Cow Milk Allergy (CMA) – as for many medical conditions that affect infants and children – can be the source of stress and worry for their parents, who are searching for the truth about diagnosis, treatment and long-term prognosis. Lack of awareness and old wives' tales can all create an environment of confusion.

Here, we'd like to help you to separate the facts from the fiction about cow milk allergy.

1. FICTON: “Cow Milk Allergy only affects the baby with the condition.”
   FACT: Cow Milk Allergy not only has a debilitating effect on the sufferer, with symptoms including vomiting, diarrhoea, failure to thrive and eczema, it also has a secondary impact on the parents and other siblings, which include: loss of sleep, arguments with their partner, absence from work and lack of attention to other children in the family.¹ 
   
   
2. FICTION: “Cow Milk Allergy is extremely rare.”
   FACT: Cows' milk is the most common cause of food allergy in infants and children², affecting at least 10,000 infants in the UK³. 10,000 is a modest figure because the potential for under diagnosis suggests that the actual number of cases of infant Cow Milk Allergy likely exceeds the number of documented cases.
   
   
3. FICTION: “Cow Milk Allergy is just a more serious case of lactose intolerance”
   FACT: Lactose intolerance and Cow Milk Allergy are two different things, affecting the body in different ways⁴.
   Lactose intolerance is the inability to digest significant amounts of lactose (a sugar found in milk) due to a shortage of the enzyme lactase. The main symptoms are bloating, wind and nausea⁵.
   A true cows' milk allergy, however, occurs when the immune system abnormally reacts to one or more of the proteins found in milk, as though they were a harmful body. It presents in one or more of three organ systems:
   
   
   • Gastrointestinal (vomiting, diarrhoea, abdominal cramps, bloating) – affecting 50-60% of those with Cow Milk Allergy
   • Skin (rashes, including eczema and atopic dermatitis) – 50-70%
   • Respiratory (wheeze, cough, runny nose) – 20-30% ⁶ 
     
     
4. FICTION: “Cow Milk Allergy is easily diagnosed by GPs.”
   FACT: The variety of symptom combinations and time to onset make Cow Milk Allergy troublesome to diagnose, including the risk of treating individual symptoms (skin or stomach problems) without establishing a proper Cow Milk Allergy diagnosis. 4 out of 5 doctors confuse milk allergy symptoms with other conditions such as gastroenteritis and colic¹.
   
   
5. FICTION: A child can only develop it if one of its parents has the condition.”
   FACT: Children do not have to have a parent with Cow Milk Allergy to develop the condition themselves. Although risk increases with the number of first-degree family members affected by an allergic disease, there's a 10-15% chance that a child with no family history of allergy can still develop the condition⁷. Other factors that increase the risk of allergy development include atopic conditions such as asthma and eczema, the environment, exposure to allergens⁸ and immunity status.
   
   
6. FICTION: “A child's diet will be compromised by a Cow Milk Allergy, causing long-term health problems”
   FACT: If a prompt diagnosis is made and effective treatment, e.g. suitable alternative hypoallergenic formula milk, introduced quickly into the diet, a child with Cow Milk Allergy can thrive as normal. Under the supervision of a medical professional, the essential vitamins, minerals and proteins provided by cows' milk can be substituted to ensure a perfectly nutritious and balanced diet. However, it is important to act quickly if a case of Cow Milk Allergy is suspected and to seek proper medical attention, since some commonly-available off-the-shelf milk alternatives are not recommended in young children e.g. soya, goats', sheep or rice milks⁶.
   
   
7. FICTION: “People with Cow Milk Allergy can use soya, goats' or sheep's milks as suitable alternatives to cows' milk”
   FACT: Many people with Cow Milk Allergy will find that they are also allergic to soya⁹, goats' and sheep milks⁶. None of these cows' milk alternatives are recommended as the main source of nutrition for young infants because they contain a lower nutritional content not equivalent to breast or cows' milk². A knowledgeable medical professional will be able to provide advice about suitable hypoallergenic formula that is easy to use, palatable, will provide rapid relief of symptoms and enable optimal growth and development⁹.
   
   
8. FICTION: “Cow Milk Allergy is for life”
   FACT: The vast majority of infants (>95%) will outgrow Cow Milk Allergy by the age of 3–5 years.
   

References

1. Telephone Survey among 1,000 European Parents of Children Aged 0-3 Years.  KRC Research, November/December 2005
2. Niggemann B et al . Prospective, controlled, multi-center study on the effect of an amino acid based formula in infants with cows' milk allergy/intolerance and atopic dermatitis. Pediatr Allergy Immunol 2001;12:78-82
3. Calculated using UK population statistics and estimation of milk allergy in infant population by Sicherer SH (Lancet 2002;360:701-710)
4. Host A. Cow's milk protein allergy and intolerance in infancy. Pediatr Allergy Immunol 1994;5:1-36
5. National Institutes of Health, National Institute of Allergy and Infectious Diseases, An overview: Food allergy. NIH Publication No. 04-5518, 2004.
6. Host A et al . Dietary products used in infants for treatment and prevention of food allergy. Arch Dis Child. 1999;81:80-84
7. Warner JO. The hygiene hypothesis. Pediatr Allergy Immunol. 2003: 14; 145-6.
8. Vance GH et al. Early life exposure. Early life exposure to dietary and inhalant allergens. Pediatr Allergy Immunol . 2002: 13 (Suppl 15); 14-8
9. Isolauri E et al . Efficacy and safety of hydrolyzed vow milk and amino acid-derived formulas in infants with cow milk allergy. J Pediatr 1995;127:550-7