Adverse reactions to cows’ milk

Cows’ milk has been drunk by humans for almost 9000 years. It is of particular importance as a substitute for human breast milk. Milk ingestion can cause a spectrum of adverse reactions in children, including both immune-mediated (food allergy) and non-immune-mediated (food intolerance) reactions. Immune-mediated responses include immediate, potentially life-threatening IgE-mediated milk allergy as well as non-IgE and mixed IgE/non-IgE manifestations of disease. This review examines the different types of response that cows’ milk ingestion may elicit and considers the different underlying mechanisms. New manifestations of adverse reactions, previously considered unrelated to dietary intake, are also considered.