Cows milk allergy for child
The baby with cows milk allergy is restless, with recurrent vomiting, diarrhoea and colic. The stools are watery and may contain small amounts of fresh blood. The baby fails to gain mass normally and may develop anaemia. If the diarrhoea and vomiting are severe the child can become dehydrated with serious consequences. Because the baby is sensitive to the protein in the milk it is not absorbed, leaving the baby hungry and malnourished. Colic also causes restlessness and crying so it should not be assumed that the baby is allergic if there is no diarrhoea and if the baby gains mass. Other common symptoms of cows milk allergy are excessive sweating from the head, especially when the baby is feeding, watery discharge from the nose, and noisy breathing.
Young babies often sneeze and this should not be seen as a sign of allergy, but if the childs nose appears to be itchy it could point to an allergy. The child who is allergic to cows milk often has rashes and dry rough patches on the face, arms and legs, and eczema often develops later.
Although there is no easy, sure test for cows milk allergy, it is possible to make a diagnosis by giving the child with suspicious symptoms a milk substitute. If there is a marked improvement within 24 to 48 hours it is an almost certain indication that the problem was indeed cows milk allergy. However, if there is not a quick improvement, the cause is probably not cows milk allergy and there is no point in subjecting parents and child to the expense and inconvenience of providing a milk substitute. Milk substitutes can produce unpleasant symptoms such as windiness so dont put your baby on to them unless there is really good reason to believe she is allergic to milk. Occasionally, a child is allergic to the milk substitute as well, and in this case further tests will have to be done
Temporary lactose intolerance can also mimic the effects of cows milk allergy. In this case the child is not allergic to the protein in cows milk, but to the carbohydrate (lactose). (See p. 83 for lactose intolerance.) Tests for lactose intolerance must be done and, if they are positive, a milk in which the carbohydrates are replaced by glucose can be tried, or one of the new products that replace the lactase enzyme.
To prove that the child is indeed allergic to cows milk it is possible to do a challenge test by giving the child 5 ml cow’s milk after four days on a substitute milk. If there is no reaction in four hours, 10 ml cows milk can be given in addition to the usual feed. The cows milk should be increased by 5 ml every feed. After five days, normal cows milk formula should be given. If there are no reactions such as diarrhoea, bulky stools and loss of mass after a month, you can conclude that the child was not allergic to cows milk or that it was a temporary deficiency of an enzyme, and other causes for the previous symptoms should be sought. If the child is allergic to cows milk, a substitute such as soya or other vegetable milk, goats milk or one of the specially modified cows milks will have to be given, supervised by your doctor or clinic.
If cows milk allergy has been proved it is necessary to cut it out of the childs diet for at least six months before trying it again as described in the challenge test. But it could take a year or two, perhaps longer, before the child outgrows the allergy.
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