How is cow's milk allergy managed?

Management of cow's milk allergy is centred around removing cow dairy products from the baby's diet, and possibly your own if you are breastfeeding. Milk of other animals (such as goat's milk) may be fine for your child, but you will need to check with your doctor. If your baby is being formula fed, replacing his or her usual formula with a hypoallergenic formula will help. The proteins in hypoallergenic milk formulas are broken down into their building blocks (known as amino acids), so will not cause an allergic reaction although the baby will still get all the nutritional benefits of milk. Hydrolysed milk formulas contain smaller proteins and may be suitable as well. Soy milk is tolerated well by infants who have immediate reactions (unless they also have a soya allergy), but not so well by babies who have delayed type reactions. Thus, calcium enriched soy milk or rice milk is also an option, but consult a paediatric dietician before making this decision.

Milk is commonly used as an ingredient in many other foods (such as baking, cheese, yoghurt), so you will need to buy products that are marked as “dairy free,” which means that there is less than 0.5 % milk in the product by weight. For adults and older children who are still allergic to milk, there are a number of other varieties of milk, such as soya milk, almond milk, or rice milk. These are not suitable forms of nutrition for infants. You can also get fruit juices enriched with calcium (milk is a good source of calcium, which is needed for healthy and strong bones, as well as other roles in the body too).

If your child accidentally drinks something with milk in it or accidentally eats a dairy product, an EpiPen containing adrenaline or anthistamines (such as loratadine) should be given. Which medicine you give to your child will depend on how severe the milk allergy is, and you should seek advice from your doctor about this.

After 2 years of age, after consultation with a paediatrician, you may be able to start reintroducing milk into your child's diet. This can either be done in the hospital or at home. At first, only a few drops of milk are given, but the amount is increased slightly every day. If there are no problems encountered, your child might be able to start drinking milk without problems in several weeks. If you do notice any allergic reactions, you can simply stop giving your child milk and wait a few months to start again.

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