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Cow’s Milk Allergy & Intolerance

Learn the difference between Milk Allergy, Dairy Sensitivity, and Lactose Intolerance.



When speaking to patients (especially parents to young children), there can be a lot of confusion with terminology.

Here is how I explain it:


CMPA (Cow’s Milk Protein Allergy) IMMEDIATE:

This looks like a typical allergic reaction and occurs during or very soon after being given cow’s milk. Symptoms to look out for include itchy rash or hives, diarrhoea, lip or facial swelling, horse crying and sobbing, being floppy, or even anaphylactic symptoms.


CMPA DELAYED (Cow’s Milk Protein Intolerance):

Symptoms will come on some time after ingestion - usually within 24 hours. It is still considered an allergy.

Symptoms of delayed allergy include itchy skin, snuffly and nasal congestion, eczema, acne, bloating and gas, constipation, and feed refusal.


Lactose Intolerance (LI)

This is not an allergy to milk, but rather an inability to digestive the sugar portion of the milk lactose due to reduced enzyme lactase levels. It is rare for babies to be born with this - we see it more commonly after bouts of gastro.

Symptoms of LI include excessive gas, stomach cramping and pain, bloating and distension, diarrhoea, green and runny poos.


What to do?


With CMPA immediate you child will need urgent medical attention and then referral to an allergist or immunologist.


If you are questioning a CMPA intolerance or lactose intolerance I encourage to:

•keep a record of symptoms related to what foods are being consumed. Keep note of bloating, bowel movements throughout the day, nasal congestion - anything that is not normal for you or your child.

•take note of the form, colour and consistency of poo and rank them against the Bristol Stool Chart.


As naturopaths treating CMPA and LI, we recommend the following:

🥛 Follow a dairy-free diet. Looking at a list of dairy free products can be helpful if you’re not sure what to avoid.

🥛Use truly dairy-free milk alternatives as some ‘dairy-free’ products may still contain milk derivatives such as caseinate (a milk protein).

🥛Consider improving your gut health by means of introducing good bacteria and prebiotic fibre blends. This can help strengthen your gut and digestive capabilities. As the gut is home two approximately two-thirds of the body’s immune system cells , this can explain the link between allergies and gut health.


Questions about CMPA or LI, get in touch!