HCP Disclaimer

If you are a parent or carer please visit www.nutramigen.co.uk/parent

This website is intended for healthcare professionals and contains information about Mead Johnson Nutrition special infant formulas.

Important Notice: Breast feeding provides the best nutrition for babies. Mead Johnson special formulas are intended for bottle-fed infants and are Food for Special Medical Purposes (FSMPs) and must be used under medical supervision.

This website relies on the use of cookies to function correctly. This includes a cookie to recognise that you have agreed to accept cookies, analytic cookies that help us analyse use of the website for improving the content, and social sharing cookies that allow users to share content on the web more easily. By clicking “accept” below you agree to allow us to place cookies into your computer. For more information about how we use cookies, please read our privacy policy.

By proceeding you confirm you are a healthcare professional.

Not a HCP?

CMA Fast Facts

What is cow’s milk allergy (CMA)?

CMA is an immune reaction to the proteins found in cow’s milk and dairy products (including standard infant formula).1

What are the common symptoms of CMA?

Symptoms of CMA can manifest in the skin, gastrointestinal system and respiratory system. Infants often present with a spectrum of symptoms affecting more than one of these three organ systems.1 Recognising patterns and overlap among symptoms can be key to identifying children with CMA.

You need to have a HTML5 enabled browser or to view the Flash version you'll require the Adobe Flash Player

Get Adobe Flash player

Adapted from Vandenplas et al.1

CMA can have a profound impact on quality of life for the child and their families, arising from the distress of the symptoms and the constant vigilance to avoid allergens.2

How common is CMA?

CMA is the most common type of food allergy in infants and young children, affecting between 2 and 7.5% of infants.1

How do I diagnose CMA?

If you recognise signs and symptoms of potential allergy, take a thorough allergy-focused history and examine the child.3 Skin prick or blood tests (e.g. specific IgE) can be carried out if an IgE-mediated allergy (an immediate reaction) is suspected. Alternatively, an elimination diet followed by oral food challenge is advised for non-IgE-mediated allergy (delayed reactions).3

Is there an effective treatment for CMA?

The only effective management strategy for CMA is the complete avoidance of cow’s milk, dairy products and other mammalian milks (e.g. goats milk).4

  • Breast-fed infants: maternal exclusion of dairy from the diet1,5,6
  • Bottle-fed infants:
    • Manage mild-to-moderate CMA with an extensively hydrolysed formula (eHF) with demonstrated clinical efficacy, such as Nutramigen LIPIL (where the milk proteins have been broken down into small fragments that rarely trigger a reaction in most infants)1,5
    • Weaning and older children: Stage 2 eHF, such as Nutramigen LIPIL 2, suitable from 6 months of age, can be incorporated into foods to replace the nutrients that would have been supplied by dairy products.
    • The taste profile of Nutramigen LIPIL 2 has recently been improved to help older infants get established on the formula. In a blind sensory test, mothers of Nutramigen-fed babies found the improved taste to be appropriately sweeter.7 Some mothers also commented that it was ‘milkier’.
    • o Manage severe CMA and multiple food allergies with an amino acid-based formula (AAF), such as Nutramigen PURAMINO1,5

How long does CMA last?

On average most infants with CMA will reach oral tolerance by outgrowing CMA naturally, but not usually until 3-5 years of age.9-10 However, Nutramigen LIPIL has been proven to accelerate time to oral tolerance. In a clinical study, 54% of infants on Nutramigen LIPIL were proven to become tolerant to cow’s milk after 12 months’ intake.11

Where can I find out more?

Explore this website for much more in-depth information or visit the Allerni website (www.allerni.co.uk) to find out details of educational events and resources from Mead Johnson Nutrition, the makers of Nutramigen.

Show references
  1. Vandenplas Y, Koletzko S, Isolauri E et al. Guidelines for the diagnosis and management of cow's milk protein allergy in infants. Arch Dis Child 2007;92:902-8.

  2. Cummings AJ, Knibb RC, King RM, Lucas JS. The psychosocial impact of food allergy and food hypersensitivity in children, adolescents and their families: a review. Allergy 2010;65:933-45

  3. National Institute for Health and Clinical Excellence. CG116: Food allergy in children and young people. 2011.

  4. Crittenden RG, Bennett LE. Cow's milk allergy: a complex disorder. J Am Coll Nutr 2005;24:582S-91S.

  5. Du Toit G, Meyer R, Shah N et al. Identifying and managing cow's milk protein allergy. Arch Dis Child Educ Pract Ed 2010;95:134-44.

  6. Host A, Koletzko B, Dreborg S et al. Dietary products used in infants for treatment and prevention of food allergy. Joint Statement of the European Society for Paediatric Allergology and Clinical Immunology (ESPACI) Committee on Hypoallergenic Formulas and the European Society for Paediatric Gastroenterology, Hepatology and Nutrition (ESPGHAN) Committee on Nutrition. Arch Dis Child 1999;81:80-4.

  7. PMR report for Mead Johnson Nutrition. Sensory analysis of two prototypes of Nutramigen in Poland – final report. Data on file. June 2013.

  8. Santos A et al. Predictive factors for the persistence of cow's milk allergy. Pediatr Allergy Immunol 2010;21:1127–1134.

  9. Host A. Frequency of cow's milk allergy in childhood. Ann Allergy Asthma Immunol 2002;89(Suppl):33–37.

  10. Canani R et al. Formula selection for management of children with cow's milk allergy influences the rate of acquisition of tolerance: a prospective multicenter study. J Pediatr 2013;163:771–777.

  11. Canani R et al. Effect of Lactobacillus GG on tolerance acquisition in infants with cow's milk allergy: a randomized trial. J Allergy Clin Immunol 2012;129:580-582.