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NOVEMBER 17, 2017
AUGUSTA MEDiCAL EXAMINER
MASTERS OF CLINICAL RESEARCH 706-210-8890
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MILK… from page 1 within 30 minutes to several hours after consuming dairy products. Lactose intolerance is caused by a deficiency in an enzyme called lactase, which helps digest the lactose. Inability to digest lactose results in the unwanted symptoms; however, these symptoms are not considered to be related to any true allergy (unlike milk protein allergy). Milk protein allergy can occur with breastfed and formulafed babies alike. If breastfeeding mothers are worried that their babies are not tolerating milk well, it does not mean she has to stop breastfeeding. Eliminating dairy and milk from her own diet can allow a mother to continue to breastfeed with resolution of the allergic symptoms, but this should be discussed with the care provider fi rst. When treating a milk protein allergy, the gut instinct is to switch to a soy-based formula with the intention of avoiding dairy. Interestingly, however, milk proteins are very similar to soy protein, and often cross-reactions can occur, eliciting the same symptoms and allergic reaction to the soy milk. True milk protein allergy in an infant is treated instead with special formula with proteins already broken down (called hydrolyzed formula) so that the baby’s gut does not have to. If true MPA exists, then switching to this special formula will resolve symptoms within several weeks. Note: instantaneous relief is unlikely to occur, as the offending milk protein needs to be cleared from the system and the inflammatory, allergic response subsequently calms down. If milk protein allergy is diagnosed in a baby, it does not mean that milk and milk products will need to be eliminated from the diet forever. Frequently, children can tolerate reintroduction of milk products into the diet gradually at 1-2 years of age after a period of time of milk-free diet. Lactose intolerance, on the other hand, may or may not get better in time, but because it affects older children rather than infants, this is not an issue that would be present or a cause of concern with a symptomatic baby. Symptoms of colic, vomiting, diarrhea, poor weight gain, etc., are not guaranteed to be caused by milk protein allergy or lactose intolerance. Just because a baby is fussy or having GI symptoms does not automatically mean that the formula needs to be switched either, although of course it is a possibility. The main take-home message is that suspected difficulties digesting milk can manifest in a variety of ways, but other causes for a set of presenting symptoms need to be explored by a child’s pediatrician as well. +
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