Cow's milk allergy : symptoms, treatments, and in the baby?
Cow's milk allergy
Cow's milk allergy is the most common food allergy in babies. It most often disappears in childhood. Symptoms, foods containing these famous proteins, reintroduction of milk...
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The point with Dr. Laure Couderc-Kohen, an allergist and pneumopediatrician at the University Hospital of Rouen
"Allergy is an abnormal reaction of the immune system to a protein - the allergen - the protein in cow's milk in the case of milk allergy" defines Dr. Laure Couderc-Kohen, an allergist and pneumopediatrician at the University Hospital of Rouen.
Milk allergy should not be confused with milk intolerance.
"Milk intolerance does not integrate the immune system, unlike allergy.
It is an intolerance to sugar, lactose. It usually affects older children. Then it is enough to give the intolerant child low lactose milks" specifies the allergist.
The symptoms differ according to the form of the allergy. "In case of immediate allergy, the baby, after a second bottle of milk in general, will have hives within minutes of drinking the milk, sometimes accompanied by edema (swelling), or even in severe forms of anaphylactic shock," says Dr. Couderc-Kohen.
The most common forms of delayed allergy, which last several days, are more difficult to diagnose.
There is a digestive form and a cutaneous form. If it is a digestive form of milk allergy, the child regurgitates, vomits, has diarrhea, has difficulty gaining weight.
If it's a form of skin, the baby has severe eczema (atopic dermatitis), not just a few eczema patches," he says. The evaluation of these two forms of allergy is different.
Beginning and end
"Cow's milk allergy begins in the first weeks or months of life. It usually disappears around 2 or 3 years of age," the allergist teaches.
In the case of IgE-mediated allergies, that is, immediate forms with rapid reactions that can
being serious, the reintroduction of milk is always done in a hospital environment.
Food containing cow's milk protein
Milk and dairy products (yogurts, cheeses, etc.) contain milk proteins.
"It is important to read the labels of all foods when diversifying your diet because many foods can contain milk protein, especially cakes and preparations.
Dr. Couderc-Kohen warns. On the other hand, when traces of milk are indicated, children allergic to milk may consume them. They are tolerated by more than 99% of them," he says.
An allergologic evaluation is not always performed for children with a delayed form of milk protein allergy. "Allergologic tests are usually negative in these delayed forms," the allergist reports.
In case of suspected allergy to milk proteins in a delayed form, the doctor prescribes a milk without milk proteins and waits four weeks to see if there is an improvement in the symptoms on the skin or in the digestive tract," he explains.
On the other hand, if the allergy to milk protein is immediate, which is more rare, allergy tests are performed more frequently.
"In these immediate forms, the presence of IgE in milk can be effectively sought," says the allergist.
Two types of tests are performed: a blood test to determine specific cow's milk protein allergy antibodies (cow's milk specific IgE) and puncture tests.
"These skin tests consist in depositing a drop of milk on the skin with a standardized needle and see if hives or swelling appear".
Describe Dr. Couderc-Kohen. Skin testing requires milk and can only be done with standardized needles, so in the allergist's office.
IgE allows the allergist to more accurately track allergy during progression and reintroduction and is accessible to the non-allergenic general practitioner, he reports. These two tests will be performed again when the cow's milk is reintroduced. "
The treatment of cow's milk allergy is based on the removal of the proteins from the milk and the use of hydrolyzed cow's milk proteins (very small pieces of milk protein), milk in the form of amino acids or rice milk (vegetable milk proteins).
"Cow's milk protein allergy can be prevented by breastfeeding," says Dr. Couderc-Kohen.
The prevention of food allergies in infants also involves the early introduction of foods from 4 months of age," adds this specialist.
Reintroduction of cow's milk
Attempts are made to reintroduce cow's milk around 1 year of age, in a hospital environment when it is a form of immediate allergy.
"Even in the case of a delayed cow's milk allergy, a blood test is performed to measure specific IgE antibodies because children can go from a delayed allergy to an immediate form," warns the allergist.
For some years now, a tolerance induction has been carried out on children aged 3 to 5 years who are still allergic to milk proteins, reports Dr. Couderc-Kohen.
This is introducing increasingly small amounts of cooked milk, often in a cake, under medical supervision, to promote tolerance and healing in children whose allergy to cow's milk protein is not cured by age three.
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