Symptoms for Cow’s Milk Protein Allergy

I will be sharing some insight about the cow’s milk protein allergy, the symptoms for cow’s milk protein allergy and ways to prevent it. I hope you will find this article useful.

Cow’s milk protein allergy is one of the most common food allergy happened in babies. It is confirmed that 5-15% of baby are suffered from adverse reaction from cow’s milk protein. Babies who are exclusively formula fed are in the high risk of getting cow’s milk protein allergy than breastfed babies. However, breastfed babies may also get the allergen from the mother if the mothers consume the dairy products which contain casein protein can transmit via human milk to the babies.

The statistics also show the cow’s milk protein allergy can be developed during neonatal stage, reach at its peak when the baby are around 1 year old, and mostly will be resolved when the children reach at the age of 3-4 years old. Only minor group may reach up to 18 years old.

What is cow’s milk protein allergy

Based on World Allergy Organization, the definition of adverse reaction to milk is known as milk hypersensitivity and can be divided into

  • Immune mediated hypersensitivity or milk allergy
  • Non immune mediated hypersensitivity or milk intolerance

Sometimes, we get confused about the milk allergy and milk lactose intolerance due to their shared symptoms. Milk allergy is due to immune reaction to casein protein in cow’s milk whereas milk intolerance is due to lack of enzyme (lactase) to metabolize lactose existed in milk, in the intestines.

Besides cow’s milk protein allergy, children are also prone to other food allergen such as eggs, soy, peanuts, tree nuts, fish, shellfish and wheat. Almost 90% childhood allergy is due to cow’s milk protein allergy because milk is their main source of food before they reach 6 months old.

Symptoms for Cow's Milk Protein Allergy

Symptoms for cow’s milk protein allergy

Cow’s milk protein allergy symptoms can be divided into two:

  • immediate onset of allergy reaction which happened within minutes of ingestion of cow’s milk. Some common symptoms associated with immediate reaction are
    • vomiting
    • wheezing due to difficult in breathing
    • hives ( appear as swollen red bump on the skin and cause itchiness)
    • In some cases, it can cause serious problem and is potentially fatal. It is called anaphylaxis ( or anaphylactic shock) in medical terms and it will cause swelling of the throat and mouth, a drop in the blood pressure and difficulties in breathing. Immediate medical attention is needed to ease the situation.
  • Late onset of allergy reaction which can develop from few hours to several days of ingestion of cow’s milk. The late onset reaction symptoms includes
    • skin rashes e.g eczema
    • diarrhea (sometimes come with blood or mucus)
    • colic (unexplained crying and fussy for more than 3 hours, at least 3 times a week and can last for 3 weeks time)
    • coughing
    • recurrent fever
    • poor weight gain
    • constipation

There are solutions how to overcome the cow’s milk protein adverse reaction. I have listed the major two:

How to overcome it?

Elimination diet

Breast milk is the best source of nutrient for babies. For nursing moms, just be aware of the food intake. Avoid the eight main food allergens in your diet as it will transmit through the breast milk to the babies. In a nutshell, fully breastfeed with human milk is the best solution.

If breastfeeding is not possible due to some reason, the best way is to implement elimination diet, avoid cow’s milk intake totally. There are some good alternatives to replace cow’s milk formula and they are clinically proven which can tolerate better than cow’s milk and less likely to cause adverse allergy reaction to babies.

Substitution for cow’s milk

Substitution for cow’s milk may not be necessary for exclusive breastfed babies and children above 2 years old. For babies below 2 years old who are mixed fed or fully formula fed, substitution is essential to replace cow’s milk. There are 3 type of substitutions which I will discuss here in this post.

Hydrolyzed formula is invented to overcome cow’s milk protein allergy after soy protein formula. Soy protein formula was first introduced as an alternative formula to overcome the issues of getting cow’s milk protein allergy reaction but 8-14% for those with symptoms associated with cow’s milk protein allergy still react adversely to soy. However, report on anaphylaxis on baby fed on soy protein formula is extremely rare.

However, none of the hydrolyzed formulas are completely safe. There are still better alternatives and are meeting the standard for hypoallergenicity too.

1. Extensively hydrolyzed milk – the protein structure has been broken down to smaller pieces protein for easy digestion. They are hypoallergenic which can reduce and most time to no allergic reaction to babies. Their nutritional value is still comparable to standard formula (cow’s milk formula) and no impact on their development milestone. There are clinically proven for substitution of cow’s milk protein allergy babies. Some examples of milk powder which are extensively hydrolyzed are:

  • Nutramigen® with Enflora™ LGG®* from Enfamil
  • Similac Alimentum from Abbott
  • Pregestimil from Enfamil
  • Nutrilon pepti from Nutricia
  • Profylac from Semper

2. Amino acid based milk – also known as elemental formula. Basically it is 100% broke down protein. No intact protein with only amino acid, a building block of protein to form the required protein needed for the growth and development of the babies. It is also hypoallergenic and the simpler amino acid structure making it easy to digest. Some examples of milk powder which are amino acid based formula are:

  • Neocate from Nutricia
  • Elecare from Abbott
  • Puramino from Mead Johnson
  • Extensive HA from Gerber

Usually no.1 & 2 type of baby milk formulas are very expensive and sometimes the taste is a bit unacceptable (noticeable bitter taste) by the babies.

3. Hydrolyzed rice protein formula – Has preliminary clinically studies on the efficiency of hydrolyzed rice protein formula which is designed to achieve similar amino acid profile to mother’s milk using rice. The study shows that hydrolyzed rice protein formula can also be used to replace cow’s milk. Since rice is cheaper, and its nutritional value is comparable to soy protein formula, it may become the first option in the treatment of cow’s milk protein allergy in the near future. Here is the examples of milk formula which are made from hydrolyzed rice protein formula:

  • Novarice from Novalac
  • Similac for spit-up from Abbott


Babies who are suffered from cow’s milk protein allergy have shown significant improvement by substitutions of cow’s milk formula.

Choosing the best formula for your babies can be overwhelming and complicated. Always consult your doctor to discuss about your concern regarding the babies condition before you make any alteration to the formula. Every baby are unique, choose the right formula will encourage their growth and development, somehow their comfort and tolerance are the first priority.

Please do not hesitate to drop me a comment if you have experienced cow’s milk protein allergy in your baby and do not mind to share here how you overcome it. It is always nice to share experiences so that all the moms will be benefited after reading this article.

Happy reading!

8 thoughts on “Symptoms for Cow’s Milk Protein Allergy”

  1. Hi Boniface,
    Thank you for sharing your experience with us. I think goverment or hospital shall play good role to instill awareness on food allergy issue and provide useful information so that appropriate treatment can be carried out.
    Thank you for taking your precious time to read this post. Really glad you also have raised concern on this issue.

  2. Hi Jessie,

    This is quite crucial information for everybody and especially so for nursing mothers and new fathers. Small babies are quite sensitive to raise until they get to an age a child will say what they are actually feeling by way of words. For infants, they can only wail or sob- and a lot of other things in between. 

    I have two sons (6 and 1.5) and I’m glad they are all growing pretty fast. One thing I have realised is that they are totally different in terms of allergic reaction to proteins (especially from eggs). One gets an immediate response- hives etc- while the other is unaffected at all. For milk they are ok. However, I am the victim there. I have lactose intolerance. I don’t know how you’d advise that families cannot have a blanket approach to how they approach food allergens?

    Boniface from AndroidBix 

  3. Dear Jessie,

    By GODS grace, my wife gave birth to our boy baby on 2nd of March 2019. I often look for information online related to parenting and how to take care of the baby. I came across your helpful and informative article on cow’s milk protein allergy.

    Apart from breastfeeding, we started to give cow’s milk (Mixed fed) but after drinking cow’s milk our baby vomit it and he struggles to drink it. By GODS grace no wheezing but there are hives.

    The best thing is you not only discussed the problem, but you have provided with the solutions as well which is amazing. Thanks a lot for the list of alternatives to cows milk. I will share your post with my wife and for sure she will find great value.

    I got helpful insights from your article. Recently, I watched Dr. Raymond Francis videos on YouTube in which he talks about the dangers in the dairy products for adults and elders and advice to avoid it.

    Much Success!


    • Hi Paul,

      Sometimes, it is just not easy to choose the right formula for babies and it often ends up buying a lot of different brand milk powder as we do not have knowledge on what is happening to our baby. I am glad you find this post insightful. 


  4. Hello; I am always concern about my baby sometimes I get real nervous about him as I would not want him to get any allergy from the food I fed to him. Because babies are innocent people they cannot say what is their problem they can only cry and at times they cried so woeful as if they die in the next minute.

     Your post has helped me to be looking out for more than I generally look out for. I never knew that milk intolerance or milk protein allergy comes with so many symptoms.


    • Hi Dorcas, it is really sad to see our children suffer from allergy reaction. Really glad to hear that you find it useful. 


  5. Excellent overview into the symptoms for milk allergies in babies. My sister who just gave birth told me they had to fake their kid to hospital few days ago and were told it was a result of cow milt allergy that the baby has. Well. I decided to carry out little research on this and I came across this post. I will suggest this for her so that she can enrich her knowledge with this post and probably work towards changes. Thanks

    • Hi Rodger, my daughter cannot take fresh cow milk and she is 2.5 years old. She has serious eczema and no more cow milk for her ever since. Looks  like quite common happen in young children.  I am really glad you find it useful. 


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