Ask the Expert – Milk Allergy or Lactose Intolerance?

Ask The Expert is a weekly column on Littlestomaks.com. The idea is to have a reader-submitted question answered by a nutrition expert or a pediatrician. Feel free to submit your question in the comments section below.

This week, registered dietitian Kerry Robinson clarifies the difference between milk allergy and lactose intolerance and offers advice on how to deal with both.

Kerry Robinson, RD
  • B.S. Virginia Tech – Human Nutrition, Foods and Exercise with concentration in Dietetics
  • Dietetic internship at Virginia Tech
  • Expertise in food and health communication at IFIC
  • Analyzes trends in food and health issues on traditional and social media
  • Twitter – @IFICmedia
  • Contact via email – robinson@ific.org
  • Question: How can I be sure if my child has milk allergy or lactose intolerance?

    Lactose intolerance is an inability to digest and absorb the sugar in milk (lactose) that results in gastrointestinal symptoms such as nausea, vomiting and diarrhea when milk or milk-containing products are consumed.

    Unlike lactose intolerance, a milk allergy is caused by an immune system response in which milk proteins (casein and whey) are mistakenly identified as being dangerous and antibodies are created to fight them off in an effort to protect the body.

    For example, a child with a lactose intolerance, can consume  lactaid (lactose –free milk) or yogurt without symptoms but a child with milk allergy can not. The difference between milk allergy and lactose intolerance is not only the cause, but also the severity of the symptoms.  While a child with a milk allergy can display similar gastrointestinal symptoms as one who suffers from lactose intolerance, it is important to understand that the symptoms of an allergic reaction can be much more severe, and even life threatening at times.

    The following are the most common signs and symptoms of a reaction to a food allergen, like milk

    • Skin rashes, itching, swelling or hives
    • Vomiting or other gastrointestinal symptoms
    • Respiratory distress, such as wheezing or breathing difficulties
    • Anaphylaxis, which is a systemic allergic reaction that can involve multiple symptoms at once and can range from mild to fatal

    Once you suspect that your child or loved one has a reaction or intolerance to milk you should consult your health care provider, pediatrician and/or a board-certified allergist.  He or she may ask you detailed questions about signs and symptoms, perform a physical exam, request a detailed food diary, and perform a combination of skin prick or blood sample tests to confirm an allergy or intolerance.

    Should a milk allergy be confirmed, you will need to eliminate all milk and milk-containing products from your child’s diet.   While this can seem like a daunting task, a registered dietitian can provide expertise in helping to ensure your child receives adequate nutrition, especially calcium to foster proper growth and development.  Since strict avoidance of the offending food allergen (in this case, milk) is the only way to prevent a food-allergic reaction, a registered dietitian can work as part of the healthcare team to:

    • Review how to avoid specific food allergens
    • Ensure nutrient adequacy (especially calcium and Vitamin D)and add variety to your child’s diet
    • Provide suggestions for meals and snacks and strategies to enjoy dining out
    • Assist in label reading
    • Monitor growth and development
    • Share resources related to food allergies

    Whether your child is lactose intolerant or allergic to milk, it is important to engage your healthcare team, especially a registered dietitian to help guide you in making sure your child eats and stays healthy.

    For more information on allergies, join IFIC and Food Allergy and Anaphylaxis Network for a Twitter chat on Tuesday May 11, 2010 at 8 p.m EST using hashtags #foodinsight and #FAAW

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    Disclaimer – Information provided in Ask The Expert column on Littlestomaks.com is intended to give you general guidance on a question related to toddler nutrition. It is not meant to be treated as medical advice. You are welcome to contact this expert for a detailed consultation on your specific situation to determine what actions, if any, you should take regarding nutrition and health of your toddlers. We do not recommend you to take any action based solely on the information presented in this column. Experts have agreed to provide their professional opinion on toddler nutrition related questions on a voluntary basis and no compensation is offered to them by Littlestomaks.com.

    5 comments

    1. Great, clear post. As an RD and a mom my words of encouragement would be, what our allergist said to us “the more completely you remove the allergen from the child’s diet the greater the chance they will outgrow.” My son had a terrible reaction to eggs and was diagnosed with an egg allergy as an infant. He outgrew it by the time he was 3 years old. I know this isn’t always the case but thought I’d share the story.

    2. Great, clear post. As an RD and a mom my words of encouragement would be, what our allergist said to us “the more completely you remove the allergen from the child’s diet the greater the chance they will outgrow.” My son had a terrible reaction to eggs and was diagnosed with an egg allergy as an infant. He outgrew it by the time he was 3 years old. I know this isn’t always the case but thought I’d share the story.

    3. Kerry Robinson, RD

      Thanks for your comment and for sharing your story! Allergies are different from person to person and people react to varying levels of allergens. I’m glad to hear that your son outgrew his allergy to eggs.

    4. Kerry Robinson, RD

      Thanks for your comment and for sharing your story! Allergies are different from person to person and people react to varying levels of allergens. I’m glad to hear that your son outgrew his allergy to eggs.

    5. Pingback: Ask the Expert - Fruit Juice for Child With Reflux | LittleStomaks

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