We understand that navigating the complexities of allergies, especially in the early stages of a child's life, can be challenging for parents and caregivers. This resource is designed to provide you with reliable and up-to-date information to help you better understand and manage Cow's Milk Allergy, ensuring the well-being of your little ones.
There are two types of cow’s milk allergy depending on how the immune system reacts.
- IgE-mediated food allergy is caused by the immunoglobulin E antibody (called IgE). Symptoms are ‘immediate’ (quick to appear) and can occur within minutes of consuming cow’s milk or up to two hours afterwards.
- Non-IgE mediated food allergy is the most common type of cow’s milk allergy and symptoms are ‘delayed’ (slow to appear) and are caused by a different part of the immune system reacting in a different way. The symptoms typically develop from two hours after consumption but can take up to 72 hours.
Symptoms of CMA often start in the early weeks and months of life. There are many possible symptoms which may suggest your baby has a cow’s milk allergy. Allergic symptoms can affect one or more of the body’s systems, including the skin, digestive and, less commonly, breathing or blood circulation. Common symptoms of cow’s milk allergy include:
- Skin reactions such as hives, eczema, redness, or itching.
- Gastrointestinal issues include vomiting, diarrhoea, abdominal pain, or discomfort.
- Respiratory symptoms include sneezing, runny nose, coughing, wheezing, or shortness of breath.
- General discomfort can display as fussiness, irritability, and refusal to feed.
Allergic symptoms may be called mild, moderate, or severe. However, it is important to remember that many of the symptoms of delayed allergies, such as eczema, colic, reflux and diarrhoea are common in infants and milk allergy is only one of a number of possible causes.
In severe cases, cow’s milk allergy can lead to a life-threatening allergic reaction known as anaphylaxis, which requires immediate medical attention.
If you suspect your child has cow’s milk allergy do not delay in seeking advice from your GP or Health Visitor. They will listen to your concerns and take an allergy focused history (a series of questions to help decide if allergy is a possible cause of the symptoms). They will also be able to assess whether the symptoms may be due to milk allergy or if there is another cause.
Testing will only be discussed after a detailed allergy focused history has been taken. It will depend on the suspected type of cow’s milk allergy.
If immediate (IgE mediated) cow’s milk allergy is suspected your GP can arrange a referral to a children’s specialist allergy service for testing and further management. Usually the information from the allergy-focused history and the tests will be enough to confirm the diagnosis.
The referral process and waiting times to see a specialist will depend on where you live, and the allergy service and resources in your area. Allergy UK’s Helpline on 01322 619 898 can help signpost you to an approved NHS or Private allergy clinic. If you choose not to be seen through the NHS, you have the choice to pay to see a private allergy doctor. Whilst waiting for an NHS or private appointment, your GP or Healthcare Professional should advise you on the dietary changes that you will need to start immediately.
If delayed (non-IgE mediated) cow’s milk allergy is suspected, skin prick testing and/or blood tests are not helpful. The diagnosis for delayed allergy needs to be confirmed or excluded by starting a trial elimination of all cow’s milk protein; either from you baby’s diet in the case of a formula fed baby or from your own diet if you are exclusively breast feeding. Those babies who are formula fed need to be prescribed a special low allergy formula (called a hypoallergenic formula).