Pediatric allergy

Could it be cow’s milk protein allergy?

Eczema? Reflux? Constipation? Diarrhea? Crying? Do you suspect that your patient has a food allergy?

Cow's Milk Protein Allergy is one of the most common food allergies in the first year of life.

Food allergy or non-allergic food hypersensitivity?
Food allergies and non-allergic food hypersensitivities in babies and young children can present a real challenge. Until a diagnosis is reached, the process for parents, children and healthcare professionals can be a long and painful one.

Non-allergic food hypersensitivities, such as intolerances, arise because the body is unable to digest or reacts to certain naturally occurring component of foods, i.e., lactose or fructose, or, less commonly, food coloring, additives or preservatives. Non-allergic food hypersensitivities do not involve the immune system and are much more common than food allergies.

Food allergies arise due to the body’s immune system reacting to certain, normally harmless, allergy-triggering substances (allergens) in food. These allergens are almost always proteins. Proteins are one of the essential nutrients that make up the body, together with vitamins, minerals, carbohydrates and fat. Other components in food, such as lactose and sugar, do not act as allergens.

Certain allergens cause more reactions than others. Here are the top eight allergens accounting for approximately 90 percent of all allergic reactions to food in children.

The prevalence of food allergies, especially in the first years of life, has increased dramatically in the last 10 years or so. The challenge to find better ways to prevent and manage food allergies is a pressing one.

Cow’s milk protein allergy is one of the most common food allergies in children


Although cow’s milk protein is one of the most common food allergens in babies and toddlers it can be difficult to diagnose. Cow's milk protein allergy occurs when a baby’s immune system reacts negatively to the proteins in cow’s milk. If breastfed, the reaction is to the cow’s milk protein ingested by the mother and passed to the child through the breast milk, and if formula-fed, the reaction is to the milk protein in the formula. In both cases the body’s immune system sees these proteins as foreign and in an effort to protect itself, the body releases natural substances, such as histamines, which cause the allergic symptoms that your baby might be experiencing.

Cow’s milk protein allergy generally occurs for the first time between the third and fifth month of life in affected children, but can also develop later in life.

Lactose intolerance is not the same as cow’s milk protein allergy.


Cow’s milk protein allergy and lactose intolerance are often confused. Although some symptoms such as diarrhea, are similar, lactose intolerance is an inability to digest the lactose found in both cow’s milk whereas cow’s milk protein allergy is an immune reaction to certain proteins within these milks. Lactose intolerance is extremely rare before 3 years of age, even in those with cow’s milk protein allergy. After all, breast milk naturally contains a high amount of lactose.

Developed by top international experts, the CoMiSS (Cow’s Milk-related Symptom Score), is a fast and easy-to-use awareness tool that can aid an earlier accurate diagnosis. For more information on how this tool works and how it can help you in your practice, click on the link below.

Learn more about CoMiSS

Start Scoring



    Discover how easy it is to use this scoring system (CoMiSS® = Cow’s Milk-related Symptom Score) to assess and interpret the incidence of non-specific symptoms that may be related to Cow’s Milk Protein Allergy (CMPA): e.g. crying, regurgitation, stool consistency, skin and respiratory.

Signs and symptoms of cow's milk protein allergy
The signs and symptoms linked with cow's milk protein allergy, ranging from colic and reflux to constipation, diarrhea and crying, make diagnosis a real challenge.

Read more
Accurate and early: Diagnostic support for cow's milk protein allergy.
Eczema? Reflux? Constipation? Diarrhea? Crying? Could it be cow’s milk protein allergy?

Learn more about how to diagnose cow's milk protein allergy early
Help parents prepare for their visit.
In order to raise parents’ awareness and prepare them for their visits, Nestlé Health Science has developed a cow’s milk protein allergy awareness brochure.

Download CMPA awareness brochure
Download CMPA symptoms diary

Available solutions
  • Specialized solutions are available

    After diagnosing your patient with cow's milk protein allergy, you may recommend a strict cow’s milk protein free diet for the breastfeeding mother or a special formula for infants and young children with food allergies. In case breastfeeding is not an option, two types of formula are particularly recommended for infants with cow's milk protein allergy.

    Read more

Althéra, Alfaré and Alfamino. A specially designed range of nutritional solutions developed to help meet the needs of babies and children with food allergies and intolerances.

Mothers should be encouraged to continue breast-feeding while avoiding all milk and milk products from their own diet. This usually requires qualified dietary counseling to completely exclude hidden sources of cow’s milk protein. If a decision to use a special formula intended for infants is taken, it is important to give instructions on correct preparation methods, emphasising that unboiled water, unsterilised bottles or incorrect dilution can all lead to illness. Formula for special medical purposes intended for infants must be used under medical supervision.
We believe breast milk is the best food for infants. When in consultation with their healthcare professional, mothers and families find that optimal breastfeeding is not possible due to their infant’s medical condition, formulas for special medical purposes play a vital role in providing essential nutrients to infants. We have a global commitment to market breast-milk substitutes responsibly.
This website is about the management of cow’s milk protein allergy and nutritional solutions intended for infants. By continuing on this website, you accept that Nestlé supplies the information at your own request.
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