What is Cow's Milk Protein Allergy (CMPA)?
Cow’s Milk Protein Allergy, or CMPA, is one of the most common food allergies to affect babies. It occurs in 2-3% of babies, with symptoms usually appearing before 12 months of age.
CMPA occurs when the body’s immune system reacts abnormally to proteins in cow’s milk, which are recognised as a potential threat. This can cause the immune system to be ‘sensitised’ 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. So one bad reaction can then turn into an allergy.
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 risk.
CMPA and lactose intolerance are NOT the same thing
CMPA is often confused with lactose intolerance as they can share some symptoms, but they’re actually two very different things with completely different causes and treatments.
Lactose intolerance doesn’t involve the immune system. Instead, it is the inability to digest sugar found in cow’s milk. It’s common in adults, but very rare in children under the age of 5.
Lactose is in fact one of the most important carbohydrates found in breast milk and provides many benefits to babies, such as helping to promote a healthy gut and calcium absorption.
Symptoms of Cow’s Milk Protein Allergy
There are two different types of CMPA: immediate reaction (IgE) and delayed reaction (Non-IgE). In immediate reaction, symptoms usually start within 2 hours of drinking cow’s milk. In delayed reaction CMPA, the symptoms can occur from 48 hours to 1 week after consuming cow’s milk protein.
CMPA symptoms may include:
Skin problems: rashes, hives, dry, scaly or itchy skin (up to 7 in 10 babies with CMPA experience skin-related symptoms)
Digestive system problems: diarrhoea, vomiting, constipation, reflux (up to 6 in 10 babies with CMPA experience digestive symptoms)
Respiratory system problems: noisy breathing, coughing, runny nose (up to 3 in 10 babies with CMPA experience airway and breathing-related symptoms)
What should I do if I think my baby has CMPA?
If your baby is experiencing CMPA symptoms, it can be a very anxious and worrying time for you as a parent. Thankfully, once diagnosed, CMPA can be easily managed through diet.
It can be difficult to spot the symptoms of a food allergy, as the sign’s and symptoms of CMPA can easily be mistaken for other common conditions seen in babies.
You should speak to your health visitor or GP if you suspect your baby has CMPA. They will likely recommend eliminating cow’s milk protein from your baby’s diet and then slowly reintroducing to see if any symptoms occur when reintroduced.
It’s a good idea to keep a record of your baby’s symptoms, when they occurred and what they’re eating to help track and eliminate any other causes of their symptoms.
Here are some questions to consider before your appointment with your doctor:
- What are the signs and symptoms that make you think your baby may have CMPA?
- How old was your baby when you first noticed the symptoms?
- How quickly do symptoms develop after feeding?
- How often do they happen? Are they the same every time?
- Do the same symptoms happen each time your infant eats/drinks a particular food?
- Is there a family history of any allergies, especially in parents or siblings? (e.g. asthma, eczema and hayfever)
- Do you suspect a specific food is involved - either in your infant’s diet or the mother’s diet if breastfed? If so, how much of the suspected food does your infant need to eat for symptoms to appear?
- Remember, being able to identify Cow’s Milk Protein Allergy signs and symptoms is the first step in providing relief for your baby. So the more you can show and tell your doctor, the better.
What is the treatment for CMPA?
The most common treatment for CMPA is following a cow’s milk protein elimination diet.
If you are formula feeding, this will involve moving your child onto a prescribed special formula specifically designed and developed for babies with CMPA. Specialist formulas for cow’s milk allergic babies will contain different ingredients, some which are completely free from cow’s milk protein and others which contain cow’s milk protein in a broken-down form.
If you are breastfeeding, your doctor will advise you to eliminate cow’s milk protein from your diet as well and will offer support to help you fo this. You’ll still be encouraged to continue breastfeeding if your baby is diagnosed with CMPA.
Your GP and health visitor will be able to help guide you while managing your baby’s CMPA.
Does CMPA improve over time?
Most parents are relieved to hear that yes, most children usually grow out of CMPA over time. By 12 months, 50% of babies will have developed a tolerance to cow’s milk protein. By 3 years of age, more than 75% of children will no longer have symptoms of CMPA, and by 6 years old 90% of children no longer have issues with cow’s milk protein.
After 6-12 months of eliminating cow’s milk protein from your baby’s diet, your doctor will be able to advise when and how to start slowly reintroducing cow’s milk protein to their diet.