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Adverse reactions in CMA individuals consuming soy milk have been attributed to a 30-kDa, glycinin-like protein from soybean that cross-reacts with Cas CM. The European and American guidelines do not recommend soy in infants with CMA as first option [1, 2, 53]. Tolerance to soy protein has been reported in 83-92% of the infants with CMP allergy [40, 53]. Nutritional and safety concerns are mostly related to absorption of micronutrients and phytate and isoflavone contents. More recently, a review on soy infant formula concluded it to be safe [54].

Other protein sources have been assessed in the treatment of CMA. In some countries, goat’s milk exists as commercialized infant formula and is adapted to the nutritional needs of infants. However, the cross-reactivity with CMP is about 80-90% [8]. Milk from other mammalians or chicken-based formulas cannot be recommended for the treatment of CMP allergy for limited data on tolerance, safety and nutritional adequacy [1-3].