If there is one situation that is every parent’s fear and that no child should ever have to go through, it is having CMPA or cow’s milk protein allergy. Even though it is a frightening problem that directly affects a child’s diet, it has been diagnosed in around 7% of children, mainly in the first few months of life.

In the first months, the problem is common due to the immaturity of the digestive system and the body’s low immunity, which facilitate the development of CMPA. Diagnosis must be carried out by a specialist who will carefully analyze the case before recommending a treatment that is quite radical, requiring the complete removal of cow’s milk and its derivatives from the baby’s or child’s diet.

In the case of babies up to 6 months of age who should be exclusively breastfed, the removal of cow’s milk and its derivatives must come through the mother, who will need to eliminate from her own diet any food containing cow’s milk so it does not pass to the baby through breast milk.

At first, this is a complicated task, as a large portion of the foods we consume contain cow’s milk. Butter, yogurt, breads, cakes, biscuits—all require milk in their recipes, in addition to some products that are not for consumption but are used daily, such as some soaps and even cosmetics.

One of the tasks that will be necessary after the discovery of CMPA is to read the labels of all products that enter your home. Checking the ingredients is extremely important, and it’s important to be aware that cow’s milk is not always labeled with its original name but can be listed as:

  • Caseinate
  • Lactate
  • Whipped cream
  • Cream
  • Clotted cream
  • Whey
  • Lactic ferment

Other names such as lactulone, lactulose, hydrolyzed casein, buttermilk, curd, butterfat, butter oil, and dairy blend may also be found referring to milk ingredients in the product. Unfortunately, companies are not required to disclose these ingredients with explicit names to make identification easier for consumers.

Symptoms of Cow’s Milk Protein Allergy

In most cases of children suffering from CMPA, the symptoms are very similar, such as vomiting and regurgitation leading to significant nutrient loss, lack of appetite, and traces of blood in the stool. Symptoms can appear immediately after consumption or within minutes up to 2 hours after ingestion.

There are also cases of delayed-onset cow’s milk protein allergy, which can begin to cause reactions 48 hours after consumption or even up to a week later. Symptoms such as skin signs and breathing difficulties are also indications of possible CMPA and should be carefully investigated, as they may be symptoms of other allergies or even food poisoning.

Episodes of diarrhea, constipation, and presence of blood in the stool together with chronic cough and abdominal pain are the most common signs and are present in 99% of cases. Weight loss, anorexia, and irritability can occur in some isolated cases.

Diagnosis should proceed with the elimination of all foods containing cow’s milk protein, followed by skin tests for more detailed investigation, with the IgE test being one of the possible exams to be requested.

Treatment should be carried out by completely replacing cow’s milk with protein hydrolysate formulas or formulas containing soy. For older children, substitution may be made with goat’s milk, rice milk, soy, and other options available for children intolerant to milk protein, including those based on free amino acids.

It’s important to remember that CMPA and lactose intolerance are different issues, even though both result from cow’s milk consumption. CMPA is an allergy caused by the proteins in milk, while lactose intolerance occurs when the body cannot digest products containing milk.

See also: Breast Milk – Breastfeeding is essential!

Photos: Russell James Smith, camille habib