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Infant problems usually not cow milk allergy
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Infant problems usually not cow milk allergy

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If you think your baby has a cow’ s milk allergy, and you have changed your baby’ s diet on your own, you should still talk about it with your baby’ s doctor.

Q: Since I started giving my infant daughter formula, she spits up more than before and seems fussier. Could she be allergic to the cow’s milk in the formula?

A: When young infants develop digestive symptoms or fussiness, it’s often blamed on an allergy to cow’s milk protein. When that diagnosis is made, babies on formula have to switch to a specialized formula, and the mothers of breastfeeding babies have to eliminate all dairy from their diets.

The problem is that specialized formulas are very expensive, which can be a real burden for families. And eliminating all dairy from your child’s diet can be very difficult.

However, many — if not most — of the babies who get labeled with milk allergy don’t have it at all.

There are two kinds of cow’s milk allergies. One of them is mediated through a type of immunoglobulin called IgE, which causes classic food allergy. This kind is easier to diagnose as children have more classic symptoms of allergy such as rashes, facial swelling or flushing. There are also blood tests that can help make the diagnosis.

The other kind is not mediated through IgE and is tougher to diagnose with certainty.

Babies with a non-IgE mediated cow’s milk allergy can have various symptoms, such as vomiting, fussiness during or after feeding, diarrhea, or blood in the stool. The problem is that lots of babies without allergy can have similar symptoms.

The only way to definitively diagnose non-IgE mediated allergy is to eliminate all dairy, see if the baby gets better and then reintroduce dairy again and see if the symptoms come back.

For lots of understandable reasons, many doctors and parents don’t want to do that reintroduction once a baby gets better, but the baby getting better may have nothing to do with the diet change.

According to a special communication published in JAMA Pediatrics, while 14% of babies are reported to have a cow’s milk allergy, only about 1% actually do have it.

If you think your baby has a cow’s milk allergy, and you have changed your baby’s diet on your own, you should still talk about it with your baby’s doctor. Since the symptoms may be unrelated to the dietary changes, you will want to know if that is the right diagnosis.

Remember that fussiness, and problems with feeding and stools, are very common in little babies, and the majority get better with nothing more than the passage of time.

(Claire McCarthy, M.D., is an assistant professor in pediatrics at Harvard Medical School and a senior faculty editor, Harvard Health Publishing. For additional consumer health information, please visit www.health.harvard.edu.)

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