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Diagnosing cow's milk protein allergy

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Tests if suspected IgE mediated cow's milk protein allergy:

  • an infant with suspected IgE-mediated milk allergy will require testing for specific IgE to milk (skin prick test or blood tests) - infants with suspected non-IgE-mediated disease do not need these tests

Tests if suspected non-IgE mediated cow's milk protein allergy:

  • exclusion diet (No milk protein) (symptom improvement) and then reintroduction (symptom recurrence). May take 4–6 weeks for symptoms to improve (1)

A flowchart for the diagnostic considerations if suspected CMPA is presented (3):



  • Walsh J et al. Differentiating milk allergy (IgE and non-IgE mediated) from lactose intolerance: understanding the underlying mechanisms and presentations. Br J Gen Pract 2016; DOI: 10.3399/bjgp16X686521
  • Ludman S, Shah N, Fox AT. Managing cow’s milk allergy in children. BMJ 2013; 347: f5424.
  • Wessex Infant Feeding Guidelines and Appropriate Prescribing of Specialist Infant Formulae (Accessed 8/3/2020)

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