There is a lot of talk about cow’s milk. Some people consider it an essential food for children and who calls it directly poison.
As usual, neither one end nor the other. Milk is a complete food, but not essential. His bad reputation comes from being the food that most often produces allergies or intolerances.
There are two elements that can generate it:
- Cow’s milk proteins. Especially Casein, lactalbumin and lactoglobulin.
- Lactose. It’s the sugar in milk.
Allergy to cow’s milk proteins:
What do we notice in the baby when he drinks milk and has an allergy?
An immediate reaction when drinking cow’s milk with vomiting, diarrhea, skin rash, coughing, lowered tension with pale skin and decay. Allergy means that the baby’s defensive system defends against cow’s milk proteins because it is considered to be somewhat aggressive.
If this happens, we suspect that there may be an allergy. To confirm it we can do analytics.
Analytics to confirm the allergy to cow’s milk proteins:
- High total IgE. They are the antibodies that usually rise in allergies. The high total figures tell us that there is something that is causing allergy. But it does not tell us what.
- Casein-specific IgE, Alfalactoalbumin and Betalactoglobulin. These are the three milk proteins that you are most allergic to. If it is positive to one or several of them, the allergy is confirmed. But if they are negative it is not ruled out. Because in milk there are many more proteins capable of causing allergy.
- Prick or positive patch test. Contact on the skin with what we suspect produces the allergy. This test is more reliable, because we test with full milk and whatever it is that produces allergy, the body reacts. The problem is that it has its risks, especially when the first reaction has been very intense.
Intolerance to cow’s milk proteins:
What do we notice in the baby?
In this case, it is not that the defensive system defends itself by mistake against cow’s milk proteins. The problem is that the baby’s intestine can not digest them. When left undigested, some germs of the intestinal flora do and can release substances that irritate the intestine, causing it not absorb well the rest of nutrients and causing discomfort.
The most frequent are: heavy digestion, irritability, weight gain, diarrhea or sporadic vomiting.
Tests to confirm:
- Elevated serum IgA. Sometimes it appears. But often not.
- Elevated steatorrhea or creatorrea. That is, as the intestine is irritated we can not absorb nutrients well and there is too much fat in the stool and some other indications that something is not going well.
- A biopsy (not indicated) would show areas of patchy villous atrophy. It is done in studies, but it is not necessary to diagnose intolerance.
- Withdrawal- Introduction: It is the clearest. If we suspect that a baby is intolerant to cow’s milk proteins, we can remove them from their diet. In doing so, the baby usually improves in a few weeks (2-4 weeks is usually enough). After that period, we reintroduced cow’s milk proteins into their diet and if there is Intolerance, the discomfort reappears in a few days. Sometimes in hours.
Special milk for children who can not tolerate cow’s milk:
This can also occur in children who take only breast, but whose mother takes cow’s milk or products that contain it in their ingredients. When this happens it is treated by eliminating cow’s milk from the mother’s diet.
The treatment in babies who take artificial milk is to change it for another one that:
- Do not contain cow’s milk proteins. Today there are soybeans or rice. In allergy specialists prefer soy hydrolysates only for more than 6 months, because some babies under that age can also make allergies to soy.
- In intolerance, cow’s milk hydrolysates are preferred, because with soybean they can appear cross reaction after weeks of use. And in that case we would have the problem of milk and also soy.
The elementals are milks in which we break so much proteins that only single amino acids remain. They are often used for chronic diarrhea or allergies to soybeans and their hydrolysates.
But it is your pediatrician or the infant digestive who will indicate the most appropriate in each case.
Acting on children who are sick with cow’s milk proteins
In the allergy to cow’s milk proteins:
Special milk is usually kept until one year or a year and a half. And from there it is valued with Blood Analytics first. If the IgE are negative you can prick it and if it is negative, try to give it milk. It is what is called provocation test. In cases where you have had severe allergies, this test should be done in a medical center where the child can be adequately treated if he / she makes an intense reaction.
If at least one of the tests (IgE or Prick) is positive: wait 6 months and repeat tests.
The provocation test consists of giving cow’s milk in the hospital (under control if any reaction appears) starting with 1ml, 20 minutes later if there is no reaction 10ml, 30 minutes later if there is no reaction 50ml and 1 hour later if There is no reaction 100 ml.
If at the end of this pattern there is no reaction it is considered that it is no longer allergic and can take dairy without problem.
In cow’s milk protein intolerance:
Usually the special milk stays until the year. At that age we tried to introduce cow’s milk proteins with lactose-poor products, such as cheese or yogurt. If there are no symptoms of intolerance, such as diarrhea, braking of weight gain, belly aches, vomiting … we try normal whole milk.
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