Some reactions to cows’ milk involve the immune system while others are caused by difficulty digesting the milk. In medicine, the term cow’s milk allergy is only used to describe reactions involving the immune system, while other reactions are normally called cow’s milk intolerance. Cow’s milk allergy is common in infants and very young children, but rarely develops after one year of age. The onset is closely related to the introduction of cow’s milk based infant formula. It affects about 1 child in 50 among children under one year old. Fortunately about half of these will outgrow their allergy by one year, and most children have outgrown it by the age of three years. However, in a small minority of people, cow’s milk allergy may be lifelong and severe.

Milk protein allergy can occur in both formula-fed and breastfed infants, usually in the first year of life. Cow’s milk protein allergy is the most common among the allergies.

Cow’s milk contains around 30–35 g of proteins per liter and includes more than 25 different proteins but only some of them are known to be allergenic.

Through the acidification of raw skim milk to pH 4.6 at 20 °C two fractions can be obtained: the coagulum containing the casein proteins which accounts for 80% and the lactoserum (whey proteins) representing 20% of the total milk proteins. The casein fraction (Bos d 8, Bos domesticus) consists of four proteins which account for different percentages of the whole fraction: αS1-casein (Bos d 9, 32%), αS2-casein (Bos d 10, 10%), β-casein (Bos d 11, 28%) and κ-casein (Bos d 12, 10%) with αS1-casein being the most important allergen of the casein fraction.

Allergens found in the whey fraction are α-lactalbumin (Bos d 4), β-lactoglobulin (Bos d 5), immunoglobulins (Bos d 7), bovine serum albumin (BSA, Bos d 6) and traces of lactoferrin (Bos d lactoferrin). Α-lactalbumin and β-lactoglobulin are the most important allergens of the whey fraction, accounting for 5% and 10% of the total milk proteins.

Cow’s milk protein and soy protein allergy causes symptoms like: colic, irritability, runny nose, cough or wheezing, diarrhea, bloody stool, vomiting, swollen lips/eyelids, rash.

Why Nutrition Management is Important?

Cow’s milk and soy provide protein, calcium and energy in the diet. If your child cannot drink cow’s milk, soy milk or cow’s milk or soy based formula they will need a milk substitute. Formula free from cow’s milk and soy should be included, which also provide alternative source of protein, energy and for the requirement of calcium.

The diet is specific to each infant depending on the severity of condition, age, growth rate and result of diagnostic reports. Consult a dietician to fine-tune your child’s diet over time.

Providing education and support for the family is the key to a successful long range of therapy. Effective treatment is best achieved by a team of specialists such as your Physician, Nutritionist, Geneticist, Neurologist, and Psychologist.