On the occasion of Shavuot: milk allergy – what is it? How do you cope? And how dangerous is it?

Allergy to milk

On the occasion of Shavuot, the Israeli Allergy and Immunology Association of the Medical Association publishes essential information for the public on the subject of milk allergy.

Allergy to milk
Milk allergy – it can be dangerous!

How common is the phenomenon of milk allergy?

Milk is one of the most common allergenic foods in Israel (along with egg, peanuts, sesame and nuts). The prevalence of milk allergy among toddlers and babies in Israel is estimated at around 1%. About half of the cases will pass by the age of 5 years.

What is a milk allergy?

A milk allergy is caused by the creation of IgE antibodies against the milk proteins (casein, lactalbumin and lactoglobulin). Contrary to beneficial immune reactions, which attack viruses and bacteria as part of the body’s defense mechanism, in the case of a milk allergy, the immune system attacks the milk proteins with the same IgE antibodies – as if they were a foreign and dangerous factor. This reaction leads to a chain of processes in the body – the allergic reaction.

The allergic reaction may include a wide variety of symptoms, starting with skin reactions (rash and reddening of the skin), respiratory symptoms (runny nose, difficulty breathing, asthma attack, feeling of suffocation), gastrointestinal symptoms – including abdominal pain, diarrhea and vomiting.

In more severe cases, an anaphylactic reaction involves the involvement of two or more systems. In rare and even more severe cases, there can also be involvement of the cardiovascular system, which can lead to an anaphylactic shock, a drop in blood pressure, loss of consciousness and even life-threatening.

The severity of the reaction usually depends on the age and the amount of the allergenic protein. It is also known that during a viral illness, or following sleep deprivation, the threshold for an allergic reaction is lower and the severity of the reaction may be more severe.

Active and unbalanced asthma – is a risk factor for severe respiratory reactions in those who also suffer from milk allergy (and food allergy in general).

It is important to emphasize – do not confuse a milk allergy with lactose intolerance. Lactose intolerance is a very common phenomenon and is not dangerous. Lactose intolerance is caused by a decrease in the amount of the enzyme lactase, which breaks down lactose, which is milk sugar.

An allergic reaction to milk can be life-threatening
An allergic reaction to milk can be life-threatening

What to do? How do you cope?

A child or an adult, known to suffer from a milk allergy, should completely avoid the consumption of dairy products, including products marked “may contain” milk. It is important to note that even products defined as “fur” may contain milk, they may contain a small amount of milk protein, which can cause an allergic reaction.

The treatment of a mild allergic reaction – in the form of rash and itching, can be with antihistamines, such as: Fenistil. However, in more severe reactions, the treatment with Epifen is a life-saving treatment. The earlier it is given, the higher its effectiveness.

It is important to emphasize, you should not wait with the epifene injection until the appearance of severe and life-threatening symptoms, such as loss of consciousness or suffocation, because then it may be too late. It must be remembered, an Epifen syringe contains adrenaline, which is secreted in our body all the time, so that even if given by mistake, no harm will be caused. Therefore, in any case of doubt, Epifen should be injected.

Epiphane syringe
Epiphane syringe

The epiphane is injected into the front-lateral part of the thigh (no need to remove the clothes first). First, take out the blue nazra, hear a “click”, and leave the needle in the thigh for at least 3 seconds. After an Epifen injection, you should go to the hospital quickly. If there is no rapid improvement, another Epifen should be injected.

In patients who are also known to be asthmatic at the same time, if there are respiratory symptoms, it is recommended to use an inhaler. Any child with a milk allergy – should be monitored periodically by an allergist, make sure that the subject has two valid Epifen injections, and practice how to use it.

Epiphane syringe
Epiphane syringe

How do I know if I have a milk allergy?

A milk allergy usually develops during the first exposures to dairy products. Because of this, most cases of milk allergy develop and are detected in the first year of life. Most of the time, the symptoms in young babies include a skin rash that appears within a few minutes after exposure to milk, and passes within about an hour without treatment, or following treatment with Penistil drops.

When it is suspected that the child has developed symptoms suspected of being an allergic reaction, an allergist should be consulted (a specialist in the field of allergy), who will better assess the nature of the reaction, and will consider the need for further investigation, which usually includes skin tests (tests).

The skin tests are performed by dripping the milk protein extract on the arm and a small puncture, in order to introduce the milk protein extract into the skin. In the allergic patient, this action will cause a local reaction (redness and swelling), in the area of ​​the test.

When the diagnosis is not clear-cut, it will usually be recommended to complete the investigation using a ‘challenge’ test, under supervision. In the challenge test (from tongue to challenge), the patient is exposed to milk in a controlled and gradual manner under supervision. This is the most accurate way to diagnose or rule out a milk allergy. Admittedly, there is a risk of developing an allergic reaction in this test, but it is safe when done according to the correct indications and by trained staff in allergy centers, and is most important in cases where the diagnosis is not clear-cut.

In any case, only an ergologist can determine for sure whether it is an allergy to milk (or to another food).

How do I know if I have a milk allergy?
How do I know if I have a milk allergy?

Is it possible to prevent the development of a milk allergy?

It is now known, based on many studies from Israel and the world, that early exposure to allergenic foods reduces the risk of developing an allergy to that food. In most foods (egg, peanuts, sesame), the recommendation is to start early consumption at the age of 6 – 4 months.

In the case of milk protein, it is necessary (probably) to start early and consistent exposure to TML (baby food substitutes), earlier, even at the same time as breastfeeding.

how early The answer is still not clear-cut, however, in babies with an allergic background (atopic dermatitis/asthma of the skin, or with a nurse with a food allergy), it is recommended to consume milk formula at the same time as breastfeeding, immediately after birth. Consumption of individual portions of milk formula in the first days of life, and then switching to full breastfeeding, significantly increases the risk of developing a milk allergy.

For this reason, if the mother is interested in exclusive breastfeeding, it is recommended to completely avoid exposure to individual doses of Tamal near birth, in her babies.

Is it possible to suffer from an allergic reaction to milk without drinking milk, or without eating a dairy product?

Here it is important to calm down. Dangerous allergic reactions occur when eating the allergenic food. Contact with milk will cause a local reaction only. Reactions to smelling milk while cooking, or baking – are extremely rare. In addition, dairy products are a good source of proteins, calcium and other nutritional values ​​for children.

Dairy products are a good source of proteins, calcium and nutritional values ​​for children
Dairy products are a good source of proteins, calcium and nutritional values ​​for children

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