APLV bébé avec docteur

Diagnosing and treating CMPA in babies

6 min

Knowing the nature of the allergy

IgEs are antibodies produced during an allergic reaction. There are two types of cow’s milk protein allergy. IgE-mediated allergy (with the production of antibodies) and non IgE-mediated allergy (without the production of antibodies). The former concerns 60% of cases. Diagnosing this type of allergy can be easy when an allergic reaction occurs within 2 hours following ingestion of the milk product. There are 3 tests that can be used to confirm the diagnosis:
• Prick-test: pricking of the skin with the baby’s usual milk and observation of the reaction;
• CMP RAST: blood assay of IgE
• Oral challenge test: reproduction of symptoms with ingestion of increasing quantities of milk, under medical supervision (in a hospital setting)

The diagnosis of non IgE-mediated allergy, which concerns 40% of cases is made primarily by observing the symptoms, which are very predominantly digestive:
• Allergic enterocolitis: starts soon after the introduction of milk. This involves vomiting, bloody diarrhoea, gastroesophageal reflux
• Enteropathy: manifested by chronic diarrhoea with very poor weight gain

Measures to be taken after diagnosis

After your doctor has confirmed a diagnosis of allergy in your baby, a milk protein avoidance diet is necessary. Certain ingredients are clearly highlighted on food labels. They warn of the potential presence of milk proteins: milk proteins, casein, caseinates, lactose, whey protein, whey, lactalbumin, serum albumin. If mum opts to breastfeed, it is important that she stops consuming any cow’s, goat’s or sheep’s milk proteins for a period of time defined by her doctor. The doctor will also recommend she takes calcium and vitamin D supplementation to cover the needs of both mum and baby. If mum opts to bottle-feed her baby, her doctor will guide her towards a specific formula in which the proteins have been hydrolysed to reduce their allergenicity. These formulas, known as hydrolysates, have been designed to meet the nutritional needs of baby*. A milk protein exclusion diet prohibits any cow’s, goat’s or sheep’s milk. Any products made with these milks are also banned (dairy products, cheese, butter, cream, etc.). Clearly highlighted information on the labels of such products warns you of the potential presence of milk proteins. Your doctor is the best port of call to identify when and how to reintroduce milk proteins to keep pace with your baby’s digestive development.

* In accordance with the regulations