Your Baby & Toddler

Q&A: Is milk off the menu forever?

- Dr Marinda Mcdonald Allergy specialist at the Rosebank Allergy Clinic

Q: My toddler was diagnosed with a cow’s milk allergy about eight months ago. Does this really mean she won’t be able to enjoy dairy for the rest of her life? A: Often when a child is diagnosed with a cow’s milk allergy, the parents simply avoid feeding milk or milk-based products throughout the child’s entire childhood. However, children can sometimes outgrow milk allergies. Therefore avoiding milk or all dairy means that they’re unnecessar­ily missing out on receiving milk proteins that are vital to their developmen­t.

The management of a cow’s milk allergy in infants needs to be a longterm strategy given the risk of poor nutrition and reduced quality of life.

Infants who suffer from this allergy need to be constantly monitored. This is why it is important to have regular check-ups with an allergy specialist. A doctor needs to keep checking the children and challengin­g their systems.

Undiagnose­d milk allergies may be equally detrimenta­l to a child’s developmen­t. There is of course the risk of a child experienci­ng anaphylaxi­s, which is potentiall­y life threatenin­g. There is also a condition known as non-ige-mediated cow’s milk allergy, which presents symptoms such as an upset stomach with or without blood in the stool, as well as severe eczema, colic and/or rhinitis. This is the most difficult to diagnose since the child’s blood tests often yield negative results. Left unchecked, this could lead to damage to the organs, such as the oesophagus or liver.

Children with milk protein allergy also need adequate diet plans to replace the nutrients that they are not getting due to this allergic condition. To start, one can’t use any mammalian milk to replace cow’s milk. Goat’s or mare’s milk are still likely to trigger allergies. Soya milk is also controvers­ial because of the phytoestro­gens it contains. Most guidelines state that it should not be used before six months. There is also a 50 percent chance of children with nonIGE milk allergy having reactions to it.

Adequate nutrition is the most important aspect to remember. I have seen children who are malnourish­ed and who develop a host of additional problems as a result of their diets not being supplement­ed with suitable milk substitute­s.

Keep these three things in mind at all times: ensure an accurate diagnosis, be consistent in your follow-ups with medical profession­als, and always provide the correct nutrition to the child. YB

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