Cows Milk Protein Allergy - CMPA - HealthSurgeon - Healthy Living and Fitness

Cow milk protein allergy, CMPA, is the most common food allergy in babies. A cow milk protein allergy occurs when a baby’s immune system reacts to the protein in cow’s milk, causing an allergic reaction. This allergy usually occurs in babies that are under the age of one year old. Many babies outgrow this allergy by the age of 3. Cow milk protein can be found in many formulas. The rate of CMPA in breastfed babies is lower than formula fed babies. It is important to know if your baby has an allergy or an intolerance. There is a difference between the two. An intolerance does not include the immune system.

Symptoms

The presence of a cow milk protein allergy usually appears within the first few months of your baby’s life, usually before six months of age. Severity of the allergy can vary from baby to baby and can even vary per each time your child is exposed. There are two different types of cow milk protein allergy. Rapid onset which symptoms appear with an hour of ingestion. Slow onset involves the GI tract and skin and symptoms can take longer to appear. Symptoms of slow onset can take hours or days to appear.

Rapid onset symptoms include: hives, wheezing, tingling feeling in mouth and lips, swelling of the lips, tongue, or throat, vomiting, anaphylaxis, or blood in the stool.

Slow onset symptoms include: diarrhea, constipation, colic, constant fussiness, blood in stool, hives, eczema, vomiting, and excessive spit up.

Other symptoms can include poor growth due to poor absorption of nutrients, or constant irritability in your baby.

Milk intolerance symptoms are gas, bloating, or diarrhea. They do differ from an allergy.

Diagnosis

The best way for your pediatrician to diagnose a cow milk protein allergy is with a history and physical examination. Describing your child’s symptoms and how quickly they occur after exposure to milk can help your doctor understand your child’s allergy. Family history of allergies, asthma, and eczema can also help your doctor. The best way to know for sure if your child suffers from a cow milk protein allergy is to eliminate cow’s milk from your child’s diet completely. Seeing how symptoms happen after the elimination can give your doctor an idea if the cow milk protein allergy is a possibility. One test your doctor can do is taking a stool sample from your baby and testing it for blood in the stool. A blood or skin allergy test does not help diagnose delayed onset CMPA. This is because it takes too long for symptoms to occur. In some cases your doctor can try to do a monitored food challenge, but with delayed symptoms this may not give them accurate information either.

Treatment

For any allergy the best course of treatment is complete elimination. If you are breastfeeding your baby and your doctor suspects a cow milk protein allergy they will suggest you cut all foods containing cow’s milk from your diet. This includes foods such as cheese, yogurt, butter, ice cream, cream, milk drinks, and condensed milk. Some foods will have milk in them without you realizing, it is important to read labels of all products. The FDA requires that companies say on their ingredients if a product contains milk, or milk derivatives. For babies that are formula fed your doctor will suggest a formula that is not cow milk based. These are hypoallergenic formulas. Not all hypoallergenic formulas are created equal. For CMPA it is best to go with a formula that is extensively hydrolyzed. Fifty percent of babies with CMPA will also develop a soy protein intolerance, so switching to a soy based formula is not always suggested for baby’s who have CMPA.

Fifty percent of children will develop a tolerance for cow’s milk by age one, seventy-five percent will develop a tolerance by age 3, and ninety percent will develop a tolerance by age 6. Having a cow’s milk protein allergy does raise your child’s risk of developing other food allergies.

Babies are usually ready to start solid foods between the ages of 4-6 months. When you start your child on solids it is important to make sure their foods are milk-free. Baby cereals, crackers, and yogurt melts can contain milk, so make sure you are reading labels of pre-made baby foods. Other foods to avoid are butter, cheese, cream, custards, puddings, yogurt, frozen yogurt, milk, tuna, and margarine. Baked goods can also contain milk, talk with your pediatrician if you should avoid baked milk, or if you can try it. While your child is around the six month age it is important to feed them other common allergen foods. Feeding them to your child young can help prevent food allergies. Feed your baby one of these one week in between so you know if the food causes a reaction. Common allergen foods are eggs, peanuts, sesame seeds, soy, fish, tree nuts, and wheat. Talk to your doctor before adding in foods that contain milk. They will have a plan on how and when to safely introduce your little one to milk.