Protein Allergies in

Infants
What are protein allergies?

Food allergies are an undesired effect that occurs when the immune
system responds to a given food and is a reproducible effect.
The immune system thinks that the milk proteins are harmful and
works to fight them, causing the reaction.
Cows milk protein allergy is most common in infants
Not the same as lactose intolerance
How prevalent are protein allergies?

Cows milk protein allergies peak in the first twelve months

Breastfed infants have lower risk
Approximately 2-3% of population experiences symptoms
Most infants outgrow the allergy within the first few years of life
Signs and Symptoms of Protein Allergies
Can occur immediately or up to one week after consuming protein
Reactions vary depending on type of allergy (immediate or delayed)
Allergy symptoms, such as runny nose, itchy eyes
Inflammation of the air passage
Inflammation of the middle ear
Wheezing and coughing
Dry, scaly patches of skin or hives
Nausea, vomiting, colic, diarrhea, constipation
Acid reflux
Inflammation of the colon (with bloody stools)
May result in behaviors such as refusing to eat or continuous
crying
How can protein allergies be managed?
Avoiding allergens is the main method of management; improvements
usually seen within 2-4 weeks
Breastfed babies
Breastfeeding remains the most efficient, cheapest, and healthiest
option, even with cows milk protein allergies
Mother should avoid foods that contain cows milk protein
Calcium supplements and nutrition counseling
Praise mother for willingness to continue breastfeeding
Formula fed babies
Extensively hydrolyzed formula (Alimentum, Nutramigen) and diet
free of cows milk
If symptoms do not improve, switch to an amino-acid based formula
(Neocate or Elecare)
 EDCUATION! Referral to a Registered Dietitian
helps the mother avoid feeding their infant foods containing protein that
may be less obvious
A restrictive diet beyond the allergy can lead to improper nutrition,
especially calcium and sometimes protein
Milk is 1 of 8 allergens with labeling requirements under Food Allergen
Labeling and Consumer Protection Act of 2004
Some foods that can include cows milk protein (casein or whey): butter,
cheese, yogurt, scalloped vegetables, canned soups, gravies, candies,
breads, cookies, cakes, salad dressings, foods fried with butter or
margarine, canned tuna, sausage, energy drinks
Solid foods can be introduced at the same time, being mindful to avoid
foods containing milk proteins
Important to monitor an infants weight
Reevaluation should occur every 6-12 months. More than 75% of 3 year olds
and more than 90% of six year olds develop tolerance to cows milk.
References
American College Of Allergy, Asthma & Immunology. (2014). Milk Allergy |
Causes, Symptoms & Treatment. Retrieved from
http://acaai.org/allergies/types-allergies/food-allergy/types-food-
allergy/milk-dairy-allergy
Can Fam Physician. (2008, September). Approach to milk protein allergy in
infants. Retrieved from
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2553152/
De Greef, E., Devreker, T., Hauser, B., Vandenplas, Y., & Veereman-
Wauters, G. (2012). Diagnosis and Management of Cows' Milk Protein Allergy in
Infants. Allergic Diseases - Highlights in the Clinic, Mechanisms and
Treatment, 8(1), 19-24. doi:10.5772/26885
Helm, N. (2014). Promoting breastfeeding in infants with cow's milk protein
allergy: A case study. Pediatric Nursing, 40(5), 253-256.
Milk Allergy in Infants. (2017). Retrieved from
http://kidshealth.org/en/parents/milk-allergy.html