Cow Milk Allergy
In some children the ingestion of cow milk can trigger the body into launching an inappropriate
immune response to the proteins in the cow milk resulting in an allergic reaction: the
cow milk allergy.
Cow milk allergy (CMA) is as an immunologically mediated
adverse reaction to one or more cow's milk proteins.
Cow milk allergy is the
most common food allergy, affecting somewhere between
2% and 3% of infants. Around 0.5% of exclusively breast fed infants react to cow's milk
protein in human milk.
Cow milk allergy generally affects children less than three years of age. Approximately 85% of children lose
clinical reactivity to milk once they surpass 3 years of age.
The mean age of onset is reported as
between 3 months and 5 months. Children with immediate reaction following milk ingestion usually present earlier.
Principal cow milk allergy
symptoms are gastrointestinal, dermatological and respiratory: cow milk allergy is associated with the following symptoms:
skin rash,
wheezing,
vomiting,
diarrhoea,
constipation and
distress.The symptoms may occur within a few minutes after exposure (
immediate reactions) or after 1 hour and in some cases after several days (
delayed reactions).
Cow milk allergy clinical spectrum extends to diverse disorders: acute
anaphylactic reactions,
atopic dermatitis,
wheeze,
infantile colic,
gastroesophageal reflux (GER),
oesophagitis,
allergic colitis and
constipation.
Parents should consult a healthcare professional if milk allergy is suspected and request referral to a paediatrician if appropriate.
Currently the only
treatment for cow milk allergy is total avoidance of cow's milk proteins. But most infants formulas and baby milks are based on cow's milk. Initially if the infants are breastfed the lactating mothers are given an elimination diet. If symptoms do not resolve or the infants are bottlefed, cow's milk substitute formulas are used to provide the infant with a complete source of
nutrition, which does not provoke
immune mediated symptoms.
Cow's milk substitutes include soybean formula (but, generally, they are not recommended by specialists), and
hypoallergenic formulas based on hydrolysed protein or free amino acids