Understanding Cow’s Milk and Food Allergies in Children

A food allergy occurs when the immune system mistakenly identifies a food protein as harmful and triggers an allergic reaction. Genetics, family history of allergic disease, the child’s immune system, and environmental factors may all contribute. However, food allergy is not usually caused by one single behaviour during pregnancy or infancy.

With proper diagnosis, avoidance of confirmed allergens, and regular medical follow-up, many children eventually outgrow certain food allergies.

Symptoms That Require Medical Attention

Food allergy symptoms may affect several parts of the body, particularly the digestive system, skin, respiratory system, and cardiovascular system.

Reactions may occur within minutes or up to two hours after eating, while some delayed reactions may take several hours or days to appear.

Digestive Symptoms

Possible gastrointestinal symptoms include:

๐ Vomiting

๐ Abdominal pain or cramping

๐ Acute diarrhoea shortly after eating

๐ Delayed diarrhoea developing several hours later

๐ Watery stool containing mucus or blood

๐ Poor feeding

๐ Infantile colic-like symptoms

๐ Poor weight gain

๐ Nutritional deficiencies caused by impaired absorption

Persistent blood in the stool, repeated vomiting, poor growth, or signs of dehydration require medical assessment.

Skin Symptoms

Skin reactions are common in children with food allergies.

Immediate Reactions

Symptoms may develop within minutes or up to two hours and include:

๐ Hives or raised itchy patches

๐ Swelling around the eyes

๐ Swelling of the lips or face

๐ Generalised itching

๐ Sudden redness of the skin

Delayed Reactions

Some children develop eczema-like symptoms over several days or weeks, including:

๐ Dry, rough, or itchy skin

๐ Rashes on the cheeks or face

๐ Irritation around the neck

๐ Rashes in the elbow or knee folds

๐ Widespread eczema on the body

Food is not the cause of every eczema flare. A doctor should determine whether the rash is genuinely related to a specific food.

Respiratory Symptoms

Possible respiratory symptoms include:

๐ Runny nose

๐ Sneezing

๐ Itchy or watery eyes

๐ Cough

๐ Throat tightness

๐ Hoarse voice

๐ Wheezing

๐ Shortness of breath

๐ Difficulty breathing

Breathing difficulties after eating should always be treated as a medical emergency.

Severe Allergic Reaction

Anaphylaxis is a rapid and potentially life-threatening allergic reaction that may affect several body systems simultaneously.

Possible signs include:

๐ Hives together with breathing difficulty

๐ Swelling of the tongue or throat

๐ Wheezing or chest tightness

๐ Repeated vomiting

๐ Dizziness or fainting

๐ Low blood pressure

๐ Collapse or shock

Emergency medical treatment is required immediately. Adrenaline, also known as epinephrine, is the first-line treatment for anaphylaxis.

Children with a known risk of severe reactions may be prescribed an adrenaline auto-injector to carry at all times.

Do Children Outgrow Food Allergies?

The likelihood of recovery depends on the type of food and the nature of the allergic reaction.

Cow’s Milk Allergy

Many children with cow’s milk protein allergy gradually develop tolerance during early childhood. Some gastrointestinal forms may improve after a period of strict avoidance under medical supervision.

Egg and Wheat Allergies

Many children eventually outgrow egg or wheat allergy, although the timing varies.

Peanut, Tree Nut, and Seafood Allergies

Allergies to peanuts, tree nuts, fish, and shellfish are more likely to persist into adulthood and may remain lifelong.

Food should never be reintroduced without medical advice when the child has previously experienced a severe reaction.

How Is Food Allergy Diagnosed?

Diagnosis begins with a detailed medical history. No single test can diagnose every food allergy accurately.

Food and Symptom Diary

Parents may be asked to record information for one or two weeks, including:

๐ Foods and drinks consumed

๐ Ingredients in prepared foods

๐ The amount eaten

๐ The time between eating and symptom onset

๐ The type and severity of symptoms

๐ Medicines given

๐ Previous reactions to the same food

This information helps the doctor identify possible patterns.

Skin Prick Test

A skin prick test may help detect sensitisation to specific foods, particularly in immediate IgE-mediated allergies.

A small amount of allergen is placed on the skin, which is then lightly pricked. A raised reaction may suggest sensitisation.

A positive result does not always prove that eating the food will cause symptoms. The result must be interpreted together with the child’s medical history.

Antihistamines may interfere with the test. The doctor will advise how long they should be stopped beforehand. Parents should not discontinue prescribed medicines without medical guidance.

Blood Test

A blood test may measure food-specific IgE antibodies.

It may be used when:

๐ The child cannot stop taking antihistamines

๐ Severe eczema prevents reliable skin testing

๐ There is a history of a serious allergic reaction

๐ Skin testing is considered unsuitable

Like a skin prick test, a positive blood test indicates sensitisation but does not always confirm clinical allergy.

Oral Food Challenge

A medically supervised oral food challenge is often considered the most reliable method for confirming or ruling out a food allergy.

During the test, the child receives gradually increasing amounts of the suspected food under close medical observation.

This test must be conducted in a properly equipped medical setting because a serious reaction may occur.

Treatment and Management

Avoid the Confirmed Allergen

Children should avoid the food that has been medically confirmed to cause an allergic reaction, including products containing it as an ingredient.

Unnecessary avoidance of several foods may lead to nutritional deficiencies and should be avoided.

Read Food Labels Carefully

Parents should check labels for:

๐ The allergen’s usual name

๐ Alternative ingredient names

๐ Milk, egg, nut, seafood, or soy derivatives

๐ Cross-contamination warnings

๐ Changes in product ingredients

When the ingredients are unclear, the food should not be given until its safety has been confirmed.

Prepare an Emergency Plan

Children at risk of anaphylaxis should have a written allergy action plan shared with:

๐ Family members

๐ Teachers

๐ Nursery staff

๐ School nurses

๐ Other caregivers

An adrenaline auto-injector should be immediately accessible when prescribed.

Use Antihistamines Appropriately

Antihistamines may help relieve mild symptoms such as itching or limited hives.

They do not replace adrenaline in anaphylaxis and should not be used to allow continued consumption of a known allergen.

Cow’s Milk Allergy Is Different from Lactose Intolerance

Cow’s milk allergy involves an immune reaction to milk proteins.

Lactose intolerance occurs when the body cannot digest lactose, the natural sugar in milk, because of insufficient lactase enzyme.

Lactose intolerance commonly causes:

๐ Bloating

๐ Gas

๐ Abdominal discomfort

๐ Diarrhoea

It does not normally cause hives, facial swelling, wheezing, or anaphylaxis.

When to Take a Child to the Doctor

Parents should seek medical advice when a child develops repeated symptoms after eating a particular food, especially:

๐ Vomiting or diarrhoea

๐ Blood or mucus in the stool

๐ Persistent eczema

๐ Hives or swelling

๐ Poor feeding

๐ Slow weight gain

๐ Breathing problems

Immediate emergency care is required for breathing difficulty, throat swelling, fainting, severe weakness, or symptoms affecting more than one body system.

Accurate diagnosis is important because both untreated allergy and unnecessary food restriction can affect a child’s health, nutrition, growth, and quality of life.

 

Reference :

BPK 9 International Hospital Food Allergies in Children

ArokaGO Providers BPK 9 International Hospital