When you have a child, one of your first concerns is whether or not they will develop allergies. You may not think about it until several months down the road when your child develops an itchy rash, or other symptoms that make them suffer.

No parent wants to see their child suffer. I’m a mum myself, so I know how scary it feels when your baby is unsettled and / or has diarrhoea. Cow's milk allergy or sometimes referred to as 'Cow's Milk Protein Allergy' is quite rare, only affecting about 2-5% of babies, but the symptoms of cow's milk allergy are very similar to symptoms of reflux, colic and some other conditions so it is important to get the right diagnosis. 

If you are unsure whether your baby has colic, reflux or cow's milk allergy you can take this Quiz. This will differentiate the symptoms between these different conditions and give you a score to say that your baby is or is not likely to have Cow's Milk Protein allergy. 

In this article, you will learn about the signs and symptoms of cow's milk allergy in babies and how to recognise them. I also give information on how to treat them properly.

What is a Cow's Milk Allergy?

The term "cow's milk allergy" means that the baby has developed an immune reaction to certain proteins found in cow's milk. These proteins are called allergens. When the body makes antibodies against these allergens, inflammation of the gut and swelling of the skin occurs. This reaction is called an allergic reaction.

There are different forms of cow’s milk allergy. The most common form of cow’s milk allergy has a delayed onset (also called Non IgE Mediated Cow’s Milk Allergy) and occurs 2-72hrs after having food containing cow’s milk protein. This is not life-threatening but does cause a lot of discomfort to the baby and may cause faltering growth (in some instances) if not properly treated.

The other type is 'immediate' onset (IgE mediated Cow's Milk Allergy). The symptoms occur within 2 hours of ingestion and present with swelling, rash, breathing difficulties. This can be life-threatening so it is important to seek medical attention immediately.

Symptoms of a Delayed Cow's Milk Allergy

If your baby develops a milk allergy, the following symptoms might occur:

Your baby may only display two of these symptoms or many. It is very important to get it properly diagnosed so that we can rule out other possible causes of your babies symptoms.

How can I tell if my child is allergic to milk?

Since there are no specific diagnostic tests for delayed cow's milk protein Allergy (CMPA) in infants, doctors usually rely on clinical signs and symptoms to diagnose it..

If you suspect that your child has a milk allergy, talk to their doctor immediately, and they will be able to help you find an effective solution.

The first things you should look out for include:

• Do they have eczema? Eczema may be a symptom of food allergies in children.
• Are they suffering from constipation or diarrhoea? Constipation  and diarrhoea are common symptoms of milk allergy.
• Do they have blood in the poo?
• Have they vomited? Vomiting is a sign of reflux, often associated with CMA.
• Are they experiencing difficulty sleeping? If they are uncomfortable and in pain this can affect sleep.
• Are they struggling to gain weight? Weight loss and failing to thrive is a sign.
• Do they have frequent ear infections? Ear infections may be another symptom of food allergies, especially when accompanied with other symptoms.
• Has their behaviour changed? Changes in behaviour are a good indication that something is wrong, this is especially true in toddlers.
• Are they showing other signs of discomfort such as irritability, crying, fussiness, or lethargy?

If your child has an allergic reaction after drinking breast milk or formula, talk to your doctor first. They will probably recommend a dietitian to help you find out what is going on.

How is Delayed Cow’s Milk Allergy diagnosed?

Delayed Cow’s Milk Allergy is diagnosed by eliminating all cow’s milk from the baby's diet either by eliminating it from mums breast milk or by changing to a special formula which is prescribed by your GP  for a period of 3-4 weeks.

Click here to purchase 'Step by Step Guide to Diagnose Cow's Milk Allergy - Mini Course'

After a period of elimination it is important to challenge with some ordinary formula or by Mum consuming milk again in her diet. If the symptoms go away during the elimination period and return during the challenge then this confirms a delayed cow’s milk allergy.

To be guided through the process of how to diagnose cow's milk protein allergy -  purchase the course here

Unfortunately there are no reliable clinical tests for delayed cow’s milk allergy. It is important to get professional advice about the challenge phase so please speak to your health visitor, GP or NHS dietitian for more guidance and support or purchase my mini course to be guided through the process by a series of emails and videos.

Once diagnosis is confirmed it is advisable to be referred to your local NHS Paediatric Dietitian (or you can book and appointment with me here) for support and advice regarding weaning and reintroduction of dairy at the right time. 

How is a cow's milk allergy treated?

Treating a milk allergy is very simple, and all you need to do is eliminate all dairy products from your baby's diet. Milk, cheese, butter, yoghurt and all other dairy products are not suitable for babies. This includes any mammalian milks such as goats and sheep's milk since the proteins in these are similar to cow’s milk.

Breastfeeding mothers

Although breast milk is always best for babies, very sensitive babies can react to the very small amounts of cow’s milk protein particulars that pass from mother to baby in breast milk. Should this happen you may be advised to remove all diary from your diet. Have a look at my 'Feeding You Booklet' which is a dairy and soya free diet for breastfeeding mum's. Please talk to a dietitian when eliminating dairy from your diet to ensure you are getting all the nutrition you and your baby needs. You can book a discovery call with me here.

Formula-fed babies

There are a variety of special milk available specifically for babies with Cow’s Milk Allergy. If you suspect your baby as having Cow’s Milk Allergy ensure to contact your G.P. in the first instance so they can prescribe an appropriate formula. Your GP can prescribe a special formula for your baby if they have been fed formula instead of breast milk. If you are struggling to get your GP to prescribe the milk you can book a consultation with me here and I will happily write a prescription letter.

How long does the cow's milk allergy last?

It depends on how severe the allergy is. Some babies only need to avoid dairy products for a few months, while others can suffer for years. 

Lactose Intolerance vs Milk Allergy

Lactose intolerance means you can't break down the lactose (the sugar in milk) in your digestive system. This leads to bloating, gas, stomach cramps and diarrhoea.

Milk allergy is an immune reaction caused by specific allergens found in milk. This reaction causes swelling around the mouth and eyes in immediate (IgE Mediated) milk allergy and gut type reactions such as vomiting and diarrhoea in delayed (Non IgE) milk allergy.

We Are Here To Help

We have developed an evidence-based membership for parents of cow's milk allergy and unsettled babies. This membership is called 'Settled Baby Club' and is access to a library of masterclasses, information booklets, recipes and weekly dietitian clinics along with a community of other parents just like you. Since the pandemic, we have found that parents are not getting the support they need from their GP and are sitting on long waiting lists to get an appointment with a dietitian. We want to close this gap. Have a look at Settled Baby Club. This club is not just about advice on handling a cow's milk allergy, but everything to do with babies at this stage.

If you are a parent who suspects your child has a cow's milk allergy then purchase my 'Step by Step Guide to Diagnose Cow's Milk Allergy - mini course', or if your baby have been diagnosed with a cow's milk allergy and you would like some personalised one to one support then have a look at my cow's milk allergy services here