Although many children will grow out of their cows’ milk allergy, for others it will continue, and for some, it may persist into their teenage years. During this time, children will be regularly reviewed, and possibly undergo further allergy tests and dietary challenges to see when they have outgrown CMA.
Growing children need calcium and other nutrients which are found in milk. Fortunately this can be obtained from a growing range of products that can be substituted in place of cows’ milk in a child’s diet.
These products vary in terms of taste, appearance and nutritional content and it will be important to tailor the choice of product to the dietary needs and preferences of the child.
It is important that parents and children think carefully before introducing any milk proteins. For instance, CMA reactions are often worse if the child is unwell, so it’s worth being extra careful with diet if they have a cold or other illness. If you are in any doubt, discuss these decisions with your healthcare professional.
It’s difficult to predict when children will grow out of CMA. You and your healthcare professional will want your child reviewed periodically to see if they still react to cows milk, however it is important to be prepared in case CMA persists into the school years. There are a wide range of modified products and milk protein alternatives available, and your healthcare professional is there to guide and support you, no matter how long CMA persists.
When CMA does persist beyond the early years, this can be particularly challenging because;
• Energy requirements and the need for certain nutrients change as children grow
• By this time, the child is developing his or her own taste preferences and can increasingly choose for themselves what they do and don’t eat
• Food shopping for a child with CMA can be tricky because milk proteins are present in a wide range of products that are not always clearly labelled on the packaging
• It is important to continue to exclude all cows’ milk protein from the diet whilst offering a healthy balanced diet in terms of calories, protein, calcium and vitamin content.Nutritional needs will vary between children and change as the child grows.
Even if CMA persists beyond the early years, you don’t need to manage alone. The advice of a dietitian can be invaluable in tailoring the diet to meet the child’s specific nutritional needs.
*Skripak et al., 2007, J. Allergy Clin. Immunol., 120 (2007), pp. 1172-1177