Frequently asked questions

Babies who show signs of CMA (see the symptom checklist) should be assessed by a healthcare professional (the exception is for signs of anaphylaxis—call 999 for an ambulance immediately).^1,2
At this point, the healthcare professional should also examine the baby’s medical and family history, looking specifically for any allergy-related conditions.^1,2
If the healthcare professional still thinks that CMA is a likely cause of a baby’s symptoms, then they will either:^1,3

• Refer to the local paediatric services immediately (severe symptoms)
• Attempt to diagnose CMA and make sure it is not confused with other conditions (mild symptoms)

To confirm a diagnosis of CMA, a series of tests can be performed depending on the type of CMA that is suspected, which may include completely removing cow’s milk from the baby’s diet and then reintroducing it 2 to 4 weeks later, and a skin prick or blood test.³

Learn more about diagnosis

Once a healthcare professional confirms a diagnosis of CMA, the condition can be managed by providing the baby with a cow’s milk-free diet.

Breastfeeding is considered the gold standard for feeding babies for the first 6 months of life.⁴ Mothers who are able to breastfeed will be given advice about how to completely remove cow’s milk from their own diet.^1,2

For those mothers who are unable to exclusively breastfeed, their doctor or other healthcare professional will prescribe a special formula that is made specifically for infants with food allergies like CMA.^2,3 These are called ‘hypoallergenic formulas’, which contain proteins that are so thoroughly broken down that the immune system of most babies with CMA are unable to recognise and react to them.^5,6 Both Alimentum and EleCare are hypoallergenic formulas.

Learn more about hypoallergenic formulas and managing CMA

It’s perfectly normal for all babies to cry, but your baby may have colic if they cry a lot with no obvious cause (for more than 3 hours a day, 3 days a week for more than 3 weeks).^2,7

Colic can be a symptom of food allergies, such as a CMA.^5,7 But it is also commonly seen in babies who do not have CMA and will improve with time.^7,8

Your baby does not usually need to see a doctor or other healthcare professional if they have colic, but if you are concerned or your baby is showing other signs of CMA (see the symptom checklist), then they should be assessed by a healthcare professional.⁸

You can also speak to your health visitor for advice and support on how to manage colic.⁸

No, CMA and lactose intolerance are not the same, but they are both caused by milk and share some of the same digestive issues (e.g. diarrhoea and bloating).^5,9,10

Lactose intolerance is a condition where the body finds it difficult to fully digest lactose, a sugar mainly found in milk and dairy products.^9,11 This usually appears after the age of weaning and is typically not seen in babies.¹¹

In fact, infants are more likely to have CMA, which is where the immune system reacts to proteins in cow’s milk (e.g. whey and casein).^10,12 This can lead to respiratory and skin allergy symptoms (e.g. wheezing and itchy rash), as well as digestive issues.^10,13

Learn more about CMA and the symptoms you should be aware of.

If you are still confused about the difference between CMA and lactose intolerance, then you may wish to speak to a healthcare professional.

CMA is where the immune system reacts to the proteins in cow’s milk.²

So when a baby is diagnosed with CMA and the mother is unable to exclusively breastfeed, their doctor or other healthcare professional will prescribe a ‘hypoallergenic’ formula, which contains proteins that are so thoroughly broken down that the immune system of most babies with CMA cannot recognise and react to them.^5,6

For a formula to be considered ‘hypoallergenic’, it should be well tolerated by at least 90% of infants with proven CMA.¹⁴

The two main types of hypoallergenic formula are:^5,6

• Extensively hydrolysed formulas (e.g. Alimentum) – made from small fragments of cow’s milk protein that do not cause allergic reactions in around 90% of infants with CMA
• Amino acid-based formulas (e.g. EleCare) – made from the tiny individual building blocks of protein (amino acids), which are not recognised by the body and will not cause allergic reactions in any infants with CMA

Both Alimentum and EleCare are great examples of hypoallergenic formulas which have been specially formulated to resolve symptoms of CMA, while providing the nutrition needed to support growth. Learn more about Alimentum and EleCare.

The following formulas are not considered to be hypoallergenic and are not suitable for infants with CMA:⁵

• •Comfort formula - contain cow’s milk protein that have only been partly broken down, so infants with CMA are likely to react
• •Goat and other types of mammalian milks - the proteins they contain are very similar to those in cow’s milk, so infants may react to these formulas
• •Lactose-free formula – are free from lactose sugar but not from cow’s milk protein, so infants may react to these formulas
• •Hungry formulas, staydown formulas and partially hydrolysed formulas

Learn more about hypoallergenic formulas.

Soya formulas may be suitable for some babies with CMA from 6 months onwards. Depending on the type of allergy, 7% to 50% of infants with CMA are also allergic to soy protein, so should only be used if recommended by a healthcare professional.^5,15,16

However, the following formulas are not considered to be hypoallergenic and are not suitable for infants with CMA:⁵

• •Comfort formula - contain cow’s milk protein that have only been partly broken down, so infants with CMA are likely to react
• •Goat and other types of mammalian milks - the proteins they contain are very similar to those in cow’s milk, so infants may react to these formulas
• •Lactose-free formula – are free from lactose sugar but not from cow’s milk protein, so infants may react to these formulas
• •Hungry formulas, staydown formulas and partially hydrolysed formulas

REMEMBER - Only use formulas recommended by your doctor or other healthcare professional, even once symptoms begin to improve. Doing so will ensure that your baby receives the essential nutrition they need, and are unlikely to experience allergic reactions.

While some babies will take to their new specialist formula straight away without any complaints, it also common and very normal that your baby is not so keen on their formula at first. 

If breastfeeding is not possible, your doctor or other healthcare professional has prescribed you with Alimentum or EleCare, the most important thing you can do for your baby at this stage is to keep using the formula recommended by a healthcare professional, even once symptoms begin to improve. Doing so will ensure they are receiving the essential nutrition they need.

See some of our helpful tips on how to start formula feeding.

The healthcare professional will also be on hand to offer advice, help and support on how to introduce formulas to your baby – speak to them if you have any difficulty with getting your baby to accept their new formula.

Hypoallergenic formula can also be introduced to your baby as part of a recipe. For recipe ideas, click here.

Not all milk is suitable for feeding babies. Off-the-shelf supermarket milks are not nutritionally complete, and are nutritionally different from infant formula, so may not contain the correct and safe balance for your growing baby.^5,17

You should never give the following types of milk to a baby under 1 year:^5,17

• •Condensed milk
• •Evaporated milk
• •Dried milk
• •Goats' or sheep's milk
• •Other types of drinks known as "milks", such as soya, rice, oat or almond drinks
• •Food Safety Authority of Ireland does not recommend giving rice milk until your child is 5 years old because of the potential of high arsenic levels and low levels of nutrients¹⁸

Soya, rice, oat or almond milk may be used in cooking or mixed with food in older infants with CMA who are weaning. Speak to a healthcare professional (e.g. dietitian) for advice on which foods and drinks are suitable for your baby.

REMEMBER - Only use formulas recommended by your doctor or other healthcare professional, even once symptoms begin to improve. Doing so will ensure that your baby receives the essential nutrition they need, and are unlikely to experience allergic reactions.

Alimentum and EleCare are the first and only hypoallergenic formulas to contain biosynthesised 2’-FL.

2’-FL is the most abundant human milk oligosaccharide (HMO) found in most mothers’ breast milk.¹⁹ HMOs are a group of non-digestible carbohydrates and the third most abundant solid component of breast milk.^20,21

2’-FL has been shown to feed and support healthy bacteria in the gut and have an important role in supporting the developing infant immune system.^19,21–26

With over two decades of research, now you can provide your baby with this special ingredient with Alimentum or EleCare.

Learn more about how 2’-FL can support your baby’s development.

Both Alimentum and EleCare are nutritionally complete and have been shown to support the healthy growth of infants. Both formulas can be used as a sole source of nutrition, and can be incorporated into solid foods when baby is ready to start weaning.

See our Alimentum or EleCare weaning cookbooks for delicious recipes and advice to help make the transition from formula to solid food as smooth as possible.

Discuss with a healthcare professional if you have any questions about nutrition or growth.