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cow's milk protein intolerance (CMPI)

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Cow's milk protein intolerance (CMPI), and cow's milk allergy (CMA)

    • Cow's milk protein allergy/cows' milk allergy
      • defined as adverse reactions to cow's milk that can be reproduced and are immune-mediated
        • most common immune responses are immunoglobulin E (IgE)-mediated, cell-mediated (non-IgE), or the combination of the two

    • Cow's milk protein intolerance/cow's milk intolerance
      • not immune-mediated
        • said to be undefined because an immune component is not clearly identifiable

    • sensitivity and allergic reaction to cow's milk protein is said to be the most common allergy seen in infancy
      • incidence has been reported to be anywhere between 1.8% and 7.5%
        • variability in incidence reporting has been attributed to the differences in diagnostic criteria used to identify infants with the disorder, as well as differences in the design of studies used to evaluate the disease
    • definition of CMPI/CMI does not include the symptoms of lactose intolerance or the presence of incidental isolated GI tract infections
    • children with CMA or CMI can present with a variety of clinical features that are cutaneous, GI, or respiratory in origin
      • most common cutaneous reactions include urticaria, atopic dermatitis, angioedema, and contact rashes
      • infants with GI reactions can present with nausea, vomiting (including haematemesis), colic, diarrhoea, (including occult and frank blood), enterocolitis, colitis, constipation, and transient enteropathies
      • respiratory reactions include rhinoconjuctivitis, asthma, wheezing, laryngeal edema, otitis media, and anaphylaxis


  • 1. Host A., Clinical course of cow's milk protein allergy and intolerance. Pediatr Allergy Immunol 1998; 9 (Suppl 11):48-52
  • 2. Host A. Cow's milk protein allergy and intolerance in infancy. Pediatr Allergy Immunol 1994;5:5-36.
  • 3. Wilson J. Milk Intolerance: Lactose Intolerance and Cow's Milk Protein Allergy. Newborn and Infant Nursing Reviews 2005; 5 (4): 203-207.



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