CMPA (Cow's Milk Protein Allergy) Q&A - Here's What You Wanted To Know!

We here at Mamamade have had loads of questions sent to us by parents who are a little unsure about CMPA, which refers to Cow's Milk Protein Allergy! So, I got digging and set myself a task to help you out.

Here are a few things you should know and be aware of ✌🏼

Q 1. What is CMPA (Cow's Milk Protein Allergy)?

This is definitely the most requested question! Cow's Milk Protein Allergy, or CMPA, is actually one of the most common food allergies affecting little ones. It normally occurs in 2-3% of babies! The symptoms caused by this allergy usually appear before 12 months of age. CMPA is caused by your baby's immune system reacting abnormally to some of the proteins found in cow's milk, which essentially can cause a potential threat by "sensitising" your baby's immune system to the proteins found in cow's milk. When this happens, there is the potential that when the body identifies cow's milk, later on, the immune system remembers this protein and may try to defend itself by reacting with allergic symptoms. CMPA is more common in formula-fed babies than breastfed babies, and having a parent or sibling with asthma, eczema or hayfever also appears to increase the chances of CMPA

Q 2. How likely is a baby with IgE CMPA to grow out of it?

Most children are known to have two different types of allergies; the two types depend on whether the allergic reaction is caused by antibodies called IgE. So, to break down the lingo! IgE refers to immunoglobulin E; These antibodies are the chemical signals which can then set off a sudden allergic reaction.

• For example, In an IgE-mediated food allergy, can be very severe and can happen within a few minutes of eating the food (A bit like a nut allergy). The common symptoms are reddening of the skin, an itchy rash, swelling lips, face or around the eyes.

• The second type is a non-IgE-mediated food allergy where IgE antibodies do not cause it but is actually a cause of cells reactions in the immune system. Non-IgE-mediated reactions often appear several hours or days after the food is eaten and can cause symptoms over a more extended period, such as eczema, diarrhoea, and constipation.

Sometimes children have a mixed reaction that causes both IgE and non-IgE symptoms and signs (for example, this happens in some children with cows' milk allergy).

Luckily around 80% of children with cow milk allergies will outgrow it by 3-5 years. We advise that you keep in touch with a healthcare professional for advice. Ask them about ways of testing when and whether your little one has grown out of the allergy altogether.

Q 3. Weaning one twin with CMPA and one without is proving very stressful. I'd love some help!

We can only imagine how difficult that must be, but we're always here to help!

My first top tip would be to change the mindset of giving your little one's milk or dairy products (finding alternatives for butter and cheese can be hard but to be honest, there's no need for any of that in their diet. So, try to avoid them altogether if that's easier for you! It's been proven that there's no need for children to consume cow's milk. I know that I was told time and time again by my mum to drink a glass of milk every day "to make those bones stronger and get my calcium intake!" But after doing some research and looking into the topic, I've found that cows milk isn't essential. As long as your children are offered a varied diet including fortified, non-dairy sources (i.e. fortified soya milk), there's no need to worry! Plus, there's so much variety in stores now - almond milk, oat milk, coconut milk, soya milk, and the list goes on! So, look at some non-dairy recipes and give them a try; you never know it might make life easier. But if that's not an option, know that most children grow out of SMPA by the age of 3-5 years! So, hold in there and be assured that you can always contact us for any advice.

Q 4. I'd love more information on how to transition from formula/breast milk to non-dairy milk from 12 months +. There's hardly any info out there!

This is an exciting milestone for you and your baby! But it definitely can come along with a load of uncertainty around the topic. So, there's no need to worry; I've got you covered!

By the age of 1 year, children are likely to get most of their nutrients from food! So, there's actually no longer any 'need' from a nutritional perspective like your little one's formula. If you are breastfeeding/pumping, there are loads of benefits of extended the process if you are prepared or willing to do so! Either way, make sure your baby has a good nutritional food plan.

On to the next stage, from the age of 12-14 months, you have the option to replace your little one's formula with any milk! And If you're breastfeeding/pumping, there's no reason to stop unless you choose to.

Specific things to look out for when choosing non-dairy milk options:

• Many of the non-dairy options are lower in protein, fat, and certain vitamins and minerals such as calcium, vitamin D, and B12 – all of which cow's milk is rich in, which is why cow's milk is recommended! - You can choose to give your baby a vitamin booster in the form of a syrup if you want to include some of these goodies alongside the non-dairy option.

• You might want to look for fortified, unsweetened options; they do exist! - fortified is more important than organic, if it's one or the other. We like fortified soya milk, oat and pea milk.

Q 5. The hardest thing I've found is the uncertainty around "may contain" - what does this actually mean and how can I be sure I'm giving my child the right thing?

We understand your struggle! It can be so frustrating when things aren't clear, especially when children are involved. But sometimes, that is why it's a necessary proportion.

The term "May contain" simply refers to the labelled product that isn't supposed to contain the allergen. Basically, the manufacturer can't be 100% sure that there hasn't been any cross-contamination during preparation and packaging. The truth is that foods with this label might not contain any allergens at all, but there is also a chance that they do. Whether or not you can tolerate a product with a 'may contain' warning will depend on the severity of your little one's allergy.

Q 6. Can I still drink cows milk as a breastfeeding mum if my child has CMPA?

The truth is that you might still need to avoid cow's milk in your diet! I'd advise you to check in with your GP or health visitor to make sure that is still the case. But in the meantime, have a look at this diagram by Vandenplas et al. (2007) for the diagnosis and management of cow's milk protein allergy (CMPA) in exclusively breastfed infants!

Q 7. What are the side effects of CMPA for a baby?

The signs and symptoms that you need to look out for a baby usually include:

• Digestive problems (such as diarrhoea, vomiting, constipation and reflux)

• Skin problems (such as urticaria, hives and eczema)

• Respiratory symptoms (such as persistent cough and wheezing)

• Generic symptoms (such as problems sleeping or persistent crying)

But If you notice anything out of the ordinary or if your mum gut/ instincts are trying to tell you something, I would defiantly advise you to talk to a health care professional.

Q 8. Can babies get CMPA after 13 months?

It's important to acknowledge that every child is different, and the Symptoms of CMPA do often start in the early weeks and months of life. But most research suggests that children usually grow out of it by preschool age. But if you are unsure, it's always worth getting an allergy test to be sure that your child is protected.

That's all for now; thank you so much for sending in all of your questions. I hope this has helped; please feel free to get in touch with us on our Instagram and on our Facebook group for more insights into parenthood. And if you want some further reading into the topic of SMPA, click here to read our blog "Cow's Milk Protein Allergy (CMPA): Signs & Symptoms."

Love,

Himanshi @ Mamamade