Cow’s Milk Protein Allergy (CMPA) – what is it and how can we manage it?

For many parents, before having a little one with a cow’s milk protein allergy (CMPA), we’d never really thought about what it entailed. Most of us have heard of lactose and gluten intolerances. But for many families I’ve encountered in the last few years of my business, we simply hadn’t been exposed to the true realities of allergies and the impact this can have on the lives of the whole household. 

Whether your little one has an allergy or not, I hope that this gives you some useful information to help either your own little one.

What exactly is an allergy to cow’s milk protein?

When the body’s immune system reacts in an abnormal way in response to something, like food, it is because it has been identified as a potential threat and the body may produce symptoms of this allergic reaction. CMPA is one of the most common food allergies in the UK for babies and young children; fortunately the majority grow out of it before the age of five.

More common, however, is a delayed reaction (from two hours to three days after consumption) which causes gut discomfort, abnormal nappies (for example excessive diarrheoa, mucus or blood in stools etc) which may also cause the skin to become very red and sore, vomiting, rashes that don’t respond to normal treatment for eczema etc. Medical advice should still be sought for these reactions and professionals may advise an elimination diet to check whether it is an allergic reaction to a product, like cow’s milk, or if it is caused by something else requiring treatment. With this type of reaction, symptoms may build if the product concerned continues to be consumed, as the immune system will continue to react to each occasion. This type of reaction is known as a Non-IgE allergy. 

Both allergies are normally picked up on in the first few weeks or months of life, as formula contains cow’s milk protein and if a breastfeeding mother is consuming cow’s milk, little ones can react through their mother’s milk. The reactions for both can range from mild to moderate or severe and sometimes parents may worry it’s an allergy but it could be an illness, reflux or other cause and vice-versa. 

What should I do if I suspect my baby is allergic to cow’s milk?

If you feel your little one may be reacting to cow’s milk, speak to your Health Visitor or GP. As each baby may react in a very different way, as briefly shown above, it is important that your little one’s case is looked at specifically. They may refer you to a dietician for further support or they may ask you to undertake an elimination diet, in which cow’s milk is removed from your little one’s diet. Normally this is only done when all other options are ruled out, because it could be a number of other things and removing aspects of the diet isn’t encouraged unless necessary. 

You may wish to keep a food diary if you’re breastfeeding, or if your little one is weaning, so that you can track reactions alongside the food/drink they have consumed recently over a week or two. It may not an easy diagnosis if your little one has a Non-IgE allergy, so it’s important to work with a medical professional with all the information available. 

My little one has CMPA, what do I do now?

So you’re little one has been diagnosed with CMPA and you’re wondering what to do next: don’t panic! 

When we first found out our little one was allergic to cow’s milk and soya we were suddenly thrown into the realisation that an insane amount of products contain one or both of these products. I’d gone through my whole life not being aware that some crisps, wine and many conveniences and packaged foods contain milk – and soya is a close runner up too, working its way into everything! 

But it doesn’t need to be overwhelming. My top tips for how we coped are detailed below:

Check labels

Don’t assume! This is important not just for you, but anyone who may cook for you at family meals or in restaurants. There are a lot of people in society who don’t realise the vast amount of seemingly ‘fine’ foods that actually contain cow’s milk, so it’s really important to check all labels and know for sure. I’ll never forget my mother opening a tub of guacamole and reassuring me it was just avocado …when I dug the packaging out of the bin looking like a truly paranoid woman, the ingredients clearly listed ‘double cream (milk)’ in bold. 

Join a Facebook support group

The blog Dilan and Me and her supporting Facebook group were really helpful for me, as parents frequently shared ‘safe’ foods that they’d found in normal areas of the supermarket, so I didn’t need to get the expensive ‘free-from’ products. If you’re breastfeeding, knowing where you can get your doughnut fix or biscuit fix is crucial!

What if someone you know has CMPA? How can you cater for them at meals/parties?

You may be reading this because your friends’ little one has CMPA, or because you’re hosting a party and someone attending has CMPA. The bullet points above are just as useful: be aware of packaging and ingredient lists, consider cooking from scratch if possible and don’t feel you are confined to the ‘free-from’ aisle! 

Using gold foil-wrapped Stork will mean there’s no ‘butter’ in your home-made cakes, for example. Using Jus Roll pastry will make your sausage rolls or pasties suitable for anyone with CMPA. Little tricks like these can be really helpful. 

Speak to the parents and ask what food/treats their little one is allowed and enjoy, especially if you don’t have time to make anything. Some of my child’s friends could have Oreos so we made sure to get these and some Party Rings so they didn’t have to ‘avoid’ anything and the parents didn’t have to worry about what they were picking. 

Product substitutes

This was the one thing that made my life infinitely easier when dealing with CMPA. Instead of thinking about what your little one can’t have, consider what they can have to make life for you and the rest of your family easier. 

• Milk – Oatly Barista 
• Butter – Gold foil-wrapped Stork or Vitalite sprea
• Yoghurt – Koko yoghurt
• Cheese – Violife (or one of the increasing products from supermarket ranges like Asda)
• Cream/custard – Oatly

There are many more products that we used, but these ones meant that I could cook any of my usual recipes (chicken pie, cakes etc) and just make a simple ingredient switch that would mean the whole family could eat the same thing! 

I hope that whatever your situation, you can take away some useful information or tips. If you have any questions or any of your own ideas to share, please do let me know so that I can help/share these with other parents. 

Parenthood needs a village – and the bigger that village of support and ideas the better!