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Identifying cow's milk allergy

Cow’s milk allergy (CMA) is an immune-mediated response to proteins in cow’s milk.1
CMA symptoms present in up to 7% of all infants and 0.5% of breastfed infants2,3

CMA is either IgE-mediated or non-IgE-mediated (or a mix of both), which can be distinguished by symptoms and speed of symptom onset:1,2

  • IgE-mediated: symptoms usually occur within minutes to up to 2 hours after ingestion
  • Non-IgE-mediated: symptoms usually occur 2–72 hours after ingestion

CMA usually involves multiple systems - key symptoms include:*2

IgE-mediated CMA

Gastrointestinal

  • Vomiting
  • Abdominal pain
  • Diarrhoea
  • Colicky abdominal pain/discomfort
  • Angio-oedema of the lips, tongue and palate
  • Oral pruritus
 

Skin

  • Pruritus
  • Erythema
  • Acute urticaria
  • Acute angio-oedema
  • Atopic eczema

Respiratory

  • Acute rhinitis
  • Conjunctivitis

Other

  • Anaphylaxis
 

Non-IgE-mediated CMA

Gastrointestinal

  • Vomiting
  • Abdominal pain
  • Diarrhoea
  • Infantile colic/persistent irritability
  • Constipation
  • Food refusal
  • Blood/mucus in stool
  • Faltering growth
 

Skin

  • Pruritus
  • Erythema/flushing
  • Atopic eczema

Both IgE- and non-IgE-mediated CMA can present with mild-to-moderate or severe symptoms.1,2 Some of the symptoms listed above are very common in otherwise well infants, particularly in those with mild-to-moderate CMA symptoms.2,4

Because of this, a diagnosis can only be considered if the initial assessment (physical examination and allergy-focused clinical history) strongly suggests CMA.2,4

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IMPORTANT NOTICE: Breastfeeding is best for infants and is recommended for as long as possible during infancy. Alimentum and EleCare are infant formulas for special medical purposes and should only be used under the recommendation or guidance of a healthcare professional.

*This is not an exhaustive list of CMA symptoms. Absence of these symptoms does not exclude CMA.

CMA: cow’s milk allergy; IgE: immunoglobulin E.

 

References

UK-SIMILAC-2000016 December 2020