Tuesday, September 10, 2013

Got Milk? Not if You Have Milk Allergy!

Along with wheat, milk is among the top allergens for children if not the leading allergy for babies under one year old. As with all allergies, milk allergy is a case of mistaken identity by the immune system; in this case, it mistakes the proteins in milk as foreign invaders and releases histamines to vanquish the attackers.

Symptoms can range from mild to severe and may affect the digestive tract (vomiting, diarrhea, cramps, gas, abdominal pain), the respiratory tract (coughing, sneezing, wheezing or shortness of breath, runny nose, watery/itchy eyes), or the skin and soft tissue (eczema, hives, red rash, or swelling of the face, mouth, throat, tongue, or lips).

Most people with a milk allergy must avoid not only cow’s milk but sheep and goat’s milk as well, since the proteins in these milks are all similar and will cause an allergic reaction.

Although there are multiple proteins in cow's milk that can cause allergic reactions, casein (80% of milk protein) and whey (the other 20%) are the two main components. Casein is the curd that forms when milk is left to sour and the watery part (after the curd is removed) is the whey.  Who knows, maybe “Mary, Mary quite contrary, eating her curds and whey” might have been feeling contrary due to milk allergy!

Side note: There is a subset of people who are allergic to and cannot tolerate milk but can safely ingest other dairy products if baked (subjected to high heat) in a dessert or food.

Appearance of Milk Allergy
As with many food allergies, milk allergy is seen more commonly in children than in adults. Between 2-5 percent of infants develop milk allergy but many outgrow this; however, statistics about the percentage of children that outgrow milk allergy are all over the map. A Johns Hopkins study, cited on allergicchild.com, reported that just 20 percent of children in its studies outgrew their milk allergy by age 4 and 42 percent by age 8. By age 16, almost 80 percent were allergy-free.

If your baby exhibits reactions to milk-based formula or to dairy foods as he/she gets older, consult a physician to determine if milk allergy is the culprit. Symptoms may include rash, upset stomach, lack of weight gain, or breathing problems.

If your baby tests positive for milk allergy there are two ways to treat it depending on the baby’s food source: eliminate milk proteins from nursing mothers’ diets or switch to a formula-fed baby to an amino-acid-based formula which is non-allergenic. Older babies and toddlers who cannot tolerate cow’s milk might do fine drinking goat’s milk, sheep’s milk, or soy milk (these alternatives are available in many grocery and health food stores).

Another side note: It has been observed that milk allergy symptoms may change over time from affecting one bodily system to another (for example, to move from digestive symptoms to respiratory symptoms).

Lactose Intolerance is Different
Although the symptoms may appear similar in some cases, having a milk allergy is not the same as being lactose intolerant, which is very specific to lactose, the sugar found in dairy products. People who are lactose intolerant lack the lactase enzyme to properly digest this sugar. This causes digestive distress such as stomach aches, gas, or diarrhea. It does not affect other systems.

What to Eat, What to Avoid
There are obvious milk-based foods to avoid—butter, all types of cheeses, yogurt, cream (heavy cream, light cream, sour cream, ice cream), pudding, and custard. And there are many foods that contain cow’s milk protein, such as: candies, gum, and chocolates; cake mix and baked goods; coffee creamers, malted milk, margarine, salad dressings, cereals, sherbet, canned and processed meats, and mashed potatoes. Check all labels!

There are also many processed foods with hidden milk in them, often in the form of whey or casein—even in “non-dairy” products. Be sure to check labels very carefully or contact the manufacturer about ingredients if this is a concern. These ingredients contain milk proteins:
  • Casein, caseinates (sodium caseinate)
  • Whey, whey solids, whey products
  • Curds
  • Cream
  • Ghee (clarified butter)
  • Buttermilk solids
  • Milk solids
  • Lactalbumin, lactalbumin phosphate
  • Lactose, lactoglobulin, lactoferrin, lactulose
  • Rennet
  • Hydrolysates
  • Artificial butter or cheese flavor
Dairy Substitutes
Just because you or your child suffers from a dairy allergy, don’t let that stand in your way of enjoying food and life! In a prior blog post we talked about dairy substitutes for cow’s milk which can be used in baking and cooking, as a beverage, over cereal, and are popular in alternatives to traditional ice cream. Many people eat pizzas with soy-based cheeses, use almond milk in their coffee, or love coconut milk-based frozen desserts. What are your favorites?