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  • Allergic reactions can affect different areas of the body but are most likely to appear on the skin, in the tummy area and the respiratory tract.

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    • Back arching

      Back arching, also during feeding, can occur in babies with significant reflux of food. This arching behaviour can be a show of discomfort of ‘acid burn’ feeling in the back of the throat. If this is likely to happen when your child feeds and your child is not growing well, advise your doctor.

      Bloat or wind

      Bloating is any abnormal general swelling, or increase in diameter of the abdominal area. The most common symptoms associated with bloating include pain in the abdominal cavity, chest pain, vomiting, diarrhoea, constipation, and bloody or darkened stools. Others include difficulty swallowing, abdominal fullness, and excessive gas after drinking. Unexplained weight loss can also be experienced as the amount of food ingested decreases due to a poor appetite and stomach discomfort. Stomach bloating also causes the body to feel fatigue, breathing problems, and pain. Bloating may have several causes, a common one being food allergy.

      Blood in stool

      Bloody stools often indicate an injury or disorder in the digestive tract. Your doctor may use the term “melena” to describe black, tarry, and foul-smelling stools or “hematochezia” to describe red- or maroon-coloured stools. Blood in the stool may come from anywhere along the digestive tract, from mouth to anus. It may be present in such small amounts that you cannot actually see it, but is only detectable by a faecal occult blood test.

      A black stool usually means that the blood is coming from the upper part of the gastrointestinal tract. This includes the oesophagus, stomach, and the first part of the small intestine. Blood will typically look like tar after it has been exposed to the body’s digestive juices. Maroon-coloured stools or bright red blood usually suggests that the blood is coming from the lower part of the gastrointestinal tract (large bowel, rectum, or anus). Consuming black liquorice, lead, iron pills, bismuth medicines like Pepto-Bismol, or blueberries can also cause black stools in your breast-fed infant. Beets and tomatoes can sometimes make stools appear reddish.

      In children, the most common causes for blood in the stool are constipation and food allergies. Advise your doctor if you notice blood in your child’s stool.


      Constipation refers to bowel movements that are infrequent and/or hard to pass. Constipation is a symptom with many causes and either comes from an obstruction in the bowel or a very slow mobility of the gastrointestinal tract. Because constipation is a symptom, not a disease, effective treatment may require first determining the cause.

      After birth, most infants pass 4-5 soft liquid bowel movements a day. Breast-fed infants usually tend to have more motion compared to formula-fed infants. Some breast-fed infants have a motion after each feed, whereas others have only one every 2–3 days. Infants who are breast-fed rarely develop constipation. By the age of two years, a child will usually have 1–2 bowel movements per day.


      Diarrhoea is frequent loose, watery stools. The loss of fluids through diarrhoea can cause dehydration and electrolyte imbalances.

      Acute diarrhoea is usually related to a bacterial, viral, or parasitic infection. It usually lasts 1 or 2 days and often goes away without special treatment. It may also be preceded by other symptoms, such as nausea, vomiting, chills, fever, or bloody stools.

      Prolonged or chronic diarrhoea persists longer, for more than 2 days, and may be a sign of a more serious disorder such as reaction to medicines, intestinal diseases, bowel disorders, or food allergies. Food allergy can trigger chronic diarrhoea as a consequence of an inflammation of the bowel.

      Diarrhoea should be treated promptly to avoid dehydration risks, which is especially dangerous in newborns and infants. It is essential to quickly replace the fluid, salts and minerals lost during diarrhoea.

      WARNING: If your child does not improve after 24 hours, call the doctor. This is especially important if your child is 6 months old or younger.


      Eczema is a form of dermatitis - inflammation of the skin. Sufferers generally display cracked, red, dry skin which can be very itchy. One of the most common forms of dermatitis in young children and babies is atopic eczema. This is one of the most common forms of allergic reaction experienced by babies with cows’ milk allergy. Atopic eczema is triggered by an allergic reaction (atopy is an increased sensitivity to allergens). People with atopy often suffer from eczema, hay fever (allergic rhinitis) and allergic asthma all together.

      Excessive crying

      See severe irritability.

      Eye, lip and facial swelling

      A swelling is an abnormal accumulation of fluid beneath the skin. It can occur throughout the body or a specific part or organ can be affected. Swelling is considered one of the five characteristics of inflammation. Allergic reactions can lead to swelling in the face, including around the eyes.


      Normal infant fussiness starts at about 1-3 weeks, peaks at about 6 weeks and reliably ends by 3-4 months, yet infants continue to experience plenty of burps and flatus well beyond 4 months of age. Most babies will “fuss” about 2-4 hours per day, no matter what you do. They want to be “in arms” or at the breast very frequently and fuss even though you attempt to calm them. They often seem “unsatisfied” with their feedings and even seem to reject or cry at the breast. It most commonly happens in the evening hours, and usually the baby will take their longest stretch of sleep after this fussy time. You can tell it is normal fussiness if it occurs about the same time each day, if your baby has other times of the day when feedings are calm and he/she seems happy and growing and gaining well. Car rides and vacuum cleaner sounds may calm fussing, yet have no power to lessen abdominal pain. Persistently fussy babies with poor weight gain, vomiting more than 5 times a day, or other significant feeding problems should be evaluated by a healthcare professional for other illnesses. Signs of colic and distressed behaviour can present to be the first manifestations of food allergy.

      Growth faltering

      Growth faltering or failure to thrive means poor physical growth of any cause and does not imply abnormal intellectual, social, or emotional development. Growth is a dynamic process that starts before a child is born and continues until the bones fuse after puberty. Growth in length per year is age dependent and may be affected by many different factors including, but not limited to: hormonal abnormalities, chronic illness, and genetic abnormalities. Failure to grow should be taken seriously as it may indicate a hidden illness, a paediatrician should be consulted if a child is exhibiting slow growth outside of the ranges shown below. All ranges described are averages for the age range. In addition, to rate of growth, the position of the child on the growth chart (which compares other children of the same age) should be observed.
    • Itchy, red, raised skin

      See skin rash.

      Night sweat

      Night sweats is the occurrence of excessive sweating during sleep, even if your baby may not suffer from excessive perspiration while awake. Night sweats may occur for genetic reasons and may be relatively harmless. However, they can be distressing and disrupt sleep patterns if severe; your child may wake up frequently due to the discomfort of damp sleepwear or bedding. While some causes of night sweats may be relatively harmless, others may not and can be a sign of a serious underlying disease. While there can be several possible causes of excessive sweating at night, it is important to distinguish night sweats due to medical causes from those that occur simply because the sleep environment is too warm, either because the bedroom is unusually hot or because there are too many covers on the bed. True night sweats with medical causes should be properly investigated by a paediatrician.


      Gastro-oesophageal reflux disease (GORD) or acid reflux are chronic symptoms or damage to the mucous membrane caused by stomach acid coming up from the stomach into the oesophagus. GORD may be difficult to detect in infants and children, it may cause repeated vomiting, effortless spitting up, coughing, and other respiratory problems. Inconsolable crying, failure to gain adequate weight, refusing food, bad breath, and belching or burping are also common. Children may have one symptom or many — no single symptom is universal in all children with GORD. Babies with persistent reflux may have weight gain issues. Many doctors advise that babies outgrow reflux once they can sit up, or once they stand. Many do, but some will not only fail to outgrow it, but will noticeably worsen with developmental milestones, teething episodes, viral illness and weaning. GORD may be a secondary manifestation of other conditions such as a food allergy.

      Restless sleeping

      The medical term for restless sleeping or sleeping difficulties is insomnia. Insomnia is most often thought of as both a sign and a symptom that can accompany several sleep, medical, and psychiatric disorders, characterised by persistent difficulty falling asleep and/or staying asleep or sleep of poor quality. Insomnia is typically followed by functional impairment while awake. It can be transient, acute, or chronic. In many cases, insomnia is co-morbid with another disease, side-effects from medications, or a psychological problem.

      Severe irritability (colic)

      Colic (also known as infant colic, three month colic, and infantile colic) is a condition in which an otherwise healthy baby cries or screams frequently and for extended periods, without any discernible reason. The condition typically appears within the first two weeks of life and almost invariably disappears, often very suddenly, before the baby is three to four months old, but it can last up to 12 months of life. It is equally common in bottle-fed and breastfed babies.

      There is a broad body of evidence showing that soothing measures, such as dummies, strong white noise and jiggly rocking are effective in calming babies during crying bouts. Persistently fussy babies with poor weight gain, vomiting more than 5 times a day, or other significant feeding problems should be evaluated by a healthcare professional for other illnesses. Signs of colic and distressed behaviour can present to be the first manifestations of food allergy.

      Severe breathing problems

      Breathing problems or breathlessness is the inability to take in the oxygen the body needs. Sometimes mild breathing problems are from a stuffy nose or hard exercise. But shortness of breath can also be a sign of a serious disease. Lung conditions can be the reason for breathing difficulties such as asthma, emphysema or pneumonia. Heart disease can cause breathlessness if the heart cannot pump enough blood to supply oxygen to the body. Stress caused by anxiety can also make it hard to breathe. If your child often has trouble breathing, it is important to find out the cause. In this case a pulmonologist might help you.

      Skin rash

      A rash is a change of the skin which affects its colour, appearance or texture. A rash may be localised in one part of the body, or affect all the skin. Rashes may cause the skin to change colour, itch, become warm, bumpy, dry, cracked or blistered, swell and may be painful. The causes, and therefore treatments for rashes, vary widely. Diagnosis must take into account such things as the appearance of the rash, other symptoms, what the patient may have been exposed to, his occupation, and if other family members are affected. A baby’s skin rash may be a symptom of another condition, such as food allergy, and will last until causes are identified and the condition is managed. Typically, it is never a good to scratch a rash, as doing so may invigorate the rash and cause it to spread. Gently rubbing the rash may provide temporary relief, but it is more than likely better to avoid contact with the affected areas altogether.


      A sneeze is a sudden, forceful, involuntary burst of air through the nose and mouth and is caused by irritation to the mucous membranes of nose or throat. Sneezing can also be triggered through sudden exposure to bright light, a particularly full stomach, a viral infection, or allergy. Proven methods to reduce sneezing generally advocate reducing irritants, such as keeping pets out of the house to avoid animal dander, ensuring the timely and continuous removal of dirt and dust particles through proper housekeeping, replacing filters for furnaces and air-condition systems, air filtration devices and humidifiers and staying away from industrial and agricultural zones.


      Vomiting (known medically as emesis and informally as throwing up and a number of other terms) is the forceful expulsion of the contents of one’s stomach through the mouth and sometimes the nose. Vomiting can occur due to a wide variety of conditions. Regurgitating after a feed is quite normal with most infants. As the child gets older the organs of the gastrointestinal tract become more competent so the vomiting should begin to improve and stop eventually. If your infant is throwing up large amount of milks with forceful vomits after feeding, contact your baby’s doctor right away.


      A wheeze is a continuous, coarse, whistling sound produced in the respiratory airways during breathing. For wheezes to occur, some part of the respiratory tree must be narrowed or obstructed, or airflow velocity within the respiratory tree must be heightened. Wheezing is commonly experienced by persons with a lung disease; the most common cause of recurrent wheezing is asthma attacks. Children with recurrent wheezing may have an allergic condition, to check this go and see a pulmonologist.
Symptom Checklist

Visiting your doctor

Filling out this guide will help you prepare to visit your doctor if you suspect your child might have CMA.

Visiting your doctor

What is CMA?