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Allergy vs Sensitivity 101: What toddler tummy troubles and chronic congestion could be telling you

Allergy vs Sensitivity 101: What toddler tummy troubles and chronic congestion could be telling you

As a naturopath, I’m often asked if goat milk is appropriate for children with cow milk allergies. The short answer to that question is no – but before closing down the discussion, it’s important to explore another question. Are we talking about a medically confirmed cow milk protein allergy (CMPA), or is it cow milk sensitivity (CMS)?

By Dr. Kate Morrison, N.D.

You might be surprised at how rare true cow milk allergies are – according to the North American Society Pediatric Gastroenterologists, only about 2-3% of children under the age of six are allergic to the proteins found in cow milk. If your child suffers from the far more common phenomenon of cow milk sensitivity, they it’s possible that they will tolerate goat milk well.

Because cow milk sensitivity is not well-defined in research, it’s tough to say exactly how common it is, but from a combination of parental and clinician surveys, it may be that 30-50% of children experience symptoms related to cow milk consumption. Let’s take a look at the differences between the two.

What is a Cow Milk Protein Allergy?

A confirmed cow milk protein allergy (CMPA) can be a serious health problem. Children with ‘obvious’ CMPA will have an immediate reaction to cow milk that happens within hours of ingestion. Symptoms will most commonly be moderate to severe in intensity and may include:

  • Swelling around the mouth
  • Difficulty swallowing
  • Vomiting and regurgitation
  • Diarrhea
  • Blood in the stool
  • Food refusal
  • Failure to thrive
  • Severe colic
  • In rare cases, anaphylactic shock

What is Cow Milk Sensitivity?

Cow milk sensitivity may encompass the delayed, mild to moderate symptoms associated with consumption of cow milk. It appears to involve two main body systems: the gut and the immune system. The gut is involved when components of cow milk – either the fat, lactose, protein, or a combination of components – are digested poorly. Inadequate food breakdown and delayed transit time in the digestive system can lead to symptoms such as:

  • Bloating
  • Gas
  • Abdominal pain
  • Colic
  • Loose stools
  • Diarrhea
  • Constipation

In addition, an immune response may be triggered as a result of injury to the gut mucosa. There are a number of factors that influence susceptibility of the gut to injury – including delayed transit time, certain proteins found in foods and even current or past use of medications (such as antibiotics).

When the gut is injured, it can cause a condition referred to as leaky gut, where the normally impermeable gut becomes permeable. In cow milk sensitivity (CMS), milk proteins are able to pass through the intestinal walls, triggering an immune response that initiates inflammation. This can lead to non-illness related mild to moderate inflammatory symptoms in the respiratory and dermatological symptoms such as:

  • Mucous congestion
  • Chronic runny nose
  • Chronic cough
  • Chronic wheezing
  • Eczema
  • Rashes

How do I know the difference?

It can be difficult to tell the difference between a food allergy and sensitivity, especially when symptoms are moderate. The most accurate and gold standard diagnostic method involves the complete avoidance of cow milk for one month, followed by a medically supervised reintroduction and monitoring of symptoms. Other diagnostic tests for CMPA, such as blood tests or a skin-prick test, can be used as supportive diagnostic tools, but the elimination/challenge method is recognized as the gold standard.

I’ve seen many symptomatic children improve after making the switch to goat milk (including my own son!), but since every child is different, it’s best to work with your healthcare provider if you are concerned about whether your little one’s symptoms stem from allergy or sensitivity.

Dr. Kate Morrison, N.D. is a board-certified naturopathic doctor and is co-founder of KABRITA USA.

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