Baby Dairy Allergy Q&A with Board Certified Allergist Dr. Katie Marks-Cogan

In honor of Food Allergy Action Month, we’re excited to answer your most common baby dairy allergy questions in our interview with Ready, Set, Food! Chief Allergist Katie Marks-Cogan M.D (see bio below).
What are the symptoms of an igE-mediated dairy allergy? Are they the same for babies?
Symptoms can include hives, swelling of lips/tongue, stomach upset, breathing problems in addition to others.
Symptoms can occur within seconds to minutes, and almost always occur within 2 hours. In babies, hives and vomiting are the most common symptoms of a severe food allergic reaction.
Babies can also develop a delayed milk allergy, which is different than an IgE-mediated/immediate-type milk allergy. Delayed baby milk allergy symptoms include mucus and blood in the stool and colicky abdominal pain and can occur many hours after milk ingestion.
What’s the difference between a baby dairy allergy and a baby dairy intolerance?
Food intolerances are adverse health effects caused by foods that do not involve the immune system. The term food intolerance is often used interchangeably with the term food sensitivity. In addition to a dairy intolerance or milk allergy symptoms in babies, non-immunologic reactions to food (food intolerances) can include:
- Metabolic (lactose intolerance)
- Inability to digest lactose, a prominent sugar found in milk, which leads to gas, bloating, diarrhea
- Pharmacologic (caffeine)
- Jitteriness, etc
- Toxic (scombroid poisoning)
- Ingestion of fish with high histamine levels due to improper handling
- Undefined mechanisms
- Gluten intolerance
- Metabolic (lactose intolerance)
What are the most common food allergens for babies?
Although more than 170 foods have been identified as triggers of food allergy, the FDA classifies 8 foods/food groups as the major food allergens in the US: milk, egg, peanut, tree nuts, shellfish, fish, wheat, and soy. In babies, milk, egg and peanut are the most common food allergens.
What can parents do to reduce their baby’s risk of developing a dairy or other food allergies?
There is currently no cure for food allergies, which makes prevention the first and best line of defense against food allergies for families. The current recommendations for food allergy prevention include:
- Start Introducing Allergens Early: Starting at 4-6 months of age is likely more effective at reducing a baby’s risk of developing food allergies, but positive results have been seen in the studies for babies who started as late as 11 months of age. Studies suggest that delaying peanut introduction may put your child at a greater risk for developing a peanut allergy. For infants with severe eczema, it is recommended to consult with your pediatrician before starting early allergen introduction.
- Once is not Enough — The Importance of Sustaining Exposure: Sustained introduction is just as important as early introduction. In recent landmark studies that resulted in 67-80% reduction in certain food allergies, participants sustained exposure multiple times a week for 3 to 6 months or more. A baby’s immune system needs time and repeated oral exposure to develop a positive response to foods.
But early and sustained allergen introduction can be challenging. It’s common for parents to struggle with sustaining exposure because feeding infants certain foods multiple times a week can be challenging. In fact, in one of the landmark studies, only 50% compliance was achieved among participants, indicating that early and sustained introduction is difficult at such a young age.
With the rate of food allergies rising, it’s exciting that parents have the opportunity to reverse this trend through the proven benefits of early and sustained allergen introduction. However, many parents struggle with following the new guidelines on prevention. Parenting is difficult enough, so when we discovered that there wasn’t a product on the market that made this process easy for parents, I helped a team of leading experts, physicians, and parents, create one. After over 12 months of research and development, we’re proud to offer a gentle, guided system that helps reduce the risk of developing peanut, egg, and milk allergies by up to 80% for families like yours. To learn more about how Ready, Set, Food! makes early and sustained allergen introduction easy, visit our website here.
Bio: Katie Marks-Cogan, M.D., is board certified in Allergy/Immunology and Internal Medicine, and treats both pediatric and adult patients. Originally from Cleveland, Ohio, she received her M.D. with honors from the University of Maryland School of Medicine. She then completed her residency in Internal Medicine at Northwestern and fellowship in Allergy/Immunology at the prestigious University of Pennsylvania and Children’s Hospital of Pennsylvania (CHOP). After finishing training, she moved to Southern California and currently works in private practice. She is a member of the scientific advisory board for Ready, Set, Food! She currently resides in Los Angeles with her husband, 3 year old son, and 1 year old daughter where she enjoys hiking, building LEGO castles with her kids, and cooking with her family.
FROM: Allergies, Contributors, Food Allergies
Hi Laura Dolgy,
I am a pediatric nurse practitioner and I will be giving a presentation on- Food Allergy Prevention in 2023: Applying Current Guidelines & Overoming Adoption Barriers for the American Association of Nurse Practitioners and would like to obtain permission to use your Food Allergy Reaction Symptoms chart in this blog article.
Thanks for your consideration,
Julianne Doucette