COWS MILK PROTEIN ALLERGY IN INFANTS
Also known as ‘Allergic Colitis,’ Cow’s Milk Protein Allergy affects 2-3% of infants. Your baby’s immune system overreacts to the protein in cow’s milk causing inflammation in their colon. Often this leads to blood in your infants stool. Other symptoms may include a very fussy or uncomfortable baby, especially when feeding, as well as a possible lack of weight gain. Sometimes other allergic symptoms may be present, such as severe eczema.
It is unknown what exactly causes Allergic Colitis, there may be a hereditary component, as babies who come from a family with a history of food allergies, asthma or environmental allergies seem to be more likely to have allergic colitis.
Treatment of Allergic Colitis is the removal of milk protein from your infant’s diet. This will be done either by switching your baby to a hypoallergenic formula (such as Alimentum or Nutramigen) or having the mother go on a dairy-free diet if she wishes to continue to breastfeed. 30% of infants who are allergic to milk protein are also allergic to soy; therefore, your provider may suggest a soy-free diet as well.
HOW TO READ A LABEL FOR A MILK-FREE DIET
Avoid foods that contain milk or any of these ingredients:
Butter, butter fat, butter oil, butter acid butter ester Buttermilk
Casein Casein hydrolysate
Caseinates Cheese
Cottage cheese Cream
Curds Custard
Diacetyl Ghee
Half-and-half Lactoalbumin
Lactoferrin Lactose
Lactulose
Milk (in all forms, including condensed, derivative, dry, evaporated, goat’s milk & milk from other animals, low fat, malted, milkfat, nonfat, powder, protein, skimmed, solids, whole, lactaid)
Milk protein hydrolysate Non-dairy creamer
Nougat Pudding
Recaldent Rennet casein
Sour cream Sour milk solids
Tagatose Whey
Whey protein hydrolysate Yogurt
Milk is sometimes found in the following:
Artificial butter flavor Baked goods
Brown sugar flavoring Caramel Candies
Chocolate High protein flour
Lactic acid starter culture & other bacterial cultures Margarine
Nisin Nondairy products
Luncheon Meat, hot dogs, sausages
HOW TO READ A LABEL FOR A SOY-FREE DIET
Avoid foods that contain soy or any of these ingredients:
Edamame Miso
Natto Shoyu
Soy (soy albumin, soy cheese, soy fiber, soy flour, soy grits, soy ice cream, soy milk, soy nuts, soy sprouts, soy yogurt)
Soya Soybean
Soy protein Tamari
Tempeh Tofu
Textured vegetable protein
Soy is sometimes found in the following:
Asian cuisine Vegetable broth
Vegetable gum Vegetable starch
- Remember to recheck labels as recipes change often
- Certain vitamin & mineral supplements, as well as prescribed &
over-the-counter drugs may contain lactose as fillers. Please check with pharmacist before using these products
- Supplementation is necessary for calcium, phosphorus & Vitamin D.Either by a fortified milk substitute or a vitamin supplement.
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MILK-FREE SUGGESTIONS
FATS: Kosher margarine (Mother’s brand), unsalted Mazola margarine, unsalted Fleishmann’s stick margarine, lard, vegetable oil, mayonnaise, cocoa butter, ‘Tofutti’ brand sour & cream cheeses (not soy free).
FRUITS/VEGETABLES: All types
MEAT/FISH/POULTRY/EGGS: Plain beef, poultry, fish, pork, lamb, bacon, kosher hotdogs, kosher cold cuts (Hebrew National), peanut butter, eggs, tofu(not soy free).
POTATO/PASTA/RICE: All except prepackage (canned or frozen) in which casein is added to pasta to maintain shape.
SOUPS: Clear canned soups or commercial and homemade soups made with allowed ingredients.
BEVERAGES: carbonated beverages, Kool-Aid, cocoa without added milk solids, Almond or Rice milk.
CEREALS: Most cereals do not contain milk products in the ingredient list but occasionally there may be cross-contamination.
Baby Cereal: ‘Earth’s Best’ Brown Rice Cereal
SWEETS/DESSERTS: Sugar, jams, jellies, syrups, honey, marshmallow cream, gelatin, fruit sorbet, Italian ice, milk free Popsicles, Baked products made with Crisco, oil or allowed margarine, ‘ROYAL’ pudding mix made with appropriate milk substitute.
MISC: Mustard, relish, ketchup, salt, pepper, spices, cocoa powder, carob powder, potato chips, pretzels, olives, peanut butter (without added milk), plain popcorn, corn ships, soy sauce (if milk-free only).
It may take up to 72 hours for breast milk to become free of milk protein. Your provider may suggest using a hypoallergenic formula during this time period. It will take several weeks for your infant’s intestines to heal; therefore, you may see blood in the stool for this amount of time. However, your baby should be feeling better; less irritable, less reluctant to feed & may even be putting on weight. You will continue to follow-up in the office to assess for this improvement.
Allergic Colitis is different than a true milk allergy. Most babies outgrow the milk protein allergy by the time they’re one year old. Your provider will discuss with you introducing cow’s milk around this age.
For more information:
Food Allergy
http://www.foodallergy.org
Kids with Food Allergy
http://www.kidswithfoodallergy.org
Childrens Hospital
http://www.childrenshospital.org