Cow’s milk protein allergy: practical tips and recipes

Very similar to the most common and easily recognized allergies, cow’s milk protein allergy (CMPA) is an immune reaction of the body that identifies these milk substances as “invasive” and attack it. This allergic process can trigger a series of reactions, which are not always just gastrointestinal and can appear even days after food consumption.

The identification of this food allergy is even more recurrent in the first years of life “and the patient usually loses the allergy in childhood”, explains the allergist and member of the Brazilian Association of Allergy and Immunology (ASBAI) Dr. Renata Cocco. Despite this occurrence being the most frequent, however, there are still more “severe” cases, which can extend into adolescence and very rarely into the second decade of life.

Due to the higher rate of CMPA records in early childhood, some studies point out that one of the possible causes of this immune deficiency may be related to the premature intake of cow’s milk – caused even by the nutrients transmitted by the mother during breastfeeding.

Symptoms and diagnosis of milk allergy

The reactions provoked in those allergic to milk, as they can appear up to a week after consumption of the product, are not easily associated with immunological deficiency. In addition to gastrointestinal symptoms, which include the presence of blood in the stool, vomiting and regurgitation, hives, dermatitis, edema and respiratory system problems such as rhinitis and chronic cough can also be noticed.

From the perception of a pattern in the occurrence of these symptoms, associated with the lack of explanations that could attribute them to other diseases, the diagnosis proceeds with an analysis of the clinical history and, in some cases, specific laboratory tests.

Among the most frequent exams are the prick test, in which holes are made in the skin of the patient so that there is contact of the antigens with the bloodstream, and the oral provocation tests, which consists of “offering the food, always under the supervision of the doctor”. experienced person, who will evaluate possible related symptoms”, details the allergist.

Despite these possibilities, the tests are still not fully effective for the diagnosis, since they can deliver results falsified by external factors, such as the use of medications. Even for this reason, the oral provocation test tends to be more faithful, especially if it is applied more than once and by professionals who are competent to assess the patient’s reactions, ruling out chances of placebo effects.

Coexistence and treatment of CMPA

Unfortunately, there is still no treatment that cures CMPA quickly, making it necessary, therefore, to completely restrict the consumption of milk in the diet, “as well as in products that may contain milk proteins, including cosmetics and medicines”, he warns. Renata. Ideally, the suspension of these products should also be accompanied by a specialist doctor, who will be able to assess the best time to start a food reintroduction and how to proceed so that reactions are minimized.

Due to this suspension, Fernanda Amorim, nutritionist and professor at the Centro Universitário Celso Lisboa in Rio de Janeiro, explains that it is important to be careful to adopt a diet with a good vitamin balance, both in the case of mothers who breastfeed allergic who are exclusively from breast milk and in the case of patients at other stages of life. “Cow’s milk (as well as its derivatives) is a source of calcium, phosphorus, vitamin D and thiamine, for example”, lists the professional.

To avoid the deficiency of these nutrients, Fernanda advises that all other food groups be consumed, with greater attention to “fruits, dark green vegetables and legumes, which are sources of calcium, B vitamins and vitamin C”. In addition, it is also important to increase the body’s stimulus to produce vitamin D, because in this way the absorption of calcium and magnesium is favored. This purpose can be achieved through the ingestion of eggs, sardines, tuna and some mushrooms, “in addition to controlled sun exposure, in the early morning, for approximately 10 to 15 minutes, about three times a week”, indicates the professor. .

Combined with a balanced diet, another habit is necessary: ​​reading labels. This is the only way to prevent the unwanted consumption of foods that have traces of milk or any of the dozens of variations of its proteins.

What about Lactose Intolerance?

Because it is an organism’s response to the consumption of cow’s milk, CMPA can be easily confused with lactose intolerance, especially if there is no clarification about this immune deficiency. As their names suggest, the diseases are totally different, although some of their symptoms may coincide.

“Intolerance occurs due to the deficiency of specific enzymes that digest lactose, the main sugar in milk”, defines allergist Renata Cocco. This condition is more common in adults and is manifested exclusively by gastrointestinal reactions such as bloating, excessive gas, and diarrhea.

Cow’s milk protein allergy, in turn, has a variety of symptoms, which may or may not be combined and manifest in different ways in each patient. It is also important to remember that it appears as a result of an immunological process in imbalance and not due to the difficulty of digestion.

Pay attention to labels!

When a dairy-restrictive diet is the solution to your problems, it is also necessary to suspend the consumption of its derived foods and be more careful with other industrialized products that may have any trace of proteins, such as breads, creams, snacks and cookies, for example. example.

In this way, the allergist recommends that all food, cosmetic and medication labels be read carefully before ingestion by the allergic to milk. The doctor listed some of the various components that should be eliminated from food when living with CMPA:

• Milk (derivatives, proteins, solids, condensed, evaporated, dehydrated, malted, skimmed, semi-skimmed, lactose-free);
• Artificial flavorings based on butter/margarine;
• Butter/margarine;
• Casein;
• Caseinates (ammonium, calcium, magnesium, potassium or sodium);
• Hydrolysates (from casein, milk proteins, whey, whey proteins);
• Whey (lactose-free, demineralized, from protein concentrate);
• Lactoalbumin, lactalbumin phosphate;
• Lactoglobulin;
• Cheese, cottage, cream;
• Cream, cream cheese;
• Pudding;
• Yogurt;
• Chocolate;
• Bavaria cream.

Another care with labels is mentioned by Fernanda Amorim and concerns the so-called plant-based milks. “This nomenclature came from the food industry, but the correct name is vegetal extract. Milk is a product of the mammary gland, so vegetables are not able to produce milk”, explains the nutritionist.

These plant extracts, so that they become equivalent to cow’s milk, are added with vitamins and minerals. Other products that are sold as substitutes for cow’s milk are those from other mammals, such as goats and buffaloes, but, according to the expert, it is possible that “some individuals who are carriers of CMPA also develop allergies to their proteins”, since they are similar to the cow.

Thus, it is essential that the replacements of cow’s milk in a restrictive diet are made only with medical advice.

Delicious and allergy friendly recipes

After the diagnosis and the beginning of a treatment, with the adoption of a restrictive diet, the best way to guarantee the health and good nutrition of the allergic person is to avoid industrialized products and dedicate yourself to cooking with the most recommended ingredients.

The novelty of eating habits can be nerve-racking. Suddenly, it seems that all the recipes in the world use milk, but a good tip is to resort to a vegan diet, which is always milk-free, discover new dishes and, of course, invent!

In the list below, check out a selection of 12 recipes made by people with some type of dietary restriction and/or who have been found to be allergic to cow’s milk.

1. Negresco Popsicle: consuming industrialized sweets is possible, as long as the label does not reveal any ingredients prohibited to the person allergic to milk, which is the case of several common stuffed cookies. The popsicle league is on account of coconut milk.

2. Milk-free Coconut Yogurt: Yogurt is one of the main dairy products and, with this recipe, the coconut flavor becomes reality for the allergic person when prepared with fruit and honey.

3. Flavored Liqueur Truffle: another recipe to satisfy chocolate addicts! This delight is preferably made with a specific brand of milk-free chocolates and has a vegetable extract to bind it together.

4. Cristina Cake: This banana cake does not have cow’s milk equivalents in its recipe. The dough binds is provided by mixing the fruit with eggs and oil.

5. Sausage Bun: the snack is prepared with margarine and soy milk, so it is important to be careful that both ingredients are allowed in the allergy-restricted diet. In addition, it is also worth checking the sausage label for traces of milk, as most sausages rely on this element to be mixed and compacted.

6. Chocolate Mousse: to consume chocolate without worries, the secret is to bet on those that have a very high percentage of cocoa: the more bitter, the less milk the chocolate has. Despite this, it is also important to check the product label, as most chocolates — even those that do not have milk in their formula — are prepared in instruments that mix the most traditional products. There are more serious cases of allergy in which the mere contact with cow’s milk is enough to provoke reactions.

7. Milk-free Stroganoff: traditionally, the stroganoff sauce is made from sour cream or natural yogurt, but in this recipe, almond extract is substituted for the tomato sauce, ketchup, soy sauce and sauce. English.

8. Basic Unfermented Bread: Unfortunately, finding cow’s milk-free breads at affordable prices is a big battle for allergy sufferers. An alternative can be to try different recipes and adapt them until you find the best one for the restrictive diet in question. In this recipe, the gluten is replaced by a special mixture of flours and the milk is replaced by the plant extract that can be consumed without problems by the person with CMPA.

9. Vegan Carrot Cake: Many traditional recipes for simple cakes rely only on water to bind. Fortunately, carrot cake is one of those that can be consumed by the allergic person without fear! Here, it is still taught how to make a simple chocolate coating, with accessible ingredients, and free of milk.

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