Cow’s milk is a complete food. Complete means that it contains all three major food groups: carbohydrates (sugars), fats and proteins. Each group can be a problem in atopic dermatitis
1/ Sugars = lactose
We need a substance called lactase to digest lactose, the sugar contained in milk. Babies produce lactase, but less and less is produced as the child grows, until, by the age of 6, production is just 10% of what it was to start with. Asians produce hardly any at all whereas Northern Europeans make more. Yoghurt is the only dairy product containing enough lactase to make it digestible. What happens if someone consumes more milk than they can digest? They have digestive problems, such as bloating, cramps and transit issues. Bloating is a major cause of acid production. Acid production affects sweat quality, which in turn exacerbates atopic dermatitis
Too much milk = impossible to digest lactose = digestive problems = acidity = triggering factor for AD
Milk contains 2 fats: one good one, vitamin A, and some bad ones – saturated fatty acids.
Vitamin A is destroyed by heat, so it is only found in uncooked butter: 10g per day is sufficient.
Bad fats are found mainly in cheese. A feature they all share is that they are all pro-inflammatory, in other words they exacerbate all inflammatory diseases, including AD. The fats in goats’ milk and ewes’ milk are the least pro-inflammatory.
Too much cheese = exacerbation of the inflammation = triggering factor for AD
2 very different situations: genuine allergy vs. intolerance.
Genuine allergies mainly affect babies and are never isolated. When babies are allergic to the proteins in cow’s milk, they also have other problems (regurgitation, vomiting, diarrhoea, etc.). Allergy test results are positive. This situation does not occur often.
Intolerance, meanwhile, is not necessarily associated with digestive problems and allergy test results are negative – it can often be a triggering factor for atopic dermatitis in babies. Diagnosis is a two-stage process: first the skin must be treated correctly, with cortisone cream and emollients – but the intestinal flora must also be treated. If the eczema doesn’t recede, then a hydrolysed milk should be tried – the milk proteins in these milks have been broken down until they are so small that they cannot irritate the intestinal mucosa.
CMPA and CMPI = directly stimulate the immune system = triggering factor for AD
Where there is a true allergy to cow’s milk protein – which is rare – you will need to seek the help of a paediatrician or allergist.
If it is rather a case of intolerance, hydrolysed milk should be used for two or three years, but any contact with cow’s milk should be kept to a minimum, and should mainly take the form of yoghurt. Tolerance should be preserved.
Mots clefs : cow's milk controversy