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Managing Your Child’s Cow Milk Protein Allergy

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Having a child who has Cow’s Milk Protein Allergy (CMPA) can be a stressful experience for parents. Approximately 70% of infants outgrow CMPA within their first year but there are many who continue to experience symptoms when they go to a day care centre or later on to pre-school or kindergarten. At this stage, it’s virtually impossible for parents to oversee every single dietary detail on their own – this is why it’s essential to get babysitters, family members and schoolteachers on your “CMPA Management Team” right from the start.

Here are some important steps:

1. Understand Your Child’s Allergy Fully

Your child may experience specific symptoms, or describe their symptoms in a specific way; what form of treatment your child’s doctor recommends; whether your child’s reaction is severe enough to require epinephrine; and how to administer your child’s medication and/or epinephrine.

2. Establish Guidelines for Your Child’s Diet

For babysitters and other caregivers (such as family members), it’s important to inform them that all forms of cow’s milk must be eliminated from your child’s diet.

  • Infants with CMPA require special formulas such as extensively hydrolysed formula (EHF) and amino acid formula (AAF). In EHF, cow’s milk proteins are broken down into really small particles so it’s less likely to cause allergic reactions, while AAF contains protein in its simplest form and is recommended for infants with CMPA as a second option. Soy-based products are not recommended for infants below six months due to the risk of soy allergy and possible long term side effects.
  • For older children who are already eating solid foods, avoid baked goods and pastries like doughnuts, muffins, pancakes, biscuits and French toast, creamy soups and pasta sauces, ice cream and chocolates which are usually prepared with milk.

3. Prepare and Provide Information About Your Child’s Allergy

Adults include the babysitter, family members, and schoolteachers while children include your child’s playmates, cousins, and schoolmates. The objective is to educate them that allergies can be very severe, hence your child needs to very careful with what they eat – this will help them understand that your child isn’t being rude or difficult if they decline food or refuse to share their friends or classmates’ snacks and treats. For adults, the information should include a list of symptoms such as skin reactions and digestive problems; if your child’s reaction is severe, you should include advice from your child’s doctor on the appropriate steps to take.

4. Educate Your Child on Safety and Etiquette

Young children may not understand the importance of avoiding an allergic reaction, so it’s important to explain the facts in an age-appropriate manner. For example, preschool or kindergarten-aged children may only know that certain foods make them feel unwell, but you can tell them to alert their teacher quickly if they feel they are starting to feel unwell. As your child grows older and more able to understand their allergy and its triggers, you can help them to play a more active role in managing their allergies.

Here are some things that children should be taught:

  • How to recognise the symptoms of an allergic reaction
  • How to communicate clearly and as quickly as possible when a reaction begins
  • How to read labels before consuming any prepared foods
  • To avoid sharing of food or medication with friends/fellow students

Despite the obvious challenges, many children with CMPA are able to attend school normally, albeit with some precautions. On your part, the best way to manage your child’s health and allergy is to ensure that both you and your child are sufficiently educated and prepared, with the help and of your “CMPA Management Team” and the advice of your child’s doctor.

If you’d like more information on CMPA, visit the Malaysian Society of Allergy and Immunology and Malaysian Paediatric Association.

Dr. Bee Boon Peng is a consultant pediatrician from Klinik Pakar Bayi & Kanak-Kanak Dr. Bee.

Image Credit: Flickr user ThomasLife

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