Got milk for your kid? Beware she could be lactose intolerant or allergic
by Agencies
For ten-year-old Molly, it was a big deal when she ate a piece of buttered toast and nothing happened. Diagnosed with a severe milk allergy aged six months, daily life had been difficult. She and her family had to be extremely cautious and carry dairy-free food for her to consume. Molly has an allergic reaction when antibodies become over-sensitive and attack the lactose proteins in food she eats. These antibodies then bind themselves to the allergen and cause the release of chemicals, including histamine, which triggers swelling, itching, rashes and tightening of the airways. It can cause anaphylactic shock, with severe swelling, breathing difficulties and sometimes loss of consciousness, making it potentially life-threatening. A new scheme has given Molly an alternative to a life spent anxiously avoiding dairy. A UK doctor said, 'The principle is if you give someone very small doses of the allergen, very slowly building it up over time, their sensitivity to it will decrease.
In India, we often mistakenly use the term 'lactose intolerant,' for what may actually be an allergy to dairy.
What is lactose intolerance?
Dr Vipla Puri, consultant doctor at Hinduja Hispital's Reproductive Immunology Associates (RIA) Lab, has worked with food allergies for over 20 years. She explains, 'Lactose intolerance means the body is not able to break lactose into various proteins. It is due to enzyme deficiencies. Cramps, a feeling of heaviness and acid reflux are tell-tale signs.' Living with intolerance does not mean that you have to stop consuming dairy products completely. 'You can reduce your intake and watch for symptoms to reduce. In some cases you have to stop it for some time, and slowing reintroduce it into your diet,' she says. Ruchi Kumar, a new mom says that after repeated discomfort, she realised that she was intolerant to milk. 'I switched to skimmed milk and experienced much relief. Now I enjoy my milky chai and desserts without worrying about cramps and acidity.'
What is a milk allergy?
Vipla says, milk allergies are caused by the body's reaction to a specific immunoglobulin protein. 'I have seen milk allergies in 15 per cent of the 300 patients I have worked with over the past one and half years. And even then, allergy levels differ in severity and are mostly non-life-threatening. In an allergy, the reaction — rashes, redness, swelling of lips — is immediate.' Like other food allergies, a milk allergy too is detected via a blood test. For people who have this allergy, the best option is to switch to a milk alternative. Soya, almond and rice milk are common kinds that can be consumed.
'It is crucial to be careful as many products may contain milk and you may not realise it,' Vipla says. 'Often packages are labelled in a complicated manner, marking the specific lactose protein. It should just be labelled as 'contains milk' for a layperson's benefit.' Though not always, it is possible for allergies to be reduced, though it may take a long time. 'Introducing small doses of the milk can help, like it did for Molly, but it is not a sure-shot method, and there is not time-frame. It must be done under careful supervision to avoid complications,' Vipla adds.
Low-dose allergy / antigen treatment (LDA)
Dr Amit Saraf, Consultant Physician (Internal Medicine), DNB Medicine Coordinator explains that LDA may be the best possible treatment for allergy patients. 'It is used to induce tolerance in patients with intolerances to foods and allergens in the environment. LDA is a method of allergy desensitisation using combinations of a variety of extremely low-dose allergens,' he says. LDA can either be initiated by orally starting low dose of the concerned allergen or is administered by injection of the allergen into the forearm. LDA treatments need only be given every two-three months at first, then less often.
Patients are treated every two-three months about six-eight times. After that, treatments usually decrease to every three-six months and eventually less often. The main disadvantage of LDA, especially the injectable, is that it takes six-eight injections to achieve a sustained effect that may for three months. Patients have to follow a specific protocol during the 'three critical days' when the LDA is given. This includes a restricted diet, avoidance of specific medications, allergens and chemicals and taking specific medications and supplements.
Lactose intolerance – an evolutionary tale
The story behind lactose intolerance is pretty old. Most young humans can digest raw milk's sugar component called lactose, thanks to an enzyme called lactase without any problems but they lose the ability to do so as they grow older. In fact, researchers estimate that 75% of adults around the world exhibit some form of lactose intolerance or to the use the scientist's lingo lactose non-persistent. But what caused allowed the other 25% to chug milk happily?
Scientists believe that about a thousand years ago, a genetic mutation forced a part of our species to switch from lactophobics to lactophiles! What brought on this mutation is still hotly debated. Some argue that it could be due to the nutritional benefits of milk – it was literally the first superfood for our ancestors – especially during times of famine. Individuals who could digest milk properly without suffering bouts of horrible diarrhoea were far likelier to survive longer. Of course this is all speculation and it will take a while before we figure out what makes some people love milk and others hate it.
With inputs from DNA/Varsha Naik
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