Milk Protein Intolerance in Babies

The excitement of becoming a new parent is sometimes overshadowed by a fussy baby. A little fussing is one thing, but excessive crying is cause for alarm for most parents. When the crying is accompanied by other symptoms, a trip to the doctor is warranted to determine if your baby has an intolerance to milk protein, an allergy to cow’s milk.

Background

• Cow’s milk is the basis for regular baby formula, but some babies cannot tolerate milk protein. Their immune system reacts to fight it off, causing allergy symptoms. Most babies who are allergic to cow’s milk are also allergic to goat’s milk and some are even allergic to soy protein. Breastfed babies seem to have a lower risk of developing a milk allergy. The causes of milk allergy are not fully understood, but many researchers feel it is genetic. Some children outgrow the allergy by 5 years of age, but some never outgrow it.

Symptoms

• Symptoms of milk allergy may occur by 2 to 3 months of age, usually with a slow onset. Loose stools, vomiting, refusal to eat, skin rashes and fussiness may occur 7 to 10 days after consumption. These symptoms also occur with other conditions, making diagnosis potentially difficult.

  Symptoms such as vomiting, swelling, hives, bloody diarrhea or wheezing may come on suddenly. In rare cases there may be more-severe reactions that affect the baby’s breathing, blood pressure or skin.

Diagnosis

• Contact your doctor if you suspect a milk allergy. He will take a family history and conduct a physical examination. He may order lab tests to rule out other health problems, including stool and blood tests and a skin test for a milk allergy. For a skin test a small amount of milk protein is introduced under the skin with a needle. A raised spot (wheal) at the site of the injection indicates the possibility of a milk allergy.

  In an oral challenge test, the baby is taken off of milk for a week. Milk is reintroduced. The baby is observed for several hours for a reaction.

Treatment

• If you are breastfeeding, limit intake of milk products, as milk protein can cross into the breast milk. If you are formula feeding, you may be advised to switch to a soy-based formula. If your baby cannot tolerate this, the doctor may suggest a hypoallergenic formula in which the proteins are broken down. Most babies tolerate an extensively hydrolyzed formula. An amino acid based formula may be recommended if the hydrolyzed formula doesn’t help.

Other Formulas

• Use formulas approved by the U.S. Food and Drug Administration (FDA). Goat, rice and almond milk are not considered safe and are not suggested for consumption by babies. Partially hydrolyzed formulas are available but may still cause reactions and are not recommended.

  Once you switch to a new formula, the symptoms should go away in 2 to 4 weeks. Typically a doctor will advise you to continue with the hypoallergenic formula until your baby is 1 year old. Then you will gradually reintroduce cow’s milk into her diet.