Cow’s milk allergy in babies

Breastfeeding is the best food for babies. Babies need breast or bottle feeding to grow properly. But sometimes a baby’s immune system reacts abnormally to cow’s milk proteins in this food. We then speak of cow’s milk allergy. It is the most common allergy in babies.

What is cow’s milk allergy?

Cow’s milk allergy in babies is caused by, as the name suggests, cow’s milk. If your child suffers from cow’s milk allergy, this means that your child produces antibodies against the proteins in cow’s milk. This can cause an allergic reaction. Do not confuse a cow’s milk allergy with lactose intolerance. The symptoms of lactose intolerance are similar to those of a cow’s milk allergy, but the two are not the same. If you have lactose intolerance, you cannot properly process the milk sugars in a product. With a cow’s milk allergy, the body reacts allergically to the proteins in cow’s milk.

Symptoms of cow’s milk allergy

Complaints that may indicate cow’s milk allergy are:

• Skin rash (for example, red spots on the child’s face)
• Spitting
• Diarrhea
• Intestinal colic (this can cause a baby to overstretch its body)
• Stomach ache
• Shortness of breath
• To cry
• Unrest

Symptoms in multiple organs often occur in parallel. The allergic reactions can occur very quickly. 30 minutes after ingesting cow’s milk, your baby may already experience vomiting or breathing problems. But symptoms of cow’s milk allergy may only appear later. Think of a rash, stomach ache or diarrhea. Your child may even show symptoms up to 24-48 hours after ingesting cow’s milk proteins.

Different types of cow’s milk allergy

There are different types of cow’s milk allergies; the IgE-mediated cow’s milk allergy and the non-IgE-mediated cow’s milk allergy. Below we describe the symptoms of both variants.

IgE-mediated cow’s milk allergy
In this type of allergy, symptoms appear after a few minutes or in the first hours after ingesting food containing cow’s milk protein. Your baby’s immune system responds quickly to milk proteins by producing IgE antibodies that cause the symptoms. These antibodies, produced by immune cells, are responsible for the production of histamine. This causes an immediate allergic reaction.

The most common symptoms of an IgE-mediated cow’s milk allergy:

• Skin conditions such as: hives and swelling of the lips, tongue or face, itchy rash,
• Gastrointestinal symptoms such as: vomiting and diarrhea, abdominal pain,
• Symptoms similar to hay fever such as: sneezing and a stuffy nose, an itchy or runny nose, breathing difficulties. 

In a severe form, the IgE-mediated allergic reaction can sometimes be so severe that it is life-threatening: this is called anaphylaxis, which fortunately is still very rare. Anaphylaxis occurs suddenly and affects the entire body and requires immediate medical attention.

Non-IgE-mediated cow’s milk allergy
In this second type of cow’s milk protein allergy, symptoms appear several hours or even days after ingesting food containing cow’s milk protein.

The symptoms of non-IgE-mediated allergy are sometimes very similar to those of IgE-mediated allergy. However, they can also be much less obvious and more difficult to diagnose. Possible symptoms in case of non-IgE mediated cow’s milk allergy:

• Symptoms similar to colic
• Reflux
• Gastrointestinal symptoms such as diarrhea, stomach upset and constipation
• Crying, restlessness
• Food refusal
• Deflective growth

Mixed allergic reaction
It also happens that babies have both non-IgE-mediated and IgE-mediated symptoms: this is called a mixed allergic reaction.

The first symptoms appear quickly after eating or drinking a product containing cow’s milk proteins. And then other symptoms may occur in the hours or days after ingesting the cow’s milk.

What can I do if my baby has a cow’s milk allergy?

Babies come into contact with cow’s milk proteins during both breastfeeding and bottle feeding and can react to them. The proteins in bottle feeding usually come from cow’s milk. Small amounts of (cow’s milk) proteins can end up in breastfeeding through the mother’s diet. 

The symptoms of cow’s milk allergy can be reduced or disappear completely by omitting cow’s milk protein from the diet. But a baby does need proteins for its growth and development. In the first years of life, milk is the most important source of protein. If a child has a cow’s milk allergy, an equivalent alternative to milk must be sought.

Is your child breastfed? Then you can consider no longer eating cow’s milk protein as a mother. This way, the cow’s milk proteins from your diet cannot reach your baby through breastfeeding. You can ask a dietitian for guidance on how you can best adjust your diet so that your child still gets enough protein. 

Does your child receive bottle feeding? There are various cow’s milk-free formulas available. For example, there is food in which the cow’s milk proteins have been cut into small pieces (this is called intensive protein hydrolyzate), so that it no longer leads to allergic complaints. Please note: this is food for medical use. Always consult a doctor about this.

Does this not reduce the complaints sufficiently, or is your child’s growth lagging behind? Then infant food without cow’s milk protein may be a solution. This food is made from 100% free amino acids. These are foods for medical use and your doctor or dietician will advise you which food is suitable for your child.

If you suspect that your child is allergic to cow’s milk protein, it is best to contact your doctor. The doctor will conduct further examination and start treatment if necessary. Or provide you with appropriate advice.

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