Clinical PracticeMilk Intolerance: Lactose Intolerance and Cow's Milk Protein Allergy
Section snippets
Lactose Intolerance
Lactose intolerance is a result of lactase deficiency and is a form of carbohydrate malabsorption. Lactose is hydrolyzed by lactase in the intestinal mucosa. Lactase is one of many β-galactosidases seen in the small bowel and is most active in the jejunum.4 The by-products of lactose hydrolysis are the monosaccharides: (1) glucose and (2) galactose. When lactase is absent or deficient, hydrolysis of the sugar lactose is incomplete. Because it is osmotically active, the undigested sugar will
Cow's Milk Protein Allergy/Cow's Milk Protein Intolerance
Intolerance or allergy to cow's milk is more complex and less well understood.3, 7 Sensitivity and allergic reaction to cow's milk protein is said to be the most common allergy seen in infancy.8 The incidence has been reported to be anywhere between 1.8% and 7.5%.3, 9, 10, 11, 12, 13 The variability in incidence reporting has been attributed to the differences in diagnostic criteria used to identify infants with the disorder, as well as differences in the design of studies used to evaluate the
Lactose Intolerance Diagnosis and Management
The symptoms of lactose intolerance tend to be primarily GI in origin. If a bout of gastroenteritis or use of antibiotics occurs around the time of the GI symptoms, a secondary lactose deficiency should be suspected. In the intestinal insult that often occurs with secondary lactose intolerance, lactase is the first enzyme to be negatively impacted and the last to recover as the insult resolves.5 Testing for reducing substances in the stools is not always helpful. Infants with positive reducing
Cows' Milk Protein Allergy/Intolerance Diagnosis and Management
There is no single one test that can be used to identify all children with CMA.16, 19, 25 Total serum IgE levels are not helpful by themselves. Infants with normal IgE levels can still have CMA. Skin or prick tests specific for cow's milk protein can be used but have high rates of false positives and false negatives.19, 26 The radioallergosorbent test can be done to detect specific IgE to cow's milk but may be negative in children who are truly allergic.19 Scratch and radioallergosorbent tests
References (33)
- et al.
Immaturity of gastrointestinal host defense in newborns and gastrointestinal disease states
Adv Pediatr
(1998) - et al.
Soy protein for the prevention and treatment of children with cow-milk allergy
Am J Clin Nutr
(1998) - et al.
Manifestations of milk allergy in infancy. Clinical and immunological findings
J Pediatr
(1986) - et al.
Combined skin prick and patch testing enhances identification of food allergy in infants with atopic dermatitis
J Allergy Clin Immunol
(1996) Pediatric allergy
(1951)The history of infant feeding II. Seventeenth and eighteenth centuries
Arch Dis Child
(1953)Clinical course of cow's milk protein allergy and intolerance
Pediatr Allergy Immunol
(1998)Carbohydrate metabolism of the fetus
- et al.
Development of the human digestive system
Digestive—absorptive functions in fetuses, infants and children
Jejunal response to B-Lactoglobulin in infants with cow's milk allergy
C R Acad Sci III
Gastrointestinal manifestation of cow's milk protein allergy during the first year of life
J Med Assoc Thai
Cow's milk protein allergy and intolerance in infancy
Pediatr Allergy Immunol
Aspects of nutritional management of food allergy
Pediatr Allergy Immunol
Intolerance to hydrolysed cow's milk protein in infants: clinical characteristics and dietary treatment
Clin Exp Allergy
Importance of the first meal on the development of cow's milk allergy and intolerance
Allergy Proc
Cited by (14)
Concanavalin A layered calcium alginate-starch beads immobilized β galactosidase as a therapeutic agent for lactose intolerant patients
2008, International Journal of PharmaceuticsEffect of multi-pass high pressure homogenization on physicochemical properties of hazelnut milk from hazelnut cake: An investigation by response surface methodology
2018, Journal of Food Processing and PreservationDetermination of a new cow's milk-based formula allergenic capacity in 7 infants
2017, Revista Alergia MexicoThe neural bases of disgust for cheese: An fMRI study
2016, Frontiers in Human Neuroscience