What is Milk Allergy and lactose intolerance?

Milk allergy and lactose intolerance are two very different things though one is often confused with the other.
Milk allergy is when your baby's immune system reacts to proteins in milk. It is a common allergy and babies who have eczema are more likely to suffer from it. In fact it is the most common food allergy during infancy all over the world and can occur in purely breast fed babies also.
Lactose intolerance is when your baby has difficulty digesting the lactose, or the sugar, found in milk. This is much rarer than milk allergy during early childhood although it can occur temporarily after a bout of gastroenteritis.
Milk allergy
Your baby can be exposed to cow milk protein either through cow's milk-based formula milk or through your breastmilk if you have drunk or eaten dairy produce. Even butter or ghee contain milk protein. If your baby is allergic to this protein, she might have an immediate reaction in which case you might notice the following symptoms:
her face will flush and show a rash
she's likely to have watery eyes and a stuffy nose
it's also possible she'll feel sick or have diarrhoea
you might notice blood in her stools
she might be extremely irritable and fussy
rarely, a baby may have a more serious reaction called anaphylaxis.
Though allergic reactions to milk can be immediate, delayed allergic reactions are common too. With a delayed reaction, you might notice that your baby has:
eczema
reflux
colic
diarrhoea with or without blood
constipation
failure to thrive (not putting on enough weight)
These symptoms are common in early childhood and an allergy is only one possible explanation. Your doctor will be able to find out whether your baby has an allergy by doing a skin prick test or a blood test. But as with most allergies, the history you provide to the doctor and a physical examination of your baby are often enough for him to give a diagnosis.

If it is an allergy causing your baby’s symptoms and you are breastfeeding, your doctor will advise you to cut all dairy products from your diet including ghee, breads or biscuits made with milk solids and all other forms of dairy products.

If your baby is allergic to milk and is formula-fed, talk to your doctor before changing formula. It may not be the answer simply to switch to a soya-based product, because babies with milk allergies can react to this too. Almost 30 percent of babies who are allergic to milk will be allergic to soya as well. If your baby is allergic to both milk and soya, she will need a formula that is hypoallergenic, meaning she won't react to it.

It can take up to two weeks for your baby’s symptoms to disappear once you have stopped taking milk products or changed formula feed. But the good news is that most children will grow out of their milk allergy by the time they are three. You will know whether your baby is still allergic to milk only by reintroducing milk products to her diet very gradually and observing whether she reacts to them. Your doctor will guide you as to how and when to start doing this.

Lactose intolerance
If your baby is lactose intolerant, it means she has difficulty digesting lactose, the sugar found in milk. This happens when the body doesn’t produce enough lactase, the enzyme needed to digest lactose. The symptoms of lactose intolerance are:
abdominal pain
gurgling
bloating
diarrhea, which can lead to a diaper rash
Your baby might develop lactose intolerance for a short period after she has had a stomach infection. This gets better on its own. Lactose intolerance is very common in adults (almost 70% of all adults in India have lactose intolerance) but it usually starts anytime after the age of 5 years. Lactose intolerance before that is very rare. Lactose intolerance is not life threatening but it is permanent.

If your baby is lactose intolerant and formula-fed, your doctor may advise you to give her lactose-free formula milk for a short time.

Lactose intolerant children who have started on solids can have some dairy products like yoghurt without any problem and small amounts of ice-cream, cheese, cottage cheese or paneer (unlike in the case of an allergy when all milk and milk products can trigger a reaction).

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