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Difference between Allergy to Cow’s Milk Protein and Lactose Intolerance


What is the difference between cow’s milk allergy and lactose intolerance, a lot of people think it’s the same thing, but in fact they are totally different things.

Allergy to Cow’s Milk Protein (APLV): When people hear or say that someone has cow’s milk allergy, they actually have an allergy to cow’s milk protein (s). There are 3 main proteins of cow’s milk (casein, β-lactoglobulin and alpha-lactalbumin). The five types of caseins (phosphoproteins) account for 80% of milk proteins, the remainder consisting of β-lactoglobulin and alpha-lactalbumin with 16% and 4% of total proteins respectively. That is, APLV is an allergic reaction to the cow’s milk protein (s). It is much more common in children, especially in babies. Adults rarely present APLV.

One or more of the following symptoms: vomiting, cramps, diarrhea, abdominal pain, constipation, blood in stool, dermatitis (redness of the skin, peeling, small blisters and “thick skin”), respiratory problems (asthma, breast and rhinitis) and weight loss. They can occur in minutes, hours or days after the ingestion of cow’s milk or derivatives, in a persistent or repetitive way. Diagnosis is usually made by the physician through the observation of symptoms, but the diagnosis is confirmed by the “trigger test”, which consists of the observation of withdrawal of cow’s milk and derivatives with subsequent reintroduction of these foods.

If the mother is still nursing the child in the breast, she can and should continue breastfeeding, but she should follow a special diet, without cow’s milk and dairy products, always under the guidance of a professional as a nutritionist.

If the baby is no longer breastfeeding he needs to follow a special diet and in this case the diet consists of the complete exclusion of cow’s milk and its derivatives, in addition to all foods prepared with milk. In this case a lot of ATTENTION to industrialized foods, which may contain milk or derived ingredients (such as casein, caseinate, whey or whey protein). Attention should be paid to replacing cow’s milk with another mammal (sheep, buffalo), as these may also cause allergic reactions and are not indicated for APLV. The most appropriate in this case is soy milk.

The big question is whether the baby will return to normal life, it may be that since half of the children with cow’s milk protein allergy improves by one year of age. Most (90%) are cured at the age of three. A few people remain allergic for life, but it happens and then the person needs to follow a diet with total exclusion of milk.

Lactose intolerance:It is the difficulty of the body to digest and absorb milk sugar (lactose which is the characteristic ingredient of animal milk and dairy products). It is more common in adults than in children. With advancing age, there is a natural tendency to develop lactose intolerance. It develops as follows on the mucosal surface of the small intestine there are cells that produce, stock and release a digestive enzyme (yeast) called lactase, responsible for the digestion of lactose. When it is poorly absorbed it starts to be fermented by the intestinal flora causing diarrhea, cramps, abdominal distension (stomach belly) and nausea. If lactose intolerance reaches a baby and he is no longer breastfeeding in the breast he should follow a diet with small amounts of cow’s milk and its derivatives are generally tolerated, being allowed the consumption of foods that contain a little milk, like some cookies, cakes, breads, among others. With regard to formulas, they should only be used for infants who are not being breastfed.

For children up to 1 year, use special lactose-free formulas. Over 1 year, low lactose products are well tolerated.

What everyone wants to know is if it happens to baby, will he return to normal life? Most people continue to have lactose intolerance for life. But if your baby has an intolerance to lactose caused by prolonged diarrhea, it may improve after a while, and then you can go back to drinking cow’s milk.

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