Outgrowing milk allergy

Kelly posted: “My daughter just turned one year old and has started the switch from breastmilk to cow’s milk. She has broken out in a rash each of the three times she has had cow’s milk, so we are switching back to breastmilk temporarily. If she does turn out to have a milk allergy, what’s the likelihood that she will grow out of it? And, does the milk allergy extend to milk-based products like cheese, yogurt and cottage cheese?”

True milk allergy (sometimes called “milk protein allergy” or “IgE mediated allergy” or “type 1 hypersensitivity”) causes either hives, wheezing, severe vomiting, or a drop in blood pressure that can cause unconsciousness. Of these reactions, hives are by far the most common and the most benign. The rash is raised pink blobs, occurring anywhere on the body. For some reason, they sometimes seem to prefer the armpits or just around the belly button. Hives itch, and each individual raised area resolves on its own within twelve hours. More hives can follow, but no single spot stays in the exact same place for very long.

Children who have hives triggered by milk will usually outgrow their allergy. It may take a few years, but by kindergarten age over 90% of these children will be able to tolerate milk.

Some, but not all, children who have mild allergies to milk can tolerate dairy products that are cooked or heated. This includes most cheeses and yogurt, but not typically ice cream.

Other reactions can occur to milk, including lactose intolerance. This is not an allergy, but rather an inability to digest milk sugars. It is common in adults (especially those of non-Caucasian descent), but it is very uncommon in children. Babies are almost always born with an ability to digest milk; lactose intolerance typically begins later, as a late teenager, in a child who loses their ability to digest milk sugar. Once a person is lactose intolerant, they will not outgrow this condition.

If your child has had a serious reaction to milk (including severe or widespread hives, any difficulty breathing, mouth swelling, any dramatic vomiting, or anything that led to a trip to the emergency room), be very careful about re-challenging. Sometimes, rather than just trying milk again, it’s more appropriate to do allergy testing first. Talk with your pediatrician about the best and safest way to determine if milk can be given.

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3 Comments on “Outgrowing milk allergy”

  1. Gretchen Says:

    On a similar note, when is it ok to feed a child peanut butter? I have heard that you should wait until 4 years old because if you try sooner then the child could become allergic. I have been feeding my 14 month old peanut butter since his first birthday and he has shown no signs of allergy, but can he develop one if I give him peanut butter too often (another rumor I have heard)? He eats it about 3 – 4 times a week.

    Thanks,
    Gretchen

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  2. Dr. Roy Says:

    An excellent question, Gretchen. I’m going to start a new post with this, and I’ll get to an answer soon.

    A quick answer for now: if your child is doing fine with peanut butter now, there’s no reason to stop giving it. There is really no agreed-on guideline for when to introduce peanut, and there is no good evidence that delaying peanuts is likely to prevent allergy.

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  3. Dr. Roy Says:

    There are both blood tests and skin-prick tests that can help determine if a child has a specific allergy to a food or environmental exposure. These tests are not 100% accurate, and need to be interpreted while considering the history of the child. The best blood test is a test for specific IgE, often called a “RAST.” Older blood tests looking at IgG or IgG subtypes are not accurate and should not be used. For more information, discuss this with your child’s pediatrician or an allergist.

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