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 infants^2,3

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.

*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

Identifying cow's milk allergy

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

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

IgE-mediated CMA

Non-IgE-mediated CMA

This website is intended for SAhealthcare professionals only

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 infants^2,3

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

This website is intended for SA
healthcare professionals only