I identified my son’s cow’s milk protein allergy (CMPA) when he was about six weeks old, and did lots of research to better understand what CMPA meant for our family. Below, you’ll find answers to many of the questions I had when we started this journey.
I am not a medical professional. The information below is based on my personal experience and research. If you think your baby may have a cow’s milk protein allergy, please discuss with your pediatrician.
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What is Cow’s Milk Protein Allergy (CMPA)?
Cow’s milk protein allergy (CMPA) is an abnormal response by the body’s immune system when cow’s milk protein is ingested. Many people call this a dairy allergy, which is fine for casual speak, but isn’t entirely accurate. The reason the “cow’s milk” part is so important is because human milk (mom’s breastfeeding milk) does not have the same protein, and the protein is what causes the allergic reaction. That said, breast milk isn’t fully in the clear for babies with allergies. Read on to find out why.
Is CMPA common for babies?
Three in every 100 babies develop CMPA in their first year of life1. While 3% seems like a pretty low number, think about your circle of friends and family. It’s not unlikely that you know 100 moms. That means 3 of your friends (or 2 of your friends and yourself) deal with CMPA. This is the most common food allergy in infants and young children.2
What is the difference between CMPA, CMPI and lactose intolerance?
If you’ve done any research on CMPA, you might also see CMPI pop up. CMPA stands for cow’s milk protein allergy, and CMPI stands for cow’s milk protein intolerance. From what I have found, people seem to use the terms interchangeably, and I haven’t been able to find a true difference. (Please comment if you know of one.) That said, it’s important to note that a cow’s milk protein intolerance is very different from lactose intolerance. Lactose intolerance is the inability to fully digest sugar in dairy products – not the protein. Lactose intolerance is very rare in children under 5 years of age1, so if your baby has a dairy issue, it’s likely CMPA/CMPI.
What are the symptoms of cow’s milk protein allergy?
There are many potential symptoms of CMPA. It’s important to note that most babies will only show a few of these symptoms, so don’t rule out CMPA just because you aren’t seeing all of these signs:
- Bloody stool
Sometimes you can see blood in the diaper. Other times, blood might be present, but it’s microscopic and not noticeable to the naked eye. Doctors can do tests on dirty diapers to identify traces of blood. - Mucusy diapers
If baby’s poo looks mucusy, this is another sign. Not sure what mucusy poo looks like? While it may feel odd, a quick Google image search will do the trick. - Colic-like crying
CMPA can cause serious pain for babies, and your little one will let you know by crying. These extreme crying spells can sometimes be mistaken for colic, and make parents feel helpless. The good news is… there is hope if it truly is CMPA! - Kicking, grunting and gas
When baby’s stomach hurts, he might let you know by kicking his legs, making grunting noises and passing gas. This stomach pain might be caused by CMPA. - Diaper rash
Diaper rash on its own is normal, but I was AMAZED at how quickly my little one’s diaper rash went away once we cut dairy. It was one of the first signs that he was getting better. - Skin irritation
Eczema and other rashes are signs of CMPA. While baby acne is common amongst all babies, some acne is also caused by allergies. - Congestion
Just like seasonal allergies in adults can cause congestion, cow’s milk protein can cause congestion in babies who are allergic.
How do I know if my baby has a cow’s milk protein allergy?
The symptoms above are good signs of CMPA, but there are blood tests, diaper tests and skin prick tests that can be done to officially identify the allergy. That said, these tests can be rough on babies, and many pediatricians just recommend cutting dairy out of the baby’s diet to see if baby gets better. This sounds simple, but can be difficult for breastfeeding moms, and can also take weeks to identify.
How do I cut dairy out of baby’s diet?
Cow’s milk protein is passed to babies through breast milk, so the only way to eliminate it from baby’s diet is to eliminate it from mom’s diet. This means more than just cutting out milk and cheese; it means looking at every single food label before consuming and making sure it doesn’t have any “hidden dairy” ingredients. (See cheat sheet from kellymom.com.) This can be difficult, but so worth it if you can make your little one feel better!
If you’re formula feeding, you’ll want to try formulas that have broken down milk protein. Soy-based formulas might seem like a good choice, but 8 to 14 percent of infants with cow’s milk allergy will also react to soy.3 While it’s not the cheapest option, hypoallergenic formula is a great place to start. Similac Alimentum breaks casein (cow’s milk protein) into smaller, more digestible pieces.
How quickly will a dairy-free diet help a baby with CMPA?
Unfortunately, it can take up to 6-8 weeks for baby to start feeling better after eliminating cow’s milk protein (CMP) from his diet. If you’re breastfeeding, it takes 2 weeks from the time you go dairy-free for dairy to be fully flushed from your system. After that, it takes 2 weeks for CMP to be flushed from baby’s system. Once baby’s system is clear, there might still be 2-4 weeks needed for his gut to heal, and for him to feel better.
I know… this sounds like an awful long time to wait! It’s hard to go through this detox period as a mom while your baby suffers. On a positive note, many parents will notice a difference sooner than 6-8 weeks. Some babies might start feeling better as quickly as 2-3 days.
If you’re breastfeeding and can’t stand the thought of your baby suffering for 2 weeks while you eliminate dairy from your system, you can switch to a hypoallergenic formula (like Alimentum) for that period of time. Just make sure you keep pumping at the same frequency that your baby eats to keep your supply up!
Living with a baby with CMPA
Having a baby with CMPA can make life difficult, but there’s hope and support out there!
Will my baby outgrow CMPA?
It’s encouraging to know that CMPA is temporary. Up to half of all babies with CMPA will outgrow it after just 1 year, over three quarters will outgrow CMPA after 3 years, and nearly all babies with CMPA will outgrow it by their 6th birthday.1 If you have frozen breastmilk from before you went dairy-free, save it for later! Your little one might be able to tolerate it at 9 months to a year old.
Are there support groups for dairy-free breastfeeding moms?
When I first suspected my son’s CMPA and cut dairy out of my diet, I was stressed out. I had questions, doubted myself and really wanted some pizza! I joined a few different Facebook groups, but there was one that I found to be super helpful. It’s called Dairy Free Diet – Breastfeeding. You can ask questions, share recipes and even post pictures of your little one’s poo to get input from other moms. The group admins are extremely knowledgeable, and there are almost 50K members to share their experiences!
What if dairy elimination doesn’t make my baby better?
Cow’s milk protein is the most popular child allergy, but it’s certainly not the only one. Eggs, peanuts, soy, wheat, tree nuts, fish and shellfish are other common allergies. If you’re breastfeeding and a dairy-elimination diet didn’t help your baby (or only helped with the symptoms, but didn’t fully take them away), your baby might have another allergy. Trying a hypoallergenic formula (like Alimentum) can at least indicate if baby’s food intake is the issue. If you notice improvements during a formula trial, you can then decide if you want to continue with formula, or try to identify the allergy through food testing and continue breastfeeding.
CMPA moms: You are not alone
While it can be challenging having a baby that deals with CMPA, you are not alone! Feel free to drop a note in the comments or fill out my contact form. I’d love to connect with you!
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Sources:
(1) https://www.nestlehealthscience.com/health-management/food-allergy/milk-allergy/milk-allergy-babies
(2) https://www.foodallergy.org/common-allergens/milk-allergy
(3) https://www.kidswithfoodallergies.org/page/formula-options-infants-food-allergies.aspx