Understanding Milk Protein Allergy In Children

By Ahmet Aybar, MD

Annapolis Pediatric Gastroenterology and Nutrition

. https://www.annapoliskidsgi.com/

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Understanding Milk Protein Allergy In Children

Cow’s Milk is often one of the first foods introduced to infants and toddlers, making it especially concerning when a child reacts negatively to it. Milk protein allergy, also known as cow’s milk protein allergy (CMPA), is one of the most common food allergies in young children, affecting approximately 5% of infants worldwide.

What Is Milk Protein Allergy?

Milk protein allergy occurs when a child’s immune system mistakenly identifies proteins found in cow’s milk—primarily casein and whey—as harmful invaders. This triggers an immune response, leading to symptoms that can affect the skin, digestive tract, and respiratory system. CMPA is different from lactose intolerance, which is caused by an inability to digest lactose, the sugar in milk, rather than an immune reaction.

Symptoms To Watch For

Symptoms of milk protein allergy can appear within minutes or up to several hours after consuming milk or dairy products. They may include:

• Skin rashes, hives, or eczema
• Vomiting or diarrhea
• Blood or mucus in the stool
• Abdominal pain or colic-like symptoms
• Runny nose, wheezing, or coughing
• Poor weight gain or growth (in more chronic cases)

In rare cases, a child may experience anaphylaxis, a severe allergic reaction requiring immediate medical attention.

Diagnosis and Testing

If milk protein allergy is suspected, a pediatrician or allergist will review your child’s symptoms and medical history. Diagnosis may involve:

Elimination diets: The primary treatment is avoidance of  all cow’s milk protein  along with soy protein and soy oils as frequently soy protein allergy goes hand-in-hand with dairy allergy.

skin prick test and food-specific IgE antibody tests are not useful because in many cases, the culprit is non-IgE based allergens that are not detected by such tests. Therefore, a detailed history obtained from the parents and physical examination including a stool test for presence of microscopic blood are adequate to establish a clinical diagnosis

Oral food challenges, done under medical supervision, to confirm the allergy

It’s important not to eliminate milk from your child’s diet without guidance, as dairy is a major source of calcium, vitamin D, and protein.

Treatment and Management

The primary treatment for milk protein allergy is avoidance of all cow’s milk and dairy products. For formula-fed infants, hypoallergenic formulas such as extensively hydrolyzed or amino acid-based formulas are typically recommended.

For  breast feeding mothers this may mean removing all dairy and soy protein from their own diet. Fortunately, about 80% of the affected infants outgrow this problem by their birthday and some may continue to have symptoms till age 3-5 years.

Supporting Your Child’s Health

Work closely with your pediatrician or a registered dietitian to ensure your child gets the nutrients they need without dairy. Many milk alternatives, such as oat or soy milk, can be fortified with calcium and vitamin D—but not all are suitable for young children, so professional guidance is key.