How Are Infants Suspected to Have Cow’s Milk Allergy Managed? A Real World Study Report
The purpose of this study was to evaluate the diagnosis and management of infants presenting with symptoms attributable to cow’s milk allergy (CMA) in a real life setting and to test how the Cow’s Milk-related Symptom Score (CoMiSS®) can be used to support the awareness to diagnose cow’s milk protei...
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Published in | Nutrients Vol. 13; no. 9; p. 3027 |
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Main Authors | , , , , , |
Format | Journal Article |
Language | English |
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30.08.2021
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Abstract | The purpose of this study was to evaluate the diagnosis and management of infants presenting with symptoms attributable to cow’s milk allergy (CMA) in a real life setting and to test how the Cow’s Milk-related Symptom Score (CoMiSS®) can be used to support the awareness to diagnose cow’s milk protein allergy in primary care practice. The CoMiSS is an awareness tool based on various symptoms such as crying, gastrointestinal symptoms, dermatological and respiratory symptoms. The study was conducted on 268 infants from four countries (Belgium, Czech Republic, Germany, UK) aged 0 to 18 months consulting for CMA related symptoms. The analysis was based on two visits of these subjects. The results show an average CoMiSS of 11 at the first visit. After a therapeutic dietary intervention, the score at the second visit, which happened 3 weeks ± 5 days after the first one, dropped to an average value of 4. A satisfaction questionnaire completed by the primary care practitioners suggested an overall high level of satisfaction with the application of the CoMiSS tool in routine practice. These data highlight a huge discrepancy in the diagnosis and management of infants suspected of CMA in the different countries. The findings suggest that the CoMISS questionnaire is an effective tool in aiding awareness of CMPA in primary health care. |
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AbstractList | The purpose of this study was to evaluate the diagnosis and management of infants presenting with symptoms attributable to cow’s milk allergy (CMA) in a real life setting and to test how the Cow’s Milk-related Symptom Score (CoMiSS
®
) can be used to support the awareness to diagnose cow’s milk protein allergy in primary care practice. The CoMiSS is an awareness tool based on various symptoms such as crying, gastrointestinal symptoms, dermatological and respiratory symptoms. The study was conducted on 268 infants from four countries (Belgium, Czech Republic, Germany, UK) aged 0 to 18 months consulting for CMA related symptoms. The analysis was based on two visits of these subjects. The results show an average CoMiSS of 11 at the first visit. After a therapeutic dietary intervention, the score at the second visit, which happened 3 weeks ± 5 days after the first one, dropped to an average value of 4. A satisfaction questionnaire completed by the primary care practitioners suggested an overall high level of satisfaction with the application of the CoMiSS tool in routine practice. These data highlight a huge discrepancy in the diagnosis and management of infants suspected of CMA in the different countries. The findings suggest that the CoMISS questionnaire is an effective tool in aiding awareness of CMPA in primary health care. The purpose of this study was to evaluate the diagnosis and management of infants presenting with symptoms attributable to cow’s milk allergy (CMA) in a real life setting and to test how the Cow’s Milk-related Symptom Score (CoMiSS®) can be used to support the awareness to diagnose cow’s milk protein allergy in primary care practice. The CoMiSS is an awareness tool based on various symptoms such as crying, gastrointestinal symptoms, dermatological and respiratory symptoms. The study was conducted on 268 infants from four countries (Belgium, Czech Republic, Germany, UK) aged 0 to 18 months consulting for CMA related symptoms. The analysis was based on two visits of these subjects. The results show an average CoMiSS of 11 at the first visit. After a therapeutic dietary intervention, the score at the second visit, which happened 3 weeks ± 5 days after the first one, dropped to an average value of 4. A satisfaction questionnaire completed by the primary care practitioners suggested an overall high level of satisfaction with the application of the CoMiSS tool in routine practice. These data highlight a huge discrepancy in the diagnosis and management of infants suspected of CMA in the different countries. The findings suggest that the CoMISS questionnaire is an effective tool in aiding awareness of CMPA in primary health care. |
Author | Belohlavkova, Simona Järvi, Anette Makwana, Niten Frühauf, Pavel Vandenplas, Yvan Enninger, Axel |
AuthorAffiliation | 3 Olgahospital, Zentrum für Kinder-, Jugend- und Frauenmedizin, Klinikum Stuttgart, 70174 Stuttgart, Germany; A.Enninger@klinikum-stuttgart.de 5 Sandwell and West Birmingham Hospitals, Birmingham B18 7QH, UK; nmakwana@nhs.net 1 Vrije Universiteit Brussel (VUB), UZ Brussel, KidZ Health Castle, 1090 Brussels, Belgium 4 Pediatric Clinics and Inherited Metabolic Disorders, 1st Faculty of Medicine Charles University, 12108 Prague, Czech Republic; fruhaufp@volny.cz 6 Nestlé Health Science, 1800 Vevey, Switzerland; anette.jarvi@nestle.com 2 Immuno-flow, s.r.o., 12843 Prague, Czech Republic; Simona.Belohlavkova@seznam.cz |
AuthorAffiliation_xml | – name: 4 Pediatric Clinics and Inherited Metabolic Disorders, 1st Faculty of Medicine Charles University, 12108 Prague, Czech Republic; fruhaufp@volny.cz – name: 6 Nestlé Health Science, 1800 Vevey, Switzerland; anette.jarvi@nestle.com – name: 1 Vrije Universiteit Brussel (VUB), UZ Brussel, KidZ Health Castle, 1090 Brussels, Belgium – name: 5 Sandwell and West Birmingham Hospitals, Birmingham B18 7QH, UK; nmakwana@nhs.net – name: 2 Immuno-flow, s.r.o., 12843 Prague, Czech Republic; Simona.Belohlavkova@seznam.cz – name: 3 Olgahospital, Zentrum für Kinder-, Jugend- und Frauenmedizin, Klinikum Stuttgart, 70174 Stuttgart, Germany; A.Enninger@klinikum-stuttgart.de |
Author_xml | – sequence: 1 givenname: Yvan surname: Vandenplas fullname: Vandenplas, Yvan – sequence: 2 givenname: Simona surname: Belohlavkova fullname: Belohlavkova, Simona – sequence: 3 givenname: Axel surname: Enninger fullname: Enninger, Axel – sequence: 4 givenname: Pavel surname: Frühauf fullname: Frühauf, Pavel – sequence: 5 givenname: Niten surname: Makwana fullname: Makwana, Niten – sequence: 6 givenname: Anette surname: Järvi fullname: Järvi, Anette |
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Cites_doi | 10.1136/adc.2006.110999 10.1007/s00431-014-2422-3 10.3390/nu13020297 10.5223/pghn.2014.17.2.61 10.1016/j.jaip.2017.09.003 10.5223/pghn.2020.23.2.154 10.1111/all.13947 10.1111/apa.12902 10.1097/MPG.0b013e31825c9482 10.1111/apa.15248 10.1111/apa.12349 10.3390/nu11071444 10.1111/pai.12960 10.3390/nu13010226 10.3390/nu11102402 10.3390/nu12020438 10.1016/j.jpeds.2020.02.076 |
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References_xml | – volume: 92 start-page: 902 year: 2007 ident: ref_9 article-title: Guidelines for the diagnosis and management of cow’s milk protein allergy in infants publication-title: Arch. Dis. Child. doi: 10.1136/adc.2006.110999 contributor: fullname: Vandenplas – volume: 174 start-page: 141 year: 2015 ident: ref_11 article-title: Cow’s milk allergy: Evidence-based diagnosis and management for the practitioner publication-title: Eur. J. Pediatr. doi: 10.1007/s00431-014-2422-3 contributor: fullname: Lifschitz – ident: ref_8 doi: 10.3390/nu13020297 – volume: 17 start-page: 61 year: 2014 ident: ref_12 article-title: Middle East Consensus Statement on the Prevention, Diagnosis, and Management of Cow’s Milk Protein Allergy publication-title: Pediatr. Gastroenterol. Hepatol. Nutr. doi: 10.5223/pghn.2014.17.2.61 contributor: fullname: Vandenplas – volume: 6 start-page: 383 year: 2018 ident: ref_4 article-title: When Should Infants with Cow’s Milk Protein Allergy Use an Amino Acid Formula? A Practical Guide publication-title: J. Allergy Clin. Immunol. Pract. doi: 10.1016/j.jaip.2017.09.003 contributor: fullname: Meyer – volume: 23 start-page: 154 year: 2020 ident: ref_16 article-title: Cow’s Milk-Related Symptom Score in Presumed Healthy Polish Infants Aged 0-6 Months publication-title: Pediatr. Gastroenterol. Hepatol. Nutr. doi: 10.5223/pghn.2020.23.2.154 contributor: fullname: Bigorajska – volume: 75 start-page: 14 year: 2020 ident: ref_2 article-title: Diagnosis and management of Non-IgE gastrointestinal allergies in breastfed infants-An EAACI Position Paper publication-title: Allergy doi: 10.1111/all.13947 contributor: fullname: Meyer – volume: 104 start-page: 334 year: 2015 ident: ref_3 article-title: A workshop report on the development of the Cow’s Milk-related Symptom Score awareness tool for young children publication-title: Acta Paediatr. doi: 10.1111/apa.12902 contributor: fullname: Vandenplas – volume: 55 start-page: 221 year: 2012 ident: ref_5 article-title: Diagnostic approach and management of cow’s-milk protein allergy in infants and children: ESPGHAN GI committee practical guidelines publication-title: J. Pediatr. Gastroenterol. Nutr. doi: 10.1097/MPG.0b013e31825c9482 contributor: fullname: Koletzko – volume: 109 start-page: 2366 year: 2020 ident: ref_7 article-title: A large-scale study to describe the prevalence, characteristics and management of functional gastrointestinal disorders in African infants publication-title: Acta Paediatr. doi: 10.1111/apa.15248 contributor: fullname: Bellaiche – volume: 102 start-page: 990 year: 2013 ident: ref_13 article-title: Treating cow’s milk protein allergy: A double-blind randomized trial comparing two extensively hydrolysed formulas with probiotics publication-title: Acta Paediatr. doi: 10.1111/apa.12349 contributor: fullname: Vandenplas – ident: ref_1 doi: 10.3390/nu11071444 – volume: 29 start-page: 689 year: 2018 ident: ref_10 article-title: Nutritional disorders resulting from food allergy in children publication-title: Pediatr. Allergy Immunol. doi: 10.1111/pai.12960 contributor: fullname: Meyer – ident: ref_14 doi: 10.3390/nu13010226 – ident: ref_17 doi: 10.3390/nu11102402 – ident: ref_15 doi: 10.3390/nu12020438 – volume: 221 start-page: 107 year: 2020 ident: ref_6 article-title: Prevalence of Functional Gastrointestinal Disorders in European Infants and Toddlers publication-title: J. Pediatr. doi: 10.1016/j.jpeds.2020.02.076 contributor: fullname: Steutel |
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SubjectTerms | amino acid formula Breastfeeding & lactation CoMiSS Cow's milk cow’s milk allergy Diagnosis Diet extensive hydrolysate Food allergies Gastrointestinal symptoms Health care Hypersensitivity Infantile colic Infants Milk partial hydrolysate Pediatrics Population Primary care Proteins Questionnaires |
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Title | How Are Infants Suspected to Have Cow’s Milk Allergy Managed? A Real World Study Report |
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