Cow's milk protein allergy

Abstract

Cow's milk protein allergy (CMPA) affects 2–7.5% of children; persistence in adulthood is uncommon since a tolerance developing in 51% of cases within the 2 years and 80% within 3–4 years. CMPA is an immunological reaction to one o more milk protein: α-lactalbumin, β-lactoglobulin, casein, IgE or non-IgE associated, responsible of immediate or late onset symptoms.

The suspicion of CMPA is based on detailed family and medical history, skin test, patch test, laboratory test, an elimination diet and food challenge. The general treatment for CMPA is dietary: elimination of cow's milk protein and introduction of extensively hydrolyzed whey or casein formula, aminoacid formula, and soy formula. Extensively hydrolyzed whey or casein formula is recommend as first choice for infants in mild or moderate reactions, aminoacid formula in severe CMPA and in cases with poor response to extensively hydrolysed whey or casein formula.

Keywords:

• Cow's milk protein allergy
• immediate reactions
• late onset reaction
• skin test
• patch test
• laboratory test
• food challenge
• elimination diet
• extensively hydrolyzed whey or casein formula
• aminoacid formula
• soy formula

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.