Cows milk intolerance Flashcards
What age of child is affected by a Cow’s milk protein allergy?
Children under 3 years.
Which children are affected by a cows milk protein allergy?
Formula-fed infants
What type of reactions occur with a cows milk protein allergy?
Both immediate (IgE mediated) and delayed (non-IgE mediated) reactions
What term is used for immediate reactions?
CMPA is usually used for immediate reactions
What term is used for delayed reactions?
CMPI for mild-moderate delayed reactions.
What is the difference between lactose intolerance and cow’s milk intolerance?
People with cow’s milk protein allergy do not have an allergy to lactose.
Lactose is a sugar, not a protein.
What does cows milk intolerance not involve?
It is not an allergic process and does not involve the immune system.
At what age does cows milk protein allergy become apparent?
Before 1 year of age
When can cows milk protein intolerance become apparent?
When weaned from breast milk to formula milk or food containing milk.
In breastfed babies when the mother is consuming dairy products.
What GI symptoms can cows milk protein allergy present with?
- Bloating and wind
- Abdominal pain
- Diarrhoea
- Regurgitation and Vomiting
What are the general allergic symptoms in response to the cow’s milk protein?
- Urticarial rash (hives)
- Angio-oedema (facial swelling)
- Colic symptoms: irritability, crying
- Cough or wheeze
- Atopic eczema
How is cows milk protein allergy diagnosed?
Usually clinical (e.g. improvement with cow’s milk protein elimination).
What investigations can you do for cows milk protein allergy?
- skin prick/patch testing
* total IgE and specific IgE (RAST) for cow’s milk protein
What is the main management of cows milk protein allergy?
Avoiding cows milk- symptoms should fully resolve
What is the management of formula fed babies?
Extensive hydrolysed formula (eHF) milk is the first-line replacement
What could you give to a child with severe CMPA or if no response to eHF?
Amino acid-based formula (AAF)
What is the management of breast fed babies?
Eliminate cow’s milk protein from maternal diet
How does cows milk intolerance present?
Presents with the same gastrointestinal symptoms as cow’s milk allergy however it does not give the allergic features
What is the prognosis of children with IgE mediated intolerance?
55% will be milk tolerant by the age of 5
What is the prognosis iof children in children with non-IgE mediated intolerance?
They will be milk tolerant by the age of 3
What is the management if the symptoms are severe? (e.g. failure to thrive)
Refer to paediatrician
What should a child be given when they are no longer breast fed?
Use eHF until 12 months of age and at least for 6 months
