Cow’s Milk Protein Allergy in Term and Preterm Infants: Clinical Manifestations, Immunologic Pathophysiology, and Management Strategies

Well-recognized tactic for the management of formula-fed children with cow’s milk protein allergy (CMPA) is exclusion of whole cow milk protein and its replacement with extensively hydrolyzed or amino acid formula. One of the most topical issue is the choice of therapeutic formula for a child with CMPA. This article presents information about the clinical manifestations of CMPA and describes the principles of nutrition therapy. All the stages of preparation of adapted therapeutic formula are discussed in detail. It has been shown that the choice of therapeutic formula for a child with CMPA depends on the disease clinical manifestations, their severity, and the presence of comorbid conditions. Current requirements for extensively hydrolyzed formula are reduced to limitations in the size of peptides with immunoreactive properties and indicate the need for evidence of the clinical efficacy of such formula in double-blind placebo-controlled studies.

Download Full-text

In Vitro Cow's Milk Protein-Specific Inflammatory and Regulatory Cytokine Responses in Preterm Infants With Necrotizing Enterocolitis and Sepsis

Pediatric Research ◽

10.1203/pdr.0b013e31820263e7 ◽

2011 ◽

Vol 69 (2) ◽

pp. 165-169 ◽

Cited By ~ 20

Author(s):

Adel E Abdelhamid ◽

Shu-Ling Chuang ◽

Peter Hayes ◽

John M E Fell

Keyword(s):

Preterm Infants ◽

Necrotizing Enterocolitis ◽

Milk Protein ◽

Cow’S Milk ◽

Cow's Milk ◽

Cytokine Responses ◽

Regulatory Cytokine ◽

Cow’S Milk Protein

Download Full-text

Evolution of In Vitro Cow's Milk Protein-Specific Inflammatory and Regulatory Cytokine Responses in Preterm Infants With Necrotizing Enterocolitis

PEDIATRICS ◽

10.1542/peds.2013-2294nn ◽

2013 ◽

Vol 132 (Supplement) ◽

pp. S25-S26

Author(s):

K. H. Waibel

Keyword(s):

Preterm Infants ◽

Necrotizing Enterocolitis ◽

Milk Protein ◽

Cow’S Milk ◽

Cow's Milk ◽

Cytokine Responses ◽

Regulatory Cytokine ◽

Cow’S Milk Protein

Download Full-text

Feeding practices and the prevalence of cow's milk protein allergy in Irish preterm infants

Journal of Human Nutrition and Dietetics ◽

10.1111/jhn.12971 ◽

2021 ◽

Author(s):

Davina Henderson ◽

Claire A. Murphy ◽

Anna‐Claire Glynn ◽

Michael A. Boyle ◽

Naomi McCallion

Keyword(s):

Preterm Infants ◽

Milk Protein ◽

Feeding Practices ◽

Cow’S Milk ◽

Cow's Milk ◽

Cow’S Milk Protein

Download Full-text

Allergy to cow’s milk protein

Pediatrician (St Petersburg) ◽

10.17816/ped73153-156 ◽

2016 ◽

Vol 7 (3) ◽

pp. 153-156 ◽

Cited By ~ 1

Author(s):

Natalia B Platonova

Keyword(s):

Atopic Dermatitis ◽

Food Allergy ◽

Milk Protein ◽

Clinical Manifestations ◽

Allergic Diseases ◽

Maternity Hospital ◽

Cow’S Milk ◽

Cow's Milk ◽

Cow’S Milk Protein ◽

Inhalant Allergens

The prevalence of allergic diseases is increasing year by year. Atopic dermatitis (AD) - the earliest clinical manifestation of atopy. By definition, atopic dermatitis is the allergic skin disease that occurs usually in early childhood in individuals with hereditary predisposition to atopic diseases having a chronic relapsing course, age characteristics of the location and morphology of the foci of inflammation, characterized by pruritus and caused hypersensitivity as to allergens, and to nonspecific irritants. Food and inhalant allergens play an important role in the formation of atopic dermatitis. The protein of cow’s milk is one of the first products to which developing sensitization. This is especially important for children in their first year of life. During this period neonatologists of the maternity hospital and precinct pediatricians are very important to assess the risk of a child’s food allergy and, if necessary, artificial feeding or supplementary feeding to recommend an artificial mixture, taking into account evaluation results. The proper purpose depends largely on whether the risk is realized or not, as well as the effectiveness of treatment in the presence of existing clinical manifestations, because a rational diet is the guiding principle of therapy of atopic dermatitis in infants. Unfortunately, precinct pediatricians do not always assess the situation correctly. The article gives a clinical case, an example of which analyzed the most typical errors made when bottle-fed infants with food allergy to cow’s milk protein.

Download Full-text

Assessment of IgE-Mediated and Non-IgE-Mediated Cow’s Milk Protein Allergy in Children

ARS Medica Tomitana ◽

10.2478/arsm-2019-0026 ◽

2019 ◽

Vol 25 (3) ◽

pp. 129-131

Author(s):

Balasa Adriana ◽

Mihai Cristina ◽

Pruna Irina ◽

Chisnoiu Tatiana ◽

Daineanu Diana ◽

...

Keyword(s):

Primary Care Physicians ◽

Milk Protein ◽

Immunoglobulin E ◽

Clinical Manifestations ◽

Specific Ige ◽

Cow Milk ◽

Cow’S Milk ◽

Cow's Milk ◽

Ige Mediated ◽

Cow’S Milk Protein

Abstract Cow’s milk protein allergy (CMPA) is the most common food allergy found in children under 3 years of age. In most cases, it occurs in infancy. Early diagnosis and appropriate treatment can decrease the risk of impaired growth. In our study, we evaluated 40 children, with ages between 1 month and 3 years, diagnosed with IgE-mediated or non-IgE-mediated CMPA, from january to december 2017, in the Department of Pediatrics of the Clinical Emergency County Hospital of Constanta. The inclusion criteria consisted of: age, natural or artificial feeding, specific IgE levels, CoMiSS score, and clinical manifestations. The Cow’s Milk-related-Symptom-Score (CoMiSS) was developed as a screening and diagnostic tool for CMPA prediction, and can guide pediatricians and primary care physicians to make an early diagnostic, as it can be easily missed. We observed a higher number of cases of CMPA registered among children who were artificially fed (57,5%), followed by those with mixed nutrition (25%), the remaining (17,5%) being represented by exclusively breastfed infants. The most frequent clinical manifestations were rashes (87,5%), failure to thrive (82,5%), regurgitation (50%) and diarrhea (35%). Further data should be collected to prove if the association between a CoMiSS score higher than 12 and specific IgE-mediated CMPA is clinically relevant, and can predict, based on clinical examination and anamnesis, high serum levels of specific immunoglobulin E. The prognosis can depend on the titre of specific IgE at the time of diagnosis, as they are more likely to develop several crossed allergies and less prone to become tolerant to cow milk proteins than those with non-IgE-mediated CMPA.

Download Full-text