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Cow’s Milk Protein Allergy (CMPA) Symptoms and Signs in Children

For most young children, cow’s milk is a dietary staple that provides calories, protein, fat, calcium, and other key nutrients essential for proper growth. For a small minority of children, however, cow’s milk consumption may result in negative side effects. Children with a cow’s milk protein allergy (CMPA) face a heightened immune response when exposed to milk and it is important that parents become familiar with possible indicators of such an allergy when starting their child on cow’s milk or cow’s milk-based formulas. Here, the experts at Cambrooke – makers of amino acid-based formulas for children over 1 year of age– discuss some of the common signs and symptoms of a cow’s milk allergy so you can tell if it affects your child.

Identifying the Two Types of Cow’s Milk Allergies

Before diving into the symptoms of a cow’s milk allergy, it is important to distinguish between the two types of CMPA, especially given that each type may present in a different manner with the possibility of some overlapping symptoms. In both cases, the reaction a child experiences involves the immune system, but exactly how the reaction is triggered and the type of immune response is what separates one allergy from another.

The main distinguishing feature here is whether the antibodies called immunoglobulin E (IgE) have a role in the response. When they do, the body typically reacts more quickly; this is known as an IgE-mediated1 cow’s milk allergy, and it is commonly associated with not only cow’s milk but also eggs, wheat, soy, peanuts, tree nuts, fish, and shellfish. In some cases, however, the reaction to a particular food protein causes a different immune response that does not involve IgE antibodies; when this happens, it is called a non-IgE-mediated allergy.

Common Signs Your Child Might Have a Cow’s Milk Allergy

Although most people are familiar with some of the more obvious signs and symptoms of an allergic reaction – hives, swelling, trouble breathing – an allergic reaction to cow’s milk or other food allergens can actually feature other parts of the body as well, including the, cardiovascular and digestive system. These can appear as changes in blood pressure, stomach cramping, vomiting, or diarrhea. The amount of time that passes between exposure to the allergen and the occurrence of symptoms can provide clues as to the type of allergen.  Below, we will look at the different types of cow’s milk allergies in more detail and discuss how to identify the symptoms..

IgE-Mediated Cow’s Milk Allergy

An IgE-mediated reaction is commonly known to occur more suddenly, and it is what is often portrayed as severe or extreme in movies or on television. However, IgE-mediated responses do not always occur as a severe or violent reaction, they can appear with milder symptoms and it may even take a few hours before you notice a reaction. That said, even relatively mild reactions to cow’s milk or other foods can lead to anaphylaxis, a severe reaction2 that often affects several areas of the body at once. Symptoms and severity of anaphylaxis can vary from one experience to the next and once you notice the symptoms start, they can progress rather quickly. If anaphylaxis is suspected, it is important to seek treatment immediately since this type of reaction is serious and may be life-threatening in some cases. Below are common symptoms seen with an IgE-mediated cow’s milk allergy:

  • Shortness of breath or trouble breathing
  • Abdominal pain
  • Nausea or vomiting
  • Diarrhea
  • Swelling in or around the mouth or throat
  • A rash or hives on the skin
  • A feeling of anxiety or that something bad may happen

Non-IgE-Mediated Cow’s Milk Allergy

When a cow’s milk allergy presents with a delayed response and symptoms are confined to the skin and/or GI tract, it may indicate a non-IgE-mediated allergy. The symptoms of non-IgE mediated allergies are typically present in the digestive tract and may take the form of nausea, vomiting, or diarrhea. The most problematic part of diagnosing non-IgE-mediated allergies is that the appearance of symptoms may occur a day or more later and it can be difficult to pinpoint the cause. Treatment occurs by removal of the suspected food while monitoring for improvement in symptoms.

Those with non-IgE-mediated allergies may also experience related conditions1 caused by contact with cow’s milk or other food allergens, including eosinophilic esophagitis (EoE) or food protein-induced enterocolitis syndrome (FPIES).

Diagnosing a Cow’s Milk Allergy Based on Common Signs and Symptoms

As important as it is to keep an eye out for the common signs and symptoms of a cow’s milk allergy, it can be very difficult to base a diagnosis on a child’s reactions alone. To help determine whether an allergy is causing a child’s health problems, doctors, allergists, and dietitians will be able to help investigate your child’s diet and symptoms a little deeper and, in some cases, may recommend certain testing methods to help establish a diagnosis and layout a treatment strategy.

The two simplest tests3 used in diagnosing an IgE-mediated cow’s milk allergy are the skin-prick test and blood test, both of which can be done in a doctor’s office. In the first test, an allergist will place a drop of solution containing milk protein on the skin and then prick the patient’s skin with a tiny probe, then observe for a reaction; in the second, doctors test the blood for the presence of IgE antibodies specific for the suspected food.

However, the result of these tests is not always certain, so it is recommended that they be used as a tool for a food allergy diagnosis in conjunction with the history of reaction and reported symptoms. A third test known as an oral food challenge has been considered the gold standard for diagnosis. In this procedure, the patient ingests a small amount of the suspected allergen in a clinical setting, where medical help is readily available. As the amount consumed increases, the allergist monitors the patient for a reaction. This test can be very expensive, time-consuming, labor-intensive, and stressful for the patient and therefore, it is not typically considered as a practical option when diagnosing a patient.

Try an Elemental Formula for Children with Cow’s Milk Allergies

Because of the outsized role milk plays in many children’s diets, the parents of those with a cow’s milk allergy often struggle to find ways of ensuring their child gets the proper nutritional support without the risk of a reaction. For many parents, the solution is an amino acid-based formula free from the whole milk proteins known to cause allergic reactions. If you or someone you know has a child with a cow’s milk allergy, visit Cambrooke online and learn more about our elemental formulas for children over 1 year of age with food allergies or digestive disorders or call 1-833-377-2773 today.

  1. https://www.kidswithfoodallergies.org/what-is-a-food-allergy.aspx
  2. https://www.aaaai.org/conditions-and-treatments/allergies/anaphylaxis
  3. https://acaai.org/allergies/types-allergies/food-allergy/types-food-allergy/milk-dairy-allergy