Infantile insomnia is defined as a difficulty falling or staying asleep and is characterised differently during a child’s development.1

Poor sleep is common in infants. It is perfectly normal that newborns will not have a full night of sleep before they reach 3 months of age.2

What causes insomnia in infants?
In older infants, Cows' Milk Allergy (CMA) may cause infantile insomnia.1 In most cases, the causes of insomnia are environmental factors; however, in some cases sleep problems are due to an underlying medical condition.1

Insomnia as a symptom of Cows' Milk Allergy
Infants with clinically evident CMA may suffer from symptoms of insomnia. When no evident causes for chronic insomnia can be found in an infant, the possibility of a CMA should be given serious consideration.3,4

Signs and symptoms related to CMA
The majority of infants affected with CMA have at least two symptoms affecting at least two different organ systems.5,6

Having an awareness of the most common symptoms of CMA can help you to make an earlier diagnosis of CMA in your patients.



The Cows' Milk-related Symptom Score (CoMiSSTM) is a simple, fast and easy-to-use awareness tool designed to help you more easily recognise the signs and symptoms that can be cows' milk-related in infants and young children.


If you suspect your patient is suffering from symptoms that may be suggestive of CMA, use the CoMiSSTM tool to score and assess the likelihood of CMA.

Other Symptoms of Cows' Milk Allergy


  1. Nunes ML. and Cavalcante V. J Pediatr (Rio J). 2005;81(4):277–86
  2. Newborn-Sleep Patterns. Stanford Children’s Health (Accessed February 2016)
  3. Kahn A., et al. Sleep. 1988 Jun;11(3):291-7
  4. Kahn A ., Pediatrics. 1989 84: 595-603.
  5. Lifschitz C. and Szajewska H. Eur J Pediatr. 2015;174:141–50
  6. Høst A. Pediatr Allergy Immunol. 1994;5:1–36

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.