Allergy to milk in a child of 6 years. Symptoms of milk allergy in a child, photo, diagnosis and treatment. How to distinguish from lactase deficiency. Why is cow's milk protein allergic?

For some parents, a milk allergy in a child is a serious concern, most often during the period of introduction of complementary foods or transition in early infancy to artificial feeding.

Causes contributing to the appearance of milk allergy in children

Among the causes of rejection of milk proteins in infants, there is an insufficient development of the digestive system. They have not yet established the fermentation process. For the development of allergies in a child, protein molecules are responsible, which in structural formula There are several types of milk.

The dominant protein is casein. Because of large sizes its molecules are more difficult to break down in the baby's stomach. In a semi-split form, when absorbed into the blood, they become foreign elements for immune cells. There are other proteins - antigens, of which the most active are albumin, lactoglobulin, alpha-lactoglobulin.

In children, as statistics show, a negative reaction to a specific type of milk is more often manifested, since when originating from different types Animal amino acid composition of proteins varies. For example, with intolerance to cow's milk, a baby is often able to consume a similar product obtained from a goat or sheep.

Milk proteins are not always the cause of allergies. Sometimes the provocative role is played by substances of a chemical nature (for example, antibiotics), which are stored in the milk of a treated cow or goat.

If a fairly rare allergy to breast milk appears in a child, then the cause should be sought in the mother's diet.

There are two varieties:

A true allergy that occurs even when a child consumes a minimal amount of milk. This is due to the individual immaturity of the enzymatic system.
Pseudo allergies can be a one-time occurrence associated with the inability of the infant's digestive system to process an excessive amount of a dairy product.

The risk of allergy to milk protein in children increases in the presence of a number of adverse external factors:

the tendency of parents to negative reactions of this kind
living in an area with unfavorable ecology
harmful working conditions during mother's work during pregnancy
early artificial feeding
the occurrence of pathology of gestation

It is important to pay attention in a timely manner to the appearance of an allergy to dairy varieties of food in an infant in order to exclude the development of dermatitis and a decrease in immunity.

Characteristic symptoms

An allergy to milk protein in children can manifest itself in a general form in the form of specific signs.

Gastrointestinal disorders

Due to insufficient digestion of milk entering the stomach, loose stools appear with characteristic curdled clots. Infants experience profuse regurgitation after each feeding. Vomiting may occur.

Often, an allergy to cow's milk in a child is accompanied by discomfort and pain in the abdomen, which causes anxiety, poor sleep, and crying.

Skin lesions

On the skin, among the obvious signs of an incipient allergy to dairy food varieties, milk scabs or gneisses are most often observed. These are formations on the head of an infant in the form of a crust, which usually appear when artificial feeding is introduced into the diet. Less commonly, they are found in infants. The reason in this situation is the food consumed by the mother.

Another symptom that occurs in different parts of the body of a baby up to six months old is childhood eczema. Bubbles appear, degenerating into erosion with the release of a clear liquid - exudate. After tightening the wounds, the skin becomes covered with a crust, which gradually peels off.

In areas of the inner ulnar surface and under the knees, limited atopic dermatitis may appear. This is a rash in the form of scaly plaques that cause intense itching.

One of the serious allergic manifestations is Quincke's edema, which occurs on the eyelids, lips, and genitals. If the swelling is localized on the mucous membranes of the larynx, the child is threatened with the development of asphyxia. Urgently required medical attention.

Known to many, urticaria is less dangerous, but causes suffering in a child due to severe itching. Visually distinguished by blisters surrounded by reddened skin.

Pathological conditions of the respiratory system

A dangerous consequence of an allergy to milk is a variety of painful conditions of the respiratory system that threaten the condition of the baby. Allergy symptoms often include coughing and runny nose. The baby may develop nasal congestion, causing difficulty in wheezing.

Differences between milk allergy and other diseases

It is impossible to independently understand whether the listed symptoms are a clear confirmation of the fact that the crumbs are allergic to milk. Since they can be signs of other diseases, then a visit to the doctor is a must.

The most reliable result is shown by diagnostic tests conducted by specialists. This will distinguish milk allergy from intestinal infections or a variety of colds that affect respiratory system. Additionally, tests are prescribed to exclude lactase deficiency, the symptoms of which are almost completely identical to milk allergy.

To clarify the diagnosis, you may need an analytical blood test for the presence of antibodies secreted by the defense system in the fight against allergens. Often, a comprehensive examination with stool and urine tests is required.

Treatment methods

The priority treatment method for identifying an allergy to milk protein is to exclude formula milk from the menu of infants. If possible, stop breastfeeding.

It should be borne in mind that in rare cases, when an allergy to breast milk is detected in infants, it is necessary to feed them with special mixtures produced on the basis of milk hydrolysates. This is a fermented milk protein that has undergone partial cleavage.

Such mixtures are easier to digest and digest faster, but require careful monitoring, since in some cases an allergic reaction is observed after taking them. Therefore, the doctor may recommend a diet based on milk protein molecules that have been more deeply cleaved. If the course of an allergy takes a severe form, then even such mixtures are not suitable for the baby. In such a situation, specialized varieties of baby food are used.

If only cow's milk is a problem, you can use mixtures based on the processing of goat's or sheep's milk. Starting to introduce porridge as a complementary food, they are cooked on the water. If at the same time a more rare allergy to goat's milk is detected in a child, then the approach to the selection of mixtures should be more serious.

It should be noted that a mother who is able to organize full breastfeeding should revise her diet as much as possible. She will have to exclude dairy varieties from the menu, many types of pastries, chocolate. Do not use milk powder, ice cream, butter. If the baby, after all these restrictions, continues to become covered with a rash, then the mother's diet should be even more strict. Fish, nuts, eggs are removed from the diet.

Any medical treatment for a child is prescribed by a doctor. When an allergic rash appears on the skin, children's ointments with anti-inflammatory properties bring relief. The course of therapy may include prebiotics that normalize digestion. In accordance with age, antihistamines are prescribed that relieve allergic lesions. To remove allergens that have entered the body, enterosorbents will be required.

Allow to reduce itching from skin rashes of lotion with infusion of a string. It is made from 4 tablespoons of herbs, which are poured with boiling water (500 ml) and kept under a towel for 60 minutes. Cotton pads are moistened in the filtered infusion and applied to the affected areas for 15 minutes.

With extensive rashes, a ten-minute evening bath with the addition of an infusion of string will benefit. It is advisable to prepare it from pharmacy briquettes, brewing 75 g of raw materials with boiling water - 0.5 liters. Withstand until the infusion cools down, filter and pour into a bath of water prepared for bathing.

What to cook for a child after a milk allergy is diagnosed

When deciding how to replace milk in case of an allergy in a child, it is possible to gradually give sour-milk children's products no earlier than seven months of age. Prepare during this period yogurt or kefir. A ten-month-old baby can be given homemade cottage cheese once a week.

Sour-milk varieties contain milk protein split during the fermentation process, so they are faster and easier to digest. Although babies are practically not observed after their use of skin rashes, intestinal disorders, caution and constant monitoring of the child's condition are still required.

Store-bought children's cottage cheese is not recommended for babies prone to allergies. You can cook it at home. To do this, take a glass of milk, stir in it a tablespoon of sour cream. Keep the mixture in the kitchen under normal room conditions 6-8 hours. The acidified milk is poured into a small saucepan (enamelled) and heated over low heat until the whey separates. Spread the curd mass on gauze and hang over a bowl, allowing the liquid to drain. If cottage cheese is needed urgently, then you can squeeze it out. It is necessary to give the product to the child on the day of preparation, since the maximum shelf life of it in the refrigerator is a day.

If a child’s allergy to milk does not go away by the age of one, then it can be replaced with plant varieties.

To prepare oat milk, in the evening take half a glass of whole grain oats in the husk and wash it thoroughly. Pour a glass of pre-boiled and cooled to room temperature water. In the morning, ready-made natural milk is filtered.

Get more oat milk fast way boiling washed oat grains in water (1: 2) for an hour over low heat will help. After cooling and straining, the useful liquid is ready for use.

Can be used cereals(200 g), which are poured with cool boiled water (2 l) and kept for 20 minutes. Beat with a blender and strain.

If you cook rice and grind it in a blender, then filter it, you get rice milk, which should be given to children in small quantities (about 100 ml in laziness), since this product can cause constipation.

Forecasts

It is believed that allergy to milk protein in children disappears by the time they reach the age of three. But there is a small percentage of maturing babies who have a similar negative reaction. They will have to exclude dairy products from the menu almost throughout their lives.

Usually, clinical nutrition with mixtures based on casein hydrolysates does not last longer than 12 months. After this period, it is advisable to introduce fermented milk mixtures. If allergic reactions are no longer observed, then you can carefully give milk nutrition, starting with minimal portions. At the same time, from the age of four months, the child is given vegetable purees.

Turning to statistics allows us to identify the following dynamics of getting rid of milk allergy in children:

by the age of one year, 40 - 50% of babies cope with allergies
in the period from 3 to 5 years, the number of recovered children is 80 - 90%
intolerance to dairy varieties persists in approximately 15% of children

Knowing these data, parents should not worry too much if their baby has an allergic reaction to dairy food. Considering that in the structural formula of milk there are many substances important for the life of the body, if medical recommendations are followed, this problem can be dealt with.

Select a rubric Allergic diseases Allergy symptoms and manifestations Allergy diagnostics Allergy treatment Pregnant and lactating Children and allergies Hypoallergenic life Allergy calendar

Allergy in children is a common disease that every mother needs to know about. Due to the fact that the child's body does not function quite the same as in an adult, the problem of allergies is so important and relevant.

The peculiarity of food allergies in children is that it is mainly due to the immaturity of the digestive system. Due to the insufficient activity of enzymes and their small number, as well as the unformed intestinal biocenosis, allergens that enter the stomach and intestines actively affect the body.

This mechanism underlies the formation of food allergies in children. However, with timely detection and treatment, and as the child grows and matures, allergies may eventually disappear.

Causes of milk allergy in children

In this article, we will take a closer look at the most common type of food allergy in children - an allergy to milk.

Allergy to cow's milk

Cow's milk is the most highly allergenic type of milk. Another name for such an allergy is an allergy to milk protein (cow's milk protein).

Photo: Food allergies most often manifest themselves as various rashes on the face

This concept is general and non-specific, since cow's milk contains more than 20 proteins that can cause an allergic reaction. The most important of them is casein. (causes an allergic reaction more often than others), α- and β-lactalbumins.

goat milk allergy

It is much less common than cow's milk allergy due to the low content of allergenic proteins. Goat milk is considered hypoallergenic and is included in many food products for allergy sufferers, infant formulas.

Therefore, if an allergy in a baby also manifests itself in goat's milk, you should carefully read the composition of specialized products and exclude those products where it is contained.

Allergy to mother's milk

With an allergy to mother's milk, the reaction does not occur to substances produced by the mother's body, but to allergens from her diet. Thus, if a hypoallergenic diet is observed, mother's milk will also not contain allergens and will not cause a reaction in the baby.

For more information about breast milk allergy -.

It is important not to confuse milk allergy per se with lactose (or other milk components) intolerance.

If in the first case we are talking about the immune mechanism of the development of the reaction, and the manifestations can be very different, from the gastrointestinal to the skin, then in the second we are talking about enzymatic deficiency.

In this case, the manifestations will be only food. Of course, allergies can occur against the background of lactase deficiency, but this is not always the case.

Allergy in older children more often occurs on any particular product / substance, and is associated with persistent sensitization of the body. Such an allergy has nothing to do with the immaturity of the body and, as in adults, will be observed every time you are exposed to an allergen.

Another possible cause of a milk protein allergy in a child is dysbacteriosis, in which the number of "beneficial" bacteria involved in the processing of allergen proteins in the digestive tract is reduced. Dysbacteriosis can occur after an infection, against a background of weakened immunity, or after taking a course of antibiotics.

Gastrointestinal symptoms - a common manifestation of an allergic reaction to milk

Treatment of dysbacteriosis consists in taking probiotic drugs that restore the normal intestinal microflora:

Bifiform Baby,
Linex for children,
Acipol.

In this case, allergy is also a temporary concept, and with the restoration of microflora it will disappear.

If children are allergic to milk, it must be replaced with other products containing a sufficient amount of calcium and other necessary substances, without which the child's body will not be able to fully grow and develop.

How does milk allergy manifest in children?

In infants, milk allergy is manifested mainly by skin symptoms and gastrointestinal symptoms.

Photo: Red rash around the mouth as a symptom of milk allergy in infants

From the gastrointestinal tract:

The most common is vomiting after feeding;
In addition, it manifests itself in the form of regurgitation, colic and stool disorders.

Another possible manifestation is skin changes:

dry skin;
red, itchy rash around the mouth;
eczema, hives.

A child with allergies behaves restlessly, cries a lot, sleeps poorly. In addition, breathing problems may occur immediately after consuming the product.

Treatment and diagnosis of milk protein allergy in children

Due to the fact that Small child will not tell us what is bothering him, and because of the similarity of allergy symptoms and many other diseases, when diagnosing milk allergy in children, laboratory methods should be preferred:

skin allergy tests,
determination of specific immunoglobulins IgE, IgG to cow's milk.

The cost of this study in various laboratories varies from 400 to 1000 rubles.

When confirming an allergy, two important areas of therapy should be observed: a hypoallergenic diet and the treatment of the allergic reaction itself.

What to do if the allergy has already manifested itself? You should not wait for it to pass on its own - with such tactics, complications are possible in the form of a dangerous systemic allergic reaction (anaphylactic shock).

At the first manifestations of allergies, the child should be given an antiallergic (antihistamine) agent approved for use at the appropriate age, for example:

Suprastin- approved for use in children older than 1 month (daily dose - ¼ tablet).
Fenistil(drops) - for children older than 1 month; daily dose in children 1-12 months - from 9 to 30 drops, a single dose of 3-10 drops.
Peritol(syrup) - for children older than 6 months, the dose is calculated according to the instructions, based on the weight of the child.
Zyrtec(drops) - for children older than 6 months, dosage - 5 drops 1 time per day.

Attention!

For children from birth to 1 month, the appointment of antiallergic drugs is possible, but with caution and under the supervision of a doctor!

If a small amount of time (up to 1-2 hours) has passed from the moment of taking the allergen-containing product to the manifestation of allergy, enterosorbents will help to stop or slow down the allergic reaction - drugs that bind and remove harmful substance(including allergens) from the stomach and intestines.

Photo: Possible manifestations of an allergy to cow's milk in a child

For use by children from birth are allowed:

Enterosgel- 2.5 g (0.5 teaspoon) of the drug should be mixed in a triple volume of breast milk or water and given before each feeding - 6 times / day.
Polysorb- with a child weighing up to 10 kg - a daily dose of 0.5-1.5 teaspoons
Smecta- 1 sachet per day.

Also, in the presence of allergies, it is most important to exclude the effect of the allergen on the body. So, if you are allergic to cow's milk, you must follow a hypoallergenic diet (read below) and do not consume milk and all products containing it in the composition.

However, allergies to dairy products may not be observed, since during their production most antigens are deactivated. In this case, the use of yogurt, kefir, cottage cheese, cheese and other fermented milk products is acceptable.

Diet food for allergies

The diet for an allergy to cow's milk in a child should be balanced and contain a sufficient amount of nutrients, vitamins, and trace elements.

The first complementary foods for children with allergies are introduced later, from the seventh month of life, the second - from the eighth. According to Tatyana Maksimycheva, a pediatrician at the Department of Child and Adolescent Nutrition at the Russian Medical Academy of Postgraduate Education, the proteins in fermented milk products are much less aggressive, and in some cases such products are suitable for children with allergies.

Calcium for children with cow's milk allergy is a very important and often deficient micronutrient, and a sufficient amount of calcium-containing foods should be included in the diet on a hypoallergenic diet.

An example of a diet for an allergy to cow's milk protein is given on his website by Dr. Komarovsky.

Sample menu for cow's milk allergy:

When it comes to children over three years old it is useful to include prunes, figs, canned fish with bones, beans in the menu for allergies to milk. It is acceptable to use any meat, but without sauces containing milk.

Forbidden any bakery products, which includes milk: pancakes, donuts, pancakes, biscuit, etc. Cocoa is prepared on the water, or replaced by other drinks - tea, fruit juices.

Replacing cow's milk with milk from other animals

approximate cost 150 rubles / liter.

Allergy to goat's milk is possible, but extremely rare due to the low allergen content. In the absence of an allergic reaction to goat's milk, it is recommended to introduce it into the child's diet.

It contains a large amount of nutrients, macro- and microelements, and its beneficial features even superior to cow's milk.

More exotic product - hypoallergenic camel milk. It can be purchased at camel farms, which are not available in all cities of our country, costing about 3,000 rubles / liter.

However, Dr. E.O. Komarovsky argues that if a child has an allergy to cow's milk, most likely it will also develop to goat's or sheep's milk, so replacing one with another is not advisable.

An overview of formulas for a child with a milk allergy

Milk allergy in infants is an important problem that can be solved by feeding the baby with hypoallergenic mixtures.

In connection with the manifestations of allergies in children, the use is often necessary. Now on sale there is a wide range of hypoallergenic products from different manufacturers. In this article, we will take a closer look at the most popular of them and see what the differences are.

Nutrilak Nutrilak Peptidi MCT

Hypoallergenic formula for feeding children from birth.

According to reviews, the mixture is well suited for children with an allergy to goat's milk and intolerance to other hypoallergenic mixtures. The disadvantages include a specific smell and a bitter taste, which is why some children refuse this product.

Approximate cost - 780 r / 300 gr.

NUTRICIA Nutrilon Nutrilon Pepti MSC

Hypoallergenic formula for feeding children from 0 to 12 months.

Due to the high degree of protein hydrolysis, it has low allergenicity. The mixture, due to the rather high content of glucose, is more palatable, but at the same time, it worsens it. useful qualities. In addition, the mixture has a rather high content of maltose and galactose, which can cause allergies and intolerances.

When using this mixture, the color of the child's stool may change (acquire a greenish tint).

Milk allergy in a child is one of the most common reasons for visiting pediatricians. Manifesting from an early age, it can significantly complicate the life of the baby and his parents. How are the insidious properties of milk manifested and is it possible to cope with this problem?

Why does milk allergy develop?

Experts call an allergy the response of the body to the introduction of a foreign protein (allergen). This reaction is not found in all children on the planet. One child may drink two glasses of fresh milk and ask for more, another after a while will complain of a rash or loose stool. It is not possible to accurately predict whether an individual child will develop an allergy. It is believed that the tendency to overreact is inherited. If one of the parents suffers from allergies, then his child has a 30% chance of getting a similar problem. In the case when an inadequate reaction to milk is manifested in both parents, the risk increases to 80%.

Unfortunately, even perfectly healthy parents have children with allergies. At the same time, it is not the sensitivity to the product itself that is inherited, but only the body's tendency to build its response to foreign proteins in this way. Doctors call this phenomenon atopy and note that this condition is increasingly common in children living in large cities. Seasonal allergic rhinitis, atopic dermatitis, bronchial asthma - all these diseases are only part of the problem called atopy. Parents suffering from one of these pathologies are more likely to have children with a tendency to allergic reactions, including to milk.

What kind of milk is dangerous for children?

It is noticed that in most cases the reaction is found on cow's milk protein. In fact, this condition is a form of food allergy and is due to the increased sensitivity of the body to certain food products. One of the first manifestations of the disease is usually a reaction to cow's milk. Babies who are on breastfeeding receive allergens from their mother. Formulas intended for supplementary feeding of newborns also contain cow's milk protein, which means that they cannot be considered safe for children with allergies. The disease can also make itself felt when complementary foods are introduced (for example, when eating cereals cooked in milk).

A new product should be introduced into the child's diet gradually, in small portions.

Unlike cow's milk, goat's milk is much less likely to cause allergic reactions. It is impossible to completely exclude an undesirable reaction to the product. A small percentage of children who are allergic to cow's milk protein also react to goat's. In most cases, parents learn this through experience by trying to replace one product with another.

It is worth distinguishing between an allergy to cow's milk protein and intolerance to this product. In the first case, a typical reaction develops, leading to the production of antibodies and the formation of a stable immune response. With intolerance, the problem lies in the insufficiency of lactase, an enzyme that breaks down milk. The cause of this condition can be both a true lactase deficiency and an improperly organized breastfeeding process.

The first symptoms of the disease appear a few days after birth. Breastfed babies get dangerous allergens from their mother's milk. Babies who use formula may react to ingredients in baby food. It has been observed that children who receive breast milk during the first year of life are much less likely to suffer from allergies than formula-fed babies.

How to recognize a milk allergy? First of all, children develop a rash. Red scaly spots are first visible on the cheeks, then gradually cover the entire surface of the body. The baby feels unbearable itching, is naughty, sleeps poorly, refuses to breast or bottle. In most cases, the following signs join the skin symptoms:

stool disorder (diarrhea);
frequent regurgitation;
bloating;
painful colic;
inadequate weight gain.

If a nursing mother has been on a diet, symptoms of an allergy to cow's or goat's milk protein may appear in a child along with the introduction of complementary foods. Milk cereals and other allergenic foods can cause a rash or loose stool reaction. In some children, such a manifestation of the disease may be one-time, in others it will constantly remind of itself when slightest change diets.

When the first symptoms of allergies appear, contact your local pediatrician!

What threatens an excessive reaction to milk? Children who are prone to food allergies are at high risk of acquiring other chronic diseases. Experts call this phenomenon an atopic march and argue that food allergies with age can lead to the development of atopic dermatitis, hay fever or bronchial asthma. That is why it is so important to see a doctor for treatment of this disease when you detect the first symptoms of milk intolerance.

Allergy to milk in infants: can I continue to feed?

The reaction to milk protein in breastfed babies is not so rare. What should mom do in this case? Do you really have to transfer the crumbs to artificial mixtures? Not at all! mother's milk - the best food for a child, and no mixture, even the highest quality, will ever replace this useful product. In addition, artificial mixtures are much harder to digest in the baby's intestines and by themselves can cause an increase in an allergic reaction.

Pediatricians recommend that mothers feed their allergic babies with breast milk as long as possible. This also applies to those children who have not yet produced an adverse reaction to dairy products, but are at risk for developing the disease (for example, if one of the parents has an allergy). When the first symptoms of a nursing mother appear, you should switch to a hypoallergenic diet.

What should not be eaten by a woman whose child suffers from a protein allergy? First of all, it is worth excluding whole milk, as well as products in which it is included in any form (including dry milk). Beef should be used with caution - an allergic reaction to meat is possible. Dairy products can be left in - they are not dangerous for the baby.

Can cow's milk be substituted for goat's? Unfortunately, this practice does not always positive result. Many children who are allergic to cow's milk protein have a reaction to goat's too. It is better to wait with experiments for up to a year. It is noticed that with age in many babies the disease goes away by itself. After three years, more than half of children completely get rid of unwanted reactions to dairy products.

Complementary foods in infants with food allergies should not be introduced before 6 months of age.

Allergy to milk in formula-fed children: how to feed a child?

Most infant formulas contain cow's milk protein. With the development of allergies, pediatricians recommend switching to therapeutic mixtures of hydrolyzed proteins or amino acids. Finding the right food isn't always easy. In some cases, parents have to try many different formulas before they find best option for your child.

At the moment, there are infant formulas on the market based on goat's milk. Using this product allows you to get rid of allergies and restore your baby's health. It should be borne in mind that in rare cases, children have a reaction not only to cow's milk, but also to goat's milk - in this situation, such mixtures will have to be abandoned.

In addition to goat milk-based products, the pediatrician may suggest that parents switch to using soy formulas. Such a diet is allowed from 6 months and is used only in babies who are not allergic to soy. An undesirable reaction to this product is manifested in the form of a breakdown of the stool, frequent regurgitation and flatulence.

Do not try to replace one mixture with another without consulting a doctor!

Allergy to milk in children older than a year

In rare cases, an undesirable reaction to a foreign protein may occur in a child only after a year. This situation may be associated with the appearance of a new product in the baby’s diet, including one containing powdered milk. The recommendations of pediatricians are to eliminate the dangerous agent until the food allergy disappears completely. After three years, you can gradually introduce dairy products into the diet in small portions.

If the child tolerates goat's milk well, you can use it not only as a delicious drink. Goat milk can be used to cook porridge, as well as add this product to tea and other dishes. The main thing is to carefully monitor the reaction of the child and prevent the appearance of a rash and stool disorder.

When you find out that your baby is allergic to milk, do not rush to get upset. Remember that in many cases the reaction to food subsides with age. Perhaps, after a few years, you won’t even remember what you once experienced because of a rash on your cheeks?

Allergy symptoms are similar to each other, so it is not always possible to recognize the allergen. With untimely detection, it is constantly in the blood, affecting all organs and systems, so it is important to eliminate it as soon as possible. Allergic reactions to milk are most common due to the underdevelopment of the digestive system of a child under two years of age. With the right approach to nutrition and treatment, such a reaction disappears by the age of five. The main thing is not to confuse a true allergy with lactase deficiency and other diseases.

Mom can test for lactase deficiency at home, report the results to the doctor. All milk-containing products are removed from the child's diet. The baby is transferred to a lactose-free formula. If the child is breastfed, the mother herself adheres to a lactose-free diet. With a deficiency of the lactase enzyme, digestion returns to normal as soon as the products containing it are removed from the body, that is, the very next day.

Allergens will be present in the blood for several more days, so the symptoms will not go away so quickly. In addition, allergy is also distinguished by the fact that its manifestations help to remove antihistamines, while with lactase deficiency, even after taking them and further consuming dairy products, the symptoms will not go away.

Allergy to milk protein, as well as lactase deficiency, disappears, as a rule, by 2-3 years, when the digestive system develops, all the necessary enzymes are produced.

Video: How to recognize lactase deficiency

Milk allergy treatment

The main rule in the treatment of allergies is the elimination of the allergen, without this, any medications will have only a temporary effect, and with their constant intake, addiction develops altogether.

Nutrition Features

If a baby has an allergy to milk, a nursing mother should follow a hypoallergenic diet by excluding whole milk from the diet. At the same time, in most cases, the use of sour-milk products is not prohibited. The same goes for older children. As soon as they have a confirmed allergy to milk, it is removed from the diet.

As a rule, allergies do not apply to sour-milk products. During fermentation, milk protein is broken down into simple amino acids, and it is much easier for the child's digestive system to digest it. From 7-8 months, it is allowed to carefully introduce yogurt, cottage cheese, fermented baked milk into the children's diet.

It should be remembered: The use of any dairy products is allowed only with the label "for children", as manufacturers often take into account the high percentage of milk allergy and subject their products to additional processing to facilitate digestion. But in this case, the development of allergies is not excluded.

Often mothers replace cow's milk with goat's milk in the hope that the child will not react to it. Indeed, it has a different composition and a different set of proteins, less aggressive for a child, however, an allergy to goat's milk is also possible. In the nutrition of children under one year old, it is better not to use milk at all; with mixed or artificial feeding, preference is given to children's adapted mixtures.

Choosing an adapted formula for formula-fed babies

Most infant formulas are made from cow's milk. If a child has a confirmed allergy to it, such a mixture will have to be replaced. Most often, mixtures based on goat's milk or special hydrolysates are recommended, where proteins are already split into amino acids (mixtures of FrisoPep AS, Nutricia Pepticate, Nutrilon Pepti TSC). Such mixtures are hypoallergenic also because they do not contain lactose and gluten.

There are mixtures with incomplete protein breakdown. They are recommended for children who have a genetic predisposition to milk intolerance to prevent the development of allergies. These are "Nutrilon Hypoallergenic", "NAN Hypoallergenic", hypoallergenic mixtures "HiPP", "Humana".

After six months, the child can try to give a few milliliters of the usual mixture, gradually increasing the volume. If the reactions return, the introduction of the product should be postponed for another 2-3 months.

Video: Dr. Komarovsky on choosing a mixture for milk protein allergies

Medical treatment

If allergy symptoms bother the child, you should give him an antihistamine drug that will relieve itching and swelling (suprastin, loratadine, fenistil, zodak, erius, zyrtec and others). Dosages of drugs differ from adults, it is advisable to consult a pediatrician before using them.

Anti-allergic drops (allergodil, histimet), vasoconstrictors (naphthyzine, tizin, nazol, nazivin) or combined action (vibrocil) will help relieve swelling from the nasal mucosa and restore nasal breathing.

To improve digestion and the speedy removal of allergens and toxins, enterosorbents (polysorb, polyphepan, smecta, enterosgel, activated charcoal), preparations for restoring intestinal microflora (linex, bifidumbacterin, bifiform, normobact and others) are used.

Ointments and creams based on dexpanthenol (panthenol, bepanthen), moisturizing creams or cosmetic oils (peach, almond) will help restore the skin (with the formation of ulcers, eczema, cracks, dryness and flaking of the skin).

Video: What to do if a child is allergic to milk

B-lymphocytes carry out a different type of immunity. If necessary, they transform into plasma cells that do not attack the allergen on their own, but produce antibodies of various classes that destroy it on their own or with the help of the complement system and T-lymphocytes. Thus, humoral or extracellular immunity is carried out.

Stage of biochemical reactions

bio stage chemical reactions develops with repeated contact of the allergen with the human immune system. T-lymphocytes and antibodies actively migrate to the site of contact and begin to destroy the antigen. Along the way, a number of substances are released, which lead to the appearance of classic signs of allergy, such as rash, itching, fever, shortness of breath, etc. These substances, first of all, include histamine, serotonin and bradykinin. These substances, otherwise called inflammatory mediators, are produced and stored in special mast cells and released under the influence of the command of any immune cell.

Being released into the tissue, they dilate the vessels in the affected area, thus slowing down the blood flow and improving the conditions for the deposition of lymphocytes on the vascular wall. Settling on the vascular wall, lymphocytes penetrate through it into the focus of an allergic reaction and come to grips with the allergen. Slowing blood circulation has another goal - limiting the spread of the allergen through the bloodstream throughout the body. This mechanism is extremely important, because with its inferiority, anaphylactic reactions develop, which pose a threat to life.

Together with histamine, serotonin and bradykinin, other inflammatory mediators are included in the allergic process, which indirectly or directly affect the course of the allergic process. These include various interleukins, cytokines, leukotrienes, neurotransmitters, tumor necrosis factor, and many other factors. Together, they provide an increase in body temperature, itching and pain reaction.

Stage of clinical manifestations

This stage is characterized by the response of tissues to the release of biologically active substances. Since milk is one of the most powerful allergens, the range of the body's response will be large - from simple urticaria to anaphylactic shock. The severity of clinical manifestations directly depends on the dose of the allergen, the rate of its spread throughout the body, the degree of sensitivity of the immune system to it, and the state of the immune system itself. Also, the reaction of the body may differ in terms of manifestation. So, there are four main types of allergic reactions. The first, second and third types proceed as an immediate hypersensitivity reaction. In this case, the count goes for seconds, minutes, less often for hours. The fourth type of allergic reactions proceeds as a delayed-type hypersensitivity reaction. With this type, an allergic reaction develops within hours or even days.

Possible manifestations of a milk allergy are:

allergic rhinitis;
headache;
skin manifestations;
bronchospasm;
anaphylactic shock.

Risk Factors Contributing to the Development of Milk Allergy

An allergy to breast milk can develop in a newborn baby, and an adult can develop an allergy to the milk of mammals. The mechanism of allergization of the body is almost identical in both cases, but the factors leading to allergies are different. That is why risk factors are conditionally divided into congenital and acquired, and acquired, in turn, into those acquired in the first year of life and after the first year.

Risk factors leading to congenital milk allergy:

hereditary predisposition;
the use by the mother during pregnancy of highly allergenic foods;
excessive consumption of milk during pregnancy;
intensive drug therapy during toxicosis;
insufficiency of secretory immunity;
features of the immune response;
changes in the innate balance of pro-inflammatory and anti-inflammatory cytokines;
increased sensitivity of peripheral tissues to allergy mediators;
violation of the enzymatic activity of phagocytes;
congenital violation of the processes of deactivation of biologically active substances.

hereditary predisposition

Some nationalities and ethnic groups have a genetically programmed deficiency of certain enzymes that digest milk proteins. Representatives of such a population are some nomadic tribes of the northern regions of Siberia. Drinking milk causes severe diarrhea and abdominal pain in them, and also makes the body more sensitive to this product. With the repeated use of milk in these people, allergy symptoms are added to the usual symptoms of intolerance, which, as previously indicated, can be very diverse.

Maternal consumption of highly allergenic foods during pregnancy

It is clinically proven that children born to mothers who allowed themselves the use of highly allergenic foods during pregnancy also had an allergy to certain substances, including milk. These foods include cow's milk, eggs, fish, peanuts, soybeans, citrus fruits, strawberries, strawberries, black currants, hazelnuts, crustaceans and even wheat. This does not mean that these products should be completely excluded from the diet, but they should be used extremely moderately, knowing about possible consequences. The reason is that in utero the fetus receives nutrients from the mother's body through the umbilical cord. Those nutrients that circulate in the mother's blood can interfere with the fetus's developing immune system. The result of such malfunctions, as a rule, is a violation of the body's immune tolerance to certain substances.

Excess milk consumption during pregnancy

Milk is a high-calorie and valuable product in terms of protein composition. However, if it is consumed in excess, part of the milk proteins reaches the intestines in an insufficiently prepared form for absorption due to the limited resource of its digesting enzymes. As a result, some of the large, undigested milk proteins are absorbed unchanged. Since these proteins are unknown to the body, the cells of the mother's immune system absorb it, and when milk is subsequently ingested, even in normal quantities, it causes allergies in both the mother and the child due to the close interaction of the immune systems of the two organisms during pregnancy.

Intensive drug therapy during toxicosis of pregnancy

Toxicosis develops as a reaction of the mother's body to the fetus growing in it. It develops when there is an imbalance between factors that support pregnancy and immune system factors that tend to reject the fetus as a foreign body. During toxicosis, millions of chemical reactions occur in the mother's body every second. Many biologically active substances are released into the blood, which, in parallel with their direct effect, significantly change general state mother herself. In such conditions, all systems of her body and the body of the fetus are working for wear and tear.

When layering on this state of any other disease, such as pneumonia, cystitis or sinusitis, it becomes necessary to take such medicines as antibiotics, antipyretic or pain medications. These medicines have side effect manifested by the development of the syndrome of instability of cell membranes. The essence of this syndrome is the release of allergy mediators even with the slightest irritation. Since the mother and fetus are closely related, this syndrome will manifest itself in the child and may persist for life. One of its manifestations is an allergic-like reaction to any substance ( milk, strawberries, chocolate, etc.) or a physical factor (), provoking the release of allergy mediators.

Lack of secretory immunity

Many glands of internal and external secretion of the body secrete a secret containing substances that neutralize many potential allergens before they come into contact with the mucous membranes of the body. These substances include lysozyme and class A immunoglobulins. In addition, the mucus itself performs a protective function, since it prevents direct contact of the allergen with the mucous epithelium, while simultaneously increasing the time taken for lysozyme and immunoglobulin A to destroy a substance that can cause allergization of the body. Some people have a congenital deficiency of protective substances in saliva, lacrimal fluid and the secretion of the cone glands. This leads to the fact that an aggressive substance, which may include milk, freely penetrates into the blood and, upon repeated contact with them, causes the development of an allergic process.

Features of the immune response

The immune system healthy person is distinguished by a clear balance of the number of its certain elements and well-functioning interaction between them. Under the influence of numerous factors, disturbances in the correct intrauterine development of the immune system can occur. As a result, immune cells may become excessively active, the number of antibodies will exceed normal values, and the ratio between their various classes will be disturbed. The above changes will contribute to an increased allergic background, in which any substance, and even more so milk, will cause an allergic reaction.

Altering the innate balance of pro-inflammatory and anti-inflammatory cytokines

Cytokines are substances that regulate the speed and intensity of the inflammatory process in the body. Pro-inflammatory cytokines increase the inflammatory process, while anti-inflammatory cytokines, on the contrary, reduce it. Since the allergic process is a specific inflammation, it is also subject to the influence of cytokines. With certain disorders of embryonic development, there is a shift in the balance towards pro-inflammatory cytokines, leading to the fact that the child is born with increased reactivity. In such a situation, milk, being a strong allergen, will provoke sensitization of the body and the development of an allergy to this product in the future.

Hypersensitivity of peripheral tissues to allergic mediators

The main mediators of allergy are histamine, serotonin and bradykinin. When these substances interact with tissues, symptoms characteristic of the inflammatory process develop. In the case when peripheral tissues are highly sensitive to the above mediators, the tissues respond to irritation of normal strength too actively, and the usual inflammation develops into an allergic process.

Violation of the enzymatic activity of phagocytes

Phagocytes are called cells of the macrophage system, located both in the blood and in other tissues of the body, which perform the function of collecting and destroying various substances that have fulfilled their function, fragments of dead cells, even harmful bacteria. One of the functions of phagocytes is the absorption and destruction of allergy mediators. In the case of a slow metabolism of these cells, allergy mediators are more long time are located in the tissues and, accordingly, have a more pronounced effect. At the same time, the allergic background of the body increases, and milk, being a strong allergen, most likely sensitizes the immune system and, if it enters the body again, will cause an allergic reaction.

Congenital violation of the processes of deactivation of biologically active substances

Biologically active substances released in large quantities into the tissues of the body during a relapse of an allergy should be promptly removed and rendered harmless. These substances include hormones, neurotransmitters, mediators of various phases of the inflammatory process, etc. The neutralization of these substances is carried out by the previously mentioned phagocytes, as well as liver and kidney enzymes. Some of the substances bind to blood proteins and circulate in it in bound form until the detoxifying enzymes are released. With insufficient function of neutralizing systems, biologically active substances accumulate and cause an increase in the allergic background.

Risk factors leading to milk allergy in the first year of life:

failure of a hypoallergenic diet during breastfeeding;
late attachment to the breast;
early artificial feeding.

Breaking a hypoallergenic diet while breastfeeding

During pregnancy and especially during lactation, a woman must, without fail, follow a diet that excludes the most allergenic foods. If such a diet is violated, some elements of prohibited foods enter the milk in less than 2 hours after consumption. When such milk enters the underdeveloped gastrointestinal tract of a child, highly allergenic products are absorbed unchanged in the intestine. This is due to the fact that the enzymes that must process them are either not yet present in the intestines, or are present, but in insufficient concentration. As a result, an increased sensitivity of the child's immune system to a particular allergen develops. Cow's milk in the same way can cause an allergy in a child when consumed by his mother, especially if she has the lowest tolerance for milk.

Late attachment to the breast

According to the latest guidelines in obstetrics and gynecology, the newborn should be attached to the mother's breast no later than 2 hours after birth. This measure is intended to shorten the period during which the intestines of the newborn remain empty, or more precisely, not containing mother's milk. Breast milk and especially colostrum a thick, whitish, sticky substance that comes out of the breasts during the first 2 to 3 days of breastfeeding) contain a large number of antibodies that destroy pathogenic microbes that already inhabit the intestines of the newborn. With an increase in this period to 5-6 hours, 70% of newborns develop dysbacteriosis, which is a factor contributing to the appearance of an allergy in a child even to breast milk, despite the fact that it is the most suitable product for his nutrition.

Early artificial feeding

The quality of artificial infant formula has greatly improved today. They contain almost all the components that are in breast milk and even those with which it could be enriched. However, they have one important drawback - the absence of antibodies. It is the antibodies that support the child's immunity against those infections that the mother's body has encountered throughout her life. The mother's milk-borne antibodies protect the baby until its own immunity can protect the body on its own. In other words, as long as a child is fed with breast milk, he is much better protected from infections than if he were fed the best artificial mixtures that exist today. Accordingly, if there is a risk of infection, there is also a risk of developing allergies, since many infections create conditions for the penetration of potential allergens into the bloodstream.

Risk factors leading to acquired milk allergy after the first year of life:

pathology gastrointestinal tract;
liver disease;
helminthic invasion;
unreasonable intake of immunostimulants;
aggressive environmental factors;
acquired hypovitaminosis;
long-term use of ACE inhibitors.

Pathology of the gastrointestinal tract

As mentioned earlier, the gastrointestinal tract ( gastrointestinal tract) is a kind of barrier that prevents the penetration of the allergen into the body in the form in which it could harm it. Gradual exposure of milk as a potential allergen to first acidic and then alkaline environments, various enzymes and intestinal microflora deprives it of antigenic properties and the ability to interact with the immune system.

In the presence of a disease of one of the sections of the digestive system ( gastritis, gastric ulcer, chronic duodenitis, etc.) milk is less carefully processed. Absorbed into the blood in the form of a large molecule, it is perceived by the body not as nutrient, but as an aggressive factor that must be destroyed. Upon repeated contact with it, the inflammatory process can begin even before it penetrates into the blood, for example, in the intestinal lumen. In this case, the patient will have diarrhea and pain throughout the abdomen, the body temperature will rise. The appearance of a rash will indicate the allergic nature of the disease and, together with the fact of drinking milk, a diagnosis of allergy to this food product will be established.

Diseases of the liver and gallbladder

The liver is an organ that secretes bile into the intestinal lumen, which is involved in the breakdown of milk fats. The gallbladder has the ability to accumulate and concentrate bile in order to allocate it to a certain phase of digestion and accelerate the breakdown of fats. When one of these organs becomes ill, their function suffers, and the digestion of milk is incomplete. With the penetration of undigested milk molecules into the blood, an allergization of the body with this product develops.

Children after the first year of life are more likely to develop subacute or chronic pain. Pain is better localized compared to earlier age. Pain in the umbilical region indicates acute enteritis of an allergic nature. At the same time, the nature of the pain is undulating, so the child's behavior will change. Periods of crying will be replaced by periods of rest. The mechanism of pain in this case is associated with peristaltic waves of the intestine. The inflamed and edematous intestinal mucosa contracts and stretches to the beat of peristaltic waves, which provokes the appearance of pain. With a slight pressure on the abdomen, no abnormalities are determined or a slight bloating is determined. The chronic course of an allergy to milk is dangerous because it is sluggish, and the mother will not always be able to guess about the incompatibility of this product with the child's body and will not exclude it from the diet. This can eventually lead to chronic pancreatitis, cholecystitis, and cholangitis, as well as intestinal enzyme deficiencies with the development of secondary celiac disease.

In adults, the symptoms of lesions of the gastrointestinal tract, as a rule, are less pronounced than in children and are reduced to pain in the stomach. The appearance of pain, in this case, is associated with an excessive accumulation of histamine in the blood during the phase of active clinical manifestations of allergy. Histamine is one of the substances that increase the acidity of gastric juice. With increased acidity, the mucus covering the stomach is corroded, and hydrochloric acid gradually destroys the stomach wall. This explains the concomitant gastric and duodenal ulcers, as well as the frequent feeling of heartburn in patients with a long-term allergy to milk. The nature of the pain is undulating. Against the background of an empty stomach, the pain intensifies, and when eating any food, it subsides, and then reappears. This phenomenon is associated with a decrease in the acidity of gastric juice when it is diluted with food.

Dyspnea
This symptom appears only with the rapid and aggressive course of the allergic process and requires emergency medical care and follow-up in the intensive care unit.

There are several types of shortness of breath depending on the duration of the various phases of breathing:

inspiratory;
expiratory;
mixed.

Inspiratory dyspnea develops when there is an obstruction to the passage of air into the lungs. With an allergy to milk, swollen vocal cords and less often greatly enlarged tonsils become this obstacle. With this type of shortness of breath, inhalation is difficult and lengthened, and exhalation is normal.

expiratory dyspnea develops when an allergic reaction triggers an asthma attack, the main manifestation of which is bronchospasm. As a result, air passes freely into the alveoli, and exits only when a certain effort is applied. With this type of shortness of breath, inhalation is free and short, and exhalation is long and labored. At the time of the attack, patients are forced to take a specific position in which their hands rest on a table, chair or window sill. In this position, the upper shoulder girdle is fixed, and in addition to the diaphragm, the intercostal and scalene muscles are connected to the act of breathing, further reducing the chest and expelling air out. Exhalation is accompanied by a specific whistle, audible at a distance.

Mixed dyspnea with an allergy to milk, as with any other allergy, it develops infrequently. In one case, its occurrence is associated with a rare Heiner's syndrome, in which, in response to the use of cow's milk, an allergic reaction develops, manifested by primary hemosiderosis of the lungs and their edema. In another case, the appearance of mixed shortness of breath is caused by acute heart failure. Due to the need for the heart to work hard with a decrease in blood pressure against the background of anaphylactic shock, myocardial infarction develops. With the development of myocardial infarction, stagnation of blood in the lungs occurs, gradually turning into pulmonary edema. With this type of breathing, the patient tends to take vertical position. Breathing is frequent and shallow. On the face is an expression of panic and fear of death.

Cyanosis
Cyanosis is a skin manifestation of shortness of breath and lack of oxygen in the tissues. The color of the skin and mucous membranes changes to blue, gray and, in an extremely serious condition, to lilac-violet. This is due to the fact that hemoglobin ( a protein found in red blood cells and responsible for gas exchange processes), binding carbon dioxide, takes on a dark color compared to the combination of hemoglobin with oxygen, which is scarlet red. With prolonged oxygen starvation, hemoglobin compounds with carbon dioxide begin to predominate in the blood, which stain the blood in a dark color.

Earlier and more intensely stained areas of thin skin and the most distant parts of the body from the body. Usually cyanosis begins with a slight cyanosis of the nasolabial triangle and fingers. With the progression of hypoxia ( lack of oxygen in tissues), blueness extends to the skin of the hands and forearms, the feet and lower legs are involved. Cyanosis of the trunk and in particular the chest is a poor prognostic sign.

Cough
This symptom is a reflex response of the body to irritation of the receptors of the larynx. In the case of an allergy to milk, a cough occurs when angioedema spreads to the larynx. The respiratory epithelium lining the mucosa of this organ becomes excessively irritated. As a result, even normal respiratory flows or minor change temperature or humidity of inhaled air can cause coughing. The typical cough of laryngotracheitis is barking and harsh. It is characterized by a paroxysmal course with a long breath - a reprise.

Hoarseness of voice
Hoarseness develops for the same reason as a cough, but in this case, the swelling extends to the vocal cords. As a result, the ligaments swell, thicken and stop producing sound when air flows through them. As the glottis narrows, the voice disappears completely, and the air passes into the lungs with a characteristic quiet whistle.

Ear congestion
This symptom is not specific to milk allergy. Rather, it is associated with inflammation in the oral cavity and nasopharynx. With an allergic lesion of these departments, swelling of the Eustachian tubes develops - hollow canals that communicate the middle ear cavity with oral cavity. The main task of these channels is to maintain the same pressure in the tympanic cavity and in the atmosphere. This mechanism ensures the safety of the tympanic membrane and maintains the function of hearing during sudden changes in pressure, which occur, for example, during a fall and climb, during explosions.

Autonomic disorders

Vegetative disorders are manifestations of compensatory mechanisms designed to restore balance, disturbed due to the allergic process. These mechanisms are activated mainly in life-threatening conditions, a striking example of which is anaphylactic shock. According to statistics, at least half of the deaths from anaphylaxis occurred after drinking milk.

With an allergy to milk, the following vegetative disorders develop:

heartbeat;
frequent breathing;
dizziness, nausea and loss of balance;
loss of consciousness.

heartbeat
This symptom is the body's response to a sharp decrease in blood pressure during the development of anaphylactic shock. It is felt by the patient as a tingling sensation in the chest Feeling like your heart is about to jump out. Palpitations are accompanied by a feeling of discomfort and incomprehensible anxiety. The heart rate increases to maintain blood pressure. Upon reaching a value of 140 beats per minute, a threshold occurs, after which an increase in heart rate does not make sense, since it is no longer effective. However, with a further drop in pressure, the heart rate continues to increase to 180, 200 and even 250 beats per minute. At this rate, the heart muscle is soon exhausted, and the normal rhythm is replaced by arrhythmia. In the absence of medical intervention at a given moment, arrhythmia entails a repeated drop in blood pressure to zero values. Blood circulation stops, and the brain, which is the most sensitive organ to hypoxia, dies after an average of 6 minutes.

Rapid breathing
Tachypnea or rapid breathing is also a consequence of a drop in blood pressure. On the one hand, it is due to the fact that the blood flow rate decreases, the tissues receive insufficient oxygen and report this to the brain. The latter increases the oxygen content in the blood by increasing the frequency of respiratory movements. On the other hand, increased heart rate is associated with the patient's emotional response to a sharp deterioration in the condition.

Dizziness, nausea and loss of balance
The above symptoms develop as a result of oxygen starvation and a decrease in the functions of the cerebellum. This part of the brain is responsible for maintaining a constant tone of skeletal muscles, as well as their coordinated work. If its functioning is disturbed, a swagger of gait occurs, the accuracy of movements is lost, the handwriting becomes large and sweeping, there is a feeling of a sharply increased weight of one's own body. The adoption of a horizontal position improves the blood supply to the cerebellum and temporarily restores the patient's condition. However, with the further development of anaphylactic shock, the symptoms return and worsen.

Loss of consciousness
Syncope, otherwise known as loss of consciousness, develops when systolic blood pressure is less than 40 - 50 mm Hg. Art. It is caused by acute oxygen starvation nervous tissue of the brain. In the absence of oxygen, communication between the cortex and subcortical structures slows down. When the activity of these brain structures is completely disconnected, the patient falls into a coma. The duration of the patient's stay in this state determines how great the chances of complete rehabilitation after returning him to consciousness are.

Diagnosis of milk allergy

Timely and accurate diagnosis of milk allergy is extremely important in light of the complications it can entail. In addition, a correct diagnosis proper treatment and maintaining a proper lifestyle. Ultimately, all of the above measures lead to the maximum reduction of the negative effects of milk allergy and improve the overall quality of life.

Which doctor should I contact in case of problems?

An allergist is a specialist who is directly involved in the treatment of allergic diseases, and in particular in the treatment of allergies caused by milk. Some symptoms and complications of the allergic process can be treated by other specialists. A dermatologist deals with the treatment of skin manifestations of allergies. A nephrologist treats chronic recurrent glomerulonephritis, which may be initiated by an allergic process. A rheumatologist will be helpful if it is necessary to differentiate allergies from one of the rheumatoid diseases, the skin manifestations of which are very similar to allergic ones. A pulmonologist treats bronchial asthma, which often occurs in patients with a long-term allergy to milk. A general practitioner treats allergies of mild to moderate severity.

At the doctor's appointment

Arriving at the doctor's appointment, the patient must fully concentrate on his illness and provide the specialist with all the information he needs. Sometimes the doctor has to ask the patient about some of the nuances that the latter would not want to talk about. Even in spite of this, the patient should answer unpleasant questions, since in some cases it is these answers that allow shedding light on the cause of the disease, even if they seem insignificant and irrelevant to the patient himself.

The most likely questions from the attending physician include:

What manifestations of allergy does the patient complain about?
What provokes the appearance of allergic conditions?
How does the body come into contact with the allergen?
After drinking how much milk do allergy symptoms appear?
How long after drinking milk does an allergic reaction develop?
How often does an allergic reaction occur on average?
Do allergy symptoms go away on their own or do you have to resort to the use of medications?
What medications does the patient use and how effective are they?
At what age did the first signs of allergies appear?
Are there allergies to substances other than milk?
Does the patient have relatives suffering from allergic diseases?
Is it possible that the allergic symptoms are caused by another substance and masked by the consumption of milk ( allergic to lead, present in the paint applied to the cup; allergy to milk packaging polyethylene; allergic to industrial preservatives, etc.)?
What else does the patient eat, what hygiene products does he use in everyday life?
Are there comorbid chronic diseases?
What drugs does the patient take daily for concomitant diseases?

Patient examination
It is extremely successful if the patient goes to the allergist during the manifestation of an allergic reaction. In this case, the doctor has the opportunity to observe with his own eyes all the existing symptoms and immediately conduct some examinations to clarify the allergic nature of the above manifestations. To do this, it is necessary to demonstrate to the doctor the places where the symptoms are present most abundantly. For example, a rash often appears on the intimate parts of the body. Despite its complex localization, the rash must be shown to the doctor, as it may be a symptom of another disease. For example, a rash on the buttocks and legs is one of the first signs of a meningococcal infection, which is much more dangerous than allergies. However, if there are no signs of allergy at the time of the visit to the doctor, then in no case should they be provoked by the intentional use of milk. Practice shows that after such a provocation, patients often do not have time to even reach the handset and call ambulance not to mention a visit to the doctor.

The presence of allergy symptoms at the time of examination definitely simplifies the diagnosis, but even in their absence, the doctor can assume the degree of their severity by indirect residual effects on the skin. In addition, it would be very helpful if the patient had photographs taken at the time of the recurrence of the allergic reaction. It is desirable that the photographs are clear, taken from various angles in good lighting.

Laboratory diagnostics

In addition to taking anamnesis of the disease and examining the patient, a series of laboratory tests and provocative tests are usually performed to finally establish the diagnosis.

The following laboratory tests and clinical tests are used to confirm a diagnosis of milk allergy:

immunogram;
detection of lymphocytes and antibodies sensitized to milk proteins;
scarification tests.

General blood analysis
This analysis can be called routine, but it often orients the attending physician towards the alleged group of diseases. With an allergic disease, the number of leukocytes will be moderately increased ( 12 – 15 * 10 ^9 ), and their largest fraction will be eosinophil cells ( more than 5%). The erythrocyte sedimentation rate will also be moderately increased to 15-25 mm/h. These data are not specific to any allergen. Moreover, they can indicate with the same degree of probability the presence of helminths in the body.

General urine analysis
With proper urine sampling ( cleanly washed genitals and collection of a medium portion of urine in a sterile container) and good laboratory conditions, this analysis can provide important information about the development of the allergic process. First of all, the level of protein will be increased, which indicates a general inflammatory process. The appearance of erythrocytes in the urine indicates the failure of the filtration function of the renal nephrons, which develops during inflammatory processes in this organ. Sometimes in the urine cylinders containing whole or dilapidated eosinophils are determined. Their finding indicates an allergic lesion of the renal tissue and the development of glomerulonephritis as a complication of milk allergy.

Blood chemistry
In this laboratory study, the acute phase proteins of inflammation ( C-reactive protein, tumor necrosis factor, etc.). In addition, an increase in the number of immune complexes circulating in the blood will indicate the course of an allergic reaction.

Immunogram
The immunogram represents the ratio of different classes of immunoglobulins ( antibodies) circulating in the blood. An allergic reaction is characterized by the predominance of class E immunoglobulins, but sometimes there are allergic reactions that occur without their involvement.

Detection of lymphocytes and antibodies sensitized to milk proteins
This laboratory analysis is one of the most accurate basic analyzes that establishes a direct relationship between the consumption of milk and the development of an allergic process in a single individual. The accuracy of this analysis approaches 90%.

Scarifying tests
In addition to laboratory tests in allergology, the use of skin prick tests is often practiced. During their implementation, shallow scratches 0.5–1.0 cm long are made on the skin of the forearm or back, on which one drop of a different allergen is applied. Near each scratch, a brief designation of the allergen that was applied is inscribed with a pen. In the case of an allergy to milk, various proteins, fats and carbohydrates that are part of it are used separately as allergens. According to the latest data, milk contains about 25 antigens, each of which can provoke an allergic reaction. After a certain time, an inflammatory shaft is formed around one or more scratches, which is larger in size than around the other scratches. This means that the body shows an allergic reaction to this component of milk.

Milk allergy treatment

Milk allergy treatment should be taken seriously. First of all, it is necessary to change the lifestyle in such a way as to completely exclude this allergen from the diet. Periodically, you should undergo preventive treatment courses aimed at reducing sensitization to milk. Finally, it is extremely important to help the patient correctly and in a timely manner in the midst of an allergic reaction, since this often determines his future fate.

Drug treatment in the acute period of allergy

Allergy medications

Drug group	Elimination of symptoms	Mechanism of action	Representatives	Mode of application
Antihistamines	Rash, swelling, itching, shortness of breath, cough, hoarseness,	Termination of histamine synthesis and acceleration of its destruction processes in tissues	*Gel:*	1 - 2 times a day in a thin layer, externally
			Fenistil
			Rash, swelling, itching, shortness of breath, nausea, dizziness, cough, hoarseness, nasal congestion, ear congestion, abdominal pain		*Injections:*	4 - 8 mg 1 - 2 times a day intramuscularly
			Dexamethasone
			Topical corticosteroids	Rash, swelling, itching, shortness of breath	Powerful anti-inflammatory, anti-allergic and immunosuppressive action	*Ointment:*	0.1% thin layer 1-2 times a day externally
						Advantan
						*Spray:*	200 - 400 mcg ( 1 – 2 poufs) 2 times a day, inhalation
						Budesonide
			Mast cell membrane stabilizers	Edema, rash, itching, shortness of breath, cough, hoarseness	Increasing the excitability threshold of mast cell membranes	*Pills:*	1 mg 2 times a day, by mouth
						Ketotifen
Systemic adrenomimetics	Dizziness, loss of balance, loss of consciousness	constriction blood vessels and strengthening of the heart	*Injections:*	0.1% - 1 - 2 ml intravenously slowly! During resuscitation
			Adrenalin
Local adrenomimetics	Nasal congestion	Powerful vasoconstrictor action, edema reduction	*Nasal drops:*	0.1% 2-3 drops 4 times a day, intranasally
			Xylometazoline
Bronchodilators	Dyspnea	Constriction of the blood vessels of the bronchi and relaxation of the muscles of their wall	*Spray:*	1 - 2 puffs ( 0.1 - 0.2 mg) not more than 1 time in 4 - 6 hours, inhalation
			Salbutamol
			*Injections:*	2.4% - 5 ml in 5 - 10 ml of saline, intravenously slowly!
			Eufillin
Local anesthetics	Cough, itching	Increased excitability threshold of nerve receptors	*Gel:*	5% thin layer 1-2 times a day, externally; 0.3 g 3-4 times a day inside
			*Drops:*
			Benzocaine
Antispasmodics	Vomiting, abdominal pain	Relaxation of smooth muscles	*Injections:*	2% 1 - 2 ml 2 - 4 times a day intramuscularly
			Papaverine
			Drotaverine	1% 2 - 4 ml 1 - 3 times a day intramuscularly
Antidiarrheals	Diarrhea	Acceleration of reabsorption of fluid from the intestinal lumen	*Capsules:*	4 - 8 mg per day, by mouth
			loperamide
Eubiotics	Diarrhea	Restoration of normal microflora in dysbacteriosis in chronic allergy sufferers	*Capsules:*	1 capsule 2 times a day, orally
			subtil
Enzyme preparations	Abdominal pain, diarrhea	Compensation of missing intestinal and pancreatic enzymes in chronic allergy sufferers	*Pills:*	1 - 2 tablets 3 times a day, inside
			Festal
			Mezim	1 - 2 tablets 3 times a day, inside
Cholagogue	Abdominal pain, diarrhea	Elimination of bile deficiency in chronic allergy sufferers	*Pills:*	1 tablet 2-3 times a day, orally
			Holiver

Hyposensitization of the body

The treatment of allergies by the method of desensitization and hyposensitization was introduced at the beginning of the twentieth century and has not changed significantly since then. There are two approaches. The first one is practically not used due to the high risk to the patient's life and dubious effectiveness. It consists in the fact that a concentrated solution of the same allergen is intravenously injected into the body of a patient with an allergy to milk or to a certain component of it. Contrary to expectations, an allergic reaction does not develop due to the fact that the immune system is paralyzed for a while big amount foreign antigen. The disadvantage of this method is that an error associated with an incorrect calculation of the dose of the allergen can lead to the development of anaphylactic shock, from which it is not always possible to get the patient out even if the necessary medicines are available. In case of success, the effect, as a rule, is not very long and the body's sensitization to milk is restored.

The second approach is more practical and most commonly used. According to the author, this method is called "hyposensitization according to Bezredko". Its principle is the regular intravenous administration of a small dose of a solution containing the allergen to a patient with an allergy to milk. The dose of the allergen should be such that, on the one hand, it provokes a weak response of the immune system, and on the other hand, it does not lead the patient into anaphylactic shock. As treatment progresses, the dose is gradually increased until the patient can consume the pure product. This method is more often used for allergies to substances, contact with which cannot be limited without compromising the quality of life of the patient ( dust, gasoline, etc.). Milk is a product that can be painlessly removed from the diet and replaced by other products with a similar composition. Therefore, this method is rarely used, despite the fact that it shows good results. With an allergy to one component of milk, a complete cure occurs in 90% of patients. With an allergy to two or more components, the effectiveness is reduced to 60%.

Lifestyle

Since milk is not vital necessary product nutrition, it can be easily replaced with other products with a similar chemical composition that won't cause allergies. Therefore, the patient is required to comply with the only rule - the complete exclusion of milk and dairy products from the diet.

It is important to remember that even after many years of preventive treatment, when, it would seem, the allergy is completely cured, contact with milk should not be allowed. The first contact after a long break will not cause a violent allergic reaction due to the fact that over time the titer of antibodies to milk will decrease many times over. However, after a few days, the immune system will develop new antibodies, and upon repeated contact with milk, the allergic reaction will be much more pronounced.

It is also recommended, along with the allergen, to exclude from the diet foods rich in histamine and those that have an increased histamine-releasing effect. These foods include strawberries, citrus fruits, legumes, sauerkraut, nuts, and coffee.

Prevention of milk allergy

In some cases, milk allergy can be prevented. In this case, we are talking about the behavior of the mother during pregnancy and lactation and its impact on the development of the fetus. In the case when an allergy to milk has already manifested itself, there is nothing left but to minimize the contact of the body with this substance.

What do we have to do?

During pregnancy, drink milk no more than 2 times a week, 1 glass per dose;
Exclude from the diet foods containing a large amount of histamine;
Instead of milk, use fermented milk products;
Exclude industrial canning products from the diet;
Introduce complementary foods later than expected if the family has relatives with allergic diseases;
Periodically take preventive courses of treatment for allergies;
Provide yourself and close relatives with a first aid kit for allergies;
Restore the lack of substances present in milk by taking additional vitamins and microelements;
Receive antihelminthic treatment once or twice a year.

What should be avoided?

Late attachment of the newborn to the breast;
Failure of the hypoallergenic diet in the mother;
Early artificial feeding;
stressful situations;
Prolonged course of intestinal disorders and dysbacteriosis;
Aggressive environmental factors;
Uncontrolled intake of immunostimulants.