Q&A about lactose intolerance with Lactofree's expert and Consultant Paediatric Allergist, Dr Adam Fox - ANSWERS BACK

[RachelMumsnet]

Do you, your partner of your child suffer from digestive disorders which you think could be related to dairy? This week Lactofree's expert and Consultant Paediatric Allergist Dr Adam Fox is joining us on Mumsnet to answer your questions. Dr Adam Fox has trained in Paediatrics and then Paediatric Allergy in some of the country's leading teaching hospitals including Great Ormond St Hospital, St Mary's and the Royal Free Hospital. He is now a consultant Paediatric Allergist at Guys' & St Thomas' Hospitals as well as an honorary senior lecturer in Paediatric Allergy at King's College London. He also sits on Lactofree's expert Advisory Board, providing regular advice to their lactose intolerant community. Send your questions to Dr Adam Fox before the end of Sunday 15th May and we'll link to his answers from this thread on the w/c 23rd May.

Oh brilliant!

Dr Fox, my daughter has an allergy to cow's milk protein. She's only 1 and a half and was diagnosed at 6 months after a violent reaction to the first food I gave her (porridge made with milk). So far, she has been tested for everything going and has no other known allergies. Is there a critical period during which children develop allergies or could she suddenly react to something which she has previously been able to eat? She's showing all the signs of growing out of her milk allergy and I'm really hopeful that that might mean she is allergy free one day but wonder if that is unrealistic...

Thanks.

Dr Fox

My daughter is 5 months old and has been diagnosed with cow's milk allergy and as such is on Nutramigen. She also has very servere reflux and as such is on a high dose of infacol (2.5ml before feeds) ranitidine and carobel.

My question is really about weaning, we are due to see a dietician alongside her consultant but I wondered what your opinion was on how to challenge her with dairy and whether there are any other associated allergic reactions we should watch out for?

Thank you in advance.

Hi Dr Fox

I suffered with severe allergies to dairy products when I was a child (birth to 7 years old).
I am wondering if this is a hereditary thing and if I am likely to pass the allergy to my child. My husband and I are currently trying to conceive our first. Neither of my parents have any food allergies.

With thanks

Maeve

Dr Fox - could you please explain how a milk allergy/ intolerance is 'tested'?

Are there many 'medical' tests to do so or do you just wait for reactions like face swelling/ vomit and runny bums?

Ours was 'trial and error' with foods and it was a miserable experience.

Love from Pancakeflipper who has a 2 yr old on dairy-free diet. And an extensive collection of recipes of dairy-free foods.

Ah I just came here and realised its milk only too. Agree with nottirednow about putting it in the title.

Hello Dr Fox

Is cows' milk protein always present in a mother's breastmilk if she consumes cows' milk?

I ask because I knew my DS1 was allergic to milk (and soya), and his severe eczema improved hugely when I cut out soya and milk from his diet, but I didn't exclude them from mine while breastfeeding him.

When I tried him with cows milk (on a dietitian's advice) at a year old he had an extremely serious reaction, after which he had to carry an epipen. His allergy to milk had obviously got a lot worse in the 7-8 months since he last had cows' milk.

I accept that his allergy probably would not have got worse if I had cut out milk from my diet (although the soya allergy went away), and feel pretty guilty about it.

However, he went on to always react to the smallest trace of milk contamination in any food he was given, yet he would never have a reaction to breastmilk. Why is that?

Hello Dr Fox

Our son has 'off the scale' allergy to milk ( epipens always at the ready)and I just wondered is the statistic that 80% outgrow it by 5 correct? I am intrigued how you can outgrow an allergy? Is it genetic and does this mean if we have another child there is a good chance he or she will have alleriges- none on my side of the family but husband's mother/family have excema.

Thanks for your time with us all.

Hello Dr Fox,

my 4yo DD is allergic to CMP. It presented itself as projectile vomiting and extreme listlessness after being given small amounts of formula milk as a small baby and then hives on her face after contact with cheese/milk whilst weaning her.

At 1 year old she had her first RAST test with a score of 2. Last year (when she was 3) it had risen to 8 and then in February this year it had gone up to 24.

having been told that it was quite likely that she would outgrow the allergy before starting school, (which is now impossible with September looming fast)I am beginning to wonder if she will ever outgrow it.

Also, will it continue to get worse? She had an accidental exposure to icecream last December where her fingertip touched a dessert and despite having wiped it clean she then rubbed her face and a trace, that must have been left under her fingernail, caused her to have hives all the way across her cheek and forehead and her eye to swell up. 2 doses of Piriton finally got her eye back to normal but I'm worried that this might not be enough if she is accidentally exposed to CMP in the future.

Finally, is there anything to be gained by seeing an allergy specialist? My DD also has cystic fibrosis so we see a hospital dietician every two months but allergies are obviously not their speciality so I'm wondering if there is anything we might be missing out on?

thank you

hello Dr Fox
My 8 year old son is autistic and has been on a dairy free diet since he was 5 months old, following the advice of a dietician at the time. I know he did some testing but can't remember what type . What is the most reliable test for a dairy allergy/intolerance? My problem with reintroducing foods ( he is also sensitive to egg, nuts, gluten and soya ) is that he doesnt have an immediate reaction - it seems to build up over time. Reactions are increased eczema, loose bowels and an increase in autistic behaviours.
Thanks very much

Hi Dr Fox,

My 3yo daughter is allergic to dairy, diagnosed at 8 months old.
Between the ages of 1 1/2 and 2 1/2 she looked to be gradually outgrowing her allergy - she could tolerate small amounts of cooked milk in baking, and her reactions became less severe (sneezing and streaming nose rather than hives and lip swelling).

However, in the last six months or so her allergy seems to have worsened again - even some foods which only have a 'may contain traces of dairy' warning now provoke consistent and immediate complaints that they make her mouth and throat hurt. Her most recent skin prick test in January was I think 4mm which was similar to previous tests.

Am I right in now feeling gloomily pessimistic about her chances of outgrowing her allergy? The reactions have never been very severe (we do not have an epipen, just piriton), but the fact that they appear to have worsened is presumably a bad sign?

It is a moot point now that she reacts to even tiny traces of dairy, but in the past we have received conflicting medical advice about whether she should be 100% dairy free, or whether we should be 'inducing tolerance' and giving her as much dairy as she is able to consume without reaction. What is your view on this?

We now avoid all dairy like the plague, but I'd also be interested to know how long we now wait until giving her another challenge?

Oddly, she has always had negative skin pricks to butter (and used to eat small quantities without reaction - we have not tried recently) - our registrar was unable to explain this!

Many thanks for any advice that you are able to give.

Hi Dr Fox,
Like the other mums who've listed, my daughter, now age 8 has a dairy intolerance. It started once I'd stopped breastfeeding age 2 months. Symptoms were vomiting, hives, diarrhoea, severe eczema . After one vaccine she developed a severe egg allergy - couldn't even touch an egg without her whole hand swelling up! I tried an alternative approach, after my GP suggested steroids and paraffin based creams, and went down the homeopathy and restricted diet route. On the whole it's been a successful journey; she can now eat some skimmed milk powder in products, eg biscuits, crisp flavourings without being violently sick, her eczema has vanished,infact she now has beautiful skin, and I can manage her eating some cheese, chocolate, etc if she takes Holland and Barretts Lactase Enzyme tablets prior to dairy. And she can eat egg! Why, oh why doesn't the pharmaceutical companies make these tablets to sell on prescription? They can really change a childs life and coupled with a proactive , non-invasive approach are surely cheaper? What are your views on this? Homeopathic remedies so much cheaper and better than piriton as well! Makes me really cross that GPs don't, on the whole, take dietary issues very seriously......

Hi Dr Fox.

My third son was born 5 weeks early. We had a hellish 12 weeks when he was finally diagnosed with a cows milk protein allergy. I would like to know the best way to tackle weaning when the time comes, do I need a referral to a dietician? my local hospital is a bit rubbish and hv seems to live in space lol so very rarely seen! He is 16 weeks old now and I have read a number of people experience of early weaning helping reflux (which he also has)

Would his early birth be to cause of this allergy? There are no other allergies in the family at all...

Hello Dr Fox
My grandson (3) was diagnosed with CMP allergy at 10months after symptoms that seemed to be present from birth. He was dairy free for a year and then tested with skin prick tests and Raste test. We have been told he has an IgE result of 491 and that this is a severe allergy to CMP so is still dairy free now. He is a very poor sleeper and will wake up itching his body. My question is should he be eating beef? As this has been mentioned by a friend and I must admit we didn't think to omit this from his diet. Is he likely to outgrow it?

Hello Dr Fox. I have a 2 year old who has been tested for allergies and appears to have none. However she has almost constant diarrhea and I THINK it is milk, soya and egg which cause this.

Is there any way to test for other things she may be intolerant to?

Will strictly excluding all of these from her diet help her to get over the intolerance with time?

Many thanks

basically all these allergies happen because human are not designed to digest cows milk lol

Why is it so difficult to get referals to see peadiatric allergists and why dont drs know more about allergies in babies?

I was told my 11 day old dd 'just had colic' and i needed to 'stop being so paranoid there is nothing wrong with her' she has a severe allergy to cows milk

Ivette that's not really helpfull. My dd reacted to my BREAST MILK because of the dairy I had as well as the formula I tried her on.

Hi dr fox,
My son breast fed and formula fed when he was born, during this time we noticed a lot of smelly farts and bloated tummy but was told this was normal. 4 months later he was in hospital due to bloody diarrhoea, which was actually just blood and we were never given a conclusive answer as to what this may be due to, but it was suspected that it was cows milk protein intolerance.

My son has since just been on breast milk and mainly dairy free foods. I gave him the odd petit filous to try and with that came the a bit more farting ( not offensive!) which had predominantly stopped since the hospital incident. I'm not sure if this is due to intolerance and what I should do next? He is 1 yr old now, so do I start introducing dairy or not. Would it help build tolerance? I've been to gps but don't seem to get any advice on it.

Thanks

I have a 3 year old son who is allergic to many things, including CMP. It has been a difficult journey from when we started weaning at 6 months. We have only managed to get epipens after much fighting with health professionals, despite him being anaphylactic to numerous foods and us having to call 999 more than once.

It is now under control somewhat, but I'd really like to know what is being done in the way of research into the causes of such allergies. Can you elaborate on that? Is there funding available? I'm in Scotland, if that makes any difference. Currently we see a paediatrician twice a year at best.

There seems to be some confusion in people mind about lactose intolerance and general dairy intolerance. There is a huge difference.

I dont want to step on Dr Fox's toes but I believe he is coming to talk about lactose intolerance. I am a coeliac and as a result am intolerant to lactose which is the naturally occuring sugar in milk. I am not intolerant to milk protein which is what many of you appear to be talking about when you say you or your child are dairy intolerant.

As the Lactofree website notes, allergy to cows milk protein is often confused with lactose intolerance. They are quite different things.

I can drink Lactofree milk which is a brand that can be bought in most supermarkets and is ordinary cows milk that has been pre-treated with an enzyme called lactase that breaks down the lactose. A baby or child or adult who is intolerant to milk protein could not drink Lactofree milk as it still has milk protein in it.

If you or your child are intolerant to lactose you can also buy lactase and treat dairy products yourself but obviously buying pre-treated Lactofree milk is a lot more convenient. It is a good product and tastes a lot nicer than soya milk and oat milk that i have also tried.

Obvioulsy, I defer to Dr Fox if any of what is written above is wrong.

My son (aged 5) is almost certainly autistic, probably Aspergers or on the high functioning end of the spectrum (currently awaiting diagnosis) and has soiling problems. My GP shrugged this off when I took him recently. He doesn't have extreme reactions but having read that there are links between soiling and behaviour in autistic children and dairy I am keen to find out if we can do any allergy testing. He loves yogurt, cheese, milk and hates most of the dairy-free alternatives!

Can he be tested to ascertain whether it is due to dairy intolerance? How long does a child need to have a dairy-free diet before noticing a difference with regard to these problems if dairy is the cause?

Hi :)

I've a question - both DD & myself are lactose intolerant, neither of us were born that way

So I'm curious if there are any definitive links to either antibiotic use & lactose intolerance, or Heliobacter Pylori infection & lactose intolerance??

I ask as I've noticed the beginning of & worsening of DDs sensitivities, lactose included after antibiotics, more than just the usual tummy problems associated with Anti B's

I've also recently been diagnosed with H.Pylori, (new GP) which I have probably had for years & years, but never previously tested for, just fobbed off with IBS/GERD etc & now wonder if there is any possible link there too??

Thank you :)

Dr Fox, what do you think about Guernsey milk and the theory that form of casein it contains is less intolerable to humans than the form of casein in Friesian and Holstein milk? (For the benefit of other MNers, who may not know what I am talking about, almost all dairy-farmed animals produce milk in which the beta-casein is predominantly A2, except for Friesian and Holstein cows, in which the beta-casein is predominantly A1. Virtually all commercial milk, and milk products, are from Friesian and Holstein cows. Guernsey milk contains 90% or more A2 beta casein. There are studies linking A1 beta casein with various chronic conditions, and demonstrating a reduction in these issues when dairy consumption is of A2 beta casein milk.)

"It is interesting to note that a factor in regular milk, BCM7, is released when A1 beta casein is digested. BCM7 is a strong opioid that can affect gut processes and mucus production ? causing some allergic or intolerance symptoms. BCM7 can also stimulate skin reactions and the release of histamine. A2 milk does not produce BCM7 on digestion."

on this website: www.naturaltherapypages.co.uk/article/beta_casein_intolerance (I would have liked to find a more mainstream source)

My brother was a typically sickly, snotty, asthma-y, weedy kid in the 60s and 70s. As an adult he realised that milk made him ill, and cut it out of his diet. He is now a farmer and has access to unhomogenised milk from a single herd of pure-bred Guernsey cows, and has discovered that he can safely drink their milk with no ill-effects, whereas 'conventional' milk still makes him ill.

I would also like to know whether, for someone with a dairy intolerance that is quality-of-life-affecting, rather than life-threatening, it is better to totally exclude dairy products or to consume them only in amounts that are small enough not to set off a reaction.

Thanks!

MoreBeta - I believe lactose intolerance is incredibly rare in babies/young children though, where CMP intolerance is very common, so few people will have experienced lactose intolerance in their children. The question does ask about dairy problems in general.