During this period of time, some friends have asked if it is okay for their babies to drink cow’s milk allergy and some recommend drinking goat’s milk. This question needs to be explained in terms of the mechanism of milk protein allergy, which is too profound for families to understand, but they need to have the patience to read this short article. First, let’s talk about the incidence and manifestations of milk protein allergy. Most infants with milk protein allergy develop within the first month of life and generally have two or more clinical manifestations, including vomiting (as soon as 1-2h after ingestion) and diarrhea (2-6h after ingestion), as well as oral allergy syndrome, abdominal pain (crying and noise), blood in the stool, growth retardation, skin changes (eczema, urticaria, rash, dryness, itching, erythema, edema, etc.), coughing and wheezing, rhinitis …. It is safe to say that most families have experienced similar problems, only in varying degrees of severity. Some children have mild allergy symptoms that last for a short time, while others have severe and long-lasting symptoms. Milk protein allergy (CMPA) is an immunological reaction to one or more milk proteins (CMP) in the body, with an incidence of 2-7.5%. CMPA can be IgE-mediated or non-IgE-mediated, and there can be some differences in presentation and prognosis between the two. IgE-mediated CMPA mainly manifests as atopic dermatitis (AD), with an incidence of 40-50% in children with CMPA within one year of age. Children with atopic dermatitis who have persistent CMPA have a very high risk of developing allergic rhinitis and asthma in the future. These children are more likely to detect specific IgE (so-called IgE-positive), while children with IgE-negative CMPA are more likely to develop multiple food allergies. ”IgE-mediated” is an immunological concept, and the process is complex, so families may not delve into it. It is important to remember that children with CMPA can be tested for total serum IgE and milk-specific IgE, but the results cannot be used as a direct diagnostic basis because of the test method, reagents, immune status of the child, and the influence of food and drugs. The gold standard for the diagnosis of CMPA is dietary avoidance and food provocation tests. As for how the test is performed, it is the doctor’s specialty and one need not get too hung up on it. What do families do when they encounter their child with a milk protein allergy? Is it enough to not eat cow’s milk or to switch to goat’s milk? 1. Children who are diagnosed with CMPA should continue to eat milk. The reason is that milk should be the main food for children within one year of age. Parents who encounter such problems often choose artificial feeding or mixed feeding because they do not have breast milk or breast milk is not enough. In children with suspected CMPA, it is necessary to change the formula to a hydrolyzed formula. There are two types of these formulas, namely partially hydrolyzed protein formula (pHF), fully hydrolyzed protein formula (eHF), and now of course amino acid formula (AAF), which is actually a more thoroughly hydrolyzed formula. For infants at high risk of CMPA, pHF can be given orally for a long time, because studies have proven that this type of formula can induce immune oral tolerance, which actually prevents the occurrence of CMPA; for children with confirmed CMPA, different treatment plans are chosen according to the clinical manifestations and signs of the child to determine the degree of allergy. As for the implementation plan, there are corresponding standards that doctors can grasp. 2. Is it appropriate to replace soy milk powder or goat milk powder for children diagnosed with CMPA? The answer is: No! Why is it inappropriate? The reason is that children who are allergic to cow’s milk protein may be allergic to soy protein, any unmodified mammalian milk and its products may still produce allergic reactions in children with CMPA, and unmodified other dairy products or soy milk cannot meet the needs of infants and children’s growth and development. A reminder that children with suspected mild or moderate CMPA should be given dietary avoidance and therapeutic hydrolyzed formula. By dietary avoidance, we mean avoiding some foods, including complementary foods. As a therapeutic formula, eHF (fully hydrolyzed formula) is preferred. The indications for AFF application are: (1) the infant refuses to eat eHF but accepts AAF (2) the symptoms do not improve after 2-4 weeks of eHF application (3) the individual’s letter-price ratio prefers AFF. after all, these formulas are good but not cheap! We hope that you have some understanding of milk protein allergy and that it will help you in your future visits.