Yogurt Should Be Avoided in Infants with Milk Protein Allergy
An infant with a milk protein allergy cannot tolerate yogurt, as yogurt contains cow's milk proteins that will trigger allergic reactions. The fermentation process in yogurt production does not eliminate or sufficiently alter the allergenic milk proteins responsible for causing symptoms in milk-allergic infants 1, 2.
Why Yogurt Must Be Avoided
Yogurt is a dairy product containing the same allergenic cow's milk proteins (casein and whey) that cause allergic reactions in infants with CMPA, regardless of the fermentation process 1, 3.
Complete elimination of all cow's milk products is required for treatment, including milk, cheese, yogurt, butter, and hidden sources in processed foods 1, 2.
The proteins in yogurt remain structurally similar enough to trigger both IgE-mediated and non-IgE-mediated allergic responses in sensitized infants 3.
Appropriate Dietary Management
For Breastfed Infants
The mother must eliminate all cow's milk and dairy products from her diet, as milk proteins transfer into breast milk in sufficient quantities to cause reactions 1, 4.
Improvement typically occurs within 1-2 weeks of strict maternal dietary elimination 1.
The mother requires calcium supplementation and consultation with a registered dietitian to maintain nutritional adequacy while avoiding all dairy sources 1.
For Formula-Fed Infants
First-line treatment is an extensively hydrolyzed formula (eHF) of cow's milk protein, which has demonstrated efficacy in clinical studies 5, 1, 3.
For severe reactions or life-threatening symptoms, an amino acid-based formula (AAF) should be used as first-line treatment 5, 1.
If symptoms persist despite eHF, switching to an amino acid-based formula is warranted 3.
Critical Pitfalls to Avoid
Do not assume fermented dairy products like yogurt are safe alternatives—they contain the same allergenic proteins as regular milk 1, 2.
Goat's milk and sheep's milk yogurts are also inappropriate due to high protein homology with cow's milk (cross-reactivity occurs in most cases) 1, 2.
Soy formula is not recommended as a first-line alternative due to potential cross-reactivity, particularly in infants under 6 months 5, 1.
Timeline for Reintroduction
Reintroduction of cow's milk protein (including yogurt) should be attempted under medical supervision, typically after 6-12 months of complete elimination 1.
The prognosis is favorable: approximately 80% of infants acquire tolerance before age 3-4 years 4, 3.
An oral food challenge in a hospital setting is recommended at 9-12 months of age to assess tolerance development before attempting home reintroduction 3.