Cow’s Milk Protein Allergy (CMPA)  
                                                                          Frequently Asked Questions  
                      Q:          Can goat’s milk formula be used as a treatment for CMPA 
                      A:          No: Goat’s milk and sheep’s milk are not advised due to cross reactivity with cow’s milk 
                      Q:          What happens when an infant reaches 1 year of age and is still CMPA? 
                      A:          - If soya is tolerated: Children over 1 year of age can use Alpro Junior 1+ soya milk instead of formula (this 
                                        can be used in cooking from 6 months).  Available to purchase in supermarkets. 
                                  -     If soya is not tolerated: Continue with specialist formula (ensure child has review appointment with the 
                                        paediatric dietician and, if necessary, the specialist paediatrician). 
                      Q:          What happens when an infant reaches 2 years of age and still has a cow’s milk protein and soya allergy? 
                      A:          The specialist formula milk should no longer be required and the child can go onto a supermarket milk 
                                  substitute i.e. oat, coconut, almond, hazelnut or hemp milk.  Rice milk is not suitable for children under 5 
                                  years due to the high arsenic content.  Further advice and support can be sought from the paediatric 
                                  dietician. 
                      Q:          Are vitamin and mineral supplements required? 
                      A:          The Department of Health recommends that a supplement containing vitamin A, C and D in the form of 
                                  vitamin drops is given to: 
                                  ·     All breastfed infants from 6 months of age 
                                  ·     Infants under 1 year of age who are taking less than 500ml of formula daily 
                                  ·     All children from 1 – 5 years 
                                  The Health Visitor can provide advice on vitamin drops and where to get them.  The child will be entitled to 
                                  free vitamin drops if the family is eligible for the Healthy Start scheme. 
                      Q:          What are Neocate Active® and Neocate Advance®? 
                      A:          These are highly specialised hypoallergenic amino acid products and should only be initiated and advised by 
                                  secondary care.  They should not be prescribed in infants under the age of 1 year.  They are not designed as 
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                                  follow on from Neocate LCP  and will not be required automatically by all infants over 1 year on an amino 
                                  acid formula.  Neocate Active® is a high calorie formula and is not suitable as sole source of nutrition.  
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                                  Neocate Advance  is a high calorie product and is used as a sole source of nutrition for tube fed infants aged 
                                  1-10 years. 
                      Q:          What is Neocate Spoon®? 
                      A:          This is a hypoallergenic amino acid based food. It is not to be used as a drink/formula. It is suitable for infants 
                                  from 6 months of age who have multiple food allergies. It should only be initiated and used under the 
                                  direction of a paediatric dietician. 
                      A:          Why is soya formula not routinely advised? 
                      Q:          Soya formula is no longer indicated for cow’s milk allergic infants under the age of 6 months due to its phyto-
                                  oestrogen content and the increased risk of sensitisation to soya protein (as per Chief Medical Officer 
                                  Statement, 2004). 
                                  Parents wishing to feed their infant (over the age of 6 months) on a soya based formula should be advised of 
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                                  the risks and advised to purchase the formula over the counter. These soya formulae (Infasoy , Wysoy ) are 
                                  available from pharmacies and supermarkets at a similar cost to standard infant formula. 
                      Q:          Can lactose free products be used in CMPA? 
                      A:          No: These products contains cow’s milk protein and are therefore not suitable. 
                      Hertfordshire Guidelines for Specialist Infant Feeds, Hertfordshire Medicines Management Committee (HMMC) Feb 2015 (updated July 2015)