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Grass pollen discharging granules on exposure to water - picture by Dr H Morrow Brown

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Dr H Morrow Brown MD
General Medical Council Registered Specialist
for Allergy and Respiratory Medicine


Milk Intolerance runs in Families

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A very allergic family

Father had had infant feeding problems which faded out in infancy, and he had no further trouble until aged twenty-nine, when he had asthma so severe that he was coughing up bronchial casts like worms in the sputum and he had to have oral steroids for over a year. He was then referred to the late Professor Pepys who found a strong skin test reaction to milk, and he was much improved by avoiding milk products. This was proved at Brompton Hospital by double blind challenges, and he has been well ever since simply by avoiding all milk products. Thirty-five years later he still has to avoid milk because if he eats any cheese or yoghourt he will have asthma in three hours, and a little later he will produce a bronchial cast with a peculiar taste.

Mother had great potential as an opera singer, but discovered by age eighteen that if she sang in a smoky hall she soon became hoarse and finally lost her voice. She gave up her singing career and became an English teacher, but found the the smoke in the staff rooms, or in a pub with her husband would still affect her voice.

A selection of legumesWhen aged fifty-six she also began to react to handling any sort of legumes in the kitchen, including her husband’s soya milk. The smell of fresh beans from the garden or handling them would cause acute conjunctivitis, but they would have no effect after cooking. She also began to have skin reactions to touching cherries and other fruits, and her mouth would react to potato, tomato, apples and other fruits.

Her son had chronic sinus problems which were also found due to milk, and her daughter has seasonal hay fever from childhood. She had no other allergic problem until aged twenty-three, when she developed an intensely itchy rash which was diagnosed by a dermatologist as ‘ scabies or self-inflicted’ Her case is described in detail elsewhere, but she turned out to be very allergic to wheat, to milk like father, and to potato, tomato, and tobacco smoke like mother.

A RAST test showed very positive specific IgE for Grass pollen, nettle, and plantain, which explained her hay fever only, and with a total IgE over twice the maximum normal level. It is very important to note that the RAST test was negative to wheat, milk, and potato, which were the major causes of her skin problem, so that if any reliance had been placed on this scientific laboratory test the right answers would never have been found.

It is not often realised that the RAST test is quite unreliable in cases of intolerance, and the unfortunate patient may be informed that they do not have a food allergy because the ‘gold standard’ tests were negative.

A Family of Milk Intolerant Dairy Farmers

Mother and her three children were all milk intolerant in various ways, and were referred one by one over a period of ten years. Their farm ran a herd of diary cows, and of course milk was freely available.

EggsThe first to be seen was the eldest son aged four with asthma of six months duration, with the history that he was breast fed for ten days, developed eczema on change to formulas, was hyperactive, seldom slept, and disliked milk! Skin tests and RAST were negative, but a nasal smear was crowded with eosinophil cells indicating allergy. Asthma ceased on avoidance of milk, and recurred after three test feeds which also produced misbehaviour.

Beef caused aggressive behaviour, and after a teaspoonful of milk or scrambled egg he was ‘berserk’ all day. A change to Wysoy, a soya formula which contained some beef fat, repeatably caused misbehaviour. His school performance improved remarkably, and the teachers always knew by his behaviour when he had been cheating. He went to university had good athletic performance, became a teacher, is now aged forty, and still cannot tolerate milk products.

Second son was breast fed for six months, with mother avoiding milk and eggs. Asthma and rhinitis began aged three, and skin tests were positive for dust mites and cat. He reacted to milk products, especially to casein in milk substitutes, with wheezing and hyperactive behaviour up to the age of thirteen, when he was able to tolerate a little milk. The inhalant allergies never caused a problem, but could have been misleading.

Scones with jam and creamDaughter was referred aged eight with seasonal hay fever, but also had a significant history of vomiting problems in infancy followed by vague stomach aches, occasional sickness and constipation. With milk avoidance all symptoms vanished, but recurred after accidental milk ingestion. By her teens she could tolerate milk, and then got married and had no trouble while pregnant with the first grandchild. While breast feeding she took extra milk, and the child had eczema and incessant screaming with colic for the first three months to such an extent that nobody had any sleep. I was asked to see him and stopped mother taking milk, with the result that the whole family slept all night for the first time. When mother had some clotted cream the colic and eczema promptly recurred.

Mother was the last to seek advice aged fifty with severe asthma of two years duration. She had not tolerated milk as a child, and as an adult always felt that ’milk clogged her chest up’ Milk intolerant patients often express themselves in these words, and they are often right. Her asthma was severe, requiring oral and then inhaled steroids for a time, but cleared completely with milk avoidance.


"It is a paradox that while Britain has the highest incidence of allergic disease in the world, it also has the most inadequate allergy service"

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