Respiratory Symptoms of Cow'S Milk Protein Allergy.

Wheezing is a high-pitched, whistling sound due to a narrowing of the airways, making it difficult to breath.1 Wheezing typically occurs when breathing out (expiration) but can also occur when breathing in (inspiration).  

It is a common problem in infants and young children, and approximately 25–30% of infants will have at least one episode of wheezing during infancy.2 Children wheeze more often than adults purely because of the physiological differences in the size of their airways.2


What Causes
Wheezing in

The most common causes of wheezing in children include asthma, allergies, infections, gastroesophageal reflux disease (link to Reflux and Regurgitation), and obstructive sleep apnea.2

The presence of a respiratory infection, as a cause of wheezing needs to be ruled out before proceeding with the diagnosis.

Could It Be a
Symptom of
Cow’s Milk
Protein Allergy?

Up to 30% of infants with Cow’s Milk Protein Allergy (CMPA) will present with a respiratory symptom such as wheezing.2  In infants with immediate symptoms of wheeze after consuming milk/dairy, CMPA should be suspected.3  Ear infections are also more common in infants with CMPA.4

However, when considering the diagnosis of CMPA, it’s important to note that the majority of these infants have at least two symptoms affecting at least two different organ systems.5-7

Therefore, it is important to consider the individual child as well as the magnitude of their symptoms.  This can be achieved using an awareness tool such as the Cow’s Milk Related Symptom Score (CoMiSS™) which will help you determine if CMPA might be indicated.8,9

Overview of Symptoms

Respiratory icon


Up to 30% of affected infants with CMPA have respiratory symptoms15,20

Anaphylaxis icon


Anaphylactic shock is a severe, immediate, allergic reaction, which can affect many organ/systems

Skin icon


Up to 75% of infants with CMPA can have skin-related symptoms21

General Symptoms icon


Inconsolable crying is very common in infants with CMPA associated with sleeping problems and food refusal