Cow's milk protein allergy

Question 1

When does cow milk protein allergy present?

Answer 1

first 3 months of life in formula fed infants

(rare in breastfed but could happen)

Question 2

Why may reactions be immediate or delayed

Answer 2

Can be immediate - IgE mediated

Delayed - non-IgE

Question 3

How does cow milk protein allergy present

Answer 3

Regurgitation
Vominting + DIARRHOEA
Urticaria
Chronic cough

these symptoms can switch when switching formula

Question 4

How to investigate for cow’s milk protein allergy

Answer 4

Skin prick / patch testing

Total IgE and specific IgE = RAST - for cow’s milk protein

Monitor growth

Question 5

How to manage cows milk allergy?

depends on what they are being fed

Answer 5

If formula fed -> Extensive hydrolysed formula milk

Breastfed -> mum to eliminate cow milk protein from diet *can give calcium and vit D supplements to mum

Question 6

How to f/u with this?

Answer 6

Monitor growth, counselling with paeds dietician

Re-evaluate tolerance using milk ladder every 6-12 months