Recently, I often encounter scenarios such as
Q: What is the treatment for baby with eczema?
A: Doctor, we’ve stopped the formula and switched to amino acid formula~~~
Q: Why do you want to change the formula?
A: Some doctors say that babies have eczema because of milk protein allergy, let us eat amino acid milk powder ~ ~ ~ ~ ~
Q: Is the eczema getting better?
A: No…???!
This also leads to a few questions.
1. How is milk protein allergy diagnosed?
We often encounter parents who claim that their babies are “allergic to milk”, and these babies are usually diagnosed in the following way.
A baby within 1 year of age has a rash and goes to the doctor, who looks at the skin symptoms and tells him, “This is a milk allergy.
A baby with recurrent eczema goes to the doctor, who takes blood tests and finds that milk protein IgE is elevated, so the diagnosis is “milk protein allergy”;
The baby repeatedly has eczema, the parents seek medical help all over the place, and then they look it up on the Internet and ask questions in their circle of friends, thinking that their child is “allergic to milk protein”.
Is there anything else? There must be all kinds of different claims about “milk allergy”.
So are all these diagnoses and all the other claims on the internet and in the circle of friends reliable?
2. How should milk protein allergy be diagnosed?
When parents suspect that their baby may have a milk protein allergy and go to the doctor, the doctor will usually.
Inquire in detail about the baby’s signs and symptoms, including skin symptoms, nasal symptoms, eye symptoms, respiratory symptoms, and gastrointestinal symptoms.
Perform a careful physical examination.
Perform a milk allergen test: either a skin prick test, or a blood test for IgE antibodies specific to milk proteins.
For their part, parents should provide the following information:
A diary of the diet: a detailed record of the various foods ingested by the baby and by the breastfeeding mother.
Whether there is a temporal sequence between the onset of each symptom and the ingestion of milk and milk-containing foods.
whether the symptoms improved or subsided after the cessation of the intake of milk and various foods containing milk.
Even though all of the above information combined is highly suggestive that the baby may be allergic to milk protein, it is not yet completely certain that it is a milk protein allergy.
The most accurate method of diagnosis is the oral provocation test, which is commonly known as “trial feeding”: stop consuming milk and milk-containing foods for 2-4 weeks, stop using various medications to control symptoms, then start consuming milk in small amounts and gradually increase the intake to observe whether symptoms appear. (Note: this oral provocation test carries the risk of inducing a systemic allergic reaction and must be performed by a specialized physician in a clinic or hospital).
So to diagnose milk protein allergy is not really a matter of looking, taking a blood sample, looking up on the internet or asking questions in a circle!
3. What are the manifestations of milk protein allergy?
Some symptoms appear within minutes of ingesting milk or milk-containing foods, while others may appear several hours or even days later.
Symptoms that appear within minutes to 2 hours are called “fast-onset reactions” and can manifest as follows.
Wind clouds and hives.
Acute attacks of wheezing or asthma.
Vomiting, abdominal pain.
Symptoms that appear several hours later are called “late onset reactions” and include the following.
Softening and thinning of the stool, blood in the stool.
Diarrhea or abdominal pain.
Cough or wheezing.
Runny nose.
Itchy or watery eyes.
The appearance of a rash or itchy skin (usually more pronounced on the skin around the mouth), or worsening eczema.
Infantile colic some patients may have both rapid onset and delayed onset symptoms, skin, digestive or respiratory tract, and these will require a professional doctor to determine.
4. Is infant eczema caused by milk allergy?
As we mentioned earlier, allergen testing (skin prick test and blood test for IgE antibodies) can help diagnose milk protein allergy. If the test result is positive, it is not certain that it is a milk protein allergy, it just means that the body has been sensitized after contact with milk protein (note: sensitization does not always produce allergy symptoms). Whether a positive test result is causally related to skin eczema will also be determined by dietary avoidance and oral provocation tests.
Some studies have tested eczema patients for food allergens and found that 30% to 80% of eczema patients with food allergens experienced sensitization, but no more than 15% had a true food allergy as determined by oral provocation testing.
The rate of food-induced eczema varies with the severity of the eczema, with the rate of food-induced eczema in children ranging from about 1 to 3 percent for mild eczema, 5 to 10 percent for moderate eczema, and 20 to 33 percent for severe eczema.
Adults rarely develop eczema due to food.
Therefore, when parents see that their baby has a rash, or that the eczema is repeatedly bad, they should not rush to blame it on the milk, but to find the cause of their baby’s rash together with a professional doctor.