8 COMMON SIGNS AND SYMPTOMS OF A COW MILK ALLERGY

WHEN TO ASK IF YOUR BABY MIGHT HAVE A COW MILK ALLERGY?
DIGESTIVE: PERSISTENT DIARRHEA OR CONSTIPATION
Diarrhea can be very concerning to someone caring for an infant. Every infant has loose stools from time to time. However, if you see multiple loose or liquid stools a day, it could signal a milk allergy. (“Multiple” = average of 2-4 times a day for more than 5-7 days.) Over half of children with CMA can have diarrhea, the most common digestive symptom. Remember: diarrhea has many causes. Ask your healthcare team if you think your little one has diarrhea.
DIGESTIVE: BLOOD AND/OR MUCUS IN THE STOOL
Blood in the stool is a likely sign of CMA in infants. The blood results from inflammation in the gut. It can appear in the diaper as either red or black. Red blood means the bleeding is in the lower end of the gut. Black color usually signals bleeding higher up, like from uncontrolled reflux. If you notice red or black in your baby’s diaper, call the doctor.
Mucus looks like what comes out of your nose when you have a cold or runny nose. It looks sticky when you open the diaper. A little bit can be normal, but if you see a lot or it lasts a while, it can signal a food allergy.

DIGESTIVE: FREQUENT VOMITING, REFLUX OR SPITTING UP
In infants, frequent reflux or vomiting can be related to CMA. Almost 50% of infants with reflux may be diagnosed with CMA. In those cases, taking cow milk out of the diet should help resolve reflux.

DIGESTIVE: PERSISTENT GASSINESS
Gas happens when there is excess air in the stomach or intestines. This can result in discomfort, burping, or passing gas. Discomfort can cause an infant to be “fussy”, “cranky”, or “colicky.” All babies have gas, but when it occurs with several other signs, it signals a possible allergy to cow milk.

SKIN: UNEXPLAINED RASH
There are many causes for skin rashes, like atopic dermatitis (eczema) or hives (urticaria). CMA is a possible cause, especially when other CMA signs are present. Up to 70% of infants with CMA have skin-related signs. Rashes related to CMA may be very uncomfortable, with nonstop itching and scratching. This may be worse after feedings.

Rashes often appear on the face, but can appear anywhere on the body. Remember, it is important to check with your child’s physician if you suspect the rash to be related to CMA. For more information about skin rashes and when it might signal CMA, check out Baby Rashes from Acne to Eczema.

RESPIRATORY PROBLEMS
Children can have different respiratory issues with CMA. Up to 30% of infants with CMA have respiratory signs. These generally fall into two types; either mild or severe.

Mild–Includes runny noses, sneezing, and nasal congestion. These look like what you might see when your child has a cold.
Severe–Includes shortness of breath, struggling to breathe or wheezing: all need immediate attention. Shortness of breath can look like sudden and/or severe gasping or difficulty breathing. Your child may look to be in pain and frightened. Wheezing is a whistling or rattling sound in the chest when a child breathes. Both indicate obstructed airways. If your child shows a severe respiratory symptom, seek immediate medical assistance.
The scariest respiratory symptom of all is the shortness of breath that occurs with anaphylactic shock. Anaphylaxis is a sudden reaction to a food allergen. This requires immediate attention, as trouble breathing can quickly become life-threatening.

GENERAL: EXCESS FUSSINESS, SLEEPLESSNESS OR “COLIC”
Every baby cries, but crying continuously and inconsolably for extended periods is unusual. You might hear someone say a baby who cries a lot has colic. Some doctors find colic controversial, but excess crying comes from somewhere, often with insomnia. Doctors also often downplay fussiness, which can delay diagnosing CMA. We hear this from parents all too often!

GENERAL: LOW OR NO WEIGHT GAIN OR FAILURE TO THRIVE (FTT)
Many factors contribute to slow weight gain, and often several factors are at play. Food allergy reactions can cause problems digesting or absorbing food, leading to failure to thrive. For example, babies may not get the nutrition they need because of excessive diarrhea or vomiting. The body may not get all the nutrients needed, which can mean they can’t grow as quickly as they should.

As always, ask your child’s healthcare professional if you are concerned about your child’s weight.