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How Do I Know If My Baby Has a Cow's Milk Allergy?

Cow’s milk allergy, also known as cow’s milk protein allergy (CMPA),  is a common childhood food allergy, and infants who have it may have different experiences after consuming the proteins found in cow's milk. If you’re ever concerned that your little one may have it, don’t hesitate to contact your pediatrician.

Key Insights: "How Do I Know If My Baby Has a Cow's Milk Allergy?"

  1. Common Indicators: Colic, bloody stools, eczema, vomiting, diarrhea, gas, or bloating; skin reactions, coughing or wheezing may also occur.
  2. Behavioral Clues: Fussiness, irritability, or excessive crying after feedings could signal a reaction to cow’s milk proteins. These behaviors often appear shortly after eating.
  3. Confirmation: Your pediatrician may recommend eliminating cow’s milk protein from your baby’s diet to monitor changes. Skin prick or blood tests may also be used to confirm an allergy.
  4. Next Steps: Ask your pediatrician about switching to a hypoallergenic formula like Nutramigen® with Probiotic LGG®.

Cow’s Milk Protein Allergy Indicators

IndicatorDescription
ColicProlonged crying (more than 3 hours/day, 3 days/week, for 3+ weeks) in an otherwise healthy baby. Often worst in the evening or night. Learn more about colic.
Nausea or vomitingYour baby could feel sick or might vomit excessively. Learn more about baby vomit.
RefluxSome babies have more severe reflux, spitting up large amounts, forcefully vomiting, choking, gagging, arching away from the bottle or breast, seeming irritable during or after feedings, or struggling to gain weight.
Diarrhea or unusual poopsDiarrhea can be frequent, watery, foul-smelling loose poops—especially concerning if baby becomes dehydrated. Breastfed baby poop is usually runny and seedy; formula-fed baby poop is typically thicker. If you notice blood and/or mucus in the stool, contact your doctor right away. Learn more about baby poop.
GassinessA bloated or firm stomach, clenched fists, stiff or pulled-up legs, and frequent passing of gas can indicate discomfort. Learn more about baby gas.
ConstipationHard, pellet-like stools or infrequent bowel movements. Note: some healthy infants may go several days without pooping. Learn more about constipation.
Hay fever-like indicatorsSneezing, and an itchy, runny, or blocked nose may be signs of a reaction to cow’s milk.
AnaphylaxisA rare but serious allergic reaction: indicators include difficulty breathing, fainting, facial swelling, and full-body skin irritation. Seek emergency medical help immediately (call 911).
Eczema or rashSmall red bumps on the face, scalp, hands, or feet that may itch, ooze, crust over, or feel dry and scaly. Learn more about baby rashes.

Cow’s Milk Allergy Vs. Dairy Sensitivity Vs. Lactose Intolerance

Some cow’s milk allergy indicators, such as gassiness and diarrhea, are similar to dairy sensitivity indicators. However, cow’s milk allergy, dairy sensitivity, and lactose intolerance, are all different.

Food allergies involve the immune system, and in the case of a cow's milk allergy, the body's immune system triggers an adverse response to the protein in cow's milk.

Lactose intolerance in babies and lactose sensitivity have to do with an inability to fully break down or digest lactose, a milk sugar. If you're unsure if your child has sensitivity vs CMPA talk your pediatrician about the issues your baby is experiencing.

Understanding the Steps to a Cow’s Milk Protein Allergy Identification

If you suspect your baby may have a cow's milk protein allergy, following these steps could make identifying the allergy a bit easier, but remember, any number of things could be causing your baby’s behaviors, so it’s best to consult your pediatrician.

  1. Start keeping a diary of your baby’s issues.
    • Note whether your little one flares up during or after feeds or at certain times of the day.
    • Keep track of indicators over 1–2 weeks.
    • Track which foods your baby is consuming—breast milk, formula, or solids.
    • Note if your baby gets upset when you try to nurse or offer a bottle or whether they seem uninterested in eating even when you know they’re hungry. Bring your diary to your pediatrician appointment to discuss your concerns together. Download Our Feeding Log to record your baby’s eating and stooling behaviors.
  2. Prepare questions for your pediatrician. There are no wrong questions, but Download Our List of Questions to Ask Your Pediatrician to get you started on the right track to a productive conversation.
  3. Test and learn. To confirm if your little one has a cow’s milk allergy, your doctor may suggest an elimination diet and food challenge guided by them or another health care professional, such as a dietitian. A skin prick or blood test may also be recommended to gather more data about the body’s immune responses. Do not perform a food challenge on your own–be sure to consult with your doctor first.
  4. Your doctor may suggest specific dietary changes. If you’re breastfeeding, ask your doctor if you should take cow’s milk out of your diet. If you’re formula-feeding, you may be advised on suitable hypoallergenic formulas such as Nutramigen® with Probiotic LGG®.
  5. If your baby continues to have issues, your pediatrician may refer you to a specialist who can advise you on further next steps or look into other food allergies.

Always speak to a doctor if you’re ever worried about your baby’s health. Get immediate medical help if your baby has trouble breathing, seems faint, or has swelling around their mouth and face.

Cow’s Milk Allergy Management

If your doctor suspects cow's milk allergy, they may suggest eliminating cow's milk proteins from your baby’s diet. This isn't as daunting as it might sound.

  • For breastfed babies
    Cow's milk protein fragments can be passed in breast milk when the mom consumes dairy products. Breast milk still provides the best nutrition for your baby, so you shouldn't stop nursing. You should not remove dairy foods from your diet without speaking to your doctor.
  • For formula-fed babies
    Switching to a hypoallergenic, extensively hydrolyzed formula designed for babies with cow’s milk allergy may help. Some infants experience a reduction in excessive crying due to colic as early as 24 hours after the switch.* Other cow’s milk allergy indicators—like eczema, reflux, vomiting, and diarrhea—may take longer to improve and are often seen after 3–6 weeks of continued feeding with Nutramigen® with Probiotic LGG®. Talk to your doctor to see if this option is right for your baby.

As your baby gets older, your doctor may suggest you start reintroducing your child to foods made with cow's milk. This should always be done carefully and under a doctor's supervision. Most children outgrow cow's milk allergy eventually,1 so you may not be facing a lifetime of saying no to your child's pleas for ice cream and mac and cheese. In the meantime, there are other ways you can manage CMPA and the indicators associated with it.

Ask Your Doctor About Nutramigen® With Probiotic LGG®

If you think your little one may have an allergy to cow’s milk protein, talk to your doctor about switching to Nutramigen®, a hypoallergenic formula that is clinically shown to manage colic due to cow's milk allergy in as quickly as 24 hours. It helps more babies overcome cow’s milk allergy and return to consuming regular milk in as soon as six months of feeding.2 It’s also lactose-free, which helps reduce the incidence of future allergies related to cow’s milk.§ 


*In a clinical study of infants with cow’s milk allergy, some experienced a reduction in excessive crying due to colic within 24 hours after starting an extensively hydrolyzed formula; results and timing vary by infant.
Improvements in additional indicators associated with cow’s milk allergy (e.g., eczema, reflux, vomiting, diarrhea) were observed with continued feeding over 3–6 weeks on Nutramigen with Probiotic LGG; results and timing vary and not all infants will experience benefits.
Starts as early as 24 hours and 90% of infants experienced colic relief within 24 hours, due to cow’s milk allergy.
§Fewer incidences of asthma, rhinoconjunctivitis, urticaria, and eczema at 6 years compared to other hypoallergenic infant formulas.

References

  1. https://www.worldallergy.org/education-and-programs/education/allergic-disease-resource-center/professionals/cows-milk-allergy-in-children

  2. Berni Canani R, Nocerino R, Terrin G, et al. Effect of Lactobacillus GG on tolerance acquisition in infants with cow’s milk allergy: a randomized trial. J Allergy Clin Immunol. 2012;129:580-

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