What are the symptoms of cow’s milk allergy. How is cow’s milk allergy different from lactose intolerance. What causes cow’s milk allergy. How is cow’s milk allergy diagnosed and managed. What are the risks of severe allergic reactions to cow’s milk.

Understanding Cow’s Milk Allergy: Prevalence and Impact

Cow’s milk allergy is a significant health concern, particularly among infants and young children. This condition affects approximately one in 50 babies, making it a relatively common food allergy in early childhood. Interestingly, while it’s prevalent in infants, cow’s milk allergy is rare in adults.

It’s crucial to distinguish cow’s milk allergy from lactose intolerance, as they are often confused but are fundamentally different conditions. Cow’s milk allergy involves an immune system response to milk proteins, while lactose intolerance is a digestive issue related to the inability to break down lactose, the sugar found in milk.

Cross-Reactivity with Other Animal Milk

Individuals with cow’s milk allergy may also react to milk from other animals, such as goats, sheep, and buffalo. This cross-reactivity occurs due to the similarity in protein structures across different animal milks. Therefore, those diagnosed with cow’s milk allergy should exercise caution with all animal-derived milk products.

Identifying Symptoms of Cow’s Milk Allergy

Cow’s milk allergy can manifest in various ways, with symptoms ranging from mild to severe. The onset of these symptoms can be immediate or delayed, occurring within minutes or up to several days after consuming milk or dairy products.

Immediate Symptoms (within minutes)

• Hives (urticaria) – raised, red, itchy bumps on the skin
• Itchy, red, weeping, or crusty rash (dermatitis or eczema)
• Facial swelling
• Wheezing or persistent cough
• Vomiting
• Diarrhea

Delayed Symptoms (within hours to days)

• Eczema
• Persistent diarrhea
• Asthma-like symptoms
• Vomiting (if onset is within hours)

The severity and combination of symptoms can vary greatly between individuals and may even change over time in the same person.

Anaphylaxis: A Life-Threatening Allergic Reaction

Anaphylaxis is a severe, potentially life-threatening allergic reaction that can occur in response to cow’s milk in highly sensitive individuals. Recognizing the signs of anaphylaxis is crucial for prompt and appropriate action.

Symptoms of Anaphylaxis

1. Difficulty breathing or noisy breathing
2. Swelling of the tongue
3. Swelling or tightness in the throat
4. Difficulty talking or hoarse voice
5. Persistent wheezing or coughing
6. Dizziness or collapse
7. Paleness and floppiness (particularly in young children)

In case of anaphylaxis, immediate medical attention is crucial. Call emergency services (000 in Australia) and administer adrenaline via an auto-injector if available. Do not allow the person to stand or walk, as this can worsen their condition.

The Science Behind Cow’s Milk Allergy

Cow’s milk allergy is an immune-mediated response to specific proteins found in milk. When the immune system mistakenly identifies these proteins as harmful, it triggers a cascade of reactions leading to allergic symptoms.

Allergens in Cow’s Milk

The main allergens in cow’s milk are proteins, primarily:

• Whey proteins
• Casein proteins

An individual may be allergic to one or both of these protein types. The immune system produces antibodies specific to these proteins, which then trigger the release of chemicals like histamine, causing the allergic symptoms.

Diagnosing Cow’s Milk Allergy: A Clinical Approach

Accurate diagnosis of cow’s milk allergy is essential for proper management and to avoid unnecessary dietary restrictions. If you suspect that you or your child has a cow’s milk allergy, it’s crucial to consult a healthcare professional for a proper diagnosis.

Diagnostic Methods

• Medical history and symptom evaluation
• Skin prick tests
• Blood tests to measure specific IgE antibodies
• Oral food challenges (under medical supervision)

Diagnosis often involves a combination of these methods, as no single test is definitive. In some cases, an elimination diet followed by a controlled reintroduction of milk may be necessary to confirm the diagnosis.

Managing Cow’s Milk Allergy: Avoidance and Alternatives

The primary treatment for cow’s milk allergy is strict avoidance of milk and dairy products. This requires careful reading of food labels and awareness of hidden sources of milk proteins in various foods.

Nutritional Considerations

Eliminating dairy from the diet, especially in growing children, requires careful planning to ensure adequate nutrition. Calcium and protein, which are abundant in dairy products, need to be obtained from alternative sources.

• Calcium-fortified non-dairy beverages (soy, almond, oat milk)
• Leafy green vegetables
• Calcium-set tofu
• Fish with edible bones (sardines, salmon)

It’s advisable to work with a registered dietitian to ensure a balanced diet, particularly for children with cow’s milk allergy.

Importance of Professional Guidance

Exclusion and reintroduction of cow’s milk and dairy foods should only be undertaken under the guidance of a medical specialist and, in many cases, a dietitian. This is particularly crucial in cases where there’s a risk of anaphylaxis.

Caution: Do not alter your child’s diet without consulting a healthcare professional, as this could lead to nutritional deficiencies and impact growth and development.

Differentiating Cow’s Milk Allergy from Other Reactions

Not all adverse reactions to milk are due to allergies. Understanding the differences between various milk-related conditions is important for proper diagnosis and management.

Lactose Intolerance vs. Cow’s Milk Allergy

Lactose intolerance is often confused with cow’s milk allergy, but they are distinct conditions:

• Lactose intolerance: A digestive issue caused by the lack of lactase enzyme needed to break down lactose (milk sugar)
• Cow’s milk allergy: An immune system reaction to milk proteins

Symptoms of lactose intolerance can include diarrhea, vomiting, stomach pain, and gas, which may seem similar to milk allergy symptoms. However, lactose intolerance does not involve the immune system and is not life-threatening.

Other Non-Allergic Reactions

Some individuals report experiencing excess thick mucus in their throat after consuming dairy products. According to the Australasian Society of Clinical Immunology and Allergy (ASCIA), this mucus production is not caused by an allergy and is not considered a health risk.

Living with Cow’s Milk Allergy: Practical Tips and Considerations

Managing cow’s milk allergy requires vigilance and careful planning, but it doesn’t have to significantly limit one’s quality of life. Here are some practical tips for living with this condition:

Reading Food Labels

Become an expert at reading food labels. Milk proteins can be found in unexpected places. Look out for ingredients such as:

• Casein
• Whey
• Lactose
• Milk solids
• Milk powder
• Butter
• Cheese

Be aware that terms like “non-dairy” do not always mean milk-free. Always check the ingredient list thoroughly.

Eating Out Safely

Dining out can be challenging but not impossible. Here are some strategies:

1. Inform the restaurant staff about your allergy
2. Ask about ingredients and preparation methods
3. Choose simple dishes with fewer ingredients
4. Consider bringing your own safe snacks or meals when uncertain

Cross-Contamination Awareness

Even trace amounts of milk protein can trigger an allergic reaction in sensitive individuals. Be mindful of potential sources of cross-contamination:

• Shared cutting boards or utensils
• Fryers used for milk-containing and milk-free foods
• Buffet-style serving where utensils may be shared

Emergency Preparedness

For those at risk of severe reactions:

• Always carry prescribed emergency medication (e.g., epinephrine auto-injector)
• Wear a medical alert bracelet or necklace
• Educate family, friends, and colleagues about your allergy and how to respond in an emergency

The Future of Cow’s Milk Allergy Research and Treatment

While current management of cow’s milk allergy primarily involves avoidance, ongoing research is exploring new avenues for diagnosis, treatment, and potential prevention.

Emerging Diagnostic Tools

Researchers are working on developing more accurate and less invasive diagnostic methods. These include:

• Component-resolved diagnostics: Identifying specific milk protein components that trigger allergies
• Basophil activation tests: Measuring cellular responses to milk proteins
• Microarray technology: Allowing for simultaneous testing of multiple allergens

Potential Therapeutic Approaches

Several promising treatment strategies are under investigation:

1. Oral immunotherapy: Gradually introducing increasing amounts of milk to build tolerance
2. Sublingual immunotherapy: Placing small amounts of milk protein under the tongue
3. Epicutaneous immunotherapy: Applying milk proteins to the skin via patches
4. Anti-IgE therapy: Using monoclonal antibodies to block allergic reactions

These approaches aim to desensitize the immune system or block the allergic response, potentially allowing individuals with cow’s milk allergy to safely consume dairy products in the future.

Prevention Strategies

Research is also focusing on understanding risk factors and potential prevention strategies for cow’s milk allergy. Areas of interest include:

• The role of gut microbiome in allergy development
• Timing of introduction of allergenic foods in infancy
• Maternal diet during pregnancy and breastfeeding

While these areas show promise, more research is needed to develop evidence-based recommendations for allergy prevention.

Addressing Common Misconceptions About Cow’s Milk Allergy

Misconceptions about cow’s milk allergy can lead to unnecessary anxiety or improper management. Let’s clarify some common misunderstandings:

Myth: Cow’s Milk Allergy and Lactose Intolerance Are the Same

This is a prevalent misconception. While both conditions involve adverse reactions to milk, they are fundamentally different:

• Cow’s milk allergy: An immune system response to milk proteins
• Lactose intolerance: Inability to digest lactose due to lack of the enzyme lactase

Understanding this difference is crucial for proper diagnosis and management.

Myth: All Milk Alternatives Are Suitable for People with Cow’s Milk Allergy

While many plant-based milk alternatives are safe for those with cow’s milk allergy, it’s important to note:

• Some individuals may have multiple food allergies
• Cross-contamination can occur during production
• Always check labels and consult with a healthcare provider before introducing new foods

Myth: Children Always Outgrow Cow’s Milk Allergy

While many children do outgrow cow’s milk allergy, it’s not universal:

• Approximately 80% of children outgrow the allergy by age 16
• Some individuals retain the allergy into adulthood
• Regular follow-ups with an allergist are important to monitor potential changes in allergy status

Supporting Individuals with Cow’s Milk Allergy: A Community Approach

Managing cow’s milk allergy extends beyond individual efforts. A supportive community can significantly improve the quality of life for those affected by this condition.

Education and Awareness

Increasing public understanding of cow’s milk allergy is crucial. This includes:

• School programs to educate staff and students about food allergies
• Workplace training on accommodating employees with food allergies
• Community events to raise awareness and dispel myths

Support Groups and Resources

Connecting with others who share similar experiences can be invaluable. Support can be found through:

• Local and online support groups
• Allergy foundations and organizations
• Social media communities focused on food allergies

These platforms provide emotional support, practical tips, and up-to-date information on managing cow’s milk allergy.

Advocacy for Improved Labeling and Policies

Advocating for clearer food labeling and allergy-friendly policies can make a significant difference. This may involve:

• Pushing for stricter labeling laws
• Advocating for allergen-free options in schools and public spaces
• Supporting research initiatives for better diagnosis and treatment options

By working together, we can create a more inclusive and safe environment for individuals with cow’s milk allergy.

Cow’s milk allergy – Better Health Channel

About cow’s milk allergy

An allergy to cow’s milk and related dairy products affects one in 50 in babies and is different to lactose intolerance. Very few adults are allergic to cow’s milk. People who are allergic to cow’s milk can also be allergic to milk from other animals such as goats, sheep and buffalo.

Symptoms of milk allergy vary and range from mild reactions to a severe allergic reaction (anaphylaxis). Some people experience symptoms immediately, but in others, the symptoms can take time to develop.

If you think you, or someone in your care, have a cow’s milk allergy, visit your doctor for a diagnosis. To manage a cow’s milk allergy, all food containing milk must be avoided (under strict medical supervision).

Exclusion and reintroduction of cow’s milk and other dairy foods should only be undertaken with advice from a medical specialist (and in many cases, a dietitian), particularly in cases of anaphylaxis. If long-term exclusion is required, an alternative source of calcium and protein is needed, to ensure adequate nutrition and growth.

Do not change your child’s diet without consulting a doctor or your child could suffer from nutritional deficiencies.

Food allergies can be life threatening. If you, or someone in your care, have a severe allergic reaction (anaphylaxis), call triple zero (000) for an ambulance. Do not stand or walk. Administer adrenaline (epinephrine) via injector (EpiPen® or Anapen®), if available.

Causes of cow’s milk allergy

Milk allergy is most commonly caused by an allergy to cow’s milk, although some people are allergic to milk from other animals such as goats, sheep and buffalo.

In all allergies, the immune system reacts to triggers, also known as allergens. Your immune system produces antibodies that detect the allergen, causing inflammatory reactions and the release of chemicals, including histamine, which cause allergic symptoms.

In the case of milk, the triggers are milk proteins including whey and casein. You or your child may be allergic to either one of these proteins, or both.

More researchExternal Link is needed into the causes, diagnosis and treatment of food allergy.

Some reactions to milk are not caused by allergies

Some people can have a physical reaction to milk that is not due to an allergy. If you lack an enzyme called lactase, which breaks down the milk sugar lactose, you can experience symptoms that seem similar to an allergy (diarrhoea, vomiting, stomach pain and gas). This is called lactose intolerance and is different from milk allergy, because it does not involve your immune system reacting to a trigger.

Some people also experience excess thick mucus in their throat after eating or drinking dairy products, but this is not caused by an allergy. The Australasian Society of Clinical Immunology and Allergy (ASCIA) advises that this mucus production is not a health risk.

Symptoms of cow’s milk allergy

Symptoms of a cow’s milk allergy can appear within minutes or several days of consuming cow’s milk or dairy products. The severity of the symptoms will depend on the person and the amount of cow’s milk they consume.

Symptoms that can appear within minutes of having a small amount of milk include:

• raised red bumps of skin – hives (urticaria)
• itchy, red, weeping or crusty rash of the skin – dermatitis or eczema
• swelling of the face
• wheeze or persistent cough
• vomiting
• diarrhoea.

If your child is prone to a severe allergic reaction to milk, these symptoms can also appear very rapidly.

Symptoms that can appear within hours include:

• vomiting
• diarrhoea
• rashes or eczema.

Symptoms that can appear within days include:

• eczema
• diarrhoea
• asthma.

Severe allergic reaction – anaphylaxis

Cow’s milk is one of the most common foods to cause severe allergic reactions. Severe allergic reaction (anaphylaxis) is life threatening.

Symptoms of a severe allergic reaction include:

• difficult or noisy breathing
• swelling of the tongue
• swelling or tightness of the throat
• difficulty talking or hoarse voice
• wheeze or persistent cough
• persistent dizziness or collapse
• paleness and floppiness in young children

If you, or someone your care, have a severe allergic reaction (anaphylaxis), call triple zero (000) for an ambulance.

• Do not stand or walk.
• Administer adrenaline (epinephrine) via injector (EpiPen® or Anapen®), if available.
• Further adrenaline may be given if there is no response after 5 minutes.
• Give adrenaline first, then asthma reliever puffer, if required.

Keep a record of your symptoms

Keep a diary that describes your symptoms or your child’s symptoms and when and where they occur. Your diary could include information about whether the symptoms occur:

• inside your home, outside or both
• for a short time or longer
• at night, during the day or when you wake up
• after you have had a particular food or drink
• after you have taken a particular medication, either prescription or over the counter from a pharmacy or supermarket
• after you have taken a herbal medicine.

Diagnosis of cow’s milk allergy

If you or your child have allergic symptoms, visit your family doctor who will ask some questions about your reactions. You can also discuss your record of your symptoms. To diagnose your allergy, your doctor may refer you to a clinical immunology/allergy specialist.

If your symptoms appear rapidly after eating or drinking milk or dairy products, the allergy may be easier to diagnose, whereas symptoms that take longer to appear make diagnosis more difficult.

Allergists can test for allergies using a number of methods depending on the type of potential allergy. To test for an allergy, the allergist may:

• do a skin prick test
• do a blood test
• ask you to temporarily avoid all milk or products containing milk (elimination diet), then follow up with the introduction of milk back into your diet (food challenge) under strict medical supervision.

A number of methods claim to test for allergies but have not been medically or scientifically provenExternal Link. They can be costly and could lead to dangerous avoidance of certain foods. The Australasian Society of Clinical Immunology and Allergy (ASCIA) recommends that you do not use certain methods to have potential allergies tested, including:

• cytotoxic food testing
• electrodermal testing
• hair analysis
• iridology
• kinesiology
• pulse testing
• reflexology
• Vega testing.

Always speak with your doctor if you are thinking of using a complementary medicine or therapy for allergies.

Treatment for cow’s milk allergy

If you or your child have been diagnosed with milk allergy, treatment involves total avoidance of milk or products containing milk. This can be difficult to achieve.

The Australasian Society of Clinical Immunology and Allergy (ASCIA) advises that children who are allergic to cow’s milk are often allergic to goat’s milk, and so substitution with a milk of animal origin may not be possible.

To avoid milk and milk products, read food labels and avoid foods that contain milk or milk products such as:

• butter
• buttermilk
• casein and caseinate
• cheese
• chocolate
• cow’s or goat’s milk – including ‘A2 milk’
• cream
• crème fraiche
• ghee
• ice cream
• margarines that contain milk products
• milk powder
• nougat
• whey
• yoghurt.

ASCIA has more information about dietary avoidance of cow’s milk for food allergyExternal Link.

Eliminate milk and milk products from your baby or young child’s diet only under strict medical supervision. Your doctor will need to advise on replacement sources of calcium and protein, which are especially important nutrients for children. Replacement formulas for babies also needs to be carefully supervised. For example, some children with cow’s milk allergy will not be able to tolerate soy milk products.

Emergency treatment for severe allergic reactions (anaphylaxis)

If you are at risk of a severe allergic reaction (anaphylaxis), carry an adrenaline injector such as an EpiPen® or Anapen®, an Australasian Society of Clinical Immunology and Allergy (ASCIA) Action Plan for AnaphylaxisExternal Link and a means of calling for medical assistance, such as a mobile telephone.

Emergency responses for a severe allergic reactionExternal Link are:

• Lay the person flat – do not allow them to stand or walk.
• Administer adrenaline with an injector into the outer mid-thigh.
• Always dial triple zero (000) to call an ambulance in a medical emergency.
• Further doses of adrenaline may be given if there is no response after 5 minutes.
• Give adrenaline first, then asthma reliever puffer, if required.

If you are at risk of a severe allergic reaction (anaphylaxis) make sure you:

• Have an ASCIA Action Plan for Anaphylaxis.
• Carry an adrenaline injector (such as an EpiPen® or Anapen®) to treat a severe allergic reaction.
• Consider wearing medical identification jewellery – this increases the likelihood that adrenaline will be administered in an emergency.
• Avoid medication (where possible) that may increase the severity of allergic reaction or complicate its treatment such as beta blockers.
• Avoid the food which causes your allergic reaction.
• Tell food staff about your allergy when eating out.
• Seek medical advice from a doctor or clinical immunology/allergy specialist.

Adrenaline injectors are also available over the counter from a pharmacy.

Where to get help

• In an emergency, always call triple zero (000)
• Emergency department of your nearest hospital
• Your GP (doctor)
• NURSE-ON-CALL Tel. 1300 60 60 24 – for health information and advice (24 hours, 7 days)
• St John Ambulance AustraliaExternal Link Tel. 1300 360 455
• Australasian Society of Clinical Immunology and Allergy (ASICA)External Link
  • Cow’s milk allergyExternal Link
  • Locate a specialistExternal Link
• Allergy and Anaphylaxis AustraliaExternal Link

Lactose Intolerance vs. Dairy Allergy: Symptoms, Diagnosis, Living With

Written by WebMD Editorial Contributors

• Symptoms
• Am I More Likely to Have Dairy Allergy?
• Getting Tested
• Testing for Lactose Intolerance
• Testing for Dairy Allergy
• Living With Lactose Intolerance
• Living With Dairy Allergy
• More

Lactose intolerance and dairy allergy sound a lot alike. Many people think they’re the same thing. But, how they’re caused (and how they affect your body) are very different.

Lactose intolerance involves the digestive system: If you have it, your body doesn’t make lactase, the enzyme needed to digest lactose. That’s the sugar in milk. Instead of digesting normally in your stomach and small intestine, undigested lactose moves into your colon, where it’s broken down by bacteria and causes bloating and gas. It can be uncomfortable, but it’s not dangerous.

Lactose intolerance is common in adults – about 30 million Americans have it by age 20. It’s more common in people with Asian, African or Native American heritage and less common in people with a northern or western European background.

Dairy allergy involves the immune system: If you have it, your body reacts to the proteins in milk and other dairy products as if they’re dangerous invaders. It releases substances that cause allergy symptoms. This allergic reaction can be mild (rashes) to severe (trouble breathing, loss of consciousness).

Dairy allergy is one of most common allergies, especially in children. As many as 2 in every 100 children under 4 years old are allergic to milk. It’s even more common in babies.

Some symptoms of lactose intolerance and dairy allergy may be the same:

• Diarrhea
• Nausea; sometimes vomiting
• Abdominal cramps
• Bloating
• Gas

But dairy allergy can also cause a reaction in other parts of your body, including the skin and lungs:

• Rash
• Hives
• Swelling, often in the lips and face
• Wheezing
• Tightness in throat
• Trouble swallowing

There may be blood in the stool (poop) too, especially in babies.

Anaphylaxis is a serious, life-threatening allergic reaction and often begins minutes after you eat a food you’re allergic to, but sometimes it can happen hours later. It usually involves more than one symptom in more than one part of your body at the same time.

If you have a severe allergy or if you’ve ever had anaphylaxis in the past, talk to your doctor about carrying an injectable epinephrine (Adrenaclick, Auvi-Q, EpiPen, a generic auto-injector, Symjepi) to slow down or stop the allergic reaction.

You’re more likely to develop dairy allergy if:

• You have other allergies
• You have eczema
• One or both of your parents has a food or other allergy, like hay fever, eczema or asthma
• You’re young. Milk allergy is more common in children. As you get older, your digestive system is less likely to react to milk, but you’re likelier to have lactose intolerance.

First your doctor will take your medical history to understand your symptoms and how your body reacts to dairy foods. Then you’ll be tested to confirm whether it’s lactose intolerance or a dairy allergy.

Lactose tolerance test: You’ll drink a liquid that contains a lot of lactose. About 2 hours later, the amount of glucose (sugar) in your bloodstream will be measured. If your glucose level doesn’t rise, you’re not digesting the lactose in the drink.

Hydrogen breath test: You’ll drink a liquid that contains a lot of lactose. Then, the hydrogen in your breath will be measured at regular intervals. If you’re not digesting lactose, it will be broken down in your colon, releasing hydrogen that can be detected in your breath.

Stool acidity test: Babies and children who can’t be tested otherwise can have their stool tested for lactic acid caused by the breakdown of undigested lactose in the colon.

Skin prick test: A small drop of liquid containing the dairy allergen is placed under your skin on your forearm or back. If a raised bump surrounded by itchy red skin appears, a dairy allergy is likely.

Your doctor might have you take a blood test too, which measures the amount of certain antibodies in your blood.

Both tests can have “false positives.” You can test positive for an allergy even though you really don’t have it. Your allergist will explain the results.

If an allergy is still suspected but not confirmed, your doctor may have you take an oral challenge. You’ll be fed different foods that may or may not contain milk in increasing amounts to see if you react to food that contains milk.

Lactose intolerance is easily managed, mostly by limiting the amount of dairy food and drink you consume. You can also try lactose-reduced ice cream and milk, or take lactase enzyme supplements when you eat dairy products to help your body digest lactose.

If you have dairy allergy, you’ll need to avoid all dairy foods and other foods that contain dairy products.

Staying safe means reading food labels to see if milk or ingredients containing milk are included. Milk proteins are found in many foods you wouldn’t expect. Some canned tuna, energy drinks and even chewing gum contain them. And don’t eat lactose-reduced foods if you have dairy allergy. They still contain the milk proteins that can cause allergic reactions.

Top Picks

Lactose insufficiency – articles from the specialists of the clinic “Mother and Child”

what it is
The main food of babies is milk (breast or formula). It contains many different nutrients (proteins, fats, carbohydrates), which, with the help of special digestive enzymes, are broken down into simple components and digested. But in young children, the gastrointestinal tract is still immature, there are few enzymes in it, others are not at all or they are not yet working at full capacity. When the baby grows up, there will be more enzymes, the digestive system will mature, but for now there may be various problems with it.

All milk (women’s, cow’s, goat’s, artificial mixtures) and dairy products contain the carbohydrate lactose, also called “milk sugar”. In order for lactose to be absorbed, the lactase enzyme must break it down, but if the child has little or no lactase enzyme, then lactose is not broken down and remains in the intestine. As a result, there is always a large amount of milk sugar in the intestines, which begins to ferment, and where there is fermentation, conditionally pathogenic flora actively reproduces. What we feel during fermentation: intestinal motility increases (it rumbles), plus gas formation increases (the stomach swells). But in an adult, this is usually a one-time situation due to some inaccuracies in nutrition, and it quickly passes. But in babies, everything is different, especially since they lack the enzyme not once, but constantly. What it looks like: The milk sugar lactose retains water, hence loose stools. In the child’s stomach, “rumbles and boils”, colic begins, the stool becomes frothy, greens, mucus and even blood may appear in it. If at first the stool was liquid, then constipation appears, and all this changes in a circle: yesterday there was diarrhea, today and tomorrow there is no stool at all, the day after tomorrow it is liquid again. And the most unpleasant thing is endless colic and endless crying, there is no rest for both the parents themselves and the baby. Mom at some point notices that the baby is crying just after feeding, and then a variety of advice falls upon her. “Your milk is bad, better give the mixture,” says the beloved mother-in-law. “Only breasts and nothing else!” – advise breastfeeding gurus. As a result, the mother tries one thing or the other, but neither breast milk nor artificial mixture gives relief to the child. Colic, crying and problems with the stomach and stool continue. The parents are in a panic because they don’t understand what is going on. In fact, this is a typical picture of bright lactase deficiency (LN), or insufficient production of the lactase enzyme.

various reasons

There are several types of lactase deficiency, and it is with them that confusion arises.

Congenital lactase deficiency is a genetic and very rare disease (one case in several thousand newborns), it is difficult to confuse it with something, since it is very difficult. The diagnosis is made in the maternity hospital or in the first days after birth, the child does not have lactase at all, he quickly loses weight, he is immediately started to be fed intravenously or through a tube. Some experts (but not doctors) on breastfeeding read once that congenital lactase deficiency is an extremely rare disease, and that’s all – they further began to assure young mothers: “In fact, LN is extremely rare, you don’t have it, you don’t need to listen to doctors “, etc. Yes, congenital LN is a rare disease, but the key word here is “congenital”, and there are other types of lactase deficiency.

Transient lactase deficiency in infants . And this is exactly the condition that occurs very often. The baby was born, and so far he still has little lactase enzyme, plus little normal intestinal microflora. Hence the colic, and loose stools, and mucus, and greenery, and crying, and the nerves of the parents. After a while, the child’s digestive system will fully mature, all enzymes will begin to work actively, the intestines will be populated with what is needed, and “lactase deficiency” will disappear. Therefore, such a LN is called “transient”, that is, temporary, or passing. It passes for someone a month after birth, for someone longer – after six to seven months, and there are children in whom lactase deficiency completely disappears only by the year.

Secondary lactase deficiency. This condition appears if a person has had some kind of intestinal infection, and it does not matter whether it is an adult or a baby. For some time after the illness, the child does not tolerate milk (any), and then with proper nutrition and sometimes even without treatment, everything quickly passes.

Lactase deficiency in adults. There are people in whom the lactase enzyme begins to be lacking only in adulthood, this happens for various reasons: for some, lactase ceases to be produced in the right amount after some kind of illness, for other people, the activity of this enzyme simply fades over time by itself. yourself. As a result, at some age, a person begins to tolerate milk and dairy products poorly, although before that everything was fine. The symptoms are the same as in babies: he drank milk and after that the stomach rumbles, boils, and the stool is liquid. Sooner or later, a person realizes that milk is not his product, and simply stops drinking it in its pure form.

what to do

If there is transient lactase deficiency, then what to do with it? First you need to understand if it exists at all. Why does the child have problems with the stomach, stool, why does he cry all the time? Is it neurology, common colic, errors in the mother’s diet, an inappropriate mixture (if the baby is bottle-fed), improper breastfeeding technique, lactase deficiency, or a reaction to the weather? It can be difficult to figure it out right away, but if the tests show that there is lactase deficiency, then it is most likely in it. Now what to do next – treat it, wait for the enzymes to mature, or something else? Firstly, everything here will depend on how much the enzyme is lacking and, therefore, on how much LN worries the child and parents. Some children lack the enzyme quite a bit, so their colic is mild and children cry quite normally. Plus, the violation of the stool is also not very bright: there are a couple of times a slightly liquefied stool, but that’s all. In other children, the lack of lactase is more pronounced, the child does not cry, but simply yells after each feeding, if at first he gained weight well, then after two months the increase is minimal, problems with stools begin in parallel (day – constipation, day – diarrhea), stool sometimes green, sometimes with mucus. Atopic dermatitis appears on the skin (the skin is the first to react to problems with the gastrointestinal tract). Parents have no rest day or night: the baby cries – he is fed – he cries again, they try to calm him down in other ways. But nothing helps. Mom and dad are in a panic, and no one has the strength anymore.

If parents see that the child may have signs of lactase deficiency, that he needs help, first of all, you need to look for a good doctor. Only an experienced pediatrician will be able to figure out why the baby has colic or green stools, what the numbers in the tests say, and what is the norm for one baby and the pathology for another. And of course, it is not necessary to cancel breastfeeding and immediately prescribe lactose-free or low-lactose artificial mixtures (even as a supplement). By itself, milk sugar lactose is very necessary for a child, when lactose is broken down, its components (glucose and galactose) go to the development of the brain, retina, for the life of normal intestinal microflora. So do not completely eliminate this sugar, you need to help it break down. With a strongly pronounced LN, the missing enzyme is given before each feeding (it has long been learned to produce and it is sold in pharmacies), with a dim clinic, its dose can be reduced. And it is also possible that there is lactase deficiency (even according to tests), but it does not need to be treated, there are almost no symptoms.

But what cannot be done is to listen to non-specialists who deny either lactase deficiency itself or its treatment. They see the cause of all problems with the child’s stomach and stool either in the wrong technique of breastfeeding, or partially admit that there is immaturity of the enzyme, but this is natural and will pass by itself. Yes, for some, LN is expressed easily and will pass quickly, but what about those parents whose child yells day and night, covered with a crust from atopic dermatitis and stopped gaining weight? Wait for the time to come and the enzymes to mature? Alas, with pronounced lactase deficiency (even if transient), enterocytes (intestinal cells) often suffer, so it is simply necessary to help such a child.

If you see that your baby has signs of lactase deficiency, look for a doctor who is committed to maintaining breastfeeding and has extensive experience. He will definitely help to find out why the baby is crying, why he has a stomach ache or has problems with stool. And then the life of the parents and the child will return to normal.

“Transient” (temporary) lactase deficiency in someone passes a month after birth, in someone longer – after six to seven months, and there are children in whom lactase deficiency completely disappears only by the age of one

If the tests show that there is a lactase deficiency, then the matter is most likely in it.

Milk sugar lactose is very necessary for a child: when lactose is broken down, its components (glucose and galactose) go to the development of the brain, retina, for the life of normal intestinal microflora

Parent’s note

1. In infants, transient (temporary) lactase deficiency is most common.

2. Symptoms of lactase deficiency usually appear some time after birth. These are colic, frequent crying, increased gas formation, stool – either constipation or diarrhea (over time it becomes frothy, greens, mucus and even blood may appear in it).

3. The simplest study that can reveal lactase deficiency is the analysis of feces for carbohydrates.

4. It is usually not necessary to cancel breastfeeding or partially replace it with lactose-free or low-lactose formulas. You can give the missing enzyme from the outside.

Lactase deficiency, food allergy – Symptoms and treatment

How to recognize lactase deficiency and not confuse it with an allergy to cow’s milk proteins in a child, which doctor to contact and how to correctly diagnose this pathology, we will describe below.

Today, such a diagnosis as lactase deficiency has become very “fashionable” and is often unjustifiably given to children of different age categories. This often causes an unreasonable transfer of a child from breastfeeding to artificial, early introduction of complementary foods and long-term treatment of a child for a disease that he does not have.

Lactase deficiency or lactose intolerance is a condition in which the intestine does not produce enough lactase enzyme to digest milk sugar (lactose).

Lactose is very important for babies in their first months of life because breast milk or formula is the main food for these babies. Lactose is the main source of energy for a small organism. It is also used for the proper growth and development of all organs and systems. Therefore, problem lactase deficiency should be given special attention in children of the first year of life.

Symptoms of lactase deficiency in children can be completely different.

Undigested lactose gets into the intestines and is broken down by the bacteria that live there. This leads to the following symptoms:

• bloating,
• malodorous loose stools,
• regurgitation,
• Anxiety of the baby (baby throws up the breast, bends over during feeding or cries immediately after feeding),
• allergic skin rash,
• the child is not gaining weight well and lags behind in development,
• in older children there is pain in the abdomen without a clear localization.

Other types of food intolerances, such as gluten intolerance or celiac disease, may show the same symptoms.

Due to nonspecific symptoms lactase deficiency is often confused with food allergy, cow’s milk protein allergy in children . Despite this, the mechanism of development, diagnosis and treatment of lactase deficiency and allergy to cow’s milk proteins are completely different. Also, one should not forget that there is a combined pathology – this is when a food allergy in children is accompanied by lactase deficiency.

Most often, lactase deficiency in babies is acquired and develops as a result of other diseases, such as food allergies or celiac disease, and is not an independent or congenital condition. And after treating the aforementioned conditions, it is possible to restore the body’s ability to digest lactose. Only after eliminating the cause of lactose intolerance can we talk about the solution of the problem.

Gastrolyzer® is the first breath test in Ukraine for the diagnosis of lactase deficiency and other types of food intolerance, presented at the FxMed Clinic.

Hydrogen breath test is a painless method for determining the level of hydrogen, which is formed when sugar is broken down by intestinal bacteria and then absorbed into the bloodstream and can be measured in exhaled air.

The Gastrolyzer® breath test is known worldwide as the “ gold standard for diagnosing lactase deficiency , many types of food intolerance and other diseases of the gastrointestinal tract (overgrowth syndrome (SIBO), irritable bowel syndrome) and is recommended by leading European experts.

Hydrogen breath test detects:

• lactase deficiency
• fructose intolerance
• intolerance to sorbitol (sugar substitute)
• small intestine transit time determinations
• bacterial overgrowth syndrome (SIBO)

The test technique is quite simple and can be performed on children of all ages. The presence of a mask allows the test to be performed on younger children.

Treatment of lactase deficiency

It is based on a dairy-free diet and lactase enzyme replacement therapy. Complete exclusion from the diet of dairy products, which is most often prescribed for children with lactase deficiency, is not the best way to solve the problem.

Dairy products are a source of calcium, vitamin D, phosphorus and other trace elements necessary for the normal growth and development of the child. In this case, it is better to use products that are lactose-free or low in lactose.

Treatment of lactase deficiency in children of the first year of life

For children with congenital lactase deficiency, the only method of treatment is to transfer the child to therapeutic lactose-free formulas. In children with acquired lactase deficiency, it is necessary to establish the cause and eliminate it.

Formula-fed babies are most often treated with therapeutic lactose-free formulas.