What to do if you suspect your baby might be allergic to cows’ milk protein


When your baby is experiencing distressing symptoms, it can be a worrying time for you as a parent. It’s often difficult to obtain a clear cow milk allergy diagnosis, but if you’re worried your baby may have CMA, you can prepare for your baby’s doctor’s appointment by following these steps:

Step 1
Understanding the symptoms of CMA


Digestive Digestive

Up to 6 in every 10 babies with CMPA will experience digestive symptoms such as: vomiting, reflux, refusal to feed, colic, diarrhoea, constipation, dysphagia and frequent regurgitation.


Respiratory Respiratory stats

Up to 3 in every 10 babies will experience airway and breathing-related symptoms including wheezing or noisy breathing, persistent cough and/or runny noses.


Skin Skin stats

Up to 7 in every 10 babies with CMPA will have skin-related symptoms such as: hives, rashes with raised red lumps, lip and/or eyelid swelling and dry, scaly itchy red skin.

Click here to read about the common symptoms of CMA

Step 2
Check your baby’s symptoms

If you’re unsure if your baby has a cow’s milk allergy or not, try answering a few simple questions with our symptom checker. This can help your doctor make an accurate CMPA diagnosis.

Fill out the symptom checker here.
Step 3
Track your baby’s symptoms

Preparing for your doctor's appointment will help to ensure that they’re aware of all your baby's symptoms. Keep track of their symptoms and feeds with the handy SmilesBack app.

Step 4
Getting the diagnosis

During your appointment, the doctor may suggest carrying out the following tests to make a cow’s milk allergy diagnosis:

Elimination diet followed by food challenge

During this form of testing cows’ milk protein is completely eliminated for 2 – 6 weeks, then reintroduced to see if the symptoms reappear. It’s worth noting that currently, the elimination diet and food challenge are the only tests that provide a confirmed CMPA diagnosis.

Skin prick test

With a skin prick test, the skin is firstly scratched and then a tiny amount of the food/allergen is added to the skin.

Patch test

A patch test is where a patch that contains a tiny amount of the food/allergen is attached to the skin.

Blood test

During a blood test, your physician will take a small amount of blood in order to investigate for antibodies against a protein in cow’s milk known as ‘immunoglobulin E IgE’.


Elimination diet and food challenge

cows' milk-free diet for your baby without recommendation and guidance from your HCP. Based on the age of your baby and the severity of the symptoms, your doctor or HCP will recommend the most suitable solution.

The best way for your doctor or HCP to confirm or exclude the diagnosis of CMA is through an elimination diet, which involves eliminating cows' milk protein from your baby’s diet, followed by a food challenge, in which cows' milk protein is reintroduced. Although CMA is rarely observed in breastfed babies, if you are breastfeeding, your doctor will help you eliminate cows' milk protein from your diet.

If your baby has an allergic reaction to cows’ milk protein, you are likely to notice improvements very quickly after starting the elimination diet; most symptoms will disappear within 2 to 4 weeks, and all should completely disappear within 6 weeks. If improvements in symptoms are seen, then your doctor will suggest reintroducing cows' milk protein into your baby’s diet in small amounts to check if symptoms reappear to confirm the diagnosis. If avoiding cows' milk protein does not help your baby, it is unlikely that your baby has CMA, and your doctor or HCP will investigate other possible causes of the symptoms observed.

If the diagnosis of CMPA is confirmed, the good news is that with the support of your doctor, it can be managed. The key is to seek support from your doctor as early as possible to ensure a fast and accurate diagnosis.

Diagnosis of a cows’ milk protein allergy should not impact your breastfeeding routine. Mothers are encouraged to continue breastfeeding even when their babies have CMA. This usually requires qualified dietary counselling to completely exclude all sources of cows’ milk protein from the mother’s diet.

Learn more about feeding with CMA


Do you suspect that your baby may have cows’ milk allergy?

The most important step is to schedule an appointment with your doctor or HCP to ensure a correct diagnosis.

Check the symptoms

With a wide range of signs and symptoms, CMA can be difficult to recognise. It is particularly difficult when symptoms are similar to the expected behavior of your baby or when they overlap with other conditions.

Learn more about the common signs and symptoms of CMA

Symptom checker

How can I prepare for the doctor’s appointment

Your doctor will examine your baby and ask more about his symptoms. The SmilesBack app helps you to easily record and keep track of your baby’s symptoms and feeds, to support a faster and accurate diagnosis of CMA.

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.