What are the symptoms of milk allergy in toddlers

Treatment depends on the extent of your child’s intolerance.

What are the symptoms of milk allergy in toddlers

Some children with lactose intolerance may be capable to own little amounts of dairy products without having symptoms.

Your kid may be referred to a dietitian for specialist advice.

Read more about treatment for lactose intolerance in children.


Further information:

Sheet final reviewed: 12 July 2019
Next review due: 12 July 2022

Lactose intolerance and cow's milk allergy often get mixed up. Lactose intolerance is caused by a lack of an enzyme that helps you to digest the sugar in milk. Cow’s milk allergy, on the other hand, is an adverse immune reaction to proteins found in milk.

They are completely unrelated conditions except that they share a common cause – cow’s milk and dairy products.

After returning from the Beagle expedition in 1836, Charles Darwin wrote: "I own had a bad spell. Vomiting every day for eleven days, and some days after every meal."

Darwin struggled for more than 40 years with endless bouts of vomiting, stomach cramps, headaches, severe tiredness, skin problems, and depression.

Researchers now ponder that he had lactose intolerance, and his case is a excellent example of how easily it can be missed or misdiagnosed.

Lactase persistence

So why are some people capable to digest lactose after weaning and others not?

'Lactase persistence' originates from a genetic mutation that occurred among a little number of European and African pastoral tribes within the final 5,000-10,000 years – in evolutionary terms, this is extremely recent history.

It provided a selective advantage to populations using dairy products, enabling them to live endless enough to own children. The average life expectancy was probably little more than 25 years, but this meant the ability to digest lactose could be passed on to subsequent generations.

Descendants of these people are still capable to consume cow's milk without suffering the symptoms of lactose intolerance. It doesn't mean, however, that it's excellent for them.

Common allergy

Cow's milk allergy is one of the most common food allergies in children, affecting between two and 7.5 percent of infants under one, although some grow out of it by the age of five.

Symptoms include an itchy rash or swelling, stomach ache, vomiting, colic, diarrhea or constipation, and a runny nose. Symptoms can appear almost immediately or up to 72 hours after consuming cow's milk protein. This makes it hard to diagnose.

A large problem affecting infants can be gastrointestinal bleeding resulting from cow's milk allergy. Blood loss often occurs in such little quantities that it goes unnoticed but over time can cause iron-deficiency anemia.

Scientists propose that blood loss associated with cow's milk consumption during infancy may affect 40 percent of otherwise healthy infants. Exactly how cow's milk causes blood loss from the intestines is unclear but it's generally agreed that it is probably an adverse immune (allergic) reaction.

However, because healthy infants lose some blood anyway and cow's milk-induced bleeding is clinically silent and shows no other symptoms, it's hard to tell how numerous more infants than the widely accepted figure of less than 10 percent may actually be allergic to cow's milk.

Avoiding cow's milk

The only dependable treatment for cow's milk allergy is to avoid every cow's milk and dairy products, including milk, milk powder, milky drinks, cheese, butter, margarine, yogurt, cream, and ice-cream.

Products with hidden milk content should also be avoided – glance out for: casein, caseinates, hydrolyzed casein, skimmed milk, skimmed milk powder, milk solids, non-fat milk, whey, and milk solids.

People with cow's milk allergy face a similar problem as those avoiding lactose – milk-based ingredients can be hard to avoid as they are commonly used in the production of so numerous foods. It can seem a daunting prospect, having to read the ingredients labels, but most supermarkets now produce product 'free-from' lists, and numerous own their own-label range.

There are even iPhone apps available now to assist you identify ingredients by scanning the product bar code.

Soya ice creams, spreads and yogurts, and dairy-free cheeses are just some 'free-from' examples.

Cow's milk allergy

Cow's milk allergy is extremely diverse to lactose intolerance. An allergic reaction is when the body's immune system launches an inappropriate response to substances mistakenly perceived as a threat.

What are the symptoms of milk allergy in toddlers

Common triggers include latex, detergent, dust, pollen or certain proteins in food. In cow's milk, it is the protein casein that causes most problems, but whey protein can also trigger a reaction in some people.

General symptoms include inflammation, sneezing, runny nose, itchy eyes, and so on, giving rise to the classic allergies – asthma, eczema, hay fever, and urticaria (skin rash or hives). Because cow's milk allergy is linked to numerous conditions – including asthma and eczema – it's always useful to consider it when treating them.

What is lactose intolerance?

This is 'lactose intolerance', and most symptoms result from the production of gases and toxins by these gut bacteria.

Symptoms include a bloated and painful stomach, wind, diarrhea, and, on some occasions, nausea and vomiting.

Other symptoms can include muscle and joint pain, headaches, dizziness, lethargy, difficulty with short-term memory, mouth ulcers, allergies, irregular heartbeat, sore throat, increased need to pass urine, acne, and depression.

Even more worrying is that the toxins produced by bacteria may frolic a key role in diseases such as diabetes, rheumatoid arthritis, multiple sclerosis, and some cancers.

Lactase and weaning

Everyone naturally produces lactase when they are babies – without it we couldn't drink our mother's milk.

However, every mammals and the vast majority of people stop producing it soon after weaning – for us, around the age of two. This is the normal state for most people – around 70 percent of the world's population, in fact.

In Northern Central Europe, lactose intolerance affects between two and 20 percent of people, rising to 40 percent in Mediterranean countries – most common in Italy where it affects 56-70 percent in some regions.

Highest rates are seen in Africa, where it affects 65-75 percent of people, and Asia, where more than 90 percent of people are lactose intolerant.

What is lactose?

Lactose is the sugar in mammal's milk.

In order to release its energy, it must be broken below into its constituent simple sugars – glucose and galactose – so they can be absorbed. This task falls to an enzyme called lactase, produced by cells lining our little intestines

If your body doesn't produce this enzyme, then lactose travels to the large intestine where it is fermented by gut bacteria, producing hydrogen and a range of potential toxins.

Not excellent for kids

Regardless of these problems, it's simply not a excellent thought to give cow's milk to children at every as it contains virtually no iron but does contain potent inhibitors, reducing the body's ability to absorb iron from other foods in the diet.

The high protein, sodium, potassium, phosphorus, and chloride content of cow's milk present what is called a 'high renal solute load'.

Unabsorbed solutes from the diet must be excreted by the kidneys and this can put a strain on immature kidneys, forcing them to draw water from the body thus increasing the risk of dehydration. This is why most health bodies tell that cow's milk should not be given to children under 12 months of age.

Ditching lactose

The treatment for lactose intolerance is straightforward: avoid lactose. It means cutting out every cow's milk, and other dairy foods and checking labels as lactose is added to numerous unlikely foods, including bread, breakfast cereals, salad cream, mayonnaise, biscuits, chocolate, cake, crisps, instant soup and some processed meats, such as sliced ham.

The expression 'lactose' will not necessarily be listed on food labels so glance out for things love dried milk or whey powder.

Lactose is also used as a filler in numerous types of medication and while this may not trigger symptoms in most people with lactose intolerance, it can cause problems in some. Check with your doctor and request lactose-free tablets.

Developing allergies

Although a lot of food allergies start in childhood, you can develop them as an adult, too.

Cow's milk allergy in adults is relatively rare, but symptoms tend to be much more severe than in children when they do happen, with reactions being triggered by amounts as low as 0.3 milligrams of cow's milk protein.

The most severe type of allergic reaction (anaphylactic shock) may involve difficulty in breathing, a drop in blood pressure, and ultimately heart failure and death.

Occasionally, cow's milk allergy can cause severe symptoms that come on suddenly, such as swelling in the mouth or throat, wheezing, coughing, shortness of breath, and difficulty breathing.

In such cases, immediate medical assist must be sought.

The calcium myth

It's a myth that people who avoid dairy miss out on calcium – there are numerous excellent non-dairy sources, including green leafy vegetables (spinach is a relatively poor source as it contains oxalate which binds calcium), dried fruits, nuts and seeds, calcium-set tofu and calcium-fortified soy milk. Remember, 70 percent of the world's population don't do dairy – so you're not alone.

Dairy consumption in the UK is in decline as the market for plant-based milks, vegan cheese, yogurt, and other alternatives is booming.

Whether you are lactose intolerant, allergic to cow's milk protein, or simply desire to cut out dairy for health reasons, the animals or the environment, there's never been a better time to go dairy-free.

Going vegan has never been easier, there are vegan foods labeled as such in every major supermarket. Discover out how simple it is on Viva!'s website here 

The reported prevalence of CMA varies but it is estimated that it is between 1.8 -7.5% of infants in the first year of life. The treatment is the finish exclusion of cow’s milk from the infant’s diet.

CMA presents with a variety of clinical symptoms and the reactions may either be non-IgE mediated or IgE mediated.

What are the symptoms of milk allergy in toddlers

Non- IgE mediated reactions generally present as delayed, with mild to moderate symptoms.

IgE mediated reactions result in immediate and potentially severe symptoms e.g. acute angioedema or urticaria (see table 2.1) needing further investigation.

In numerous infants the diagnosis of cow’s milk allergy has not been confirmed and the baby may remain on the specialist formula and a cow’s milk free diet for longer than necessary, which might own nutritional and social implications. CMA is confirmed in only one in three children presenting with possible symptoms, using strict, well defined elimination and open challenge criteria.

There are no validated laboratory or skin tests for the diagnosis of non-IgE CMA.

The diagnosis can only be confirmed by the planned avoidance of cow’s milk and cow’s milk containing foods followed by re-introduction.

Many a new mom dealing with a fussy newborn (and truthfully, what newborn isn’t fussy?), has suspected that her suffering sweetheart must own a cows’ milk allergy or intolerance, especially when well-intentioned friends and relatives are also blaming milk. If you’re breastfeeding, you may assume it’s the dairy in your diet that’s causing your little one to wail; if you’re formula feeding, you assume it’s the cow’s milk in the baby formula that’s causing the trouble.

Although it is one of the more common allergies in infants, milk allergies still only affect an estimated 2 to 3 percent of babies.

Confusing the issue further is that numerous people are unaware of the difference between a milk allergy and milk intolerance. To clear up the confusion, here’s the breakdown on milk allergies and intolerance in breastfed and formula-fed babies.


Cows’ milk allergy in babies

Cows’ milk allergy (CMA), also called cows’ milk protein allergy, is one of the most common childhood food allergies.

What are the symptoms of milk allergy in toddlers

It is estimated to affect around 7% of babies under 1, though most children grow out of it by the age of 5.

CMA typically develops when cows’ milk is first introduced into your baby’s diet either in formula or when your baby starts eating solids.

More rarely, it can affect babies who are exclusively breastfed because of cows’ milk from the mother’s diet passing to the baby through breast milk.

There are 2 main types of CMA:

  1. immediate CMA – where symptoms typically start within minutes of having cows’ milk
  2. delayed CMA – where symptoms typically start several hours, or even days, after having cows’ milk


Symptoms of cows’ milk allergy

Cows’ milk allergy can cause a wide range of symptoms, including:

  1. digestive problems – such as stomach ache, vomiting, colic, diarrhoea or constipation
  2. hay fever-like symptoms – such as a runny or blocked nose
  3. skin reactions – such as a red itchy rash or swelling of the lips, face and around the eyes
  4. eczema that does not improve with treatment

Occasionally CMA can cause severe allergic symptoms that come on suddenly, such as swelling in the mouth or throat, wheezing, cough, shortness of breath, and difficult, noisy breathing.

A severe allergic reaction, or anaphylaxis, is a medical emergency – call 999 or go immediately to your local hospital A&E department.


Could it be lactose intolerance?

Lactose intolerance is another type of reaction to milk, when the body cannot digest lactose, a natural sugar found in milk. However, this is not an allergy.

Lactose intolerance can be temporary – for example, it can come on for a few days or weeks after a tummy bug.

Symptoms of lactose intolerance include:

  1. vomiting
  2. stomach rumbling and pains
  3. diarrhoea 
  4. wind


Treatment for CMA

If your baby is diagnosed with CMA, you’ll be offered advice by your GP or an allergy specialist on how to manage their allergy.

You may also be referred to a dietitian.

Treatment involves removing every cows’ milk from your child’s diet for a period of time.

If your baby is formula-fed, your GP can prescribe special baby formula.

What are the symptoms of milk allergy in toddlers

Do not give your kid any other type of milk without first getting medical advice.

If your baby is exclusively breastfed, the mom will be advised to avoid every cows’ milk products.

Your kid should be assessed every 6 to 12 months to see if they own grown out of their allergy.

Read more about cows’ milk allergy.


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What are the symptoms of milk allergy in toddlers