Understanding Cow Milk Sensitivity

The terms cow milk allergy, lactose intolerance and cow milk sensitivity are often used interchangeably though the prevalence and severity of each condition is very different.

A confirmed cow milk protein allergy (CMPA) is very rare – affecting only about 2-3% of children under six. Lactose Intolerance is even more rare in young children. All milk contains lactose and babies are genetically programmed to digest the lactose in breast milk. In most children, research shows lactase, the enzyme responsible for digesting lactose, doesn’t start to decrease until they reach age 3-5.

According to the American Academy of Pediatrics, “No studies have documented that these [Lactose-free or reduced lactose] formulas have any clinical impact on infant outcome measures including colic, growth, or development.”

The prevalence of cow milk sensitivity (CMS) is less defined in research, however clinical and parental observation suggests that up to 30-50% of children may have at least one symptom consistent with CMS.


If your child suffers from cow milk sensitivity, they will likely tolerate goat milk, and goat milk-based products very well. Let’s take a look at the difference between cow milk allergy and cow milk sensitivity.

What is a Cow Milk Protein Allergy?

A confirmed cow milk protein allergy (CMPA) can be a serious health problem. It’s most often an immediate immune reaction that happens within hours of ingestion and results in moderate to severe symptoms. These can include:

  • Swelling around the mouth
  • Difficulty swallowing
  • Vomiting and regurgitation
  • Diarrhea
  • Blood in the stool
  • Food refusal
  • Failure to thrive
  • Colic
  • In rare cases, anaphylactic shock leading to death


What is Cow Milk Sensitivity?

Cow milk sensitivity involves two main body systems: the gut and the immune system.


The gut is involved when components of cow milk – the fat, carbohydrate, and primarily protein, or a combination of components – are digested poorly. Inadequate digestion often causes an uncomfortable ‘churn’ in the stomach that may lead to other intolerance symptoms such as bloating, gas, abdominal colic, diarrhea or constipation due to the damage created by the churning action.

The area of the digestive tract that comes into direct contact with digested food is called the gut lining or mucosa. An immune response may be triggered when the gut mucosa is injured. There are number of factors that influence susceptibility of the gut to injury – including delayed transit time (the amount of time it takes for food to pass through the digestive system), proteins found in food such as cow milk protein and even current or past use of medications, such as antibiotics. When the gut is injured, it can cause a condition referred to as leaky gut, more formally known as ‘intestinal hyperpermeability’.

In cow milk sensitivity (CMS), injury to the mucosa with subsequent leaky gut allows milk proteins that would normally be digested and used as energy to pass through the intestinal walls, triggering an immune response that initiates inflammation. This can lead to mild to moderate inflammatory symptoms in the lungs and skin, such as mucous congestion, wheezing and eczema.

Until around 6 months of age babies have immature digestive systems – or naturally leaky guts.

How do I know the difference?

It can be difficult to tell the difference between allergy and sensitivity because symptoms are similar. Many healthcare providers rely on the intensity of symptoms, serum (blood) IgE testing and skin prick testing to guide their diagnosis. The gold standard diagnostic method for cow milk protein allergy is the 'Challenge Test' involving the complete avoidance of cow milk for one month, followed by a medically supervised reintroduction and monitoring of symptoms.

Since every child is different, we recommend speaking with your healthcare provider if you are concerned about whether your little one’s symptoms stem from allergy or sensitivity.

KABRITA USA’s mission is to provide the highest standard of goat milk nourishment to children, while inspiring parents and health care professionals with expert nutrition education.

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