| Category | Milk Protein Allergy |
Cow’s milk protein allergy (CMPA)
Cow’s milk protein allergy is now called bovine milk protein allergy. Previously it was thought that milk protein allergy is rare in India. But now it is one of the common causes of diarrhea or colitis (loose stools mixed with blood) in children especially those less than 3 years of age.
What is cow’s milk allergy?
Cow’s milk protein allergy is a type of food allergy. Food allergies involve the body’s immune system which normally fights infections. When someone is allergic to a food, the immune system overreacts to the particular food protein present in the food. So children who are allergic to cow’s milk protein react adversely to one or more proteins present in the milk (cow milk, bovine milk, or goat milk). The proteins present in the milk are caseins and Whey protein. Children allergic to milk may react to either or both of the proteins present in milk.
Each time children eat milk proteins, the body thinks they are harmful invaders. The immune system responds adversely. This causes an allergic reaction, in which chemicals like histamine are released in the body.
Release of these chemicals causes signs and symptoms in patients with cow’s milk protein allergy.
What are the problems of milk protein allergy?
Your child can develop one or more of the following symptoms if your child has a milk protein allergy:
Loose stools that persist more than 2 weeks
Blood in the stools
Vomiting
Perianal rash
Vomiting
Hematemesis (vomiting of blood)
Skin rash, hives
Itching
Wheeze
Body swelling
Shock (fall in blood pressure)
Rarely milk protein allergy can cause severe anaphylaxis reaction which can be life-threatening.
Milk intolerance is different from milk allergy. In milk intolerance, there is a deficiency of enzyme which digestive milk in the intestine. It does not involve immune system activation.
How does your doctor diagnose it’s a Milk Allergy?
The doctor suspects milk protein allergy after asking you details of your child’s history related to signs, symptoms including feeding in details, and clinical examination. Few routine tests like blood and stool examination to rule out another disease which may present like milk protein allergy may be required to do.
Proctosigmoidoscopy- to see the rectum from inside for evidence of feature of milk protein allergy and biopsy to confirm that may be required. This is a simple daycare procedure that is done in 3 to 5 minutes. The majority 87% of children with milk protein allergy will have endoscopic or histopathologic changes in the rectum with helps early to suspect milk protein allergy. It also helps to rule out other diseases like IBD, infections.
How milk protein allergy is treated?
Ilk protein allergy is treated by the elimination of milk and milk products from the child’s diet. Depending on the child or infant's age special formula or diet will be advised by your doctor. Your doctor will also provide a proper diet chart. Your child should be on the milk and milk products free diet for at least 1 year. But one should keep in mind that few children may need to continue the milk-free diet for a longer duration. So, regular follow up with a Pediatric gastroenterologist is required.
What is the prognosis of milk protein allergy?
Prognosis in milk protein allergy is excellent. Gradually your child will become tolerant to milk protein. By 3 years 75% and by 5 years 90% of children are able to tolerate milk and milk products.
