Cows Milk Protein Allergy

Often presenting in the first 12 months of life, cows’ milk protein allergy (CMPA) is thought to occur in about 2-4% of babies. The majority of babies diagnosed with CMPA will grow out of their allergy by the age of 3.

Diagnosing CMPA can present a challenge to even the most competent GP. Frequently presenting with the same symptoms of other infant ailments, it’s hard to judge whether an allergy, colic or reflux is at the root of the problem. Suffice to say, the doctor will need to suspect that your baby or child’s symptoms are more likely to be caused by CMPA than another condition.

CMPA can present with a wide range of symptoms:

  • Rash
  • Hives
  • Swelling (of the lips, eyes, nose, mouth and throat)
  • Diarrhoea
  • Vomiting
  • Stomach cramps
  • Itching
  • Sneezing
  • Runny nose
  • Sticky eyes
  • Reflux
  • Loose or frequent poops
  • Blood and/or mucus in the poops
  • Colic
  • Constipation
  • Failure to thrive
  • Paleness and tiredness
  • Food/milk refusal
  • Redness of the bum hole
  • Severe nappy rash not helped by barrier creams

Before visiting your doctor about a suspect cows’ milk allergy, it’s worth writing a list of all of your child’s symptoms and when they occur (as the baby drinks the milk/2 hours after a feed/ at 3am etc). This information will help your doctor assess the likelihood of CMPA.

Once cows’ milk protein allergy is suspected, the doctor will usually consider starting a hypoallergenic infant formula or recommending a dairy free diet with calcium substitution for the breastfeed mother. A referral may be made to an allergy clinic, paediatrician, immunologist or dietician, depending on local area guidelines.

A wide range of helpful resources and support groups for parents adjusting to a diagnosis of CMPA are available online and via Facebook.

Interesting Reading

Allergy UK have a page dedicated to cows’ milk protein allergy:

https://www.allergyuk.org/information-and-advice/conditions-and-symptoms/469-cows-milk-allergy

Food Allergy Research and Education also have a page dedicated to milk allergy:

https://www.foodallergy.org/common-allergens/milk

The NICE guideline for food allergy in children-

https://www.nice.org.uk/guidance/cg116/resources/cg116-food-allergy-in-children-and-young-people-full-guideline3

Last modified: 14.02.2018

Review date: 14.02.2020