The non-specific signs and symptoms of CMPA, ranging from colic and reflux to constipation, insomnia, eczema, diarrhoea and crying, make diagnosis a real challenge. The symptoms involve many different organ systems, predominantly the skin and the gastrointestinal and respiratory tracts. The involvement of two or more organ systems increases the likelihood of CMPA. 1
Cow’s Milk Protein Allergy
We believe breast milk is the best food for infants. When in consultation with their healthcare professional, mothers and families find that optimal breastfeeding is not possible due to their infant’s medical condition, formulas for special medical purposes play a vital role in providing essential nutrients to infants. We have a global commitment to market breast-milk substitutes responsibly.
This website is about the management of cow’s milk protein allergy and nutritional solutions intended for infants. By continuing on this website, you accept that Nestlé supplies the information at your own request.
Are you a healthcare professional or a parent ?
Digestive
Frequent regurgitation, vomiting, diarrhea, constipation (with/without perianal rash), blood in stool.
Up to 60% of affected infants have digestive symptoms. 2
- Dysphagia
- Reflux and regurgitation
- Colic
- Abdominal pain
- Vomiting
- Anorexia, refusal to feed
- Diarrhoea ± intestinal protein or blood loss
- Constipation ± perianal rash
- Failure to thrive
- Occult blood loss
- Iron-deficiency anemia
Find out more
Respiratory
Runny nose, (otitis media), chronic cough, wheezing (unrelated to infection).
Up to 30% of affected infants have respiratory symptoms. 2
- Runny nose and sneezing
- Wheezing
-
Chronic cough
(all unrelated to infections)
Skin
Atopic dermatitis, angioedema, urticaria unrelated to acute infections, drug intake manifestations.
Up to 70% of affected infants have skin-related symptoms. 2
- Urticaria
- Atopic dermatitis (eczema)
- Rash
- Angioedema
General
Persistent distress or colic (≥ 3 hours per day wailing/irritable) at least 3 days/week over a period of > 3 weeks.
Inconsolable crying is very common in infants with CMPA, while anaphylaxis is very rare. 3
- Anaphylaxis
- Shock-like symptoms with severe metabolic acidosis
- Abdominal pain
- Infantile insomnia
- Inconsolable crying
THE MOST COMMON SYMPTOMS OF CMPA
CLARIFY THE DIAGNOSIS
Diagnosis of CMPA can be challenging, and few tests are available to help assess the presence of CMPA. The gold standard for diagnosing CMPA is the elimination diet, which is free from cow’s milk protein, followed by a food challenge.
CoMiSS® AWARENESS TOOL
If you suspect your patient is suffering from symptoms that may be suggestive of CMPA, use the CoMiSS® tool to score and assess the likelihood of CMPA.
ONGOING MANAGEMENT OF CMPA
It’s important for physicians and caregivers to work closely together to successfully manage cow’s milk protein allergy (CMPA) in infants and young children. Nestlé Health Science has a range of practical tools and information to help you and your patients learn more about CMPA.
REFERENCES
- Koletzko S, et al. Diagnostic Approach and Management of Cow’s-Milk Protein Allergy in Infants and Children: ESPGHAN GI Committee Practical Guidelines. J Pediatr Gastroenterol Nutr 2012;55(2):221-229..
- Høst A, Halken S. A prospective study of cow milk allergy in Danish infants during the first 3 years of life. Clinical course in relation to clinical and immunological type of hypersensitivity reaction. Allergy. 1990;45:587-96.
- Lifschitz C, Szajewska H. Cow’s milk allergy: evidence-based diagnosis and management for the practitioner. Eur J Pediatr. 2015;174:141-50