Milk and products thereof

Milk and products thereof

Milk and products thereof (including lactose), except:

(a) whey used for making alcoholic distillates including ethyl alcohol of agricultural origin
(b) lactitol

Milk is one of the most common allergy triggers in infants and toddlers. It is estimated that more than two per cent of children in industrialised countries are allergic to cow's milk. The allergy is not as common in adulthood.

milk contains many proteins that can trigger allergies. Those most commonly involved in allergic reactions are casein and the whey proteins beta-lactoglobulin and alpha-lactalbumin. Most allergic individuals react to several proteins at once.

Casein is heat stable and is not destroyed through cooking. On the other hand, the proteins beta-lactoglobulin and alpha-lactalbumin are heat sensitive. Therefore patients who only react to these heat-sensitive proteins may be able to tolerate products containing milk that has been cooked or baked.

Symptoms

Symptoms occur within minutes, but may also appear up to 48 hours after milk consumption. The skin is most commonly affected, along with the gastrointestinal tract in many cases. Skin symptoms include redness, hives and itching. Facial swelling also occurs in some patients. In delayed reactions, atopic dermatitis can be triggered or worsened. Gastrointestinal symptoms include diarrhoea or constipation, nausea and vomiting. Infants may experience delayed growth.

As with other food allergies, the airways can be affected, resulting in allergic rhinitis or asthma symptoms. In rare cases, anaphylactic shock with difficulty breathing and circulatory collapse may occur.