Dairy allergy

Dairy allergy is a food allergy immune adverse reaction to one or more of the proteins in cow's milk.

Symptoms

The principal symptoms are gastrointestinal, dermatological and respiratory. These can translate to: skin rash, hives, vomiting, diarrhea, constipation and distress. The clinical spectrum extends to diverse disorders: anaphylactic reactions, atopic dermatitis, wheeze, infantile colic, gastroesophageal reflux (GER), oesophagitis, allergic colitis and constipation.

The symptoms may occur within a few minutes after exposure in "immediate reactions", or after hours (and in some cases after several days) in "delayed reactions".

Difference between milk allergy and lactose intolerance

Milk allergy is a food allergy, an adverse immune reaction to a food protein that is normally harmless to the non-allergic individual. Lactose intolerance is a non-allergic food sensitivity, and comes from a lack of production of the enzyme lactase, required to digest the predominant sugar in milk. Lactose intolerance is not actually a disease or malady; indeed, 70% of the world's population is lactose-intolerant. Adverse effects of lactose intolerance occur at much higher milk consumption than adverse effects of milk allergy.

Difference from milk protein intolerance

Milk protein intolerance (MPI) is delayed reaction to a food protein that is normally harmless to the non-allergic, non-intolerant individual. Milk protein intolerance produces a non-IgE antibody and is not detected by allergy blood tests. Milk protein intolerance produces a range of symptoms very similar to milk allergy symptoms, but can also include blood and/or mucous in the stool. Treatment for milk protein intolerance is the same as for milk allergy. Milk protein intolerance is also referred to as milk soy protein intolerance (MSPI).

Treatment

Currently the only treatment for milk allergies is total avoidance of milk proteins.Products in addition to milk itself to be avoided by those with milk allergy includeyogurt,butter,cheese, andcream.

Ingredients that also denote that food product contains dairy milk include
whey,
casein,
caseinate,
butter flavor,
lactic acid,natural or artificial flavors, and
sodium caseinate.

It is commonplace for milk or milk derivatives to be included in processed foods such as bread,crackers,cookies,cakes,prepared meats,"soy cheese",soups,gravies,potato chips, margarine, andproducts labeled "non-dairy", such as whipped topping and creamer (non-dairy simply means less than 0.5% milk by weight [ [http://www.godairyfree.org/Food-to-Eat/Food-Label-Info/Dairy-Ingredient-List.html Go Dairy Free | Dairy Ingredient List ] ] ) Also, many processed foods that do not contain milk may be processed on equipment contaminated with dairy foods, which may cause an allergic reaction in some sensitive individuals.

Milk Avoidance and Replacement For Infants

Since milk protein may be transferred from a breastfeeding mother to an allergic infant, lactating mothers are given an elimination diet. For formula fed infants, milk substitute formulas are used to provide the infant with a complete source of nutrition. Milk substitutes include soy based formula, hypoallergenic formulas based on partially or extensively hydrolyzed protein (such as nutramigen, alimentum, and pregestemil) or free amino acids (such as neocate).Partially hydrolysates formula are characterised by a larger proportion of long chains (peptides) and are considered more palatable. However, they are intended for prophylactic use and are not considered suitable for treatment of milk allergy/intolerance.Extensively hydrolysed proteins comprise predominantly of free amino acids and short peptides. Casein and whey are the most commonly used sources of protein for hydrolysates because of their high nutritional quality and their amino acid composition.Non-milk derived amino acid-based formulas are suitable for the treatment of both mild-moderate and severe milk allergy, if allergic infants don’t respond to protein hydrolysate formulas.Soy based formula does have a risk of allergic sensitivity, as some infants who are allergic to milk may also be allergic to soy.

Milk Substitution for Children and Adults

There are many commercially available replacements for milk for children and adults - Rice milk, soy milk, oat milk and almond milk are also sometimes used as milk substitutes, but are not suitable nutrition for infants. Fruit juices supplemented with calcium which may provide an alternative for adults and children. If on an avoidance diet, it is important that dietary advice is taken as a replacement source of calcium may need to be found to prevent the longer term risk of calcium deficiency and osteoporosis.

"'Accidental Exposure"'Treatment for accidental ingestion of milk products by allergic individuals varies depending on the sensitivity of the allergic person. Frequently medications such as an Epinephrine pen or an Antihistamine such as Diphenhydramine (Benadryl) are prescribed by an allergist in case of accidental ingestion. Milk allergy can cause anaphylaxis, a severe, life threatening allergic reaction.

Like many food allergies milk allergy may be outgrown eventually by children, although a percentage of children do not outgrow their allergy. Milk allergy is more likely to be outgrown than peanut allergy.

Statistics

Milk allergy is the most common food allergy in early childhood. It affects somewhere between 2% and 3% of infants in developed countries, but approximately 85-90% of affected children lose clinical reactivity to milk once they surpass 3 years of age. [Host A. Frequency of cow's milk allergy in childhood. Ann Allergy Asthma Immunol 2002;89(6 Suppl 1):33-7. PMID 12487202.]

Between 13% and 20% of children allergic to milk are also allergic to beef. [Martelli, A, A. De Chiara et al (2002). "Beef allergy in children with cow's milk allergy; cow's milk allergy in children with beef allergy." Ann Allergy Asthma Immunol. 2002 Dec;89(6 Suppl 1):38-43. http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12487203&dopt=Abstract]

Famous People Allergic to Dairy

Famous people allergic to dairy include:
* NFL player Drew Brees [cite web |url=http://sportsillustrated.cnn.com/2007/players/01/09/nfl.workout0115/index.html
title=NFL Workout: Strapped In A system designed by a Navy SEAL got the Saints' Drew Brees in shape to succeed
accessdate=2008-10-01 |date=2007-01-09]

References

See also

* Food allergy
* Allergy
* Anaphylaxis

External links

* [http://www.aafa.org/display.cfm?id=9&sub=20&cont=516 Milk Allergy] information page. Asthma and Allergy Foundation of America
* [http://web.mit.edu/kevles/www/nomilk.html Eating without Casein] Practical guide to milk-free eating
* [http://www.checkmytag.com/2007/11/milk-allergy-more-persistent-disease.html Milk Allergy More Persistent Disease]