In an exclusively breastfed child, the‘maternal’ intake of all milk and milk products must be stopped for period of not less than 4 weeks. During this period, the child should show clinical improvement. She can resume milk products after 4 weeks and if the child shows either gastrointestinal, dermatological or respiratory manifestations then the diagnosis is proved. In a top fed baby, soya milk formulation can be initiated in a similar way.
Most children would respond to soya milk formulations. However cross reactivity has been known and about 30% of CMPA kids may be allergic to soya as well. This percentage is thought to be less among Indian population and that might as well be the reasons why soya formulations work well in Indian setting. The children who do not respond to soya formulations, one may have to resort to partial or completely hydrolyzed formula.
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