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Digest This – Cow’s Milk Protein Allergy

Cow’s milk protein allergy (CMPA) is a medical condition, occurring in 2-3 percent of infants under one year of age, and less commonly in older children. It happens when the body’s immune system sees cow’s milk protein as foreign or harmful and attacks it.  This immune reaction can damage the gastrointestinal system including the intestine.  A higher risk of developing CMPA exists for those with a family background of allergic diseases like asthma, eczema or environmental allergies.

An allergic reaction to milk can be immediate or delayed.  Immediate reactions usually start within two hours after being exposed to cow’s milk.  Symptoms can include skin rashes, breathing troubles, vomiting, diarrhea, stomach pain, mucous and blood in stools.  Symptoms of delayed reactions appear within 24 hours to one week, and present mainly with skin or gastrointestinal symptoms such as vomiting, fussiness, abdominal pain, blood and/or mucus in stool.  CMPA is usually diagnosed only with a history and physical exam by your doctor.  Seeing how your child responds after removal of cow’s milk will also help.

The treatment of CMPA usually involves eliminating cow’s milk.  If your baby is breast-fed, your doctor may recommend excluding all dairy and soy foods from your diet because the proteins from these foods can get into the breastmilk.  If this is challenging, your baby may alternatively feed on a hydrolyzed formula with broken-down proteins that do not cause any reactions.  There are broken-down formulas containing only the individual building blocks of proteins (amino acids).  Goat’s or sheep’s milk and soy milk should not be fed to your child as they are expected to cause a similar reaction to cow’s milk.  If your child has an immediate reaction to CMPA like anaphylaxis (a severe allergic reaction causing hives, breathing difficulties) and low blood pressure, your doctor may prescribe an Epi pen for treatment.  Fortunately, many babies will outgrow their milk allergy and will be able to tolerate milk-containing foods by one to two years of age.  If you are concerned about CMPA, consult your family doctor or pediatrician.


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