Cow milk protein allergy and other common food allergies and intolerances

Paediatr Int Child Health. 2019 Feb;39(1):32-40. doi: 10.1080/20469047.2018.1490099. Epub 2018 Jul 17.


The prevalence of food allergy and food intolerance is increasing and it is an important public health problem affecting children. Food allergy results from an immunological reaction to certain food(s) and affects numerous organs in the body. Food intolerances are non-immunological reactions including metabolic, toxic, pharmacological and undefined mechanisms. Cow milk is the most common cause of food allergy and food intolerance, especially in young children. Food intolerance can present with similar symptoms to those of food allergy. Health-care personnel, patients and their caregivers often confuse food intolerance with food allergy. This review focuses on the clinical manifestations, diagnostic evaluation, treatment and prevention of food allergy and food intolerance.

Keywords: DBPCFC: double-blind placebo-controlled food challenge; FDEIA: food-dependent exercise-induced anaphylaxis; FGIDs: functional gastrointestinal disorders; FPE: food protein-induced enteropathy; FPIAP: food protein-induced allergic proctitis; FPIES: food protein-induced enterocolitis syndrome; Food allergy; IBS: irritable bowel syndrome; IgE-mediated; MSG: monosodium glutamate; children; coeliac disease; food intolerance; histamine; lactose; non-IgE-mediated.

Publication types

  • Review

MeSH terms

  • Allergens / immunology
  • Animals
  • Cattle
  • Diagnosis, Differential
  • Diagnostic Tests, Routine
  • Disease Management*
  • Food Hypersensitivity / diagnosis*
  • Food Hypersensitivity / epidemiology
  • Food Hypersensitivity / pathology
  • Food Hypersensitivity / therapy*
  • Food Intolerance / diagnosis*
  • Food Intolerance / epidemiology
  • Food Intolerance / pathology
  • Food Intolerance / therapy*
  • Humans
  • Milk / toxicity
  • Milk Proteins / immunology
  • Prevalence


  • Allergens
  • Milk Proteins