Cough is a reflex action of the respiratory tract that is used to clear the upper airways (Chung KF & Pavord IF 2008).
Chronic (or ongoing) cough is a cough which lasts for more than three weeks and is a common reason for referral to a health care professional (Pavord IF 2008).
A consistent cough that does not go away could be related to an environmental trigger or to a pathogen/infection (Chung & Pavord 2008). Environmental triggers might include exposure to cigarette smoke or to pollution.
However, there are also illnesses that can cause a consistent or chronic cough including asthma, bronchitis, gastroesophageal reflux disease (GERD) (link to GERD), postnasal drip syndrome or rhinosinusitis (Chung & Pavord 2008).
CMPA can be suspected in infants who display immediate symptoms of cough following the ingestion of cow’s milk/dairy proteins (Caffarelli C et al., 2010; Koletzko et al 2012). The presence of a respiratory infection as a cause of cough in the infant, needs to be ruled out before proceeding to other diagnosis.
However, when considering the diagnosis of CMPA, it’s important to consider that the majority of infants with CMPA have at least two symptoms affecting at least two different organ systems (Lifschitz C. and Szajewska H 2015; Høst & Halken 1990; Høst et al 1994).
Therefore, it is important to consider the individual child as well as the magnitude of their symptoms. This can be achieved using an awareness tool such as the Cow’s Milk Related Symptom Score (CoMiSS®) which will help you determine if CMPA might be indicated (Vandenplas et al 2015;Vandenplas et al 2022).
Respiratory
