Definition

By Mayo Clinic staff Milk allergy is an abnormal response by the body's immune system to milk and products containing milk. Cow's milk is the usual cause of milk allergy, but milk from sheep, goats and buffalo also can cause a reaction. Some children who are allergic to cow's milk are allergic to soy milk, too. Milk allergy is one of the most common food allergies in children. A milk allergy usually occurs minutes to hours after consuming milk. Signs and symptoms of milk allergy range from mild to severe and can include whee ing, vomiting, hives and digestive problems. !arely, milk allergy can cause anaphyla"is # a severe, life$threatening reaction. Avoidance is the primary treatment for milk allergy. %ortunately, most children outgrow a milk allergy by age &.

Symptoms
By Mayo Clinic staff Milk allergy symptoms, which differ from person to person, occur a few minutes to a few hours after drinking milk or eating milk products. 'mmediately after consuming milk, signs and symptoms of a milk allergy might include( )ives *hee ing +omiting Signs and symptoms that may take more time to develop include( ,oose stools, which may contain blood -iarrhea Abdominal cramps Coughing or whee ing !unny nose *atery eyes 'tchy skin rash, often around the mouth Colic, in babies Milk allergy or milk intolerance? 't's important to differentiate a true milk allergy from milk protein intolerance or lactose intolerance. .nlike a milk allergy, intolerance doesn't involve the immune system. Milk intolerance causes different symptoms and re/uires different treatment from a true milk allergy. Common signs and symptoms of milk protein or lactose intolerance include digestive problems, such as bloating, gas or diarrhea, after consuming milk or products containing milk. Anaphylaxis !arely, milk allergy can cause anaphyla"is, a life$threatening reaction that can narrow the airways and block breathing. 'f you or your child has a reaction to milk, tell your doctor about it no matter how mild the reaction was. 0ests can help confirm a milk allergy, so you can take steps to avoid future and potentially worse reactions. Anaphyla"is is a medical emergency and re/uires treatment with an epinephrine 1adrenaline2 shot and a trip to the emergency room. Signs and symptoms start soon after consuming milk and can include( Constriction of airways, including a swollen throat that makes it difficult to breathe

%acial flushing 'tching Shock, with a marked drop in blood pressure When to see doctor See a doctor or allergist if you or your child e"periences milk allergy symptoms shortly after consuming milk. 'f possible, see your doctor when the allergic reaction is occurring. 0his will help the doctor make a diagnosis. Seek emergency treatment if you or your child develops any signs or symptoms of anaphyla"is.

Causes
By Mayo Clinic staff All true food allergies are caused by an immune system malfunction. 3our immune system identifies certain milk proteins as harmful, triggering the production of immunoglobulin 4 1'g42 antibodies to neutrali e the protein 1allergen2. 0he ne"t time you come in contact with these proteins, these 'g4 antibodies recogni e them and signal your immune system to release histamine and other chemicals. )istamine and other body chemicals cause a range of allergic signs and symptoms. )istamine is partly responsible for most allergic responses, including runny nose, itchy eyes, dry throat, rashes, hives, nausea, diarrhea, difficulty breathing and anaphylactic shock. 0here are two main proteins in cow's milk that can cause an allergic reaction( Casein, which is found in the solid part 1curd2 of milk that curdles Whey, which is found in the li/uid part of milk that remains after milk curdles 3ou or your child may be allergic to only one milk protein or allergic to both casein and whey. 0hese proteins not only are present in milk, but they're also found in processed foods. Additionally, most people who react to cow's milk will also be allergic to sheep, goat and buffalo milk. ,ess commonly, people allergic to cow's milk are also allergic to soy milk.

Risk factors
By Mayo Clinic staff Certain factors may increase the risk of developing a milk allergy( Other allergies Many children allergic to milk also have other allergies. 5ften, however, milk allergy is the first to develop. Atopic dermatitis Children who have atopic dermatitis # a common, chronic inflammation of the skin # are much more likely to develop a food allergy. !amily history A person's risk of a food allergy increases if one or both parents have a food allergy or another type of allergy # such as hay fever, asthma, hives or ec ema. Age Milk allergy is more common in children. As you grow older, your digestive system matures, and your body is less likely to react to milk.

"ests and diagnosis

By Mayo Clinic staff *hen food is the cause of an allergic reaction, it isn't always easy to pinpoint what food is to blame. 0o evaluate whether you or your child has a milk allergy, your doctor may( Ask detailed /uestions about signs and symptoms

6erform a physical e"am )ave you keep a detailed diary of the foods you or your child eats )ave you eliminate milk from your diet or your child's diet 1elimination diet2 # and then have you add back the food to see if it causes a reaction )e or she may also recommend one or both of the following tests( Skin test 'n this test, your skin is pricked and e"posed to small amounts of the proteins found in milk. 'f you're allergic, you develop a raised bump 1hive2 at the test location on your skin. Allergy specialists usually are best e/uipped to perform and interpret allergy skin tests. Be aware that this type of test isn't always accurate for detecting a milk allergy. #lood test A blood test can measure your immune system's response to milk by measuring the amount of certain antibodies in your bloodstream, known as immunoglobulin 4 1'g42 antibodies. A blood sample is sent to a medical laboratory, where it can be tested for evidence of sensitivity to milk. )owever, this test isn't always accurate in correctly identifying a milk allergy. 'f your e"amination and test results can't confirm a milk allergy, your doctor might administer an oral challenge, in which you are fed different foods that may or may not contain milk in increasing amounts to see if you react to the ones that contain milk. 'f your doctor suspects your symptoms are caused by something other than a food allergy, you may need other tests to identify # or rule out # other medical problems.

"reatments and drugs

By Mayo Clinic staff 0he only way to prevent an allergic reaction is to avoid milk and milk proteins altogether. 0his can be difficult because milk is a common ingredient in many foods. -espite your best efforts, you or your child may still come into contact with milk. 'f this happens, medications, such as antihistamines, may reduce signs and symptoms of a mild milk allergic reaction. 0hese drugs can be taken after e"posure to milk to control an allergic reaction and help relieve discomfort. 0alk with your doctor about which medications might work best for you. 'f you or your child has a serious allergic reaction 1anaphyla"is2, you may need an emergency in7ection of epinephrine 1adrenaline2 and a trip to the emergency room. 'f you're at risk of having a severe reaction, you or your child may need to carry in7ectable epinephrine 1such as an 4pi6en2 at all times. )ave your doctor or pharmacist demonstrate how to use this device so you're prepared for an emergency. Allergy shots, also sometimes called immunotherapy, haven't been proved effective for treating food allergies, but research is ongoing.

$re%ention
By Mayo Clinic staff 0here's no sure way to prevent a food allergy, but you can prevent signs and symptoms by avoiding the food that causes them. 'f you know you or your child is allergic to milk, the only sure way to avoid an allergic reaction is to avoid milk products. 8now what you or your child is eating and drinking. Be sure to read food labels carefully. ,ook for casein, a milk derivative, which can be found in some une"pected places, such as in some canned tuna or other meats. Ask /uestions about ingredients when ordering in restaurants.

Sources of milk products 5bvious sources of allergy$causing milk proteins are found in dairy products, including( *hole milk, low$fat milk, skim milk, buttermilk Butter 3ogurt 'ce cream, gelato Cheese and anything that contains cheese )alf$and$half Milk can be harder to identify when it's used as an ingredient in processed food products, including baked goods, processed meats and breakfast cereals. )idden sources of milk include( *hey Casein 'ngredients spelled with the prefi" 9lact9 # such as lactose and lactate Candies, such as chocolate, nougat and caramel %at$replacement products, such as Simplesse 6rotein powders Artificial butter flavor Artificial cheese flavor )ydrosolate 4ven if a food is labeled 9milk$free9 or 9nondairy,9 it may still contain allergy$causing milk proteins # so you have to read the label carefully. *hen in doubt, contact the manufacturer to be sure a product doesn't contain milk ingredients. *hen eating out, ask how foods have been prepared. -oes your steak have melted butter on it: *as your seafood dipped in milk before being cooked: *hile there's no sure way to prevent an allergic reaction to milk, reading labels, being cautious when eating out, and using hypoallergenic or milk$free products can help you or your child avoid an unpleasant or dangerous reaction. 'f you're at risk of a serious allergic reaction, talk with your doctor about carrying and using emergency epinephrine 1adrenaline2. 'f you have already had a severe reaction, wear a medical alert bracelet or necklace that lets others know that you have a food allergy. Milk alternati%es for infants Some research suggests that breast$feeding during the first four months of a baby's life instead of giving a standard cow's milk formula can help prevent milk allergy. 'n children who are allergic to milk, breast$feeding and use of hypoallergenic formula can prevent allergic reactions. #reast&feeding is the best source of nutrition for your child. Breast$feeding for at least the first four to si" months of life if possible is recommended, especially if your infant is at high risk of developing a milk allergy. 'ypoallergenic formulas are produced by using en ymes to break down 1hydroly e2 milk proteins, such as casein or whey. %urther processing can include heat and filtering. -epending on the level of processing, products are classified as either partially or e"tensively hydroly ed. 5r they may also be called elemental formulas. Some hypoallergenic formulas aren't milk based, but instead contain amino acids. Along with e"tensively hydroly ed products, amino$acid$based formulas are the least likely to cause an allergic reaction.

Soy&(ased formulas are based on soy protein instead of milk. Soy formulas are fortified to be nutritionally complete # but, unfortunately, some children with a milk allergy also develop an allergy to soy. Milk from other animals, such as goats or sheep, isn't a good substitute for cow's milk, as these types of milk contain proteins similar to the allergy$causing proteins in cow's milk. 'f you're breast$feeding and your child has a milk allergy, cow's milk proteins passed through your breast milk may cause an allergic reaction. 'f this is the case, you may need to e"clude all products that contain milk from your diet. 0alk to your doctor if you know # or suspect # your child has a milk allergy and has allergy signs and symptoms that occur after breast$feeding. 'f you or your child is on a milk$free diet, your doctor or dietitian can help you plan nutritionally balanced meals. 3ou or your child may need to take supplements to replace calcium and nutrients found in milk, such as vitamin - and riboflavin.