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Cow’s Milk-Induced Infant Apnea

The opiate-like effects of the casomorphin in cow’s milk may have a depressive effect on the respiratory center of infants and lead to “milk apnea,” in which babies temporarily stop breathing and are placed at risk for sudden infant death syndrome (crib death).

May 7, 2012 |
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Images thanks to D Dinneen, Ion Chibzii, and Roshnii via Wikimedia Commons, and Charles Williams, MD,, and


Evolution devised an ingenius way to bond infant to mother. Select for milk proteins that break down into peptides that have opiate-like drug effects. But what if the breastfeeding mother is herself effectively suckling by still drinking milk as an adult. Evolution never counted on that, which may explain this recent report in the Journal of Pediatric Gastroenterology and Nutrition.
Cow’s milk-induced infant apnea with increased serum content of bovine beta casomorphin 5-- that's one of the opioid compounds formed in our stomachs when we drink milk. Infant apnea means when a baby stops breathing.
They report a case of a breast-fed infant with recurrent apnea episodes, which have always been preceded by his mother’s consumption of fresh cow’s milk. A biochemical examination has revealed a high level of casomorphin in the child’s blood. They speculate that it is an opioid activity that may have a depressive effect on the respiratory centre in the central nervous system and induce a phenomenon they coin milk apnoea. The reason we ‘re so concerned is that ‘’about 7-10% of infants with recurrent apneic episodes cannot be saved and they die of sudden infant death syndrome.
The researchers hooked the kid up to a monitor and wanted to give him some cows milk to provoke a reaction on tape, but The boy’s mother did not grant consent for his oral provocation with cow’s milk because of her fears for the child’s life. She finally relented, though, and when the boy was 4 months old, attempted to provoke him with milk, after which the apparent life-threatening event reoccurred. Presently the 21 month old boy is kept on a milk-free diet and has no more symptoms.
The aim of the present report, they conclude, is to draw researchers’ attention to the possibility of occurrence of a systemic reaction with an apnoea seizure on the infant’s exposure to the proteins in cow’s milk. We are convinced that such a clinical situation occurs rarely; however, it is accompanied by a real threat to the infant’s life that can be avoided when applying a simple and not costly dietetic intervention, a dairy free diet.

To see any graphs, charts, graphics, images, and quotes to which Dr. Greger may be referring watch the above video. This is just an approximation of the audio contributed by veganmontreal.

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Dr. Michael Greger

Doctor's Note

Today is the first of a three-video series on the latest evidence implicating bovine casomorphin in apnea, crib death, and autism--stay tuned! In the meantime, help yourself to the 49 other videos on dairy, 44 videos on child health, and hundreds of other videos on more than a thousand subjects.

For more context, check out my associated blog post, Cow’s Milk Casomorphin, Crib Death, and Autism.

  • Michael Greger M.D.

    Today is the first of a three-video series on the latest evidence implicating bovine casomorphin in apnea, crib death, and autism–stay tuned! In the meantime, help yourself to the 49 other videos on dairy, 44 videos on child health, and hundreds of other videos on more than a thousand subjects.

    • HemoDynamic

      There is a reason I get up every morning and watch your videos first. . . They save lives!!!!  My patients lives!
      As always, keep up the great work!

    • nadav

      Hi Michael
      So you are suggesting to avoid cow milk baby formula?
      what should we pay attention in a vegetarian formula?
      Thank you in advance

      • Don Forrester MD

        The best food for infants is breast milk followed by a transition to whole foods appropriately prepared given the infants age. Most young mother’s I encounter tell me their doctors recommend avoiding cow’s milk until age 2. I would extend that indefinitely as I see no data to support it’s use when adequate calories are available from healthier alternatives. It is important to work with your physicians in deciding what alternatives are most appropriate as far as non-dairy formula’s. PCRM’s Nutrition for Kids is an excellent resource for older children. Unfortunately I haven’t seen a good resource for infants who are not able to be breast fed.

        • jodi

          What if breast feeding is not an option?

          • mommy

            Donor milk

          • Don Forrester MD

            I agree that using donor milk is an option for women who for whatever reason are unable to breast feed. Although we like to think we can “engineer” a replacement product as good as the original product we are certainly not there yet. However if donor milk is unavailable you should work with a knowledgeable health care professional.

  • Michael Greger M.D.

    Also be sure to check out my associated blog post Cow’s Milk Casomorphin, Crib Death, and Autism!