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Milestone 1: Identifying Cow’s Milk Protein Allergy Symptoms in Your Infant Milestone 2: Getting a CMPA Diagnosis Milestone 3: Managing Cow’s Milk Protein Allergy Milestone 4: Reintroducing Cow’s Milk

Article Summary:

  • Cow’s milk protein allergy (CMPA) is one of the most common allergies in infants.
  • Parents should learn the symptoms of CMPA to determine if their child needs allergy testing.
  • CMPA is manageable. Parents should avoid giving their children foods with dairy in it.
  • Parents typically can re-introduce cow’s milk to their child’s diet when they get older since most children outgrow the allergy.

CMPA (cow’s milk protein allergy) is one of the most common allergies in infants.1 If your infant has CMPA, their immune system will overreact to proteins found in cow’s milk which causes inflammation of the gastrointestinal tract.1,2 CMPA is not lactose intolerance. The first step in navigating a milk protein allergy in infants is looking for the symptoms. CMPA can result in immediate (IgE) or delayed (non-IgE) symptoms.

Milestone 1: Identifying Cow’s Milk Protein Allergy Symptoms in Your Infant

The first step in managing your infant’s allergies is recognizing the signs and symptoms of a cow’s milk allergy. If your infant is allergic to milk protein, you may notice these symptoms:3

  • Bloody stools
  • Diarrhea
  • Vomiting
  • Colic or irritability
  • Hives
  • Facial swelling
  • A swollen tongue, throat or mouth
  • Difficulty breathing, asthma or wheezing.

If you think your infant may have a cow’s milk protein allergy or intolerance, contact your doctor.3

Anaphylaxis is a rare and potentially life-threatening reaction that impairs breathing, if you think your child is having difficulty breathing seek emergent medical attention.

Milestone 2: Getting a CMPA Diagnosis

Currently, there aren’t any specific tests that can detect a cow’s milk protein allergy.2 Your doctor may refer you to an allergist for a skin prick test or a blood test to determine if your infant has a cow’s milk protein allergy.2 Your doctor may also recommend removing cow’s milk protein from your infant’s diet to see if their allergy symptoms go away.4 If your infant’s CMPA symptoms go away, then cow’s milk is reintroduced to see if the symptoms reappear.5 A CMPA diagnosis is likely if your infant’s milk protein intolerance symptoms reappear.5

Milestone 3: Managing Cow’s Milk Protein Allergy

The best way to manage your infant’s cow’s milk protein allergy is to avoid foods that trigger it.5 Work with your doctor to help you understand what foods your little one should avoid.5 Many infant formulas contain cow’s milk protein, and cow’s milk protein may be passed to your baby if you are breastfeeding and consume dairy products.3 To prevent an allergic reaction, it’s important that you inform your child’s caregivers about their cow’s milk protein allergy.5 If your child accidentally consumes dairy and has a severe allergic reaction (for example, they have hives or trouble breathing) call 911 immediately.5

The thought of avoiding cow’s milk protein might be stressful, but don’t worry—CMPA usually resolves by 1 to 6 years of age.6 Eliminating cow’s milk protein is only necessary for a limited period.4

Milestone 4: Reintroducing Cow’s Milk

In general, once your child is 12 months old, parents can start to reintroduce dairy.6 Please check in with your health care provider before reintroducing dairy so they can decide whether reintroduction can be done at home or under their supervision.7 Many parents introduce cow’s milk to their children with what’s known as the milk ladder.7 With the food ladder, you start by introducing foods like baked goods to your child and then work your way up the ladder to foods with higher dairy content like yogurt.7  Here’s an example of what the milk ladder looks like:7

  • Step 1: Baked goods containing milk ingredients, like cookies or muffins are introduced.
  • Step 2: Foods with greater milk content, like pancakes, crepes or waffles are introduced.
  • Step 3: Foods like pizza or boiled milk are introduced.
  • Step 4: Cheese, yogurt, milk, and ice cream may be introduced.

While introducing new foods with dairy to your infant, start with pea-sized amounts.7 You can spend the next several days or weeks slowly increasing the amount of food that contains dairy.7 You should spend at least one to three months on each step of the milk ladder.7 If your child moves to the next step of the milk ladder and has allergic symptoms, you should go down a step on the milk ladder for at least a month before re-trying the next step.7

If your infant has CMPA, you may be wondering what your formula choices are. Take control of common cow's milk protein allergy issues/concerns* such as colic^, eczema, vomiting and diarrhea with Nutramigen® A+® with LGG®. Talk to your doctor if you suspect your baby has cow’s milk protein allergy. Explore the allergy centre to learn more about common baby allergies.

* HCPs evaluated infants with suspected cow's milk protein allergy by the follow-up visit and reported improvement in infants with the following common symptoms observed in the current study: 90% improvement in diarrhea, 74% improvement in reflux/regurgitation, 86% improvement in vomiting, 95% improvement in bloody stools, and 86% improvement in rash/eczema.

^ 90% infants experienced relief within 48 hrs, due to cow's milk protein allergy.

  1. https://cdhf.ca/en/digestive-conditions/cows-milk-allergy/
  2. https://www.ncbi.nlm.nih.gov/books/NBK542243/
  3. https://www.healthlinkbc.ca/health-topics/cows-milk-protein-allergy-babies
  4. https://cdhf.ca/en/frequently-asked-cows-milk-allergy-questions/
  5. https://myhealth.alberta.ca/Health/aftercareinformation/pages/conditions.aspx?hwid=acc9728
  6. https://cps.ca/en/documents/position/cows-milk-protein-allergy
  7. https://www.bcchr.ca/sites/default/files/group-food-allergy-treatment/canadian-milk-ladder.png
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