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cow's milk hypersensitivity (CMH); cow's milk allergy

Also see food allergy Epidemiology: 1) 2-3% of infants - most common childhood food allergy [3] 2) most children outgrow it - only 1/2 of children with milk allergy outgrow it by 5 years of age [3,6] 3) 75% can tolerate milk in a baked product [2] Clinical manifestations: - symptoms generally develop within a few months of exposure - gastrointestinal symptoms - nausea/vomiting - diarrhea - anorexia - growth retardation - respiratory symptoms - coughing - wheezing - rhinitis - skin symptoms - urticaria - eczema - angioedema Laboratory: - milk-specific IgE Special laboratory: skin testing Complications: - anaphylaxis Differential diagnosis: - lactose intolerance (symptoms limited to GI tract) Management: - supervised baked milk challenges for milk-allergic children [2] - ability to tolerate baked milk predicts outgrowth of milk allergy [2] - regular consumption of milk in baked goods speeds resolution of milk allergy [6] - comment: its seems a trial of soy milk might be in order

Related

lactose intolerance (milk intolerance)

General

food allergy

References

  1. Journal Watch 24(8):67, 2004 - Vanto T et al Prediction of the development of tolerance to milk in children with cow's milk hypersensitivity. J Pediatr 144:218, 2004 PMID: 14760265
  2. Kim JS et al. Dietary baked milk accelerates the resolution of cow's milk allergy in children. J Allergy Clin Immunol 2011 May 23; PMID: 21601913 http://www.sciencedirect.com/science/article/pii/S0091674911006749
  3. Wood RA et al. The natural history of milk allergy in an observational cohort. J Allergy Clin Immunol 2013 Mar; 131:805. PMID: 23273958 http://www.jacionline.org/article/S0091-6749(12)01859-3/abstract - Spergel JM. Natural history of cow's milk allergy. J Allergy Clin Immunol 2013 Mar; 131:813. PMID: 23452903 http://www.jacionline.org/article/S0091-6749(13)00187-5/abstract
  4. De Greef E, Hauser B, Devreker T et al Diagnosis and management of cow's milk protein allergy in infants. World J Pediatr. 2012 Feb;8(1):19-24. Epub 2012 Jan 27. Review. PMID: 22282379
  5. Vandenplas Y, De Greef E, Devreker T. Treatment of Cow's Milk Protein Allergy. Pediatr Gastroenterol Hepatol Nutr. 2014 Mar;17(1):1-5. Review. PMID: 24749081
  6. Efron A, Zeldin Y, Gotesdyner L et al. A structured gradual exposure protocol to baked and heated milk in the treatment of milk allergy. J Pediatr 2018 Sep 27 PMID: 30270168