Our expert from SBCC Baby & Child Clinic gives the facts on cow’s milk allergy among children, and why soy formulas can be a suitable alternative.
When it comes to feeding children, one of the things that parents worry the most is when their child develops an allergy towards regular cow’s milk formulas.
Reeling from the stress of dealing with the symptoms of cow’s milk allergy, parents get confused when it comes to deciding on a suitable milk substitute for their child.
Dr Liew Woei Kang, Consultant Paediatrician at SBCC Baby & Child Clinic speaks to theAsianparent about the facts on cow’s milk allergy among children, and why soy formula is suitable for kids with cow’s milk allergy.
1. What is cow’s milk allergy? Is it the same as lactose intolerance?
Cow’s milk allergy is an adverse reaction that occurs in the body’s immune system after consuming cow’s milk protein.
Common symptoms include rashes around the mouth and body, lip or facial swelling, vomiting and blood in the stools. These usually appear immediately (immediate cow’s milk allergy) but can sometimes be delayed up to 24 hours after consumption (delayed cow’s milk allergy).
On the other hand, lactose intolerance refers to the body’s inability to digest lactose, which is the natural sugar found in milk. This condition is due to a lack of enzymes that break down lactose, and is not related to the immune system. Common symptoms associated with lactose intolerance include cramping, bloating, flatulence and diarrhea.
2. At what age do kids usually develop an allergy towards cow’s milk?
Most cow’s milk allergy emerge in the first year of life, soon after the introduction of cow’s milk formula.
3. Is there anything that parents can do to help their kids overcome the allergy towards cow’s milk?
Strict avoidance of the cow’s milk protein is usually suggested if an urgent and serious food allergy is diagnosed. Recent research has shown that some children may be suitable to undergo oral food immunotherapy which involves giving the child small amounts of baked milk products in a controlled environment. This procedure can help to hasten the tolerance of cow’s milk protein over time.
4. Why is soy formula often recommended for children who have cow’s milk allergy?
Local guidelines published by the Ministry of Health recommend the use of soy-based formula for managing cow milk allergy (CMA). An extensively hydrolysed or amino acid-based formula is indicated if there are cross-reactive reactions to soy formula. Soy formula is well-tolerated in most children with IgE-mediated cow’s milk allergy and is preferred over hydrolysed formulas due to cost and taste considerations.
5. Can soy formula be provided to children who are lactose intolerant?
Being lactose-free, soy formulas are also suitable for children who are lactose intolerant. Studies have shown that babies who are fed with soy or lactose-free formulas grow and develop normally, similar to those on cow’s milk-based formulas.
6. What are the key nutrients available in soy formula that can help support the growth and development of a growing child?
Soy formulas are designed to meet the nutritional needs of growing children. Soy formula provides a complete source of dietary protein, meaning that, unlike most plant proteins, it contains all the essential amino acids. In addition, soy milk formulas are typically fortified with vitamins, minerals and fatty acids such as AA and DHA.
7. Are there any significant differences between soy milk formula and cow’s milk formula? Is it advisable for parents to start their kids on the former, even if they are not allergic to cow’s milk? What are the benefits of doing so?
The key differences between the formulas originate from the source (i.e. plant as opposed to animal source of protein). The proportions of major key nutrients are generally the same in both soy and cow’s milk-based formulas.
Parents can start their children on soy formula, even if they are not allergic to cow’s milk. This is often practiced in vegetarian families, and it is a personal choice.
8. Is there an age limit for children to be on soy formula? If so, what kind of formula should they switch to after that?
Cow’s milk allergy is the most common food allergy in young children and may persist up to school-going age. There is no age limit for children to be on soy formula. If a soy formula was used for cow’s milk allergy, the child can continue to take it for as long as she needs. You may choose to use an age-appropriate growing-up soy formula. Cow’s milk formula may be started after the child has achieved tolerance for cow’s milk protein.
9. Do children generally accept the taste of soy milk formula? How can parents help to make the milk taste better for their kids if they refuse to drink?
Soy milk formula is well accepted by the majority of children. Addition of cocoa flavouring can be done to make it more palatable to some children.
We hope that the facts and tips given by Dr Liew Woei Kang above will help clear your doubts on cow’s milk allergy and giving soy milk formula as an alternative. Before you decide on which soy milk formula to give your child, it may be a good idea to request for a sample to try out the milk until you find one that is suitable.
Dr Liew Woei Kang
Paediatric Allergy and Immunology
MBBS (S’pore), MRCPCH (UK), FAMS (Paediatrics)
SBCC Baby & Child Clinic
Gleneagles & Mount Elizabeth Medical Centre