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If your kids are diagnosed with cow’s milk allergy, the only way to manage CMPA is the complete avoidance of cow’s milk and all the foods that contain cow’s milk. Before discussing the formula option, it is crucial to understand that CMPA is an allergic reaction caused by the cow’s milk protein. 

Below are some available options in the market, best to seek advice from a health care professional before making decisions regarding which formula to use.

Rice Hydrolysed Formula

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Rice hydrolysed formula (RHF) has been used as a treatment for children with CMPA in Europe since the 2000s. Rice is one of the less allergenic staple foods, reacting in <1% of allergic children. It has no phytoestrogens too. For this reason, RHFs are safe for children allergic to milk and soy and to those with poliallergic reaction. Based on DRACMA guidelines, RHF can be considered as the first-line treatment for children with CMPA if available. Speak to a paediatrician to find out if a rice hydrolysed formula is suitable for your child today!

Extensively Hydrolysed Formula

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Extensively hydrolysed formula (EHFs) is the formula in which all the cow’s milk protein is broken down into individual and small particles. Thus the body does not recognise the small particle as allergen thus causing an allergic reaction less likely to occur. However, about 10% of severe CMPA cases will still have an allergic reaction when consumed EHFs.

Amino Acid Based Formula

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Amino acid based formula is the formula made from individual amino acids. It is also known as an elemental formula. However, due to its simplest form of protein content, the taste is less likely palatable and high in cost.

Breastfeeding is the best 

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Malaysian Dietary Guidelines recommend breastfeeding exclusively for the first 6 months of life, and continue breastfeeding until the child is at least 2 years old. However, you may need to follow a complete avoidance diet from cow’s milk and cow’s milk products. Sometimes, the cow’s milk protein you ingest can cross into your breast milk and results in an allergic reaction in your kids. 

Do consult healthcare professional to ensure you obtain adequate calcium intake when you eliminating the cow’s milk. 

How about other types of formula?


Partially Hydrolysed Formula

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Partially hydrolysed formula (PHFs) is the formula in which the cow’s milk protein is broken down to a slightly shorter chain. However, children with CMPA will still react with the partially hydrolysed protein. Therefore, this formula is also not recommended at all.

Goat's Milk Formula

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The formula from other mammalian milk such as goat milk and sheep milk are not indicated. This is because children with CMPA are more likely to have cross reaction with these mammalian milks.

Soy Based Formula

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Soy based formula is the formula made from soy protein. Unfortunately, 10 – 14% of children with CMPA also have a soy allergy. Moreover, soy formulae have nutritional disadvantages because their absorption of minerals and trace elements may be lower because of their phytate content.

They also contain appreciable amounts of isoflavones with a weak estrogenic action that can lead to high serum concentrations in children.

Thus it is not recommended to use soy based formula as the first choice particularly in babies under 6 months of age.

Last but not least, it is best to seek advice from a health care professional before making decisions regarding which formula to use.