What is Milk Protein Allergy in a Baby?
Milk protein allergy (also called cow’s milk protein allergy, or CMPA) is one of the most common food allergies in infants, especially in the first year of life. It occurs when a baby’s immune system mistakenly identifies proteins found in cow’s milk—casein and whey—as harmful and mounts an allergic reaction.
Types of Milk Protein Allergy:
1. IgE-mediated (immediate):
- Symptoms appear within minutes to 2 hours after consuming milk.
- Includes: hives, vomiting, wheezing, swelling, anaphylaxis (in severe cases).
2. Non-IgE-mediated (delayed):
- Symptoms occur hours to days later.
- Includes: eczema, diarrhea, blood or mucus in stools, reflux, irritability, poor growth.
Symptoms to Watch For:
- Skin: eczema, hives, swelling
- GI: vomiting, diarrhea, blood/mucus in stool, constipation, colic
- Respiratory: nasal congestion, wheezing
- General: poor weight gain, fussiness, feeding difficulties
Diagnosis:
- Based on symptom history and response to eliminating cow’s milk.
- For IgE-mediated: skin prick test or blood tests (specific IgE).
- For non-IgE: no reliable test—diagnosis is clinical. Elimination diet and oral food challenge is often the gold standard for confirmation.
Treatment:
1. For Breastfed Babies:
- Mother removes all dairy (milk, cheese, butter, yogurt, whey, casein, etc.) from her diet.
- Takes 2–4 weeks to see improvement in symptoms.
- Calcium and vitamin D supplementation may be needed.
2. For Formula-fed Babies:
- Switch to a hypoallergenic formula:
- Extensively hydrolyzed formula (eHF) – proteins broken down.
- Amino acid-based formula (AAF) – for severe or non-responsive cases.
- Avoid regular cow’s milk formulas and soy formula in many cases (soy can also trigger allergies).
3. Solid Food Introduction:
- Delay introducing dairy-containing solids until advised by a pediatrician or allergist.
- Work with a healthcare provider to determine when and how to reintroduce dairy—usually after 9–12 months or based on tolerance testing.
Prognosis:
- Most children outgrow CMPA by 3–5 years old.
- Regular follow-up with a pediatrician or allergist is important to assess tolerance development.
Parental Tips:
- Learn to read ingredient labels (look for casein, whey, lactoglobulin, etc.).
- Inform caregivers, daycare providers, and schools about the allergy.
- Consider medical ID if reactions are severe.
- Keep an epinephrine auto-injector if there’s a history of anaphylaxis.
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