Cow’s Milk Protein Intolerance in Infants
Protein intolerance (CMPI) (sometimes called allergic proctitis) is a common cause of bloody stools in an otherwise healthy infant. The disease is caused by an abnormal reaction of the immune system to one or more food proteins - the most common being cow’s milk and soy protein. This reaction can cause irritation/inflammation in the distal part of the intestine and can lead to a wide range of clinical symptoms. These proteins are also found in yogurt, cheeses and other dairy products. Cow’s milk proteins can pass into breast milk, and breast-fed babies with CMPI may have symptoms if there is milk in their mother’s diet.
CMPI is different from lactose intolerance or a milk allergy. It’s more likely in babies who have a close relative who had CMPI or has allergies. Most babies outgrow this condition by one year of age, although in some children it may take 2-3 years.
Symptoms
Infants who have CMPI will usually start having symptoms within a couple of weeks of their first meal that contains protein from cow’s milk or another dairy product. This condition can cause abdominal pain, and your baby may be fussy and irritable. You also may see some of these symptoms:
Diarrhea, possibly with mucous or blood
Excessive spitting up or vomiting
Poor feeding
A rash or eczema
Congestion (stuffy nose or wheezing)
In some cases, infants with CMPI don’t gain weight or grow as expected. This is called failure to thrive, and it requires a doctor’s care.
Diagnosis
If your child has symptoms of CMPI, the team at Orlando Health Children's Arnold Palmer Hospital Center for Digestive Health and Nutrition can help. Your specialist will ask about your child’s symptoms and whether any close family members have had a similar problem. They will also do a physical exam to rule out other health issues.
The information from your child’s history of symptoms and physical exam are usually enough for a diagnosis. In some cases, a stool sample may be helpful.
Treatments
The most important step toward helping your child is to remove all cow’s milk products from their diet. If you’re breastfeeding your baby, you’ll need to stop eating dairy products, too.
For formula fed baby, cow’s milk can be replaced with a special formula such as hypoallergenic formulas (extensively hydrolyzed formulas or amino acid-based formulas)— your doctor will recommend the type that is best for your child. Using goat's milk as a treatment for cow milk protein intolerance (CMPI) is generally not recommended. Goat's milk contains proteins that are structurally similar to those in cow's milk. Many children who are allergic to cow’s milk proteins will also react to goat’s milk.
You’ll need to read food labels closely to make sure the foods don’t contain cow’s milk. Between 6 months and one year, your doctor may recommend that you start slowly reintroducing cow’s milk products to your child’s diet. Be sure to watch closely for CMPI symptoms and stop feeding milk products if they appear.
Next Steps
An unhappy baby means an unhappy family. You can depend on the experts at Orlando Health Children's Arnold Palmer Hospital Center for Digestive Health and Nutrition to provide the right diagnosis for your child and the quality care they need to heal. With full time experienced registered pediatric dietitians in our clinic, we can give you the care and advice you need, when you need it.
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