Dietary management CMA
Infants with confirmed cow’s milk allergy should be treated by complete exclusion of cow’s milk protein (CMP) .
Exclusively breastfed infants
As in healthy infants, breast feeding should be encouraged. However, very rarely, exclusively breast-fed babies can react to cow’s milk proteins present in breast milk. Infants can be exposed to these proteins in breast milk following maternal consumption of dairy products. Therefore in the exclusively breast fed infant an elimination diet of the lactating mother should be tried.
Formula fed infants
In formula fed CMA infants cow’s milk derived infant formula should be avoided, including soy formulae which are not recommended before the age of six months. ESPGHAN recommends that, hypoallergenic formula including extensively hydrolysed formula (eHF) and amino acid based formula (AAF) should be the formula of choice. The choice between extensively hydrolysed formulae (eHF) and amino acid based formulae (AAF) depends on the type of allergy and the severity of symptoms [5, 6].
Wood R. The Natural History of Food Allergy.Pediatrics2003;111;1631-1637
Fiocchi A et al. World AllergyOrganization (WAO) Diagnosis and Rationale for Action against Cow’s Milk Allergy (DRACMA) Guidelines.WAO Journal April 2010;57-161
Du Toit G; Meyer R; Shah N; Heine RG; Thomson MA; Lack G; Fox A Identifying and managing cow’s milk protein allergy Arch Dis Child Educ Pract Ed 2010
Skypala I. and Venter C. Food Hypersensitivity: Diagnosing and Managing Food Allergies and Intolerance 1st edition Wiley –Blackwell 2009
Hill DJ et al. The efficacy of amino acid-based formulas in relieving the symptoms of cow’s milk allergy: a systematic review. Clin Exp Allergy 2007; 37, 808-822.
Høst A et al Dietary products used in infants for treatment and prevention of food allergy. Joint Statement of the European Society for Paediatric Allergology and Clinical Immunology (ESPACI) Committee on Hypoallergenic Formulas and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition. Arch Dis Child. 1999 Jul;81(1):80-4. Review