Could your baby be allergic to cows’ milk?

NUTRITION ESSENTIALS

Could your baby be allergic to cows’ milk?

Toddler with cow's allergy

Cows’ milk is one of the most common causes of food allergy in children. In fact, around 1 in 50 babies in Australia and New Zealand are allergic to cow’s milk. This article provides answers to common questions about the causes of cows’ milk allergy, the symptoms to look for, how it’s diagnosed, and steps you can take to manage cows’ milk allergy while still ensuring your child gets the nutrition they need.

 

What causes cows’ milk allergy in babies?

Cows’ milk allergy is caused by the immune system reacting to the protein found in cows’ milk and other dairy products. Infants with a family history of allergic disease are at higher risk of having cows’ milk allergy. Being allergic to cows’ milk is not the same as having lactose intolerance.

 

What are the symptoms of cows’ milk allergy in babies?

Babies who are allergic to cows’ milk may experience a variety of symptoms which usually appear around 15 minutes to 2 hours after exposure to milk or dairy products. However, a small number of children may not show symptoms until several days later.

 

There are 3 main types of cows’ milk allergy symptoms:

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Skin symptoms
e.g. itching, redness, raised and itchy rash or swelling

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Gastrointestinal (gut) symptoms
e.g. vomiting, diarrhoea or constipation, refusing food, tummy pain

Respiratory (airway) symptoms
e.g. runny nose, wheezing, coughing or sneezing

 

Most children with cows’ milk allergy experience 2 or more of these symptoms.

 

For more information, see our article How to identify cows’ milk allergy in toddlers.

 

How do I know if my child has cows’ milk allergy?

If your child has some of the symptoms mentioned above, you should see your doctor who may perform allergy tests – such as skin prick tests or blood tests – to confirm whether the symptoms are related to cows’ milk. Your doctor may also refer you to a specialist or recommend you see a dietitian for further advice.

 

Will my child always be allergic to cows’ milk?

Fortunately, most babies eventually outgrow cows’ milk allergy by the time they are 3–5 years of age. However, some people do not grow out of cows’ milk allergy.

 

How is cows’ milk allergy managed?

Cows’ milk allergy in babies is managed through the removal of cows’ milk and other dairy products from their diet and substituting them with non-dairy-based alternatives (see table below). Most children with cows’ milk allergy are also allergic to milks from other animals (e.g. goats or sheep) and products made from these milks. Be careful with coconut milk products, as some may contain undeclared cows’ milk (particularly imported products).

 

What foods can I give if my child is allergic to dairy?

Cows’ milk and other dairy products are an important source of energy, protein and calcium for growing children. The table shows common food and drinks that contain cows’ milk and suggests appropriate substitutions to provide your baby with the energy and nutrients they need for growth and development. You might like to see a dietitian for more practical advice about ensuring good nutrition for your child. Also, remember that milk or milk products are often found in unlikely products, so it’s important to carefully read all ingredient labels and avoid any foods that contain cows’ milk, unless advised by your healthcare professional.

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Instead of cow’s milk infant formula
Use breast milk or appropriate formula, as advised by your child’s healthcare professional

Appropriate formulas may include:

  • Extensively hydrolysed formula (EHF) is usually the first choice for infants with cows’ milk allergy
  • Soy protein formula
  • Rice protein formula
  • Amino acid based formula
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Instead of cows’ milk (children over 1 year & adults)
Use soy, rice, oat or nut-based drinks – choose one with more than 120 mg calcium per 100 mL

These may not be an adequate milk replacement for some young children, as they usually contain low levels of protein and fat.

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Instead of yoghurt
Use soy yoghurt

Some products contain a small amount of cows’ milk protein – check the label carefully.

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Instead of cheese, sour cream
Use soy cheese, soy sour cream

Some products contain a small amount of cows’ milk protein – check the label carefully.

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Instead of ice cream
Use soy ice cream, sorbet, milk-free gelato

Some products contain a small amount of cows’ milk protein – check the label carefully.

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Instead of butter & margarine
Use oil or milk-free margarine

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Instead of cream & condensed milk
Use soy cream, soy cooking milk, soy condensed milk, rice cream

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Instead of chocolate
Use soy or rice-based (milk free) chocolate

Adapted from ASCIA, Dietary avoidance – cow’s milk protein allergy. Visit www.allergy.org.au/patients/food-allergy

 

Do I need to avoid cows’ milk if I’m breastfeeding?

In rare situations, mothers who are breastfeeding a baby with cows’ milk allergy may also need to remove cows’ milk from their own diets. However, you should seek advice from a healthcare professional before removing milk and dairy products from your own diet.

 

REMEMBER: If you have any questions or concerns about cows’ milk allergy, please speak to a healthcare professional, like a Pharmacist, GP or Maternal Child Health Nurse.

 

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Try our Baby Symptom Checker

Does your baby have tummy troubles, issues with feeding or won’t stop crying? If your baby is less than 12 months old, our Baby Symptom Checker is a useful way to capture your baby’s symptoms for your discussion with your HCP.

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