Milk Allergy In Toddler

Protein is a milk component that causes milk allergy in toddler. That is why it is more appropriate to say allergy to bovine proteins, often written as allergy to PV. The allergy to the proteins of bovine one talks about to the symptoms that present some people when they take milk, the dairy derivatives, the foods prepared that take milk or derivatives in their composition, and the meat of cow, ox, bull and calf. Allergy can also occur by touching milk or derivatives, or by indirect contacts through other people. Here we will discuss special aspects of beef protein allergy, although some general details about food allergy will be repeated, which are discussed in another area of this website. It is recommended to read first the General section of food allergy, and then the specific aspects related to beef proteins.

What components does milk have?

Milk has different vitamins and minerals, but the main components are of three types: those we call carbohydrates, carbohydrates or sugars, which we call lipids or fats, and which we call protids or proteins. The carbohydrate in milk is lactose, the fats are mostly triglycerides, and finally it has 20 to 30 proteins.

What is lactose allergy?

Lactose allergy does not exist as such. Lactose is not all milk, but one of the many components of milk. Lactose is a carbohydrate or sugar found in milk, which can sometimes cause digestive symptoms caused by lactose intolerance. Although milk allergy and lactose allergy are popularly used alike, the latter is an error.

What is lactose intolerance?

Lactose, to be absorbed from the intestine, undergoes the action of an enzyme called lactase. Some people do not have enough lactase and can not digest lactose; This remains in the intestine, is not absorbed and gives rise to diarrhea and colic-type pains. This reaction is not, therefore, allergic type, but digestive. Lactose intolerance in children usually appears because of an intestinal infection. The infection causes a lesion in the inner layers of the intestine, and the lactase enzyme is lost. Until that injury is repaired and the enzyme is recovered, the child has lactose intolerance. If you drink milk with lactose, you will have diarrhea, and the injury will be prolonged. There is a very small number of children who may have a congenital deficit, a lack of the enzyme lactase from birth, and that will persist throughout life. It is common that some people, with the passage of time, lose the enzyme completely or partially, and when they become adults they become lactose intolerant. This loss of the enzyme in adulthood does not recover.

How is lactose intolerance treated?

While intolerance lasts, lactose in the diet must be avoided. In infants special milks without lactose are used. If the diagnosis is not delayed, it usually recovers in about 20 days. If it is delayed, a bowel injury may occur that will require more time to recover. The congenital and adult forms do not recover, and they must always avoid lactose. Where there is more lactose is in liquid milk. Yoghurts and other dairy products have less lactose; If someone has a partial but not complete lack of the lactase enzyme, they can tolerate those derivatives better than liquid milk.

What problems do milk fats give?

Lipids or fats do not cause allergy. People with some digestive disease of the pancreas may have an inability to digest fats and diarrhea and malabsorption occur. When the intestine is damaged by an infection or other intestinal problem, diarrhea also appears, which prolongs the intestinal lesion.

What components of milk give allergy?

The components that give allergy are proteins. The first group includes the three main proteins, which are casein, alpha-lactalbumin, and beta-lactoglobulin. These proteins are in liquid milk and in all its derivatives, but not in beef. The second group includes other proteins, such as serum albumin or bovine serum albumin, lactoferrin, various immunoglobulins, and others. These proteins are in both liquid milk and beef. You can have allergy to a single protein or several. If you have an allergy to any protein in the second group, you can not drink milk, or derivatives, or meat. If the allergy is to any of the first group, but none of the second, you can not take milk or derivatives, but you can take meat, which is what happens in most cases. The milk of other mammals, such as goat or sheep, also has casein, lactalbumin, serum albumin, etc. They are not exactly the same, but some are very similar to those of the cow, and therefore should be avoided in protein allergy vaccines.

In whom does the protein allergy (PV) appear?

It can appear in any person, but almost all of them are nursing infants, under one year of age. Allergies do not occur from birth, but they develop little by little, without being able to give symptoms, until they reach a level from which they already trigger symptoms. The milk that babies drink is almost entirely obtained from cow’s milk. This milk undergoes some modifications, some components are removed and others are added, to make it similar to breast milk, but the proteins are the same as in normal cow’s milk.

Does PV allergy appear the first time you drink milk?

Like all other allergies, it does not appear the first time you drink milk. It does appear the first time you think that the child drinks milk, but the child must have previously had contact, even if one is not aware of it. To cause obvious symptoms, a sufficient amount of the food is needed. Trace quantities are usually not able to cause those symptoms. When the child already takes a larger amount the symptoms appear. Some of the food that a breastfeeding mother takes passes into breast milk. Thus, an infant may be taking traces of cow proteins through the breast; That amount is minimal, it is capable of generating an allergy, but not cause obvious symptoms. When the child takes more volume, such as when taking bottles, the amount of vaccine proteins is much higher, and obvious symptoms appear.

What kinds of allergy to PV are there?

There are two classes: allergy mediated by IgE antibodies or classical allergy, and non-IgE-mediated allergy, often called bovine protein intolerance. Do not confuse protein intolerance with lactose intolerance, discussed above. It must be remembered that talking about lactose allergy is a mistake.

What are the symptoms of PV allergy?

It can give very varied symptoms. The skin symptoms can be hives and edema or inflammation, or atopic dermatitis. The respiratory symptoms are asthma, rhinitis and conjunctivitis. It can cause digestive symptoms such as colic pains, vomiting and regurgitations, diarrheas of variable intensity, and hemorrhages of the digestive tract, with blood in the vomit or in the feces. Finally, it can cause anaphylaxis reactions. IgE antibody allergy tends to give more hives and edema, respiratory symptoms, and anaphylaxis. It can also give, but less frequently, atopic dermatitis and digestive symptoms. Allergy without IgE tends to give more digestive symptoms, followed by atopic dermatitis. Less frequent are respiratory symptoms and hives and edema. This division of symptoms is the most frequent, but it does not always occur, so that any symptom can appear both in allergy to PV with IgE and without IgE. In addition, these symptoms may appear due to allergies other than PV, and for causes in which there is no allergy.

At what age do the symptoms of allergy to PV usually appear?

The allergy develops without symptoms until it reaches a level from which the obvious symptoms appear. For such symptoms to occur, a sufficiently large quantity of PV is needed. Children who have breastfed tend to have symptoms from the first days they take a bottle, the most typical since the first bottle. Children who bottle from the beginning, usually take more time, several weeks or even months.

How soon do the allergy symptoms to PV appear?

IgE antibody allergy is usually immediate; appears before an hour, sometimes in a few minutes, after taking the PV. The allergy without IgE is later; it takes more than two hours, sometimes even several days. With this division occurs as with the symptoms, it is not constant, but there may be non-typical occurrences.

How much PV causes symptoms?

Each allergic person has an individual limit. IgE allergy appears with a small amount, usually less than 100 milliliters of milk or its equivalent. It can appear with minimal amounts, like a drop, with traces simply, or with contact without getting to swallow the food. The allergy without IgE usually needs more quantity, usually more than 100 milliliters of milk or its equivalent. Sometimes several liters are needed, amount that is reached after drinking milk or derivatives for several days. This larger amount is the usual rule, but it is not always fulfilled: there are children with allergies without IgE who have symptoms with only the traces they take through breastfeeding.

When is the allergy to PV suspected?

It is easily suspected when the symptoms appear immediately after taking or touching milk or derivatives, especially if they are the most typical, type urticaria and edema. If the symptoms take several hours or days to appear, such as diarrhea or dermatitis, they are more difficult to relate. Although in principle it is not suspected, if a patient presents symptoms of the aforementioned and the cause is not ascertained, the possible importance of PV should be assessed.

How is allergy to PV studied?

Same as other allergies, with skin tests, blood tests and exposure test (tolerance and provocation). More details are given in the General section of food allergy and in the study of allergy.

How do allergies to PV differ with IgE and without IgE?

The type of symptoms, the time they take to appear and the amount needed to give symptoms guide the cause with IgE or without IgE. The way to know for sure is to do skin tests and blood tests. If the tests give positive results, or the analytic detects IgE against PV, we say that the allergy is mediated by IgE. It may be the case that the tests are positive and normal analytical, otherwise the tests are normal and the analytical positive, or both are positive. With that it is positive in anyone, it is said that the allergy is mediated by IgE. To say that it is not mediated by IgE tests must be normal, and analytical normal, both results.

Milk Allergy In Toddler

What is the treatment of allergy to PV?

The treatment of the acute reaction is that corresponding to the symptoms. Antihistamines for skin, nose and eye reactions, bronchodilators for asthma or bronchospasm, rehydration fluids for digestive symptoms. In the reactions of anaphylaxis adrenaline is used. The preventive treatment to avoid symptoms is the diet avoiding the proteins of bovine. The etiological treatment consists of avoidance, to see if the allergy disappears spontaneously, and desensitization is also being used.

What is the diet for allergy to PV?

The diet is used both in allergy with IgE and without IgE. Avoid cow’s milk and its derivatives, and avoid foods that have PV among its ingredients. You have to read the list of ingredients of all the prepared foods that are bought. To know with what names the PVs can appear, download another document by clicking here. Regarding the influence of the traces details are given in the General section of food allergy.

What milk do infants with an allergy to PV use?

Infants are required to take special pharmacy milks when they do not have enough with breast milk. The most used special milks are the extensively hydrolyzed ones and those of soy. The extensively hydrolyzed and semielemental proteins have bovine proteins broken into very small fragments to reduce their ability to give allergy. Soybeans are extracted from the soybean plant and have proteins that have nothing to do with beef proteins. Both milks and others undergo modifications to have the right amount of nutrients, vitamins and minerals for infants. There are other so-called elemental milks, which carry amino acids, the minimum fragments of proteins, to completely lose the ability to give allergies. They are used less frequently, in general when the child does not respond well to previous milks. There are some milks called hypoallergenic or HA. They are not currently recommended for allergy to PV, because they retain a lot of allergy.

Does the mother have to diet if she is breastfeeding?

If the child is a baby who is breastfeeding, the mother should diet avoiding PV while breastfeeding. The mother should take an additional calcium supplement, of around one gram a day, to replace the calcium she stops taking when removing the dairy products, and not to decalcify it. This calcium should be added to other vitamins or minerals that you were already taking when you were dieting with dairy. This supplement should be taken by the mother and not the baby.

What milk do older children and adults with PV allergy use?

Actually do not need to take any milk for obligation, provided that the rest of the diet is varied, taking meat, fish, vegetables, cereals, etc. You can take, to your liking, soy milk from food stores, which is balanced and generally enriched with vitamins and minerals. They can drink almond milk, but knowing that it does not have the same nutritional value as cow’s milk or soy milk.

Can a nutritional deficit appear if milk is avoided?

Special infant formulas are balanced so that they are as nutritious as the milk used by non-allergic infants. No extra intake of vitamins or minerals is needed. In older children and adults there is no deficit of vitamins, minerals, etc., if a varied diet is followed on the other hand. The nutrients provided by dairy products are compensated if food is taken with meats, fish, fruits, vegetables, etc. Even calcium is compensated with a varied diet, although calcium supplements are sometimes used for tranquility. If the child has other food allergies in addition to the allergy to PV, and their nutrition is very limited, it is advisable an assessment and monitoring by a nutritionist.

Can people with allergies to PV take beef?

As discussed above, you can have allergy to proteins that are only in liquid milk and derivatives, which is the most frequent, or proteins that are also in beef. 90% of those allergic to PV can take meat. Each patient should consult their particular case with their specialist.

Can people who are allergic to PV take milk from goats or sheep?

Usually not. They should not drink milk or dairy products of goat, sheep, etc. The proteins of these milks are very similar to those of the cow, and can cause symptoms. Unless the specialist authorizes it, they should not be taken, because although they do not give obvious symptoms, they can delay the disappearance of the allergy. Each patient should consult their particular case with their specialist.

How does the allergy to PV evolve?

When avoiding PVs, the symptoms should disappear. The disappearance of the allergy itself occurs in the vast majority of children after dieting without PV for a variable period, which can be from a few months to several years. Non-IgE allergies disappear faster than IgE allergies. If the symptoms do not disappear or if the allergy does not disappear, it is necessary to look for possible reasons for it, as it is commented in Generalities of food allergy. The effects of not meeting the diet are also discussed in General. If the allergy to PV does not disappear, whatever the reason, desensitization can be considered.

What is desensitization to PV?

The desensitization consists in taking small quantities of PV at the beginning, and gradually increasing that amount until reaching a dose of one glass of milk or equivalent, twice a day. It is used in case of allergy by IgE antibodies; It does not work for allergy without IgE. More details on desensitization are given in General food allergy.

Can the allergy to PV disappear if there is still sensitization?

The sensitization to PV indicates that there are IgE antibodies against PVs, antibodies that are identified by skin tests or blood tests. With the passage of time they may disappear, but in some patients they may be present throughout life, although the patient will tolerate PV normally when he takes them. Some children who have antibodies and symptoms (that is, they are allergic) when they get older are able to take and digest PV without problems even though the tests are still positive (ie they are only sensitized). The specialist decides when is the appropriate time to do a provocation test on a child who continues with positive tests or analytics.

Do more food allergies appear in people who are allergic to PV?

In allergy to PV due to IgE, it is common for egg allergy to appear as well. It is convenient to study that possibility, even if the child has never taken an egg. In the allergy to PV without IgE other allergies can appear in front of varied foods, among which soy and meat stand out above all. The proportion of children who develop these allergies is lower than the proportion of children who develop them. It influences the time it takes to diagnose. The more time that has elapsed, the inflammatory lesion of the intestine makes the appearance of new allergies easier.

If you have allergies to PV, will there be more allergies afterwards?

Having an allergy to PV due to IgE in the period of an infant is a factor of having a higher risk of developing new allergies in the future, allergies to environmental substances. This happens especially in children we call atopics, which genetically have great facility to develop allergy. They usually also have a high total IgE, and symptoms of atopic dermatitis, or asthma. It does not occur in all those allergic to PV due to IgE, since some only have allergies to PV, then they overcome it, and no other allergy appears in their entire lives. The risk of the appearance of environmental allergies in children with allergy to PV without IgE is the same risk as that of children without allergy.

If you have an allergy to PV, should other foods be delayed?

If it is suspected that the allergic to PV is an atopic child, it may be prudent to delay the introduction of other foods such as eggs, legumes, fish and nuts into the diet. As there is no assurance that this is useful, it is best to consult with the specialist.

Is there any precaution for the newborn siblings of a child with a PV allergy?

These newborns have a somewhat higher risk than usual that they also have a PV allergy. The fact that the mother does diet without PV during pregnancy or while breastfeeding does not seem to influence the appearance of allergy to PV in the new baby, so that special diet is not recommended to the mother. When the new baby drinks a bottle, the use of a widely hydrolyzed type milk provides some protection so that it does not develop allergy to PV. The benefits of these measures are debated, so the advantages and disadvantages must be weighed together with the specialist.

Summary of beef protein allergy

The proteins of bovine (PV) are a frequent cause of food allergy, especially in children under one year of age. The symptoms, the suspicion, the study and the treatment of the allergy to PV are the same as those of other food allergies. The treatment consists of dieting avoiding PV. In infants, special milks are used, with adequate and complete nutritional capacity. The diet should avoid liquid milk, dairy products, foods with milk or its components among its ingredients, and traces. You should also avoid the milk of other animals, such as goat, sheep and others, as well as their derivatives. In general you can take beef, with the authorization of the specialist. If the allergy to PV does not end up disappearing, desensitization can be considered. The allergy to PV can be an indicator of other future allergies.