Signs and symptoms of CMPA

Cow’s milk protein allergy (CMPA), also known as cow’s milk allergy (CMA), is a common food allergy (or dairy allergy).

With such a wide range of symptoms, recognising CMPA can be a challenge. It is particularly difficult when symptoms are similar to the expected behaviour of your baby or when they overlap with other common problems.

Babies with CMPA may experience the following symptoms:
  • Digestive problems (such as diarrhoea, vomiting, constipation and reflux)
  • Skin problems (such as urticaria, hives and eczema)
  • Respiratory symptoms (such as persistent cough and wheezing)
  • Generic symptoms (such as tiredness, problems sleeping or crying)

It is also important to note that not all symptoms will occur immediately (within 2 hours) after feeding; some may be delayed by up to 2 days or even a week.
We understand that the symptoms can be distressing, particularly at this time when you are getting to know your baby. CMPA can be easily managed with the correct diet, so getting an early and accurate diagnosis is very important. If you suspect your baby may be allergic to cows’ milk protein, you should always discuss this with your doctor or healthcare professional.

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CMA presents with multiple and diverse symptoms

The majority of babies and young children with CMA have 2 or more symptoms impacting at least 2 organ systems

CMA appears during infancy

CMA is often diagnosed before the baby is 6 months old however it can sometimes take longer. Most babies outgrow CMA by the time they are 3 years old

You should continue to breastfeed even if your baby has CMA

In rare cases, babies who are exclusively breastfed can react to cows’ milk protein from the mothers breast milk. A doctor may recommend a cows' milk protein elimination diet for the mother in these cases

CMPA Symptoms to Look Out For


Digestive CMPA Symptoms

Prevalence of digestive symptoms

Up to 60% of affected infants have digestive symptoms.


Respiratory CMPA Symptoms

Prevalence of respiratory symptoms

Up to 30% of affected infants have respiratory symptoms.


CMPA Symptoms


General CMPA Symptoms

Inconsolable crying is very common in infants with CMPA, while anaphylaxis is very rare.

You should visit your doctor if your baby has suspected symptoms related to cows’ milk allergy

It is important that you do not experiment with a cows’ milk-free diet for your baby without recommendation and guidance from your doctor.

The information in this section will help you understand what CMA is and the most common signs and symptoms you may see in your baby, as well as how it is diagnosed and managed by your doctor.

Could it be cows’ milk allergy?

Answering a few simple questions in the “Symptom checker” may help your doctor determine if your baby may have cows' milk allergy.


Your doctor will examine your baby and ask more about the symptoms your baby is experiencing.

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.

Learn more about how CMPA is diagnosed

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.