[Allergy & Asthma Corner]

Milk allergy is the number one concern in young children that develop skin rash, eczema, hives, diarrhea or vomiting. Children that have these problems after drinking milk should be evaluated for possible milk allergy. If other foods or beverages are being consumed milk may or may not be the problem. In young children (less than 1 year old) the prevalence is much higher simply because milk is their main if not sole food source. Young children tend to be more vulnerable to milk and other food allergies.

Older children and adults of course consume many other products in addition to milk or other dairy products. Whether milk allergy is a reason for itching, swelling, skin rash, abdominal pain, bloating, flatulence (stomach gas), stomach cramps or diarrhea, should  be determined by evaluation. Milk allergy is diagnosed  in my office, by getting a detailed diet and symptom history as well as overall medical history and physical exam. Milk or allergy to other foods may be confirmed by skin test or blood test (serum test for IgE specific to cow's milk).

Lactose intolerance (milk intolerance) is more common in older children and adults who complain of stomach upset, diarrhea or bloating after drinking milk or eating dairy products. This is not an allergy. Allergy skin test and blood test are negative in people that have lactose intolerance as the reason for their discomfort. Generally, I diagnose lactose intolerance by the history and negative milk allergy test, but there are other more specific tests available to confirm lactose intolerance.

As mentioned, young children more commonly have milk allergy. It should be confirmed by your physician for proper dietary adjustments. Sometimes the alternatives (such as soy based milk or formula) may also be a problem because of allergic sensitivity. Knowing whether the problems a child is experiencing is from milk or other foods may be be important in order to consider whether other diseases or disorders should be considered. 

Fortunately many young children will grow out of their milk allergy over a course of one or more years (with cows milk restriction). Re-testing is important to confirm the milk allergy status before re-introducing it into the diet.

People with lactose intolerance should talk with their doctor about diet adjustments. Some people simply drink milk that has lactase enzyme added to it. Others take lactase pills (over the counter) just before drinking regular milk, eating ice cream or consuming other dairy products.

It is important to know what you have in order to establish a good treatment plan. If you suspect that you or your child has a problem with milk or another food, consult your doctor. You may require referral to a board certified allergist.