Milk Allergies: Types, Symptoms, and Treatment

In his childhood, Rahul was being punished for not drinking milk.  His mother did not even realise that he could be allergic to it. Even though he often used to feel nauseous or refuse vehemently to empty the glass. No amount of pleading could save him from the torture until in his thirties when he decided to have an allergen test. It showed that he has extreme milk intolerance or cows milk protein allergy. 

This is the story of every household. Milk is considered the most wholesome nutritious food for a growing child. If you were not doing well in the exam, you needed milk, if you could not sleep at night, you needed to drink warm milk. If you got hurt or were under the weather, you needed to drink “haldi wala doodh”, which Gen Z now fancily calls ‘the Golden Latte’. Little do they know that milk can be allergic to someone, it is being forced on us. 

Read till the end if you want to know all about what kinds of allergy milk can cause and how it can affect everyone from a child to an adult. 

Milk Allergy 

It is a type of food allergy where the proteins in the milk or milk products trigger your immune system to react and release antibodies. Most often, it is caused by alpha S1 casein protein in cow milk. Sometimes, lactose intolerance is confused with milk allergy. You are lactose intolerant when you lack an enzyme named ‘Lactase’ that is used to metabolise milk sugar. Though cow milk allergy is the predominant one, almond milk, soy milk, and even rice milk can cause allergic reactions. 

What Causes Milk Allergy?

All kinds of food allergies are caused by unwanted reactions of your immune system. Allergic symptoms occur when your immune system is triggered to release immunoglobulin E(IgE) antibodies in response to certain proteins in the ingested milk, which is considered a foreign body or allergen. The next time you drink milk, these proteins are recognised by the antibodies which then trigger your immune system to produce histamine and other chemicals, which express as allergic symptoms. Two main parts of cow milk that can cause allergies are : 

• Casein: It forms 80% of cow milk and gives milk its pristine white colour. It is the solid part of the milk which separates when the milk is curdled or spoiled. 
• Whey: The remaining liquid part of the milk which is also called a by-product of cheese manufacturing, is the whey protein. It forms 20% of the protein in milk.

You can be allergic to either one or both proteins, and these are hard to avoid as most processed products may contain either of them. 

Some other factors or conditions that enhance your risk of having milk allergy are: 

1. Sensitivity: Some children with milk intolerance are also prone to other allergies. Their immune systems are susceptible and may react to other animal protein-related products.
2. Atopic Dermatitis: It is a common chronic skin inflammation with red and itchy bumps. Children with such sensitive skin are more likely to have milk allergies.
3. Genetic Predisposition: If one or both parents suffer from food allergies, a child's risk of having food allergies increases manifold. Even if they suffer from other allergies like asthma, or hay fever, the child may be sensitive enough to food allergies.
4. Age:  Kids may be more sensitive to milk or milk products. As they grow up, the digestive system and enzymes mature and they become less prone to milk or food allergies.

Healthcare providers and researchers are yet to find out the exact cause of sudden milk allergy in adults.

Milk Allergy Symptoms 

Cow Milk intolerance symptoms in children develop over several hours to several days. The symptoms of a slow reaction include: 

• Abdominal cramps with loose stool which can be bloody and with heavy mucus
• Diarrhoea with dehydration
• Skin rashes all over, which are red and itchy
• Intermittent coughing with runny nose and infected sinuses
• As digestion is impacted, the child has slow growth, both in weight and height

Visible Symptoms that occur within seconds may include nausea, vomiting, hives and wheezing.

In case of a severe allergic reaction, children may go into Anaphylactic shock with swollen throat and mouth. The blood pressure drops, and breathing becomes difficult, ultimately leading to cardiac arrest. In such cases, you must contact your health provider for immediate medical attention. 

Types of Milk Allergy

Almond Milk Allergy 

Almonds, along with its other nut brothers, walnuts, cashews, and peanuts, are known to cause allergic reactions in most people. Nut allergies tend to last a lifetime, unlike signs of milk allergy.

Tree nut allergy may be expressed in the form of: 

• Itchy, red skin with eczema or hives
• Nausea, severe abdominal pain and diarrhoea
• Runny nose, wheezing, and troubled breathing

Anaphylactic reactions are more common with tree nut allergies.

Soy Milk Allergy

Soybean, along with lentils and kidney beans falls under the legume family. The milk extracted from these plant beans can cause reactions, especially in infants and children. Some prominent symptoms of soy milk allergy are:

• Flushing when your child’s face, neck and chest area turn red and it feels warm
• Itching and small swelling on the skin forming hives
• Runny nose and sore throats as if the child has a cold
• A high-pitched whistling sound can be heard  while breathing
• Inflammation of lips, tongue or throat along with severe abdominal pain

Rice Milk Allergy 

Although rare, rice milk allergy cases can be found in rice-eating Southeast Asian countries. Some symptoms include: 

• Redness of skin, rashes and hives
• A fluffy and runny nose makes it difficult to breathe normally
• Inflammation around face, throat and neck
• Wheezing while breathing
• Anaphylaxis may happen in severe cases in which the oxygen does not reach the brain due to poor breathing.

Infant Milk Allergy 

This can be avoided completely by breastfeeding as it is the best source of all required minerals and vitamins and helps to develop a strong immunity. However, if a mother drinks cow milk, then the casein is transferred to the baby, which may cause infant milk allergy.

However, those who have breastfed for a sufficient amount of time which is 6 months, are healthier and do not suffer much from any allergic reaction. 

Diagnosis of Milk Allergy 

If you feel that your milk sensitivity symptoms are getting difficult to manage, consult your doctor or physician at once before it turns serious. If possible, consult an allergist who will advise on the tests to check your level of reaction: 

1. Blood Test

The technician draws blood and sends it to the laboratory. The lab then injects milk proteins into the sample collected to check the measure of antibody released.

2. Skin Prick or Patch Test

A patch of skin on your forearm is cleaned with iodine or alcohol. Then, the allergist uses a thin needle to put some milk proteins on your upper layer of skin. Along with it, a positive and a negative control are  introduced in that area. Positive control is a tiny amount of histamine solution, and negative control consists of a neutral saline solution. The controls are then measured, and results are given. 

3. Graded Oral Challenge

Allergists may recommend this test if your allergy history and the test results do not match. Initially, you will need to ingest a small amount of milk and the reaction will be recorded. Slowly the amount will be increased to check on the reactions and accordingly, the test will be carried on. As it is understood this is a time-consuming method. 

Thankfully these tests can be covered under your health insurance plan. To support you with these tests, Care Health Insurance plans have outpatient coverage and specialised consultancy coverage. Sign up for a comprehensive plan with us and get financial coverage for listed diagnostics and physician appointments. 

Managing and Treating Milk Allergy 

When you feel signs of milk allergy are quite predominant, and even tests indicate the same, you should contact your doctor for a treatment consultation. The best way to manage milk allergy is to avoid milk and milk products. However, some of you might be tolerant towards some of the milk products like yoghurt or cream cheese etc. Check the labels of any packaged food for allergen awareness. Some products may not have milk but might be manufactured in facilities producing milk products as well. You should be conscious enough to avoid them. The allergen caution is mandated to be mentioned on the package. 

In case your child does not outgrow milk allergy, you can go for oral immunotherapy (OIT), which desensitises the person to the allergic reaction of the food allergen.

Some food and drinks are advisable to be avoided to prevent milk allergy:

• All forms of milk, including condensed, evaporated, or powdered milk, should be avoided. 
• Animal milk sources should be avoided at all costs.
• Butter, buttermilk, cottage cheese, and yoghurt should also not be consumed. 
• Custard, pudding, mousses, milkshakes, etc., are best not eaten as a dessert. 
• If possible, add baked goods like cakes and muffins to the list. 

Due to the absence of milk from the diet, one may lose out on calcium, vitamin D, and other vitamins and minerals. Speak to your healthcare provider if you need supplements or incorporate other nutrient-rich food into your diet. Consult a dietician for a healthy, balanced diet without milk. There are not many medications for the variety of milk allergies. But it depends on the severity of the reaction. If your milk intolerance symptoms are almost fatal, doctors will prescribe you an EpiPen or Epinephrine auto-injector which reverses the allergic reaction almost instantly. 

Also Read: Summer Skin Allergy and Their Prevention Tips

Conclusion

Being the most nutrient-rich food and easily available in nearby kirana shops, milk is considered to be healing and auspicious to residents of 80 % of the population. However, we need to open our eyes and ears to this problem and modify our lifestyle and habits with new findings and research. One of the most common causes of anaphylaxis-a life threatening reaction is milk. However, with a comprehensive health insurance cover you can at least rest assured for the treatment expenses that can arise due to an allergic reaction. 

Disclaimer: The above information is for reference purposes only. Kindly consult your general physician for verified medical advice. The health insurance benefits are subject to policy terms and conditions. Refer to your policy documents for more information.