Cow’s Milk Protein Allergy Diagnosis

The symptoms and indictors of cow’s milk protein allergy (CMPA) can be diverse and non-specific. This creates a challenge for parents and healthcare professionals, and often leads to misdiagnosis or delays in diagnosis. To help prevent this and speed up the diagnosis pathway a range of guidelines and tools are available.

Each has been designed with the goal of helping healthcare professionals reach a diagnosis sooner, whilst leading to better outcomes and experiences for children with CMPA and their parents.

hcp
Child smiling at her pediatrician in a medical appointment. Child smiling at her pediatrician in a medical appointment.

Diagnosis

The symptoms and indictors of cow’s milk protein allergy (CMPA) can be diverse and non-specific. This creates a challenge for parents and healthcare professionals, and often leads to misdiagnosis or delays in diagnosis. To help prevent this and speed up the diagnosis pathway a range of guidelines and tools are available.

Each has been designed with the goal of helping healthcare professionals reach a diagnosis sooner, whilst leading to better outcomes and experiences for children with CMPA and their parents.

The steps on the
diagnosis pathway

  • Take an allergy-focused history
  • Perform supportive IgE tests (when appropriate)
  • Prepare the management plan

The IgE test results are interpreted along with the allergy-focused history. The diagnosis may be confirmed through an elimination diet followed by food reintroduction (food challenge).

Illustration of CMPA causes

01
The Allergy
Focused History

The European Academy of Allergy and Clinical Immunology (EAACI) Guidelines on food allergy (Muraro et al 2014) suggest that the allergy-focussed history is a fundamental first step in the diagnosis of any food allergy, including CMPA.

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Illustration of CMPA types

02
Supportive IgE Tests

Supportive procedures, such as IgE testing, exist to help diagnose CMPA. However, none of the IgE tests available when used alone confirm the diagnostic. They are used in combination with the allergy-focused history to support HCP to come to a decision on diagnosis. 

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Illustration of CMPA versus Lactose intolerance

03
The Elimination Diet and
Food Reintroduction
(food challenge)

The elimination diet is as intuitive as it sounds – cow’s milk protein (CMP) (or dairy) is completely eliminated from the infant’s diet for 2-6 weeks. This includes eliminating CMP (dairy) from the mother’s diet, if they are breastfeeding.

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Illustration of CMPA versus Lactose intolerance

04
The Management Plan

Successfully managing cow’s milk protein allergy (CMPA) is always easier when it starts with an early, and accurate, diagnosis. Following the diagnosis, ongoing structured support is required for infants and young children with CMPA.

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CMPA DIAGNOSIS

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