Cows’ Milk Protein Sensitivity In Babies – 8 Facts

Caring for babies can be challenging and exhausting. When a baby has a food sensitivity, things can be even more challenging and exhausting.

One of the most difficult parts of having a baby with a food sensitivity is obtaining a fast and accurate diagnosis. So what does a food sensitivity mean?

Food sensitivity is a term used to cover food allergy and food intolerance.

Food allergy is caused by an overreaction of the immune system to the offending food (often a food protein). With a food allergy even just a small amount of the offending food can trigger a big reaction which tends to occur fairly quickly.

Food intolerance does not involve the immune system but is when a person experiences stomach or bowel upsets when the offending food is eaten (commonly food chemicals). With a food intolerance, reactions can be quite delayed (e.g. 24–48 hours or more after being exposed to the food). There’s also a graded effect with a food intolerance meaning a small amount generally won’t cause a reaction but a larger amount can.

One common food sensitivity is to cows’ milk protein (CMP).

Cows Milk Protein Sensitivity In Babies

Here are 8 facts about cows’ milk protein sensitivity (CMPS) in babies.

#1: There Are A Range Of Signs Of CMPS

There are a variety of signs a baby with a CMPS may show. Some babies’ signs may be very subtle while others may be very obvious.

Here are some signs a baby may have a CMPS (these signs are not limited to only CMPS but can be for any other food sensitivity):

• Family history of food sensitivity
• Refluxes frequently
• Cries inconsolably for long periods (more than what would be expected to be normal)
• Sleeps little and wakes suddenly with obvious discomfort
• Tummy upsets (e.g. constipation or diarrhea)
• Mucus in poos
• Poor growth (if the sensitivity is severe)
• Eczema (if severe, more likely food allergy-associated)
• Hives
• Swelling of lips, eyes and/or face *
• Rash, often around mouth *
• Respiratory troubles (e.g. wheezing) *
• Frequent runny nose and watery eyes *
• Bloodstained poos *
• Anaphylaxis *

* associated with food allergy rather than food intolerance

#2: Reflux Can Be A Sign Of CMPS

Reflux can be a sign a baby has a CMPS. For this reason, gastro-oesophageal reflux disease may be diagnosed when the true diagnosis may actually be a CMPS. It can help to discuss this possibility with your health care professional.

#3: Lactose Intolerance May Be Misdiagnosed For A CMPS

Primary lactose intolerance (where a baby is born with it), is very rare. A baby with primary lactose intolerance would fail to thrive from the very start unless a lactose free formula was given.

Secondary lactose intolerance is not rare however. This can occur secondary to anything that irritates the gut. One thing that can irritate the gut is a CMPS. Once this is recognised and treated, the secondary lactose intolerance goes away.

Unfortunately, lactose intolerance may be misdiagnosed for a CMPS. This may result in a formula fed baby receiving a lactose free formula which has CMP in it. For a breastfed baby, this may mean undertaking an exhausting and bandaid measure of expressing and using lacteeze drops. Lacteeze drops help break down the lactose in the expressed breastmilk prior to the baby drinking it.

#4: Specialised Formula Is Needed For Formula Fed Babies With CMPS

It’s important to seek medical advice if you suspect your formula fed baby may have a CMPS. One of the following formulas may be suggested:

• Soy formula
• Extensively hydrolysed formula
• Amino acid based (or elemental) formula

The last two formulas in the list above are usually obtained only upon prescription from a paediatrician.

#5: Maternal Dietary Changes Can Help Breastfed Babies With CMPS

Most of the time, a baby with a food sensitivity does not show any obvious signs of it while being exclusively breastfed. Rather, more obvious signs are shown once the baby eats the offending food(s) directly.

Nonetheless, it’s important to seek advice from a dietitian or paediatrician if you suspect your breastfed baby may have a CMPS.

If a breastfed baby has a medically diagnosed food sensitivity (particularly if severe), the mother can keep breastfeeding by avoiding the offending foods in her diet.

#6: Babies With CMPS May Also Be Sensitive To Other Food Proteins

It’s common for babies with a CMPS to also be sensitive to other food proteins such as soy and goats’ milk proteins.

Hence, these proteins may not necessary be suitable substitutes when a CMPS is present.

#7: It May Be Something Other Than A CMPS

There can be a range of possible causes for the signs listed above. Other possible causes could be:

• Low milk supply
• Lactose overload from a mother having an oversupply
• Gastro-oesophageal reflux disease (although this can be associated with a CMPS as discussed above)
• Normal baby behaviour. For example, could your baby be going through a Wonder Week? Or is it normal newborn behaviour?

#8: Your Baby May Grow Out Of The CMPS

The good news is that most babies grow out of a CMPS. In fact, by 4 years of age about 80% of children have outgrown an allergy to CMP.

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If you suspect your baby may have a food sensitivity, it’s important to seek individual diagnosis and management. Many major children’s hospitals have allergy departments that specialise in this area. Visit Royal Children’s Hospital, Melbourne and go to the department of allergy and immunology section, or the Royal Prince Alfred Allergy Centre, Sydney.