Milk Allergy

Diagnosis

When food triggers an allergic reaction, it is not always easy to identify which food is responsible. To diagnose a milk allergy, a healthcare professional may begin by gathering detailed information and evaluating overall health.

The diagnostic process may include discussing symptoms in detail, performing a physical examination and asking you or your child to keep a diary of foods eaten and symptoms experienced. In some cases, milk is removed from the diet for a period of time and then added back to see whether symptoms return.

To help confirm a milk allergy, one or both of the following tests may be recommended:

• Skin test
  During this test, the skin is lightly pricked and exposed to small amounts of milk proteins. If a milk allergy is present, a raised, itchy bump known as a hive may appear at the test site. Allergy specialists are best trained to perform and interpret these tests. While helpful, skin tests are not fully accurate on their own.

• Blood test
  A blood test measures the immune system’s response to milk by checking the level of immunoglobulin E antibodies. This test can support a diagnosis but may not always clearly identify a milk allergy.

If the results of exams and tests are unclear, a healthcare professional may recommend an oral food challenge. In this controlled test, increasing amounts of foods that may or may not contain milk are given to see if a reaction occurs. Because of the risk of severe reactions, this test should be done by an allergist trained to manage emergencies.

If milk allergy is ruled out, additional testing may be needed to identify or exclude other medical conditions that could be causing symptoms.

Treatment

The most effective way to prevent an allergic reaction is to completely avoid milk and milk-containing proteins. This can be challenging, as milk is a common ingredient in many foods. Some people with a milk allergy may tolerate milk in certain forms, such as milk that has been heated in baked goods or found in specific processed foods like yogurt. A healthcare professional can help determine which foods are safe and which should be avoided.

If you or your child is at risk of a severe allergic reaction known as anaphylaxis, emergency treatment may be needed. Management may include immediate use of injectable epinephrine and prompt medical care.

People at risk of severe reactions may be advised to:

• Carry injectable epinephrine at all times

• Learn how to properly use the injection device before an emergency occurs

Proper avoidance strategies, clear labeling awareness and an emergency action plan are essential parts of managing a milk allergy safely.