My 4 month old baby has bad eczema. Could he be allergic to cows’ milk protein?

Possibly, but not necessarily.   The National Institute for Health and Clinical Excellence (NICE) guideline for eczema in children suggests that health professionals should consider cows’ milk protein allergy (CMPA) in babies under 6 months of age who have not responded to optimised eczema treatment.  Allergists will tell you that 80% of young babies with significant eczema do indeed turn out to have some sort of food allergy. 

CMPA is not always easy to diagnose.  Allergy tests are often negative and the only way to really tell is to exclude cows’ milk from the baby’s diet for a few weeks and see if the eczema improves.  Bottled formula milk is based on cows’ milk so this is not something to be done lightly.  Goats’ and sheep’s milk have very similar proteins to cows’ milk so can not be used instead.  Not many breastfed babies exhibit signs of CMPA due to traces from dairy foods in Mum’s diet although there are some rare cases.  Soya milk is not recommended for babies under 6 months, particularly baby boys, because of phyto-oestrogens that have been found in it and many CMPA children are also allergic to soya so it often doesn’t help anyway.

The milks we use in CMPA babies are only available on prescription and, because of the difficulty getting enough calcium from these formulas, your baby should be under close review by a paediatrician, paediatric dietician or GP. 

You may find the following patient/parent information useful:

Click here for NICE guidance for parents on eczema in the under 12s

Click here for NICE guidance for parents on diagnosing food allergies

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