Here's a little more info for you bro,
A. Milk allergy
What is milk allergy?
Milk allergy refers specifically to adverse reactions involving immunoglobulin E (IgE) antibodies to one or more protein fractions of milk, whether belonging to the casein or whey protein group. Proteins belonging to the casein group are heat-stable, i.e., they cannot be broken down using heat. Thus, individuals allergic to casein proteins cannot tolerate any cow's milk, including boiled milk. In most instances, whey proteins can be broken down by heat.
The majority of IgE-mediated reactions to milk involve both the casein and whey fractions, which means that most milk-allergic individuals cannot tolerate boiled milk. Allergy to milk may occur in any individual. The group of people most commonly affected by milk allergy are young children, although people can develop milk allergy at any age.
How common is milk allergy?
Clinicians have not been able to determine the exact prevalence of allergy to milk. Studies throughout the world suggest that between 1% and 7% of children will develop allergy to milk. Allergy to milk in adults is much less frequent.
What are the symptoms of milk allergy?
Reactions can be immediate or start several hours or even days after the intake of moderate to large amounts of cow's milk. The most common symptoms are that of other food allergy: nausea, vomiting, diarrhoea and abdominal cramps, or symptoms involving the skin (urticaria [hives], eczema). See Table 1.
Three patterns have been recognised:
Type 1 - Symptoms start within minutes after the intake of small volumes of cow's milk. The reactions seen are mainly on the skin: eczema or urticaria (hives), with or without respiratory or gastro-intestinal symptoms.
Type 2 - Symptoms start several hours after intake of modest volumes of cow's milk. These symptoms are mainly vomiting and diarrhoea.
Type 3 - Symptoms develop after more than 20 hours, or even days after intake of large volumes of cow's milk. The main symptom is diarrhoea, with or without respiratory or skin reactions.
Colic in some children may be due to milk allergy. There is evidence that milk allergy in certain children may result in recurrent or chronic "glue" ear. Occult blood loss associated with cow's milk allergy can be a cause of iron deficiency (anaemia) in children.
Unfortunately, 50% of cow's milk allergy patients will develop an allergy to other food proteins (e.g., egg, soya, peanut), and 50-80% will develop an allergy to one or more inhalant allergens (e.g., grass pollens, house dust mite, cat) before puberty.
Table 1. Symptoms that may indicate milk allergy
Chronic runny nose
Coughing
Ear infections
Excessive colic
Excoriated buttocks
Failure to thrive
Fluid behind ears
Irritability
Nasal stuffiness
Rash, hives and eczema
Recurrent "colds," sinusitis,
Recurrent bronchitis
Recurrent diarrhoea
Vomiting, abdominal pain
Wet and wheezy chest
How is milk allergy diagnosed?
The diagnosis of milk allergy in infants may be easy if the symptoms started soon after the child began on milk formula (made from modified cow's milk). The diagnosis may also be easy if a person has the same reaction repeatedly after eating milk-containing food. In older children and adults, more often the diagnosis is difficult because milk is usually consumed with other food. Diagnosis usually entails clinical evaluation (medical history, family history, food history) supported by appropriate laboratory tests (CAP® RAST blood tests, skin-prick testing). An elimination-challenge test may be employed to make the diagnosis. Only the milk reactions that develop after a few minutes are very likely to give a positive blood or skin test, as these detect IgE that is involved in the immediate-type reaction. Approximately 30% of reactions are allergic in nature but not IgE-mediated. These may be difficult to diagnose using laboratory tests.
How is milk allergy treated?
Medication is ineffective in treating this condition. Avoidance of milk and milk-containing foods is the only treatment. (See Table 2.) This may be difficult to maintain, particularly as milk protein may be "hidden" in other foods. Soy milk may be substituted for cow's milk or cow's milk-derived formulae. Unfortunately, around 20% of milk-allergic children are also allergic to soy milk. A dietician must supervise treatment. Goat's milk is not a good alternative, as it contains a protein similar to one of the major ones in cow's milk. Milk may be present where least expected. For example, in vienna sausages, other sausages, fish fingers, pie crusts, crackers such as Provita, and breakfast cereals.
Prognosis
The majority of young children with milk allergy will outgrow it after avoiding milk for 12-18 months. Individuals who develop the allergy later in life will probably retain it.
Table 2. Label ingredients that indicate the presence of milk proteins
butter
casein
caseinate (potassium, sodium,
calcium, magnesium, zinc and iron caseinates.
cream
cheese
curds
lactose
lactalbumin
lactoglobulin
margarine
milk (also buttermilk)
milk solid
whey
whey powder
yoghurt
