Why is my baby permanently under-par?
Q. My six-month-old son is permanently below par, with eczema, runny tummy (and nose), and shortness of breath. My doctor says he will grow out of it but I wonder whether he could have an allergy to something?
A. Your child may have cow’s milk allergy (CMA ), according to paediatric allergy specialist Dr Adam Fox, chair of the Allergy UK Health Advisory Board (www.allergyuk.org), who is leading the campaign Act on CMA to raise awareness of the condition. ‘This often develops when milk is first introduced either in formula or at weaning, but it can also appear in exclusively breast-fed children, due to cow’s milk proteins in breast milk.’
CMA is the most common food allergy among infants and young children. ‘It affects between two and 7.5 per cent of infants, although up to 15 per cent may exhibit symptoms suggestive of CMA,’ says Dr Fox.
CMA normally presents with a variety of symptoms. Symptoms such as skin rashes or gastro-oesophageal reflux may be treated individually, but CMA is often not considered as a cause by GPs.
There are two types of CMA, immediate and delayed. Both are triggered by an adverse response from the immune system but, as the name suggests, the time frame is different.
Immediate CMA typically begins within minutes (and no more than two hours) after exposure to cow’s milk protein. Symptoms include reflux, which causes crying, back-arching and regurgitation after feeds, also diarrhoea or constipation, abdominal pain, severe colic, refusing food and faltering growth.
Delayed CMA typically begins several hours or even days after exposure to cow’s milk protein. The main symptoms are reddening of the skin or itchy rash (like nettle rash), swelling of lips, face or eye area, runny nose, vomiting, diarrhoea, and in severe cases (called anaphylaxis) can include sudden wheezing, coughing or shortness of breath.
If these symptoms keep occurring, or get worse, alert your GP immediately. If immediate CMA is suspected, you may be referred to a specialist for tests. If symptoms are chronic and persistent, your doctor may suggest excluding cow’s milk for a trial period. (In this case, it’s essential to have expert advice from a doctor or registered dietician to replace the nutrients, see www.cowsmilkallergy.co.uk.)
CMA is usually outgrown in childhood, although there is a greater chance of developing other food allergies, asthma or hay fever over time.
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