Understanding Cow’s Milk Allergy

  • Article
  • August 22, 2017

A food allergy – whether to protein from cow’s milk, eggs, peanuts or other foods – is often misunderstood.

According to a consensus report published last year, some people confuse a food allergy with a food intolerance, mistakenly believe a food allergy can be prevented or cured or lack specialized training in how to keep children with a food allergy safe.

As health and wellness professionals, we are in a unique position to help the public understand and manage food allergies. In that spirit, let’s focus on eight things to keep in mind when talking to clients about a cow’s milk allergy:

  1. A cow’s milk allergy is an immune reaction to the protein in cow’s milk and may develop in infancy.
  2. Cow’s milk is among the eight food allergens – including eggs, peanut, tree nuts, wheat, soy, fish and shellfish – that account for most cases of food allergies in the United States.
  3. Although previous advice may have encouraged delayed introduction of allergenic foods (i.e., egg, cow milk, wheat) to infants to help prevent an allergy, studies suggest this may not decrease the risk of food allergy. However, parents may still want to consult a pediatrician before introducing new foods. Parents of babies not diagnosed with cow’s milk allergy can introduce them to whole milk yogurt and cottage cheese when developmentally ready (i.e., at 6 months) and can give them cheese as a finger food at 9 months, as this handout shows. Breast milk or iron-fortified infant formula is recommended until 12 months of age, after which children can drink whole cow’s milk.  
  4. A cow’s milk allergy is a relatively common allergy in early childhood; approximately 2-3 percent of infants in developed countries are reported to have it. Most children with a cow’s milk allergy will develop a natural tolerance or “outgrow” it by age 3.
  5. There is no simple test for diagnosing any food allergy, including an allergy to cow’s milk protein. Instead, physicians use a combination of medical history, a food-specific skin prick test, food-specific serum IgE test and/or confirm using an oral food challenge.
  6. There is no treatment for a cow’s milk allergy other than eliminating cow’s milk and other dairy foods and ingredients from the diet. This can be difficult, so parents can benefit from counseling with a nutrition professional who can help them manage their child’s allergy, avoid adverse reactions and obtain recommended nutrients needed for growth and development.
  7. Parents of children diagnosed with a cow’s milk allergy should follow up with their doctor for repeat testing. Once the allergy has resolved itself, dairy foods may be reintroduced back into the child’s diet as per the direction of their physician, and at the discretion of the parents. Prolonged avoidance of dairy foods during the formative years has been linked to stunted growth, lower bone density and nutrient deficiencies. Milk is the top food contributor of nine essential nutrients in the diets of American children 2-18 years old, including calcium, vitamin D and potassium – three of the four nutrients of public health concern identified by the 2015 Dietary Guidelines of America.
  8. Symptoms of lactose intolerance are sometimes misinterpreted as a cow’s milk allergy, even though their origin and management approaches are very different.

It takes many organizations and individuals to build a safer environment for people with food allergies, as this infographic illustrates. Health care professionals can do their part by following evidence-based, standardized procedures to diagnose a food allergy and using established practice guidelines to help their clients understand and manage their child’s food allergy or their own.