A 5-month-old infant was breastfed at home during routine feeding. Otherwise well, no eczema.
A (Allergen)
Cow’s milk protein in formula feed.
T (Timing)
Symptoms developed within 10 minutes of ingestion.
E (Exposure)
Orally given 30 mL of cow’s milk formula for the first time.
R (Reproducibility)
Often, the first known exposure is with no prior direct ingestion (although many will have had infant formula in the first 2 weeks of life to support the establishment of breastfeeding).
S (Symptoms)
Facial urticaria, angioedema, and coughing that resolved with a large vomit.
X (Extra/Rx)
Parents administered an antihistamine; emergency services were called. The paramedic assessed, and the child was observed in the emergency department for 4 hours. No further treatment given.
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