What's New Events Calendar Research Professional Information Public Information
Awards Recipients
Health Advisory
Board of Directors


What to do when baby can’t drink milk.
New parents need to quickly identify problems so that baby’s growth is not compromised.

OTTAWA, April 2, 2004 - The incidence of cow’s milk allergy and lactose intolerance in young infants is rare – about 2-8% in North America -- but the need to be able to identify them is a legitimate concern. An allergy to cow’s milk can be life threatening, and lactose intolerance can lead to malnutrition. The symptoms of food allergies can be confusing too – while wheezing, coughing and an upset stomach can indicate an allergy, it can also mean that baby has a cold!

Few things are more frustrating for parents than dealing with a baby who won’t feed or is being “fussy”. New parents can feel helpless when their baby refuses to eat, or starts experiencing symptoms such as diarrhea and vomiting. Fortunately, there is a lot of information available about allergies, and your paediatrician is there to help.

“Breast milk is the best food for your baby”, explains Dr. Rhoda Kagan, Paediatric Allergist for the McGill University Health Centre’s Montreal Children’s Hospital, “but problems can occur in breast feeding as well. It’s important for parents to watch for signs of food allergies so that a breast-feeding mother can alter her diet if necessary, or so that the baby’s formula can be switched to an alternative, such as a soy-based formula. Basically, you need to consult your paediatrician as soon as possible if you suspect allergies or lactose intolerance. Aside from some immediate dangers, there is also a concern that the infant will not get the optimal nutrition he or she needs in that important first year.”

A spokesperson from the Canadian Allergy, Asthma and Immunology Foundation, which is dedicated to research, education and training in all areas of allergy, asthma, immunology and allergic diseases in Canada, agrees. “Food allergies affect 2-4% of our children,” notes CAAIF President Dr. Zave Chad, “and many of these allergies will resolve themselves in time. However, we know that allergic diseases have increased significantly in the past twenty years, so more families are being affected. Awareness is important.”

Cow’s milk allergy
Usually an allergy to cow’s milk will develop during the first few months or after exposure to cow’s milk through traditional infant formula. “The allergy is actually to certain proteins in the cow’s milk, not the milk itself,” continues Dr. Kagan, “and can also be a result of antigens in the mother’s breast milk.” A baby exhibiting an allergy to cow’s milk usually has symptoms within an hour of feeding, and symptoms may include abdominal pain, vomiting, a skin rash and sometimes wheezing. The rash may look blotchy or like hives, especially around the baby’s mouth.

The good news is that most infants will outgrow their allergy in a few years. By age four, about 85% of allergic children will have outgrown their cow’s milk allergy, and by age six about 95% will be allergy-free. Fewer than 1% of babies will carry a lifelong allergy to cow’s milk.

Lactose intolerance
A baby can have lactose intolerance, too, which is not an allergy yet will cause some of the same symptoms. “When an infant is lactose-intolerant,” notes Dr. Kagan, “he or she cannot digest lactose, which is a carbohydrate found in cow’s milk. The undigested lactose sits in the intestines instead of being broken down by the enzyme lactase.” In addition to vomiting and diarrhea, symptoms can include gas, bloating and cramps. “Lactose intolerance in an infant is usually the result of a gastrointestinal infection that requires a temporary change in formula,” continues Dr. Kagan, “after which the baby can go back to the original formula or breastfeeding.”

When your baby has a cow’s milk allergy or lactose intolerance, your paediatrician may suggest formulas that do not use cow’s milk, such as a soy protein-based formula. Soy is a nutritionally complete protein that has a well-rounded amino acid profile. Diets using soy as the sole protein source are capable of providing adequate amounts of all the essential amino acids to meet the needs of infants, children and adults. “It’s important to note,” explains Dr. Kagan, “that some children who have a cow’s milk allergy will develop an allergy to soy protein, but most children with milk allergies will tolerate soy products well.”

Both cow’s milk allergy and lactose intolerance are controllable with diet modification and treatment, and usually with the substitution of an iron-fortified soy infant formula. Special care must be taken to ensure proper nutrition, and you should always consult with your paediatrician before making a change in feeding habits.

Signs & Symptoms of Cow’s Milk Allergy or Lactose Intolerance
Watch for the following symptoms and contact your paediatrician if you suspect a food allergy or lactose intolerance:

- Vomiting
- Hives, rash
- Wheezing or other respiratory problems
- Gas, cramping, bloating
- Stomach rumbling
- Diarrhea

If symptoms persist after a new feeding regimen has been prescribed, return to your doctor immediately.


Dr. Rhoda Kagan is the director of the Paediatric Allergy/ Clinical Immunology Program at McGill University, Montreal, and is an associate professor of Paediatrics at the Montreal Children’s Hospital. She also acts as a medical advisor to the Association québécoise des allergies alimentaires, Anaphylaxis Canada, and the Asthma and Allergy Information Association.

A frequent participant in interviews for television, radio, newspapers, and magazines, Dr. Kagan has discussed aspects of food allergies and allergy research that are of interest to the public. Dr. Kagan’s own research focuses on the epidemiology and natural history of allergy, as well as on the quality of life of children who have food allergies. Most recently, she collaborated on a two-year study on the prevalence of peanut allergy in Montreal schoolchildren. The results of this study, the largest of its kind in North America, was published in the December 2003 issue of the Journal of Allergy and Clinical Immunology.

Dr. Kagan has been the recipient of research grants from the Montreal Children’s Hospital Foundation, the Canadian Institute of Health Research, Health Canada’s Bureau of Chemical Safety, and le Fonds de la recherche en santé du Québec. She has been an invited lecturer and participant in national and international conferences given by the Canadian Paediatric Society, Health Canada, the National Institute of Environmental Health Sciences, USAID, and ISTNA. Her work has been published in a variety of peer-reviewed journals, books, and in the publications of national allergy and asthma associations.

Dr. Kagan is a member of the Canadian Medical Association, the Quebec Medical Association, the Canadian Society of Allergy and Clinical Immunology, and the American Academy of Allergy Asthma & Immunology. She is a member of and a paediatrics examiner for the Royal Canadian College of Physicians and Surgeons of Canada.

Website by Mediaforce