Babies are full of surprises, aren’t they? Rashes, sleep regressions, that thing where they suddenly stop breathing for no good reason only to start again just as you reach peak panic levels.
Well, one more to throw into the mix is cow’s milk protein allergy, or CMPA.
This little beauty can throw a spanner into the works in the first year of life especially, because it has a huge impact on what your baby, and sometimes your baby’s Mum, can eat. It’s not as if newborns have a wide range of food choices anyway, so it really can be difficult to manage.
Interestingly, while up to 7% of bottle fed babies are estimated to develop a CMPA, only 0.5% of breast fed babies are thought to develop it. So if your little one is exclusively breast fed, they are much less likely to end up with a cow’s milk allergy.
Anyway, my son had CMPA until he was about two and a half, so I have some personal experience of this, so let me fill you in.
What is it?
CMPA comes in two forms: one that causes immediate allergic reactions (IgE-mediated) and one that leads to delayed symptoms (non-IgE-mediated). While IgE allergies can be life-threatening in extreme cases, non-IgE CMPA is the more common of the two and babies usually grow out of it by early childhood.
Put simply, a cow’s milk protein allergy is when the baby’s immune system mistakes the proteins in cow’s milk as harmful and reacts against them. This causes the symptoms parents notice that let us know something is wrong
Signs and Symptoms
The symptoms caused by the allergy are slightly different depending on which type your baby has.
Immediate symptoms caused by IgE-mediated CMPA include:
- hives
- swelling
- vomiting
- wheezing
- difficulty breathing
- anaphylaxis (life threatening)
Pretty scary stuff. These signs will appear within minutes to a couple of hours after after consuming cow’s milk.
Delayed symptoms caused by non IgE-mediated CMPA include:
- reflux
- diarrhea
- constipation
- colic
- eczema
- blood in the stool
While not nice for the baby, these signs will not cause serious illness and generally show up a few hours to a few days after consuming cow’s milk. You should still see the doctor, though.
Diagnosis and Treatment
Again, the process is a little different depending on the type of allergy your baby has.
For IgE-mediated CMPA, the allergy can be effectively diagnosed with a skin prick test or blood test. Once diagnosed, it’s case of strictly avoiding all dairy products and even potentially carrying an EpiPen adrenaline injector in case of emergencies.
For non-IgE-mediated CMPA, diagnosis is more difficult.
I went through this with my son, and to be frank, it’s a pain in the backside. You have to systematically eliminate things from the child’s diet, monitor to results, then reintroduce them one by one to see if there is any impact. It can take forever, and you will do a lot of staring at the back of packets. Plus, kids can get reactions to stuff for all sorts of reasons, so you can easily end up with false positives and negatives depending on what else is going on in their lives.
Again, treatment is just a case of avoiding dairy products.
For babies that are breast fed, the mother should avoid dairy, too. For babies that are bottle fed, parents should switch so specialist hypo-allergenic products that are extensively hydrolyzed or amino acid-based.
It’s Not the Same as Lactose Intolerance
It’s pretty common for people to confuse and conflate CMPA with lactose intolerance, but they are not the same thing despite the apparent similarities.
As we know, Cow’s Milk Protein Allergy is the baby’s immune system reacting to the proteins in milk and causing allergic reactions. Lactose intolerance is when the body is unable to digest the lactose found in cow’s milk. So although both issues are caused by cow’s milk, the specific part of the milk causing the problem is different.
On top of this, lactose intolerance is incredibly rare in children under 5 years old, despite being fairly commonly found among adults. Conversely, CMPA is the most common food allergy found in children under 1, with between 3 and 7 in every 100 developing it within the first year of life.
Foods for Kids with Cow’s Milk Allergy
This isn’t an extensive list, but to help get you started here are some food options if your little one is suffering with a cow’s milk allergy. These are for kids who are already moving onto solids, as before this it’s simply a case of using the specialist hypo-allergenic milk products I mentioned earlier. Most brands make them.
One thing I will say is that dairy free cheese is vile. I never found a good one and we tried loads. Still, if your kid will stomach it,
Milks
- Oat milk (best for cooking)
- Soy milk (nutritionally closest to cow’s milk)
- Coconut milk (good for creamy dishes)
- Almond milk (lower in protein but good for variety)
- Pea protein milk (high in protein, often fortified with nutrients)
Snacks
- Rice cakes with hummus or nut butter
- Fruits & veggies with dips (e.g., guacamole, hummus)
- Dairy-free yogurt (soy, coconut, almond-based)
- Oat or almond-based snack bars (check for dairy in ingredients)
- Homemade muffins or pancakes using dairy-free milk
General Foods
- Leafy greens like broccoli, kale, spinach
- Any vegetable
- Fortified cereals
- Canned fish
- Tofu
- Chia seeds, flaxseeds, sesame seeds
- Eggs (if they’re not also allergic to them!)
- Beans & lentils
- Meat, poultry, & fish
- Quinoa
- Nut butters (again, if no additional allergy)
I appreciate some of these might be difficult to get children to eat at the best of times, but your options are limited. We found that blending was our friend. Mush that tastes nice can contain anything really and kids will eat it. Sweet potato is good for taste.
