Cow’s Milk Protein Allergy (CMPA)

Cows’ milk allergic reactions range in severity and symptoms from one child to the next, but could include:

Rarely, a milk allergy can cause severe allergic symptoms that come on suddenly, such as difficulty breathing. This should be treated as an emergency. Call 999 for an ambulance immediately if you think your child has anaphylaxis (even if they start to feel better).

Some of the above issues can be due to other issues such as colic, read more on how to identify if your child has colic here.

How is CMPA diagnosed?

You should speak to your GP for advice if your little one is experiencing symptoms after consuming cow’s milk, especially if these symptoms are resistant to treatment such as eczema creams or reflux medications. The doctor will want to get a good idea of exactly what happened, so it is a good idea to write down any symptoms that occurred, how quickly they appeared and how long they lasted. Dealing with allergies is stressful and it is easy to forget these things quickly after the event especially as symptoms often show up in newborn babies.

Self-diagnosis is not recommended as many of the symptoms can overlap with other conditions.

When it comes to diagnosis, the process typically begins with removing milk from the diet. If breastfeeding, this involves removing milk from the mother’s diet. If formula feeding a specialist allergy formula will be used. It can take a number of weeks to see an improvement. Once symptoms have cleared it is usual to reintroduce cow’s milk, either via the mother’s diet or directly with cow’s milk formula, to see whether the symptoms return. If symptoms return the diagnosis is confirmed. This process can take time, and parents often don’t like putting milk back in and causing discomfort to their baby, but it is necessary to get a clear diagnosis.

In some cases, skin prick tests or a specific IgE blood test may be carried out, but these will only show up an immediate/IgE medicated allergy.

Treatment for CMPA

Once a milk allergy has been confirmed by a GP, treatment is to completely avoid cows’ milk products. If breastfeeding, this unfortunately means no more dairy for mum, which can be difficult, especially when milk is in so many of the foods we eat. Thankfully, with the growing range of vegan and dairy-free products in the supermarket these days, it is less challenging than it used to be. If your baby is formula-fed, the GP will prescribe special infant formula that is dairy-free.

Going forward, your baby should be referred to a dietician who will follow up with you to ensure your baby is getting everything they need and growing well. If is safe to do so, your dietitian will also help you to safely reintroduce dairy at the right time using the ‘milk ladder’.

CMPA and lactose intolerance are often confused, but they are two distinct conditions. CMPA is an allergy to the protein in the milk, whereas lactose intolerance is a digestive issue where the body struggles to break down lactose, the sugar found in milk. Lactose intolerance produces symptoms in the gut including wind, bloating and diarrhoea.

Management of CMPA involves removing milk protein from the diet and lactose intolerance requires removing the milk sugar, lactose.

Read our guide for more information on lactose intolerance here.