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Cows’ milk allergy (CMA) also known as cows’ milk protein allergy (CMPA) often presents with diverse and non-specific symptoms, making it challenging to diagnose and manage.1 At Nestlé Health Science, we understand this challenge and are committed to supporting healthcare professionals, patients and caregivers in caring for infants with CMA.


KEY FACTS ABOUT COWS' MILK PROTEIN ALLERGY

WHAT IS COWS' MILK PROTEIN ALLERGY?
INCIDENCE AND PREVALENCE OF CMA
FOOD ALLERGY OR NON-ALLERGIC FOOD HYPERSENSITIVITY
THE IMMUNE IMPACT OF CMA
DIETETIC SUPPORT IS VITAL FOR BREASTFED CHILDREN WITH CMA
IMPORTANCE OF LACTOSE FOR GUT MICROBIOTA
LACTOSE INTOLERANCE SHOULD NOT BE CONFUSED WITH CMA


NESTLÉ HEALTH SCIENCE: SUPPORTING COWS' MILK ALLERGY DIAGNOSIS AND MANAGEMENT

CMA can be a challenge to diagnose given the large variability in number and severity of the symptoms, and the fact that some of them are perfectly normal for infants to experience.


At Nestlé Health Science, we understand this challenge and are committed to providing leading expert-developed tools, nutritional solutions and support for healthcare professionals to help facilitate the earlier diagnosis and appropriate management of infants and young children with CMA. We are also dedicated to providing information, tools and support for caregivers to help raise awareness around the symptoms of CMA

CMA signs

SIGNS AND SYMPTOMS

Inconsolable crying, colic, skin rashes, vomiting, diarrhoea, and constipation are all common signs and symptoms of CMA, especially in early infancy.

SIGNS & SYMPTOMS
CMA

CONSIDER CMA

Leading experts have developed the Cows' Milk-related Symptom Score (CoMiSSTM) to help healthcare professionals recognise and assess non-specific signs and symptoms that could be indicative of CMA.

COMISS® TOOL
CMA diagnosis

CLARIFY THE DIAGNOSIS

Diagnosing CMA can often be challenging, and tests are available to help assess the presence of IgE CMA. In non-IgE CMA, the quality standard for diagnosing it is the elimination diet, which is a diet free from cows' milk protein, followed by a food challenge.25

DIAGNOSING CMA

OUR RANGE OF TAILOR-MADE NUTRITIONAL SOLUTIONS FOR FORMULA FED BABIES

The Nestlé Health Science range of hypoallergenic nutritional solutions, SMA Althéra and SMA Alfamino, are tailor-made to help meet the specific nutritional needs of non-breastfed infants with CMA.

NESTLÉ’S HEALTH SCIENCE’S COMMITMENT TO CMA EDUCATION & RESOURCES

Nestlé Health Science is dedicated to developing and sharing leading scientific information and educational tools and resources to support in the identification and management of CMA for healthcare professionals and to help caregivers during their journey with CMA

EXPERT CORNER

EXPERT CORNER:
CMA DIAGNOSIS

Leading experts in paediatric gastroenterology and food allergy answer common questions related to the diagnosis of CMA in our online video series.

WATCH NOW
CASE STUDIES

CASE STUDIES

Understand some of the diagnostic and management challenges – from the initial symptom presentation to diagnosis followed by the dietary management in a series of case studies.

READ MORE
SUPPORT FOR PARENTS AND CAREGIVERS

SUPPORT FOR PARENTS AND CAREGIVERS

Information and tools are available for parents to support them along their CMA journey.

FIND MATERIALS

REFERENCES
  1. Koletzko S, et al. Diagnostic Approach and Management of Cows'-Milk Protein Allergy in Infants and Children: ESPGHAN Gl Committee Practical Guidelines. JPGN 2012;55:221–9​
  2. NICE CKS. Cows' milk allergy in children. NICE. 2019. Cows' milk allergy in children | Health topics A to Z | CKS | NICE​
  3. Venter C et al. Diagnosis and management of non-IgE-mediated cows' milk allergy in infancy – a UK primary care practical guide. Clinical and Translational Allergy. 2013;3(1):23​
  4. Venter, C., Pereira, B., Voigt, K. et al. (2008) Prevalence and cumulative incidence of food hypersensitivity in the first 3 years of life. Allergy 63(3), 354-359.​
  5. Schoemaker, A.A., Sprikkelman, A.B., Grimshaw, K.E. et al. (2015) Incidence and natural history of challenge-proven cows' milk allergy in European children - EuroPrevall birth cohort. Allergy 70(8), 963-972.​
  6. NHS Choices. Food Allergy.2016 Available at: https://www.nhs.uk/conditions/food-allergy/ (Accessed April 2021).​
  7. US FDA. Food Allergies: What You Need to Know. Available at: https://www.fda.gov/food/buy-store-serve-safe-food/what-you-need-know-about-food-allergies (accessed August 2020).​
  8. Jalonen T. Identical intestinal permeability changes in children with different clinical manifestations of cows' milk allergy. J allergy Clin Immunol 1991;88(5):737-742.​
  9. Crittenden RG and Bennett LE. Cows' Milk Allergy: A Complex Disorder. J Am Coll Nutr 2005;24(6suppl):582S–591S.​
  10. Thompson-Chagoyan OC, et al. Faecal Microbiota and Short-Chain Fatty Acid Levels in Faeces from Infants with Cows' Milk Protein Allergy. Int Arch Allergy Immunol 2011;156(3):325–332.​
  11. Azad MB, et al. Infant gut microbiota and food sensitization: associations in the first year of life. Clin Exp Allergy 2015;45(3):632-643.​
  12. Chin AM, et al. Morphogenesis and maturation of the embryonic and postnatal intestine. Semin Cell Dev Biol 2017;66:81-93.​
  13. Tanaka M and Nakayama J. Development of the gut microbiota in infancy and its impact on health in later life. Allergol Int 2017;66(4):515-522.​
  14. Dzidic M, et al. Gut Microbiota and Mucosal Immunity in the Neonate. Med Sci (Basel). 2018;6(3):56.​
  15. Juntti H, et al. Cows' Milk Allergy is Associated with Recurrent Otitis Media During Childhood. Acta Otolaryngol 1999;119(8):867-873.​
  16. Tikkanen S, et al. Status of children with cows' milk allergy in infancy by 10 years of Age. Acta Paediatr 2000; 89(10):1174-1180.​
  17. Woicka-Kolejwa K, et al. Food allergy is associated with recurrent respiratory tract infections during childhood. Postepy Dermatol Alergol 2016;33(2):109-113.​
  18. ASCIA 2017 – Food Allergy Clinical Update for Dietitians. Received from https://etrainingdiet.ascia.org.au/login/index.php on 5th June 2019.​
  19. Nwaru BI, et al., on behalf of the EAACI Food Allergy and Anaphylaxis Guidelines Group. Prevalence of common food allergies in Europe: A systematic review and meta-analysis. Allergy 2014; 69 :992-1007​
  20. Robbins et al. Milk allergy is associated with decreased growth in U.S. children. J Allergy Clin Immunol. 2014 December; 134(6):1466-1468.​
  21. Meyer, R. Nutritional disorders resulting from food allergy in children. Pediatr Allergy Immunol. 2018; 29:689– 704. https://doi.org/10.1111/pai.12960 ​
  22. Heyman MB et al. Committee on Nutrition. Lactose intolerance in infants, children, and adolescents. Pediatrics. 2006;118(3):1279–86.​
  23. Abrams S. et al. Calcium and zinc absorption from lactose-containing and lactose free infant formulas. Am J Clin Nutr, 2002; 76:442–6.​
  24. Francavilla R et al. Effect of lactose on gut microbiota and metabolome of infants with cows' milk allergy. Pediatr Allergy Immunol. 2012;23(5):420–7.​
  25. Luyt D et al. BSACI Milk allergy guideline. Clinical & Experimental Allergy, 2014 (44) 642–672.
  26. NICE. Food Allergy NICE (QS118). 2016.


​IMPORTANT NOTICE: Mothers should be encouraged to continue breastfeeding even when their babies have cows' milk protein allergy. This usually requires qualified dietary counselling to completely exclude all sources of cows' milk protein from the mothers’ diet. If a decision to use a special formula intended for infants is taken, it is important to follow the instructions on the label. Unboiled water, unboiled bottles or incorrect dilution can make babies ill. Incorrect storage, handling, preparation and feeding can eventually lead to adverse effects on the health of babies. Formula for special medical purposes intended for infants must be used under medical supervision.​

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