Cow's Milk Allergy in Children

Fiocchi A, Restani P, Leo G, et al: Clinical tolerance to lactose in children with cow's milk allergy. Pediatrics 2003; 112(2): 359-362.

Frequently, allergists recommend that children with cow's milk allergy (CMA) avoid all lactose-containing foods because lactose may retain an allergizing protein fraction and there is a crossover between symptoms of lactose intolerance and CMA. Lactose is used as a bulking agent and nutritional supplement in many drugs, foods, and even toothpastes.

This double-blind, placebo-controlled food challenge of 24 toddlers (ages 2 to 107 months) suggests those children hypersensitive to cow's milk can tolerate foods and drugs with whey-derived lactose. Whey-sourced lactose may be acceptable as a sugar for processed foods, nutritional supplements, weaning formulas, and as an additive in formulas (soy-based) for children with CMA. Lactose assists in calcium assimilation and is a slow energy release sugar. It is unclear what the effects of a lactose-free diet play on clinical neurologic abnormalities.