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Allergy to Cow's Milk: Overview
Although cow's milk allergy and cow's milk intolerance (lactose intolerance) are two different terms, they are often used interchangeably, resulting in confusion both in clinical practice and in research reports. Cow's milk allergy is an immunologically mediated reaction to cow's milk proteins that may involve the gastro-intestinal tract, skin, respiratory tract, or multiple systems, i.e. systemic anaphylaxis.
Incidence
Its prevalence in the general population is probably 1 to 3%, being highest in infants and lowest in adults.
Treatment and Prevention
Living with a milk allergy in a dairy-oriented culture is not as difficult as you might think. There are a lot of nondairy foods you can substitute for milk or milk products. You can try calcium-enriched rice milk or soy milk - these now come in vanilla and other flavors. Goat's milk isn't a good alternative; its protein is similar to that in cow's milk and may cause the same allergic reaction.
People are usually understanding when it comes to food allergies: nobody wants to have to call an ambulance! When eating out, order the simplest foods and ask detailed questions about menu items. At a friend's house, explain your situation and don't be embarrassed to ask questions if you're staying for a meal.
Having a milk allergy doesn't mean you can't still enjoy eating. In fact, some people think that some of the milk substitutes - like vanilla soy milk - taste better than regular cow's milk. As with any specialized diet, you'll probably find avoiding milk gives you the opportunity to explore and discover some great foods that you'd never have found otherwise!
Prognosis
Even though it can cause severe morbidity and even fatality, dietary elimination is associated with good prognosis.
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Signs, symptoms & indicators of Allergy to Cow's Milk: | | | | | Symptoms - Allergy |  Moderate sneezing or frequent sneezing / attacks | "Allergy to cow's milk proteins has been defined as any adverse reaction mediated by immunological mechanisms to one or several of these proteins. Reactions to cow's milk have been classified according on their onset as immediate (< 45 min) or delayed-type (from 2 hours to days). In the challenge test, 10 hours after milk intake the patient presented serous rhinorrea, sneezing and nasalblockade." [J Investig Allergol Clin Immunol, 1998 Jul, 8: p.4] |
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Symptoms - Head - Nose |
Nasal congestion |
Symptoms - Metabolic |
Frequent colds/flus | "Symptoms of milk-protein allergy include cough, choking, gasping, nose colds, asthma, sneezing attacks..." [Annals of Allergy, 1951; 9] |
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Symptoms - Respiratory |
Recent/chronic productive cough | Respiratory symptoms of milk-protein allergy can include coughing, choking, gasping, nose colds, asthma and sneezing attacks. [Annals of Allergy, 1951; p.9] |
Shortness of breath |
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Conditions that suggest Allergy to Cow's Milk:
Recommendations and treatments for Allergy to Cow's Milk: | | | | | Diet |  Plant-Based Nutrition | Vegan foods, which can be bought at health food stores and many other places, are made without any animal products, such as eggs or milk. Be careful to read the labels of soy cheeses, though. They may say "milk-free," but they could contain milk protein. For your sweet tooth, soy- or rice-based frozen desserts, sorbets, and puddings are good substitutes for ice cream, as are ice pops. For baking, milk substitutes work as well as milk and some even come out better. Dairy-free margarine works as well as butter for recipes and spreading on a bagel. You might also want to look for foods labeled "parve" or "pareve": they are usually made without milk products according to kosher dietary laws. Kosher foods that are marked with a "D" are dairy and shouldn't be eaten. Those marked with "D.E." were made using dairy equipment and shouldn't be risked either. |
Dairy Products Avoidance
 Fried Foods Avoidance | Try to avoid fried and battered foods, because even if the batter doesn't contain milk products, the oil used to fry the foods may have been used to fry something that did contain milk. |
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Digestion |
Probiotics | Oral administration of probiotic bacteria has been shown to stabilize intestinal integrity, promote local IgA production and reduce intestinal inflammation in atopic individuals with cow’s-milk allergy. |
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KEY | Weak or unproven link: may be a sign or symptom of; may suggest |  | Strong or generally accepted link: often suggests | | Moderately useful: often helps with | | Very useful: is highly recommended for |
Last updated: Mar 13, 2012
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