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Understanding Cow’s Milk Protein Allergy in primary care

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Many children and young people are allergic to cow’s milk, but diagnosis can prove difficult

In recent years, there has been a significant rise in the number of adults and children suffering food allergies. An allergy can be defined as an adverse health effect arising from a specific immune response on exposure to a given food.1 Cow’s milk protein allergy (CMPA) is specific to the abnormal response to proteins found in cow’s milk or milk substitute products containing the proteins.2

Identification of CMPA can be difficult and is often over-estimated due to possible misinterpretations of presumed reactions to milk. Typical symptoms of CMPA can be both vague as well as being common in children who do not have allergy; including commonly presented symptoms such as skin rashes, reflux, colic and diarrhoea.1

A pan-European study, using gold standard diagnosis for food allergies, confirmed challenge-proven CMPA in approximately 1% of children up to two years of age.3

CMPA is often also confused with lactose intolerance, making diagnosis even more difficult.4,5 Lactose is a component of milk and dairy products; an intolerance may occur when there is lack of the enzyme lactase to break down the lactose into glucose and galactose. Although, it is highly unlikely in infants under the age of 3, malabsorption of lactose can lead to gastrointestinal side effects such as bloating, diarrhoea and flatulence.6


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