6 Must-Knows about Cow Milk Allergy in Children

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Rashes, wheezing, vomiting, and blood in stools are some of the symptoms of cow milk allergy. These symptoms can be distressing for children and parents. Proper diagnosis and management of cow milk allergy is crucial to helping affected children cope better. Find out more in this final part of Abbott’s monthly expert series for expert advice on cow milk allergy in children. Answer three simple questions to stand to win attractive prizes!

Baby in cow costume

It can be troubling for parents to find out that their child is allergic to cow’s milk — a nutritional staple for many children. But there are ways to successfully cope with this allergy. If breast milk, which is the best milk for your child, is not a viable option, there are other good alternatives available to ensure that your growing child receives all the necessary nutrition.

In the fourth and last video of the series, Dr. Chiang Wen Chin and Dr. Lee Bee Wah, both consultant paediatricians at Mount Elizabeth Medical Centre, share what parents need to know in order to effectively manage their child’s milk allergy.

This video is supported by an unrestricted education grant from Abbott, the leader in paediatric nutrition*.

Must-Knows on Cow Milk Allergy (CMA).

1. Definition and Common Symptoms of

CMA, the second most common food allergy in young children, is an abnormal immune reaction to cow’s milk protein. If your child has CMA, he could fall into either of two types of CMA: Immunoglobulin E (IgE) mediated CMA and non-Immunoglobulin E (non-lgE) mediated CMA.

In some children, CMA manifests itself quite immediately, sometimes within minutes of ingesting cow’s milk, in the form of cough, redness, itchiness or even becoming breathless and turning blue. Such an immediate reaction is symptomatic of lgE mediated CMA. In non-lgE mediated CMA, the adverse reaction to cow’s milk may only occur several hours after cow’s milk is consumed, and the symptoms are typically vomiting, diarrhoea or blood in the stool.

2. Proper Management of CMA is Crucial

If your child has a milk allergy, it is critical for you to know how to best manage the allergy. Many studies have shown that food allergy, including CMA, is associated with decreased quality of life for not only the child but for the caregivers as well.

Your child’s medical specialist would be the best person to educate you and your child on how to assess the severity of the reaction, and clear any misconceptions you may have about milk allergy. Do not let milk allergy affect your child’s quality of life and day-to-day performance.

3. Good Alternatives to Cow’s Milk Formula

Naturally, if your baby has CMA, it would be wise to avoid milk that contains cow’s milk protein. If breastfeeding is not a viable option, then your child will require a specialised formula.

If your child suffers from lgE mediated allergy, a tasty, economical substitute is a soy-based formula. Otherwise, an extensively hydrolysed formula should be used. In cases of CMA, an amino acid formula may be recommended for your child.

Did you know that goat's milk is not a suitable alternative to cow's milk? Find out about this and more on the next page about cow milk allergy in children.

4. Goat’s Milk Formula is not a Recommended Option

If you believe that feeding your child goat’s milk is a better alternative to feeding him milk with cow’s milk protein, you may be surprised to learn that goat’s milk protein and cow’s milk protein are very closely related. This means that if your child is allergic to cow’s milk, there is a high probability that he may be allergic to goat’s milk too. In fact, up to 80% of children with CMA cannot tolerate goat’s milk.

5. Children May Take a Longer Time to Outgrow CMA

Although some studies in the past decades have shown that 80% of babies outgrow CMA by the time they reach four or five years old, more recent research indicates that CMA may linger on till much later, with almost 60% and 40% of children still having CMA when they are 8 and 12 years of age respectively.

6. Pay more attention to your child’s food intake and growth

If your child has CMA or any other food allergies, it is advisable for your child to undergo an individualised nutritional assessment with a dietician or paediatrician to ensure that his diet is adequate. It is also important to make it a practice to plot your child’s height and weight on a growth chart, to ensure that he is growing healthily.

The timely introduction of cow’s milk or dairy in the form of baked foods and eventually the introduction of cow’s milk in the form of formula milk, fresh milk, cheeses and yogurts should be done under the supervision of a healthcare professional. During this process, parents will be advised to look out for any reactions due to CMA so that tolerance level can be assessed.

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About Dr Lee Bee Wah

Dr Lee Bee Wah is a Consultant Paediatrician with special interest in allergy and immunology at The Child and Allergy Clinic, at Mount Elizabeth Medical Centre.  Dr Lee is currently an Adjunct Professor (Department of Paediatrics) at the National University of Singapore, and a Visiting Senior Consultant Paediatrician (Children’s Medical Centre) at the National University Hospital.

About Dr Chiang Wen Chin

Dr. Chiang Wen Chin is a paediatrician with special interest in allergy and immunology at Chiang Children's Allergy and Asthma Clinic, at Mount Elizabeth Medical Centre.  Dr. Chiang is currently a committee member of the American Academy of Asthma, Allergy and Immunology, the Allergy and Clinical Immunology Society of Singapore and Singapore Paediatric Society.

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References:

[*] Based on Nielsen Singapore Market Track for the Infant Milk Category, for the 12 month period ending December 2014. (Copyright © 2014, The Nielsen Company.)