How To Navigate Cow’s Milk Protein Allergy (CMPA) as a Parent

Your baby has been diagnosed with cow’s milk protein allergy, or CMPA, and now you’re feeling a little lost. I’ve had a few moms reach out to me because of this exact scenario. Whether you’re breastfeeding or pumping, you were likely told to cut out dairy and soy. Sounds simple enough, but many people don’t realize how challenging that could be.

What is CMPA?

Cow’s Milk Protein Allergy is when a baby’s immune system reacts negatively to the proteins in cow’s milk (1). The reaction could be IgE-mediated, non IgE-mediated, or both (1). IgE, or immunoglobulin E, is an antibody that is tested to detect allergies and other conditions. Typically, IgE-mediated CMPA will have an immediate reaction, while non IgE-mediated CMPA will have a delayed reaction, however, this is not always the case (1). Common signs and symptoms of CMPA include bloody stools, vomiting, abdominal pain, rash, and colic (2).

What do I do now?

Here are some tips from a registered dietitian.

1. Eat home cooked meals as often as possible
   This is because you’ll know what you’re eating. Unless you’re reading all the food labels, packaged meals and takeout often have soy or some form of milk protein. However, depending on how severe the allergy is, you may not need to be as strict.

2. Get comfortable with reading labels
   People are surprised to find out how many foods have soy and milk in them. In addition to casein, there are other milk ingredients you need to be aware of. Hamilton Health Sciences has a handout that includes a list of cow’s milk protein and soy ingredients to avoid.

3. Connect with an allergist if you haven’t already
   An allergist can help monitor the baby’s symptoms and determine when it’s safe to reintroduce milk and soy products again. This may be more beneficial for babies with a moderate to severe allergic reaction. If there is no allergist involved, I would suggest following up with your pediatrician/family doctor and working with a dietitian to ensure your baby is growing well and mom is meeting her nutrient needs. Eventually, milk and soy products should be reintroduced with the support and guidance of your healthcare team.

4. Consider a specialized formula (if applicable)

   If you’re tired of breastfeeding, if your supply is running low, or if breastmilk is just not enough for the baby, parents can consider a special formula safe for CMPA. An amino acid-based formula consists of amino acids as opposed to intact proteins that are in regular infant formulas. Formulas such as Nutramigen, Puramino, and Alimentum are commonly used. Consult your doctor/pediatrician and dietitian before starting or switching to a specialized formula.

It may seem overwhelming at first, and the adjustment may take a while to get used to. Remember that you are doing your best and that you should never hesitate to reach out to your support system when needed. Not every CMPA baby is the same, so try not to compare your situation with other families. Contact your healthcare providers for any questions and additional support.

You got this!

Written by: Cheryl Ching, MSc, RD
Reviewed by: Kristie Pun, MHSc, RD & Pauline Bakowski, MHSc, RD

References:

1. Nestle Health Science (n.d.). Cow’s Milk Protein Allergy. Nestle Health Science. https://www.nestlehealthscience.com/health-management/food-allergy/milk-allergy-hcp/home

2. Nestle Health Science (n.d.). Signs and Symptoms. Nestle Health Science. https://www.nestlehealthscience.com/health-management/food-allergy/milk-allergy-hcp/about-cmpa#s-and-s-infographic