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60-75% of children outgrow CMPA by 2 years of age, rising to 85-90% of children at 3 years of age (EuroPrevall study, 2012). Trial of reintroduction of cow’s milk – Use the Milk Ladder (see appendix D). This should be supervised by a suitably trained health professional if symptoms are severe.
Information for Clinicians. Paediatric Department. Cow’s Milk Protein Allergy: Diagnosis and Management in Infants. This guidance is designed to be used by all health care professionals involved in the care of infants and young children with suspected Cow’s Milk Protein Allergy (CMPA).
Cow’s milk protein intolerance can be divided into IgE-mediated (immediate reaction) and non-IgE mediated (delayed reaction) types. The two types have different symptoms associated with each.
cow’s milk. Lactose intolerance is also extremely rare before 3 years of age. What is COW’S MILK PROTEIN ALLERGY? CMPA is the most common food allergy in infancy, affecting up to 3% of babies in the first year of life. Food allergies such as CMPA can affect anyone, however infants with a family history of allergy are at higher risk.
Elimination of cow’s milk protein from the infant’s or mother’s diet and challenges are the gold standard for diagnosis. This guidance is intended as a basis for local discussion, implementation and prospective evaluation.
For babies with mild to moderate delayed symptoms (unless there is evidence of IgE mediated symptoms and signs) confirm diagnosis with home milk challenge. This can be initiated two weeks after starting a specialised formula. For babies with severe symptoms or an acute reaction (usually IgE mediated): refer to secondary care.
CMPA - General features: estimated that fifty to sixty per cent of affected children have skin symptoms and/ or gastrointestinal symptoms and 20-30% have respiratory symptoms (4) CMPA may be the underlying cause of gastro-oesophageal reflux disease (GORD) in up to 40% of infants and young children (4)
