Cow's milk allergy and intolerance management


Please click on the links below to read our articles. If you are interested in research findings, click here for links to research reports.

For general articles on cow's milk allergy/intolerance, click here.

For articles and research on lactose intolerance, click here.

For articles and research on raw milk, fermented milk and A2 milk, click here.

I think that I (or my child) may have a milk allergy – what do I need to do? Michelle Berriedale-Johnson explains – in the video below and in the article here in which you will find all the links that she refers to. November 2016

New Dietary Management of CMA; Engineering the Microbiome. Nathalie Newman attends, speaks at and reports on a recent conference hosted by Mead Johnson in Rotterdam. April 2018

How not to go vegan! Hannah explains the pitfalls of giving up milk (and eggs) even when not for dietary reasons.... November 2017

Allergen-free infant formulas for cow's milk allergic babies under threat. Cost cutting measures being imposed by some Clinical Commissioning Groups may mean that such formulae may no longer be available on prescription. February 2017

Alternative milk coffee sampling. Cressida checks out how well some of the many alternative milks on the market work in that all important cappucchino... November 2016

Cow's milk intolerance and why it is so common. Registered nurse food intolerance specialist, Mary Roe, believes that it is the frequency with which people eat certain foods, especially cow's milk, that leads them to develop intolerances. August 2015

Why ‘Vegan’ may not always mean ‘Milk Free’. Alex Gazzola explores why relying on a ‘vegan’ or ‘vegetarian’ label is inadvisable when you have a food sensitivity to an animal-sourced ingredient. April 2015

MAP Guidelines A primary care guide to the diagnosis and management of cow's milk allergy in the first year of life developed by an expert group for use by health professionals in primary care. Partof the ACT on CMA eductional initiative. May 2014

Safety profile of oral immunotherapy with cow's milk and hen egg: A 10-year experience in controlled trials. Sept 2016
Some encouraging results regarding desensitisation to egg and milk allergens using oral immunotherapy.

Vegetable and nut milks used to make dairy-free yogurt. January 2014

Immunotherapy is not always successful longterm for milk allergy. Discussion from NPR. July 2013

Cow's milk genetically modified to be allergen free? Not yet a while... Michelle Berriedale-Johnson reports. October 2012

A2 Milk - what is all the fuss about? Frances Dale reports. September 2012

New EU regulations on the labelling of casein and milk products in wines. July 2012

Lactic acid – is it suitable for those with dairy allergies? April 2012

Micki Rose's delicious dairy-free milks. February 2012

Delicious and dairy-free ice cream, but beware the lupin proteins. July 2011

Rice and arsenic – what to do about it. In her second article Micki Rose gives practical advice on avoiding and dealing with high arsenic levels and some suggestions for making your own arsenic-free alternative milks. March 2010

Rice and arsenic – what is going on? In the first of two articles nutritionist Micki Rose considers the cruel irony that, for allergic people trying to avoid dairy products and wheat/gluten, eating more rice is increasing their exposure to the poison, arsenic. March 2010

Foods labelled 'nondairy' in the US may contain milk protein. January 2010

Micki Rose's low glycaemic load, gluten-free, dairy-free diet: fed up with continually cobbling together diets for her food sensitive patients, she has finally written a diet plan. 2008

Infant formulae for allergic babies: A review by Sarah Merson on the conditions that cause babies to need special formulae and what is available. 2007

Soya formulae for allergic babies: Sarah Merson investigates the use of soya milk formulae for babies allergic to cow and goat milks. 2007

Replacing the nutrition in milk: An interesting list of case studies from Margaret Moss showing the huge variety of dairy problems, followed by a list of the nutrients in dairy vital to human wellbeing and which other foods provide replacements. 2006

Research Reports

The Role of Baked Egg and Milk in the Diets of Allergic Children Feb 2018 (epub ahead of print)
It is suggested that many children with milk and egg allergy are able to tolerate some amount of baked milk or egg products. Being able to consume these may work to reduce sensitivity (in a similar way to immunotherapy). However, if not previously tolerated, any oral challenge should be carried out within a hospital.

Evidence that eating baked egg or milk influences egg or milk allergy resolution: a systematic review. May 2017
There is not much research looking into the theory that eating baked egg or milk leads to quicker resolution of allergy to eggs or milk. This is despite increasing popular belief that eating these products accelerates desensitisation. The authors suggest that trials are needed to compare the resolution rates of baked-tolerant participants who are randomized to either eat or avoid baked egg or milk products.

Extensively hydrolysed casein formula containing L. rhamnosus GG reduces the occurrence of other allergic manifestations in children with cow's milk allergy: 3-year randomized controlled trial. Dec 2016
Adding a probiotic to hydrolysed infant formula, for infants with cow’s milk allergy significantly reduced the risk of developing further allergies. Exciting therapeutic potential.

Oral Food Desensitization in Children With IgE-Mediated Cow's Milk Allergy: Immunological Changes Underlying Desensitization.
January 2017 (published online ahead of print)
This study explored the efficacy of oral immunotherapy in children allergic to cow’s milk. The procedure involved giving tiny doses of milk that had been treated at a high temperature every week. The procedure was safe and effectively desensitised 70% of the children to milk. This is another promising finding for food immunotherapy; maybe it will move from clinical trials to clinical practice in the future. In the meantime, it is not safe to try this type of therapy on your own at home.

The ingestion of cow’s milk formula in the first 3 months of life prevents the development of cow’s milk allergy
October 2016
This retrospective study suggests that drinking cow’s milk formula (either exclusively or alongside breastfeeding) in the first few months of life, is associated with a lower risk of developing cow’s milk allergy. The claim of the title is a little strong but the research suggests that further research into early exposure of allergens is much needed.

Safety profile of oral immunotherapy with cow's milk and hen egg: A 10-year experience in controlled trials. Sept 2016 Some encouraging results regarding desensitisation to egg and milk allergens using oral immunotherapy.

Presumed Allergic Proctocolitis Resolves with Probiotic Monotherapy: A Report of 4 Cases.
This article reviews four individual cases of infants with milk protein intolerance. These infants were given a probiotic (Lactoacillus rhamnosus GG) and the symptoms of their milk protein intolerance resolved within 7-28 days. This presents an exciting alternative to dietary restriction in infants with milk protein intolerance. Full article available here for free…

Three novel candidate probiotic strains with prophylactic properties in a murine model of Cow's Milk Allergy. January 2016

Limiting infants to almond milk can result in scurvy. January 2016

Challenge with instant skim milk powder could be a safe, convenient and easily standardizable alternative to home baked food for heated milk challenge. December 2015

Breast feeding, although conferring other health benefits, does not appear to protect against allergic disease. December 2015

The anti-inflammatory and anti-oxidant properties of almond milk suggest that almond milk might be considered as a potential alternative in cow’s milk protein allergy treatment. June 2015

Evaluating the impact of infant feeding guidelines on CMA prescribing in UK primary care. This study shows promising results for prospective research on a national scale, including socio-economical impact and cost-effectiveness. November 2015

Oral immunotherapy for cow's milk allergy still effective after seven years. Octoebr 2015

Traces of ovalbumin and casein detected in white and red wines by quantitative western blotting. August 2015

Biotin and carnitine deficiency due to hypoallergenic formula nutrition in infants with milk allergy. April 2014

Baked milk oral immunotherapy effective in only 21% of baked milk allergic patients. July 2015

82% of children who completed the six-month induction phase of oral immunotherapy to milk were able to consume at least 200ml of milk or 6,400mg of milk protein a day and after the two-year maintenance phase, half were consuming milk daily. July 2015

A review of the relationship between cow's milk allergy and epileptic seizures. November 2014

An extensively hydrolysed casein-based formula for infants with cows' milk protein allergy: tolerance/hypo-allergenicity and growth catch-up. April 2014

A very low dose oral food challenge allows some low dose reactive Cow's milk allergic children to change from complete avoidance to partial intake of cow's milk. May 2015

Even when the children have outgrown their cow's milk allergy, families still have nutritional concerns and should be offered dietary advice to encourage progression to unrestricted diet, prevent eating disorders and impaired growth. May 2015

Are children and adolescents with food allergies at increased risk for psychopathology? October 2015

Leading allergists call for 'a more active approach to management to be adopted, which includes early introduction of potentially allergenic foods, anticipatory testing, active monitoring, desensitisation to food allergens and active risk management'. November 2014

Sharing your microbiome with your pooch! Research suggests not only that we share much of our microbial populations with our dogs but that close relations with a dog can have a beneficial effect on our chances of getting an allergy as a child and and improve our health in old age... May 2015

Extensively hydrolysed rice infant formula good substitute for cow's milk for CMA infants. September 2014

Safety and clinical predictors of reacting to extensively heated cow's milk challenge in cow's milk-allergic children. October 2014

Breast milk sold online may contain cow's milk. April 2015

Nineteen our of 364 proteins in breast milk different in the milk of allergic and non-allergic mothers with the allergic mother's having higher concentrations of proteins linked to asthma and allergy. March 2015

Young adults with cow's milk allergy have poor bone density. August 2014

Researchers at the University of Granada use pulsed light to degrade the protein β-lactoglobulin in lactose serum. February 2015

Proteolysis by Lactobacillus fermentum IFO3956 isolated from Egyptian milk products decreases immuno-reactivity of cow's milk allergic patients. May 2011

Lower vitamin D levels found in children who drink non-cow's milk. (Cow's milk has, legally, to be fortified with Vitamin D but fortification of non-cow'smilk is only voluntary.) October 2014

Infants with a milk protein intolerance should be treated for 2 to 3 months with a hypoallergenic formula, then rechallenged at 6 months. Rechallenging before 12 months could result in cost savings. August 2014

French researchers develop fast and accurate method for determining exactly which milk proteins produce allergic reactions in specific patients which could be adapted for other allergens. July 2014

Cow's milk allergy largely prevented by dietary fish oils. July 2013

Extensively hydrolised casein formula (EHCF) accelerates tolerance acquisition in children with cow’s milk allergy (CMA) compared to rice based, soya based or amino acid based formulae, especially if  combined with Lactobacillus rhamnosus GG (LGG). April 2013

Gut microbiota as potential therapeutic target for the treatment of cow’s milk allergy. An overview. March 2013

Successful immunotherapy treatement (SOTI) for cow's milk may not protect against other animal milks such as sheep's milk. April 2013

Sabin polio vaccine contains α-lactalbumin and may trigger reactions in milk allergic children. February 2013

Milk oral immunotherapy is effective in school-aged children. February 2013

Efficacy and safety of oral desensitization in children with cow's milk allergy may depend on their serum specific IgE level. April 2013

Casein is an ingredient of dustless chalk now preferred by many schools as it keeps hands and classes clean. However, the chalk still releases small particles into the air which could cause milk allergic children to have allergy or asthma attacks. May 2013

Longtitudinal study of infants with milk allergy  shows that approximately half had resolved over 66 months. March 2013

Donkey milk an acceptable substitute for cow’s milk allergic children. September 2012

Israeli study suggests that although immunotherapy for cow's milk allergy can be successful, there is a group of children for whom it does not appear to work. Moreover, tolerance may not be maintained unless milk continues to be consumed regularly. February 2013

Oral immunotherapy for milk allergy can lead to desensitisation for some although the development of long term tolerance has not been established and mild adverse effects are not uncommon. November 2012

Milk allergy may cause trouble in nose and throat. August 2012

Study confirms that oral immunotherapy is effective in desensitising school children with cow's milk allergy and that the desensitisation can be sustained for more than three years. August 2012

Partially hydrolysed infant formulas are not hypoallergenic and are not suitable for infants who are allergic to milk, or to infants with existing milk allergy symptoms. August 2012

Standard tests may miss ingredients that cause milk allergy. March 2012

Children who undergo a prolonged trial of sublingual immunotherapy (SLIT) before undertaking oral immunotherapy (OIT) for milk allergy have fewer treatment-related symptoms, particularly severe ones, than those on OIT alone. March 2012

Chicken-based formula is better tolerated than extensively hydrolysed casein formula for the management of cow milk protein allergy in infants. April 2012

Addition of lactose to hydrolysed infant formula for cow's milk allergic infants may boost their typically low levels of Bifidobacterium and Lactobacilli while reducing their typically high levels of Clostridium. March 2012

An extensively hydrolysed casein formula supplemented with Lactobacillus rhamnosus GG is hypoallergenic and can be recommended for infants and children allergic to cow's milk. March 2012

Safety and efficacy of sublingual and oral immunotherapy for milk allergy. November 2011

Milk powder better than liquid drops to treat milk allergies. December 2011

Camel’s milk a safe alternative for children with cow’s milk allergy. May 2011

Fewer infants found to be allergic to milk and soya – and the benefits of early introduction of cow’s milk. June 2010

Test to establish whether a milk-allergic child can tolerate heated milk. Febuary 2010

Under the tongue immunotherapy as effective for milk allergy as 'by mouth' immunotherapy. March 2010

Rice milk panic. July 2009

Immunotherapy for cow's milk allergic children. March 2009

Powdered milk helps kids overcome milk allergy. December 2008

Many children with cow's milk allergy tolerate milk that has been heated. October 2008

Desensitisation for major allergens proves successful. October 2008

Organic is great but breast is best – breast milk banks. May 2008

Fermented milk may help prevent food allergies. September 2008


NB Information on this site is not a substitute for medical advice and no liability can be assumed for its use.


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