A Detailed Guide to Cow’s Milk Allergy for Parents

What is a casein allergy?

Milk is a good source of protein. Casein and whey protein are the major proteins of milk. A 2016 study by Davoodi et al. shows that casein constitutes approximately 80 percent of the total protein in bovine milk, and whey protein accounts for about 20 percent.

Casein allergy occurs when the human body identifies casein as a health threat. Of course, this happens by mistake. And so, when your body identifies casein as a threat, it will set off a chain reaction to fight it off.

There is a difference between casein allergy and lactose intolerance. Lactose intolerance occurs when your body is unable to make lactase. Lactase is an enzyme that digests lactose, the sugar in milk.

People that are intolerant to lactose usually feel a great deal of discomfort after consuming dairy products. Casein allergy causes symptoms such as:

What causes casein allergy?

Casein allergies occur mainly in infants and young children. A person experiences casein allergy when his or her body mistakenly identifies casein as a toxic substance. At this point, the body will make attempts to fight it off. This results in an allergic reaction.

The risk of a casein allergy is very low in infants who are breastfed. Experts are still researching why casein allergy occurs in some infants and doesn’t in others. Some authorities think that genetics may play a role.

Most cases of casein allergy resolve by the time a child reaches the ages of 3 – 5. In some cases, the child fails to outgrow it, and so carries the allergy into adulthood.

Where can you find casein?

The content of mammal’s milk, like cow’s milk, include:

  • Fats
  • Lactose, also known as milk sugar
  • Casein protein
  • Other kinds of milk protein

People who have cow’s milk allergy must avoid all forms of dairy and milk. Even the smallest amount can trigger a severe allergic reaction known as anaphylaxis. Anaphylaxis is usually fatal.

When a person has anaphylaxis, the person’s immune system will release many chemicals throughout their body.

Symptoms of anaphylaxis include hives, redness, difficulty breathing, and swelling. This can cause an anaphylactic shock, which frankly, can be very fatal if treatment is delayed.

The milk content in many food products can be inconsistent. And so, one cannot tell the exact amount of casein that he or she will ingest. A study by the Mayo Clinic shows that milk is the third most common dietary cause of anaphylaxis.

Foods that trigger cow’s milk allergy include:

  • Milk of all types (low-fat, whole, buttermilk, and skim)
  • Kefir, yogurt
  • Margarine, butter, butter flavorings, and ghee
  • Cheese and cheese products
  • Cream (sour, heavy, and whipped)
  • Custard, pudding
  • Half and half
  • Gelato, ice cream

You can also find casein in foods that contain milk powder or milk. Cookies and crackers are good examples. Casein is also present in nondairy flavorings and creamers. This explains why it is very difficult to avoid casein.

And so, one must read food labels with care and inquire about the contents of certain foods before buying it or eating it. If you are eating out at restaurants, ensure that you inform your server about your cow’s milk allergy before taking orders.

Avoid milk products or foods that have some milk content if you are allergic to cow’s milk. This will be clearly stated in a food’s ingredient list.

Sometimes, you may see the lines “may contain milk” or “made in a facility with milk” on some food packaging. You must avoid these foods as they may contain some casein.

What are the risk factors for cow’s milk allergy?

Studies have shown that 1 in every 13 children below the age of 18 has food allergies. Symptoms of cow’s milk allergy show up when a child has reached 3 months of age. It resolves when the child reaches 3 – 5 years of age. Experts do not know the exact reason behind this.

However, a 2011 study by Jennifer et al. have found that exposing children with a cow milk allergy to very small amounts of casein helps them to outgrow their allergies faster, as compared with children who are not exposed to casein.

The American Academy of Pediatrics advises against giving children cow’s milk before their first birthday. This is because a baby’s body is intolerant to high amounts of protein.

The American Academy of Pediatrics advises that babies should be fed with formula or breast milk until 6 months of age. Only then can you introduce solid foods. Once the child reaches 6 months of age, avoid giving them milk-based foods. Feed with formula or breastmilk (if you must give them milk).

Diagnosing a casein allergy

Call your healthcare provider if your child shows symptoms of cow’s milk allergy. The healthcare provider will inquire about the history of food allergies in your family. They will also conduct a physical exam.

The fact is, there is no specific diagnostic test for a casein allergy. Your pediatrician will perform a series of tests to ensure that there’s no underlying health condition. Sometimes, these symptoms may be caused by other health conditions. Tests for casein allergy include:

  • Blood tests (for underlying health conditions)
  • Stool tests (for digestive problems)
  • Skin prick allergy test – the doctor will prick your child’s skin with a needle laced with a small amount of casein to see if he or she will react.

In some cases, the pediatrician may give your child some milk and observe him/her for a couple of hours for any allergic reaction.

How can you avoid casein?

The following products serve as good substitutes for casein:

  • Italian ices and sorbets
  • Rice, potato, and soy-based kinds of milk
  • Coconut butter
  • Soy ice creams
  • Some brands of creams and creamers
  • Some brands of soups
  • Tofutti

If you are working with a recipe that requires a cup of milk, you can substitute a cup of rice, soy, or coconut milk, or maybe a cup of water mixed with an egg yolk. You can also use the following in place of dairy yogurt:

  • Soy sour cream
  • Soy yogurt
  • Unsweetened applesauce
  • Pureed fruit