MILK ALLERGY-DIAGNOSTIC ASPECTS AND THE ROLE OF MILK SUBSTITUTES

The frequency of allergy to cow's milk cannot be determined from existing publications because estimates in the past have often been based on symptoms that might have other explanations. Among the author's own patients, 5% report having had clinical symptoms referable to cow's milk, but less than 0.3% of his patients proved to be allergic to it. A food can cause gastrointestinal upsets and many other symptoms by virtue of nonantigenic components, special toxins, physical properties, poor preparation, or bacterial contamination. Real allergy to raw cow's milk can be overcome in many cases by boiling to denature the offending protein (usually the lactalbumin) or using evaporated milk. It may be necessary to avoid bovine products entirely and use goat's milk, or a meat base formula, or predigested casein with certain additives. It may even be necessary to exclude all animal protein by resorting to vegetable base milks like those made from soy beans. The prolonged use of these substitutes cannot be recommended with confidence. Since infants have been known to lose their sensitivity to cow's milk it should be retried at reasonably frequent intervals.