A Parent’s Guide to Cow’s Milk Allergy in Babies and Children (CMA)
- The London Allergy Clinic
- Sep 26
- 3 min read
By Misbah Primett , Specialist Paediatric Allergy Dietitian
At London Allergy Clinic, we support parents with evidence-based advice on identifying and managing food allergies in infancy, including cow’s milk allergy in babies and children (CMA). We work with families to provide safe, practical guidance through the diagnosis process, dairy-free weaning, and the reintroduction of milk when the time is right.
For many parents, CMA is an unfamiliar term until symptoms appear. Understanding the signs, getting the right diagnosis, and knowing how to feed your child safely can make a huge difference to your baby’s comfort, growth, and wellbeing.
Below, we outline the key facts every parent should know.
What is Cow’s Milk Allergy in Babies (CMA)?
CMA is a reaction to the proteins in cow’s milk. It is one of the most common food allergies in infancy occurring in formula fed babies, and less commonly in breastfed babies.
What Are the Symptoms of Cow’s Milk Allergy in Infants?
Symptoms can be immediate (within minutes to 2 hours) or delayed (hours to days later), and may include:
Immediate (IgE) reactions
Skin rashes or hives
Swelling of the lips, eyes, or face
Anaphylaxis (in rare cases)
Delayed (non-IgE) reactions
Vomiting or diarrhoea
Blood or mucus in stools
Constipation
Reflux
Poor weight gain
*Please note that many of these symptoms are common infants and may not be related to milk allergy.
It’s important to note that CMA is different from lactose intolerance, which is not an immune condition.
How is Cow’s Milk Allergy Diagnosed?
Immediate reactions (like hives or swelling) can often be confirmed with an allergy skin prick test or a specific IgE blood test.
For delayed symptoms, such as tummy troubles or reflux, there isn’t a single test. Instead, diagnosis is made by a healthcare professional, usually through a short milk elimination diet and then careful reintroduction under guidance.
When to Seek Advice
Early diagnosis is important to keep your baby safe and nourished.
If you notice persistent symptoms that could be linked to CMA, speak to your GP, health visitor, or an allergy specialist. The diagnosis process often involves:
Taking a detailed feeding and symptom history
A trial elimination of cow’s milk
A structured reintroduction to confirm whether symptoms return (in some cases this may not be appropriate).
This process should always be done with professional supervision to avoid unnecessary restrictions and to keep your child’s diet balanced.
Dairy-Free Weaning
For babies diagnosed with CMA, weaning onto solid foods needs careful planning to ensure they get all the nutrients they need for healthy growth.
A paediatric allergy dietitian can help you:
Identify hidden sources of milk in food labels
Choose fortified dairy-free alternatives to provide calcium, iodine, and vitamin B12
Offer safe and nutritious first foods
Manage multiple food allergies if they are present
Will My Child Outgrow CMA?
The majority of children outgrow CMA by the age of 3 to 5 years old, however many children can start the reintroduce milk in a graded way much sooner. When the time is right, your dietitian can guide you through a milk ladder, a step-by-step reintroduction starting with well-baked milk and progressing towards less processed dairy.
This should be done in a controlled way to monitor for symptoms and ensure your child remains safe and well. Dependant on the type of allergy your little one has, the milk ladder may vary and you should seek guidance from a dietitian to help with this.
Our team of expert professionals can guide you through this process.
How We Can Help
At London Allergy Clinic we offer:
Specialist dietary support for cow's milk allergy in babies and other infant food allergies
Guidance through the diagnosis process, including elimination and reintroduction
Practical, family-friendly dairy-free weaning plans
Nutritionally balanced food alternatives to support healthy growth
Personalised milk ladder guidance for reintroducing dairy
If you suspect your baby has CMA or you’re approaching the reintroduction stage, we can provide expert, evidence-based advice tailored to your child’s needs.
To discuss your baby’s needs or to book a consultation, please get in touch with our team.
Next Steps
If you are concerned about cow's milk allergy, it is advisable to seek a specialist opinion as soon as possible to ensure your child has the right nutritional support. Our team at The London Allergy Clinic is available to advise on diagnosis, testing and management. Contact us to arrange an appointment.
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