You cradle your baby in your arms and give her a gently warmed bottle of formula. But within minutes, the peaceful scene is shattered by crying, then vomiting.
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If this scene is familiar for you, could your baby be allergic to cow’s milk?
“There are many possible causes for this scenario,” says Brian Schroer, MD, a pediatric allergist at Cleveland Clinic Children’s Hospital. “If it occurs frequently, it may be an allergy to the proteins in cow’s milk.”
Such allergies are common in infants and children. Symptoms include diarrhea, vomiting, bloody stools and poor weight gain. This type of allergic reaction differs from the immediate, life-threatening reaction to foods such as tree nuts, eggs and shellfish, which may require immediate treatment with epinephrine or an antihistamine.
Whether the reaction is mild or severe, though, one thing is clear: You should avoid the food that caused it.
Treatment is easy, but see a doctor
Pediatricians usually diagnose a cow’s milk protein allergy if symptoms resolve following a doctor-recommended change in formula — the simplest and most effective treatment.
If you suspect that your child is allergic to cow’s milk formula, ask your pediatrician for advice before you change formulas on your own. The doctor may recommend switching to a soy-based formula or, if your baby is allergic to soy, to an advanced hypoallergenic formula.
“If you are breast-feeding your baby, speak with your doctor,” Dr. Schroer adds. “You will likely be able to continue nursing.”
Lactose intolerance: a different animal
Cow’s milk protein allergy is commonly confused with lactose intolerance. However, the two are very different.
“Lactose intolerance is rare in infants and children under age 2. It generally starts to develop after age 5 and will tend to worsen as the child grows older,” says Dr. Schroer.
People who are lactose-intolerant lack the enzyme necessary to digest lactose, a sugar found in milk. Drinking milk or eating foods containing lactose can produce digestive issues, but the condition is not deadly. It can be treated by avoiding lactose or by taking a dietary supplement that contains the missing enzyme.
If you suspect an older child has developed lactose intolerance, seek advice from a pediatrician or pediatric gastroenterologist.
They may grow out of it
If you learn your child has an allergy to cow’s milk protein, Dr. Schroer offers encouraging words: “Most kids will outgrow the allergy.”
How will you know when this occurs? By monitoring your child’s reaction to dairy foods added to the diet over time, with your doctor’s blessing. Dr. Schroer advises against introducing cheese, yogurt or other solid dairy foods before age 1.
Above all, be patient. “If symptoms recur, you may have to wait six months to a year before your physician can retest your child to see if he or she has outgrown the allergy” Dr. Schroer says.