Lactose intolerance vs. Cow’s milk allergy: is there a difference?

15th February 2024

Lactose intolerance vs. Cow’s milk allergy: is there a difference?

Picture this: It’s Tuesday Night; you’re walking home after your friend has invited you as a guest to their monthly Homage2Fromage cheese night. You’d had a brilliant time, but you’re feeling rough, and it’s a race to get the key in the door to get some relief. You hate to admit to yourself that it was the cheese, but it’s not the first time this has happened, and it’s time to do something about it. But what really is the underlying cause? Is it lactose intolerance or a cow’s milk allergy? Are they the same thing? 

Actually, no. There are undoubtedly similarities. Both conditions involve dairy products. However, it’s essential to understand that they are distinct issues with different causes, symptoms, and management strategies. 

What is lactose intolerance?

Lactose intolerance is a digestive condition where the body lacks enough lactase, the enzyme needed to break down lactose, a sugar found in milk and dairy products. This deficiency leads to difficulties in digesting lactose, resulting in gastrointestinal symptoms. Typically, you might feel bloated, sick, and gassy and have an uncomfortable relationship with the toilet. It’s generally after eating or drinking something containing lactose that puts you in a tailspin. 

What is cow’s milk allergy?

Cow’s milk allergy (CMA), on the other hand, is an immune system reaction to one or more proteins found in cow’s milk. It is one of the most common food allergies in infants and young children, though some outgrow it by adulthood. For those adults who don’t grow out of a cow’s milk allergy, the results are typically more severe. The body’s immune system mistakenly identifies milk proteins as harmful, triggering an allergic response. While both demonstrate gastrointestinal symptoms such as sickness, diarrhoea, and abdominal cramps, symptoms of CMA can be more extreme and concerning:

• Skin reactions (hives, rash, eczema)
• Respiratory problems (wheezing, nasal congestion, coughing)
• In severe cases, anaphylaxis (a life-threatening reaction)

Critical differences between lactose intolerance and cow’s milk allergy

As well as different causes and symptoms, there are a few key separators between the two. Lactose intolerance commonly develops in adulthood, while cow’s milk allergy typically appears in infancy or early childhood. Cow’s milk allergy can cause more severe and potentially life-threatening reactions compared to lactose intolerance. They have different management needs, too. Lactose intolerance is managed by reducing or eliminating lactose from the diet, using lactase supplements, or choosing lactose-free products. Cow’s milk allergy requires strict avoidance of cow’s milk and all dairy products, and in some cases, carrying an epi-pen, just in case. 

What do you do if you suspect CMA or lactose intolerance?

While lactose intolerance and cow’s milk allergy both involve reactions to dairy products, they are fundamentally different conditions. Understanding these differences is crucial for proper diagnosis, management, and treatment. If you suspect you or one of your loved ones has lactose intolerance or a cow’s milk allergy, it’s a good idea to get a test to get to the bottom of the issue. With the right knowledge and approach, both conditions can be successfully managed for a healthy, comfortable life.

Reacting adversely to dairy doesn’t need to feel scary. If you’re worried you might have lactose intolerance or a cow’s milk allergy, it’s time to do something about it. Register as a new patient today, and let’s start the process of helping you feel better. You have the option to visit our London-based allergy clinic for a comprehensive evaluation by our specialists or take advantage of our home allergy test.

Does my baby have an allergy to cow’s milk?

6th November 2023

Does my baby have an allergy to cow milk?

Parenthood is a journey filled with wonder and joy, but it also comes with its fair share of concerns and challenges. “What does that cry mean?” “Am I doing it right?” “What’s that rash?” These are just some of the many questions you may have already antagonised over as a new parent. “Does my baby have an allergy to cow milk?” is up there too. 

Having an allergy to cow’s milk is common in babies.  Especially when they’re bottle-fed. In the first year of life between 1.8% and 7.5% of infants are reactive to the protein. The good news is, it’s not always an issue for life. By age 3, more than 75% of children will have outgrown their milk allergy, and over 90% of children will become tolerant of milk by age 6.

Recognising the symptoms

Most allergies or intolerances will show up similarly. If you notice signs of colic (excessive crying when you can’t for the life of you figure out why), vomiting, diarrhoea, eczema, and extreme fussiness, it could be a sign that something is causing your baby discomfort. It can often take time for these symptoms to appear and they gradually worsen.

Test for the issue

Once you spot that there is an issue, the next best step is to test to understand the cause of the issue. It could be an allergy to cow’s milk, or it could be something else. Once you are able to identify the cause of the issue, you can take steps to help your baby feel better. 

What the future looks like when your baby has a cow milk allergy 

Many parents fear the process of diagnosis and worry about what comes next. Your concerns about your baby’s health and potential cow’s milk allergy are entirely valid but management isn’t as daunting as it seems. Managing a cow’s milk allergy in an infant often involves a change to their diet. Rather than relying solely on online sources or self-diagnosis, it’s better to get expert advice so that you can better plan what’s next. A qualified paediatrician will guide you on suitable formula options, breastfeeding techniques, and the introduction of solid foods that are free from cow’s milk that give your baby a better quality of life. 

At our London-based allergy and immunology centre, we understand that the well-being of your baby is your top priority. Our experienced paediatrician is here to provide compassionate support and guidance. If you suspect your baby has a cow’s milk allergy or if you’re unsure about the symptoms you’re witnessing, register as a new patient today and let’s start the process of helping your baby feel better.

The truth behind cow’s milk allergy in infants

29th November 2017

The truth behind cow’s milk allergy in infants

A few minutes ago your child consumed their first-ever bottle of cow’s milk-based formula. But now you watch as your baby screams, vomits, and develops skin irritations. You frantically search your mind for the reason behind your child’s onset of symptoms. It’s highly likely that your baby has a cow’s milk allergy, which is a common ailment amongst newborns and babies. However, there are two major types of allergies in babies: IgE-mediated and non-IgE-mediated. As a parent, it’s important to understand the differences between IgE-mediated and non-IgE-mediated reactions.

What are the causes behind your child’s cow’s milk allergy?

During IgE-mediated reaction to milk, the IgE antibodies on allergy cells (mast cell) bind to milk. This propels the cell to unleash a variety of allergic mediators, that cause swelling, rashes and even dangerous systemic reactions. These can occur within minutes of your child consuming cow’s milk. Some children experience a non-IgE-mediated reaction, which results in a slower onset of symptoms resulting in gastrointestinal symptoms.

The difference between IgE-mediated and non-IgE allergies

As mentioned, IgE-mediated allergies cause your child to react within minutes of consuming cow’s milk. Whereas non-IgE reactions see delays of hours or even days. IgE-mediated allergies are easy to recognise, as your child will likely vomit, break out in hives, and develop eczema. The most dangerous is that the child can have a massive reaction known as anaphylaxis.

If your child has a non-IgE reaction, it will be less severe, but pretty troublesome and should be taken seriously. Your child will experience gastrointestinal issues, skin irritations, and possible respiratory problems. In milder cases, a non-IgE allergy to cow’s milk may be confused with lactose intolerance. With this in mind, it is important to note that lactose intolerance in children is usually secondary (associated with some other digestive problem) and affects the bowels (diarrhoea, bloating, pain) because the child is unable to digest the sugar in milk: lactose.

Have no fear! Your child will likely grow out of his or her cow’s milk allergy. But, for now, there is a high chance that you just want to learn how to stop your baby from vomiting all over the carpet. For those with IgE-mediated allergies, it is advised that you switch your baby’s formula to EHF (Extensively Hydrolyzed Formula) or AAF (Amino Acid Formula). If you are breastfeeding, it is essential that you cut out all cow’s milk from your diet. However, before anything, please have your child tested for allergies.

How can you fix it?

The process of adjusting to your child’s non-IgE-mediated allergy depends on its severity. If your child has more serious symptoms, it’s recommended that you follow a similar procedure to the above.

Mothers breastfeeding children with mild non-IgE-mediated allergies can try the process of cutting cow’s milk from their diet. If your child shows no symptoms, you can slowly bring cow’s milk back into your diet. When the child doesn’t react to cow’s milk, they are unlikely to have an allergy at this point. If the symptoms reappear after you add cow’s milk back into your diet, then it is crucial that you eliminate all cow’s milk from your diet yet again. Your child’s symptoms will likely fade as you do, which is a telltale sign that they do have an allergy. Bring your baby to an allergy consultant for testing, before giving any cow’s milk.

Parents who choose to use formula rather than breastfeed can follow a similar route, except you will use an eHF formula for the elimination phase and a cow’s milk-based formula instead of you, yourself consuming cow’s milk.

It is important to note that a cow’s milk allergy is the most common allergy among newborns and your child will most likely grow out of it. However, should problems persist or you would like some help and advice, please book an appointment with our consultants on our website. If you would like further information, click here to find more about food allergy in children and young people from the National Institute for Health and Care Excellence.