Cow Milk Allergy

In most cases children with cows milk allergy will out grow their allergy by age 3-5 years.

Children who suffered from colic, reflux, eczema or diarrhoea, as an infant or young child will in most cases outgrow this in earlier life from 9-12 months, and should be safe to reintroduce dairy. 

It’s important to consult either your doctor or Dietitian to decide if you child is ready to begin reintroduction of milk. Please note though if you child suffers forms severe reactions and/or bad asthma it is safer to complete a formal milk challenge in hospital.

General consensus is to re-introduce slowly starting with baked goods, followed by cultured, then heat treated and finally normal pasteurised cows milk. The success to reintroduction is very individual and some people may never be able to tolerate a glass of milk.

How to begin milk reintroduction:

• Begin with a very small amount of the milk containing food. Wait 15-30 minutes before having a second slightly larger portion.
• Stick with a small amount the first day and then gradually increase intake the following day until a normal portion is reached.
• Working your way through the milk ladder up to step 5 should take roughly 6 months before your ready to introduce yoghurt.
• As you can see this is a very slow process allowing the body to learn how to effectively metabolise the milk proteins one mouthful at a time. 
• Wait at least 6 months continuing with cooked milk and dairy products without any reactions before trying any plain uncooked milk starting with very small quantities.

The UK resource - the milk ladder is particularly useful as a guide. http://cowsmilkallergyguidelines.co.uk/downloads-and-resources/downloadable-map-milk-ladder/

When to try reintroducing milk:

• When your child is well.
• Have some antihistamine available.
• Do not retry milk for the first time when you are very busy.

What to do if your child has a reaction:

• Most reactions occur within 2 hours of the food although eczema sometimes flares after a day or two.
• If you child has a mild reaction such as a mild rash, diarrhoea or tummy ache go back to the type of milk your child definitely tolerates. Stay on this type of milk for about 6 months after the reaction before trying new foods again. If the reaction is just mild eczema you may wish to continue with the food.
• Severe reactions are very unlikely but if your child has a more severe reaction (e.g. breathing difficulties, wheeze) get medical help immediately and discuss with your doctor before considering any further reintroduction
• If you are unclear about when to try new foods discuss this with your doctor or dietician.

Lactose intolerance

Lactose intolerance generally causes symptoms of excess wind, abdominal pain and diarrhoea. Children who have lactose intolerance (inability to digest lactose milk sugar) may tolerate milk products slightly differently as it is not the milk protein causing the symptoms.

Cooking does not necessarily alter the lactose levels. Therefore the focus hear is more on foods such a yoghurt and cheeses where the fermentation of bacteria through processing reduced the lactose levels.

The quantity of the lactose-containing food is of most importance in lactose intolerance.

Please not these guidelines above are based on general advice and may sometimes need to be altered by your doctor or Dietitian depending on the clinical situation. If you’re interested to learn more please book an appointment today.