Food allergen milk positive

This does not mean that you/your child must completely avoid all dairy products for life. Whether and how long you should avoid it depends on the clinical manifestations. The test results are only for reference.

Let me tell you a real story that I encountered when I was following up in the allergy department. Last week, a mother rushed into the clinic with a report sheet in hand, crying and saying that she had thrown away all the three-stage milk powder and children's yogurt that she had just stocked up at home. The baby is only 2 years old, and she will not be able to eat cakes in the future. I took the report and looked at it. She checked for food intolerance IgG, and the milk value showed 3+. But after further questioning, the baby usually drinks 200ml of pure milk every day. He has never had hives, swollen lips, or diarrhea or constipation. Only occasionally, the corner of the mouth will be a little red when the milk is stained, and it disappears in two minutes. The old director who attended the clinic at that time just laughed and said that it was completely a waste of money, just drink it normally. If you are really worried, take a photo next time you get some milk red. It is most likely just a little irritation on the skin, and it is not an allergy at all.

Don't underestimate the difference between the two letters in the test items, stepping on the wrong trap may really delay things. There are mostly two types of "milk positive" that can be found on the market: one is the specific IgE test, which corresponds to type I immediate hypersensitivity, which is what we often call "true allergy"; the other is the IgG test, which corresponds to food intolerance. At present, the Allergy Branch of the Chinese Medical Association and the American Academy of Allergy, Asthma and Immunology have made it clear that the IgG result cannot be used as a basis for the diagnosis of food allergy. It can only show that you have been exposed to the food, but it does not mean that you will have problems if you eat it. But the embarrassing thing is that many physical examination institutions and children's health care institutions now promote IgG as a routine allergen testing item. Many people fall into this trap because they cannot distinguish between the two.

Even if the IgE test is really positive, it is not 100% necessary to avoid all foods. What's interesting is that the industry's views on this issue are actually divided into two groups: conservative and old experts will recommend that as long as the test is positive, avoid food for 3-6 months, wait for the antibodies to drop, and then slowly try to introduce them to avoid repeated stimulation and aggravation of allergic reactions. ； The younger generation of allergists and pediatricians are more inclined to look at clinical manifestations - if there are no immediate reactions such as wheals, coughing, or severe vomiting within one hour after drinking milk, even if the test is weakly positive, there is no need to completely avoid the food. Instead, you can contact it in small amounts regularly, which will make it easier to induce immune tolerance, so as to avoid becoming more sensitive and causing problems if you touch it in the future. There is actually no right or wrong between these two views, but they are applicable to different scenarios: If you are allergic, usually out of breath after drinking half a mouthful of milk, and the IgE value measured is dozens of times higher than the normal value, then you must strictly avoid it and keep an epinephrine pen with you. ； If you just accidentally get a positive result during a physical examination, and you don't feel it at all when you drink latte or eat cheese, there is no need to hide away from milk as if you have a grudge against it.

A 26-year-old girl came to me before and said that she had given up milk for half a year. The last time she had a physical examination, her bone density had reached the lowest level for her age group, and her complexion was also bad. She said that the previous test showed that the allergen milk was positive, and she did not even dare to touch milk tea. I asked her to go back and buy a small box of low-sugar yogurt to try. After drinking it, she didn't feel any discomfort. Then she slowly added pure milk. Now she has a cup of hot milk with bread every morning. Her bone density has come up after a review last month. I have seen something even more exaggerated. A parent gave his child a milk-and-milk diet, so much so that he even refused to touch cookies containing whey protein. The child cried every time he watched other children eating birthday cakes in the kindergarten. Later, an oral provocation test was conducted, and the child even ate two large pieces of cream cake without any reaction. The parent regretted it on the spot.

Of course, it doesn’t mean that you should just drink it without hesitation after receiving the positive report. After all, if you have a serious milk allergy, it may induce anaphylactic shock. No one dares to take this risk. If you are really unsure, you can start with fully fermented sugar-free yogurt - most of the casein in milk will be decomposed during the fermentation process. Many people who are allergic to fresh milk have no reaction to yogurt. After drinking it, observe it for 48 hours and if there is no rash, cough, or diarrhea, then slowly try heated milk and cheese, adding little by little, which is much safer than cutting it off. If you really have to avoid food, remember to supplement with extra vitamin D and calcium. Don’t be like the girl before, who didn’t take precautions against allergies and made herself deficient in calcium first.

Finally, to be honest, allergen testing is an auxiliary tool. There has never been any guideline saying that if you are positive, you must avoid foods for life. Your own body's reaction is always much more accurate than that printed report sheet.