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Article: Milk Intolerance

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There is nothing more worrying for a parent than when your baby becomes ill, whether it be a common cold or something more serious. More often than not your child will suffer a few unsettled days and nights but will soon return to their normal health. However, extended or repeated periods of ill health can be traumatic not only for your child but also for you as parents. The problem comes with distinguishing what are inevitable bouts of illness in a child passed on from adults or other children, and what are abnormal episodes. This article describes our own experience of a milk intolerant child, along with definitions and symptoms, and some useful links for further information.

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Our Experience

Our own experience started relatively well following the birth of our oldest son, followed with what we assumed were just traits of a young baby adjusting to the world - bouts of unexplained crying and a liking for being rocked off to sleep in our arms, only to wake when put down! As first time parents we weren't to know any different, and we assumed these were normal signs of a sensitive baby with an immature digestive system. Then came gradual feeding problems, increased fussiness during breastfeeding and a battle to sustain any sufficient weight gain. To begin with these feeding issues were put down to difficulties with breast milk production, of course if the supply of milk is low then the less time baby spends feeding, resulting in poor weight gain and a general failure to thrive. Unfortunately this is a vicious circle as the less baby feeds the less the breast is stimulated to produce more milk. 

We struggled with breastfeeding for five long months, desperate not to give up due to the pressures put on us as first-time parents, but as we started introducing solids we slowly began substituting breast milk for formula milk. To begin with, everything seemed fine with the weaning, but then the fusiness began again, accompanied by a refusal to feed and many disturbed and sleepless nights. We checked with our health visitor who was unable to provide answers to our predicament, although our doctor suggested that our son may have a lactose intolerance which would explain his behaviour, and that we should try feeding him on soya milk (Wysoy). An improvement was certainly noticeable, although we were subsequently advised that this was not a recommended milk substitute for young babies anymore and that we should use Nutramigen instead, a prescribed hypoallergenic forumulaNutramigen which is lactose-free.

Our son was six months by now and had started nursery, however within a short while he had returned to his fussy ways, his feeding patterns were erratic, and he had constant colds, infections, and diarrhea. We naturally assumed, believing that we had solved his milk issues, that he was picking up the innevitable dose of bugs which comes with starting nursery. But as the illnesses persisted, he was becoming more and more distressed, and eating less and less, taking only very small amounts of Nutramigen first thing in the morning and last thing in the evening. The nights were unbearable for all of us, and the tiredness overwhelming, and although we had our doubts neither health visitor nor doctor seemed to have any answers. We therefore desperately struggled on believing that it was simply a difficult phase we had to face as new parents and that we were just Neocateunlucky in our experiences so far.

One day when things were particularly bad we decided that enough was enough, and armed with a diary we had been keeping of our sons eating patterns, we persuaded our doctor that he should be admitted to hospital for some tests. Various routine blood tests and examinations were carried out which showed nothing, however a dietician quickly diagnosed him as having a milk protein intolerance and he was immediately transferred onto a different hypoallergenic formula, Neocate (a more broken-down form than Nutramigen which is very unlikely to cause a reaction).

The results were incredible and within a couple of days our son was a different child. It took a good few months for total recovery, which was inevitable considering the amount of time the intolerance had been building up for, but with the new formula, accompanied by a dairy-free diet and regular check-ups with paediatricians and dieticians, our son was soon healthy, happy and putting on weight. By the age of two he had grown out of the intolerance altogether. If only this had been diagnosed earlier then we could have been saved so many months of agony! 

Our experience the first time around also allowed us to quickly identify a similar problem in our second son when he was only a few weeks old, and as a result we were able to act quickly to prevent the same thing happening again.

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Definitions and symptoms

Milk intolerance, also known as cows milk protein intolerance, is common in babies and children and is an intolerance to the protein component of milk. It is separate from milk allergy and lactose intolerance, and is difficult to diagnose as it is not a true allergy and will not give a positive result in a blood test. Children with milk intolerance can have symptoms from the first time they have cows milk, even indirectly if passed through the mother's breastmilk, and these symptoms include eczema, vomiting, diarrhoea and constipation (sometimes with blood/mucous in stools), stomach cramps, wind, and general distress and failure to thrive. From our own experience we also found that the intolerance appeared to affect our son's immune system which caused him to have a continuous succession of illnesses, more so than other children his age. Children often grow out of milk protein intolerance by the time they go to school. Treatment is normally avoidance of cows milk and cows milk products (although in some cases not total avoidance), and transfer onto a hypoallergenic formula, i.e. Neocate.


Milk allergy is also very common in childhood, and can be detected by a blood test or skin prick test. It is caused when the immune system reacts against one or more proteins (e.g. casein or whey) in the milk. When a baby has cows milk allergy he or she can react to small amounts of milk protein, either passed on through the mother's breast milk from dairy products she has eaten, or from cows milk or formula based on cows milk which has been given to the baby. The allergy occurs because the immune system fails to recognise the proteins as being harmless, and tries to eliminate them in the same way it does bacteria and viruses, by releasing toxins. It is these toxins which cause the symptoms characterisitc of milk allergy. Such symptoms include eczema, vomiting, diarrhoea, constipation, stomach cramps, breathing difficulties, hives, general distress and failure to thrive. Children usually grow out of milk allergy by the age of three. The only treatment is avoidance of cows milk and cows milk products, and transfer onto a hypoallergenic formula, i.e. Neocate.


Lactose intolerance is often confused with the above but is entirely separate. It is is caused by the body producing inadequate amounts of lactase enzyme to break down lactose, a naturally-occuring sugar found in cows milk. The symptoms are caused by undigested lactose passing into the colon, and include diarrhoea, nausea, bloating and wind, and stomach cramps. Treatment is normally a lactose-free diet, and transfer onto a lactose-free hypoallergenic formula, i.e. Nutramigen.

 

If you are at all concerned that your child may have an intolerance or allergy, then it is important that you do not start cutting out milk and dairy products from your child's diet without first seeing your GP or dietitian, as these are an essential source of nutrients such as calcium. Keep a daily diary if you can of eating, feeding and sleeping habits as this is useful for highlighting any patterns. In addition, find out if there is a history of intolerances in your immediate family as these are often hereditory. Most importantly be prepared to fight your corner - many doctors are only just becoming aware of the prevalence of such intolerances and are often slow to diagnose them. In addition, many are not up-to-date with knowledge about the various alternative formulas available so ask for immediate referral to a dietician.

 

A dairy-free diet can sound like a daunting prospect, but click here for a Neocate weaning recipe guide and also Neocate recipes for older babies. All branded jars of baby food state on the label whether they contain milk/milk products. 

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Useful links

Here are some useful links for further information on milk intolerance, milk allergy, and lactose intolerance:

http://www.babycentre.co.uk

http://www.foodreactions.org

http://www.eatwell.gov.uk

http://www.lactose.co.uk

http://www.meadjohnson.com

http://www.nutritionist-resource.org.uk 

 

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