Help: My Baby Can't Tolerate Regular Formula

During the first year of your child's life, proper nutrition plays a significant role in supporting their healthy development and immunity. Like many medical experts, I endorse breast-feeding as the best source of nourishment for babies after birth.

If you are unable to produce enough milk to breast-feed, baby formula is a safe alternative. The American Academy of Pediatrics recommends iron-fortified formulas made from cow's milk.

Most babies can handle cow's milk-based formulas very well. However, if your baby is frequently fussy or spitting up after feedings, this could be a sign of milk allergy.

What Causes Milk Allergy?

When your baby has a milk allergy, his or her sensitive immune system perceives the protein in cow's milk as a toxin and immediately produces germ-fighting antibodies (referred to as immunoglobulin E or IgE) to attack it. Each time your infant ingests cow's milk thereafter, those same antibodies (and chemicals like histamine) are released.

[See: 10 of the Biggest Health Threats Facing Your Kids This School Year.]

What Are Signs That My Baby Has a Milk Allergy?

Milk allergy is seen in about 2 to 4 percent of formula-fed babies. Your infant's individual allergic reaction to cow's milk protein can vary from mild to severe.

Potential warning signs to watch out for:

-- Abdominal pain

-- Bloody stools

-- Colic

-- Difficulty swallowing

-- Hives or skin rash

-- Poor weight gain

For purposes of clarity, milk allergy can also occur in breast-fed babies when cow's milk protein is transferred through breast milk. In most of these cases, allergy symptoms may not show up until after the first consumption of cow's milk.

Is Milk Allergy the Same as Lactose Intolerance?

Lactose intolerance is the inability to digest the sugar found in milk and other dairy products. This is rarely seen in infants or toddlers. Generally, children who are lactose intolerant start to see symptoms (including stomach bloating and watery diarrhea with gas) after age 5.

[See: >10 Concerns Parents Have About Their Kids' Health.]

How Is Milk Allergy Diagnosed in Children?

Your doctor can often diagnose milk allergy in your child with the help of a detailed history of symptoms. From there, the best testing consists of removing the source of milk protein and reintroducing as symptoms improve. Reintroduction should only be done under the supervision of your pediatrician, allergist or gastroenterologist.

How Is Milk Allergy Treated?

The simplest and most recommended treatment is eliminating cow's milk from your baby's diet and substituting with a hypoallergenic formula. Occasionally, a baby may need to be placed on a specialized formula containing amino acids -- the basic building block of proteins. Some babies can switch to soy formula, but up to half of children with milk allergy also experience adverse reactions to soy proteins.

As a rule of thumb, always seek the advice of your doctor before changing formulas. Enlisting the help of a pediatric dietitian can also be very helpful.

[See: 10 Things No One Tells You About Breast-feeding.]

Will My Baby Have Milk Allergies Forever?

About 80 percent of infants with milk allergy can tolerate cow's milk proteins by age 1 and almost all children grow out of their milk allergy by age 5.

Dr. Kadakkal Radhakrishnan, MBBS, MD (Peds), DCH, MRCP (UK), MRCPCH, FAAP, is a Pediatric Gastroenterologist and Hepatologist at Cleveland Clinic. Dr. Radhakrishnan has been on faculty in the Department of Pediatric Gastroenterology at Cleveland Clinic since June 2006. He also has joint appointment as Assistant Professor at the Cleveland Clinic Lerner College of Medicine of Case Western Reserve University. Dr. Radhakrishnan's areas of interest involve liver disorders in children, care of children after liver transplantation and small-bowel transplantation. He also has an interest in metabolic disorders involving the liver and care of gastrointestinal manifestations in children with metabolic disorders. Dr. Radhakrishnan, however, follows all types of pediatric gastroenterology problems in his clinic. He also performs upper and lower endoscopy and endoscopically places gastrostomy feeding tubes. In conjunction with Dr. Sumit Parikh from Pediatric Neurology, he runs the Cyclic Vomiting Syndrome Clinic for children. Dr. Radhakrishnan is a keen teacher involved in the teaching of medical students, residents and fellows. He was voted by the pediatric residents at Cleveland Clinic as Staff Teacher of the Year for 2007. Dr. Radhakrishnan's research areas include liver disorders and inflammatory bowel disease.