Cow milk protein intolerance

Exclusive breast feeding may prevent hypersensitivity to allergens during the first months of life when the infant s immune system is immature. Foreign protein is related to atopic diseases such as asthma, eczema and allergies such as cows milk protein intolerance. The mechanism is probably related to transient IgA deficiency due to immaturity of the body s immune system allowing intact protein to permeate the gut wall. There is no proof that any alternative to breast feeding, such as soya rather than cows milk formula, will prevent atopic disease. 

Jakobsson, I. and Lindberg, T. 1979. A prospective study of cow s milk protein intolerance in Swedish infants. Acta Paediatr. Scand. 68, 853-859. 

Lactose intolerance is a distinct entity from cow milk protein sensitivity and causes abdominal pain, diarrhea, nausea, flatulence, and/or bloating. While avoidance of milk and other dairy products will bring relief in children suffering from lactose intolerance, it may cause problems in optimal bone mineralization owing to lack of calcium in diet. Several lactose-free and lactose-reduced milks are now available in markets to cater to such infants. The scope of transgenic technology to reduce the lactose content in the milk of small animals has been reviewed elsewhere in this chapter (Section IV.A). The extension of this technique to include farm animals is targeted in the future. 

Harrison, M., Kilby, A., Walker-Smith, J. A., France, N. E., and Wood, C. B., 1976, Cow s milk protein intolerance A possible association with gastroenteritis, lactose intolerance and IgA deficiency, Br. Med. J. 1 1301. 

Savilahti, E., 1973, Immunochemical study of malabsorption syndrome with cow s milk protein intolerance. Gut 14 491. 

Sumithran, E., and lyngkaran, N., 1977, Is jejunal biopsy really necessary in cow s milk protein intolerance Lancet ii 1122. 

Soy-based formulas were developed for infants perceived to be intolerant of cow-milk protein. The first soy formulas were commercially available in 1929 (Abt, 1965). These formulas were made with soy flour and were not well accepted by parents, who complained of loose, malodorous stools, diaper rash, and stained clothing. In the mid-1960s isolated soy protein was introduced into formulas. These formulas were much more like milk-based formulas in appearance and acceptance. However the preparation of isolated soy protein resulted in the elimination of most of the vitamin K in the soy, and a few cases of vitamin K deficiency were reported. The occurrence of nutrient deficiencies in infants fed milk-free formulas contributed to the development of federal regulations concerning the nutrient content of formulas (Fomon, 1993). Soy formulas now account for about 40 percent of formula sales in the United States. Some parents want to avoid cow-milk protein in the diet and thus wean directly to soy without any reported intolerance to cow-milk formulas. While formulas containing extensively hydrolyzed protein have long been available for infants with allergy to intact cow-milk protein, formulas with protein that is not as completely hydrolyzed have recently been introduced for normal-term infants. 

Carroccio, A., Cavataio, F., Montalto, G., and D Amicio, A.L. 2000. Intolerance to hydro-lysated cow s milk proteins in infant Characteristics and dietary treatment. Clin Exp Allergy 18 1597-1603. 

Because the symptoms of lactose intolerance are nonspecific, lactose intolerance needs to be differentiated from other common disorders causing diarrhea and abdominal pain or discomfort. These differential diagnoses include milk protein allergy, gastroenteritis, colitis, and irritable bowel syndrome. Allergy or sensitivity to one or more of cow s milk proteins characteristically occurs in formula-fed infants, and although no age is exempt, it is rare in the older... 

Host A, HaUcen S, Jacobsen HP, Estmann A, Mortensen S, Mygil S. The natural course of cow s milk protein allergy intolerance J Allergy Clin Immunol 1997 99 S491. 

Nondairy substitutes for milk—Soybean derivatives are commonly used in formulas for infants who have an intolerance to cow s milk. The infants who cannot tolerate soybean protein may be given a formula based upon pureed beef heart. Therefore, it might be useful for some colitis patients to try one or more of these milk substitutes. 

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