Milk Allergy or Sensitivity

Milk Allergies and Sensitivities in Babies

Many babies who fuss or cry throughout the day are suspected of reacting to something the mom is eating or the milk protein in their formula. There is often confusion about whether it is the milk protein they are reacting to, or the lactose (milk sugar), and whether the baby is allergic, or just sensitive to the milk.

Milk Sensitivity in Babies

According to Kelly Dorfman, an expert in child nutrition, 75% of children who react to dairy are sensitive to it, but are not truly allergic. The most common reaction to dairy in infants, she says, is blood in the stool or chronic constipation. The reaction can occur 2-48 hours after exposure to milk. Most infants with a milk sensitivity will outgrow it between the ages of 1 and 2.

According to Kelly,

A reaction or sensitivity does not necessarily involve histamine. It can occur more than 2 hours after exposure and probably involves a set of messenger molecules called cytokines. Because they can involve cytokines, any neurological symptom is fair game. Cytokines talk to both the immune system and nervous system. Therefore, the symptoms can be spaciness, tiredness, crankiness , trouble concentrating and learning (all neurological) or getting sick a lot (very, very important), frequent ear infections, asthma, constipation, stomach pain or reflux. Those are the most common ones I can think of and I have seen all of them in practice.

Lactose Intolerance

Lactose intolerance, while fairly common in adults, is rare in infants or children. In adults, the symptoms of lactose intolerance all involve the gastrointestinal tract. Symptoms may include gas, bloating, diarrhea, and/or cramping. Lactose intolerance is diagnosed using a test called the hydrogen breathe test.

If you suspect your baby is reacting to dairy in her diet, it is more likely that she has a milk sensitivity or a true milk allergy, rather than lactose intolerance.

True Milk Allergy

A true allergy to milk in infants is much less common, and your child will be unlikely to outgrow it. An allergy to milk involves a histamine reaction, which means there will be itching, hives, or throat closing (anaphylaxis). The reaction will occur within 2 hours of exposure. If your baby does not experience these symptoms, it is more likely a sensitivity or intolerance.

According to Kelly,

The difference between an allergy and a sensitivity is that “allergies” are now narrowly defined as histamine reactions. Therefore, there will be itching, hives or throat closing within 2 hours of exposure. A traditional allergy response involves invoking the mast cells to release histamine. These reactions are from casein, a milk protein.

Cutting Out the Dairy

If you are breastfeeding, keep in mind that any dairy you are consuming is being passed on to your baby through the breastmilk. You may want to try cutting all dairy out of your diet for a week or two to see if it helps with the fussiness.

If you are formula feeding, remember that most formulas use cow’s milk as a base. Switching to soy formula is not recommended due to the fact that many babies who are allergic to cow’s milk are also allergic to soy. There have also been concerns raised about the long term effects of soy formula on infants due to the high levels of hormones used in growing soy.

If your baby is diagnosed with a milk sensitivity or allergy, and you are formula feeding, you will want to consider switching to a hypoallergenic formula. These are sometimes easier for your baby to tolerate as the milk proteins are broken down, making them easier to digest. The American Academy of Pediatrics suggests not switching to hypoallergenic formula unless your baby has been definitively diagnosed with a milk allergy or sensitivity, due to the high cost of the formula,

If you are breastfeeding and suspect your baby is reacting to the dairy in your diet, there is no reason to switch to formula. Cutting the dairy out of your diet should be sufficient.