Anaphylaxis is a severe, immediate, generalised, or systemic, hyper-sensitivity reaction affecting multiple organ systems and is characterised at its most severe by bronchospasm, upper airway angioedema and/or hypotension.1 The anaphylactic reaction is predominantly a paediatric condition and although it is uncommon, it is not rare.1 It is estimated to occur in one out of 170 children.2 

Anaphylaxis as a symptom of Cow’s Milk Protein Allergy

Cow’s Milk Protein Allergy (CMPA) is the second most common cause of anaphylaxis in infants2 and is responsible for up to 80% of all anaphylactic reactions that present in hospital emergency departments.1 It has also been identified in several reports of food-induced fatalities in infants.3


Signs and symptoms related to CMPA

The majority of infants affected with CMPA have at least two symptoms affecting at least two different organ systems.4,5


Having an awareness of the most common symptoms of CMPA can help you to make an earlier diagnosis of CMPA in your patients.

CoMiSS® awareness tool

The Cow’s Milk-related Symptom Score (CoMiSS)® is a simple, fast and easy-to-use awareness tool designed to help you more easily recognise the signs and symptoms that can be cow’s milk-related in infants and young children.

CoMiSS® awareness tool is available in print and online version
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.



1.    K Brown., et al. Med J Aust. 2006:185;5:285–9

2.    Silva IL., et al. Allergy. 2008:63:1071–76

3.    Younker J. and Soar J. Nurs Crit Care. 2010;15(2):94–8

4.    Lifschitz C. and Szajewska H. Eur J Pediatr. 2015;174:141–50

5.    Høst A. Pediatr Allergy Immunol. 1994;5:1–36

IMPORTANT NOTICE: Mothers should be encouraged to continue breastfeeding even when their babies have cow’s milk protein allergy. This usually requires qualified dietary counseling to completely exclude all sources of cow’s milk protein from the mothers’ diet. If a decision to use a special formula intended for infants is taken, it is important to follow the instructions on the label. Unboiled water, unboiled bottles or incorrect dilution can make babies ill. Incorrect storage, handling, preparation and feeding can eventually lead to adverse effects on the health of babies. Formula for special medical purposes intended for infants must be used under medical supervision.