Milk Allergy: Risk Factors, Symptoms and Treatment

In this article we will talk about milk allergy , that is , an immune-mediated hypersensitivity to the proteins contained in this food.

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First of all, we will differentiate it from the condition of intolerance , which instead concerns lactose .

We will subsequently expose the possible symptoms and complications of exposure to the antigen , as well as the risk factors and treatment , with specific reference to special milks for allergy sufferers.

Allergy VS Intolerance

Milk protein allergy or lactose intolerance?

Cow’s milk allergy is the most widespread food sensitization in the first years of life (2-3% of children); it tends to resolve with the maturation of the digestive tract during growth and remains in adults in only 0.5% of cases.

From childhood onwards, however, the most common allergens are fish , shellfish , peanuts and tree nuts .

This allergic form has nothing to do with milk intolerance, which is especially common in adults and the elderly.

People who suffer from milk allergy develop antibodies against some of its proteins ; for this reason, after an initial asymptomatic exposure , ingesting even very small quantities of this food or its derivatives is sufficient to trigger a potentially serious allergic reaction .

It is curious to note that, thanks to digestion , food proteins undergo a modification already at the gastric level (through denaturation). Only in the intestine , however, are they totally demolished by the enzymatic action of the pancreas and the brush border .

We know that allergies are not all the same; they exist of different severity and it seems that this correlates – in addition to the type of immune mediation – also to the length of the peptide sequences recognized as antigen. The shorter these sequences (low molecular weight ), the higher the sensitivity.

Lactose intolerance , on the other hand, is a disorder due to the lack of an enzyme, lactase , necessary to digest the sugar typical of milk and dairy products ; the severity of the symptoms is dose-dependent and there is no involvement of the immune system .

Symptoms and Complications

Symptoms and complications of milk allergy

The clinical manifestations of milk allergy appear a few minutes to a few hours after consuming the food or its derivatives. The symptoms, most often not too serious, are divided into early and late.

The most quickly manifested form of milk allergy, even at very small doses of antigen, is IgE mediated.

Although rarely , even in its early stages, milk allergy can cause a serious complication called anaphylaxis .

It should be noted that children allergic to cow’s milk are more likely to develop other forms of allergies, such as those to eggs , soy and peanuts or hay fever (a form of allergic rhinitis triggered by contact with grass pollen, hair pets or other substances).

Early symptoms

Less serious: digestive problems , vomiting , hives , and difficulty breathing ( dyspnea ).

Late symptoms

Diarrhea , abdominal colic , blood in the stool , itchy skin rashes (often located around the mouth), coughing , and excessive watery eyes .

What is anaphylaxis?

Anaphylaxis, or anaphylactic reaction, is a very dangerous condition that requires rapid medical intervention.

Considered the most serious allergic complication, it is characterized by acute symptoms – such as breathing difficulties , intense itching , facial redness and drop in blood pressure to the point of collapse – which arise early after contact with the allergen (in this case following the intake of milk’s proteins ).

Symptoms of lactose intolerance

The symptoms of lactose intolerance appear a few hours after consuming milk or other lactose-rich foods , are localized at the digestive level and typically include intestinal swelling , flatulence and diarrhea.

They can also be atypical, affecting areas not related to digestion. If ignored, it can lead to malnutrition and growth defects in infants and children .

Risk Factors and Treatment

Risk factors for milk allergy

Risk factors for milk allergy include family history of this or other allergic forms, atopic dermatitis , artificial breastfeeding (with rare exceptions, there are no cases of breast milk allergy ) and age (the incidence tends to to regress already in later childhood, with the maturation of the digestive system ).

Treatment of milk allergy

Given the widespread presence of milk and its proteins in commonly used food products , allergic manifestations are quite frequent.

The milder ones can be alleviated through oral therapy based on antihistamines , while in the presence of anaphylaxis an adrenaline injection may be necessary .

As with all other forms of sensitization, the allergic reaction can only be prevented by avoiding contact with the allergen; consequently it is necessary to exclude any source of milk and its derivatives from the diet.

In case of familiarity, extreme caution is advised when introducing milks other than breast milk to the baby. In this sense, breastfeeding until weaning is considered a protective agent against allergic complications.

In the nutrition of allergic infants it is possible to use special milks , which we will talk about in the next paragraph.