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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

digestive

Digestive

Frequent regurgitation, vomiting, diarrhea, constipation (with/without perianal rash), blood in stool.

Up to 60% of affected infants have digestive symptoms. 2

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respiratory

Respiratory

Runny nose, (otitis media), chronic cough, wheezing (unrelated to infection).

Up to 30% of affected infants have respiratory symptoms. 2

Skin

Skin

Atopic dermatitis, angioedema, urticaria unrelated to acute infections, drug intake manifestations. ​​​​​​​​​​​​​​

Up to 70% of affected infants have skin-related symptoms. 2

general

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



THE MOST COMMON SYMPTOMS OF CMPA

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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

  1. 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..
  2. 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.
  3. Lifschitz C, Szajewska H. Cow’s milk allergy: evidence-based diagnosis and management for the practitioner. Eur J Pediatr. 2015;174:141-50