Home milk challenge to confirm cow's milk protein allergy

All standard infant formula (eg SMA, Comfort milk, Cow & Gate, Aptamil) contains cow’s milk protein.

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For children with mild to moderate delayed symptoms

It is important to try your baby with milk now. This is to make sure that any improvement in their symptoms is due to cutting out milk (and they have a cow's milk protein allergy) rather than for any other reason.

  • Do NOT start this challenge if your child has had either immediate symptoms (within an hour of eating/drinking dairy) or a positive blood or skin test (specific IgE or Skin Prick Test) to cow's milk.
  • Do NOT start this challenge if your child is unwell e.g.
    • Has a cold or any other lung infections or breathing problems
    • Any tummy/bowel problems e.g. tummy ache or loose nappies
    • Any 'teething' signs that are upsetting your child
    • Atopic dermatitis (eczema) has flared up
  • Do NOT start this challenge if your child is having any medication which may upset their tummy, e.g. antibiotics
  • Do NOT try any other new foods during this challenge

Try to write down what your child eats and drinks during the challenge. Also note any symptoms e.g. sickness, loose nappies, rashes or any other changes in their atopic dermatitis.

Home challenge for a formula fed baby (those taking formula with or without some breastfeeds):

Follow the advice in the table below: each day, increase the amount of cow's milk formula given in baby's FIRST bottle of the day - (use the scoop provided in each).

 

A Practical Example of a Reintroduction in a Formula Fed Child

 

 

The Days

 

Volume of Boiled Water mls. (fl. oz.)

 

Hypoallergenic Formula

mls. (fl. oz.)

 

Cow’s Milk Formula mls. (fl. oz.)

 

Day 1

 

210 mls. (7 fl.oz.)

 

180 mls. (6 fl.oz.) in 1st bottle only

 

30 mls. (1 fl.oz.) in 1st bottle only

 

Day 2

 

210 mls. (7 fl.oz.)

 

150 mls. (5 fl.oz.) in 1st bottle

 

60 mls. (2 fl.oz.) in 1st bottle

 

Day 3

 

210 mls. (7 fl.oz.)

 

120 mls. (4 fl.oz.) in 1st bottle

 

90 mls. (3 fl.oz.) in 1st bottle

 

Day 4

 

210 mls. (7 fl.oz.)

 

90 mls. (3 fl.oz.) in 1st bottle.

 

120 mls. (4 fl.oz.) in 1st bottle

 

Day 5

 

210 mls. (7 fl.oz.)

 

60 mls. (2 fl.oz.) in 1st bottle

 

150 mls. (5 fl.oz.) in 1st bottle

 

Day 6

 

210 mls. (7 fl.oz.)

 

30 mls. (1 fl.oz.) in 1st bottle

 

180 mls. (6 fl.oz.) in 1st bottle

 

Day 7

 

210 mls. (7 fl.oz.)

 

0

 

210 mls. (7 fl.oz.) in 1st bottle

 

If no symptoms occur after Day 7, when you have replaced the 1st bottle of the day completely with cow’s milk formula, give your child cow’s mik formula in all bottles.

 

If you have not seen any symptoms in your child by day 7 (when you have completely replaced one bottle a day with cow's milk formula) you can give your child cow's milk formula in all bottles.

Home challenge for an exclusively breastfed baby:

Simply start eating dairy products to the same levels as before starting on the diet.

All babies:

If you see any obvious symptoms e.g. sickness, tummy pains, a rash, itching, STOP the challenge. Go back to the previous formula your baby was taking or to a milk free diet if you are breastfeeding, and inform your GP. 

If no symptoms occurs within 2 weeks of your child having more than 200ml (almost 7fl.oz.) of cow's milk formula per day, your child does not have cow's milk allergy

Back to Is it cow's milk allergy? page

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