Firstly, what are food allergies? Food allergies occur when the body's immune system (the body's own defense mechanism) responds abnormally to certain foods.

For people with food allergies, the immune system incorrectly identifies certain food components as harmful and produces an inappropriate response. This leads to an unpleasant and on occasions life threatening signs and symptoms associated with allergies.

Cows’ milk allergy (CMA), also known as cows’ milk protein allergy (CMPA), is one of the most common food allergies in babies, and usually appears before 1 years of age.

CMA usually develops before a baby's first birthday

Approximately 3 out of every 100 babies will develop CMA in their first year of life.
CMA is very rare in children older than 5 years of age.

Babies with CMA can still be breastfed safely

In rare cases, breastfed babies can react to cows’ milk protein in their mother's breast milk.
With changes to the mother's diet, breastfeeding can continue safely following dietary support from their health care professional.

What is CMPA?

Cow’s milk protein allergy (CMPA) is the most common food allergy in babies. CMPA is a type of milk allergy where a baby's immune system responds to the proteins found in cows’ milk, mistaking it for a harmful substance and attacks it, causing the baby to have allergic symptoms. These can include problems with the skin (rash, hives, dry, scaly or itchy skin), digestive system (diarrhoea, vomiting, constipation and reflux) and respiratory system (noisy breathing, coughing, runny nose). CMA usually occurs before a baby’s first birthday.

What causes CMPA?

CMPA is caused by the immune system mistaking one or more of the proteins found in cows' milk to be a harmful substance. This triggers an allergic reaction in response. It is not believed that CMPA is genetic or triggered by a specific incident.

How common is CMPA and who is at risk?

Unfortunately, cows' milk protein allergy is very common, with the risk being highest in infants. 2-3% of babies under the age of one years old suffer with CMPA. As children get older, the risk decreases.

If a parent or sibling has an allergic disease such as asthma, eczema, or any seasonal allergies, then the risk of developing CMPA is increased. There's evidence to suggest breastfeeding protects babies from developing CMPA.

What are the different types of CMPA?

There are two types of cows' milk protein allergy depending on how the immune system reacts. The first type is defined by symptoms that are ‘immediate’. This is when symptoms are caused by the immunoglobulin E antibody (IgE). Typically, these allergic symptoms happen within minutes of consuming cow’s milk or up to two hours afterwards. This is known as IgE-mediated.

The other type of CMPA is ‘delayed’, where symptoms are slow to appear. This is described as non-IgE mediated and is the most common type. The symptoms usually develop from two hours after consumption but can take up to a week to appear.

Lactose intolerance is not to be confused with CMPA

CMPA is commonly confused with lactose intolerance but they are very different: lactose intolerance does not involve the body's immune system. The two share some similar signs and symptoms, such as stomach and gut problems (like wind and diarrhoea).

It is important to know the difference between lactose intolerance and CMPA, as the two have different causes and also treatments; in addition, CMPA usually develops early in life, whereas lactose intolerance is extremely rare before the age of 5 years.

Use our symptom checker here to see if your baby has any symptoms of CMPA.

What is lactose intolerance?

Lactose intolerance does not involve the immune system. Instead, it is the inability to digest the lactose sugar found in cows’ milk, and it is very rare in children younger than 5 years of age. Lactose is one of the most important carbohydrates (sugars) in breast milk and provides many benefits to babies, such as helping to promote a healthy gut and calcium absorption.


Infographic of CMA vs Lactose Intolerance

Lactose intolerance is where the body is unable to digest lactose that is found in cows' milk. Whereas, CMPA is a baby's own immune system reacting to certain proteins that are found in cows' milk, which causes the allergic symptoms.

Lactose intolerance is much more common in adults than it is infants. In fact, it's very rare for children under the age of 5 to develop lactose intolerance. But, CMPA is the most common childhood food allergy.


Understand the signs and symptoms of CMA

Symptoms of CMPA may affect the digestive system, respiratory system and the skin.

Learn more about the common signs and symptoms of CMPA

How do I get CMPA diagnosed?

Diagnosing CMPA can be challenging. If CMPA is suspected, you should visit a doctor who can assess and if necessary perform specific tests to help make a diagnosis.

Learn more about the diagnosis

How can I prepare for the doctor’s visit?

For a faster and accurate diagnosis of CMPA by your doctor, the SmilesBack app helps you to easily record and keep track of your baby’s symptoms and feeds in preparation for your doctor’s appointment.

IMPORTANT NOTICE: Breastfeeding is the best form of nutrition for babies and provides many benefits to babies and mothers. It is important that, in preparation for and during breastfeeding, you eat a healthy, balanced diet. Combined breast and bottle feeding in the first weeks of life may reduce the supply of your own breastmilk, and reversing the decision not to breastfeed is difficult. Always consult your healthcare professional for advice about feeding your baby. The social and financial implications of using infant formula should be considered. Improper use of an infant formula or inappropriate foods or feeding methods may present a health hazard. If you use infant formula, you should follow the manufacturer’s instructions for use carefully – failure to follow the instructions may make your baby ill. Formula for special medical purposes intended for infants must be used under medical supervision.