Home milk challenge to confirm cow's milk protein allergy

For children with mild to moderate 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 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 atop 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).

DayVolume boiled waterCow's milk formula
No. of scoops
Hypoallergenic formula
No. of scoops
1150mls1 in the 1st bottle of the day4 in the 1st bottle of the day
2150mls2 in the 1st bottle of the day3 in the 1st bottle of the day
3150mls3 in the 1st bottle of the day2 in the 1st bottle of the day
4150mls4 in the 1st bottle of the day1 in the 1st bottle of the day
5150mls5 in the 1st bottle of the day0 in the 1st bottle of the day

If you have not seen any symptoms in your child by day 5 (when you have completely replaced one bottle a day with cow's milk formula) you can try giving cow's milk formula for each feed they would usually have from a bottle.

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 you do not see any symptoms within 2 weeks of your baby having more than 150mls cow's milk formula per day, or you having resumed your normal diet containing milk, then your baby does not have a cow's milk protein allergy.

Improving the physical and emotional health and wellbeing of expectant mothers, infants, children and young people throughout Aneurin Bevan University Health Board Area.

(N.B: The Family and Therapies team at ABUHB is NOT responsible for the content on the webpage links that we refer to in our resource sections and linked information to external sites. All information was accurate and appropriate at the time the webpage was created.)

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