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How To Manage Cow’s Milk Protein Allergy

How To Manage Cow’s Milk Protein Allergy

Managing a baby’s cow's milk protein allergy will require some dietary changes. Let’s take a look at what you might expect if your little one has this common infant food allergy.

Cow's milk protein allergy diet at a glance

Avoiding dairy products—including cow’s milk-based formula—is the primary management strategy for babies with cow's milk protein allergy. But even with a doctor’s guidance, most parents of babies with cow’s milk protein allergy understandably have lots of questions. What hidden sources of cow’s milk should you be aware of? What can you do to ease issues like reflux, rashes, and respiratory issues?

As with any health concern, if you think your baby's experiences might be due to cow's milk protein allergy, it's important to see your doctor so that they can evaluate your baby and make an appropriate identification. Your doctor will provide direction on how to make your baby more comfortable. If you’re formula-feeding, they will likely recommend switching your baby to a hypoallergenic infant formula, such as Nutramigen® with Probiotic LGG®, which has been clinically shown to manage colic due to cow’s milk protein within 48 hours.*

How can I ease my baby’s cow’s milk protein allergy issues?

If your little one has a cow’s milk protein allergy, your doctor may suggest switching to a hypoallergenic formula like Nutramigen to help manage their issues. Keep in mind, though, that even if you suspect a cow's milk protein allergy, avoid changing your baby’s diet without getting the green light from your doctor first.

If you are breastfeeding

Although it is not common, breastfed babies can develop an allergy to the milk protein in cow’s milk. The cow's milk protein that you ingest can cross into your breast milk and cause an allergic reaction in your baby. If you’re breastfeeding and your child has a cow's milk protein allergy, eliminating milk and milk products from your diet may help, but discuss it with your doctor. You may also want to talk to a dietitian about finding alternative sources of calcium and other nutrients to replace what you were getting from dairy products.

If you are formula-feeding

The American Academy of Pediatrics recommends a hypoallergenic (extensively hydrolyzed) formula for cow's milk protein allergy dietary management.1 Most babies with cow's milk protein allergy do well on an extensively hydrolyzed formula, such as Enfamil Nutramigen. However, an amino acid formula, like Enfamil PurAmino, may be recommended in some severe cases. Ask your baby's doctor which formula is appropriate for your baby.

How does extensively hydrolyzed formula work for a baby with cow's milk protein allergy?

Most infant formulas (except soy formulas) are cow milk-based. However, the cow's milk protein in our hypoallergenic Nutramigen LGG Infant Formula has been broken down extensively, so the body doesn't recognize it as a whole protein; therefore, it's much less likely to trigger an allergic response. At least 90% of babies with cow's milk protein allergy fed hypoallergenic baby formula should not react to the extensively broken down protein.2

Can I use a partially hydrolyzed formula if my baby has a cow's milk protein allergy?

There is a significant difference between a partially hydrolyzed formula and an extensively hydrolyzed formula. Many babies allergic to cow's milk protein will still react to a partially hydrolyzed formula. Therefore, the American Academy of Pediatrics does not recommend using a partially hydrolyzed formula for babies with cow's milk protein allergy.3

Can I use a soy-based formula if my baby has a cow's milk protein allergy?

Many babies who are allergic to cow's milk protein will also be allergic to soy protein. As a result, soy formulas are not recommended for babies who have cow's milk protein allergies.4

Could soy oil cause an allergic reaction if my baby has a cow's milk protein allergy?

Protein is the food component that usually triggers allergic reactions. Our hypoallergenic baby formula contains soy oil, not soy protein. Since the soy oil in our hypoallergenic formula is purified, refined, and considered hypoallergenic, we would not expect it to cause an allergic reaction.

Other tips for managing cow’s milk protein allergy issues

Aside from making dietary changes, there are other things you can do to ease some of your baby’s discomfort—even before you get an official cow's milk protein allergy identification.

Help with reflux

  • Create a comfortable atmosphere at feeding time to help your baby relax. Sometimes smaller, more frequent feedings might be better than feeding large volumes in one sitting.
  • Try to discourage your baby from drinking too quickly or gulping the formula.
  • Check that the bottle nipple you're using doesn't cause your baby to swallow too many bubbles while they are drinking.
  • Keep your baby in an upright position just after feeding to allow the food to settle.
  • Avoid dressing your baby in tight-fitting clothes that might press against their tummy.
  • Do not let people smoke near your baby, as this might affect reflux.

If these tips don't help, speak to your doctor. They might prescribe a special thickening agent to add to your baby's formula so that it's more likely to stay in their stomach rather than come back up.

Help with gas

  • Feed your baby slowly and pause from time to time.
  • If you're bottle-feeding:
    • Tip the bottle so the nipple is always full of milk to help minimize swallowing air bubbles while drinking.
    • Make sure the hole in the nipple is large enough. Babies can suck in a lot of air if the nipple is too small.
  • Ensure that your baby has at least one good burp after each feeding. Try rubbing the left side of their back, starting at the lower back and slowly moving up towards the shoulders, or gently bicycle your baby's legs while they're lying on their back.

Help with colic/excessive crying

Babies with cow's milk protein allergy might have colic, where they cry excessively for no other apparent reason. The crying tends to happen for at least three hours a day, more than three days a week, and for three weeks or more. If your baby has colic, talk to your doctor to see if a hypoallergenic baby formula such as Nutramigen could be a management solution. Here are some other tips that may help ease your baby’s colic symptoms:

  • Carry your baby in an infant sling or front carrier on your chest while you walk around, as the body contact and motion can be calming.
  • Play comforting sounds like soft music, fan sounds, or a heartbeat recording to help recreate a reassuring womb-like environment.
  • Soothe your baby with gentle, rhythmic motions, such as cradling them while rocking in a chair or using a vibrating infant seat.
  • Massage your baby's skin as babies love skin-to-skin contact. You might find that a regular massage helps ease your baby's crying and irritability. Ask your healthcare professional for more information on infant massage.

Help with skin issues

An allergic reaction to cow's milk protein might cause your baby to experience skin issues, such as an itchy rash. In this case:

  • Try to discourage your baby from scratching the rash, as this could aggravate the skin and increase the risk of infection. Your doctor may recommend anti-scratch mittens. Keep your baby's nails short to help them avoid scratching their delicate skin.
  • If you find that synthetic fibers aggravate the rash, try to dress your baby in natural materials like cotton instead.
  • Wash new clothes before trying them on your baby, and avoid fabric softeners to leave your baby's clothes free from chemical residues.
  • Hot weather could make the rash worse, so try to stay out of the heat if you find this to be the case.
  • Do not bathe your baby with scented soaps or heavy baby washes. These strip the oils from the skin and can cause adverse reactions.
  • Ask your doctor or pharmacist about using emollient creams to keep your baby's skin moisturized to avoid flare-ups and further skin damage. Emollients/moisturizers should be applied under the supervision of your doctor.

Depending on how severe your baby's rash is, their doctor may also consider prescribing certain medications or applying special bandages to help reduce swelling, redness, and itching. Speak to your doctor if you think your baby might need these.

Ask your doctor about hypoallergenic Nutramigen® specially created for babies with cow's milk protein allergy

If your baby has a cow's milk protein allergy, talk to your baby's doctor about switching to a hypoallergenic, extensively hydrolyzed formula such as Nutramigen® with Probiotic LGG®. Nutramigen LGG is a hypoallergenic formula clinically shown to manage colic due to cow's milk protein allergy fast, in as quickly as 48 hours.* It helps more babies overcome cow's milk protein allergy and return to consuming regular milk in as soon as six months of feeding. Plus, it’s lactose-free and helps reduce the incidence of future allergies.**

No matter what type of Enfamil formula you choose, you can start receiving up to $400 in savings, exclusive rewards, and support by joining Enfamil Family Beginnings. Enjoy a variety of benefits, including discount checks and digital rebates on Enfamil products, such as Nutramigen. You may also be eligible for free samples.


*Studied before the addition of LGG®, DHA, and ARA.
Vs. Nutramigen without LGG®.
**Asthma, eczema, rhinoconjunctivitis, and urticaria at 3 years compared to Nutramigen without LGG. Feeding began at 4 months of age or older in the study (ref#2).


All information on Enfamil, including but not limited to information about health, medical conditions, and nutrition, is intended for your general knowledge and is not a substitute for a healthcare professional's medical identification, advice, or management for specific medical conditions. You should seek medical care and consult your doctor or pediatrician for any specific health or nutrition issues. Never disregard professional medical advice or delay seeking medical treatment, care, or help because of information you have read on Enfamil.