Your doctor and health care team will guide you through the steps from diagnosis to treatment of cow’s milk allergy. They will use the information about your child’s symptoms and medical history to decide if allergy tests are needed and if so, what tests to use1. Once an allergy has been confirmed your health care professional will then guide you through the management of the condition.
When planning the treatment of cow’s milk allergy your health care team will consider the following:
Are you breastfeeding?
Clinical guidelines advise that breastfeeding is continued if there is a suspicion of cow’s milk protein allergy2. For some breastfeeding mothers they may be advised to eliminate cows’ milk protein from their diet1. The need to avoid cow’s milk protein should be confirmed by your child’s doctor.
As milk and dairy products provide an important source of calcium and protein, it is important to include alternative sources of these nutrients. Often breastfeeding mothers will also be referred to a specialist dietitian to ensure they are getting the right nutrition while following this restricted diet.
Is your baby formula fed?
Your child’s doctor may recommend a specialised formula. There are a variety of low allergy or ‘hypoallergenic’ formulas available. Extensively hydrolysed formulas (eHF) contain cow’s milk protein that has been broken down or ‘digested’ so that the body is less likely to react to it. Amino acid based formulas (AAF) contain the basic building blocks of protein (amino acids) and are 100% cow’s milk protein free. Both of these formulas are available on prescription and your doctor can advise which one is right for your baby.
Is your child already eating solid food?
If your child has already started eating solid food and it is suspected that they may have cow’s milk protein allergy, your healthcare professional may suggest an allergen elimination diet3. In this diet your child will need to avoid eating all products containing cow’s milk protein. Babies under 12 months of age will still need to continue breastmilk or infant formula as this provides a major source of nutrition. Breastfeeding mothers may be required to eliminate cow’s milk protein from their diet during this time. Formula fed babies in this age group will need to switch to a low allergy infant formula, such as an eHF or AAF while on the elimination diet.
Usually, after 2 to 4 weeks on the allergen elimination diet, a follow-up visit is planned to see if symptoms have resolved. Further tests may then be performed. These investigations can involve skin prick tests, blood tests or food challenge. The type of test chosen depends on how severe the allergy symptoms are and how long it takes for a reaction to occur2.
Your doctor and health care team will guide you through the steps from diagnosis to treatment of cow’s milk allergy
- 2016. Cow’s milk (dairy) allergy. Australasian Society of Clinical Immunology and Allergy. Viewed 1 June 2016. http://www.allergy.org.au/patients/food-allergy/cows-milk-dairy-allergy
- Vandenplas et al. 2007. Guidelines for the diagnosis and management of cow’s milk allergy in infants. Arch Dis Child. Volume: 902 pages: 902-908
- 2012. Diagnostic Approach and Management of cow’s milk protein allergy in infants and children: ESPGHAN GI committee practical guidelines. J Paediatric Gastroenterology Nutrition. Vol: 55. No: 2: pp: 221-229