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Cow's milk allergy
Cow's milk allergy happens when the body’s immune system reacts to the proteins in cow’s milk as if they are harmful. This causes an allergic reaction. The reaction can be mild or severe and can affect different parts of the body, like the skin, digestive system, and occasionally breathing and circulation. Cow's milk allergy is one of the most common food allergies in babies and young children.
Understanding cow's milk allergy
There are two types of cow’s milk allergy based on how the body reacts.
- IgE mediated, also called an ‘immediate’ reaction. This happens within minutes or up to 2 hours after drinking or eating cow’s milk.
- Non IgE mediated, also called a ‘delayed’ reaction. This reaction usually happens after 2 hours, but it can take up to 72 hours after drinking or eating cow's milk.
Read more about cow's milk allergy.
Symptoms of cow's milk allergy
Cow’s milk allergy can cause symptoms in different parts of the body. Common symptoms include:
- skin reactions: itching, redness, rash, eczema, swelling of the lips, eyes, and face
- digestive problems: vomiting, diarrhea, constipation, blood or mucus in poo, stomach pain
- breathing issues: sneezing, runny nose, congestion, difficulty breathing
- general discomfort: being fussy when feeding, refusing to feed, feeling irritable
What to do if you think your baby or child has a cow's milk allergy
Speak to your GP or health visitor if you think your baby or child has a cow's milk allergy. They will ask you questions to see if the symptoms are caused by a cow’s milk allergy or something else. This is called taking an allergy-focused history.
If your GP thinks the symptoms are 'immediate' (IgE mediated), they will refer you to a pediatrician for testing and further support. Testing is only available for this type of allergy.
If your GP thinks it is a “delayed” (Non-IgE mediated) reaction, they will ask you to remove cow’s milk from the diet for a short time, then reintroduce it to see if the symptoms come back.
A milk free diet when breastfeeding
If your breastfeeding baby is showing symptoms of a cow's milk allergy, you may be asked to trial a cow's milk free diet. This can help stop any proteins from dairy products being passed to your baby through breastmilk.
Reintroducing cow's milk to confirm an allergy
Early reintroduction (0 to 9 months)
After avoiding cow's milk for a period of time and checking to see if symptoms have improved, you'll need to try giving it again at home to confirm or exclude a cow's milk allergy. How you do this depends on whether you're breastfeeding or formula feeding.
View the iMAP home reintroduction to confirm a cow's milk allergy diagnosis
When your baby starts having solid food (around 6 months), you'll need to follow a cow's milk free diet. Read more about following a cow's milk free diet in babies and children.
Later reintroduction (9 months or older)
From 9 months old, you can begin giving your baby cow's milk again. If your baby is doing well, you can follow the iMAP milk ladder. This helps you slowly add cow’s milk products back into their diet. You start with baked foods that have cow’s milk in, then move on to things like yogurt and cheese, and finally cow's milk itself. The iMAP milk ladder will show you how much to give at each step. It’s a good idea to stay on each step for at least 3 days to see if anything changes.
If your baby shows any symptoms, stop and try again in 2 to 3 months. If your baby does fine on step 1 but has symptoms on step 2, you can stay on step 1 and try again in 2 to 3 months.
Last reviewed: 1 November, 2024
