Milk allergy in babies is a common concern for parents and caregivers.

While many infants thrive on breast milk or traditional formula, some little ones develop an intolerance or allergy to cow's milk proteins.

This can lead to uncomfortable symptoms, making it essential for parents to recognise the signs and take appropriate action.

What is milk allergy in babies?

Milk allergy in babies, also known as cow's milk protein allergy (CMPA), is a condition in which a baby's immune system reacts adversely to proteins found in cow's milk.

It's important to distinguish between milk allergy and lactose intolerance.

Lactose intolerance is a deficiency of the enzyme lactase that breaks down lactose, the sugar in milk, leading to digestive discomfort.

On the other hand, milk allergy involves the immune system reacting to milk proteins, often causing more severe and varied symptoms.

Causes of formula milk allergy in babies

The exact causes of milk allergies in babies are not entirely understood. However, there are some common factors that may contribute to the development of this allergy:

Immature digestive system: In newborns and infants, their digestive systems are still developing. This immaturity can make it easier for the immune system to misidentify milk proteins as harmful invaders.

Genetic predisposition: If a baby has a family history of allergies or asthma, they may be more prone to developing a milk allergy.

Early exposure to cow's milk: Some experts believe that introducing cow's milk or dairy products to a baby's diet too early can increase the risk of milk allergy. It's generally recommended to wait until a baby is at least one year old before introducing cow's milk.

Symptoms of milk allergy in babies

Milk allergy symptoms in babies can vary in severity, and not all babies will experience the same symptoms.

In some children, CMA manifests itself quite immediately, sometimes within minutes of ingesting cow's milk, while for others, the adverse reaction to cow's milk may only occur several hours after cow's milk is consumed.

Common symptoms include:

Gastrointestinal symptoms:

• Vomiting
• Diarrhoea
• Constipation
• Bloating
• Abdominal pain or cramps

Respiratory symptoms:

• Wheezing
• Coughing
• Runny or stuffy nose
• Sneezing

Skin reactions:

• Eczema (itchy, red and inflamed skin)
• Hives (raised, red, itchy bumps on the skin)
• Swelling, especially around the lips, face or eyes

General symptoms:

• Irritability
• Fussiness
• Poor weight gain
• Failure to thrive

It's important to note that some babies may experience one or more of these symptoms, while others may show no symptoms at all.

The severity of the reaction can also differ, with some babies experiencing mild discomfort and others having more severe, even life-threatening reactions known as anaphylaxis.

What does milk-allergy baby poop look like?

The appearance of a baby's stool can provide valuable insights into their health, especially when dealing with milk allergy.

Babies with milk allergies may have stools with certain characteristics, including:

1. Blood in stools: One of the most concerning signs is finding streaks or traces of blood in your baby's stool. This is often a red flag for a milk allergy, and you should consult a healthcare professional immediately.
2. Green and mucous-y stools: Stools that are green and have a mucous-like consistency can be a sign of a milk allergy. This is often due to inflammation in the baby's gastrointestinal tract.
3. Frequent bowel movements: Babies with milk allergies may have more frequent bowel movements, often accompanied by discomfort or distress.
4. Watery or loose stools: Diarrhoea is a common symptom in babies with milk allergies. Their stools may be watery or very loose.

It's important to remember that not all babies with milk allergies will have these stool characteristics, and some may have more subtle symptoms.

If you notice unusual changes in your baby's stool, consult a healthcare provider for a proper evaluation.

How to determine if your baby has a milk allergy

If you suspect that your little one might have a milk allergy, it's essential to take the right steps to get a diagnosis.

Here's what you can expect during the process:

• Get in touch with a paediatrician: The first thing you should do is reach out to your baby's doctor. They'll assess your baby's symptoms and medical history to determine if a milk allergy might be the culprit.
• Medical examination: During the appointment, the doctor will physically examine your baby to look for any signs of an allergy. They will also discuss the symptoms you've observed.
• Stool and blood tests: In some cases, the doctor may recommend stool tests and blood tests to check for specific markers of a milk allergy. These tests can provide valuable insights into your baby's condition.
• Referral to an allergist: Depending on the findings and the severity of the symptoms, your baby's doctor may refer you to an allergist. Allergists are specialists in allergies and can provide a more in-depth evaluation.
• Skin testing: An allergist may conduct skin testing as part of the diagnostic process. In this test, a small amount of milk protein is applied to the skin, followed by a gentle scratch. If your baby is allergic to milk, the skin in that area may show a slight swelling, similar to a mosquito bite.
• Epinephrine auto-injectors: If the allergist determines that your baby is at risk for a severe allergic reaction, they might prescribe epinephrine auto-injectors. These devices are used to quickly treat anaphylaxis, a potentially life-threatening reaction to allergens.

It's important to keep in mind that diagnosing a milk allergy in babies can be a complex process, and healthcare professionals play a vital role in accurately identifying and managing the condition.

If you suspect a milk allergy, don't hesitate to reach out to your baby's doctor to start the process of diagnosis and get the necessary support.

What formula do you give a baby with milk allergy?

If you suspect your baby has a milk allergy, the first step is to consult a healthcare professional for a proper diagnosis.

Once diagnosed, there are specialised hypoallergenic formulas available as alternatives to standard cow's milk-based formulas. These hypoallergenic formulas are specifically designed for babies with milk allergies, and they come in two main types:

1. Extensively hydrolysed formulas: These formulas contain cow's milk proteins that have been broken down into smaller, less allergenic fragments. This makes them less likely to trigger an allergic reaction. Examples of extensively hydrolyzed formulas include Nutramigen and Alimentum.
2. Amino acid-based formulas: Amino acid-based formulas, such as Neocate and EleCare, are free from intact cow's milk proteins. Instead, they contain individual amino acids, which are the building blocks of proteins. This type of formula is usually recommended for babies with severe milk allergies or those who don't respond well to extensively hydrolyzed formulas.

When transitioning to a hypoallergenic formula, it's important to consult with your child's healthcare provider.

They can guide you on the best choice based on the severity of the allergy and your baby's specific needs.

Signs of formula intolerance

Formula intolerance can sometimes mimic the symptoms of milk allergy in babies, leading to confusion.

However, formula intolerance is not an immune response but rather a difficulty in digesting or tolerating certain ingredients in formula.

Common signs of formula intolerance may include:

1. Fussiness or colic-like symptoms
2. Excessive gas or bloating
3. Diarrhoea or loose stools
4. Vomiting or spitting up frequently
5. Skin rashes or eczema

If you suspect formula intolerance, it's essential to work with your baby's healthcare provider to identify the specific ingredients or components causing the problem.

They may recommend switching to a different type of formula, adjusting feeding techniques or exploring other solutions.

When to seek a doctor's help on formula milk allergy

If you suspect that your baby has a milk allergy or is experiencing formula intolerance, it's crucial to seek the guidance of a healthcare professional.

Here are some key situations when you should reach out to a doctor:

1. Severe symptoms: If your baby experiences severe symptoms such as difficulty breathing, swelling of the face or throat, or severe vomiting and diarrhoea, seek immediate medical attention as this could be an anaphylactic reaction.
2. Persistent symptoms: If your baby has ongoing, bothersome symptoms that don't improve with a formula change or other interventions, consult a healthcare provider for a proper evaluation.
3. Blood in stools: The presence of blood in your baby's stools is a concerning sign and should prompt an immediate consultation with a healthcare provider.
4. Failure to thrive: If your baby is not gaining weight or is not thriving as expected, it's essential to discuss this with your healthcare provider, as it could be related to a milk allergy or other underlying issues.
5. Concerns about nutritional needs: If you have concerns about meeting your baby's nutritional needs while managing their milk allergy, a healthcare provider can offer guidance and recommend appropriate formula options.

Milk allergy in babies is a challenging condition for both parents and their little ones. Recognising the symptoms and understanding the causes are the first steps towards effective management.

If you suspect your baby has a milk allergy or is experiencing formula intolerance, don't hesitate to seek guidance from a healthcare professional.

With the right support and suitable formula options, you can ensure your baby's health and well-being.

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This article was first published in theAsianparent.