Your baby's screaming is driving you nuts! Is this normal fussiness? Or could it be a sign of something else?

Almost all infants experience irritability and sleeplessness at times. But if your bottle-fed baby seems excessively fussy much of the time, it could be due to an allergy to cow's milk.

Most of us have heard of lactose intolerance (the inability to digest the type of sugar in milk), but there's another milk-related problem that's lesser known: cow's milk protein allergy. Between 1% and 7.5% of infants are allergic to the proteins found in cow's milk and cow's milk-based formulas. About 80% of formulas on the market are cow's milk-based.

What Is Cow's Milk Protein Allergy?
Cow's milk protein allergy (also called formula protein allergy) means that the infant (or child or adult) has an abnormal immune system reaction to proteins found in the cow's milk used to make standard baby formulas. About 30% to 40% of infants who are allergic to cow's milk are also allergic to the protein in soy formulas. The baby's immune system "attacks" the proteins in the milk, resulting in symptoms of an allergic reaction.

Researchers don't fully understand the causes of food allergies and why some children develop them and others don't. However, according to Heidi Kecskemethy, a pediatric dietitian, "Studies have shown that breast-fed infants have a lower risk of developing allergies than those who receive cow or soy milk." It is believed that in many cases, this type of allergy is triggered by a combination of genetically inherited factors and the early introduction of cow's milk or soy protein into an infant's diet.

Signs and Symptoms
Symptoms of cow's milk protein allergy will generally appear within the first 6 months of life. An infant can experience symptoms of one or both of the two major types of formula allergy reactions - rapid onset or slower onset.

The rapid type of reaction comes on suddenly with symptoms that can include wheezing, vomiting, hives, anaphylaxis (a sudden and severe whole body reaction), angioedema (fluid collection in body tissues that causes swelling), and the eruption of itchy bumps on the skin.

The slower-onset reaction is the more common type. Symptoms may include loose stools (possibly containing blood), vomiting, irritability or colic, and failure to gain weight and grow normally. This type of reaction is more difficult to diagnose because the same symptoms may occur with conditions other than allergy. Most children will outgrow this form of intolerance by 2 years of age.

If an infant's symptoms are due to lactose intolerance (a sensitivity to the carbohydrate in milk) and not protein intolerance, symptoms will include a swollen or enlarged abdomen, stomach pain, excessive gas, and diarrhea.

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