Cause and effect
Identifying a reaction to cow's milk
From stomach cramps to sickness and diarrhoea, there are many similarities between milk intolerance and milk allergy symptoms. What’s more, the names of these conditions are often used interchangeably and not always correctly. Knowing how to recognise them can help get a quicker diagnosis for your baby, and lead to an effective dietary management programme. This will be through your own diet if you’re breastfeeding, or with a specialised formula milk for allergy if you are
Milk allergy and intolerance in babies
Babies can either be allergic or intolerant to milk. Because some of the symptoms of milk allergy and milk intolerance are similar, they can be difficult to diagnose.
A milk allergy involves an immune reaction to one or more of the proteins present in milk, whereas an intolerance does not involve the immune system.
Watch our video to understand the difference between allergy and intolerance, and how to recognise the associated symptoms.
How to recognise a milk allergy
If your baby is allergic to milk, they will react to infant formula which is based on cows’ milk and sometimes, but very rarely, your breast milk if you’ve recently consumed dairy products. Symptoms to look out for include stomach cramps, vomiting, diarrhoea, rashes, hives, eczema, and difficulty breathing. Individual symptoms can sometimes be related to a bug, but if your baby is affected in two separate areas of the body – for example, the stomach (vomiting) and skin (hives) – you should ask your health visitor or doctor for advice. If your baby is less than a year old, why not try our Baby Symptom Checker? It includes some useful tips and a symptom summary to show your pharmacist, health visitor or GP.
It’s common for babies who are allergic to cows’ milk to be allergic to goats’ milk and sheep’s milk too, as they contain similar proteins. Unfortunately, there is no single diagnostic test for cows’ milk allergy and a combination of tests and a series of elimination and reintroduction diets are often necessary. These tests usually happen once your baby has been referred to a specialist by your doctor. It's very important that you seek advice from your doctor if you suspect that your baby has an allergy so that they can be properly diagnosed and treated.
How you can help your doctor make a diagnosis
Giving your doctor as much detail about your baby’s symptoms as possible can help speed up the diagnosis process. By keeping a diary of their symptoms, including when they occur and how long they last for, you can help your doctor identify or rule out CMA. Taking photos of any skin reactions, such as a rash, can be helpful too. You should also let your doctor know if there is a history of allergy in your family. For more detailed information, read our article on how to get a diagnosis for CMA.
Feeding and milk allergies
Managing a cows’ milk allergy involves removing all cows’ milk from your baby’s diet, so you'll need to get familiar with reading food labels and ingredients, as milk can occur in unlikely places. Food labelling laws are there to help you, and common allergens, like milk, have to be declared on pre-packaged foods.
If your baby is being formula fed and has been diagnosed with cows’ milk allergy, your doctor may prescribe an extensively hydrolysed formula. The protein in these formulae has been broken down into smaller pieces so that the baby’s immune system does not recognise it as an allergen – a process which does not affect the nutritional value of the formula.
Soya formulae are not recommended before 6 months as they contain phytoestrogens (plant-based compounds with oestrogen-like properties), and infants who react to cows’ milk-based formulae often also react to
Are milk allergies common in babies?
Only around 2–7.5% of babies under
How to identify if your baby has a lactose intolerance
A baby with
There are two main types of lactose intolerance. The first is primary lactose
Secondary lactose intolerance is usually caused by damage to the gut, after a severe stomach bug, for example. But this form of the condition is usually
Before you worry too much about milk allergies and intolerances, it’s worth remembering that babies and small children often pick up common bugs when they come into contact with other children, which can have similar unpleasant effects. But if your baby’s symptoms persist or you notice a pattern occurring, you should seek advice from your doctor.
If you suspect your baby has a milk intolerance or allergy, you should:
- Record your baby's symptoms after a milk feed, or enter them into our Baby Symptom Checker
- Share your baby's symptoms with their doctor
- Ask your health visitor or doctor about going dairy-free (if you're breastfeeding)
Remember, you should not make any changes to your diet or your baby’s unless advised to by a healthcare professional.
1. Hill. et al (1986) JPaediatrics 109:270-276
2. NHS UK. Cows’ milk allergy pdf [Online]. Available at: www.thh.nhs.uk/documents/_Patients/PatientLeaflets/paediatrics/allergies/PI008-Cows_milk_allergy_A4-May_13.pdf [Accessed: July 2014]
Last reviewed: 28th July 2014
Questions about feeding and nutrition?
Our midwives, nutritionists and feeding advisors are always on hand to talk about feeding your baby. So if you have a question, just get in touch.