Cow's milk is a common cause of food allergy, with around 2% of infants and young children being affected. Like other forms of food allergy it appears to be more common than it was 20 years ago and we don't know why. Cow's milk is more common in babies who are fed with infant formula, but it can also occur in those who are exclusively breast fed. Using soya, goat or sheep milk formula instead of a standard cow's milk formula has not been shown to prevent cow's milk allergy from developing. There are, however, some low allergy formulas available on prescription that may be effective in doing this.

What are the signs of cow's milk allergy?

In most children the signs of milk allergy are quite obvious, because they develop within minutes of ingestion, or contact with, a food containing cow's milk. Typical symptoms are blotchiness and redness of the skin, hives, swelling o the lips or face, vomiting or diarrhoea. Severe allergic reactions may cause noisy breathing or wheeze, floppiness or unresponsiveness. In some children the connection between cow's milk and symptoms is less obvious, because symptoms can be delayed or present all of the time. This is particularly true for children with eczema or stomach symptoms including reflux and colic.

Why does cow's milk allergy happen?

There are differences in the types of protein in cow's milk and human milk. In certain individuals the immune system will recognise cow's milk protein as foreign, and an allergic response occurs. Cow's milk allergy is more common in people who also have other types of allergy like eczema and other food allergies.

What should I do if I think my child has cow's mild allergy?

The symptoms of cow's milk allergy can sometimes be confused with other problems such as lactose intolerance, a stomach infection or skin problems. However babies with cow's milk allergy can become quite unwell if it is not recognised promptly. Therefore it is important for the problem to be thoroughly investigated by a specialist doctor, and for the parents to receive appropriate nutritional advice from a dietician, to ensure their baby receives adequate protein, calcium and vitamin intake. Diagnosis can be confirmed by a skin prick test, blood tests, or a supervised food challenge in hospital, if necessary. Young children with cow's milk allergy should be tested for other food allergies too, since they sometimes have allergy to egg, nuts or other foods.

Treatment involves eliminating  cow's milk from the diet. For breast fed infants this can sometimes be achieved if their mother cuts out cow's milk from her diet - however this should be done in  close consultation with a dietician to prevent the baby becoming malnourished. Formula fed infants with cow's milk allergy need to use a low allergy formula . Goat or sheep milk ar not appropriate as their milk protein is quite similar to cow's milk, and most people with cow's milk allergy are also allergic to goat or sheep milk. There are, however, a range of low allergy formulas available which are safe for babies with cow's milk allergy, and your doctor or dietician can discuss these with you.

Does cow's milk allergy get better?

There is currently no cure for cow's milk allergy, but in at least 80% of people the allergy spontaneously resolves during childhood. Regular assessment and the reintroduction of cow's milk into the diet should be done under the supervision of a children's allergy specialist.

Source: Imperial College London

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