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Pediatric Allergy

Food allergy or non-allergic food hypersensitivity?

Pediatric Allergy

Food allergies and non-allergic food hypersensitivities in babies and young children can present a real challenge. Until a diagnosis is reached, the process for parents, children, and healthcare professionals can be a long and stressful one.


Non-allergic food hypersensitivities, such as food intolerances, arise because the body is unable to digest or reacts to certain naturally occurring component of foods such as lactose or fructose, or, less commonly, some food additives or preservatives. Non-allergic food hypersensitivities, unlike food allergies, do not involve the immune system.


Food allergies, on the other hand, are caused by the body’s own immune system reacting to certain proteins present in the food. Proteins are one of the essential nutrients that make up the body, together with vitamins, minerals, carbohydrates and fat. Other components in food, such as lactose and sugar, are not allergens.


Certain proteins are more common allergens than others. Here are the top eight allergens accounting for approximately 90 percent of all allergic reactions to food in children:


The prevalence of food allergies, especially in the first years of life, has increased dramatically in the last 10 years. The challenge to find better ways to prevent and manage food allergies is a pressing need.


Cow’s milk protein allergy (CMPA) is one of the most common food allergies in children


Although cow’s milk protein is one of the common food allergens in babies and toddlers it can be difficult to diagnose. CMPA occurs when a baby’s immune system reacts to the protein in cow’s milk. If breastfed, the reaction may be to the cow’s milk protein ingested by the mother and passed to the child through the breast milk. If the child is formula-fed, the reaction is to the milk protein in the formula itself. In both instances the body’s immune system recognizes these proteins as foreign and, in response, releases natural substances such as histamines, which cause the allergic symptoms. CMPA generally occurs for the first time between the third and fifth month of life in affected children, but can also develop later in life.


Lactose intolerance is not the same as c ow’s milk protein allergy ( CMPA)


CMPA and lactose intolerance are often confused. Although some symptoms such as diarrhea, are similar, lactose intolerance is an inability to digest the lactose (milk sugar) in milk whereas CMPA is an immune reaction to the protein in the milk. Even in those children with CMPA, lactose intolerance is uncommon before 3 years of age. After all, breast milk naturally contains a high amount of lactose.




Signs and symptoms of cow’s milk protein allergy (CMPA)

The signs and symptoms linked with CMPA, ranges from colic and reflux to constipation and diarrhea, and makes diagnosis a real challenge. Every case of CMPA is also unique, so it helps to be aware of all the possible symptoms to look out for. There are three main categories of symptoms that include skin, digestive, respiratory, and more general symptoms as listed in the chart below*. These symptoms can appear immediately, within minutes or up to two hours of ingesting cow’s milk, or sometimes even after several hours or days, depending on the nature and sensitivity of the reaction.

If you think your baby is suffering from the signs and symptoms of CMPA or other food allergies, it is important to set up an appointment with your healthcare professional and prepare for your visit. Diagnosis of CMPA should always be made by a healthcare professional.



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