Babies and young children can experience two types of reaction to milk: an allergy or an intolerance.
Allergy to cows' milk is the most common food allergy in childhood and affects 2 to 7% of babies under one year old. It's more common in babies with atopic dermatitis (a skin rash caused by an allergic reaction).
When a baby has cows' milk allergy he or she can react to small amounts of milk protein, either passed to the baby through the mother's breast milk from dairy products she has eaten, or from cows' milk, or formula based on cows' milk, given to the baby.
Infant formula and follow-on formula based on goats' milk protein are not suitable alternatives for babies who are intolerant or allergic to cows' milk formulas.
This is because some of the proteins in goats' milk are similar to those found in cows' milk and most babies that react to cows' milk protein are also likely to react to goats' milk protein. Since the levels of lactose are similar in both milks, formulas derived from goats' milk are also unsuitable for babies that are lactose-intolerant.
Goats' milk infant formulas and follow-on formulas based on goats' milk protein have not been approved for use in Europe. If you are currently using a goats' milk formula for feeding your baby it is important to seek the advice of your health professional about the most appropriate type of formula for your baby's needs, before changing to a different formula.
Remember that ordinary cows' milk (and milk from sheep and goats) isn't suitable as a drink for babies under one year old. This is because it doesn't contain the right balance of nutrients to meet babies' needs, for example it doesn't contain enough iron.
Children usually grow out of milk allergy by the age of three, but about a fifth of children who have an allergy to cows' milk will still be allergic to it as adults. The symptoms of milk allergy are often mild and can affect any part of the body. They can include rashes, diarrhoea, vomiting, stomach cramps and difficulty in breathing. In a very few cases, milk allergy can cause anaphylaxis.
Cows' milk allergy is caused by a reaction to a number of proteins in cows' milk and people can react to whole milk, or to casein or whey. Casein is the curd that forms when milk sours, and whey is the watery part that is left when the curd is removed.
People can be allergic to either whey or casein, or both, and can react to very small amounts of these. Heat treatment, such as pasteurisation, changes whey, so people who are sensitive to whey might not react to pasteurised milk. But heat treatment doesn't affect casein, so someone who is allergic to casein will probably react to all types of milk and milk products.
Since 25 November 2005, food labelling rules require pre-packed food sold in the UK, and the rest of the European Union, to show clearly on the label if it contains milk or any of the ingredients of milk. This applies to milk from sheep, goats and buffalo, as well as cows. Bear in mind that there could still be foods on the shelves that were produced before this date.
Milk from other animals (such as goats and sheep) has previously been used as a substitute for babies who are at risk of developing cows' milk allergy. But the allergens in milk from goats and sheep are very similar to those in cows' milk. This means that someone with a cows' milk allergy might also react to these other types of milk. Fewer people are allergic to milk from goats and sheep than to cows' milk, but this is probably because far fewer people drink these types of milk.
Some highly hydrolysed milk formulas are suitable for babies with cows' milk allergy, but other types of formula, such as partially hydrolysed milk and soya formulas, aren't recommended as the first choice, because many babies with cows' milk allergy might react to them as well.
If your baby has a cows' milk allergy, talk to your GP or health visitor before choosing a formula, or changing to a different type. Many baby foods that you can buy contain protein from milk, so if your baby reacts to cows' milk check the label carefully.
Milk intolerance, also known as cows' milk protein intolerance, is common in babies and children. It is different to milk allergy and lactose intolerance. Children who have milk intolerance can have symptoms from the first time they have cows' milk. Symptoms of milk intolerance can include eczema, vomiting, diarrhoea, and stomach cramps, but not hives or breathing problems (symptoms of milk allergy). Children who have milk intolerance often grow out of it by the time they go to school.
Don't cut milk and dairy products out of your diet, or your child's diet, without talking to your GP or a dietitian. Otherwise you or your child might not get enough of important nutrients such as calcium.
