the child has atopic eczema or.

Symptoms

Milk allergy symptoms are a reflection of the body's struggle to defend itself against what it considers to be "strange," in this case, the proteins in cow's milk. A first symptom, in the child, may be the systematic rejection of milk because it makes him feel bad.

Symptoms are immediate after contact with milk and can encompass a wide range of symptoms:

• Diarrhea
• Vomiting
• Urticaria
• Edema of the tongue, lips and glottis
• Itching in the mouth
• Difficulty swallowing or breathing
• Atopic eczema
• asthma
• allergic
• Abdominal pain
• Poor growth and little weight gain
• Anaphylaxis

The anaphylaxis is a serious reaction and life threatening where two or more organs are affected during the allergic reaction; for example, the child suffers from asthma and hives after ingesting milk.

Diagnosis

When the Pediatrician suspects the diagnosis of allergy to cow's milk proteins They must recommend a diet free of these proteins and refer the child for an allergy study to confirm the diagnosis.

If the baby drinks breast milk, the mother is advised to follow a diet free of milk and derivatives. If the infant is fed with artificial milk, it is changed to a milk that does not contain cow protein. In cases of allergy, children improve when they start the special diet.

The allergological study consists of performing skin tests (prick test) that allow the skin to be tested for an allergic reaction to different proteins in cow's milk and other foods; An analysis is also carried out that allows us to know how much Immunoglobulin E the child has.

The last test, when the Pediatrician considers it appropriate, is the provocation test which consists of giving, in a controlled manner under medical supervision, increasing amounts of milk and seeing if the child tolerates them or has allergy symptoms. It is always performed in the hospital because of the risk of suffering a serious reaction during the test.

In most cases, after the milk exclusion diet for several months, the child is able to successfully pass the challenge test and reintroduce cow's milk as a normal part of his diet.

Treatment

If you suspect an allergy to cow's milk proteins, the first thing to do is remove them from the child's diet. Remove dairy products and their derivatives and be extremely careful with the ingredients of the foods they contain "Camouflaged milk" with other names such as casein or caseinate, lactalbumin, H4511…. The doctor will be in charge of giving a list of all the components and preservatives derived from cow's milk.

In the case of having suffered anaphylaxis, the child should always carry self-injectable adrenaline.

Currently there are milk for infants and children allergic to cow's milk proteins. They are mainly of two types:

• Hydrolyzed milk: by means of a chemical process the proteins of the cow's milk are broken so that they do not produce the allergic reaction. They can be given from birth but their taste is not as pleasant as normal formula milk.
• Soy milk: its taste is better. They are derived from soybeans and are recommended after six months of life.
• Rice milks: its flavor is more pleasant.

It is not recommended to replace the cow's milk for milk from other mammals like the sheep, the goat or the donkey; It has been proven that some children can be allergic to cow's milk as well. They are also not adapted for babies under one year of age.

The Pediatrician is always the one who should prescribe special milks.

Prevention

Breastfeeding prevents the risk of food allergies to children with family background.

It can prevent the appearance of allergies if the introduction of complementary feeding begins after the sixth month of life, especially in children with a family history of food allergies.

You have to follow the Pediatrician's guidelines when introducing new foods and giving them when it's time, without rushing.

When to go to the Pediatrician

• When the child has allergy symptoms (hives, mouth swelling, difficulty swallowing, digestive disorders, rhinitis or asthma) within two hours of taking a certain food.
• The child shows rejection of a specific food.

If you have the feeling that some foods do not suit your child, you may be interested in doing one of the food sensitivity and intolerance tests that you can do on the MAPFRE digital health services platform

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Dra. Esther Martínez García

Pediatric Specialist