When people think about cow’s milk protein allergy, the first image is someone with stomach cramps, stomach pain, and running to the bathroom. That’s lactose intolerance, which means your body cannot “TOLERATE” lactose, a type of sugar in milk. It is not an allergic reaction, and it is usually not life-threatening.
But I want to talk about the cow’s milk protein allergy that kids and adults with ADHD experience.
When most people think about food allergy, the first image is someone ate something they’re allergic to, within minutes, they start having difficulty breathing, fainting, and have to administer the epi-pen.
Yes, that does happen. And that’s an extreme example of an IgE-mediated allergic response. This type of reaction can be tested and showed up on regular food allergy testing and skin prick test.
However, most of the food reactions we see in most people, especially kids and adults with ADHD, are non-IgE mediated reactions, which means the blood test or skin prick test shows no reaction, but you or your child is reacting to some food physically and behaviorally.
There are other immunoglobulins besides IgE. There’re also IgG, IgA, and probably some other ones.
These kinds of reactions are difficult to diagnose because the reaction usually comes on slowly, maybe hours or even days later. So most people with these symptoms don’t realize that it’s caused by the food they eat.
Most people only focus on “physical reactions” to food but ignore that your moodiness and irritability could also be the result of the food you eat. Try to eat or drink something with “red coloring” and wait for the “monster” to come out.
Why do you think they call those energy drinks “Monsters.”
Besides, milk is in every delicious dish (pizza, pasta, sandwiches, calzones, etc.) and dessert (ice cream, candies, pastries, pies, donuts, cheesecakes). To eliminate milk from your diet, you’ll have to forgo many of your favorite food, so most people would rather take a “stomach medicine” (or PPI or proton pump inhibitor or stomach-acid suppressant) and call it a day.
Did you know how harmful these medications are for the human body? PPI or proton pump inhibitor or stomach-acid suppressant suppresses stomach acid production. Stomach acid kills bacteria that we ingested with our food and breaks up chunks of protein we eat in preparation for digestion in the small intestines.
If stomach acid is low, there higher risk for bacterial infection. There’s been an increase in the incidence of c. diff (clostridium difficile) infection in both young children and adults. Second, when there’s insufficient stomach acid, your body cannot break down food and absorb nutrients properly. This can lead to nutrient deficiencies, inflammation, more food reaction, hormone imbalance and behavior symptoms.
If your child has asthma, eczema, and also frequent ear infection, cow’s milk protein allergy is very, very, very, very likely to be the cause.
Parents ask me all the time, "can we get it tested first?"
I understand that having some kind of proof that you or your child is an allergy to something makes it easier to compliant with the food restriction.
But if the clinical signs and symptoms check out and we try the dairy-free diet for at least two weeks and notice a significant change, do you still need a blood test to prove.
Generally, we don’t recommend allergy testing in children three years old and younger as their immunity is still immature, so false positives and false negatives are frequent.
For most of my patients, I’m able to diagnose cow’s milk allergy with a review of diet, signs and symptoms, and diet change. I look for family history of food allergies, physical and behavioral signs, and symptoms, skin rash, eczema, history of asthma, frequent ear infection, reflux, etc. I never have to order food allergy testing.
Besides, even if the blood test shows a positive reaction to any food, the next step is to remove those foods from the diet. So the food elimination is inevitable.
The true test is when the eliminated food is reintroduced into the diet. If you or your child shows symptoms again, both physical and behavioral, you should eliminate those foods for a long while before reintroducing them again. This is step 1 in the Eat to Focus Protocol.
In normal healthy digestion, casein (milk protein) is broken down into casomorphin. These peptides are then further broken down into individual amino acids, which then enter the bloodstream.
When these proteins are not properly digested, the casomorphin can leak into the bloodstream before being further broken down. Once these proteins enter the bloodstream, they can get through the blood-brain barrier to the brain.
Casomorphin acts like opioids, such as heroin and cocaine and binds to the same opioid receptors in the brain.
And this peptide morphine can affect your or your child’s behavior, just like cocaine and heroin. Your child is “drugged” on food.
These undigested proteins cause fatigue, aggression, irritability, moodiness, anxiety, depression, and brain fog in susceptible children and aduts.
Besides the undesired mental effects, these proteins also trigger silent allergic reactions, such as allergic shiners (dark circles under eye), colic, runny nose, ear infections, eczema, belly pain, bad breath, and insomnia, etc.
Eliminating these offending proteins from the diet is the only solution or treatment option.
A child with high levels of casomorphin may have intense cravings for milk products (ice cream, yogurt) and may even become irritable when they don’t eat these types of foods.
If your child shows addictive behaviors around dairy products, such as milk, cheese, yogurt, ice cream, mac n cheese, there’s a great chance your child with ADHD or autism may not be breaking down milk protein properly.
Parents often describe their children as very irritable and cranky when not having these items and then calm down into a sweet angel after eating them.
Signs and Symptoms of non-IgE-mediated Cow's Milk Protein Allergy in Kids and Adults with ADHD:
- Milk addiction (yes, “addiction” like, “I love cheese”)
- acne
- skin rash
- eczema
- asthma
- nasal congestion
- constipation
- blood in stool
- vomiting (often misdiagnosed as reflux)
- migraine headaches
- allergic shiners
- irritability
- mood swings
Foods to Avoid for Cow's Milk Protein Allergy
To successfully implement the dairy-free diet and achieve the best results, one has to be meticulous with nutrition label reading and savvy in the kitchen.
There’ll be new behaviors and habits and new recipes to embrace.
Because milk is such a cheap commodity (as the industry is heavily subsidized by the government’s grant), milk and its derivatives can be found in almost anything food product as additives. So you might not recognize these hidden milk ingredients on plain sight.
Fortunately, the US laws require all FDA-regulated manufactured food products that contain a “major food allergen”, such as milk, wheat, egg, peanuts, tree nuts, fish, crustacean shellfish and soy, as ingredients to list that allergen on the product label.
For tree nuts, fish and crustacean shellfish, the specific type of nut and fish must be identified.
The phrase “non-dairy” on a nutrition label indicates it does not contain butter, cream, or milk. However, this does not necessarily mean it does not contain other milk-derived ingredients.
The Kosher food label “pareve” or “parve” almost always indicates food is free of milk and milk products. A “D” on a food label next to the circled K or U indicates the presence of milk protein. These products should be avoided.
Processed meats, such as hot dogs, sausages, and luncheon meats, frequently contain milk or are processed on milk-containing manufactory lines.
Carefully read all food labels before purchasing and consuming any items. When in doubt, call the manufacturer to find out more.
Avoid foods that contain these ingredients:
- Milk in all forms (derivative, dried, powdered, condensed, evaporated, goat’s, from other animals, lowfat, malted, milkfat, nonfat, skim, sour cream, yogurt, cream, cheese, buttermilk, Half and Half™ )
- butter, butterfat, butter oil, butter acid, butter ester, ghee
- casein, caseinates (ammonium, calcium, magnesium, potassium, sodium), casein hydrolysate
- cheese, cottage cheese, curds
- cream
- custard, pudding
- diacetyl
- hydrolysates (casein, milk protein, protein, whey, whey protein)
- lactalbumin, lactalbumin phosphate, lactoferrin, lactoglobulin
- lactose
- lactulose
- nougat
- Recent
- rennet casein
- Simplesse™
- sour cream
- sour cream solids
- tagatose
- whey (delactosed, demineralized, protein concentrate), whey protein hydrolysate
- yogurt
Other possible sources of milk or its derivatives:
- artificial butter flavor
- baked goods
- brown sugar flavoring
- caramel flavoring
- chocolate
- high protein flour
- lactic acid starter culture and other bacterial cultures
- luncheon meats, hot dogs, sausages
- margarine
- natural flavoring
- nisin
"What About Calcium?" You asked.
Many pediatricians and parents automatically raise concerns about adequate calcium intake with a dairy-free diet, as milk is a very good source of calcium and other nutrients, as advertised by the Dairy Council.
And according to the various dietary guidelines over the past decades, milk and dairy products has always been represented as one group by itself.
There’s an over-emphasis on the importance of milk and dairy intake in our culture, in the American culture.
First of all, let me point out that many cultures in the world do not consume milk or dairy products on a daily basis. And people from these cultures thrive.
When it comes to calcium, the first thing that comes to most people’s minds is milk.
Thanks to the heavy marketing of the dairy industry, the world has been brainwashed to believe that cow’s milk or dairy products are the only sources of calcium and the best for bone development and growth.
If you think about it, the biggest source of calcium is bone, which is the reason why we’re so concern about calcium intake, right?
So it makes sense that we should be eating animal bones to get our calcium. After all, it is the exact source of calcium that our body needed.
I’m just appalled that after all these years, no one has ever questioned the justification of having the dairy product as its food group on Four Food Groups, Food Guide Pyramid, Food Step Pyramid, an,d the most recent MyPlate.
Anyway, my point is milk, and all dairy products are over-rated and over-marketed.
Contrary to popular belief and what the dairy industry wants you to believe, you don’t need to drink milk or eat cheese and yogurt to get your calcium for your bone health. Many cultures do not consume dairy, and if they do, dairy is just a tiny part of their diet.
Since we’re all so concern about our calcium intake, so how much calcium do we need?
Current calcium recommendation by age:
Infant 0-6 mos – 200mg/d; 6-12 mos – 260mg/d.
Children 1-3 yo – 700mg/d; 4-8yo – 1,000mg/d; 9-18yo 1,300mg/d.
Adult 19-50yo – 1,000mg/d; more if female older than 50 and male older than 70.
Non-Dairy Sources of Calcium for People Cannot Have Cow's Milk Protein
One cup of cow’s milk has about 296 mg. Below is a list of non-dairy sources of calcium that comes close to the calcium content of cow’s milk:
- Sesame Seeds A quarter cup of sesame seeds has 351 mg calcium.
- Spinach A cup of boiled spinach has 245 mg.
- Collard Greens A cup of boiled collard greens has 266 mg.
- Canned Salmon 3oz has 181mg.
- Blackstrap Molasses One tablespoon has about 137 mg.
- Tahini Two tablespoons of raw tahini (sesame seed butter) have 126 mg. *on a side note, blackstrap molasses and tahini mixed together to make a very delicious dip to go with apple slices, carrot sticks, celery sticks, etc.
- Kelp One cup of raw kelp has 136 mg.
- Broccoli Two cups of boiled broccoli have 124 mg.
- Swiss Chard One cup of boiled chard has 102 mg.
- Kale One cup of boiled kale has 94 mg.
- Brazil Nuts Two ounces of Brazil nuts (12 nuts) have 90 mg.
- Celery Two cups of raw celery have 81 mg.
- Almonds One ounce of almonds (23 nuts) has 75 mg.
- Papaya One medium papaya has 73 mg.
- Flax Seeds Two tablespoons of flax seeds have 52 mg.
- Oranges One medium orange has 52 mg.
Nutrition Tips: Mix and match any of the ingredients listed above at each meal and snack, and you’ll have a calcium- and antioxidant-rich diet.
The goal is to eat a real food plant-based diet with various fruits and vegetables of rainbow colors, beans, nuts, seeds with organic animal proteins accounting for about 25% of the diet.
That’s it…
I hope you find this information helpful. Let me know what you think and comment below.
Remember ADHD does not doom your child to a life of under-achievement. You know your child is bright, full of potential, and deserves the best. In fact, many of the world’s most significant discoveries and inventions were made by people with ADHD.
I helped my crazy wild child who couldn’t read or write when she was little, overcome her learning difficulties and become a merit scholarship student majoring in premed at Loyola Chicago University.
So don’t give up; everything is possible.
PS: Before you go, remember to download your Free 15 Quick and Simple School Day Breakfast Ideas for Kids with ADHD
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Anna
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