Milk related problems: BNSSG guidance
It is important to differentiate between an immediate type 1 IgE and Type 4 non-IgE allergic reactions to milk. Immediate type 1 reactions are IgE mediated, occur within minutes to one hour, and usually comprise acute urticaria, vomiting and breathing difficulties.
This guideline deals with two main types of milk related problems in children.
1) Non- IgE mediated Cow’s Milk Protein Allergy
This is due to a delayed, non-IgE mediated hypersensitivity to protein in cow’s milk. Presentation varies, but usually involves the skin and the gastrointestinal (GI) system.
2) Lactose intolerance
This is caused by a temporary or permanent deficiency of the enzyme lactase, which is present in the small bowel. This will result in the inability to digest lactose found in mammalian milk, and in other dairy products. It may be seen transiently following gastroenteritis. Variable amounts of lactose containing food may be tolerated. If tolerance is exceeded, the child may experience latulence, diarrhoea and abdominal pain but lactose intolerance is not associated with rashes, vomiting or other non-lower GI symptoms.
Read the full guidance below: remedy.bnssg.icb.nhs.uk/media/1493/milkrelatedproblemsinchildren.pdf