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Cow's Milk Protein Allergy (CMPA): Most Common Food Allergy in Babies

by Dr. Trupti Shirole on June 1, 2023 at 10:37 PM
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Cow's milk protein allergy (CMPA) is a prevalent food allergy among infants. While Western countries have seen an increasing number of CMPA cases, data from India is limited. In the first year of life, the estimated incidence of CMPA ranges from 2% to 7.5% (1).

Importance of Raising Awareness about CMPA in India

Given that cow's milk is a staple in the diets of Indian mothers and babies, it becomes crucial to create awareness about CMPA. Early recognition and treatment of CMPA are vital to prevent serious consequences. Here are some frequently asked questions that will help us better understand and address this condition.

Dispelling Common Myths about Cow's Milk Feeding in Children

Feeding cow's milk to children is often misconstrued as equivalent to breastfeeding or superior to artificial milk formulas. However, it is important to note that breast milk is always the superior choice and a child's birthright. The American Academy of Pediatrics recommends introducing cow's milk only after the age of 1 while continuing breastfeeding until the age of 2. Feeding cow milk to infants under the age of 1 can lead to various complications and potential harm to their kidneys due to the high protein and mineral content.

Understanding Cow's Milk Allergy in Children: Causes and Individual Susceptibility

CMPA occurs when a baby's immune system abnormally reacts to the proteins found in cow's milk, as well as in other animals' milk, such as goats and sheep. It suggests an underlying genetic susceptibility to animal protein. If a child develops CMPA, it is essential to understand that it is not an isolated case, as certain studies indicate an incidence as high as 15% among children under the age of 1. However, the risk decreases as children get older, with less than 1% of children aged 6 and above being affected (2). Children with a family history of asthma, eczema, or other allergic diseases are more vulnerable to developing CMPA.


Consequences of Untreated Cow's Milk Protein Allergy (CMPA)

Failing to address CMPA symptoms promptly can lead to various complications. These include recurrent wheezing, respiratory tract infections, treatment-resistant eczema, growth failure, and inadequate weight gain. Additionally, infants can develop severe anemia due to blood loss in stools and iron deficiency (3).

Cow's Milk Protein Allergy (CMPA) in Breastfed Babies

Even breastfed babies can be prone to CMPA if the mother consumes dairy products. However, the incidence of CMPA is significantly lower, around 0.5%, compared to formula-fed babies. Breast milk, nonetheless, offers protective factors against CMPA.

‘Cow's milk protein allergy (CMPA), the leading food allergy in babies, requires early detection and treatment to prevent complications. Breastfeeding provides some protection, but CMPA can still affect infants. #CMPA #babyhealth #allergyawareness ’

If your child is under the age of 1 and you have concerns about their well-being, it is advisable to consult a pediatrician. Recognizing the importance of accurate CMPA diagnosis is crucial, as misdiagnosis can lead to unnecessary dietary restrictions in both infants and breastfeeding mothers. It is worth noting that the perceived prevalence of food allergies among children is often higher than the actual prevalence, as highlighted by a study in which parents mislabeled 35% of children younger than 2 as reacting to food, particularly milk.

Diagnosing Cow's Milk Protein Allergy (CMPA)

CMPA is primarily a clinical diagnosis. Typically, your doctor will recommend eliminating dairy products from both the mother's and baby's diets. Other diseases, especially infections, which may mimic CMPA, will be ruled out. Once the symptoms subside (which may take up to 2 weeks), your doctor might suggest reintroducing dairy products in what is known as an oral challenge. If symptoms reoccur, it indicates the possibility of CMPA. Additionally, your doctor may recommend blood investigations or allergy tests to assist with the diagnosis (4).

Treatment for Cow's Milk Protein Allergy (CMPA)

Treating CMPA involves removing cow's milk protein from your child's diet, including the mother's diet if the baby is breastfeeding. Hydrolyzed formulas or amino acid-based formulas, which are easily digested, are usually recommended as a starting point. However, infants experiencing immediate symptoms within 2 hours of consumption, such as severe wheezing, extensive rashes, or anaphylactic shock, require immediate medical attention. In such cases, it is crucial to bring the child to the hospital, as emergency drugs may need to be administered intravenously (4).

References:
  1. Cow's Milk Protein Allergy - (https:pubmed.ncbi.nlm.nih.gov/27582492/)
  2. Cow Milk Allergy - (https:pubmed.ncbi.nlm.nih.gov/31194400/)
  3. Cow's milk protein allergy in children: a practical guide - (https:pubmed.ncbi.nlm.nih.gov/20205781/)
  4. Guidelines on Diagnosis and Management of Cow's Milk Protein Allergy - (https:pubmed.ncbi.nlm.nih.gov/32844758/)
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