Welcoming to the blog our panel expert Raphaella Rookes! Specialist Peadeatric Dietician and Founder of Latch to Ladle, inspired by her beautiful boy Monty. Raphaella shares with us some fabulous guidance on CMPA - Cows Milk Protein Allergy. Find her here on Facebook
 
"Here at Latch to Ladle, the question about cow’s milk protein allergy and lactose intolerance is a common one. That’s not surprising really, as cow’s milk protein allergy (CMPA) is one of the most common childhood food allergies which affects around 7% of babies under 1. 
 
The good news is that the vast majority of children grow out of it between the ages of 1 and 2, and almost all have outgrown it by the age of 5. 
 
 
How do I know whether or not my baby has CMPA? 
 
Symptoms really vary from child to child, but there are two ways in which an allergy presents and these are as follows: 
IgE Mediated Allergy – This is an almost immediate reaction which happens either straight away or within a couple of hours of having milk or foods containing milk. 
Non-IgE Mediated Allergy – This is a more delayed reaction which can happen up to 48 hours after your little one has had milk or foods containing milk. 
 
There are many sorts of reaction that your little one may have, including failure to gain appropriate weight, reflux, diarrhoea, constipation, vomiting and very occasionally skin problems such as eczema too. 
 
What should I do if I suspect a milk allergy? 
 
If you are breastfeeding you can try going milk-free for a week, ensuring that you’re still getting adequate calcium through milk-alternatives such as soya/oat/almond/coconut products, alongside a suitable multivitamin as well. 
 
If your baby’s symptoms improve with this, then it is highly likely they have some sort of milk allergy and it is therefore worthwhile excluding on an ongoing basis.  
 
If you are formula feeding, then the only milk-free formulas that are suitable are only available on prescription, and you will therefore need to link in with your GP to arrange this. 
 
For either method, after a couple of weeks it is worthwhile re-trialling milk products to see if this triggers a further allergic reaction, as this will then confirm the allergy situation for your little one. 
 
What is the difference between cow’s milk protein allergy and lactose intolerance? 
 
These are both very different conditions – one is an allergy to the large protein molecules found in milk, and the other is an intolerance to the sugar found in milk. 
 
Lactose intolerance is very rare in babies and would only tend to happen after a significant stomach bug, in which case you may want to follow a lactose-free diet for 6-8 weeks.  
 
Lactose-free products are not suitable for babies with CMPA, as they still contain the protein and will therefore still affect your baby. 
 
When and how can I re-introduce milk and milk products? 
 
Again, this is something that varies from one baby to another, but depending on when your little one was diagnosed, it’ll either be after 6 months milk-free or after the age of one. 
 
Depending on the reactions your baby has had will depend on how milk is re-introduced. 
 
For those with non-IgE and milder symptoms then milk can be re-introduced using something called the ‘Milk Ladder’. 
 
If you’d like any more information on cow’s milk protein allergy and/or lactose intolerance, then please do get in touch with the Latch to Ladle team." 
 
 
If you would like to find out more about how we can support you here at The Big Sleep Co. with our reassuring and realistic approach, please join our mailing list
 
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