Respiratory Symptoms of Cow's Milk Allergy

The presence of respiratory symptoms varies widely and is very much dependent on the type of allergic reaction. It has been reported that between 1-8% of Cow's Milk Allergy (CMA) cases have respiratory symptoms1, while older data suggests up to 30% of infants with CMA had respiratory involvement2,3 .

These can include one or combinations of the following:

Wheezing

Wheezing is a high-pitched, whistling sound due to a narrowing of the airways, making it difficult to breathe. 

Wheezing typically occurs when breathing out (during expiration) but can also occur when breathing in (during inspiration). 

It has been suggested that up to 30% of infants with CMA will present with a respiratory symptom such as wheezing2. 

Chronic/consistent cough (unrelated to infections)

It is not commonly linked to CMA but can be suspected in infants who display immediate symptoms following the ingestion of cow’s milk/dairy proteins4,5.

Anaphylaxis

Anaphylaxis is considered a life-threatening generalised or systemic allergic (or hypersensitivity) reaction with sudden onset within minutes to a few hours6,7.

Most frequently presents as skin and mucosal symptoms (>90% of cases) followed by the respiratory and cardiovascular symptoms (>50%)7.

Important Note: infants and children who have had an anaphylactic reaction should always be seen by an allergy specialist.

  1. Vandenplas Y, Broekaert I, Domellöf M, et al. An ESPGHAN position paper on the diagnosis, management, and prevention of cow’s milk allergy. J Pediatr Gastroenterol Nutr. 2024;78(2):386–413.
  2. Høst A. Frequency of cow’s milk allergy in childhood. Ann Allergy Asthma Immunol. 2002;89(6 Suppl 1):33–7.
  3. Høst A, Halken S. A prospective study of cow’s milk allergy in Danish infants during the first 3 years of life: Clinical course in relation to clinical and immunological type of hypersensitivity reaction. Allergy. 1990;45:587–96.
  4. Caffarelli C, Baldi F, Bendandi B, et al; EWGPAG. Cow’s milk protein allergy in children: a practical guide. Ital J Pediatr. 2010;36:5.
  5. Koletzko S, Niggemann B, Arató A, et al. Diagnostic approach and management of cow’s milk protein allergy in infants and children: ESPGHAN GI Committee practical guidelines. J Pediatr Gastroenterol Nutr. 2012;55(2):221–9.
  6. Simons FE, Ardusso LR, Bilò MB, et al. International consensus (ICON) on anaphylaxis. World Allergy Organ J. 2014;7(1):9.
  7. Muraro A, Worm M, Alviani C, et al; European Academy of Allergy and Clinical Immunology, Food Allergy, Anaphylaxis Guidelines Group. EAACI guidelines: anaphylaxis (2021 update). Allergy. 2022;77(2):357–77.
Signs of CMA
General symptoms of CMA

Related products

Browse the products available for managing this condition.